Frailty syndrome and cognitive impairment in older adults: systematic review of the literature.
Karen Miyamura, Jack Roberto Silva Fhon, Alexandre de Assis Bueno and 3 others
PMID 31664410WHAT IT FOUND
The pooled results were mixed.
Frail older adults were 1.24 times more likely to have cognitive decline in one analysis, but another analysis did not show a significant association.
Key findings
01One pooled analysis found frail older adults were 1.24 times more likely to have cognitive decline.
02A separate pooled relative-risk analysis did not show a significant association (RR 1.14; 95%CI 0.96-1.35).
03The review included eleven prospective observational studies of 12,656 older adults.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for RNs
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What it does not show
All included studies were observational, so they show association, not that frailty causes cognitive decline. Frailty and cognitive decline were defined and measured differently across studies, which makes the results hard to compare. The relative-risk meta-analysis used values that may not have been adjusted for other variables. Quality assessment with MINORS scored 9.2 points overall, and the endpoint assessment item was not described. The included older adults all lived in houses, so the findings may not apply to hospitalized or nursing-home patients. Gender analysis was based on 10,612 older adults because one study lacked gender data and another assessed only women.
The easy way to misread this
Do not read this as proof that frailty causes cognitive decline. The included studies were observational, the pooled relative-risk analysis was not significant, and the authors state cause and effect cannot be established.