Abstract
AbstractCognitive frailty (CF) is the conjunction of cognitive impairment without dementia and physical frailty. While predictors of each element are well-researched, mechanisms of their co-occurrence have not been integrated, particularly in terms of relationships between social, psychological, and biological factors. This interdisciplinary scoping review set out to categorise a heterogenous multidisciplinary literature to identify potential pathways and mechanisms of CF, and research gaps. Studies were included if they used the definition of CF OR focused on conjunction of cognitive impairment and frailty, AND excluded studies on specific disease populations, interventions, epidemiology or prediction of mortality. Searches used Web of Science, PubMed and Science Direct. Search terms included “cognitive frailty” OR ((“cognitive decline” OR “cognitive impairment”) AND (frail*)), with terms to elicit mechanisms, predictors, causes, pathways and risk factors. To ensure inclusion of animal and cell models, keywords such as “behavioural” or “cognitive decline” or “senescence”, were added. 206 papers were included. Descriptive analysis provided high-level categorisation of determinants from social and environmental through psychological to biological. Patterns distinguishing CF from Alzheimer’s disease were identified and social and psychological moderators and mediators of underlying biological and physiological changes and of trajectories of CF development were suggested as foci for further research.HighlightsSpecific impairments in cognition distinguish cognitive frailty from early dementias.Depression mediates links between frailty and cognitive impairment in aging.Psychosocial and environmental factors impact underlying biological processes.Health behaviour and population interventions could prevent or reverse cognitive frailty.Development of model organism models of cognitive frailty is needed.
Publisher
Cold Spring Harbor Laboratory