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March 14-16, 2019 | London, UK

International Conference on

Vascular Dementia and Dementia

Neurological Disorders and Stroke

Joint Event

Journal of Brain and Neurology | Volume 3

Dementia and frailty: Cause, effect or both

Reshma A Merchant

National University Health System, Singapore

railty is a clinical syndrome associated with greater risk for

adverse outcomes such as falls, disability, institutionalisation

and death. Cognition and dementia are known components

of frailty, and the role of frailty as possible determinant of

dementia especially vascular dementia is getting increasing

recognition. Cognitive frailty is a condition recently defined as

co-existence of physical frailty and mild cognitive impairment,

with two proposed subtypes including potentially reversible

cognitive frailty and reversible cognitive frailty. The definition

continues to evolve with another group validating physical

frailty and MCI using computerized neuropsychological

battery of tests. As there is no agreed standard definition, the

prevalence ranges from 1.0-22.0% in different settings. Cross-

sectional, longitudinal population-based studies including our

own local data have shown that cognitive frailty is associated

with increased risk of functional disability, poor quality of life,

hospitalization, falls, mortality and dementia. The mechanisms

and pathophysiology underlying the cognitive-frailty link is

multifactorial, and inflammatory, nutritional, vascular and

metabolic factors may have a causal link. Physical frailty may

also be prodromal stage of vascular dementia supported by

imaging and biomarkers. Physical frailty and cognition should

be considered as a single complex phenotype for interventions

on prevention of dementia. For those at risk, including prefrail

and frail older adults, a recent systematic review have shown

that multidomain interventions tended to be more effective

than single domain interventions on frailty status, muscle mass

and strength, and physical functioning. Nutrition as one of the

domains is crucial as it delivers benefit at biological, clinical and

social level. We need a more reliable definition and diagnostic

criteria for cognitive frailtysupportedby imagingandbiomarkers

to identify those at risk and implement intervention program to

delay or prevent frailty and late-life cognitive disorders.

Speaker Biography

Reshma A Merchant, Head and Senior Consultant at the Division of Geriatric

Medicine at the National University Hospital, Singapore. Prior to this, she was the

head of division of Advanced Internal Medicine for seven years since 2009 and

under her leadership, the division has made great progress in care integration, care

coordination and new models of care including acute medical unit and Innovation-42.

She is a strong advocate of ageing in place. Her main area of research interest is in

sarcopenia, cognitive frailty and successful ageing in the community. She also holds

many leadership positions in national professional organizations and advisory boards.

She graduated from the University of Edinburgh and obtained her postgraduate

qualification from Royal College of Physician London in 1999 where she worked for

several years before returning to Singapore in 2001.

reshmaa@nuhs.edu.sg