An update on cognitive frailty: Its definition, impact, associated factors and underlying mechanisms, and interventions

Abstract

Since the concept and operational definition of "cognitive frailty" (simultaneous presence of physical frailty and cognitive impairment without concurrent dementia) were proposed by the International Academy of Nutrition and Aging and the International Association of Gerontology and Geriatrics, cognitive frailty has been widely investigated. This review is intended to address the operational definition of cognitive frailty, its consequences, contributing factors and underlying mechanisms, as well as interventions for cognitive frailty. Although the definitions and assessments of cognitive frailty vary among researchers, older adults with both physical frailty and cognitive impairment are shown to be at higher risk of adverse health outcomes, including death, disability, hospitalization and incident dementia, than those with either condition alone. While the underlying mechanisms of cognitive frailty are still unclear, factors shown to be associated with cognitive frailty include sociodemographic factors, social status, nutritional status, geriatric syndrome, physical and cognitive activities, functional status, comorbidities, medication use, gut-derived metabolites and structural changes in the brain. Accumulating evidence indicates the need for comprehensive geriatric assessment that helps identify the possible causes of cognitive frailty and develop a multimodal individualized intervention to prevent adverse health outcomes for older adults with cognitive frailty. Further studies are required to clarify the mechanisms through which physical frailty and cognitive impairment interact to accelerate adverse health outcomes, particularly cognitive outcomes. In addition, for older adults with cognitive frailty, an effective flow diagram from primary screening through comprehensive assessment to multidimensional intervention needs to be developed for future implementation in both clinical and community settings. Geriatr Gerontol Int 2022; 22: 99-109.

Prevalence and associated factors of cognitive frailty in older patients with chronic kidney disease: a cross-sectional study

“…The nomogram was drafted with these factors, and applied to estimate the risk of cognitive frailty for each patient in clinical practice. It is known that the prevalence of cognitive frailty increases with age [ 21 , 22 ]. For older people, the functions of various tissues and organ systems of the body gradually undergo degenerative changes, resulting in a decline in the physiological functions and activities of the body.…”

Estimation of Human Cerebral Atrophy Based on Systemic Metabolic Status Using Machine Learning

“…VCI plays an important role not only in vascular dementia, but also in the development of dementia in the elderly with Alzheimer's disease (AD) ( 3 – 5 ). In addition, malnutrition ( 6 ), anemia ( 7 ), diabetes mellitus ( 8 ), liver dysfunction ( 9 ), and renal dysfunction ( 10 ) can cause cognitive impairment and increase the risk of dementia. Importantly, these systemic metabolic disorders, including lifestyle-related disorders, can be detected by basic blood tests for health examinations that do not contain dementia-specific biomarkers.…”

Does Preoperative Cognitive Optimization Improve Postoperative Outcomes in the Elderly?

“…Frailty is a clinical syndrome, the importance of which has been rapidly recognized in perioperative elderly populations [40]. Frailty syndrome is measured as the sum of various indicators, including unintentional weight loss, fatigue, muscle weakness, low physical activity, low gait speed, poor balance, visual impairment, and cognitive impairment [41,42]. The prevalence of preoperative frailty varies significantly (up to 50-60%) depending on age and the type of surgery, with a steep increase observed in older patients [43][44][45][46].…”