Association of frailty with survival: A systematic literature review

Shamliyan, Tatyana A.; Talley, Kristine Mc; Ramakrishnan, Rema; Kane, Robert L

doi:10.1016/j.arr.2012.03.001

Cited by 514 publications

(461 citation statements)

References 110 publications

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“…This decreased renal function is associated with increased all cause and cardiovascular mortality even in people over 75 years of age 3 . Although impaired physical function appears to be a risk marker for mortality in younger CKD patients 4 , it is less clear in older patients whether decreased renal function and impaired physical function are independent risk markers for mortality, or whether low glomerular filtration rate merely reflects frailty or impaired physical functionthemselves both powerful markers for mortality in older people 5 . Clarifying this issue is important, firstly in deciding whether labelling very old patients as having CKD serves a useful purpose, and secondly in considering whether intervening to ameliorate declines in renal function in the oldest old are likely to translate into clinically relevant benefits.…”

Section: Introductionmentioning

confidence: 99%

Association Between Kidney Function, Rehabilitation Outcome, and Survival in Older Patients Discharged From Inpatient Rehabilitation

Doyle

Sloan

Goodbrand

et al. 2015

American Journal of Kidney Diseases

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Section: Introductionmentioning

confidence: 99%

Association Between Kidney Function, Rehabilitation Outcome, and Survival in Older Patients Discharged From Inpatient Rehabilitation

Doyle

Sloan

Goodbrand

et al. 2015

American Journal of Kidney Diseases

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“…One systematic review reported hazard ratios linking frailty and mortality, but did not determine whether frailty was more lethal for males or for females (Shamliyan et al, 2013). Furthermore, the majority of studies included in these reviews represented populations from North America, with only small contributions from Europe and Asia.…”

Section: Accepted M Manuscriptmentioning

confidence: 99%

“…Systematic reviews have found the prevalence of frailty to be higher in older females than males, using phenotypic and cumulative deficit models of frailty (Collard et al, 2012;Shamliyan et al, 2013).…”

Section: Accepted M Manuscriptmentioning

confidence: 99%

Sex differences in frailty: A systematic review and meta-analysis

Gordon

Peel

Samanta

et al. 2017

Experimental Gerontology

433

269

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“…The older adult population is growing, and frailty is associated with increased risk of disability, hospitalization, and mortality. 1–4 Frail individuals are more susceptible to adverse outcomes, including adverse drug effects such as delirium and falls. These risks may be aggravated by inappropriate use and dosing of individual drugs as well as polypharmacy, a common issue in frail individuals.…”

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confidence: 99%

Frailty, Kidney Function, and Polypharmacy: The Atherosclerosis Risk in Communities (ARIC) Study

Ballew

Chen

Daya

et al. 2017

American Journal of Kidney Diseases

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Background Frail individuals are at increased risk for poor outcomes, including adverse drug events. Kidney function is often compromised in frailty and is a key consideration in medication choice and dosing; however, creatinine-based measures of kidney function may be biased in frail individuals. Study Design Observational study. Setting & Participants 4,987 community-dwelling older men and women with complete data who participated in visit 5 of the Atherosclerosis Risk in Communities (ARIC) Study (2011–2013). Predictor Kidney measures included glomerular filtration rate (GFR) estimated using serum creatinine (eGFRcr) and serum cystatin C (eGFRcys) and urine albumin-creatinine ratio (ACR). Outcomes Frailty, defined using established criteria of 3 or more frailty characteristics (weight loss, slowness, exhaustion, weakness, and low physical activity). Results In total, 341 participants (7%) were classified as frail, 1475 (30%) had eGFRcr <60 ml/min/1.73 m2, 2480 (50%) had eGFRcys <60 ml/min/1.73 m2, and 1006 (20%) had albuminuria ≥30 mg/g. Among frail participants, prevalences of eGFRcr and eGFRcys <60 ml/min/1.73 m2 were 45% and 77%, respectively. Adjusted for covariates, frailty showed a moderate association with eGFRcr and a strong association with eGFRcys and ACR. Frail individuals with eGFRcr 60–<75 ml/min/1.73 m2 were frequently reclassified to lower eGFR categories using eGFRcys (49% to 45–<60, 32% to 30–<45, and 3% to <30 ml/min/1.73 m2). Hyperpolypharmacy (taking ≥10 classes of medications) was more common in frail individuals (54% vs 38% of non-frail), including classes requiring kidney clearance (e.g., digoxin) and associated with falls and subsequent complications (e.g., hypnotic/sedatives, anticoagulants). Limitations Cross-sectional study design. Conclusions Frail individuals had a high prevalence of reduce kidney function, with large discrepancies when reduced kidney function was classified by eGFRcys versus eGFRcr. Given the substantial medication burden and uncertainty in CKD classification, confirmation of kidney function with alternative biomarkers may be warranted to ensure careful prescribing practices in this vulnerable population.

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Association of frailty with survival: A systematic literature review

Cited by 514 publications

References 110 publications

Association Between Kidney Function, Rehabilitation Outcome, and Survival in Older Patients Discharged From Inpatient Rehabilitation

Association Between Kidney Function, Rehabilitation Outcome, and Survival in Older Patients Discharged From Inpatient Rehabilitation

Sex differences in frailty: A systematic review and meta-analysis

Frailty, Kidney Function, and Polypharmacy: The Atherosclerosis Risk in Communities (ARIC) Study

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