Holland Carol A, Dravecz Nikolett, Broughton Susan, Barker Lynne A, Bature Fidelia, Clarke Charlotte, Danat Isaac M, Das Sayani, Dias Irundika H K, Dawson Annabel, Dixon M, Ellison Amanda, Façal David, Finch Roland, Gaffney Christopher J, Gow Alan, Kelaiditi Eirini, Klimczuk Andrzej, Navarro-Pardo Esperanza, Sharratt Pheobe, Sixsmith Andrew, Suemoto Claudia K, Suprawesta Lalu, Watermeyer Tamlyn, Fowler Davis Sally
Centre for Ageing Research (C4AR), Lancaster University, Lancaster, United Kingdom.
Division of Health Research, Lancaster University, Lancaster, United Kingdom.
Front Aging Neurosci. 2025 Jun 4;17:1541048. doi: 10.3389/fnagi.2025.1541048. eCollection 2025.
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.
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.
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.
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.
身体虚弱与无痴呆的认知障碍同时存在被称为认知衰弱（CF）。有迹象表明CF可能是可逆的，这促使人们提出，CF的风险因素、症状或机制将是预防、延缓或逆转干预措施的合适目标。然而，尚无研究将各部门的专家聚集在一起，以确定干预措施的目标、内容或模式，而且大多数干预措施方面的资源仅来自学术或临床研究人员的视角。这项国际德尔菲共识研究汇聚了来自学术和临床研究领域的专家、有CF实际生活经验的非专业人士、非正式护理人员以及专业护理从业者/临床医生。
开展了三轮德尔菲研究，以辨别整个样本达成共识的因素和陈述，以及在不同专业背景的人群中产生不同观点的因素和陈述。进行了一次范围综述并开展第一轮研究（29名参与者）以收集初始陈述。在第二轮研究中，58人对陈述和开放式文本项目做出了回应，其中包括7名实验室研究人员、27名从事与人相关研究的人员、14名有实际生活经验者或非正式家庭护理人员以及10名专业护理人员/临床医生。对达成一致的百分比和定性回复进行了分析，以提供一组最终陈述，这些陈述在第三轮研究中由38名受访者进行了核查。
对第二轮定量数据的分析提供了74条至少有70%的人达成一致的陈述，定性数据又产生了另外24条陈述。这些陈述合并后为第三轮研究提供了90条陈述。其中89条陈述达成了共识。在两个阶段都观察到了不同群体之间的一些差异。
与CF干预措施相关的陈述达成的共识为界定健康促进活动和干预措施提供了有益的第一步。鉴于CF在老年人群中的患病率以及由此导致的潜在残疾，这些共识陈述代表了跨部门的专家意见，将为支持实施循证预防和干预计划的公共卫生政策提供参考。本研究从一开始就纳入了所有利益相关者，是朝着改变当前方法迈出的重要一步。研究结果可用于为共同创建认知衰弱干预措施提供参考。
