{"title":"Prevalence and Outcomes of Cognitive Frailty Among Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis.","authors":"Yixiong Zhang, Haozhi Xia, Xing Jiang, Qiuling Wang, Lili Hou","doi":"10.3928/19404921-20240621-01","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To systematically review the available evidence regarding the prevalence and outcomes of cognitive frailty-a clinical syndrome characterized by the combination of physical frailty and cognitive impairment, without dementia-in community-dwelling older adults.</p><p><strong>Method: </strong>The following databases were searched: PubMed, Web of Science, Embase, EBSCO, Cochrane Central Register of Controlled Trials, ProQuest, CNKI, Wanfang, VIP, and CBMdisc (inception to October 2, 2023).</p><p><strong>Results: </strong>Twenty-four studies were included (<i>N</i> = 62,169) reporting a median prevalence of cognitive frailty among community-dwelling older adults of 12.2%. Frailty with cognitive impairment was independently associated with increased all-cause mortality (adjusted 8-year hazard ratio [HR] = 2.6, 95% confidence interval [CI] [2.05, 3.30]). There was evidence of increased risk of 3-year mortality for frailty (adjusted HR = 1.92, 95% CI [1.26, 2.93]) and prefrailty (adjusted HR = 1.79, 95% CI [1.33, 2.41]) with cognitive impairment. There was also evidence of increased risk of dementia for frailty (adjusted 24-month HR = 6.19, 95% CI [2.74, 13.99]; adjusted 4-year HR = 4.98, 95% CI [2.17, 11.41]) and prefrailty (adjusted 4-year HR = 5.21, 95% CI [2.95, 9.20]; adjusted 5-year HR = 14.5, 95% CI [1.68, 125.1]) with cognitive impairment. Activities of daily living (ADL) dependence was more frequent in individuals with cognitive impairment and frailty (adjusted 4-year odds ratio = 5.6, 95% CI [2.13, 14.72]).</p><p><strong>Conclusion: </strong>Of community-dwelling older adults, 12.2% have cognitive frailty as well as increased risk of all-cause mortality, dementia, and ADL dependence. Further studies on prevention and treatment of cognitive frailty is warranted. Health care providers should formulate specific interventions to decrease the impact of cognitive frailty. [<i>Research in Gerontological Nursing, 17</i>(4), 202-212.].</p>","PeriodicalId":51272,"journal":{"name":"Research in Gerontological Nursing","volume":"17 4","pages":"202-212"},"PeriodicalIF":1.1000,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Research in Gerontological Nursing","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3928/19404921-20240621-01","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"NURSING","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: To systematically review the available evidence regarding the prevalence and outcomes of cognitive frailty-a clinical syndrome characterized by the combination of physical frailty and cognitive impairment, without dementia-in community-dwelling older adults.
Method: The following databases were searched: PubMed, Web of Science, Embase, EBSCO, Cochrane Central Register of Controlled Trials, ProQuest, CNKI, Wanfang, VIP, and CBMdisc (inception to October 2, 2023).
Results: Twenty-four studies were included (N = 62,169) reporting a median prevalence of cognitive frailty among community-dwelling older adults of 12.2%. Frailty with cognitive impairment was independently associated with increased all-cause mortality (adjusted 8-year hazard ratio [HR] = 2.6, 95% confidence interval [CI] [2.05, 3.30]). There was evidence of increased risk of 3-year mortality for frailty (adjusted HR = 1.92, 95% CI [1.26, 2.93]) and prefrailty (adjusted HR = 1.79, 95% CI [1.33, 2.41]) with cognitive impairment. There was also evidence of increased risk of dementia for frailty (adjusted 24-month HR = 6.19, 95% CI [2.74, 13.99]; adjusted 4-year HR = 4.98, 95% CI [2.17, 11.41]) and prefrailty (adjusted 4-year HR = 5.21, 95% CI [2.95, 9.20]; adjusted 5-year HR = 14.5, 95% CI [1.68, 125.1]) with cognitive impairment. Activities of daily living (ADL) dependence was more frequent in individuals with cognitive impairment and frailty (adjusted 4-year odds ratio = 5.6, 95% CI [2.13, 14.72]).
Conclusion: Of community-dwelling older adults, 12.2% have cognitive frailty as well as increased risk of all-cause mortality, dementia, and ADL dependence. Further studies on prevention and treatment of cognitive frailty is warranted. Health care providers should formulate specific interventions to decrease the impact of cognitive frailty. [Research in Gerontological Nursing, 17(4), 202-212.].
期刊介绍:
Research in Gerontological Nursing is a forum for disseminating peer-reviewed, interdisciplinary, cutting-edge gerontological nursing research and theory to investigators, educators, academicians, clinicians, and policymakers involved with older adults in all health care settings. The Journal accepts manuscripts reporting research, theory, integrative and systematic reviews, instrument development, and research methods with the aims of improving the wellness and quality of care of the older adult population. Theory papers should advance gerontological knowledge, and integrative reviews should provide an analysis of the state of the science and provide direction for future research.