Prevalence and influencing factors of cognitive frailty in patients with chronic heart failure: a meta-analysis
TL;DR
Current evidence confirms that cognitive impairment is highly prevalent among patients with chronic heart failure, and its occurrence is influenced by multiple modifiable and non-modifiable risk factors.
Abstract
Objective To systematically investigate the prevalence and influencing factors of cognitive frailty in patients with chronic heart failure, and to provide evidence-based support for subsequent clinical intervention development. Methods We retrieved relevant studies focusing on the prevalence and influencing factors of cognitive frailty in patients with chronic heart failure from Embase, Cochrane Library, PubMed, Web of Science, CINAHL, SinoMed, CNKI, VIP, and Wanfang databases. The search period covered from the inception of each database to December 2025. Two researchers independently conducted study screening, data extraction, and methodological quality assessment. Meta-analysis was performed using Stata 15.0 software. Results Fourteen studies involving 5,127 patients with chronic heart failure were included, among which 1,875 cases of cognitive frailty were reported, and 30 risk factors were identified. Meta-analysis showed that the pooled prevalence of cognitive impairment in patients with chronic heart failure was 39.3% (95% CI: 31.0%–47.7%). Further analysis identified age, age ≥ 80 years, New York Heart Association (NYHA) classification, comorbidity burden, polypharmacy, malnutrition, and depression as significant risk factors for cognitive impairment in this population. Higher educational attainment, engaging in physical exercise ≥ 3 times per week, and regular participation in intellectual activities were confirmed as protective factors against cognitive impairment in patients with chronic heart failure. Conclusion Current evidence confirms that cognitive impairment is highly prevalent among patients with chronic heart failure, and its occurrence is influenced by multiple modifiable and non-modifiable risk factors. Therefore, clinical healthcare providers should strengthen routine cognitive function screening for this population, and implement targeted interventions based on the identified risk factors to delay the onset of cognitive impairment and improve overall patient prognosis. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/view/CRD420251247352, PROSPERO CRD420251247352.