Cognitive frailty: a useful concept or a source of confusion? Insights from a survey of European geriatricians

Abstract Background This report examines how European geriatricians understand the concept of ‘cognitive frailty’, which was first formally defined by the International Academy on Nutrition and Aging (IANA) and the International Association of Gerontology and Geriatrics (IAGG) in 2013. Methods An on...

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Main Authors: Suzanne Timmons, Mary Faherty, Catriona Curtin, Maria Cristina Ferrara, Giuseppe Bellelli, Enrico Brunetti, Mario Bo, Alessandro Morandi, Antonio Cherubini, Massimiliano Fedecostante, Alessandra Coin, Susan D. Shenkin, Pinar Soysal
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Geriatrics
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Online Access:https://doi.org/10.1186/s12877-025-05930-9
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author Suzanne Timmons
Mary Faherty
Catriona Curtin
Maria Cristina Ferrara
Giuseppe Bellelli
Enrico Brunetti
Mario Bo
Alessandro Morandi
Antonio Cherubini
Massimiliano Fedecostante
Alessandra Coin
Susan D. Shenkin
Pinar Soysal
author_facet Suzanne Timmons
Mary Faherty
Catriona Curtin
Maria Cristina Ferrara
Giuseppe Bellelli
Enrico Brunetti
Mario Bo
Alessandro Morandi
Antonio Cherubini
Massimiliano Fedecostante
Alessandra Coin
Susan D. Shenkin
Pinar Soysal
author_sort Suzanne Timmons
collection DOAJ
description Abstract Background This report examines how European geriatricians understand the concept of ‘cognitive frailty’, which was first formally defined by the International Academy on Nutrition and Aging (IANA) and the International Association of Gerontology and Geriatrics (IAGG) in 2013. Methods An online survey about delirium, dementia and frailty relationships and pathways was distributed across Europe through appropriate professional groups. Eligible participants were geriatricians or trainees in their final two years of specialist geriatric training, in a European country. Snowball sampling was used. In total, 440 people replied to the survey, of which 324 responded to the section on cognitive frailty. Respondents were predominantly female and there was a marked under-representation of Eastern European participants. Results From a list of possible definitions, only one in four of the 324 respondents identified cognitive frailty as defined by the IANA and the IAGG, i.e., a combination of physical frailty and mild cognitive impairment. Almost two thirds of those who stated that they currently use the term in their work did not choose the IANA-IAGG definition. After the definition was shared with respondents, only 44% strongly agreed with it as an apt description of cognitive frailty, with some considering it too narrow (by omitting delirium and dementia) while others considered it too broad (by including physical frailty). Conclusions There is no clear consensus opinion among geriatricians in Europe on the definition of ‘cognitive frailty’. While there is some core support for the IANA-IAGG definition, it is not intuitive to those not already familiar with the term. The variance in the current understanding of cognitive frailty among geriatricians suggests the time is right for a meaningful debate on this issue. While there is ongoing, growing research on a shared pathophysiology between physical frailty and cognitive impairment, further studies are required to evaluate the added benefit of this particular conceptual theorization in older persons care rather than its single components, and if beneficial, how awareness, understanding and correct usage of the concept can be improved.
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spelling doaj-art-5ebdf651e8a64ea6b7abd3b3605487802025-08-20T02:28:42ZengBMCBMC Geriatrics1471-23182025-04-012511710.1186/s12877-025-05930-9Cognitive frailty: a useful concept or a source of confusion? Insights from a survey of European geriatriciansSuzanne Timmons0Mary Faherty1Catriona Curtin2Maria Cristina Ferrara3Giuseppe Bellelli4Enrico Brunetti5Mario Bo6Alessandro Morandi7Antonio Cherubini8Massimiliano Fedecostante9Alessandra Coin10Susan D. Shenkin11Pinar Soysal12Centre for Gerontology and Rehabilitation, University College CorkCentre for Gerontology and Rehabilitation, University College CorkCentre for Gerontology and Rehabilitation, University College CorkSchool of Medicina and Surgery, University of Milano-BicoccaSchool of Medicina and Surgery, University of Milano-BicoccaSection of Geriatrics, Department of Medical Sciences, University Hospital Città della Salute e della ScienzaSection of Geriatrics, Department of Medical Sciences, University Hospital Città della Salute e della ScienzaDepartment of Clinical and Experimental Science, University of BresciaGeriatria, Accettazione Geriatrica e Centro di Ricerca per l’Invecchiamento, IRCCS INRCAGeriatria, Accettazione Geriatrica e Centro di Ricerca per l’Invecchiamento, IRCCS INRCAGeriatrics Unit, Department of Medicine, Azienda Ospedale – Università Padova, University of PadovaAgeing and Health Research Group, Usher Institute, University of EdinburghDepartment of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif UniversityAbstract Background This report examines how European geriatricians understand the concept of ‘cognitive frailty’, which was first formally defined by the International Academy on Nutrition and Aging (IANA) and the International Association of Gerontology and Geriatrics (IAGG) in 2013. Methods An online survey about delirium, dementia and frailty relationships and pathways was distributed across Europe through appropriate professional groups. Eligible participants were geriatricians or trainees in their final two years of specialist geriatric training, in a European country. Snowball sampling was used. In total, 440 people replied to the survey, of which 324 responded to the section on cognitive frailty. Respondents were predominantly female and there was a marked under-representation of Eastern European participants. Results From a list of possible definitions, only one in four of the 324 respondents identified cognitive frailty as defined by the IANA and the IAGG, i.e., a combination of physical frailty and mild cognitive impairment. Almost two thirds of those who stated that they currently use the term in their work did not choose the IANA-IAGG definition. After the definition was shared with respondents, only 44% strongly agreed with it as an apt description of cognitive frailty, with some considering it too narrow (by omitting delirium and dementia) while others considered it too broad (by including physical frailty). Conclusions There is no clear consensus opinion among geriatricians in Europe on the definition of ‘cognitive frailty’. While there is some core support for the IANA-IAGG definition, it is not intuitive to those not already familiar with the term. The variance in the current understanding of cognitive frailty among geriatricians suggests the time is right for a meaningful debate on this issue. While there is ongoing, growing research on a shared pathophysiology between physical frailty and cognitive impairment, further studies are required to evaluate the added benefit of this particular conceptual theorization in older persons care rather than its single components, and if beneficial, how awareness, understanding and correct usage of the concept can be improved.https://doi.org/10.1186/s12877-025-05930-9Cognitive frailtyFrailtyCognitive impairmentDeliriumDementia
spellingShingle Suzanne Timmons
Mary Faherty
Catriona Curtin
Maria Cristina Ferrara
Giuseppe Bellelli
Enrico Brunetti
Mario Bo
Alessandro Morandi
Antonio Cherubini
Massimiliano Fedecostante
Alessandra Coin
Susan D. Shenkin
Pinar Soysal
Cognitive frailty: a useful concept or a source of confusion? Insights from a survey of European geriatricians
BMC Geriatrics
Cognitive frailty
Frailty
Cognitive impairment
Delirium
Dementia
title Cognitive frailty: a useful concept or a source of confusion? Insights from a survey of European geriatricians
title_full Cognitive frailty: a useful concept or a source of confusion? Insights from a survey of European geriatricians
title_fullStr Cognitive frailty: a useful concept or a source of confusion? Insights from a survey of European geriatricians
title_full_unstemmed Cognitive frailty: a useful concept or a source of confusion? Insights from a survey of European geriatricians
title_short Cognitive frailty: a useful concept or a source of confusion? Insights from a survey of European geriatricians
title_sort cognitive frailty a useful concept or a source of confusion insights from a survey of european geriatricians
topic Cognitive frailty
Frailty
Cognitive impairment
Delirium
Dementia
url https://doi.org/10.1186/s12877-025-05930-9
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