Frailty and cognitive impairment are two major risk factors for adverse outcomes in elderly patients with diabetes. In the elderly, physical frailty and cognitive impairment frequently coexist, and have similar pathophysiological pathways, so the new concept of " cognitive debilitation” has been proposed. Physical frailty and cognitive impairment could accelerate the decline of function among elderly diabetic patients, and seriously affect their quality of life. Early identification and appropriate intervention of cognitive frailty may improve the adverse outcomes of elderly patients with diabetes. This article reviews the research progress of cognitive frailty and senile diabetes.
ObjectiveTo systematically review the associations of cognitive frailty with mortality and hospitalization in the elderly. MethodsThe VIP, PubMed, CNKI, WanFang Data, CBM, Embase, Cochrane Library and Web of Science databases were electronically searched to collect cohort studies on the association of cognitive frailty with mortality or hospitalization in the elderly from inception to May, 2023. Two reviewers independently screened the literature, extracted data and assessed risk of bias of the included studies. Meta-analysis was performed by R 4.2.2 software. ResultsA total of 19 cohort studies involving 63 624 elderly were included. The results of meta-analysis showed that compared with healthy elder, the elder with cognitive frailty had a higher mortality (OR=2.75, 95%CI 2.10 to 3.59, P<0.01) and hospitalization (OR=1.67, 95%CI 1.40 to 2.00, P<0.01). Subgroup analysis showed that cognitive frailty was related to the risk of death in different status of frailty and cognitive function, different assessment tools, different countries of development, different follow-up time and research sites. At the same time, different status of frailty and cognitive function and different levels of development of countries were related to the risk of hospitalization. ConclusionCurrent evidence shows that cognitive frailty can increase the risk of hospitalization and mortality in the elderly. It is suggested that early screening and intervention of cognitive frailty should be carried out to effectively reduce the risk of adverse consequences, so as to achieve healthy aging.