Modifiable Risk Factors for Cognitive Frailty in Older Chinese Patients With Diabetes: A Systematic Review and Meta‐Analysis

ABSTRACT To perform a systematic review and meta‐analysis clarifying potential modifiable risk factors for cognitive frailty in older Chinese persons with diabetes. We conducted a comprehensive search across four English and four Chinese databases, spanning from 1980 to May 2024. The aim was to identify studies that investigate potential modifiable risk factors for cognitive frailty in older patients with diabetes. Meta‐analysis was performed using Stata16.0. Out of the 237 records identified, 19 studies met the inclusion criteria and were consequently included for analysis. The results of the meta‐analysis revealed that the prevalence of cognitive frailty among older patients with diabetes was 22.2% (95% confidence interval [CI]: 0.177−0.270, I 2 = 93.92%). Depression (OR = 3.18, 95% CI: 2.19−4.62, I 2 = 79.6%), HbA1c (OR = 2.18, 95% CI: 1.66−2.85, I 2 = 41.5%) and malnutrition (OR = 4.04, 95% CI: 1.58−10.34, I 2 = 95.0%) were significantly associated with cognitive frailty in this population. Regular exercise (OR = 0.30, 95% CI: 0.11−0.84, p < 0.01, I 2 = 87.3%) and higher education (OR = 0.30, 95% CI: 0.16−0.58, p < 0.01, I 2 = 69.7%) are identified as protective factors against cognitive frailty. This systematic review and meta‐analysis demonstrates that interventions targeting depression, HbA1c level, malnutrition, exercise and education can effectively reduce the risk of cognitive frailty in older patients with diabetes.