Prevalence of cognitive frailty among Chinese older adults: A systematic review and meta-analysis

BACKGROUND AND PURPOSE: With China's aging population, the prevalence of cognitive frailty (CF) is increasing, posing significant risks such as reduced quality of life, higher hospitalization and mortality rates, cognitive impairment, and dementia. This study aimed to determine the prevalence of CF among Chinese older adults through a systematic review and meta-analysis to provide evidence that informs healthcare policy and practice. METHODS: A systematic search was conducted across eight databases: PubMed, Web of Science, Embase, the Cochrane Library, CNKI, WanFang, VIP, and SinoMed from their inception up to April 5, 2024. Observational studies (cross-sectional, cohort, or population-based longitudinal studies) were included. Two researchers independently reviewed the literature, extracted data, and assessed the quality of the studies. All statistical analyses were performed using Stata 14.2. RESULTS: A total of 79,059 records were screened, of which 93 studies involving 89,760 Chinese older adults met the inclusion criteria. The pooled CF prevalence was determined to be 21 % (95 % CI: 0.19, 0.23, P < 0.001). Notably, CF prevalence varied significantly across subgroups, depending on variables such as age, gender, education, marital status, living arrangements, presence of hypertension, presence of diabetes, BMI, history of falls, nutritional status, sleep condition, exercise, activities of daily living, polypharmacy, and presence of depressive symptoms (all P < 0.001). CONCLUSIONS: This study revealed a pooled CF prevalence of 21 % among Chinese older adults, with a concerning upward trend from 2012 to 2023. The CF prevalence was influenced by demographic, health, and lifestyle factors. These findings underscore the complexity of CF and highlight the need to identify key risk and protective factors, as well as to develop targeted interventions that address both health and lifestyle factors in this population.