Scoping review on the exogenous factors and biological mechanisms for cognitive frailty
Presentation by network PI, Carol Holland at the Centre for Ageing Research (C4AR) Research Showcase in Lancaster on the Scoping review on the exogenous factors and biological mechanism for Cognitive Frailty (December 2023), including gap analysis.
C4AR website: https://www.lancaster.ac.uk/health-and-medicine/research/c4ar/
Understanding exogenous factors and biological mechanisms for cognitive frailty: a multidisciplinary scoping review
Carol Holland, Nikolett Dravecz, Lauren Owens, Alexandre Benedetto, Irundika Dias, Alan Gow, Susan Broughton
You can read the full article here: https://www.sciencedirect.com/science/article/pii/S1568163724002794
Abstract
Cognitive 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 (by any measure), 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.
Evidence synthesis on Cognitive Frailty – The effect of social engagement, air quality and access to green spaces on cognitive frailty
Presentation by network Co-I, Sally Fowler-Davies and Charlotte Benkowitz from Sheffield Hallam University at the CFIN ECR Summer School on Cognitive Frailty and Ageing (June 2023)
A Scoping Review of the Effects of Ambient Air Quality on Cognitive Frailty
James Robert Hodgson, Charlotte Benkowitz, Brian C. Castellani, Amanda Ellison, Rammina Yassaie, Helen Twohig, Roshni Bhudia,Otto-Emil Ilmari Jutila and Sally Fowler-Davis
Doi: https://doi.org/10.3390/environments11010004
You can read the full article here: https://www.mdpi.com/2076-3298/11/1/4
The scoping review shows that moderate long-term ambient air pollution appears linked to increased risk of cognitive frailty, and its effects may be more detrimental to elderly people with existing conditions, including economic and health inequalities. The results suggest earlier and more active interventions are needed to protect older people and air quality appears to be a critical risk factor even at levels below World Health Organisation targets.
Green spaces and the impact on cognitive frailty: a scoping review
Sally Fowler Davis, Charlotte Benkowitz, Lucie Nield, and Chris Dayson
Doi: https://doi.org/10.3389/fpubh.2023.1278542
Read the full article here: https://www.frontiersin.org/articles/10.3389/fpubh.2023.1278542/full
The scoping review shows evidence that suggests a beneficial role of green space exposure on cognitive functions. Results suggested that poorer urban environments are high risk for older people’s mental health and these places often lack parks and green spaces, furthermore, the level of activity and social participation may be greater with access to green spaces and therefore reduces health risks.
A Scoping Review on the Opportunities for Social Engagement and Cognitive Frailty in Older Adults
Sally Fowler Davis, Charlotte Benkowitz, Carol Holland, Alan Gow, Charlotte Clarke
Doi: https://doi.org/10.3389/phrs.2024.1606494
Read the full article here: https://www.ssph-journal.org/journals/public-health-reviews/articles/10.3389/phrs.2024.1606494/full
Cognitive frailty (CF) is defined as the clinical syndrome of the combination of physical frailty and cognitive impairment, without dementia. Numerous risk factors for CF have been previously identified but this scoping review focusses on the critical need for social engagement and the association with cognition. The focus of this scoping review on the opportunity for social engagement rather than on perception or experience of loneliness. Based on the results of 55 studies were synthesised into four social engagement categories, namely participation, household, network, and habitat. Social engagement is associated with maintaining or improving cognition, particularly through active participation in social roles. Habitat (i.e., rural or urban settings) also influences cognition and the challenge is to enable social participation.
Interventions for Cognitive Frailty: developing a Delphi consensus with multidisciplinary and multisectoral experts
Delphi study paper is available in pre-print: https://doi.org/10.31234/osf.io/jr9cs
Holland, C., Dravecz, N., Broughton, S., Barker, L., Bature, F., Clarke, C., … Fowler-Davis, S. (2024, December 20). Interventions for Cognitive Frailty: developing a Delphi consensus with multidisciplinary and multisectoral experts.
Abstract:
Introduction: The conjunction of physical frailty and cognitive impairment without dementia is described as Cognitive Frailty (CF). Indications that CF is potentially reversible have led to proposals that risk factors, symptoms or mechanisms of CF would be appropriate targets for interventions for prevention, delay or reversal. However, no study has brought experts together across sectors to determine targets, content or mode of interventions, and most resources on interventions are from the perspective of academic or clinical researchers only. This international Delphi consensus study brings together experts from academic and clinical research, lay people with lived experience of CF, informal carers, and professional care practitioners/clinicians.
Methods: Three rounds of Delphi study were held to discern which factors and statements were agreed upon by the whole sample and which generated different views in those with differing expertise. A scoping review and Round 1 (29 participants) were used to gather initial statements. In Round 2, 58 people responded to statements and open text items, comprising 7 lab-based researchers, 27 researchers working with people, 14 people with lived experience or informal family carers, and 10 professional carers/clinicians. Percent agreement and qualitative responses were analysed to provide a final set of statements which were checked by 38 respondents in Round 3. Results: Analysis of Round 2 quantitative data provided 74 statements on which there was at least 70% agreement and qualitative data produced a further 24 statements. These were combined to provide 90 statements for Round 3. There was Consensus for 89 of the statements. A few differences between the groups were observed at both stages.
Discussion and Conclusion: The consensus for statements associated with CF interventions provides a useful first step in defining health promotion activities and interventions. Given the prevalence and potential disability caused by CF in older populations, the consensus statements represent expert opinion that is inter-sectoral and will inform public health policies to support implementation of evidence-based prevention and intervention plans. This study is an important step towards changing current approaches, by including all stakeholders from the outset. Outcomes can be used to feed into co-creation of interventions for cognitive frailty.
