Systematic review and meta-analysis of the prevalence of frailty and pre-frailty amongst older hospital inpatients in low- and middle-income countries.

IF 6 2区 医学 Q1 GERIATRICS & GERONTOLOGY Age and ageing Pub Date : 2025-01-06 DOI:10.1093/ageing/afae279
Sean Lawlor Davidson, Jim Lee, Luke Emmence, Emily Bickerstaff, George Rayers, Elizabeth Davidson, Jenny Richardson, Heather Anderson, Richard Walker, Catherine Dotchin
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Abstract

Background: As populations age, low- and middle-income countries (LMICs) are rapidly adapting hospital services to meet the needs of older populations. This systematic review aimed to establish the prevalence of frailty and pre-frailty amongst older people admitted to hospital in LMICs, and to compare levels with existing estimates for high-income settings.

Methods: Databases Medline, Embase, CINAHL and PsychInfo were searched, and results were manually screened by two researchers. Included studies were cross-sectional or cohort design and reported data from hospital inpatients, aged ≥60 years, in LMICs, using validated methods for identifying frailty. Risk of bias was assessed by two researchers using the Joanna Briggs Institute checklist. Where possible, results were synthesised using meta-analysis.

Results: Twenty-nine studies were included, all reporting data from middle-income countries. Physical frailty tools were the most common, with Fried's phenotype and the FRAIL Scale being the most often used methods of assessment. The pooled estimate of the prevalence of frailty was 39.1% [95% confidence interval (CI) 31.9-46.6%] comprising data from 23 311 older inpatients. For pre-frailty, prevalence was 40.0% (95% CI 25.1-51.4%) from 6954 individuals.

Discussion: Due to the paucity of eligible studies and their geographical distribution, these pooled estimates are only representative of the burden of frailty in select middle-income settings (particularly China). Future research should seek to establish the prevalence of frailty in hospitals in low-income countries, and to assess clinical outcomes by frailty status, in order to develop bespoke clinical tools and to aid the planning of future geriatric services.

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中低收入国家老年住院病人虚弱和虚弱前期患病率的系统回顾和荟萃分析。
背景:随着人口老龄化,低收入和中等收入国家(LMICs)正在迅速调整医院服务以满足老年人口的需求。本系统评价旨在确定中低收入国家住院老年人中虚弱和虚弱前期的患病率,并将其与高收入国家的现有估计水平进行比较。方法:检索Medline、Embase、CINAHL和PsychInfo数据库,由2名研究者人工筛选结果。纳入的研究采用横断面或队列设计,并报告了来自中低收入国家≥60岁住院患者的数据,采用了确认虚弱的有效方法。偏见风险由两名研究人员使用乔安娜布里格斯研究所的检查表进行评估。在可能的情况下,使用荟萃分析对结果进行综合。结果:纳入了29项研究,均报告了来自中等收入国家的数据。身体虚弱工具是最常见的,弗里德表型和虚弱量表是最常用的评估方法。虚弱患病率的汇总估计值为39.1%[95%置信区间(CI) 31.9-46.6%],包括来自23311名老年住院患者的数据。在虚弱前,6954人的患病率为40.0% (95% CI 25.1-51.4%)。讨论:由于缺乏符合条件的研究及其地理分布,这些汇总估计仅代表了中等收入国家(特别是中国)的脆弱性负担。未来的研究应设法确定低收入国家医院中虚弱的普遍程度,并根据虚弱状况评估临床结果,以便开发定制的临床工具,并帮助规划未来的老年服务。
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来源期刊
Age and ageing
Age and ageing 医学-老年医学
CiteScore
9.20
自引率
6.00%
发文量
796
审稿时长
4-8 weeks
期刊介绍: Age and Ageing is an international journal publishing refereed original articles and commissioned reviews on geriatric medicine and gerontology. Its range includes research on ageing and clinical, epidemiological, and psychological aspects of later life.
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