Prevalence of frailty in senile osteoporosis: A systematic review and meta-analysis

Background

The growing aging population has resulted in a rise in the prevalence of frailty among senile osteoporosis (SOP) patients, with frailty predisposing SOP patients to a higher risk of adverse health outcomes.

Objective

This study aimed to evaluate the prevalence of frailty in SOP patients through a systematic review and meta-analysis.

Methods

A comprehensive search was performed in nine databases (Cochrane Library, PubMed, Web of Science, Embase, CINAHL, SinoMed, CNKI, VIP, and Wanfang) to identify relevant articles from inception to June 2023. Two investigators independently conducted literature screening and data extraction and evaluated the risk of bias using the cross-sectional study quality assessment scale recommended by the Agency for Healthcare Quality and Research (AHRQ) and the Newcastle-Ottawa Scale (NOS). The meta-analysis was performed using Stata 15.1 software. Lastly, meta-regression, subgroup analysis, and sensitivity analysis were carried out to explore sources of heterogeneity.

Results

Eighteen studies involving 9,664 patients were included in the meta-analysis. The results revealed that the prevalence of frailty in SOP patients was 37.8% [95% CI (25.2%, 50.4%)]. Additionally, subgroup analyses indicated a prevalence of frailty of 47.4% [95% CI (23.7%, 71.1%)] in SOP patients aged 60–74 years and 33.3% [95% CI (17.7%, 48.8%)] in those aged ≥75 years. The prevalence rates of frailty in female and male SOP patients were 27.7% [95% CI (6.4%, 48.9%)] and 12.3% [95% CI (0.8%, 23.9%)], respectively. Meanwhile, the prevalence of frailty in SOP patients in developed and developing countries was 23.2% [95% CI (7%, 39.5%)] and 42.3% [95% CI (27.8%, 56.8%)], respectively. The prevalence of frailty in SOP patients, as measured by the Fried Frailty Phenotype Scale (FP), the J-CHS criteria, and the Frailty Assessment (FRAIL) scale, was 26.3% [95% CI (10.6%, 41.9%)], 38.1% [95% CI (31.5%, 44.6%)], and 47.2% [95% CI (31.0%, 63.5%)], respectively. Finally, the prevalence of frailty in SOP patients surveyed in 2005–2015 and 2016–2020 was 22.9% [95% CI (9.5%, 36.2%)] and 47.4% [95% CI (33.2%, 61.6%)], respectively. Meta-regression did not identify significant sources of heterogeneity.

Conclusion

The prevalence of frailty in SOP patients is high, especially in female patients, in developing countries, post-2015, and using the FRAIL scale assessments. Healthcare professionals are recommended to employ assessment tools with high reliability and validity to improve screening for frailty in SOP patients and implement timely interventions to prevent frailty in SOP patients.