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

Shu-Fang CHANG ； Chih-Ling CHENG ； Hsiang-Chun LIN

《The Journal of Nursing Research》 27卷3期 (2019/06) Pp. 1-10-010

https://doi.org/10.1097/jnr.0000000000000299

摘要

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.

關鍵字

frailty ； disability ； systematic review ； meta-analysis

參考文獻

Chang, S. F., & Chiu, S. C. (2015). Constructing optimized criteria for the objective physical function assessment of elderly people with frailty. The Journal of Long-Term Care, 19(2), 213–220. https://doi.org/10.6317/LTC.19.213 (Original work published in Chinese)

Abizanda, P., Romero, L., Sánchez-Jurado, P. M., Martínez-Reig, M., Gómez-Arnedo, L., & Alfonso, S. A. (2013). Frailty and mortality, disability and mobility loss in a Spanish cohort of older adults: The FRADEA Study. Maturitas, 74(1), 54–60. https://doi.org/10.1016/j.maturitas.2012.09.018

Al Snih, S., Graham, J. E., Ray, L. A., Samper-Ternent, R., Markides, K. S., & Ottenbacher, K. J. (2009). Frailty and incidence of activities of daily living disability among older Mexican Americans. Journal of Rehabilitation Medicine, 41(11), 892–897. https://doi.org/10.2340/16501977-0424

Ávila-Funes, J. A., Amieva, H., Barberger-Gateau, P., Le Goff, M., Raoux, N., Ritchie, K., & Dartigues, J. F. (2009). Cognitive impairment improves the predictive validity of the phenotype of frailty for adverse health outcomes: The three-city study. Journal of the American Geriatrics Society, 57(3), 453–461. https://doi.org/10.1111/j.1532-5415.2008.02136.x

Bandeen-Roche, K., Xue, Q. L., Ferrucci, L.,Walston, J., Guralnik, J. M., Chaves, P., … Fried, L. P. (2006). Phenotype of frailty: Characterization in the women's health and aging studies. The Journals of Gerontology: Series A: Biological Sciences and Medical Sciences, 61(3), 262–266. https://doi.org/10.1093/gerona/61.3.262