A secondary analysis of cortical atrophy and plasma amyloid β patterns in older patients with cognitive frailty undergoing elective surgery

Background The etiology of cognitive impairment in frailty may be related to age or to an independent neurodegenerative process, such as Alzheimer’s disease (AD). In this secondary analysis, we examine cognitive frailty in patients aged 65 and older undergoing elective surgery, and explore associati...

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Vydáno v:BMC geriatrics Ročník 25; číslo 1; s. 484 - 16
Hlavní autoři: Mörgeli, Rudolf, Borchers, Friedrich, Feinkohl, Insa, Piper, Sophie K., Pischon, Tobias, Slooter, Arjen J.C., Spies, Claudia, Wiebach, Janine, Winterer, Georg, Zacharias, Norman, Lammers-Lietz, Florian
Médium: Journal Article
Jazyk:angličtina
Vydáno: London BioMed Central 02.07.2025
Springer Nature B.V
BMC
Témata:
Aged
Aged, 80 and over
Aging
Alzheimer Disease - blood
Alzheimer's disease
Amyloid
Amyloid beta-Peptides - blood
Amyloidβ
Atrophy
Atrophy - blood
Biomarkers
Cerebral Cortex - diagnostic imaging
Cerebral Cortex - pathology
Cognition
Cognition & reasoning
Cognitive ability
Cognitive Dysfunction - blood
Cognitive frailty
Cognitive impairment
Comorbidity
Cortical atrophy
Delirium
Dementia
Elective surgery
Elective Surgical Procedures - trends
Etiology
Executive function
Female
Frail
Frail Elderly - psychology
Frailty
Frailty - blood
Frailty - psychology
Geriatrics
Geriatrics/Gerontology
Gerontology
Health risk assessment
Humans
Magnetic resonance imaging
Magnetic Resonance Imaging - methods
Male
Medicine
Medicine & Public Health
Mini-Mental State Examination
MRI
Neurodegenerative diseases
Neuropathology
Neuropsychological Tests
Neuropsychology
Older people
Pathology
Patients
Phenotypes
Registration
Rehabilitation
Surgery
White people
β-Amyloid
Berlin Germany
Netherlands
Germany
Aging
Frailty
Cognitive frailty
Amyloidβ
MRI
Cortical atrophy
ISSN:1471-2318, 1471-2318
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Shrnutí:Background The etiology of cognitive impairment in frailty may be related to age or to an independent neurodegenerative process, such as Alzheimer’s disease (AD). In this secondary analysis, we examine cognitive frailty in patients aged 65 and older undergoing elective surgery, and explore associations with aging- and AD-related cortical atrophy patterns and amyloid β (Aβ) concentrations. Methods Cognitive frailty (CF) was defined as the co-occurrence of (pre-)frailty and cognitive impairment (CI). Cognitive performance was assessed using the MMSE and the Cambridge Neuropsychological Teste Automated Battery (CANTAB), while frailty was assessed with a modified version of Fried’s frailty phenotype. Aging- and AD-related cortical atrophy patterns were derived from T1-weighted MRI using Freesurfer software. MRI patterns and plasma concentrations of Aβ species 40 and 42 (including Aβ 42/40 ratio) were compared to physically robust, cognitively unimpaired patients using multiple regression analyses and presented as regression coefficient b with 95% confidence intervals. Results MRI data of N  = 489 patients ( N  = 251 with frailty, N  = 15 with CI, N  = 43 with CF) and plasma Aβ concentrations of N  = 786 patients ( N  = 400 with frailty, N  = 20 with CI, N  = 101 with CF) were analyzed. Cognitive frailty was associated with both aging-related and AD-related MRI signatures (b age =-0.070 [-0.113; -0.028], b AD =-0.069 [-0.118; -0.020]). Amyloid β42 was significantly lower in frail patients (b=-0.14 [-0.29; -0.01]), while β42/β40-ratio was lower in patients with frailty (b=-0.11 [-0.21; -0.01]) and cognitive frailty (b=-0.015 [-0.28; -0.03]). Conclusion Our results suggest that atrophy in aging- and AD-related cortical regions is associated with cognitive frailty. Plasma amyloid β42/β40-ratios were significantly lower in patients with frailty and cognitive frailty, suggesting that (pre-)frailty in general, rather than cognitive frailty specifically, is associated with AD-like changes. Hence, AD-related pathology seems to be associated with cognitive frailty, but the available data is not sufficient to indicate shared pathomechanisms between AD and cognitive frailty. Trial Registration ClinicalTrials.gov. Identifier NCT02265263, Date October 15th, 2014.
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:1471-2318
1471-2318
DOI:10.1186/s12877-025-05740-z