Prevalence of Prefrailty and Frailty Among Older Adults in Germany: A Systematic Review, Meta-Analysis and Meta-Regression

Abstract

BackgroundVarious studies have identified the prevalence of prefrailty and frailty among older adults in Germany. Nevertheless, there is no review systematically synthesizing these studies. Thus, our aim was to close this gap in knowledge. Moreover, another aim was to perform a meta-analysis to synthesize the pooled prevalence of prefrailty and frailty. A further aim was to explore potential sources of heterogeneity based on a meta-regression.MethodsA number of three electronic databases (PubMed, PsycINFO, and CINAHL) were searched (plus an additional hand search). The observational studies that determine the prevalence of frailty among older adults aged 65 years and above in Germany were included, whereas disease-specific samples were excluded. Data extraction included the description of the sample, operationalization of frailty, statistical analysis, sample characteristics and main findings. The established Joanna Briggs Institute (JBI) standardized critical appraisal instrument for prevalence studies was used for evaluating the quality of the studies. Important steps were performed by two reviewers.ResultsIn sum, a number of 12 studies were included. The prevalence of frailty varied from about 2.4 to 25.6%. The pooled prevalence of frailty was 13.7% (95% CI: 9.0 to 18.5%). There was a significant heterogeneity among the studies (I2 = 98.9%, p < 0.001). The pooled prevalence of prefrailty was 40.2% (95% CI: 28.3 to 52.1%; I2 = 99.6%, p < 0.001). Some evidence of a publication bias exists. Meta-regressions showed that some of the heterogeneity was explained by the tool to quantify frailty and the average age of the respective sample.ConclusionParticularly, the high prevalence of prefrailty should be highlighted since it is important to prevent individuals in old age from developing to frail status. This knowledge is important for the German society as a whole and for relevant stakeholders.Systematic Review RegistrationPROSPERO, identifier: CRD42021293648.

International Classification of Diseases-10th Revision Surrogates of the Modified Frailty Index and 12-Month Referral to the Hospital in an Older Population from Germany

“…These results are in line with the scientific literature showing that pre-frailty and frailty are common in old age in Germany. For example, a systematic review and meta-analysis of 12 studies revealed that the prevalence of frailty in the older German population ranged from 2.4% to 25.6%, while the pooled prevalence of pre-frailty was 40.2% [18]. Interestingly, in the present study, the proportion of individuals with more than three ICD-10 surrogates of the mFI increased with age.…”

Relationship Between Frailty and Diabetic Pharmacologic Therapy in Older Adults with Type 2 Diabetes: A Cross-Sectional Study

“…Frailty is a condition that specifically affects older adults [ 1 ] and requires comprehensive management on a global scale [ 2 , 3 ]. Globally, approximately 13.7% of adults aged >65 years show frailty [ 4 ]. In Japan, 8.7% of people aged ≥65 years are considered frailty [ 5 ].…”

Social support and frailty progression in community-dwelling older adults

“…Frailty is commonly preceded by prefrailty, a prodromal phase that represents potentially reversible mild depletion of physiological reserves ( 7 , 8 ). Prefrailty is more prevalent than frailty with prefrail individuals having a higher risk of transitioning to frailty than robust individuals ( 2 , 9 , 10 ). Frailty is a dynamic condition that could remain stable, worsen or even improve over time ( 11 ).…”