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

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The journal of nutrition, health & aging

Abstract

Objective

To systematically assess the prevalence of frailty, including prefrailty, stratified prevalence according to frailty criteria, gender, age, and region, and the risk factors for frailty in China.

Design

We conducted a systematic literature review and meta-analysis using articles available in 8 databases including PubMed, Cochrane Library, Web of Science, CINAHL Plus, China Knowledge Resource Integrated Database (CNKI), Wanfang Database, Chinese Biomedical Database (CBM), and Weipu Database (VIP).

Setting

Crosssectional and cohort data from Chinese community.

Participants

Community-dwelling adults aged 65 and older.

Measurements

Two authors independently extracted data based upon predefined criteria. Where data were available we conducted a meta-analysis of frailty parameters using a random-effects model.

Results

We screened 915 different articles, and 14 studies (81258 participants) were ultimately included in this analysis. The prevalence of frailty and prefrailty in individual studies varied from 5.9% to 17.4% and from 26.8% to 62.8%, respectively. The pooled prevalence of frailty and prefrailty were 10% (95% CI: 8% to 12%, I2 = 97.4%, P = 0.000) and 43% (95% CI: 37% to 50%, I2 = 98.0%, P = 0.000), respectively. The pooled frailty prevalence was 8% for the Fried frailty phenotype, 12% for the frail index, and 15% for the FRAIL scale. Age-stratified meta-analyses showed the pooled prevalence of frailty to be 6%, 15%, and 25% for those aged 65–74, 75–84, and ≥85 years old, respectively. The pooled prevalence of frailty was 8% for males and 11% for females. The pooled prevalence of frailty in Mainland China, Taiwan, and Hong Kong was 12%, 8%, and 14%, respectively. The pooled frailty prevalence was 10% in urban areas and 7% in rural areas. After controlling for confounding variables, increasing age (OR = 1.28, 95% CI: 1.2 to 1.36, I2 = 98.0%, P = 0.000), being female (OR = 1.29, 95% CI: 1.16 to 1.43, I2 =92.7%, P=0.000), activities of daily living (ADL) disability (OR = 1.72, 95% CI: 1.57 to 1.90, I2 = 99.7%, P = 0.000), and having three or more chronic diseases (OR = 1.97, 95% CI: 1.78 to 2.18, I2 = 97.5%, P = 0.000) were associated with frailty.

Conclusions

These findings of this review indicate an overall pooled prevalence of frailty among Chinese community-dwelling older people of 10%. Increasing age, being female, ADL disability, and having three or more chronic diseases were all risk factors for frailty. Further research will be needed to identify additional frailty risk factors in order to better treat and prevent frailty in the community.

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Author notes

  1. These authors are co-first author.

Authors and Affiliations

  1. School of Nursing, Gansu University of Chinese Medicine, Lanzhou, China

    B. He & X. Chang

  2. Evidence-based care center, School of Nursing, Lanzhou University, Lanzhou, China

    Y. Ma

  3. Gansu Provincial Hospital, Lanzhou, China

    C. Wang & Lin Han

  4. School of Nursing, Lanzhou University, Lanzhou, China

    M. Jiang, C. Geng & Lin Han

  5. Evidence-based center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China

    B. Ma

  6. Nursing department, Gansu Provincial Hospital, No.204 donggang west road, chengguan district, Lanzhou, China

    Lin Han

  7. School of Nursing, Lanzhou University, No.28 yanxi road, chengguan district, Lanzhou, China, 730000

    Lin Han

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  1. B. He
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Correspondence to Lin Han.

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He, B., Ma, Y., Wang, C. et al. Prevalence and Risk Factors for Frailty Among Community-Dwelling Older People in China: A Systematic Review and Meta-Analysis. J Nutr Health Aging 23, 442–450 (2019). https://doi.org/10.1007/s12603-019-1179-9

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  • DOI: https://doi.org/10.1007/s12603-019-1179-9

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