Frailty in older people living in Africa: A systematic review of prevalence and associated factors

Ayele Semachew Kasa , Shu-Chun Lee , Hui-Chen (Rita) Chang
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Abstract

Background

Despite rapid population ageing in Africa, research on frailty in the region remains limited and fragmented. This systematic review aimed at summarising the available data to determine the prevalence of frailty in Africa.

Methods

Original research articles that reported the prevalence and associated factors of frailty in older people were included. The PubMed, Web of Science, SCOPUS, CINAHL, Science Direct, African Index Medicus, African Journals Online, WHO Global Health Library, and HINARI databases were searched between July 30 and September 30, 2022. Eleven studies were selected based on predefined eligibility criteria. To ensure methodological quality, the included studies were independently assessed by two authors. Data were extracted using a standardised data extraction checklist. Due to high heterogeneity among the studies, data were systematically examined using a narrative review.

Results

This review included a sample of 4,112 older people from different regions in Africa. Of the 11 included studies, five (45.5%) recruited study participants from community settings whereas two studies were from nursing homes. A variety of frailty measurement instruments were employed across the studies. The prevalence of frailty considerably varies across the studies: ranging from 9.25% to 77.1%. Increasing age, multimorbidity, nutritional problems, depression, and physical inactivity were identified as risk factors for frailty.

Conclusions

The findings revealed a varying degree of frailty among older people in Africa. It is recommended that institutions provide opportunities for physical activity, ensure adequate nutrition, promote social interaction, and manage chronic illnesses to mitigate frailty.

Registration

PROSPERO ID of CRD42021272920.

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生活在非洲的老年人体弱多病:对患病率和相关因素的系统审查
背景尽管非洲人口老龄化速度很快,但该地区对虚弱问题的研究仍然有限且零散。本系统综述旨在总结现有数据,以确定虚弱症在非洲的患病率。方法纳入报告老年人虚弱症患病率和相关因素的原创研究文章。在 2022 年 7 月 30 日至 9 月 30 日期间,对 PubMed、Web of Science、SCOPUS、CINAHL、Science Direct、African Index Medicus、African Journals Online、WHO Global Health Library 和 HINARI 数据库进行了检索。根据预先确定的资格标准,共筛选出 11 项研究。为确保研究方法的质量,两位作者对纳入的研究进行了独立评估。采用标准化数据提取清单提取数据。由于研究之间存在高度异质性,因此采用叙述性综述对数据进行了系统检查。在纳入的 11 项研究中,有 5 项研究(45.5%)从社区环境中招募研究对象,有 2 项研究从养老院中招募研究对象。这些研究采用了多种虚弱测量工具。各项研究中虚弱的发生率差异很大:从 9.25% 到 77.1%。年龄增长、多病共患、营养问题、抑郁和缺乏运动被认为是导致虚弱的风险因素。建议养老机构为老年人提供体育锻炼的机会,确保充足的营养,促进社交互动,管理慢性疾病,以减轻虚弱。
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