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Background interventions targeting older adults with cognitive frailty have grown rapidly in recent years with inconsistent findings. However, there is no meta-analysis that has synthesised pooled estimates. Objective to synthesise the pooled effect of current targeted interventions in older people with cognitive frailty. Methods we conducted a systematic search in PubMed, Embase, Web of Science, the Cochrane Library, the JBI database and three Chinese databases (CNKI, Wan-Fang and VIP) for literature from the inception of the database until 8 March 2022. The mean difference or standardised mean difference with 95% CIs was calculated. The methodological quality was assessed by the Cochrane RoB 2.0. The certainty of evidence was assessed using the GRADE criteria. Results thirteen randomised controlled trials with a total of 1,089 participants were included. The results of the meta-analysis showed that older adults with cognitive frailty in the intervention groups had significant improvement in frailty score [MD = −1.67, 95% CI (−2.39, −0.95), P  < 0.00001, I 2 = 97%], global cognitive function [MD = 3.38, 95% CI (1.90, 4.85), P  < 0.00001, I 2 = 93%], mobility [MD = −0.96, 95% CI (−1.27, −1.66), P  < 0.00001, I 2 = 0%], muscle strength [SMD = 0.75, 95% CI (0.09, 1.41), P  = 0.03, I 2 = 85%] and nutritional status [MNA:MD = 5.64, 95% CI (3.99, 7.29), P  < 0.00001, I 2 = 89%; ALB: MD = 3.23, 95% CI (0.76, 5.71), P  = 0.01, I 2 = 93%; PALB: MD = 54.52, 95% CI (25.26, 83.77), P  = 0.0003, I 2 = 96%; TRF: MD = 0.64, 95% CI (0.22, 1.06), P  = 0.003, I 2 = 97%]. The overall certainty of the evidence ranged from low to moderate. Conclusions interventions targeting older adults with cognitive frailty are effective in improving physical frailty, global cognitive function, physical function and nutritional status with low to moderate certainty. More research is still needed in the future to further enrich the evidence in these fields. PROSPERO number CRD42022318758. [ABSTRACT FROM AUTHOR]

Background Mobility is defined as the ability to independently move around the environment and is a key contributor to quality of life, especially in older age. The aim of this study was to evaluate the use of mobility as a decisive outcome for the marketing authorisation of drugs by the European Medicines Agency (EMA). Methods Fifteen therapeutic areas which commonly lead to relevant mobility impairments and alter the quantity and/or the quality of walking were selected: two systemic neurological diseases, four conditions primarily affecting exercise capacity, seven musculoskeletal diseases and two conditions representing sensory impairments. European Public Assessment Reports (EPARs) published by the EMA until September 2020 were examined for mobility endpoints included in their 'main studies'. Clinical study registries and primary scientific publications for these studies were also reviewed. Results Four hundred and eighty-four EPARs yielded 186 relevant documents with 402 'main studies'. The EPARs reported 153 primary and 584 secondary endpoints which considered mobility; 70 different assessment tools (38 patient-reported outcomes, 13 clinician-reported outcomes, 8 performance outcomes and 13 composite endpoints) were used. Only 15.7% of those tools distinctly informed on patients' mobility status. Out of 402, 105 (26.1%) of the 'main studies' did not have any mobility assessment. Furthermore, none of these studies included a digital mobility outcome. Conclusions For conditions with a high impact on mobility, mobility assessment was given little consideration in the marketing authorisation of drugs by the EMA. Where mobility impairment was considered to be a relevant outcome, questionnaires or composite scores susceptible to reporting biases were predominantly used. [ABSTRACT FROM AUTHOR]