Prevalence and factors associated with cognitive frailty in heart failure: a systematic review and meta-analysis protocol

INTRODUCTION: Heart failure (HF) is a global health issue affecting millions of people worldwide. Cognitive frailty, a syndrome characterised by physical frailty and cognitive impairment without dementia, is increasingly recognised in this population. Cognitive frailty is associated with worse outcomes, including increased hospitalisation, disability and mortality. This systematic review and meta-analysis aimed to investigate the incidence, prevalence and predictors of cognitive frailty in HF patients. METHODS: A systematic search will be conducted in MEDLINE/PubMed, EMBASE/Ovid, Web of Science and Google Scholar from inception to the latest search date. Eligible studies will report original data on adult patients (age ≥18 years) with HF, focusing on the incidence, prevalence and predictors of cognitive frailty. Two investigators will independently extract data and assess study quality using the Newcastle-Ottawa Scale and mixed-methods appraisal tool. Meta-analyses and meta-regression will be performed to estimate the pooled prevalence of cognitive frailty in HF patients and to identify predictors associated with increased risk, respectively. Subgroup analyses will be conducted to explore potential sources of heterogeneity. ETHICS AND DISSEMINATION: This systematic review does not require ethical approval and informed consent, as it does not use identifiable patient data. The results of this study will be submitted for publication in a peer-reviewed medical journal. This comprehensive meta-analysis of the literature on cognitive frailty among HF patients will inform tailored interventions and management strategies, ultimately improving patients' quality of life and outcomes.