Prospective association of white matter hyperintensity volume and frailty in older adults

Background: Frailty is a prevalent geriatric condition and its association with brain health is still weakly investigated. The objective of this study was to examine whether brain white matter hyperintensities (WMH) were related to longitudinal changes in frailty severity in community-dwelling older adults.

Methods: 113 community-dwelling older adults, aged 70 years and over, enrolled in the placebo group from the 3-year Multidomain Alzheimer's Preventive Trial (MAPT). Frailty was assessed using Fried's frailty phenotype as an ordinal variable (range from 0 to 5, higher is worse) at baseline, 6, 12, 24 and 36 months. We obtained brain WMH data using magnetic resonance imaging (MRI) at the first and last year of the trial. The progression of WMH volume was evaluated.

Results: We included 113 baseline and 83 follow-up MRIs in this study. The median baseline WMH volume was 10.6 (6.0, 15.0) cm³ and the median progression of WMH was 1.1 (-0.3, 2.2) cm³. Our results indicate that people with higher baseline WMH had a 6% increased likelihood of increasing their frailty phenotype score (adjusted OR: 1.06, (1.00-1.12, p = 0.036)). No associations were found between the progression of WMH (slow vs. fast) volume accumulation and frailty severity.

Conclusion: WMH were associated with frailty severity over time. Why the progression of WMH was not associated with changes in frailty severity requires further investigation.