Abstract
Objectives
To quantitatively examine frailty defined by FRAIL scale as a predictor of incident
disability risks by conducting a systematic review and meta-analysis.
Design
Systematic review and meta-analysis.
Setting
A systematic review was conducted using 4 electronic databases (Embase, MEDLINE, CINAHL, and
PsycINFO) in April 2018 for prospective cohort studies of middle-aged or older people
examining associations between frailty and incident disability. Reference lists of
the included studies were hand-searched for additional studies. Authors of potentially
eligible studies were contacted for additional data if necessary. Methodological quality
was assessed by the Newcastle-Ottawa scale.
Participants
Community-dwelling middle-aged and older people.
Measurements
Incident risks of activities of daily living (ADL) or instrumental activities of daily
living (IADL) disability according the FRAIL scale-defined frailty.
Results
Seven studies provided odds ratios of incident disability risks according to frailty
and were included in the meta-analysis. A random effects meta-analysis showed that
frailty and prefrailty were significant predictors of ADL [pooled odds ratio (OR) =
9.82, 95% confidence interval (CI) = 4.71-20.46, P < .001 for frailty (FRAIL scale = 3-5) and pooled OR = 2.08, 95% CI = 1.77-2.45,
P < .001 for prefrailty (FRAIL scale = 1-2) compared with robustness (FRAIL scale =
0); pooled OR = 4.44, 95% CI = 3.26-6.04, P < .001 for frailty compared with nonfrailty (FRAIL scale = 0-2)] and IADL (pooled
OR = 2.50, 95% CI = 1.67-3.73, P < .001, for frailty and pooled OR = 1.74, 95% CI = 1.10-2.77, P = .02, for prefrailty compared with robustness). There was no evidence of publication
bias.
Conclusions/Implications
The current study demonstrated that frailty status defined by the FRAIL scale was
a significant predictor of disability among community-dwelling middle-aged and older
individuals. In light of feasibility of the FRAIL scale, especially in a clinical
setting, it may be a promising tool to facilitate the translation of frailty research
into clinical practice.
Keywords
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Article info
Publication history
Published online: September 08, 2018
Footnotes
The authors declare no conflicts of interest.
Identification
Copyright
© 2018 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
