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Qiu Y, Li G, Wang X, Liu W, Li X, Yang Y, Wang L, Chen L. Prevalence of multidimensional frailty among community-dwelling older adults: A systematic review and meta-analysis. Int J Nurs Stud 2024; 154:104755. [PMID: 38522186 DOI: 10.1016/j.ijnurstu.2024.104755] [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: 10/18/2023] [Revised: 03/02/2024] [Accepted: 03/08/2024] [Indexed: 03/26/2024]
Abstract
OBJECTIVE The aims of this systematic review were to explore the pooled prevalence of multidimensional frailty assessed by the Tilburg Frailty Indicator among community-dwelling older adults. DESIGN A systematic review and meta-analysis. METHODS A comprehensive literature search was conducted across multiple databases, including PubMed, Web of Science, Embase, the Cochrane Library, CINAHL and three Chinese databases. Two independent researchers selected the literatures, extracted the data and evaluated the quality. All statistical analyses were performed using STATA version 16.0. RESULTS There were 66 studies with a total of 40,597 individuals that were eligible for the meta-analysis. Data from the meta-analysis revealed the pooled prevalence of 42 % for multidimensional frailty (95 % CI: 38 %-45 %, I2 = 98.9 %, T2 = 0.024, p < 0.001). Among the six studies that provided data for different age groups, the results demonstrated an increasing trend in the prevalence of multidimensional frailty with advancing age. The results of gender-stratified analysis proved that the pooled prevalence of multidimensional frailty in women (45 %, 95 % CI: 39 %-51 %, p < 0.001) was higher than that in men (33 %, 95 % CI: 28 %-39 %, p < 0.001). Based on different education levels, the prevalence of multidimensional frailty is highest in the primary elementary or illiterate group (41 %, 95 % CI: 30 %-52 %, p < 0.001). According to different marital status types, the pooled prevalence of multidimensional frailty in the married group was significantly lower (36 %, 95 % CI: 28 %-43 %) than that in the unmarried, divorced or widowed group (51 %, 95 % CI: 37 %-65 %). CONCLUSIONS Through a comprehensive review, we identified that 42 % of elderly individuals living in communities exhibit multidimensional frailty, indicating that multidimensional frailty is relatively common in this population. Stratified analysis revealed that advanced age, female gender, lower education level and unmarried status were associated with higher rates of multidimensional frailty.
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Affiliation(s)
- Yiming Qiu
- School of Nursing, Jilin University, No. 965 Xinjiang Street, Changchun, Jilin 130021, China.
| | - Guichen Li
- School of Nursing, Jilin University, No. 965 Xinjiang Street, Changchun, Jilin 130021, China.
| | - Xinxin Wang
- The First Hospital of Jilin University, 1 Xinmin Street, Changchun 130021, China.
| | - Wei Liu
- School of Nursing, Jilin University, No. 965 Xinjiang Street, Changchun, Jilin 130021, China.
| | - Xin Li
- School of Nursing, Jilin University, No. 965 Xinjiang Street, Changchun, Jilin 130021, China.
| | - Yali Yang
- School of Nursing, Jilin University, No. 965 Xinjiang Street, Changchun, Jilin 130021, China.
| | - Lisheng Wang
- School of Nursing, Jilin University, No. 965 Xinjiang Street, Changchun, Jilin 130021, China.
| | - Li Chen
- School of Nursing, Jilin University, No. 965 Xinjiang Street, Changchun, Jilin 130021, China; Department of Pharmacology, College of Basic Medical Sciences, Jilin University, Changchun, China.
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Vo NT, Tu YK, Lin KC, Chiu HY, Huang HC. Diagnostic Accuracy of the FRAIL Scale, Groningen Frailty Indicator, Tilburg Frailty Indicator, and PRISMA-7 for Frailty Screening Among Older Adults in Community Settings: A Systematic Review and Network Meta-Analysis. THE GERONTOLOGIST 2024; 64:gnae008. [PMID: 38332716 DOI: 10.1093/geront/gnae008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND AND OBJECTIVES This study aimed to investigate the diagnostic accuracy of four questionnaire-based tools (i.e., the FRAIL scale, Groningen Frailty Indicator [GFI], Tilburg Frailty Indicator [TFI], and PRISMA-7) for screening frailty in older adults. RESEARCH DESIGN AND METHODS The 4 databases comprising the Cumulative Index to Nursing and Allied Health Literature, Embase, PubMed, and ProQuest were searched from inception to June 20, 2023. Study quality comprising risks of bias and applicability was assessed via a QUADAS-2 questionnaire. A bivariate network meta-analysis model and Youden's index were performed to identify the optimal tool and cutoff points. RESULTS In total, 20 studies comprising 13 for FRAIL, 7 for GFI, 6 for TFI, and 5 for PRISMA-7 were included. Regarding study quality appraisal, all studies had high risks of bias for study quality assessment domains. Values of the pooled sensitivity of the FRAIL scale, GFI, TFI, and PRISMA-7 were 0.58, 0.74, 0.66, and 0.73, respectively. Values of the pooled specificity of the FRAIL scale, GFI, TFI, and PRISMA-7 were 0.92, 0.77, 0.84, and 0.86, respectively. The Youden's index was obtained for the FRAIL scale with a cutoff of 2 points (Youden's index = 0.65), indicating that the FRAIL scale with a cutoff of 2 points was the optimal tool for frailty screening in older adults. DISCUSSION AND IMPLICATIONS The FRAIL scale comprising 5 self-assessed items is a suitable tool for interview older adults for early frailty detection in community settings; it has the advantages of being short, simple, and easy to respond to.
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Affiliation(s)
- Nhi Thi Vo
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan, China
- Faculty of Nursing, University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
| | - Yu-Kang Tu
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan, China
- Department of Dentistry, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan, China
| | - Kuan-Chia Lin
- Institute of Hospital and Health Care Administration, Community Medicine Research Center, Preventive Medicine Research Center, National Yang-Ming University, Taipei, Taiwan, China
| | - Hsiao-Yean Chiu
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan, China
- Department of Nursing, Taipei Medical University Hospital, Taipei City, Taiwan, China
| | - Hui-Chuan Huang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan, China
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Liu J, Zhu Y, Tan JK, Ismail AH, Ibrahim R, Hassan NH. Factors Associated with Frailty in Older Adults in Community and Nursing Home Settings: A Systematic Review with a Meta-Analysis. J Clin Med 2024; 13:2382. [PMID: 38673654 PMCID: PMC11050860 DOI: 10.3390/jcm13082382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/06/2024] [Accepted: 03/07/2024] [Indexed: 04/28/2024] Open
Abstract
Background: Frailty is a globally recognized issue. However, there is a lack of evidence exploring factors associated with frailty among older residents in community and nursing-home settings. Methods: To explore the prevalence and factors associated with frailty among older adults in community and nursing-home settings, we conducted a systematic search following the PRISMA guidelines across Web of Science, MEDLINE, EMBASE, PubMed, and Cochrane databases up until January 2024, selecting 38 studies which encompassed 150,642 participants. Results: Our findings showed higher frailty prevalence in nursing homes compared to communities. Frailty was significantly associated with sociodemographic (living alone, poor self-reported health), physiological (poor sleep, low activity of daily living), behavioral (physical inactivity) and disease (chronic conditions, depression) factors in both community and nursing-home settings. Conclusions: There are numerous factors associated with frailty in older adults in nursing-home and community settings. These factors underscore the significance of promptly identifying high-risk individuals and devising appropriate interventions to mitigate frailty among them.
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Affiliation(s)
- Jia Liu
- Department of Nursing, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (J.L.); (A.H.I.)
| | - Yuezhi Zhu
- Department of Biochemistry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (Y.Z.); (J.K.T.)
| | - Jen Kit Tan
- Department of Biochemistry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (Y.Z.); (J.K.T.)
| | - Azera Hasra Ismail
- Department of Nursing, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (J.L.); (A.H.I.)
| | - Roszita Ibrahim
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia;
| | - Nor Haty Hassan
- Department of Nursing, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (J.L.); (A.H.I.)
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Öztürk Ö, Feyzioğlu Ö, Sarıtaş F. Identifying frailty and its associated factors in patients with axial spondyloarthritis. Int J Rheum Dis 2023; 26:519-530. [PMID: 36737413 DOI: 10.1111/1756-185x.14591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 12/16/2022] [Accepted: 01/16/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND AIM Frailty is an elderly people phenomenon; however, younger adults with comorbidities may show a higher trajectory of frailty toward older age. The frailty status of middle-aged patients with axial spondyloarthritis (axSpA) remains little researched. We aimed to identify frailty status and to investigate the association of clinical, sociodemographic, and psychosocial factors with frailty. METHODS This study included 114 patients aged between 40 and 65 years. The patients were classified as frail, pre-frail, and robust according to Fried's phenotype and the Kihon Checklist (KCL). Physical function, quality of life, depression, anxiety, and disease-related factors were assessed. Between-group comparisons and multinomial logistic regression analysis were performed. RESULTS Frailty and pre-frailty prevalences were 20.2% and 49.1% for Fried's phenotype and 36.0% and 33.3% for the KCL. Frail adults had impaired physical function and increased disease activity compared to pre-frail and robust patients. Adjusted multinomial logistic regression analysis revealed that disease activity (odds ratio [OR] = 1.62, 95% CI = 1.12-2.34) and Short Physical Performance Battery (OR = 0.32, 95% CI = 0.18-0.56) were associated with Fried's phenotype-determined frailty. Disease activity (OR = 1.91, 95% CI = 1.11-3.26), Bath Ankylosing Spondylitis Functional Index (OR = 2.70, 95% CI = 1.56-4.67), and depression (OR = 1.55, 95% CI = 1.18-2.02) were associated with the KCL determined frailty. CONCLUSION Frailty and pre-frailty are commonly detected in middle-aged individuals with axSpA. Our findings highlight a possible need for frailty screening and preventive programs targeting middle-aged axSpA patients.
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Affiliation(s)
- Özgül Öztürk
- Department of Physiotherapy and Rehabilitation, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Turkey
| | - Özlem Feyzioğlu
- Department of Physiotherapy and Rehabilitation, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Turkey
| | - Fatih Sarıtaş
- Department of Rheumatology, University of Health Sciences, Haydarpaşa Numune Research and Training Hospital, Istanbul, Turkey
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Abstract
AIMS To clarify the risk factors for frailty to help doctors prevent diseases that cause weakness, through early interventions. METHODS We searched the PubMed, EMBASE, and Cochrane Library databases to identify all relevant studies using the items "frailty," "weak," "risk factors," and "predictive factors" and compared their results. The aging population (≥65 years old) was divided into 2 groups, a "frailty group" and a "robust control group," and then the characteristics, lifestyles, and comorbidities were compared. RESULTS We compared the influence of baseline and concomitant diseases on frailty in the elderly respectively, and the analysis of the influence of baseline on frailty found that increasing age, lower weight, female sex, living alone, low levels of exercise, polypharmacy, higher education level, smoking, drinking, malnutrition, and lower vitamin D levels were associated with aging individuals being more likely to experience frailty. The data about concomitant diseases had shown that diabetes, hearing dysfunction, cognitive impairment, poor sleep, a history of falls, pain, and depression can increase the risk of frailty among the elderly population. CONCLUSION Characteristics, comorbidities, and lifestyle factors can impact the occurrence of frailty, and relevant influencing factors should be considered.
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Affiliation(s)
- Xinrui Wang
- Department of Nursery, Gulin people’s Hospital, Sichuan, China
| | - Jiji Hu
- Department of Nursery, Gulin people’s Hospital, Sichuan, China
| | - Diping Wu
- Department of Nursery, Gulin people’s Hospital, Sichuan, China
- *Correspondence: Diping Wu, Department of Nursery, Gulin people’s Hospital, Sichuan 646500, China (e-mail: )
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Zamora-Sánchez JJ, Urpí-Fernández AM, Sastre-Rus M, Lumillo-Gutiérrez I, Gea-Caballero V, Jodar-Fernández L, Julián-Rochina I, Zabaleta-Del-Olmo E. The Tilburg Frailty Indicator: A psychometric systematic review. Ageing Res Rev 2022; 76:101588. [PMID: 35150901 DOI: 10.1016/j.arr.2022.101588] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 01/11/2022] [Accepted: 02/07/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND The Tilburg Frailty Indicator (TFI) is one of the most prominent multidimensional frailty assessment instruments. This review aimed to critically appraise and summarise its measurement properties. METHODS Reports were eligible if they included results of studies aimed at developing the TFI or evaluating its measurement properties. We performed a literature search in MEDLINE, CINAHL, and PsycINFO databases from their inception until December 8, 2021. We also searched grey literature databases. We assessed the methodological quality of the included studies using the "COSMIN Risk of Bias". The measurement properties were evaluated using specific criteria. We graded the quality of the evidence using a GRADE approach. RESULTS Sixty-three studies were included. We found moderate sufficient evidence for TFI content validity, although it is still insufficient for the comprehensiveness of its items. TFI construct validity was based on sufficient evidence from two studies of its structural validity as well as multiple hypothesis-testing for construct validity studies with inconsistent results. We did not find any studies that assessed cross-cultural validity. Only one of TFI's three dimensions showed sufficient evidence for the internal consistency of its scores, and results in test-retest reliability were inconsistent. The TFI showed high sufficient concurrent validity with the comprehensive geriatric assessment. We identified several studies assessing its predictive validity for adverse frailty-related outcomes, although most of the evidence from these studies was insufficient. We did not find any studies that assessed the responsiveness of TFI scores. CONCLUSIONS The TFI had evidence gaps in several relevant measurement properties. Further research is needed to strengthen its usefulness as a clinical decision-making tool.
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Affiliation(s)
- Juan-José Zamora-Sánchez
- Gerència Territorial de Barcelona, Institut Català de la Salut, Barcelona, Spain; School of Nursing, Universitat de Barcelona, Barcelona, Spain.
| | | | - Meritxell Sastre-Rus
- Escola Universitària d'Infermeria Gimbernat, Universitat Autònoma de Barcelona, Sant Cugat del Vallès, Barcelona, Spain.
| | - Iris Lumillo-Gutiérrez
- School of Nursing, Universitat de Barcelona, Barcelona, Spain; Chronic Disease Management Team, Baix Llobregat Centre Primary Care Service, Costa de Ponent Primary Care Directorate, Gerència Territorial Metropolitana Sud, Institut Català de la Salut, Cornellà de Llobregat, Spain.
| | - Vicente Gea-Caballero
- Deanery, Faculty of Health Sciences, Valencian International University, Valencia, Spain; Nursing School "La Fe", University of Valencia, Valencia, Spain; Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain.
| | - Lina Jodar-Fernández
- Montbaig Primary Care Centre, Delta Primary Care Service, Costa de Ponent Primary Care Directorate, Gerència Territorial Metropolitana Sud, Institut Català de la Salut, Viladecans, Spain.
| | - Iván Julián-Rochina
- Nursing Department, Universitat de València, Valencia, Spain; Frailty and Cognitive Impairment Group (FROG), Universitat de València, Valencia, Spain.
| | - Edurne Zabaleta-Del-Olmo
- Gerència Territorial de Barcelona, Institut Català de la Salut, Barcelona, Spain; Nursing Department, Faculty of Nursing, Universitat de Girona, Girona, Spain; Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain.
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