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

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  • Physical Frailty
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An Erratum to this article was published on 06 June 2021

This article has been updated

Abstract

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 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. A 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. 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. Five systematic reviews were included, with a total of 434,115 participants. Three systematic reviews focused on single frailty scales; one evaluated Fried’s 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 of the systematic reviews found that frailty was significantly associated with all-cause mortality. This umbrella review demonstrates that frailty is a significant predictor of all-cause mortality, irrespective of the specific frailty scale.

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Abbreviations

AMSTAR-2:

A MeaSurement Tool to Assess systematic Reviews Version 2

CDSR:

Cochrane Database of Systematic Reviews

FRAIL:

Fatigue, Resistance, Ambulation, Illness, and Loss of weight

HR:

Hazard Ratio

JBI:

Joanna Briggs Institute

OR:

Odds Ratio

PRISMA:

Preferred Reporting Items for Systematic Reviews and Meta-Analyses

PROSPERO:

International Prospective Register of Systematic Reviews

RR:

Relative Risk

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Acknowledgments

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Authors and Affiliations

Authors

Contributions

ARMSE developed the idea, searched the literature, reviewed articles, extracted data, and contributed to writing. CB searched and reviewed the literature. RLW, SEE, ME, and JR reviewed, edited, and contributed to writing. All authors read and approved the final manuscript.

Corresponding author

Correspondence to A. R. M. Saifuddin Ekram.

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It was not requested being a review of already published literature.

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Availability of data and materials

The datasets generated during the current study are available from the corresponding author.

Competing interests

The authors declare that they have no competing interests.

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Ekram, A.R.M.S., Woods, R.L., Britt, C. et al. The Association Between Frailty and All-Cause Mortality in Community-Dwelling Older Individuals: An Umbrella Review. J Frailty Aging 10, 320–326 (2021). https://doi.org/10.14283/jfa.2021.20

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