Interventions for cognitive frailty: developing a Delphi consensus with multidisciplinary and multisectoral experts

Carol A. Holland*, Nikolett Dravecz, Susan Broughton, Lynne A. Barker, Fidelia Bature, Charlotte Clarke, Isaac M. Danat, Sayani Das, Irundika H. K. Dias, Annabel Dawson, M. Dixon, Amanda Ellison, David Façal, Roland Finch, Christopher J. Gaffney, Alan Gow, Eirini Kelaiditi, Andrzej Klimczuk, Esperanza Navarro-Pardo, Pheobe SharrattAndrew Sixsmith, Claudia K. Suemoto, Lalu Suprawesta, Tamlyn Watermeyer, Sally Fowler Davis

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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 analyzed 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 toward changing current approaches, by including all stakeholders from the outset. Outcomes can be used to feed into co-creation of interventions for cognitive frailty.
Original languageEnglish
Article number1541048
Number of pages21
JournalFrontiers in Aging Neuroscience
Volume17
Early online date4 Jun 2025
DOIs
Publication statusPublished - 4 Jun 2025

Bibliographical note

Copyright © 2025 Holland, Dravecz, Broughton, Barker, Bature, Clarke, Danat, Das, Dias, Dawson, Dixon, Ellison, Façal, Finch, Gaffney, Gow, Kelaiditi, Klimczuk, Navarro-Pardo, Sharratt, Sixsmith, Suemoto, Suprawesta, Watermeyer and Fowler Davis. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

Keywords

  • multidisciplinary
  • intervention
  • expert consensus
  • multi-sectoral
  • Delphi study
  • cognitive frailty (CF)

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