In 2013, an international panel of experts was gathered by the International Academy
on Nutrition and Aging (IANA) and the International Association of Gerontology and
Geriatrics (IAGG) to meet in Toulouse (France). The aim of the meeting was to discuss
the relationship between physical frailty and cognitive impairment. In particular,
it was felt important to attempt to bridge research conducted on neuroscience and
physical conditions of advanced age, 2 domains that had always tended to run in parallel.
The meeting resulted in the publication of a consensus paper that presented the concept
of “cognitive frailty.”
1
This condition was presented as a heterogeneous clinical manifestation defined by
the simultaneous presence of both physical frailty and mild cognitive impairment (MCI)
in the absence of dementia.
1
The rationale for creating this novel construct had 2 roots.
- •The urgency of looking at frailty as a multidimensional phenomenon. At that time, frailty was still perceived by many as mainly a physical condition, usually linked in its definition to the frailty phenotype proposed by Fried and colleagues.2The consensus was thus extending the perimeter of frailty to a different health domain (ie, cognition) that is critically involved in the determination of an individual's vulnerability to stressors.3,4
- •The need to promote a more holistic approach in the assessment and management of cognitive impairment in older persons. Cognitive impairment was too often seen as the entry door to a subsequent, unavoidable neurodegenerative condition. Suggesting that cognitive impairment might instead be due to other reasons was felt important and provided a pedagogic component to the framework. The hope was that it would (1) provide an opportunity to solicit clinicians to embrace a more comprehensive evaluation of the aging individual, not limiting the assessment to an organ (eg, brain) or function (eg, cognition), and (2) help with the identification of potentially reversible causes of the problem (eg, undiagnosed conditions and unhealthy lifestyle and behaviors), paving the way for the implementation of preventive strategies.3
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Footnotes
The authors declare no conflicts of interest.
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