Management Of Frailty Research Articles

Frailty recommendations and guidelines: an evaluation of the implementability and a critical appraisal of clinical applicability by the ISPRM Frailty Focus Group.

Aging is associated with an increased burden of multi-morbidity and disease related functional loss and disability, widely impacting patients and health care systems. Frailty is a major actor in age-related disability and is an important target for rehabilitation interventions, considering that is a reversible condition. A working group of members of the ISPRM, responding to WHO 2030 call for action to strengthen rehabilitation, was established to assess the quality and implementability of the existing guidelines for the rehabilitation of frailty. Guidelines were retrieved using a systematic search on Pubmed, Scopus and Web of Science and from the reference lists of screened articles. The included guidelines were evaluated using the AGREE II to assess their quality and using the AGREE-REX to assess their clinical credibility and implementability. Guidelines with a score >4 in the AGREE II item evaluating the overall quality of the guideline were considered for endorsement. Finally, nine external reviewers evaluated the applicability of each recommendation from the endorsed guidelines, providing comments about the barriers and facilitators for their implementation in their country. Ten guidelines were retrieved and evaluated by the working group, of which four guidelines, i.e. the WHO Guidelines on Integrated Care for Older People, the FOCUS guidelines, the Asia-Pacific Clinical Practice Guidelines for the Management of Frailty and the ICFSR International Clinical Practice Guidelines for Identification and Management of Frailty, were considered for endorsement. All these guidelines were rated as of adequate quality and implementability. The WHO Guidelines on Integrated Care for Older people (24) the ICFSR International Clinical Practice Guidelines for Identification and management of Frailty (15), the FOCUS guidelines (25) and the Asia Pacific Clinical Practice Guidelines (14) for the Management of Frailty have the best quality and applicability of the existing guidelines on the management of frailty, we suggest that should be employed to define the standards of care for patients with frailty. There are barriers for their implementation, as stated by our experts, to take into account, and some of them are country- or region-specific. Screening for frailty, exercise, nutrition, pharmacological management, social and psychological support, management of incontinence, and an overall comprehensive clinical management are the best tools to face upon frailty.

Socioeconomic support, quality of life, and prognosis of frailty among the older adults

AbstractBackgroundAlthough socioeconomic support is recommended for frailty management, its association with the prognosis of frailty is unclear.MethodsUsing data from participants aged ≥65 years in the Chinese Longitudinal Healthy Longevity Survey (2008–2018), the associations between socioeconomic support (source of income, medical insurance, community support, living status), onset of prefrailty/frailty, and worsening of prefrailty, were analyzed using multinominal logistic regression models. The associations between self‐reported low quality of life (QoL) and reversion of prefrailty/frailty were analyzed using multivariate logistic regression models. Associations with mortality risk were analyzed using Cox proportional hazard regression models.ResultsA total of 13,859 participants (mean age: 85.8 ± 11.1 years) containing 2056 centenarians were included. Financial dependence was a risk factor for low QoL among prefrail/frail individuals, but not among robust individuals. Having commercial or other insurance, and receiving social support from the community were protective factors for low QoL among prefrail/frail individuals and for the worsening of prefrailty. Continuing to work was a risk factor for low QoL, but a protective factor for worsening of prefrailty. A negative association between continuing to work and mortality existed in prefrail individuals aged <85 years and ≥85 years. Living alone was a risk factor for low QoL, but was not significantly associated with frailty prognosis.ConclusionsPrefrail and frail individuals were vulnerable to changes in socioeconomic support and more sensitive to it compared with robust individuals. Preferential policies regarding financial support, social support, and medical insurance should be developed for individuals with frailty.

The Frailty Reduction via Implementation of Exercise, Nutrition, and Deprescribing (FRIEND) Trial: Study Protocol and Recruitment Results.

Virtually all adults in aged care facilities are frail, a condition which contributes to falls, cognitive decline, hospitalisation, and mortality. Polypharmacy, malnutrition, sedentariness, and sarcopenia are risk factors amenable to intervention. The Asia-Pacific Frailty Management Guidelines recommend anabolic exercise and the optimisation of medications and nutrition. However, no study has evaluated this best practice intervention triad in aged care. The Frailty Reduction via the Implementation of Exercise, Nutrition, and Deprescribing (FRIEND) Trial (ANZCTR No.ACTRN12622000926730p) is a staged 6-month translational trial evaluating resident outcomes, staff/caregiver knowledge, and institutional implementation in a Townsville aged care facility. Residents received high-intensity resistance exercise and balance training and medication and nutrition optimisation co-implemented by investigators (exercise physiologist, geriatrician, pharmacist, and nutritionist) and facility staff. Staff and caregivers completed comprehensive education modules and training. We report the trial protocol and recruitment results. 29 residents (21 female, age: 88.6 ± 6.3 years) were recruited. At baseline, the residents were frail (frailty scale nursing home (FRAIL-NH); 6.3 ± 2.4/14), cognitively impaired (Montreal Cognitive Assessment; 13.8 ± 6.8/30), functionally impaired (Short Physical Performance Battery; 4.9 ± 3.1/12, 6 min walk distance; 222.2 ± 104.4 m), and were prescribed numerous medications (15.5 ± 5.9). Two residents died and one withdrew before the intervention's commencement. Thirty family members and 19 staff (carers, allied health assistants, nurse managers, registered nurses, lifestyle-leisure officers, kitchen/hospitality staff, and senior leadership) were recruited to receive frailty education modules. The FRIEND trial is currently being implemented with results expected in mid-2024. This is the first trial to evaluate the implementation of the best practice frailty guidelines including anabolic exercise and medication/nutritional optimisation in residential aged care.

Definition, assessment and management of frailty for people with intellectual disabilities: A scoping review.

People with intellectual disabilities may experience frailty earlier than the general population. This scoping review aimed to investigate how frailty is defined, assessed, and managed in adults with an intellectual disability; factors associated with frailty; and the potential impact of COVID-19 on frailty identification and management. Databases were searched from January 2016 to July 2023 for studies that investigated frailty in individuals with intellectual disabilities. Twenty studies met the inclusion criteria. Frailty prevalence varied between 9% and 84%. Greater severity of intellectual disability, presence of Down syndrome, older age, polypharmacy, and group home living were associated with frailty. Multiagency working, trusted relationships and provision of evidence-based information may all be beneficial in frailty management. Frailty is common for people with intellectual disabilities and is best identified with measures specifically designed for this population. Future research should evaluate interventions to manage frailty and improve lives.

What Does Cochrane Say About Assessment and Management of Frailty Among Older Adults?

What Does Cochrane Say About Assessment and Management of Frailty Among Older Adults?

Frailty and nutrition.

As the ageing population grows and forms a significant category of over 65s in many societies, along with it comes the risk of developing physical and psychological degenerative changes. This presents many challenges for health and social care services in not only identifying those at risk but also managing that risk to try to preserve health and independence for as long as possible. Screening for frailty has supported services to identify those that may be at risk of hospitalisation, requiring long term care or support services at home in older age. Frailty can be exacerbated by the risk of nutritional deficiencies and more severe malnutrition. Therefore, screening for frailty should also include a nutritional assessment, which can be supported by a recognition of the need for nutritional support along with other holistic frailty management.

Virtual wards for people with frailty: what works, for whom, how and why-a rapid realist review.

Virtual wards (VWs) deliver multidisciplinary care at home to people with frailty who are at high risk of a crisis or in crisis, aiming to mitigate the risk of acute hospital admission. Different VW models exist, and evidence of effectiveness is inconsistent. We conducted a rapid realist review to identify different VW models and to develop explanations for how and why VWs could deliver effective frailty management. We searched published and grey literature to identify evidence on multidisciplinary VWs. Information on how and why VWs might 'work' was extracted and synthesised into context-mechanism-outcome configurations with input from clinicians and patient/public contributors. We included 17 peer-reviewed and 11 grey literature documents. VWs could be short-term and acute (1-21days), or longer-term and preventative (typically 3-7months). Effective VW operation requires common standards agreements, information sharing processes, an appropriate multidisciplinary team that plans patient care remotely, and good co-ordination. VWs may enable delivery of frailty interventions through appropriate selection of patients, comprehensive assessment including medication review, integrated case management and proactive care. Important components for patients and caregivers are good communication with the VW, their experience of care at home, and feeling involved, safe and empowered to manage their condition. Insights gained from this review could inform implementation or evaluation of VWs for frailty. A combination of acute and longer-term VWs may be needed within a whole system approach. Proactive care is recommended to avoid frailty-related crises.

Screening of Hospitalized Elderly Patients for Frailty and Associated Co-morbid Conditions in Western Gujarat in India.

Older patients admitted to hospitals have a greater impact on the healthcare system as the population ages. The relationship between the recovery of functional impairments and frailty status in geriatric care units is still not clear. Simple screening technologies are required in order to operationalize frailty management in this susceptible population due to these restrictions. Aim: The study aims to screen hospitalized older adults for frailty and associated co-morbid conditions in western Gujarat, India. This is an institutionally based cross-sectional study conducted on the elderly patients (aged 60 years or more) admitted at the tertiary-level government hospital of Jamnagar District of Gujarat State during the period of October 22 to December 22. The assessment was done with a structured questionnaire for FRAIL screen, the Rapid Cognitive Screen (RCS), Charles Co-morbidity Index, Geriatric Depression Scale-5 (GDS-5), and Short Form-12 (SF-12) Health Survey. The overall findings of this study reveal that of 124 participants 34 (27%) were frail, 52 (42%) were found to be a likelihood of depression by the GDS, and 29 (23%) were having dementia by RCS, respectively. In our study, we also found a statistically significant association between frailty and dementia (P value < 0.001). The present study implies the prevalence of frailty among old age elderly patients and its association with various socio-demographic and co-morbid conditions of the participants. Early identification of frailty and co-morbid conditions can help to prevent adverse health outcomes.

The role of speech-language pathologists in frailty: An Australian qualitative study of perceptions, practices, and opportunities

Purpose Frailty is an important geriatric syndrome, yet the role of speech-language pathologists (SLPs) in identifying and managing frailty remains unclear. The purpose of this study was to explore the perspectives of SLPs regarding frailty, including enablers, barriers, and opportunities for multidisciplinary improvements to frailty prevention and management. Method In this exploratory qualitative study, data were collected from SLPs through online semi-structured interviews and analysed using a qualitative descriptive approach. Result Seven Australian SLPs from acute, rehabilitation, geriatric, and community settings were interviewed. Three overarching themes were created: (1) SLPs understand the clinical manifestation of frailty but do not use explicit language to describe it; (2) SLPs acknowledged the importance of addressing knowledge gaps and barriers in frailty management; and (3) SLPs do not currently have an established identity within the frailty field, but do have a role within the multidisciplinary team and the care of people living with frailty. Conclusion Participants’ understandings of frailty varied and highlighted the lack of education about frailty as barriers to effective service provision. Additional research is required to produce formal recommendations for SLPs regarding frailty management, which may include frailty education to SLPs and awareness of SLPs’ role within the multidisciplinary team.

Relation between frailty and adverse outcomes in elderly patients with gastric cancer: a scoping review.

Playing an exemplary role, frailty have crucial effect on the preoperative evaluation of elderly patients. Previous studies have shown that frailty is associated with complications and mortality in patients with gastric cancer (GC). However, with the development of the concept of "patient-centered", the range of health-related outcomes is broad. The differences in relation between frailty and various adverse outcomes will be further explored. The PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wan Fang, and Chinese Biomedical Literature databases were searched for keywords, including frailty (such as frail) and gastric cancer (such as stomach neoplasms or stomach cancer or gastrectomy or gastric surgery). The search period is until August 2023. The included studies were observational or cohort studies with postoperative related adverse outcomes as primary or secondary outcome measures. Valid assessment tools were used. The Quality Assessment Tool for Observational Cohort and Cross-sectional Studies was used to assess methodological quality in the included literature. Fifteen studies were included, including 4 cross-sectional studies, 8 retrospective cohort studies, and 3 prospective cohort studies. Among them, 6 studies were rated as "Good" and 9 studies were rated as "Fair," indicating that the quality of the literature was high. Then, 10 frailty assessment tools were summarized and classified into two broad categories in accordance with frailty models. Results of the included studies indicated that frailty in elderly patients with GC was associated with postoperative complications, mortality, hospital days, readmissions, quality of life, non-home discharge, and admission to the intensive care unit. This scoping review concludes that high levels of preoperative frailty increase the risk of adverse outcomes in elderly patients with GC. Frailty will be widely used in the future clinical evaluation of elderly gastric cancer patients, precise risk stratification should be implemented for patients, and frailty management should be implemented well to reduce the occurrence of adverse treatment outcomes.

Summary of best evidence for prevention and management of frailty.

Frailty in older people can seriously affect their quality of life and increase the demand for long-term care and health care expenses. Aims of this study are to provide an evidence-based basis for clinical practice of frailty in older people by systematically searching for the best current evidence on interventions for the prevention and management of frailty. According to the '6S' evidence resource model, evidence retrieval is searched from the top-down and collected relevant guidelines, best practices, evidence summaries, systematic reviews and expert consensus. The retrieval time limit was from the database establishment to 20 March 2023. Two reviewers independently screened and evaluated the literature, and then extracted and summarised the evidence according to the JBI grading of evidence and recommendation system. A total of 44 publications were finally included, including 12 guidelines, 5 best practices, 4 expert consensus, 5 evidence summaries and 18 systematic reviews. Through the induction and integration of the evidence, the evidence was finally summarised from eight aspects: frailty screening, frailty assessment, exercise intervention, nutrition intervention, multi-domain intervention, drug administration, social support and health education, and 43 best evidences were formed. This study summarised the best evidence for the prevention and management of frailty from eight aspects, which can provide guidance for clinical or community medical staff to develop and apply frailty intervention and practice programmes for older people and improved the clinical outcome and quality of life of older people.

Differences in Functional Capacity between Oncologic and Non-Oncologic Populations: Reference Values

This study is focused on the fact that in the context of increasing global aging and cancer diagnoses, additional challenges arise in clinical care. Adequate functionality and body composition are key to coping with antineoplastic treatment, which can lead to better treatment tolerance, survival, and quality of life. This is a cross-sectional comparative study focused on the assessment and comparison of body composition and functionality between cancer patients and a reference population, with the aim of establishing meaningful baseline values. Techniques such as manual dynamometry, the Five-Times Sit-to-Stand test, and bioimpedance were used to collect data from 374 oncologic patients and 1244 reference individuals. The results reveal significant disparities in functionality and body composition among participants, and provide age group-specific adjusted baseline values for those diagnosed with cancer. These findings may have crucial clinical implications for applying particular cut-off points designed for this population group, which makes the assessment process faster and more accurate, enhances the capacity of medical personnel to act quickly, and improves the management of frailty in cancer patients.

Perceptions of Frailty and Prehabilitation Among Thoracic Surgeons: Findings From a National Survey

BackgroundFrailty is associated with increased perioperative morbidity and mortality. How thoracic surgeons recognize, measure, and mitigate frailty in their daily clinical practice is unknown. We administered a national survey to determine the current practices of thoracic surgeons managing frail patients. MethodsA 144-question survey developed in collaboration with the University of Chicago Survey Lab was sent to CTSnet.org members who identified as general thoracic surgeons, practiced in the United States, and had publicly available emails. Responses were collected from August 12 to September 11, 2022. Both fully and partially (at least 20%) completed surveys were included in a descriptive statistical analysis. ResultsAfter 2796 surveys were administered, 342 surgeons responded. Surgeons were in practice a median of 23 years (range, 1-50 years) at academic (63.4% [187/295]) or community (36.6% [108/295]) centers. Most surgeons believed it important to assess frailty preoperatively (83.9% [287/342]), but only 28% (97/342) of surgeons performed routine frailty assessment. Barriers to routine frailty assessment included lack of tools (80.0% [32/40]), training (59.0% [23/39]), and staffing (56.4% [22/39]). Whereas most surgeons believed that frailty could be mitigated (72.2% [247/342]), only 49.5% (156/315) prescribed prehabilitation. Up to 78.7% (203/263) of surgeons would delay or cancel surgery for patient frailty, depending on disease cause. ConclusionsThoracic surgeons recognize that frailty is an established risk factor for perioperative morbidity and mortality; however, there is high variability in diagnosis and management of frailty. Guidelines are needed to establish best practices for screening and mitigation to optimally treat frail patients.

Application of the (fr)AGILE scale in the evaluation of multidimensional frailty in elderly inpatients from internal medicine wards: a cross-sectional observational study.

With the rapid growth of an aging global population and proportion, the prevalence of frailty is constantly increasing. Therefore, finding a frailty assessment tool suitable for clinical application by physicians has become the primary link in the comprehensive management of frailty in elderly patients. This study used the (fr)AGILE scale to investigate the frailty status of elderly patients from internal medicine wards and identified relevant factors that affect the severity of frailty. In this study, 408 elderly inpatients in internal medicine departments of Qilu Hospital of Shandong University from May 2021 to August 2022 were enrolled as research subjects, and a cross-sectional observational study was conducted. Researchers evaluated the frailty based on the (fr)AGILE scale score. The general condition, past medical history, physical examination, laboratory examination, nutrition control score, intervention and treatment measures and other elderly patient information was collected. Logistic regression analysis was used to analyze the relevant factors that affect the severity of frailty and hospitalization costs. According to the (fr)AGILE scale score, the elderly patients were divided into groups to determine whether they were frail and the severity of the frailty. Among them, 164 patients were in the prefrailty stage, which accounted for 40.2%. There were 188 cases of mild frailty that accounted for 46.1%, and 56 cases of moderate to severe frailty that accounted for 13.7%. Decreased grip strength, elevated white blood cell levels, and low sodium and potassium are independent risk factors affecting the severity of frailty. As the severity of frailty increases, the proportion of sodium, potassium, albumin supplementation as well as anti-infection gradually increases. Frailty is a common elderly syndrome with a high incidence among elderly patients in internal medicine departments. The main manifestations of frailty vary with different severity levels. Inflammation, anemia, and poor nutritional status can lead to an increase in the severity of frailty as well as blood hypercoagulability, myocardial damage, and additional supportive interventions. This ultimately leads to prolonged hospitalization and increased hospitalization costs.

Strategies to Assess and Manage Frailty among Patients Diagnosed with Primary Malignant Brain Tumors.

Frailty refers to a biologic process that results in reduced physiologic and functional reserve. Patients diagnosed with primary malignant brain tumors experience high symptom burden from tumor and tumor-directed treatments that, coupled with previous comorbidities, may contribute to frailty. Within the primary malignant brain tumor population, frailty is known to associate with mortality, higher healthcare utilization, and increased risk of postoperative complications. As such, methods to assess and manage frailty are paramount. However, there is currently no clear consensus on how to best assess and manage frailty throughout the entirety of the disease trajectory. Given the association between frailty and health outcomes, more research is needed to determine best practice protocols for the assessment and management of frailty among patients diagnosed with primary malignant brain tumors.

Research Progress on Frailty in Elderly People.

Global aging is rapidly accelerating, which significantly influences the health systems worldwide. Frailty emerges as the most conspicuous hallmark of aging, imposing novel global health challenges. Characterized by a multifaceted decline across physiological system, frailty diminishes an individual's capacity to maintain equilibrium in the presence of stressors, which leads to adverse outcomes such as falls, delirium, and disability. Several screening tools and interventions have been developed to mitigate the harm caused by frailty to human health, but research on frailty in mainland China commences belatedly with scant studies conducted. Therefore, it is imperative to explore screening methods and treatment modalities tailored to the Chinese context, thereby enhancing the older adults' quality of life and advancing social medicine. This review aims to elucidate the evolution, diagnosis, and management of frailty, alongside the challenges it poses, with the overarching goal of guiding future diagnostic and therapeutic endeavors. Specifically, we summarized the mechanisms of frailty and intervention strategies in elderly people, and meanwhile, we evaluated the advantages and disadvantages of different measurement tools.

Insights Into Geriatric Care and Healthy Ageing

The global population of older adults is expanding rapidly. According to the United Nations world social report (2023), 1 in 10 people worldwide were aged 65 or above in 2021. In 2050, this age group is projected to account for 1 in 6 people globally. In 2019, 9.6% of the Lebanese population were above 65 years of age according to statistics of the Ministry of Health. Geriatric medicine plays a vital role in enhancing the quality of life for older adults, as it drives health promotion and disease prevention and treatment. The last two decades have witnessed a lot of progress in this field due to advancement on personalized care driven by genomic analysis, comprehensive geriatric assessment, polypharmacy management, assessment of frailty to prevent cognitive decline and nutrition and exercise interventions to maintain muscle and bone health and cognitive function. Yet, a lot of aspects need to be explored, as complex multimorbidity in this age group requires coordinated care across specialties. In addition, evidence-based studies that include older adults are limited. To tackle the different aspects of geriatric care, Beirut Arab University-Tripoli branch hosted the conference entitled “Insights into Geriatric Care and Healthy Ageing” which featured a series of keynote speeches, sessions, and discussions led by esteemed experts in the fields of Ageing and healthcare. The conference was organized in collaboration with the Middle East Academy for Medicine of Ageing (MEAMA) and the International Institute on Ageing (INIA). The first session held by Dr. Abdul Razzak Abyad and Dr. Nabil Kronfol addressed the medical and social transformation of ageing, the major challenges faced by older people and proposed a comprehensive program to improve the health and well-being of older people. A session entitled “Update on Geriatric Medicine” reflected a comprehensive approach to understanding and managing common health challenges associated with Ageing and offered the latest medical protocols and treatment to improve patient outcomes. The topics included the management of Metabolic Syndrome and Parkinson’s Disease, clinical presentation and management of depression in older adults, prevention and control of urinary tract infections in elderly, medication management to prevent polypharmacy, in addition to bone healthcare to prevent osteoporosis and fracture. A session specified for dementia and delirium covered the latest update on diagnosis and management of dementia, the progress in the process of using genetic markers for diagnosis of Alzheimer’s Disease, and nursing care tools used in the screening of delirium. Another session focused on prevention, assessment, and nursing care management protocols of pressure injuries in addition to surgical treatment. The concept of “healthy ageing” and the maintenance of physical health was highlighted during the conference through a talk about frailty prevention and management, which extensively covered the different types of exercise recommended in older age, their benefits, and the conditions of each. In addition, another talk linked the different dietary patterns to the risk of frailty and cognitive decline in older adults according to a Lebanese national study. The last session of the conference was dedicated to policies and programs of elderly healthcare. Dr. Samar El Feky, Regional Focal Person for Health of Older People from the Eastern Mediterranean Regional Office of the World Health Organization, introduced the WHO guidelines for integrated care for older people (ICOPE) program implemented in several countries in the region. On the other hand, Dr. Saadallah Sabouneh presented the elderly care policies and programs in Lebanon, on behalf of the Minister of Health, Dr. Firas Abyad. The president of the order of nurses, Dr. Rima Sassine Kazan, presented the challenges of Nursing care for the elderly in Lebanon. The conference was concluded by the organizers who emphasized the significance of “healthy ageing”, the process of maintaining functional ability as people grow older to enable their continued participation in society.

The Dual Burden of Frailty and Heart Failure.

Frailty is highly prevalent among patients with heart failure (HF) and independently predicts adverse outcomes. However, optimal frailty definitions, assessments, and management in HF remain unclear. Frailty is common in HF, affecting up to 80% of patients depending on population characteristics. Even pre-frailty doubles mortality risk versus robust patients. Frailty worsens HF prognosis through systemic inflammation, neurohormonal changes, sarcopenia, and micronutrient deficiency. Simple screening tools like gait speed and grip strength predict outcomes but lack HF-specificity. Comprehensive geriatric assessment is ideal but not always feasible. Exercise, nutrition, poly-pharmacy management, and multidisciplinary care models can help stablize frailty components and improve patient-centred outcomes. Frailty frequently coexists with and exacerbates HF. Routine frailty screening should guide supportive interventions to optimize physical, cognitive, and psychosocial health. Further research on HF-specific frailty assessment tools and interventions is warranted to reduce this dual burden.

Frailty management - now!

Frailty management - now!

Risk factors of cognitive frailty in elderly chronic obstructive pulmonary disease patients and its implication for death: acohort study.

Cognitive frailty, a clinical syndrome with physical frailty and cognitive impairment, leads to mortality and other adverse health outcomes in older adults. This study aimed to investigate the prevalence of cognitive frailty, and its influencing factors, and follow its impact on short-term mortality in elderly chronic obstructive pulmonary disease patients, to provide a theoretical scientific reference basis for clinical intervention and management of cognitive frailty. A sample of 243 elderly chronic obstructive pulmonary disease patients in the respiratory department of a tertiary care hospital was conveniently sampled from November 2021 to February 2023, and the prevalence of cognitive frailty was investigated using the General Information Survey Scale, the Fried Phenotype Scale, the Mini-Mental State Examination, the Anxiety Self-Rating Scale, the Brief Geriatric Depression Scale, and the Mortality Record. The mortality was recorded by telephone follow-up after 6 months. A database was created and statistical analysis such as one-way analysis of variance, logistic regression analysis, Kaplan-Meier, and Cox survival analysis were used to analyze the data. A total of 47 patients (19.3%) had cognitive frailty; there were statistical differences in the prevalence of cognitive frailty by medical payment type, physical exercise, and sleeping time (P < 0.05). During a 6-month follow-up, 38 patients (15.6%) died. Cox survival analysis showed that the risk of death in elderly chronic obstructive pulmonary disease patients in the cognitive frailty group was 3.212 times higher than that in the normal cognitive function and non-frailty group (95% CI 1.646-6.270, P = 0.001), and 5.266 times higher than that in the normal cognitive function and frailty group (95% CI 3.159-8.778, P < 0.001). The prevalence of cognitive frailty in elderly chronic obstructive pulmonary disease patients is high, and clinical staff should pay attention to patients' medical burden and financial ability, and reduce the incidence of cognitive frailty by instructing patients to perform physical exercise and arrange sleep time. Cognitive frailty is an important risk factor for mortality within 6 months in elderly chronic obstructive pulmonary disease patients, and early intervention should be emphasised to reduce or delay cognitive frailty and mortality.