Background: Neurological conditions are now the leading cause of disability worldwide. Frailty syndrome, defined as a multisystemic state of physiological impairment, often predicts clinical outcomes more accurately than chronological age. Objective: This review examines the molecular pathophysiology of neuro-frailty, its prognostic significance in acute ischemic stroke, multiple sclerosis (MS), and Parkinson’s disease (PD), as well as the integration of emerging diagnostic technologies. Methodology: A comprehensive review of English-language articles published from 2001 to 2026 in PubMed, Scopus, and Cochrane was conducted. Grey literature and animal studies were excluded from the analysis. The synthesis focused on meta-analyses and human-based research connecting artificial intelligence diagnostics, fluid biomarkers, and clinical neurology. Results: Neuro-frailty is associated with the phenomenon of inflammaging, the secretory ageing-associating phenotype (SASP), and progressive mitochondrial dysfunction. The presence of pre-existing frailty also elevates the risk of unfavorable functional recovery (mRS > 2) in acute phase of ischaemic stroke by 3.11 times. In MS, ongoing neurodegeneration accelerates biological ageing, often resulting in premature frailty. The sarcopenia-frailty axis in Parkinson’s disease affects over 35% of patients and significantly increases the risk of recurrent falls. Modern diagnostic methods now enable objective and precise quantification of this impairment. Conclusions: Frailty is a dynamic clinical condition that is possible to reverse. The transition from age-based metrics to AI-powered biological screening enables a personalized approach to care by clinicians. These targeted strategies are essential for maintaining neurological functions and reducing socio-economic consequences of ageing.
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Michta et al. (2026) studied this question.
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