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. 2025 Jun 4:17:1541048.
doi: 10.3389/fnagi.2025.1541048. eCollection 2025.

Interventions for cognitive frailty: developing a Delphi consensus with multidisciplinary and multisectoral experts

Carol A Holland  1   2 , Nikolett Dravecz  1   2 , Susan Broughton  1   3 , Lynne A Barker  4 , Fidelia Bature  5 , Charlotte Clarke  6 , Isaac M Danat  7 , Sayani Das  8 , Irundika H K Dias  9 , Annabel Dawson  10 , M Dixon  11 , Amanda Ellison  12 , David Façal  13 , Roland Finch  10 , Christopher J Gaffney  1   14 , Alan Gow  15 , Eirini Kelaiditi  16 , Andrzej Klimczuk  17 , Esperanza Navarro-Pardo  18 , Pheobe Sharratt  1   14 , Andrew Sixsmith  19 , Claudia K Suemoto  20 , Lalu Suprawesta  21 , Tamlyn Watermeyer  22 , Sally Fowler Davis  23
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Interventions for cognitive frailty: developing a Delphi consensus with multidisciplinary and multisectoral experts

Carol A Holland et al. Front Aging Neurosci. .

Abstract

Introduction: 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.

Methods: 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.

Results: 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.

Discussion and conclusion: 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.

Keywords: Delphi study; cognitive frailty (CF); expert consensus; intervention; multi-sectoral; multidisciplinary.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

Figures

Figure 1
Figure 1
Frequency of categories of self-identified expertise (Figure preparation was conducted using GraphPad Prism 10 (GraphPad Software 2365 Northside Dr. Suite 560 San Diego, CA 92108)).
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