A review of frailty in developing countries
As the population ages, the prevalence and clinical importance of frailty are increasing. There have been few published studies about frailty in developing world. This study aims to review the evidence from developing countries on the prevalence of frailty, definition of frailty and factors associated with frailty.
A literature search was conducted via MEDLINE and EMBASE. Keywords included “frail”, “frailty”, “prevalence”, “criteria”, “definition”, “risk factors”, “outcomes”, “developing country”, “developing world”, and names of low and middle income countries according to the classification of the World Bank.
A total of 14 articles were reviewed from Brazil (n=6), China (n=3), Mexico (n=2), and one each from Russia, India, and Peru. There were 9 articles from community-based studies and 5 articles from hospital-based studies. Fried’s phenotype for frailty was used to define frailty in the majority of studies. The prevalence of frailty in community-dwelling older people was 17%–31% in Brazil, 15% in Mexico, 5%–31% in China, and 21%–44% in Russia. The prevalence of frailty was 49% in institutionalized older patients in Brazil and 32% in hospitalized older patients in India. The prevalence of frailty in outpatient clinics was 55%–71% in Brazil and 28% in Peru. Frailty was associated with increased mortality and comorbidities, decreased physical and cognitive function, and poor perceptions of health.
The limited studies available suggest that frailty occurs frequently in older people in the developing world and it appears to be associated with adverse outcomes. This has implications for policy and health care provision for these ageing populations.
Key wordsFrailty prevalence outcome developing countries low and middle income countries
Unable to display preview. Download preview PDF.
- 1.Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. 1. He, W., M.N. Muenchrath, and P. Kowal, Wan He, Mark N. Muenchrath, and Paul Kowal, U.S. Census Bureau, Shades of Gray: A Cross-Country Study of Health and Well-Being of the Older Populations in SAGE Countries, 2007–2010, U.S. Government Printing Office, Washington, DC, 2012.Google Scholar
- 3.Hilmer, S.N. and D. Gnjidic, Frailty: Chapter 12. In: Caplan G. ed. Geriatric Medicine: An Introduction. IP Communications, 2014:189–201.Google Scholar
- 10.Garcia-Gonzlez, J.J., et al., A frailty index to predict the mortality risk in a population of senior mexican adults. BMC Geriatrics, 2009. 9(1).Google Scholar
- 13.Dupre, M.E., et al., Frailty and type of death among older adults in China: Prospective cohort study. BMJ (Online), 2009. 338(7700): p. 924–927.Google Scholar
- 17.Da Silva, V.A., K.L. de Souza, and M.J. D’Elboux, Urinary incontinence and the criteria of frailness among the elderly outpatients. Revista da Escola de Enfermagem, 2011. 45(3): p. 672–678.Google Scholar
- 19.Khandelwal, D., et al., Frailty is associated with longer hospital stay and increased mortality in hospitalized older patients. Journal of Nutrition, Health and Aging, 2012: p. 1–4.Google Scholar
- 21.Capistrant, B.D., M.M. Glymour, and L.F. Berkman, Assessing mobility difficulties for cross-national comparisons: Results from the world health organization study on global ageing and adult health. Journal of the American Geriatrics Society, 2014. 62(2): p. 329–335.PubMedCentralCrossRefPubMedGoogle Scholar