Instruments and Measurement Scales for Cognitive Frailty in Midlife: A Systematic Literature Review from 2013 to 2023

Abstract This study is a systematic review addressing cognitive frailty, measurement instruments, and their impact on comprehensive care for older adults between 2013 and 2023. It seeks to identify findings on the distribution of studies in relation to year, country of publication, and methodology employed, as well as the instruments available to measure cognitive frailty and the scientific evidence supporting its assessment in midlife. We included studies published between 2013 and 2023 that addressed the topic of cognitive frailty and measurement instruments in midlife, excluding papers that did not provide primary data. A systematic search was performed in Scopus, PubMed, Web of Science, and Science Direct databases. The risk of bias was assessed using the Cochrane tool. Twenty-one studies were identified, of which three presented new instruments for measuring cognitive frailty, eleven focused on the validation and comparison of psychometric properties, and seven examined the assessment of frailty in midlife. Research on instruments for measuring cognitive frailty has grown in the last five years, concentrating on high- and upper-middle-income countries, with a quantitative and cross-sectional methodological approach. Validation and cross-cultural adaptation of scales such as FRAIL and the Tilburg Frailty Indicator predominate, demonstrating efficacy and validity in community settings. Only three studies validate Frailty Indices using longitudinal data in middle-aged population. The review highlights the efficacy and validity of existing instruments, as well as the growth in cognitive frailty research. Strengths include growing research and instrument validation; however, it is limited to high- and upper-middle-income countries. The review suggests increased attention to cognitive frailty, with new instruments incorporating cognitive components, which could improve assessment in midlife.