Cognitive frailty in patients with acute coronary syndromes: A scoping review

AIMS: To address a critical knowledge gap, this is the first scoping review to systematically map and describe the evidence on cognitive frailty in patients with acute coronary syndromes (ACS), including its prevalence, assessment tools, associated factors, and clinical outcomes. METHODS: The Joanna Briggs Institute methodology guided the conduct of this scoping review, which has been reported in line with the PRISMA-ScR checklist. Following the PCC framework, a systematic search was conducted across five databases: PubMed, Embase, CINAHL, Scopus, and Web of Science. The search was performed up to August 2026. Two reviewers independently screened studies, extracted data, and assessed quality. RESULTS: A total of 9 studies were included. The prevalence of cognitive frailty ranged from 8% to 55%, the differences attributed to the heterogeneity of assessment tools and diagnostic criteria. Regarding assessment tools, the FRAIL scale combined with the Short Portable Mental Status Questionnaire was the most commonly used combinations. Risk factors covered sociodemographic, physical health, and clinical domains. Prognostically, cognitive frailty was linked to higher composite short‑term (in‑hospital complications, prolonged stay, 30‑day events) and medium‑term (6‑month MACCE) risks, and also to elevated long‑term mortality and readmission. CONCLUSION: Cognitive frailty is commonly reported in patients with ACS, with considerable variation across studies, and an association with adverse outcomes has been noted in multiple reports. However, the lack of standardized assessment tools and criteria makes results difficult to compare and synthesize. Existing prospective studies have primarily relied on baseline measurements of cognitive frailty to predict subsequent outcomes, without repeated assessments over time. This limits the ability to characterise the dynamic trajectory of cognitive frailty during the ACS course. Future research should focus on longitudinal studies, the development of rapid screening tools, and the exploration of multidisciplinary interventions.