Prevalence and Risk Factors for Frailty Among Community-Dwelling Older People in China: A Systematic Review and Meta-Analysis

He, Bonnie; Ma, Yanhui; Wang, Chun Ming; Jiang, Mengyao; Geng, Chengjun; Chang, Xiaoxia; Ma, Bin; Han, Lin

doi:10.1007/s12603-019-1179-9

Cited by 188 publications

(174 citation statements)

References 37 publications

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“…With increasing age, the risk of being frailty and frailty worsening were both higher. Older females have widely been found to have a higher prevalence of frailty, [2,8,41] which also showed in our study. In addition, the decline rate among robust and prefrail female elders was found to be higher than in males.…”

Section: Discussionsupporting

confidence: 88%

Changes in frailty among community-dwelling Chinese older adults and its predictors: evidence from a two-year longitudinal study

Chen

Huang

et al. 2020

BMC Geriatr

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Background: It is important to clarify the transitions and related factors of frailty for prevention of frailty. We evaluated the transitions of frailty among community-dwelling older adults and examined the predictors of the transitions. Methods: A cohort study was conducted among 3988 community residents aged ≥60 years during 2015 and 2017. A multiple deficits approach was used to construct the Frailty Index (FI) according to the methodology of FI construction, and sociodemographic characteristics and lifestyles were also collected in 2015. After 2-year follow-up, the transitions of frailty between baseline and were evaluated. Multinomial logistic regressions were used to examine associations between predictors and the transitions of frailty. Results: The proportion of robust, prefrail, and frail was 79.5, 16.4, and 4.1% among 3988 participants at baseline, which changed to 68.2, 23.0, and 8.8% after 2 years with 127 deaths and 23 dropped out. Twelve kinds of transitions from the three frailty statuses at baseline to four outcomes at follow-up (including death) significantly differed within each of gender and age group, as well between genders and age groups. Among these, 7.8% of prefrail or frail elders improved, 70.0% retained their frailty status, and 22.2% of robust or prefrail elders worsened in frailty status. In multivariable models, age was significantly associated with changes in frailty except for in the frail group; higher educational level and working predicted a lower risk of robust worsening. Of the lifestyle predictors, no shower facilities at home predicted a higher risk of robust worsening; more frequent physical exercise predicted a lower risk of robust worsening and a higher chance of frailty improvement; more frequent neighbor interaction predicted a lower risk of robust worsening and prefrail worsening; and more frequent social participation predicted a higher chance of prefrail improvement.

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Section: Discussionsupporting

confidence: 88%

Changes in frailty among community-dwelling Chinese older adults and its predictors: evidence from a two-year longitudinal study

Chen

Huang

et al. 2020

BMC Geriatr

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“…The most frequently used frailty assessment methods in China are the Fried phenotype and the frailty index, which are similar to those in other countries. For community-dwelling people aged 65 or over in China, the prevalence of frailty is 5.9%-17.4% [24], close to that in developed countries. Nonetheless, very few studies on the relationship between frailty and dementia have been carried out in China.…”

Section: Introductionmentioning

confidence: 75%

The association between frailty and incidence of dementia in Beijing: findings from 10/66 dementia research group population-based cohort study

Huang

Liu

et al. 2020

BMC Geriatr

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Background: The relationship between frailty and dementia is unclear and there are very few population-based studies regarding this issue in China. The purpose of this study is to estimate the association between frailty and incident dementia in China, and to explore different effects of frailty established by three definitions of frailty on dementia incidence. Methods: A five-year prospective cohort study was carried out in 2022 participants aged 65 years and over in urban and rural sites in Beijing, China. The participants were interviewed by trained community primary health care workers from 2004 to 2009. Frailty was defined using modified Fried frailty phenotype, physical frailty definition, and multidimensional frailty definition. Dementia was diagnosed using the 10/66 dementia criterion for calculating cumulative incidence. Both competing risk regression models and Cox proportional hazards models were applied to examine the associations between frailty at baseline and five-year cumulative incidence of dementia. Results: At the end of follow-up the five-year cumulative incidence rates of dementia with frailty and without frailty defined by the modified Fried frailty were 21.0% and 9.6%, those defined by the physical frailty were 19.9% and 9.0%, and those defined by the multidimensional frailty were 22.8% and 8.9%, respectively. Compared with non-frail participants, frail people had a higher risk of incident dementia using multidimensional frailty definition after adjusting covariates based on competing risk regression model (HR = 1.47, 95% CI 1.01~2.17) and Cox proportional hazards model (HR = 1.56, 95% CI 1.07~2.26). The association between frailty and incident dementia was statistically significant in participants in the upper three quartiles of age (aged 68 years and over) using the multidimensional frailty definition based on the competing risk regression model (HR = 1.61, 95% CI 1.06~2.43) and Cox proportional hazard model (HR = 1.76, 95% CI 1.19~2.61).

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“…Our study showed that the overall prevalence of frailty of all the elderly hospitalized patients was 27.6% which was evaluated by the combined index. Compared with the pooled prevalence of frailty among community-dwelling older people (10%), 14 elderly hospitalized patients deserve more attention on assessment and intervention of frailty. We found that the prevalence of frailty of inpatients from cardiac ward, non-surgical wards, and surgical wards was 20.7%, 42.4%, and 29.3%, respectively.…”

Section: Prevalence Of Frailty In Elderly Hospitalized Patientsmentioning

confidence: 99%

“…A recent systematic review indicates an overall pooled prevalence of frailty among Chinese community-dwelling older people of 10%. 14 A limited number of studies show that the prevalence of frailty among Chinese hospitalized older patients ranges from 18% to 54%, which are evaluated by different tools, mostly focusing on the department of geriatrics. [15][16][17][18][19][20] However, due to the different characteristics of the disease itself and therapeutic approaches, the results from geriatric ward cannot be simply applied to the situation of other wards.…”

Section: Introductionmentioning

confidence: 99%

<p>Identification of Frailty and Its Risk Factors in Elderly Hospitalized Patients from Different Wards: A Cross-Sectional Study in China</p>

Liang¹,

Zhang²,

Liu³

et al. 2019

CIA

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Objectives: To survey the difference of frailty prevalence in elderly inpatients amongdifferent wards; to compare the diagnostic performance of five frailty measurements (Clinical Frailty Scale [CFS], FRAIL, Fried, Edmonton, Frailty Index [FI]) in identifying frailty; and to explore the risk factors of frailty in elderly inpatients. Participants and methods: This was a cross-sectional study including 1000 inpatients (mean age 75.2±6.7 years, 51.5% male; 542, 229, and 229 patients from cardiology, nonsurgical, and surgical wards, respectively) in a tertiary hospital from September 2018 to February 2019. We applied the combined index to integrate the five frailty measurements mentioned above as the gold standard of frailty diagnosis. Multivariate logistic regression models were used to determine the independent risk factors of frailty. Results: Frailty prevalence was 32.3% (Fried), 36.2% (CFS), 19.2% (FRAIL), 25.2% (Edmonton), 35.1% (FI) in all patients. The frailty was more common in non-surgical wards, regardless of the frailty assessment tools used (non-surgical wards: 27.5% to 51.5%; cardiology ward: 14.9% to 29.3%; surgical wards: 18.8% to 41.9%). CFS≥5 showed a sensitivity of 94.1% and a specificity of 85.2% for all patients. FI≥0.25 showed a sensitivity of 94.8% and a specificity of 87.0% for all patients. Age [odds ratio (OR) = 1.089, P<0.001], education level (OR = 0.782, P=0.001), heart rate (OR = 1.025, P<0.001), albumin (OR = 0.911, P=0.002), log D-dimer (OR = 2.940, P<0.001), ≥5 comorbidities (OR = 2.164, P=0.002), and ≥5 medications (OR = 2.819, P<0.001) were independently associated with frailty in all participants. Conclusion: Frailty is common among elderly inpatients, especially in non-surgical wards. CFS is a preferred screening tool and FI may be an optimal assessment tool. Old age, low educational level, fast heart rate, low albumin, high D-dimer, ≥5 comorbidities, and polypharmacy are independent risk factors of frailty in elderly hospitalized patients.

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Prevalence and Risk Factors for Frailty Among Community-Dwelling Older People in China: A Systematic Review and Meta-Analysis

Cited by 188 publications

References 37 publications

Changes in frailty among community-dwelling Chinese older adults and its predictors: evidence from a two-year longitudinal study

Changes in frailty among community-dwelling Chinese older adults and its predictors: evidence from a two-year longitudinal study

The association between frailty and incidence of dementia in Beijing: findings from 10/66 dementia research group population-based cohort study

<p>Identification of Frailty and Its Risk Factors in Elderly Hospitalized Patients from Different Wards: A Cross-Sectional Study in China</p>

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