Cognitive frailty: definitions, components, and impact on disability and mortality

Abstract Cognitive frailty is a condition recently defined by operationalized criteria describing coexisting physical frailty and mild cognitive impairment, with two proposed subtypes: potentially reversible cognitive frailty (physical frailty/mild cognitive impairment) and reversible cognitive frailty (physical frailty/pre-mild cognitive impairment subjective cognitive decline). A relevant heterogeneity was suggested by several studies with prevalence estimates ranging 1.0%–39.7% (10.7%–39.7% in clinical-based settings and 1.0%–19.9% in population-based settings). Cross-sectional and longitudinal population-based studies showed that different cognitive frailty models may be associated with increased risk of functional disability, worsened quality of life, hospitalization, mortality, incidence of dementia, incidence of vascular dementia, and neurocognitive disorders. Multidomain interventions have the potential to be effective in preventing cognitive frailty. More reliable clinical and research criteria are needed, with clinical, biological, and imaging markers to implement intervention programs targeted to improve frailty, with an impact on prevention of cognitive disorders in older age.