Management of cognitive frailty: A network meta‐analysis of randomized controlled trials

Abstract

ObjectivesWe aimed to compare the effectiveness of interventions in cognitive function and frailty status and rank these interventions.MethodsData Sources‐We searched PubMed, Embase, CINAHL, PsycINFO, Web of Science, Cochrane Library, Central Register of Controlled Trials (CENTRAL), CNKI, Wanfang, VIP and Google scholar. Data synthesis‐The risk of bias was assessed using the Cochrane risk bias assessment tool. Statistical heterogeneity was assessed using the Chi‐square test and quantified by I2. The results were pooled using the standardized mean difference (SMD). The rank probability for each intervention was calculated using the surface under the cumulative ranking curve (SUCRA). Additionally, the quality of the evidence was evaluated using the GRADE approach.ResultsA total of 10 randomized controlled trials (RCTs) involving 1110 patients were included in our analysis. The network map of cognitive function comprised 9 RCTs with 1347 participants, examining eight different interventions. Nutritional support (SUCRA = 99.9%, SMD = 3.02, 95% CI: 2.53, 3.51) may be the most effective intervention to improve cognitive function. The network map of frailty (including 9 RCTs with 1017 participants and 9 interventions) suggested that multicomponent exercises (SUCRA = 96.4%, SMD = −5.10, 95% CI: −5.96, −4.23) tended to have a greater effect.ConclusionsCommunity‐based multicomponent exercises have shown significant benefits for improving cognitive function and frailty status in older adults, with moderate certainty. For hospitalized older patients with Cognitive frailty (CF), current evidence suggests that nutritional support yields the most improvement. Additionally, aerobic exercise and dual‐task training have proven effective in managing CF. Further studies are needed to validate these preliminary findings and exploring more accessible and effective physical and cognitive interventions to prevent CF in aging.

Prevalence and risk factors of cognitive frailty among pre‐frail and frail older adults in nursing homes

“…The latest network meta-analysis reveals that CF multicomponent exercises may be the most effective strategies to improve cognitive function and frailty. 59 Future randomised controlled trials should be designed and evaluated based on both effectiveness and feasibility. Due to cultural factors, individuals from different countries may demonstrate varying propensities in choosing exercise methods.…”

Risk factors of cognitive frailty in elderly chronic obstructive pulmonary disease patients and its implication for death: a cohort study

“…30 Aerobic exercise, Baduanjin exercise, Otago exercise, and diverse integrative exercise have all been shown to delay and reverse cognitive frailty by improving patients' motor and cognitive functions. [31][32][33] Exercise interventions can improve patients' muscle status by reducing their C-reactive protein, reducing inflammation, improving their myocyte growth, and increasing muscle strength and endurance. 34 Exercise also affects structural plasticity in subregions of the hippocampus, such as the left parietal tract, right angular gyrus 1, and anterior inferior tract, which play a very important role in cognition, thus improving cognitive function.…”

Prevalence and modifiable risk factors of cognitive frailty in patients with chronic heart failure in China: a cross-sectional study

“…Previous studies indicated that CF could be reversible [ 13 ], thus, identifying and responding to risk factors for CF can help to slow down or even reverse its progression. However, the associated factors discovered in current studies of CF, such as age, education level, etc., are not intervenable [ 14 ]. A review shows that social status, nutrition status, physical and cognitive activities and functional status are factors shown to be associated with CF [ 15 ].…”