Harnessing knowledge of lifespan biological, health, environmental and psychosocial mechanisms of cognitive frailty for integrated interventions

The primary aim of the Cognitive Frailty Interdisciplinary Network (CFIN) is to promote collaborative, multidisciplinary research that moves along the pathway from basic laboratory studies through to having a real impact on lives. The focus is on research that addresses the challenge of alleviating the development of age-related cognitive frailty and related reduced healthspan (years, or proportion of one's life spent in good health), and poor quality of life. Cognitive frailty is defined as a variable condition characterised by simultaneous presence of physical frailty and age-related cognitive impairment, but the exclusion of existing dementia.

The issue of age-related cognitive frailty is a major societal challenge in terms of its increasing impact on quality of life in our ageing populations, but it is also a challenge in terms of bringing together research from diverse fields. Currently, much research on ageing takes place within disciplines. We are thus beginning to learn much about the biological mechanisms of the ageing process, the psychological and neurophysiological processes of cognitive ageing and the external environmental, social or personal health behaviour factors that impact on the development of frailty or cognitive decline in humans. Despite this wealth of knowledge already available on cognitive ageing, there has been little discourse and knowledge exchange between disciplines such that there has been little progress in recent years in finding multi-dimensional interventions to prevent, rehabilitate, or reduce progress in cognitive frailty in later life. This network aims to bridge the gaps between basic, clinical and social science research to foster the translation of the scientific understanding of ageing.

The objectives are focused on building and operationalising an important network in this area across disciplines including Biology, neuroscience, psychology, epidemiology, social science and citizen engagement, with an array of linked network support organisations including the NHSA and the National Innovation Centre for Ageing. With links to the NIHR NWC ARC, the use of a health inequalities assessment tool (the HIAT) will be incorporated into all research and activity outcomes of this network, to ensure that everything we do attempts to address, rather than make inequalities worse. The network is ideally constructed to deliver impact, with a significant international External Advisory Group (EAG) in place, an experienced PI/Co-I team, and an initial group of expert members across leading institutions. In addition to building the network Nationally and Internationally, via our own discipline networks, multidisciplinary research centres, learned societies, and via the network conference to be held early on, outcomes include production of a consensus paper on multi-factor pathways for intervention, an evidence synthesis of the interaction between biological mechanisms and external predictors of cognitive frailty, a series of mini-project development studies, and from these, a series of larger multidisciplinary outcome research proposals. Capacity development, particularly the development of Early Career Researchers (ECRs) will be a focus, with a mentorship programme whereby cross-disciplinary mentoring partnerships are set-up. We will also invite Co-Is and members to submit ideas for an ECR mini-conference/summer school. Involvement of older adults and other stakeholders such as carers is a crucial part of this network, which will be supported by the inclusion of a Co-I from VOICE, a well-established organisation that harnesses the mental capital, insights, and ideas of the public. They will be able to strengthen the reach and diversity of meaningful public engagement and participation in the mini collaborative projects and across the network. VOICE will strengthen links to and collaboration between citizens and a range of voluntary and community organisations (including charities).

The Cognitive Frailty Interdisciplinary Network (CFIN) will promote multidisciplinary research tackling development of age-related cognitive frailty and associated reduced healthspan and quality of life. This is both a major societal challenge in our ageing populations and a research challenge to integrate findings from multiple fields into effective prevention and therapeutic interventions across the life course that are implementable in real contexts. The primary goal of this proposal is thus network building across disciplines (including biology, neuroscience, psychology, epidemiology, social science and citizen engagement) and groups (researchers, clinicians, learned societies, business, clinicians, support organisations, older adults and carers) to foster transformative collaborative research for the purpose of better understanding and alleviation of the burdens of cognitive frailty. Network creation will be achieved by forming an external advisory group (EAG) and convening meetings, building membership through existing networks of investigators and members, and by use of social media and judicious linking of a network website. The CFIN will be fully activated at a networking conference at 6 months. Specific outcomes in addition to the EAG and researcher network will be the production of a cross disciplinary evidence synthesis of biological mechanisms and exogenous factors as related to cognitive frailty, identifying gaps, to inform creation of interdisciplinary collaborations with specific goals. Specific small projects will be funded, forming the basis of further Network-based funding proposals to external funders. There will also be a consensus document produced using a two stage Delphi process bringing together membership expertise on the most evidentially supported multi-dimensional interventions for cognitive frailty. Both papers will be submitted for publication. A Mentorship programme and summer school for ECRs will also be supported.