Aug 2026· Asia-Pacific Psychiatry· Vol 18 3, pp.
e70032
· 0 citations· 72 references
Medicine
TL;DR
Cognitive frailty is common among community-dwelling older adults worldwide and systematic identification and targeted multi-domain interventions should be prioritized in aging societies.
Abstract
Background
Cognitive frailty, defined as the co-occurrence of physical frailty/prefrailty and cognitive impairment in the absence of dementia, is a potentially reversible condition that may signal high risk for disability and dementia. This systematic review and meta-analysis estimated the global prevalence of cognitive frailty among community-dwelling older adults and examined methodological and contextual moderators of prevalence differences.
Methods
We searched for relevant studies published up to October 22, 2025 in international (PubMed, Web of Science, Embase, PsycINFO) and Chinese (CNKI, Wanfang) databases. Pooled prevalence rates and 95% confidence intervals (CIs) were calculated with random-effects models. Subgroup and meta-regression analyses examined possible sociodemographic, methodological, and clinical moderators. Study quality was assessed with the Joanna Briggs Institute checklist.
Results
Sixty-six studies of 127 556 participants were included. The pooled prevalence of cognitive frailty was 12.2% (95% CI: 9.4%-15.7%). Prevalence was higher in studies using the "Fatigue, Resistance, Ambulation, Illness, and Loss of weight" (FRAIL) scale or Fried phenotype and those using the Montreal Cognitive Assessment (MoCA) or composite cognitive criteria, in upper-middle-income countries, and in studies published after 2021. In meta-regression analyses, alcohol use status was significantly associated with cognitive frailty prevalence but most sociodemographic factors were not related to rates of cognitive frailty. Trim-and-fill analysis suggested that potential publication bias may have led to underestimation of prevalence.
Conclusion
Cognitive frailty is common among community-dwelling older adults worldwide. Given its potential reversibility and strong links to adverse outcomes, systematic identification and targeted multi-domain interventions should be prioritized in aging societies.
Objectives To explore the prevalence and associated factors of cognitive frailty in older adults with heart failure. Design A systematic review and meta-analysis. Methods We systematically searched China National Knowledge Infrastructure (CNKI), Wanfang Data, the VIP Database, SinoMed, PubMed, Web of Science, Embase, the Cochrane Library and Scopus from their inception to March 30, 2026. Results A total of 22 studies involving 8,892 older adults with heart failure were included. The meta-analysis showed that the pooled prevalence of cognitive frailty in older adults with heart failure was 32% (95% CI: 27%-37%). Descriptive stratified analyses yielded pooled prevalence estimates of 37% in women and 31% in men. According to New York Heart Association functional classification, the corresponding estimates were 44% among patients classified as class IV and 28% among those classified as classes II-III.The prevalence was also higher in patients with comorbid chronic obstructive pulmonary disease (46%) and coronary heart disease (31%). Older age was associated with higher odds of cognitive frailty (adjusted OR = 1.12, 95% CI 1.06–1.18). Depression was also associated with higher odds, whereas exercise and intellectual activity were associated with lower odds. Conclusions and Implications Cognitive frailty appears to be common among older adults with heart failure, although prevalence estimates vary across populations and assessment approaches. Older age and depression were associated with higher odds of cognitive frailty, whereas exercise and intellectual activity were associated with lower odds. These findings support early screening and comprehensive assessment, while the observed associations should not be interpreted as causal because the available evidence was predominantly observational and cross-sectional. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/view/CRD420261360024, PROSPERO, identifier CRD420261360024.
Min Cheng, Jing Zhao, Juan Hu· Frontiers in Public Health· 0 citations
AIM
To determine whether frailty is associated with activities of daily living (ADL) and other clinical outcomes in hospitalized older adults.
METHODS
MEDLINE, Embase and CENTRAL were searched for English-language cohort studies published from 1 January 2001 to 23 October 2025. Eligible studies included hospitalized adults aged ≥ 65 years (or samples with ≥ 80% aged ≥ 65 years), used a defined frailty measure and compared frail with non-frail participants. Two reviewers independently selected studies, extracted data and assessed risk of bias using the Quality In Prognosis Studies tool. Random-effects meta-analyses generated standardized mean differences (SMDs) or risk ratios (RRs) with 95% confidence intervals (CIs).
RESULTS
Fifty-seven cohort studies were included. Frailty was associated with worse ADL status (SMD -1.04, 95% CI -1.89 to -0.20), higher mortality (RR 2.26, 95% CI 1.86-2.76), lower likelihood of discharge home (RR 0.79, 95% CI 0.73-0.86), and higher 30-day (RR 1.47, 95% CI 1.13-1.90) and 90-day readmission risks (RR 1.75, 95% CI 1.07-2.86). Pneumonia risk was not statistically significant. Heterogeneity was substantial to considerable for all pooled outcomes.
CONCLUSIONS
Frailty identifies hospitalized older adults at increased risk of functional dependence, mortality, non-home discharge, and readmission. Substantial heterogeneity and residual confounding warrant cautious interpretation and support standardized frailty and functional-outcome assessment.
T. Kamo, R. Asahi, Yasuko Inaba et al.· Geriatrics & Gerontology Int...· 0 citations
Frailty components, especially weakness and slowness, are significantly associated with mortality and related outcomes, highlighting the urgency of early frailty detection to improve patient prognosis and urging early identification and intervention to enhance patient care and reduce clinical burden.
K. Prokopidis, F. S. Ragusa, Roberta Bonica et al.· Aging Clinical and Experimen...· 0 citations
Background/Objectives: Physical activity (PA) interventions have the potential to delay or reverse frailty in older people, and previous meta-analyses have shown that PA reduces frailty risk. However, introduction and maintenance of PA during midlife might be more impactful as a public health intervention to reduce frailty at the population level. This study aimed to evaluate the impact of longitudinal PA patterns on future frailty risk and to examine whether it is modified by age of onset before vs. after 60 years. Methods: We conducted a systematic review and meta-analysis of prospective population-based cohort studies evaluating the effect of longitudinal PA trajectories on frailty risk of community-dwelling adults below and above 60 years at baseline. Risk ratios (RRs) from studies eligible for quantitative synthesis were pooled using random-effects meta-analysis. Results: Ten studies involving 111,714 participants from Europe, Asia, and North America were included in the systematic review and six in the meta-analysis. Relative to long-term physical inactivity, persistent PA trajectory was associated with 44% reduced risk of frailty (RR = 0.56, 95% CI:0.42–0.76) with moderate certainty, while inclining trajectories were associated with a 38% reduced risk (RR = 0.62, 95% CI: 0.57–0.68) with low certainty. Results: were similar for populations > 60 and <60 years at baseline. Conclusions: Sustained or increasing PA patterns over time are associated with lower risk of future frailty. These findings warrant further implementation studies to quantify the impact of public health policies promoting physically active lifestyles in midlife on the burden of frailty in aging populations.
Danai Sgouropoulou, Maria-Iosifina Kasdagli, D. Panagiotakos et al.· Geriatrics· 0 citations
Abstract Introduction Multidimensional frailty among community-dwelling older adults has emerged as an important issue in ageing research, given its close association with declines in health status, functional independence and overall quality of life. This scoping review aims to map longitudinal evidence on multidimensional frailty in community-dwelling older adults, including its measurement, prevalence, changes over time and associated risk factors. The findings will be used to generate insights for future research and inform the development of interventions targeting multidimensional frailty. Methods and analysis This scoping review will be conducted in accordance with the methodological guidance of the Joanna Briggs Institute and the framework originally proposed by Arksey and O’Malley. The primary objective is to identify longitudinal evidence on risk factors associated with multidimensional frailty in community-dwelling older adults. A comprehensive literature search will be performed across six electronic databases (MEDLINE, Embase, CINAHL, the Cochrane Library, Web of Science and Scopus), covering studies published from 1 January 2010 to the date of the final search (anticipated August 2026). Only peer-reviewed studies published in English and using longitudinal designs will be included. Study selection will be guided by the Population–Concept–Context framework. The review findings will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Ethics and dissemination Ethical approval is not required for this review as it is based solely on analysis of data from previously published studies. The results are expected to contribute to the development of interventions targeting multidimensional frailty among community-dwelling older adults. Findings will be disseminated through peer-reviewed journal publications, academic conferences and scholarly forums.
Mi-So Shim, G. Kim, Somyee Min· BMJ Open· 0 citations
Abstract Frailty and multimorbidity are prevalent, interrelated geriatric conditions whose co-occurrence substantially elevates the risk of disability, hospitalisation, and mortality in older adults. Comprehensive Geriatric Assessment (CGA) is a multidisciplinary diagnostic process proposed as the gold standard for managing these complex conditions. A systematic literature review was conducted following PRISMA 2020 guidelines, searching PubMed, MEDLINE, EMBASE, CINAHL, Web of Science, and Google Scholar for peer-reviewed articles published between 2018 and 2025. Fourteen articles meeting predefined inclusion and exclusion criteria were selected and appraised using the Critical Appraisal Skills Programme (CASP) framework and an evidence-grading matrix. Included studies confirmed a bidirectional relationship between frailty and multimorbidity, mediated by chronic low-grade inflammation, immunosenescence, hormonal dysregulation, and sarcopenia. CGA was consistently effective in quantifying frailty severity, guiding individualised care planning, reducing hospital length of stay, and delaying frailty progression. Updated evidence from 2024 and 2025 confirms that CGA significantly reduces mortality risk and preserves independence in activities of daily living across hospital and community settings. The geriatric triangle, the interplay between frailty, multimorbidity, and polypharmacy, represents an important emerging framework for integrated geriatric management. Standardised CGA implementation, supported by validated digital frailty indices and multidisciplinary teams, is recommended to optimise outcomes.
Soumitra Roy· Journal of Frailty, Sarcopen...· 0 citations
We use cookies to run the site and, with your consent, for analytics and to show ads.
See our Cookie Policy.
