Highlights
- •There are significant but modest associations between cognitive frailty and physical frailty.
- •Screening instruments have often been used to determine objective cognitive decline.
- •Lifespan trajectories should be taken into account in understanding cognitive frailty.
- •A strong operational definition of cognitive frailty is necessary.
- •Interventional studies are needed to establish the role of preventive strategies.
Abstract
Objective
To analyze the definition of “cognitive frailty” and to study the conceptual and operational
definitions used and their implications for empirical research. The relationships
between this concept and cognitive reserve, the role of neuropathology and brain reserve,
motor signs of aging and the reversibility of cognitive frailty are also discussed.
Study design
Systematic review of empirical studies identified from Medline Advanced 1966, CINAHL,
Web of Science, PsycINFO, and Scopus until August 2017.
Main – outcome measures
Effect sizes. The quality of the articles was assessed by the Preferred Reporting
Items for Systematic Reviews and Meta-Analysis Statement. Three independent reviewers
participated in the study selection and data extraction.
Results
Nineteen studies involving 31,707 participants met the inclusion criteria. Significant
associations were reported between cognitive frailty and physical frailty or gait
speed. Screening instruments were usually used to determine objective cognitive decline
rather than extensive neuropsychological assessments. Educational level was the only
indicator of cognitive reserve that was systematically included in the evaluation
of cognitive frailty. Motor decline and gait variables were not systematically included
in protocols for the assessment of cognitive frailty.
Conclusions
A strong operational definition would benefit both the development of treatments to
counter cognitive frailty and the assessment of treatment effectiveness. Nevertheless,
since there is clear agreement regarding the importance of interventions for and the
prevention of cognitive frailty, randomized controlled trials investigating the efficacy
of preventive interventions are necessary.
Keywords
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Article info
Publication history
Published online: December 07, 2018
Accepted:
December 4,
2018
Received in revised form:
November 21,
2018
Received:
September 17,
2018
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
