Although frailty can arise in middle age, very few studies have investigated frailty before 65 years. Our objectives were to assess the prevalence of frailty parameters in middle-aged individuals and probe the association with future adverse events. We performed cross-sectional and longitudinal analyses of community-dwelling individuals aged 50 to 65 (n = 411, median age: 59.0) having undergone a multidomain geriatric assessment (2010–2015) in an outpatient clinic in the greater Paris area of France (SUCCEED cohort). The primary outcome was a composite measure of adverse events (non-accidental falls, fractures, unplanned hospitalizations, death), recorded in 2016/2017. Multivariable logistic regression models were built to identify independent predictors. Six frailty parameters were highly prevalent (> 20%): low activity (40.1%), exhaustion (31.3%), living alone (28.5%), balance impairment (26.8%), weakness (26.7%), and executive dysfunction (23.2%). Female sex (odds ratio: 2.67 [95% confidence interval: 1.17–6.11]), living alone (2.39 [1.32–4.33]), balance impairment (2.09 [1.16–3.78]), executive dysfunction (2.61, [1.18–5.77]), and exhaustion (2.98 [1.65–5.39]) were independent predictors of adverse events. Many frailty parameters are already altered in middle-aged individuals and are predictive of adverse health events. Our findings highlight a possible need for frailty screening and preventive programs targeting middle-aged individuals.

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Objectives: To estimate the prevalence of understated cognitive impairment by administering the Clock-Drawing Test (CDT) to community-dwelling individuals aged ≥50, and to investigate the associated clinical phenotype. Design: A cross-sectional analysis of baseline data on community-dwelling individuals assessed at an outpatient clinic in the Paris region of France. Setting and Participants: Participants aged ≥50 (n=488, median age: 62.1) prospectively included in the SUCCEED survey between 2010 and 2014. Methods: A multidimensional geriatric assessment, including cognition (7-point CDT, MMSE, the 5-word screening test (5-WT), and the Frontal Assessment Battery (FAB)), gait speed in dual tasks, mood (the Geriatric Depression Scale (GDS)), balance, physical functions (gait speed and handgrip strength), nutrition, bone density, and comorbidities; major cardiovascular risk factors, and Scheltens and Fazekas scores on brain MRI. Baseline characteristics were analyzed as a function of the CDT score (<7 versus 7), using ageadjusted logistic models.

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