Cognitive Frailty: An Update

Abstract

This review article provides an update of the empirical research on cognitive fragility conducted in the last four years. The studies retrieved were classified in four different categories. The first category includes articles relating cognitive frailty to cognitive reserve and which continue to highlight the importance of educational level. The second category includes recent research on cognitive fragility biomarkers, involving neuroimaging, metabolism and, in a novel way, microbiota. The third category includes research on how cognitive frailty is related to motor development and physical functioning, exploring e.g. the use of technology to study motor markers of cognitive frailty. Finally, in the fourth category, research clarifying the difference between reversible frailty and potentially reversible cognitive frailty has led to new interventions aimed at reducing cognitive frailty and preventing negative health outcomes. Interventions based on physical activity and multicomponent interventions are particularly emphasized. In addition, recent research explores the long-term effects of dual interventions in older adults living in nursing homes. In summary, research on cognitive frailty has increased in recent years, and applied aspects have gained importance.

White matter integrity mediates the associations between white matter hyperintensities and cognitive function in patients with silent cerebrovascular diseases

“…Furthermore, we observed a direct negative effect of the WMH on executive function and an indirect effect of the WMH on executive function by impairing the integrity of the right IFOF. Meanwhile, we found a positive correlation between educational level and executive function as seen in other studies 23,24 . Because the purpose of the present study was not to investigate whether education level acts as a factor in mediating WMH via executive function, education level was adjusted in the mediation analysis as a covariate.…”

Cognitive reserve and mental health in cognitive frailty phenotypes: Insights from a study with a Portuguese sample

“…Moreover, in Model 3 Cognitive Reserve Leisure time was significant while in Model 4, Years of education was not a significant factor. Although the protective effect of education (measured as years of formal schooling) has been demonstrated in many studies (Facal et al, 2021) we suggest that in people with relatively low levels of education -as in our sample (mean 6.56 years)-the effect of formal education received in childhood and adolescence may be "diluted" over time, but that the effect of social, family and free-time activities throughout life may be maintained. Therefore, we emphasize that social, cultural, family and free-time activities throughout life constitute important proxies or dimensions in the cognitive reserve model (Stern, 2012) and that these should be considered, together with education and professional activities, to be predictors of cognitive frailty.…”

“…Several published studies suggest a potential protective role of cognitive reserve factors against the onset and worsening of frailty among older adults, keeping their cognitive abilities at older ages ( Staff et al, 2004 ). A recent review highlighted the fact that the only proxy for CR included in studies of CF is the level of formal education and that a low level has been indicated as a risk factor for CF ( Facal et al, 2021 ). People with a lower educational level are more exposed to cognitive frailty at later age ( Gutierrez-Robledo and Avila-Funes, 2012 ; Gale et al, 2020 ).…”

“…Moreover, the Portuguese older adults have particular sociocultural characteristics characterized by a low average education with predominance of the 1st cycle (primary education) or without schooling ( Moreira, 2020 ) and a high level of early school leaving for historical reasons of socio-economic nature ( Gonçalves et al, 2021 ). At our knowledge there is not any study in Portugal devoted to analyze different cognitive frailty phenotypes and their associated factors such as cognitive reserve and mental health that are important to prevent cognitive frailty ( Facal et al, 2021 ).…”

Mediating Effect of Loneliness in the Relationship between Depressive Symptoms and Cognitive Frailty in Community-Dwelling Older Adults

“…The incidence of cognitive frailty increases year by year, and with the increase in age, its incidence is higher [ 5 , 6 ]. However, cognitive frailty may be reversed [ 7 ]. As the world’s population ages rapidly, it is urgent we pay more attention to cognitive frailty, accurately identify elderly people with cognitive frailty, explore its influencing factors, and prevent or delay it as soon as possible.…”