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Association of frailty with dementia and the impact of frailty on antihypertensive treatment protection against dementia in older hypertensive adults

Title: Association of frailty with dementia and the impact of frailty on antihypertensive treatment protection against dementia in older hypertensive adults
Authors: Chen, L; You, S; Ee, N; Rockwood, K; Ward, DD; Hubbard, RE; Woodward, M; Fitzgerald, O; Wang, R; Gao, Y; Williamson, JD; Anderson, CS; Harris, K; Chen, X; Peters, R
Source: urn:ISSN:0002-0729 ; urn:ISSN:1468-2834 ; Age and Ageing, 55, 2, afag037
Publisher Information: Oxford University Press (OUP)
Publication Year: 2026
Collection: UNSW Sydney (The University of New South Wales): UNSWorks
Subject Terms: 4203 Health Services and Systems; 32 Biomedical and Clinical Sciences; 42 Health Sciences; Health Disparities and Racial or Ethnic Minority Health Research; Aging; Clinical Research; Acquired Cognitive Impairment; Hypertension; Clinical Trials and Supportive Activities; Neurosciences; Dementia; Cardiovascular; Brain Disorders; Neurodegenerative; Minority Health; Prevention; 6.1 Pharmaceuticals; Neurological; aged; antihypertensive agents; clinical trial; frailty; older people; anzsrc-for: 4203 Health Services and Systems; anzsrc-for: 32 Biomedical and Clinical Sciences; anzsrc-for: 42 Health Sciences; anzsrc-for: 1103 Clinical Sciences; anzsrc-for: 1117 Public Health and Health Services; anzsrc-for: 1701 Psychology; anzsrc-for: 3202 Clinical sciences
Description: Background The relationship between frailty and dementia risk in hypertensive patients remains unclear, as does the impact of frailty on the effectiveness of antihypertensive treatment in preventing dementia. Methods Using data from the Systolic Hypertension in the Elderly Program trial, a baseline frailty index (FI) including 55 health deficits was constructed. Multinomial regression models were used to examine the association between frailty and dementia, as well as to examine whether the impact of antihypertensive treatment on the risk of dementia was modified by baseline FI. Results A total of 4692 participants (mean age: 72.1 years, 56.8% female) were included with a median (inter-quartile interval) FI of 0.127 (0.091–0.173). During a median follow-up of 4.4 years, 81 dementia cases occurred. Each SD (0.061) increase in FI was associated with a 33% higher risk of dementia [odds ratio (OR): 1.33, 95% confidence interval (CI): 1.08–1.64], after adjusting for age, sex, race, education and treatment group. This association differed between the active treatment group (OR: 1.57; 95% CI: 1.16–2.11) and the placebo group (OR: 1.17; 95% CI: 0.87–1.56), with a P for interaction=.049. Correspondingly, in the lowest FI quarter, antihypertensive treatment reduced dementia risk (OR: 0.19, 95% CI: 0.04–0.94), an effect not observed in higher FI quarters (interaction P=.058). Conclusion In patients with isolated systolic hypertension, frailty may serve as a risk factor for dementia, and elevated levels of frailty may attenuate the effectiveness of antihypertensive treatment in reducing dementia risk.
Document Type: article in journal/newspaper
File Description: application/pdf
Language: unknown
Relation: https://hdl.handle.net/1959.4/107479; https://doi.org/10.1093/ageing/afag037
DOI: 10.1093/ageing/afag037
Availability: https://hdl.handle.net/1959.4/107479; https://unsworks.unsw.edu.au/bitstreams/9bfb59a4-d58d-4712-835c-806908fc6017/download; https://doi.org/10.1093/ageing/afag037
Rights: open access ; https://purl.org/coar/access_right/c_abf2 ; CC BY ; https://creativecommons.org/licenses/by/4.0/ ; free_to_read
Accession Number: edsbas.2E70FEA5
Database: BASE