Frail Phenotype and Disability Prediction in Community-Dwelling Older People: A Systematic Review and Meta-Analysis of Prospective Cohort Studies

Abstract

Background: The World Health Organization has identified frailty as a crucial factor affecting successful aging. Systematic literature reviews have yet to focus on the relationship between stages of frailty and disability in community-dwelling older adults. Purpose: The purpose of this study was to investigate the relationships between various frailty types and disability in community-dwelling older adults and to explore how various frailty criteria have been used to assess disability in this population. Methods: A systematic literature review and meta-analysis were conducted on articles from the following databases: Cochrane Library, CINAHL, PubMed, and Ovid. Database search criteria included articles that were published between January 2001 and July 2017 and study samples that included community-dwelling adults aged 60 years and older. We excluded studies that were conducted in institutions or hospitals and experimental studies on frailty. Two reviewers independently assessed eligibility and extracted data. A random-effects model was used to analyze the literature and to calculate the pooled disability of frailty. Results: In total, nine studies with a total sample of 32,998 participants that recorded 8,666 disabilities and a mean follow-up time of 30.4 months ( SD = 29.26) were pooled for the meta-analysis. Using various indicators to predict the risk of disability compared with robust older adults, those with frailty faced a higher risk of disability, followed by older adults at risk of frailty. Conclusions/Implications for Practice: Frailty is a crucial health consideration among older adults. Those who are frail have the highest relative risk of disability, followed by those at risk of frailty. Early assessment of frailty may effectively prevent the occurrence of frailty-induced disability in older adults.

Regional Differences in Disability Incidence among Japanese Adults Aged 75 Years and Older: A 4-Year Prospective Cohort Study

“…Further, we found that the incident rate of disability illustrated significantly different trajectories of functional capacity between intra-city districts among the participants. Previous studies have observed regional differences in the prevalence of frailty and disability incidence among regions and countries [ 27 ] and in urban–rural areas among older people in China [ 28 ]. Generally, public health practitioners assess each indicator across districts by population groups or geographical areas and make policy choices to prioritize health inequalities within the city [ 29 ].…”

Use and Prescription of Direct Oral Anticoagulants in Older and Frail Patients with Atrial Fibrillation: A Multidisciplinary Consensus Document

“…Notwithstanding, two main methods are extensively used to describe it: (i) the frailty phenotype, which is substantially based on the evaluation of residual physical strength [ 29 ]; (ii) the frailty index (FI), which is based on the concept that frailty is the result of the cumulative juxtaposition of various health deficits, provided that these are biologically determined [ 30 , 31 ]. Irrespective of its definition, frailty is associated with a significantly higher risk of death [ 32 , 33 ] and disability [ 34 ], as well as with higher healthcare costs [ 35 ].…”

Exploring the Relationship between Frailty, Functional Status, Polypharmacy, and Quality of Life in Elderly and Middle-Aged Patients with Cardiovascular Diseases: A One-Year Follow-Up Study

“…The association between frailty and disability in ADL has been examined in multiple studies [ 31 , 32 , 33 ]. Three perspectives regarding the relationship between these concepts have been identified, with disability being (a) a negative health outcome of frailty, (b) a characteristic of frailty, and (c) a predictor of frailty [ 34 ].…”