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Yang Y, Chen B, Deng M, Song H, Yu M. The prevalence of frailty among patients with metabolic syndrome: a systematic review and meta-analysis. Contemp Nurse 2024; 60:479-495. [PMID: 38847296 DOI: 10.1080/10376178.2024.2360960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 05/22/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND Growing evidence shows that metabolic syndrome and frailty are significantly associated. Screening and assessing frailty in patients with metabolic syndrome is important to help improve their clinical outcomes and quality of life. Therefore, understanding the prevalence of frailty in patients with metabolic syndrome is the first critical step, however, the prevalence reported in the literature varies widely. AIM To pool the overall prevalence of frailty among patients with metabolic syndrome. DESIGN Systematic review and meta-analysis. METHODS The Cochrane Library, PubMed, Web of Science, Embase, APA PsycINFO, Scopus, CINAHL Complete, CNKI, Wan Fang, SinoMed, and VIP databases were searched from the inception to March 6, 2024. Statistical analysis was performed using STATA15 software. The prevalence was pooled using the random-effects model. The sources of heterogeneity were investigated by using meta-regression and subgroup analyses. RESULTS A total of 22 original studies published between 2007 and 2023 were included in this systematic review and meta-analysis, involving 19,921 metabolic syndrome patients. The prevalence of frailty and pre-frailty among patients with metabolic syndrome was 20% (95% CI: 16% to 25%, I2 = 99.44%) and 45% (95% CI: 36% to 53%, I2 = 99.20%). Subgroup analyses revealed differences in prevalence by frailty instruments, geographic regions, study settings, publication years, study quality, study design, and different components of metabolic syndrome. CONCLUSIONS This systematic review and meta-analysis showed the high prevalence of frailty and pre-frailty in patients with metabolic syndrome. In the future, more high-quality longitudinal studies and exploration of other potential demographic characteristics that may influence frailty are needed to understand more information on frailty in patients with metabolic syndrome.
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Affiliation(s)
- Yufan Yang
- School of Nursing, Peking University, Beijing, People's Republic of China
| | - Bei Chen
- The Second College of Clinical Medicine, Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Mengying Deng
- School of Nursing, Peking University, Beijing, People's Republic of China
| | - Hongdan Song
- School of Nursing, Peking University, Beijing, People's Republic of China
| | - Mingming Yu
- School of Nursing, Peking University, Beijing, People's Republic of China
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2
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Mishra M, Wu J, Kane AE, Howlett SE. The intersection of frailty and metabolism. Cell Metab 2024; 36:893-911. [PMID: 38614092 PMCID: PMC11123589 DOI: 10.1016/j.cmet.2024.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 03/11/2024] [Accepted: 03/21/2024] [Indexed: 04/15/2024]
Abstract
On average, aging is associated with unfavorable changes in cellular metabolism, which are the processes involved in the storage and expenditure of energy. However, metabolic dysregulation may not occur to the same extent in all older individuals as people age at different rates. Those who are aging rapidly are at increased risk of adverse health outcomes and are said to be "frail." Here, we explore the links between frailty and metabolism, including metabolic contributors and consequences of frailty. We examine how metabolic diseases may modify the degree of frailty in old age and suggest that frailty may predispose toward metabolic disease. Metabolic interventions that can mitigate the degree of frailty in people are reviewed. New treatment strategies developed in animal models that are poised for translation to humans are also considered. We suggest that maintaining a youthful metabolism into older age may be protective against frailty.
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Affiliation(s)
- Manish Mishra
- Department of Pharmacology, Dalhousie University, Halifax, NS, Canada
| | - Judy Wu
- Institute for Systems Biology, Seattle, WA, USA
| | - Alice E Kane
- Institute for Systems Biology, Seattle, WA, USA; Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Susan E Howlett
- Department of Pharmacology, Dalhousie University, Halifax, NS, Canada; Department of Medicine (Geriatric Medicine), Dalhousie University, Halifax, NS, Canada.
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Peng J, Ming L, Wu J, Li Y, Yang S, Liu Q. Prevalence and related factors of cognitive frailty in diabetic patients in China: a systematic review and meta-analysis. Front Public Health 2023; 11:1249422. [PMID: 37927856 PMCID: PMC10620522 DOI: 10.3389/fpubh.2023.1249422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 10/02/2023] [Indexed: 11/07/2023] Open
Abstract
Objective Cognitive frailty (CF) is characterized by physical frailty and potentially reversible cognitive impairment without Alzheimer's disease and other dementias. Clarifying the prevalence and related factors of cognitive frailty can help researchers understand its epidemiological status and formulate intervention measures. This study aims to conduct a systematic review and meta-analysis of the prevalence and related factors of CF in diabetic patients in Chinas to better understand the current status of CF in diabetic patients in China and develop effective intervention measures for related factors. Methods PubMed, Web of Science, Embase, Cochrane Library, CNKI, Weipu(VIP), WANFANG, China Biology Medicine (CBM) and DUXIU were searched to collect epidemiological data on Chinese diabetic patients. Articles published through May 29, 2023, were searched. The number of diabetes with CF and the total number of diabetes in the included studies were extracted to estimate the prevalence of diabetes with CF. For factors related to diabetes with CF, odds ratios (OR) and 95% confidence intervals (CI) were used for estimation. Results A total of 248 records were screened, of which 18 met the inclusion criteria. The results of meta-analysis showed that the prevalence of Chinese diabetic patients with CF was 25.8% (95% CI = 19.7 to 31.9%). Subgroup analysis showed that hospital prevalence was higher than in the community and in women than in men. Combined estimates showed that depression, malnutrition, advanced age (≥70, ≥80), combined chronic diseases ≥4 and glycated hemoglobin ≥8.5 were risk factors for CF in diabetics patients in China, with regular exercise and high education level (≥ college) as protective factors. Conclusion Cognitive frailty was common in diabetic patients in China. Such populations should be screened early and intervened with relevant factors.Systematic review registration: A systematic review of this study evaluated the registered websites as https://www.crd.york.ac.uk/PROSPERO/, CRD42023431396.
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Affiliation(s)
- Junjie Peng
- School of Nursing, Yunnan University of Chinese Medicine, Kunming, Yunnan, China
| | - Limei Ming
- School of Nursing, Yunnan University of Chinese Medicine, Kunming, Yunnan, China
| | - Jiaming Wu
- School of Nursing, Yunnan University of Chinese Medicine, Kunming, Yunnan, China
| | - Yunchuan Li
- School of Nursing, Yunnan University of Chinese Medicine, Kunming, Yunnan, China
| | - Shuhua Yang
- The First People's Hospital of Yunnan Province, Kunming, Yunnan, China
| | - Qin Liu
- School of Nursing, Yunnan University of Chinese Medicine, Kunming, Yunnan, China
- Postdoctoral Research Station of Public Administration, Yunnan University, Kunming, Yunnan, China
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Dao HHH, Burns MJ, Kha R, Chow CK, Nguyen TN. The Relationship between Metabolic Syndrome and Frailty in Older People: A Systematic Review and Meta-Analysis. Geriatrics (Basel) 2022; 7:76. [PMID: 35893323 PMCID: PMC9330874 DOI: 10.3390/geriatrics7040076] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 07/15/2022] [Accepted: 07/21/2022] [Indexed: 11/16/2022] Open
Abstract
AIMS Both metabolic syndrome (MetS) and frailty are associated with increased all-cause mortality, yet the complex interplay between these two conditions has not adequately been elucidated. We aim to analyse the relationship between MetS and frailty through a systematic review of the literature with meta-analyses. METHODS A literature search was conducted via MEDLINE and EMBASE. Studies were included if validated frameworks for defining frailty and MetS (presence of at least 3 out of the five constitutive components: abdominal obesity, high fasting blood glucose, hypertension, hypertriglyceridaemia, and low high-density lipoprotein level) were utilised, in addition to the inclusion of participants aged 60 or older. RESULTS Eleven studies were included, all observational. All were in community-dwelling older people, 9 cross-sectional and 2 longitudinal. Most of the studies used Fried's frailty phenotype. The prevalence of frailty ranged from 0.9% to 14.8% in population-based studies and 35.6% in the outpatient clinic setting. The prevalence of MetS was also higher in the outpatient clinic setting at 47.5%, compared to 17.5-41.0% in the community-dwelling populations. The meta-analysis of 11 studies showed that MetS was associated with an increased risk of frailty (pooled OR 1.73, 95% CI, 1.41-2.13). CONCLUSION This systematic review and meta-analysis suggest that frailty was more prevalent in older people with MetS compared to older people without MetS. The study findings suggest the importance of frailty screening in older people with MetS and a distinct role of managing MetS in preventing frailty in older people.
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Affiliation(s)
- Hiep Huu Hoang Dao
- Westmead Applied Research Centre, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2145, Australia; (H.H.H.D.); (M.J.B.); (R.K.); (C.K.C.)
| | - Mason Jenner Burns
- Westmead Applied Research Centre, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2145, Australia; (H.H.H.D.); (M.J.B.); (R.K.); (C.K.C.)
| | - Richard Kha
- Westmead Applied Research Centre, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2145, Australia; (H.H.H.D.); (M.J.B.); (R.K.); (C.K.C.)
| | - Clara K. Chow
- Westmead Applied Research Centre, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2145, Australia; (H.H.H.D.); (M.J.B.); (R.K.); (C.K.C.)
- Department of Cardiology, Westmead Hospital, Westmead, NSW 2145, Australia
| | - Tu Ngoc Nguyen
- Westmead Applied Research Centre, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2145, Australia; (H.H.H.D.); (M.J.B.); (R.K.); (C.K.C.)
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What Is Frailty? Perspectives from Chinese Clinicians and Older Immigrants in New Zealand. J Cross Cult Gerontol 2021; 36:201-213. [PMID: 33830425 PMCID: PMC8203539 DOI: 10.1007/s10823-021-09424-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2021] [Indexed: 11/03/2022]
Abstract
This qualitative study explores the meanings of frailty held by Chinese New Zealanders and Chinese health care professionals with the aim of identifying commonalities as well as potential differences. Two guided focus groups with Mandarin and Cantonese speaking older adults (n = 10), one individual interview with a English speaking older Chinese, and one focus group with Chinese New Zealand health care professionals (n = 7) were held to obtain views on frailty in older adults, followed by transcribing and a thematic qualitative analysis. Three main themes emerged: (1) Frailty is marked by ill-health, multiple chronic and unstable medical comorbidities, and is a linked with polypharmacy; (2) Frailty can involve physical weakness, decline in physical function such as reduced mobility or poor balance, and declining cognitive function; and (3) Frailty is associated with psychological and social health including depression, reduced motivation, social isolation, and loss of confidence. The perspectives of frailty that emerged are congruent with a multi-dimensional concept of frailty that has been described in both Chinese and non-Chinese medical research literature.
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Yuan Y, Li J, Zhang N, Fu P, Jing Z, Yu C, Zhao D, Hao W, Zhou C. Body mass index and mild cognitive impairment among rural older adults in China: the moderating roles of gender and age. BMC Psychiatry 2021; 21:54. [PMID: 33485307 PMCID: PMC7825154 DOI: 10.1186/s12888-021-03059-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 01/17/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Evidence concerning the association between body mass index (BMI) and cognitive function among older people is inconsistent. This study aimed to investigate gender and age as moderators in association between BMI and mild cognitive impairment (MCI) among rural older adults. METHODS Data were derived from the 2019 Health Service for Rural Elderly Families Survey in Shandong, China. In total, 3242 people aged 60 years and above were included in the analysis. Multilevel mixed-effects logistic regression was used to examine the moderating roles of gender and age, then further to explore the relationship between BMI and MCI. RESULTS There were 601 (18.5%) participants with MCI. Compared with normal BMI group, low BMI group had a higher risk of MCI among older people [adjusted odds ratio (aOR) = 2.08, 95% confidence interval (CI): 1.26-3.44], women (aOR = 2.06, 95% CI: 1.35-3.12), or the older elderly aged ≥75 years old (aOR = 3.20, 95% CI: 1.34-7.45). This effect remained statistically significant among older women (aOR = 3.38, 95% CI: 1.69-6.73). Among older men, elevated BMI group had a higher risk of MCI (aOR = 2.32, 95% CI: 1.17-4.61) than normal BMI group. CONCLUSIONS Gender and age moderated the association between BMI and MCI among Chinese rural older adults. Older women with low BMI were more likely to have MCI, but older men with elevated BMI were more likely to have MCI. These findings suggest rural community managers strengthen the health management by grouping the weight of older people to prevent the risk of dementia.
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Affiliation(s)
- Yemin Yuan
- grid.27255.370000 0004 1761 1174Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 China ,grid.27255.370000 0004 1761 1174Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Jinan, 250012 Shandong China
| | - Jie Li
- grid.27255.370000 0004 1761 1174Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 China
| | - Nan Zhang
- grid.5379.80000000121662407Manchester Institute for Collaborative Research on Ageing, Social Statistics, School of Social Sciences, The University of Manchester, Manchester, UK
| | - Peipei Fu
- grid.27255.370000 0004 1761 1174Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 China
| | - Zhengyue Jing
- grid.27255.370000 0004 1761 1174Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 China
| | - Caiting Yu
- grid.27255.370000 0004 1761 1174Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 China
| | - Dan Zhao
- grid.27255.370000 0004 1761 1174Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 China
| | - Wenting Hao
- grid.27255.370000 0004 1761 1174Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 China
| | - Chengchao Zhou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China. .,NHC Key Laboratory of Health Economics and Policy Research, Shandong University, 44 Wenhuaxi Road, Jinan, 250012, Shandong, China.
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Abstract
Although geriatric research in general has increased in recent years, there is no effective treatment for frailty. Among older adults, those with frailty have an increased risk of falls, disability, and death. The population of older adults has increased rapidly in China, and resulting in an increased demand for medical care services for older adults, including those with frailty. However, much of the research on frailty has been conducted in Europe and the United States, and European and American standards for frailty are not always applicable to Chinese individuals. Clinicians and researchers in China have shown increasing interest in frailty in recent years. Here, we reviewed the current state of frailty research in China.
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Affiliation(s)
- L Ma
- Dr. Lina Ma, Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing 100053, China, E-mail:
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Palmer K, Vetrano DL, Padua L, Romano V, Rivoiro C, Scelfo B, Marengoni A, Bernabei R, Onder G. Frailty Syndromes in Persons With Cerebrovascular Disease: A Systematic Review and Meta-Analysis. Front Neurol 2019; 10:1255. [PMID: 31849819 PMCID: PMC6896936 DOI: 10.3389/fneur.2019.01255] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 11/12/2019] [Indexed: 01/11/2023] Open
Abstract
Background: Frailty can change the prognosis and treatment approach of chronic diseases. Among others, frailty has been associated with cerebrovascular diseases such as stroke. However, the extent to which the two conditions are related is unclear, and no systematic review of the literature has been conducted. Objectives: To conduct a systematic review and meta-analysis assessing the association of cerebrovascular diseases and frailty, as well as prefrailty, in observational studies. The project was carried out on behalf of the Joint Action ADVANTAGE WP4 group. Methods: The review was performed according to PRISMA guidelines. We searched PubMed, Web of Science, and Embase from 01/01/2002-26/05/2019. Pooled estimates were obtained through random effect models and Mantel-Haenszel weighting. Homogeneity was assessed with the I2 statistic. Publication bias was assessed with Egger's and Begg's tests. Results: Of 1027 studies searched, 18 studies were included (n = 48,009 participants). Stroke was the only cerebrovascular disease studied in relation to frailty syndromes. All studies except one reported an association between stroke and prefrailty or frailty. However, most studies were not of high quality and there was heterogeneity between results. The pooled prevalence of prefrailty and frailty in stroke patients was 49% (95% CI = 42-57) and 22% (95% CI = 16-27), respectively. The prevalence of frailty was 2-fold in persons with stroke compared to those without stroke (pooled odds ratio = 2.32, 95% CI = 2.11-2.55). Only two studies longitudinally examined the association between stroke and frailty, producing conflicting results. Conclusions: Frailty and prefrailty are common in persons with stroke. These results may have clinical implications, as they identify the need to assess frailty in post-stroke survivors and assess how it may affect prognosis. Better quality, longitudinal research that examines the temporal relationship between stroke and frailty are needed, as well as studies on other types of cerebrovascular disease.
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Affiliation(s)
- Katie Palmer
- Department of Geriatrics, Centro Medicina dell'Invecchiamento, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Davide L. Vetrano
- Department of Geriatrics, Centro Medicina dell'Invecchiamento, Università Cattolica del Sacro Cuore, Rome, Italy
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Luca Padua
- Department of Geriatrics, Centro Medicina dell'Invecchiamento, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Valeria Romano
- Health Technology Assessment Department of the Institute for Economic and Social Research of Regione Piemonte, Turin, Italy
| | - Chiara Rivoiro
- Health Technology Assessment Department of the Institute for Economic and Social Research of Regione Piemonte, Turin, Italy
| | - Bibiana Scelfo
- Health Technology Assessment Department of the Institute for Economic and Social Research of Regione Piemonte, Turin, Italy
| | - Alessandra Marengoni
- Department of Clinical and Experimental Sciences, University of Brescia, Lombardy, Italy
| | - Roberto Bernabei
- Department of Geriatrics, Centro Medicina dell'Invecchiamento, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Graziano Onder
- Department of Cardiovascular, Metabolic and Aging Diseases, Istituto Superiore di Sanità, Rome, Italy
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Lam C, Li KK, Do CW, Chan H, To CH, Kwong JMK. Quantitative profiling of regional protein expression in rat retina after partial optic nerve transection using fluorescence difference two‑dimensional gel electrophoresis. Mol Med Rep 2019; 20:2734-2742. [PMID: 31524249 PMCID: PMC6691257 DOI: 10.3892/mmr.2019.10525] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 05/14/2019] [Indexed: 12/17/2022] Open
Abstract
To examine the difference between primary and secondary retinal ganglion cell (RGC) degeneration, the protein expression at four regions of retina including superior, temporal, inferior and nasal quadrant in a rat model of partial optic nerve transection (pONT) using 2-D Fluorescence Difference Gel Electrophoresis (DIGE) were investigated. Unilateral pONT was performed on the temporal side of optic nerves of adult Wistar rats to separate primary and secondary RGC loss. Topographical quantification of RGCs labeled by Rbpms antibody and analysis of axonal injury by grading of optic nerve damage at 1 week (n=8) and 8 weeks (n=15) after pONT demonstrated early RGC loss at temporal region, which is considered as primary RGC degeneration and progressing RGC loss at nasal region, which is considered as secondary RGC degeneration. Early protein expression in each retinal quadrant (n=4) at 2 weeks after pONT was compared with the corresponding quadrant in the contralateral control eye by DIGE. For all comparisons, 24 differentially expressed proteins (>1.2-fold; P<0.05; ≥3 non-duplicated peptide matches) were identified by mass spectrometry (MS). Interestingly, in the nasal retina, serum albumin and members of crystallin family, including αA, αB, βA2, βA3, βB2 and γS indicating stress response were upregulated. By contrast, only αB and βA2 crystallin proteins were altered in temporal quadrant. In the superior and inferior quadrants, βB2 crystallin, keratin type I, S-arrestin and lamin-B1 were upregulated, while heat shock cognate 71 kDa protein and heterogeneous nuclear ribonucleoproteins A2/B1 were downregulated. In summary, the use of DIGE followed by MS is useful to detect early regional protein regulation in the retina after localized optic nerve injury.
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Affiliation(s)
- Chuen Lam
- School of Optometry, Hong Kong Polytechnic University, Hong Kong 999077, SAR, P.R. China
| | - King Kit Li
- School of Optometry, Hong Kong Polytechnic University, Hong Kong 999077, SAR, P.R. China
| | - Chi Wai Do
- School of Optometry, Hong Kong Polytechnic University, Hong Kong 999077, SAR, P.R. China
| | - Henry Chan
- School of Optometry, Hong Kong Polytechnic University, Hong Kong 999077, SAR, P.R. China
| | - Chi Ho To
- School of Optometry, Hong Kong Polytechnic University, Hong Kong 999077, SAR, P.R. China
| | - Jacky Man Kwong Kwong
- Department of Ophthalmology, Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA
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