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Frailty status and the risk of dementia, Alzheimer's disease: a meta-analysis of observational studies

cognitive-disorders
geriatrics
global-health
psychiatry-and-psychology
mental-health

Abstract

Objective. This meta-analysis aims to evaluate the association between frailty and the risk of dementia, including Alzheimer's disease (AD), across different populations.

Methods. We conducted a systematic meta-analysis of cohort studies published from 2007 to 2025. A comprehensive search was performed across multiple databases, including PubMed, Embase, and the Cochrane Library, using relevant MeSH terms and keywords: "frailty," "dementia," "Alzheimer's disease," "incidence," "cohort study," and "elderly." Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random-effects models. Subgroup analyses were conducted based on study characteristics, population demographics, and frailty types. Heterogeneity was assessed using the I² statistic, and publication bias was evaluated through funnel plots.

Results. A total of 13 cohort studies, encompassing 835,992 participants, were included. The pooled OR for frailty and dementia risk was 1.76 (95% CI: 1.48-2.10, I² = 91.0%, p < 0.001). Frailty was also associated with an increased risk of Alzheimer's disease (OR = 1.91, 95% CI: 0.86-4.20, I² = 93.4%, p < 0.001). Subgroup analyses revealed a significantly higher dementia risk in European and American populations (OR = 1.67, 95% CI: 1.39-2.00, p < 0.001), while no significant association was found in Asian populations.

Conclusion. Frailty is a significant predictor of dementia risk, particularly in European and American populations. Early detection of frailty may play a crucial role in dementia prevention strategies.

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