Neurocognitive Frailty Index as a Predictor of Cognitive Function: An Opinion Letter

Frailty can be defined as a dynamic age-related vulnerability emanating from multidimensional loss of energy, physical status, cognitive functioning, and general health reserves. This multifaceted state of being renders an individual prone to adverse life outcome relative to individuals who are, i.e., more physically fit. In the elderly individuals, a clinically detectable syndrome, this state tends to phenotypically manifest by the presence of 3 or more of the following symptoms, including weight loss of 10 lbs in the past year, self-reported exhaustion, weakness (e.g., grip strength), slow walking speed, and low physical activity [1]. The evidence emerging from the Canadian Health Measures Study of general population (cycles 1-3; n = 10,995, age ranging between 18-79) shows that the prevalence of frailty, using two different approaches, was between 1.8-5.3% in the 18-34 age group, 4.3-5.7% in the 35- 49 age group, 6.9-11.6% in the 50-64 age group, and 7.8-20.2% in the 65+ age group [2]. Additionally, a systematic review and meta-analysis of 47 studies, conducted in 2017, emerging from low-income and middle-income countries, examining the rate of prevalence of frailty in community-dwelling older adults aged ≥60 years, found a pooled prevalence of 17.4% [3]. This knowledge points at the high heterogeneity across studies on how the frailty status were obtained, and that younger adults are at higher risk for frailty than commonly recognized as a geriatric syndrome. This in turn informs of an important window for treatment and prevention implementation, when frailty correlates with other latelife related conditions such as cognitive aging, Alzheimer’s disease or Vascular dementia.