Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2019;23(5):442-450.
doi: 10.1007/s12603-019-1179-9.

Prevalence and Risk Factors for Frailty among Community-Dwelling Older People in China: A Systematic Review and Meta-Analysis

B He  1 , Y Ma, C Wang, M Jiang, C Geng, X Chang, B Ma, L Han
Affiliations
Meta-Analysis

Prevalence and Risk Factors for Frailty among Community-Dwelling Older People in China: A Systematic Review and Meta-Analysis

B He et al. J Nutr Health Aging. 2019.

Abstract

Objective: To systematically assess the prevalence of frailty, including prefrailty, stratified prevalence according to frailty criteria, gender, age, and region, and the risk factors for frailty in China.

Design: We conducted a systematic literature review and meta-analysis using articles available in 8 databases including PubMed, Cochrane Library, Web of Science, CINAHL Plus, China Knowledge Resource Integrated Database (CNKI), Wanfang Database, Chinese Biomedical Database (CBM), and Weipu Database (VIP).

Setting: Cross-sectional and cohort data from Chinese community.

Participants: Community-dwelling adults aged 65 and older.

Measurements: Two authors independently extracted data based upon predefined criteria. Where data were available we conducted a meta-analysis of frailty parameters using a random-effects model.

Results: We screened 915 different articles, and 14 studies (81258 participants) were ultimately included in this analysis. The prevalence of frailty and prefrailty in individual studies varied from 5.9% to 17.4% and from 26.8% to 62.8%, respectively. The pooled prevalence of frailty and prefrailty were 10% (95% CI: 8% to 12%, I2 = 97.4%, P = 0.000) and 43% (95% CI: 37% to 50%, I2 = 98.0%, P = 0.000), respectively. The pooled frailty prevalence was 8% for the Fried frailty phenotype, 12% for the frail index, and 15% for the FRAIL scale. Age-stratified meta-analyses showed the pooled prevalence of frailty to be 6%, 15%, and 25% for those aged 65-74, 75-84, and ≥85 years old, respectively. The pooled prevalence of frailty was 8% for males and 11% for females. The pooled prevalence of frailty in Mainland China, Taiwan, and Hong Kong was 12%, 8%, and 14%, respectively. The pooled frailty prevalence was 10% in urban areas and 7% in rural areas. After controlling for confounding variables, increasing age (OR = 1.28, 95% CI: 1.2 to 1.36, I2 = 98.0%, P = 0.000), being female (OR = 1.29, 95% CI: 1.16 to 1.43, I2 =92.7%, P=0.000), activities of daily living (ADL) disability (OR = 1.72, 95% CI: 1.57 to 1.90, I2 = 99.7%, P = 0.000), and having three or more chronic diseases (OR = 1.97, 95% CI: 1.78 to 2.18, I2 = 97.5%, P = 0.000) were associated with frailty.

Conclusions: These findings of this review indicate an overall pooled prevalence of frailty among Chinese community-dwelling older people of 10%. Increasing age, being female, ADL disability, and having three or more chronic diseases were all risk factors for frailty. Further research will be needed to identify additional frailty risk factors in order to better treat and prevent frailty in the community.

Keywords: Chinese; community-dwelling older people; frailty; prevalence.

PubMed Disclaimer

Conflict of interest statement

The authors declare that no competing interest.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Reviews and MetaAnalyses (PRISMA) flow diagram for the study selection process
Figure 2
Figure 2
Forest plot of prevalence of frailty
Figure 3
Figure 3
Forest plot of prevalence of prefrailty
See this image and copyright information in PMC

References

    1. Fan Y. The Ministry of Civil Affairs issued the “Statistical Bulletin on the Development of Social Services in 2017”. Rural Know-How. 2018;19:14.
    1. Cesari M, Prince M, Thiyagarajan JA, De Carvalho IA, Bernabei R, Chan P, Gutierrez-Robledo LM, Michel JP, Morley JE, Ong P, Manas LR, Sinclair A, Won Won C, Beard J, Vellas B. Frailty: an emerging public health priority. J Am Med Dir Assoc. 2016;17(3):188–192. 10.1016/j.jamda.2015.12.016 PubMed PMID: 26805753. - DOI - PubMed
    1. Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet. 2013;381(9868):752–762. 10.1016/S0140-6736(12)62167-9 PubMed PMID: 23395245. - DOI - PMC - PubMed
    1. Kojima G. Frailty as a predictor of future falls among community-dwelling older people: a systematic review and meta-analysis. J Am Med Dir Assoc. 2015;16(12):1027–1033. 10.1016/j.jamda.2015.06.018 PubMed PMID: 26255098. - DOI - PubMed
    1. Kojima G. Frailty as a predictor of hospitalisation among community-dwelling older people: a systematic review and meta-analysis. J Epidemiol Community Health. 2016;70(7):722–729. 10.1136/jech-2015-206978 PubMed PMID: 26933121. - DOI - PubMed

Publication types

LinkOut - more resources