Zhongguo quanke yixue (Sep 2023)
Prevalence of Frailty in Elderly Patients with Comorbidity: a Meta-analysis
Abstract
Background The prevalence of comorbidity in the elderly is showing a rising trend year by year with the acceleration of population aging. Comorbidity is a key risk factor for frailty in the elderly. Then frailty only increases the risk of adverse health outcomes for patients with comorbidity, but also significantly increases their family medical expenses. It has a certain guiding value for the management of comorbidity to identify the frailty conditions of elderly patients with comorbidity as early as possible. Objective To systematically review the prevalence of frailty in elderly patients with comorbidity. Methods CNKI, VIP, CBM, WanFang, PubMed, EmBase, Web of Science and Cochrane Library were searched in December 2021 for the investigation studies on the current status of frailty in elderly patients with comorbidity published from inception to December 4, 2021. Two researchers performed literature screening and data extraction independently. The cross-sectional study quality rating scale and Newcastle-Ottawa Scale (NOS) recommended by Agency for Healthcare Research and Quality (AHRQ) were used to assess the risk of bias of the included studies and Stata 14.0 was adopted for meta-analysis. Results A total of 25 studies involving 16 062 elderly patients with comorbidity were included. Meta-analysis results showed that the prevalence of frailty and pre-frailty in elderly patients with comorbidity was 26.7%〔95%CI (21.9%, 31.5%) 〕and 47.7%〔95%CI (43.9%, 51.4%) 〕. Subgroup analysis showed that the prevalence of frailty in older adults with≥2, ≥3, ≥4, and≥5 chronic diseases was 25.1%〔95%CI (19.3%, 30.8%) 〕, 27.4%〔95%CI (13.7%, 41.0%) 〕, 60.7%〔95%CI (29.0%, 92.4%) 〕, and 23.5%〔95%CI (8.6%, 38.5%) 〕, respectively. The prevalence of frailty in elderly patients with comorbidity in Oceania (52.1%) and Asia (31.3%) were significantly higher than Europe (16.9%) and South America (13.2%) . The prevalence of frailty in elderly patients with comorbidity in hospital (26.2%) was significantly higher than community (23.2%) . The prevalence of frailty in elderly patients with comorbidity screened by Clinical Frailty Scale (CFS) , Fried frailty phenotype scale and FRAIL Scale was 42.8%〔95%CI (38.4%, 47.1%) 〕, 22.2%〔95%CI (17.8%, 26.7%) 〕and 8.5%〔95%CI (6.3%, 10.6%) 〕, respectively. The prevalence of frailty in elderly patients surveyed in 2001—2010, 2011—2015, and 2016—2020 was 21.0%〔95%CI (13.2%, 28.8%) 〕, 19.0%〔95%CI (13.1%, 24.8%) 〕and 37.7%〔95%CI (22.6%, 52.9%) 〕, respectively. Conclusion The prevalence of frailty in elderly patients with comorbidity is gradually increasing, with differences by number of co-morbidities, continents, assessment tools and study sites. Therefore, relevant personnel should pay attention to early screening of frailty in elderly patients with comorbidity and take timely measures to prevent the development of frailty in elderly patients with comorbidity.
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