Williams AM, Krull KR, Howell CR, et al. - In this study, the link between frailty and neurocognitive decline was investigated among adult survivors of childhood cancer. Participants were childhood cancer survivors 18-45 years old (≥ 10 years from diagnosis). They were assessed clinically for prefrailty or frailty (respectively defined as ≥ 2 or ≥ 3 of: muscle wasting, muscle weakness, low energy expenditure, slow walking speed, and exhaustion [Fried criteria]). Participants were evaluated neuropsychologically at enrollment (January 2008-June 2013) as well as 5 years later. Greater declines in cognitive domains linked with aging and dementia were seen, over approximately 5 years, among prefrail and frail young-adult survivors vs nonfrail survivors. Neurocognitive decline may also be mitigated or averted by interventions that have global effect and are designed to target the mechanistic underpinnings of frailty.