Prospective Associations Between Diffusion Tensor Imaging Parameters and Frailty in Older Adults

BACKGROUND Cross‐sectional associations have been found between frail individuals and worse white matter (WM) integrity. However, the prospective association between WM integrity and frailty is still unclear. Our objectives were to measure associations between WM integrity using diffusion tensor ima...

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Published in:Journal of the American Geriatrics Society (JAGS) 2020-05, Vol.68 (5), p.1050-1055
Main Authors: Perus, Lisa, Grigis, Antoine, Chupin, Marie, Bouyahia, Ali, Gabelle, Audrey, Rolland, Yves, Vellas, Bruno, Guyonnet, Sophie, Carrié, Isabelle, Brigitte, Lauréane, Faisant, Catherine, Lala, Françoise, Delrieu, Julien, Villars, Hélène, Combrouze, Emeline, Badufle, Carole, Zueras, Audrey, Morin, Christophe, Van Kan, Gabor Abellan, Dupuy, Charlotte, Caillaud, Céline, Ousset, Pierre‐Jean, Dartigues, Jean‐François, Marcet, Isabelle, Delva, Fleur, Foubert, Alexandra, Cerda, Sandrine, Costes, Corinne, Rouaud, Olivier, Manckoundia, Patrick, Quipourt, Valérie, Marilier, Sophie, Franon, Evelyne, Pader, Marie‐Laure, Basset, Marie‐France, Lapoujade, Bruno, Faure, Valérie, LiYungTong, Michael, Malick‐Loiseau, Christine, Cazaban‐Campistron, Evelyne, Desclaux, Françoise, Dantoine, Thierry, Laubarie‐Mouret, Cécile, Saulnier, Isabelle, Clément, Jean‐Pierre, Picat, Marie‐Agnès, Bernard‐Bourzeix, Laurence, Willebois, Stéphanie, Désormais, Iléana, Cardinaud, Noëlle, Livet, Pierre, Rebaudet, Pascale, Burdet, Catherine, Pesce, Alain, Roth, Stéphanie, Sudres, Kristelle, Lebrun, Nicolas, Touchon, Jacques, Bennys, Karim, Romano, Aurélia, Marelli, Cécilia, Pays, Cécile, Robert, Philippe, Le Duff, Franck, Gervais, Claire, Gonfrier, Sébastien, Gasnier, Yannick, Begorre, Danièle, Carpuat, Christian, Lefebvre, Jean‐François, Skolil, Pierre, Salles, Jean‐Pierre, Dufouil, Carole, Lehéricy, Stéphane, Mangin, Jean‐François, Bouhayia, Ali, Ricolfi, Frédéric, Dubois, Dominique, Martel, Marie Paule Bonceour, Cotton, François, Chanalet, Stéphane, Bonneville, Fabrice, Cognard, Christophe, Voisin, Thierry, Peiffer, Sophie, Hitzel, Anne, Allard, Michèle, Zanca, Michel, Monteil, Jacques, Darcourt, Jacques, Molinier, Laurent, Derumeaux, Hélène, Perret, Bertrand, Vinel, Claire, Caspar‐Bauguil, Sylvie
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Anisotropy
Brain
brain health
Brain mapping
Cardiovascular diseases
Dementia disorders
Diabetes mellitus
Diffusion Magnetic Resonance Imaging - methods
diffusion magnetic resonance imagingfrailty
Disease Progression
Female
Frailty
Frailty - classification
Frailty - diagnosis
Functional magnetic resonance imaging
Humans
Hypercholesterolemia
Life Sciences
Male
Neuroimaging
Older people
Phenotypes
physical capacity
Prospective Studies
Risk factors
Statistical analysis
Substantia alba
Thalamus
White Matter - diagnostic imaging
White Matter - pathology
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Summary:BACKGROUND Cross‐sectional associations have been found between frail individuals and worse white matter (WM) integrity. However, the prospective association between WM integrity and frailty is still unclear. Our objectives were to measure associations between WM integrity using diffusion tensor imaging (DTI) and the 5‐year worsening of frailty in community‐dwelling older adults. DESIGN Secondary analysis of the randomized controlled Multidomain Alzheimer Preventive Trial (MAPT). SETTING Thirteen memory centers in France and Monaco between 2008 and 2011. PARTICIPANTS Participants (mean age = 74.7 ± 3.9 years) with no dementia at baseline who had functional magnetic resonance imaging performed as part of the MAPT study (n = 227). MEASUREMENTS Fractional anisotropy and mean diffusivity (MD), axial diffusivity (AxD), and radial diffusivity (RD) were acquired for 10 different brain regions. Frailty was assessed by the Fried frailty phenotype (score from 0 to 5, higher is worse) at up to seven time points for 5 years. Mixed effect ordinal logistic regression model was used to assess the prospective association between DTI parameters (independent variables) and frailty (dependent variable). All the analyses were adjusted for age, sex, baseline total intracranial volume, and the presence of one of the following cardiovascular risk factors (hypertension, diabetes, and/or hypercholesterolemia). RESULTS A statistically significant association was found between the RD, AxD, and MD for different brain regions (anterior limb of internal capsule, external capsule, posterior corona radiata, posterior thalamic radiation, superior corona radiata, superior frontal occipital fasciculus, and superior longitudinal fasciculus) and worsening of frailty over 5 years after adjusting for multiple comparisons. CONCLUSIONS This is the first study to show that WM integrity is associated with frailty in older adults. The mechanisms related to these results require further investigation. J Am Geriatr Soc 68:1050–1055, 2020
ISSN:0002-8614
1532-5415
DOI:10.1111/jgs.16343