Adverse Health Effects of Frailty: Systematic Review and Meta-Analysis of Middle-Aged and Older Adults With Implications for Evidence-Based Practice

Abstract

Background: Scholars have noted that frailty easily leads to functional deterioration and proneness to complications. Little literature addresses the stages of frailty in middle-aged and older adults and the effects of frailty on overall health.

Aims: This study explores the effect of different stages of frailty on the prospective health (falls, bone fractures, disability, dementia, hospitalization, and death) of middle-aged and older adults. In addition, different frailty indicators were compared to determine their usefulness in predicting future adverse health outcomes.

Methods: The authors of this study separately reviewed and extracted data from the literature obtained while searching the following keywords: "frailty" OR "frail" and "fall" OR "disability" OR "fracture" OR "hospitalization" OR "mortality" OR "cognitive function" "dementia" OR "Alzheimer's disease" and "middle-aged people" OR "older people" OR "elderly" OR "geriatric" OR "senior." The literature search was performed from January 2001 to November 2019 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Specifically, we performed a systematic literature search in multiple databases-Embase, PubMed, MEDLINE, CINAHL, and Cochrane Library-and analyzed all obtained literature results using a random-effects model.

Results: We collected a total of 29 prospective studies for the systematic literature review and meta-analysis. The main results indicated that the frail groups had significantly higher risks of adverse health effects (falls, bone fractures, disability, dementia, hospitalization, and death) than the robust or prefrail groups.

Linking evidence to action: Frailty is a crucial healthcare topic among geriatric syndromes. Considering that older adults with frailty are most likely to develop severe adverse health outcomes, professional nursing personnel should assess frailty among middle-aged and older adults and offer relevant care strategies to reduce the adverse effects of frailty in this population.

Keywords: adverse health effect; frailty; meta-analysis; systematic review.