Cognitive Frailty Interdisciplinary Network (CFIN)

Cognitive frailty is the simultaneous presence of physical frailty and age-related cognitive impairment, and affects around 9% of older people. It is reversible and preventable, but is commonly ‘explained away’ and left untreated, which increases the risk of dementia, falls, and loss of independence among those experiencing it.

Efforts to understand and build policy around cognitive frailty through a public health response and healthy ageing could therefore reduce risks of severe physical frailty and serious long-term conditions. Research and interventions in this area are also important for anticipating the needs of, and maximising health and quality of life among our increasing older population.

Findings and recommendations

The Network’s key findings and recommendations centred around environmental risk factors – deprivation, social alienation, loss of community assets, and air pollution – as the incidence of cognitive frailty was found to be significantly associated with these.

The Network therefore recommended a collective, local-level prevention strategy run by integrated care systems. This would involve screening for environmental risk factors, as well as biological/psychological markers of deterioration in processing speed and cognitive function.

It also recommended the promotion of positive messages about healthy ageing among healthcare professional workforces and in the community, challenging the convention of accepting increased cognitive frailty as an inevitable part of the ageing process, and ‘nudging’ older people to engage in self-care and participate in physical and social activities.

As a collaboration between five universities, the outputs of this project represent a strong basis for implementing new ways of working at policy and strategic level, and dissemination of information, which is ongoing.

The Network sent its consensus paper to more than 600 Integrated Care Board leaders and Directors of Public Health with direct responsibility for prevention and wellbeing across health and care systems. Impact will be measured in terms of health impact assessments undertaken using the combination of metrics suggested to evaluate the likelihood of cognitive frailty.

The Network’s focus on assessing the wider determinants of health and the impact of air quality, green spaces, and social cohesion aligns with the NHS Green Planning concerning population health outcomes. It is hoped that further funding will be available to continue with international and national research activities that extend our understanding of the causes and consequences of climate change in relation to health risk and resilience.