Frailty and aging are associated with cognitive decline and dermal advanced glycation end-product accumulation in older Japanese men

Background

Dermal advanced glycation end-product (AGE) accumulation is associated with various diseases, as well as frailty and aging. Frailty and aging are well known to be associated with a decline in cognitive function. We placed middle-aged and older Japanese people into four groups according to their physical frailty status and age, and then evaluated the relationship their dermal AGE accumulation and cognitive function.

Materials and methods

We performed a cross-sectional study of 559 participants (236 men, mean age 67.3 years). Dermal AGE accumulation in the forearms of the participants was assessed using skin autofluorescence (SAF), and cognitive function was assessed using the touch panel-type dementia assessment scale (TDAS). Parameters relating to anthropometry, atherosclerosis, and frailty were evaluated at medical check-ups. The factors independently associated with TDAS score were identified by multivariate analysis.

Results

Multivariate analysis showed that age and frailty were inversely associated with TDAS. We then allocated risk scores (0–3) to reflect the combination of these parameters (age, 0 or 1; SAF score, 0, 1, or 2). The SAF corresponding to a score of 2-3 points on the receiver operating characteristic curve was 2.18 units in men (sensitivity 67.2 %, specificity 70.0 %, area under the curve (AUC) 0.695, p < 0.001) and 2.03 units in women (sensitivity 65.8 %, specificity 52.3 %, and AUC 0.600, p = 0.009), implying a closer relationship in men than women.

Conclusions

We have identified a relationship between dermal AGE accumulation and a high risk of cognitive decline in middle-aged and older Japanese people, especially in men.