journal articles
INCIDENT DEMENTIA RISK BY FRAILTY STATUS AND LIVING ARRANGEMENTS IN OLDER ADULTS
Kate McEwen, Suraj Samtani, Rory Chen, John D. Crawford, Perminder S. Sachdev, Katya Numbers
BACKGROUND: Frailty and social isolation are independently associated with dementia risk. This study examined whether frailty predicts dementia differently for older adults living alone versus with others.
METHODS: Participants were 967 community-dwelling, dementia-free older adults from the Sydney Memory and Ageing Study (2005–2020). Frailty was assessed using an adapted Fried Frailty Phenotype (robust, pre-frail, frail). Dementia was diagnosed via biennial neuropsychological testing and clinical consensus. Cox regressions analysed associations between baseline frailty, living arrangements (alone vs. with others), and incident dementia over 12 years.
RESULT: Frail individuals had 1.74 times higher dementia risk than robust individuals (HR = 1.74, 95% CI: 1.16–2.60, p = .007). Living alone was not independently associated with dementia (HR = 1.03, p = .825). The interaction between frailty and living arrangements was non-significant (HR = 1.23, p = 0.600). Exploratory stratified analyses showed frailty predicted dementia among those living alone (HR = 1.92, 95% CI: 1.06–3.51, p = .033) but not those living with others (HR = 1.42, p = 0.224).
CONCLUSION: Frailty is a significant predictor of dementia risk in older adults. While the formal interaction test was non-significant, exploratory findings suggest frail individuals living alone may be particularly vulnerable, warranting further investigation and potential targeting for combined physical and social interventions, pending replication.
CITATION:
Kate McEwen ; Suraj Samtani ; Rory Chen ; John D. Crawford ; Perminder S. Sachdev ; Henry Brodaty ; Katya Numbers (2026): Incident dementia risk by frailty status and living arrangements in older adults. The Journal of Frailty and Aging (JFA). https://doi.org/10.1016/j.tjfa.2026.100185