Geriatrics

Frailty is common in preclinical Alzheimer’s and independently linked to worse cognition

Among 4,486 cognitively unimpaired A4 participants (mean age 71), frailty prevalence was 22% using a full frailty index and 44% without cognitive items. Amyloid-positive participants were more likely to be frail than amyloid-negative peers with both frailty models, after adjusting for age, sex, and education. Frail participants had lower Preclinical Alzheimer Cognitive Composite scores than non-frail participants, independent of amyloid status. Frailty did not modify the relationship between amyloid status and cognition, suggesting partly independent pathways to early cognitive vulnerability. 1

Dual-task high-velocity power training modestly improves several cognitive domains

In this 18-month cluster RCT, 300 at-risk residents from 22 retirement communities were allocated to dual-task functional power training or usual care. Six months of supervised twice-weekly training produced small benefits in psychomotor-attention, choice reaction time, and composite cognition versus control. At 12 and 18 months, benefits extended to visual learning and learning–working memory, with effect sizes in the small range. Controls showed better executive function at 18 months, suggesting domain-specific rather than global cognitive gains from training. BDNF Met carriers in the intervention group had larger working memory improvements, indicating possible genotype-dependent responsiveness. 2

Higher plasma GDF-15 identifies older adults at elevated frailty risk

In 1,096 MAPT participants (mean age 75), higher plasma GDF-15 at year 1 was strongly associated with prevalent Fried frailty. Those in the highest GDF-15 category had over threefold higher odds of being frail than those in the lowest group. Over four years, very high GDF-15 levels predicted increased incident frailty risk in longitudinal models. Lower physiological GDF-15 levels were not linked to frailty development, suggesting a threshold effect rather than a simple linear association. 3

Fat-to-muscle ratio outperforms BMI and waist circumference for sarcopenic obesity screening

This cross-sectional analysis of 7,916 community-dwelling Japanese adults compared multiple screening tools against JWGSO-defined sarcopenic obesity. Higher fat-to-muscle ratio measured by BIA showed strong independent associations with sarcopenic obesity in both sexes, with per-SD odds ratios around 3. Receiver operating curves showed better discrimination for fat-to-muscle ratio than BMI, waist circumference, or phase angle in both women and men. BMI and waist circumference performed reasonably in women but poorly in men, and phase angle showed only moderate accuracy overall. 4