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KMID : 1130620230190050447
Journal of Clinical Neurology
2023 Volume.19 No. 5 p.447 ~ p.453
Clinical Significance of Physical Frailty in Subjects With Subjective Cognitive Decline: A Prospective Study With Amyloid PET Data
Lim Eun-Ye

Ho Seong-Hee
Hong Yun-Jeong
Jeong Jee-Hyang
Park Hee-Kyungk
Park Kee-Hyung
Kim Sang-Yun
Wang Min-Jeong
Choi Seong-Hye
Shim Yong-Soo
Cho A-Hyun
Yang Dong-Won
Abstract
Background and Purpose Physical frailty is known to be closely associated with cognitive impairment and to be an early sign of Alzheimer¡¯s disease. We aimed to understand the characteristics of physical frailty and define factors associated with physical frailty in subjects with subjective cognitive decline (SCD) by analyzing amyloid data.

Methods We prospectively enrolled subjects with SCD from a cohort study to identify predictors for the clinical progression to mild cognitive impairment or dementia from SCD (CoSCo).
All of the subjects underwent brain magnetic resonance imaging, and brain amyloid positron- emission tomography (PET) to detect amyloid beta plaques. Self-reported exhaustion, handgrip strength, and gait speed were used to measure physical frailty.

Results Of 120 subjects with SCD, 26 (21.7%) were amyloid-positive in PET. Female (odds ratio [OR]=3.79, p=0.002) and amyloid-PET-positive (OR=3.80, p=0.008) subjects with SCD were at high risks of self-reported exhaustion. Amyloid PET positivity (OR=3.22, p=0.047) and high burden from periventricular white-matter hyperintensity (OR=3.34, 95% confidence interval=1.18?9.46, p=0.023) were significantly associated with a weaker handgrip. The subjects with SCD with self-reported exhaustion and weaker handgrip presented with lower cognitive performance in neuropsychological tests, especially for information processing speed and executive function. Subjects with a slower gait performed worse in visual memory function tests.

Conclusions Amyloid PET positivity was associated with a higher risk of self-reported exhaustion and weaker handgrip in subjects with SCD. The subjects with SCD and physical frailty also performed worse in neuropsychological tests.
KEYWORD
physical frailty, subjective cognitive decline, Alzheimer¡¯s disease, amyloid positron emission tomography computed tomography
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