Browse by author
Lookup NU author(s): Vansh MaheshwariORCiD, Dr Louise Robinson, Dr Andrew KingstonORCiD
Full text for this publication is not currently held within this repository. Alternative links are provided below where available.
© 2026 The AuthorsBackground: Frailty and cognitive impairment frequently co-occur in the oldest old, yet most research focuses on younger older adults and fails to account for survival bias. We aimed to determine whether frailty accelerates the rate of cognitive decline and to quantify the combined mortality risk of frailty and cognitive impairment in the oldest old. Methods: We utilised data from the Newcastle 85+ Study, a prospective longitudinal cohort of individuals aged 85 at baseline (n = 695). Frailty was assessed using the Fried phenotype, and cognitive function using the standardised Mini-Mental State Examination (MMSE). Joint models were used to link longitudinal cognitive decline with survival data to account for informative censoring. Adjusted survival probabilities and restricted mean survival time (RMST) were estimated to quantify the cumulative loss of life. Results: Frailty was associated with cognitive decline over time (β = -1.28, 95% confidence interval (CI):1.88 to -0.67). Compared to robust, cognitively normal participants, mortality risk increased for those with pre-frailty and cognitive impairment (hazard ratio (HR) = 2.22, 95% CI: 1.40 to 3.53) and was highest for those with frailty and cognitive impairment (HR = 3.67, 95% CI: 2.28 to 5.90). The co-occurrence of frailty and cognitive impairment was associated with a 28.14% reduction in 10-year survival probability and an approximately 2-year loss of RMST. Conclusions: Frailty prognostically amplifies cognitive impairment in the oldest old, creating a high-risk phenotype associated with rapid decline and reduced longevity. These findings support the need for integrated care plans that target physical resilience alongside cognitive care.
Author(s): Maheshwari V, Robinson L, Kingston A
Publication type: Article
Publication status: Published
Journal: Archives of Gerontology and Geriatrics
Year: 2026
Volume: 150
Online publication date: 18/06/2026
Acceptance date: 14/06/2026
ISSN (print): 0167-4943
ISSN (electronic): 1872-6976
Publisher: Elsevier Ireland Ltd
URL: https://doi.org/10.1016/j.archger.2026.106338
DOI: 10.1016/j.archger.2026.106338
Altmetrics provided by Altmetric
