The Fried Phenotype Is More Closely Associated With Dementia in Older Adults Than the FRAIL (Fatigue, Resistance, Ambulation, Illness, and Loss of Weight) Index

TL;DR

This study finds that the Fried frailty scale is better than the FRAIL scale at predicting dementia in older adults.

Contribution

The Fried frailty scale shows a stronger independent association with dementia compared to the FRAIL scale in older adults.

Findings

The Fried scale identified a higher frailty rate (36.1%) compared to the FRAIL scale (24.7%).

Dementia frequency was significantly associated with frailty only in the Fried scale after adjusting for confounding factors.

Frail individuals on the Fried scale had higher dementia risk independent of demographics and comorbidities.

Abstract

Introduction: There is a close relationship between dementia and frailty in older adults. The aim of our study was to compare the relationship between the Fried and FRAIL (fatigue, resistance, ambulation, illness, and loss of weight) frailty scales and the frequency of dementia in elderly individuals.

Methods: A cross-sectional study was conducted on 558 patients who presented to the geriatric outpatient clinic between 2022 and 2024. The Fried and FRAIL frailty scales were used to assess frailty. On both scales, the groups were divided into three subgroups: frail, prefrail, and robust. The groups were also compared in terms of dementia frequency and other features. Correlations between frailty scores and the geriatric assessment test were examined. Logistic regression analysis was performed on the relationship between dementia frequency and frailty scores on both scales, independent of confounding factors.

Results: The mean age of 558 patients was 75.55 (6.83) years, and 69.7% were female. According to the FRAIL scale, the frailty rate was 24.7%, while according to the Fried scale, this rate was 36.1%. When the groups were compared on both scales, there were significant differences between age, gender, Parkinson's disease, Charlson Comorbidity Index, and geriatric syndromes. According to the FRAIL and Fried scales, the frequency of dementia was high in the frail group. Only in the Fried frailty index, the risk of dementia was significantly associated with frailty, independent of demographic characteristics, geriatric syndromes, and comorbidities.

Conclusion: In geriatric practice, frail patients diagnosed with the Fried frailty scale need to be carefully and comprehensively evaluated for cognitive impairment, but further studies are needed.