Abstract
Those living with coexistent frailty and cognitive impairment are at risk of poorer health outcomes. Research often focuses on identifying biological factors. This review sought to identify the association psychological and social factors have with coexisting physical and cognitive decline. Six databases were systematically searched in July 2020. Studies included individuals aged 60 years or older identified as being both frail and cognitively impaired. A narrative synthesis examined patterns within the data. Nine studies were included, most employed a cross-sectional design. Depression was investigated by all nine studies, those with coexistent frailty and cognitive impairment had higher levels of depressive symptoms than peers. Findings were mixed on social factors, although broadly indicate lower education, living alone and lower material wealth were more frequent in those living with coexistent decline. Further research is needed to explore potentially modifiable psychological and social factors which could lead to the development of supportive interventions.
Highlights
Increases to life expectancy have led to elevated risk of agerelated illness and associated disability (Lunenfeld & Stratton, 2013)
Aim: The aim of this review is to identify, and evaluate the quality of, existing evidence regarding the nature and impacts of psychological and social factors in people living with coexistent frailty and cognitive impairment
Studies were undertaken with those living in the community, recruitment was through hospital clinics in two studies (Aguilar-Navarro et al, 2019; Wu et al, 2020)
Summary
Increases to life expectancy have led to elevated risk of agerelated illness and associated disability (Lunenfeld & Stratton, 2013). Ensuring healthy ageing is a priority for both healthcare providers and policy makers worldwide (WHO, 2015) This includes improved understanding of factors linked to age-related illness and improving healthcare provision for older people (WHO, 2015). Social inequalities and psychosocial factors may play a role in this chronological discrepancy given there is an established association with poor health outcomes across the life course and into old age (Braveman & Gottlieb, 2014). To address these inequalities in age-related health, the focus has been on identifying factors linked to poorer outcomes that might be amendable by intervention to promote healthy ageing. One area of interest is the identification and support of those living with frailty (Vernon, 2020)
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