Frailty as a Predictor of Future Fracture in Older Adults: A Systematic Review and Meta‐Analysis

Chen, Kuo-Wei; Chang, Shu‐Fang; Lin, Pei‐Ling

doi:10.1111/wvn.12222

Cited by 34 publications

(30 citation statements)

References 26 publications

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“…Frailty, the state representing a decline in functional reserves, has emerged as a key aspect in research on population ageing. It is used as a health indicator for how well populations are aging and is commonly used in the context of the elderly facing functional disabilities, as many studies have demonstrated that frail individuals are at a high risk of becoming disabled, independent of the presence of co-morbid diseases [ 8 , 9 , 10 , 11 , 12 , 13 ]; thus, frailty has been suggested as a better predictor of health and well-being than the presence or absence of disease and has been used as an indicator of the compression of morbidity to predict the demands on the healthcare system [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Frailty and Its Contributory Factors in Older Adults: A Comparison of Two Asian Regions (Hong Kong and Taiwan)

Leung

et al. 2017

IJERPH

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This study aimed to compare the prevalence of frailty across three Chinese populations: Hong Kong, Taiwan-urban and Taiwan-rural. Contributing factors to disparities in frailty were also examined. Data were derived from the Osteoporotic Fractures in Men (MrOs) and Women (MsOs) (Hong Kong) Study (n = 4000) and the Taiwan Longitudinal Study on Aging (n = 2392). Frailty was defined as an index calculated from 30 multiple deficits. The ratio of the frailty index to life expectancy at birth (FI/LE) was used as an indicator of compression of morbidity. Frailty was more prevalent in Taiwan-urban (33.1%) and Taiwan-rural (38.1%) compared to Hong Kong (16.6%, p < 0.05) and was higher in women (22.6–49.7%) than in men (10.5–27.5%, p < 0.05). The ratios of FI/LE were higher in Taiwan-urban and Taiwan-rural (both 0.27) compared to Hong Kong (0.20, p < 0.05). Multivariate analyses revealed that older age, being a woman and low levels of physical activity were common risk factors for frailty across the three populations. Alcohol use was inversely associated with frailty in both Hong Kong and Taiwan-urban populations, but not in Taiwan-rural. Living alone was associated with frailty in Hong Kong men, but not in Hong Kong women or Taiwanese people. For all study populations, older age and being a woman constituted the highest attributable factor. This comparison provides useful data to inform government policies.

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Section: Introductionmentioning

confidence: 99%

Frailty and Its Contributory Factors in Older Adults: A Comparison of Two Asian Regions (Hong Kong and Taiwan)

Leung

et al. 2017

IJERPH

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“…A total of 969 records were identi ed from the six databases, and after removing the duplicates, 686 were screened for eligibility based on title and abstract. Twenty-three full-text articles were then reviewed for relevance, out of which 18 were excluded because aspects similar to, but not de ned explicitly as, frailty were assessed, e.g., gait speed (17,18), sarcopenia (19), different health indicators (20) or geriatric syndromes (21); outcomes other than mortality were examined, e.g., trauma (22), fractures (23,24), falls (25), high blood pressure and cardiovascular outcomes (26) or heart failure (27); study population included were from clinical practice (28), nursing home (29) or critical care (30) but not from a community setting; the study involved interventions, e.g., treatment modalities (31); or the article was a systematic review protocol or an umbrella review which evaluated frailty scales for clinical outcomes from community, residential care and hospital settings (32)(33)(34). This left ve eligible systematic reviews and meta-analyses in the umbrella review ( Fig.…”

Section: Search Resultsmentioning

confidence: 99%

The Association Between Frailty and All-Cause Mortality in Community-Dwelling Older Individuals: An Umbrella Review

Ekram

Woods

Britt

et al. 2020

Preprint

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Background Frailty is associated with multiple adverse health outcomes, including mortality. Several methods have been used to characterize frailty, each based on different frailty scales. These include scales based on a phenotype, multidomain, and deficit accumulations. Several systematic reviews have examined the association between frailty and mortality; however, it is unclear whether these different frailty scales similarly predict mortality. This umbrella review aims to examine the association between frailty assessed by different frailty scales and all-cause mortality among community-dwelling older adults. Methods The umbrella review protocol was registered at PROSPERO, and it was conducted following the PRISMA statement. MEDLINE, Embase, PubMed, Cochrane Database of Systematic Reviews, Joanna Briggs Institute (JBI) EBP database, and Web of Science database was searched to identify systematic reviews and meta-analyses examining the association between frailty and all-cause mortality. Methodological quality was assessed using the JBI. Critical Appraisal Checklist and online AMSTAR-2 critical appraisal checklist. For eligible studies, essential information was extracted and synthesized qualitatively. Results Five systematic reviews were included, with a total of 434,115 participants. Three systematic reviews focused on single frailty scales; one evaluated Fried physical frailty phenotype and its modifications; another focused on the deficit accumulation frailty index. The third evaluated the FRAIL (Fatigue, Resistance, Ambulation, Illness, and Loss of weight) scale. The two other systematic reviews determined the association between frailty and mortality using different frailty scales. All the systematic reviews performed meta-analyses and assessed between-study heterogeneity. All of the systematic reviews found that frailty was significantly associated with all-cause mortality.Conclusion This umbrella review demonstrates that frailty is a significant predictor of all-cause mortality, irrespective of the specific frailty scale.

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“…A correlation between comorbidity at discharge and poor functional outcomes has been demonstrated (20). Persons with the physical frailty phenotype have an increased risk of fractures in general and poor surgical outcomes (21,22). A rapid screen for the physical phenotype for frailty -the FRAIL scale has been developed (23-27).…”

Section: High Risk Populationsmentioning

confidence: 99%

Orthogeriatrics and Hip Fractures

Sanford

Morley

McKee

2018

The Journal of nutrition, health and aging

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Frailty as a Predictor of Future Fracture in Older Adults: A Systematic Review and Meta‐Analysis

Abstract: Professional nurses caring for frail or prefrail people should actively develop fracture prevention measures to reduce the risk of death caused by fractures.

Cited by 34 publications

References 26 publications

Frailty and Its Contributory Factors in Older Adults: A Comparison of Two Asian Regions (Hong Kong and Taiwan)

Frailty and Its Contributory Factors in Older Adults: A Comparison of Two Asian Regions (Hong Kong and Taiwan)

The Association Between Frailty and All-Cause Mortality in Community-Dwelling Older Individuals: An Umbrella Review

Orthogeriatrics and Hip Fractures

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