Effectiveness of interventions in older adults with cognitive frailty: a systematic review and meta-analysis of randomised controlled trials

Abstract

Background interventions targeting older adults with cognitive frailty have grown rapidly in recent years with inconsistent findings. However, there is no meta-analysis that has synthesised pooled estimates. Objective to synthesise the pooled effect of current targeted interventions in older people with cognitive frailty. Methods we conducted a systematic search in PubMed, Embase, Web of Science, the Cochrane Library, the JBI database and three Chinese databases (CNKI, Wan-Fang and VIP) for literature from the inception of the database until 8 March 2022. The mean difference or standardised mean difference with 95% CIs was calculated. The methodological quality was assessed by the Cochrane RoB 2.0. The certainty of evidence was assessed using the GRADE criteria. Results thirteen randomised controlled trials with a total of 1,089 participants were included. The results of the meta-analysis showed that older adults with cognitive frailty in the intervention groups had significant improvement in frailty score [MD = −1.67, 95% CI (−2.39, −0.95), P < 0.00001, I2 = 97%], global cognitive function [MD = 3.38, 95% CI (1.90, 4.85), P < 0.00001, I2 = 93%], mobility [MD = −0.96, 95% CI (−1.27, −1.66), P < 0.00001, I2 = 0%], muscle strength [SMD = 0.75, 95% CI (0.09, 1.41), P = 0.03, I2 = 85%] and nutritional status [MNA:MD = 5.64, 95% CI (3.99, 7.29), P < 0.00001, I2 = 89%; ALB: MD = 3.23, 95% CI (0.76, 5.71), P = 0.01, I2 = 93%; PALB: MD = 54.52, 95% CI (25.26, 83.77), P = 0.0003, I2 = 96%; TRF: MD = 0.64, 95% CI (0.22, 1.06), P = 0.003, I2 = 97%]. The overall certainty of the evidence ranged from low to moderate. Conclusions interventions targeting older adults with cognitive frailty are effective in improving physical frailty, global cognitive function, physical function and nutritional status with low to moderate certainty. More research is still needed in the future to further enrich the evidence in these fields. PROSPERO number CRD42022318758.

Prevalence and associated factors of cognitive frailty in community‐dwelling older adults: Results from the Korean longitudinal study of aging

“…The prevalence rates of MCI, PF, and CF among the sample population were approximately 12%, 15%, and 11% respectively. Compared with previous studies, the prevalence rate in this study was lower for MCI and somewhat higher for PF and approximately equal for CF (Kim et al, 2019; Shimada et al, 2013; Xie et al, 2021; Zheng et al, 2022). A systematic review reported that the CF prevalence among older adults varied widely from 1% to 22.6% across studies due to variations in operational definitions of CF (Zheng et al, 2022).…”

“…Compared with previous studies, the prevalence rate in this study was lower for MCI and somewhat higher for PF and approximately equal for CF (Kim et al, 2019; Shimada et al, 2013; Xie et al, 2021; Zheng et al, 2022). A systematic review reported that the CF prevalence among older adults varied widely from 1% to 22.6% across studies due to variations in operational definitions of CF (Zheng et al, 2022). As the ageing population continues to accelerate, the number of older adults with CF will increase substantially due to age‐related biologic changes.…”

“…Zheng et al, 2022). As the ageing population continues to accelerate, the number of older adults with CF will increase substantially due to age-related biologic changes.…”

Scleral Grafts in Ophthalmic Surgery. A Review

“…V současné době výrazně častěji využívané materiály při tarzofrontálním závěsu jsou ale zejména již zmíněná autogenní nebo alogenní fascia lata femoris [117][118][119] a syntetické materiály jako silikon, Gore-Tex nebo polypropylen [119][120][121].…”

Resistance training's impact on blood biomarkers and cognitive function in older adults with low and high risk of mild cognitive impairment: a randomized controlled trial

“…For instance, a network meta-analysis on the effect of exercise to improve cognition in older adults indicated that resistance training (RT) appears to have larger beneficial effects on cognitive and motor functioning than other exercise modalities, although more research has been done on aerobic exercise training [10]. In general, the beneficial effect of exercise was found for all subcognitive domains, with resistance exercise having the greatest benefits on executive function, according to a meta-analysis [11]. Another meta-analysis in individuals with MCI showed that RT improved cognition and alleviated MCI [12].…”