Chronic inflammation and cognitive frailty in older adults: A narrative review

Cognitive Frailty (CF) is a clinical syndrome characterized by the co-occurrence of physical frailty and cognitive impairment in the absence of dementia. This geriatric condition has emerged as a significant contributor to compromised health status and diminished quality of life among aging populations, yet its underlying pathological mechanisms remain incompletely elucidated. Chronic low-grade inflammation, recognized as a hallmark of biological aging, has been implicated in the pathogenesis of multiple age-related diseases, including hypertension, diabetes, panvascular diseases, and cerebrovascular disorders. Given the established associations between these inflammatory-related diseases and CF progression, systemic inflammation is hypothesized to constitute a pivotal pathophysiological mediator in CF development. We systematically searched PubMed and Web of Science databases (from inception to July 2025) using MeSH terms (e.g., Inflammation, Frailty, Cognitive decline, Cognitive Frailty, Microcirculation) and related keywords. This comprehensive review synthesizes current evidence regarding the inflammation-CF nexus, particularly emphasizing the potential role of microcirculation dysfunction as a mechanistic link. This review aims to advance our pathophysiological understanding and identify potential intervention targets, thereby facilitating the development of predictive models for CF risk stratification in older adults.