Cognitive frailty as a predictor of adverse outcomes among older adults: A systematic review and meta-analysis

Objective A systematic review and meta-analysis basing on the prospective cohort studies were conducted to explore the risk of all-cause mortality and dementia in cognitively frail older adults compared to robust older adults and to determine whether it was a predictor of adverse outcomes. Methods Pubmed, Web of Science, The Cochrane Library, EMBASE, and CINAHL databases were searched to retrieve studies on adverse outcomes of cognitive frailty. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Stata 15.0 Software was used to perform the meta-analysis. The all-cause mortality and dementia were observed to be the primary outcomes, while the other data were considered as the secondary outcome. Results A total of 14 studies were included in qualitative analysis and 12 studies were included in the meta-analysis, with low risk of bias and moderate to good methodological quality. The results showed that cognitive frailty in older people had a higher risk of all-cause mortality [HR = 1.93, 95%CI (1.67, 2.23), p < .001] and dementia [HR = 3.66, 95%CI (2.86, 4.70) as compared with robust. The subgroup analysis showed that the assessment tools were the main source of heterogeneity. Conclusion In older adults living in communities, the cognitive frailty was found to be a significant predictor of all-cause mortality and dementia. Nonetheless, cognitive frailty was found to be a better predictor of all-cause mortality and dementia than just frailty.