Yong Loo Lin School of Medicine (YLLSoM), National University of Singapore (NUS).
Singapore Eye Research Institute (SERI), Singapore National Eye Centre (SNEC).
J Gerontol A Biol Sci Med Sci. 2020 Nov 13;75(12):2461-2470. doi: 10.1093/gerona/glaa171.
BACKGROUND: Age-related sensory loss and frailty are common conditions among older adults, but epidemiologic research on their possible links has been inconclusive. Clarifying this relationship is important because sensory loss may be a clinically relevant risk factor for frailty. METHODS: In this systematic review and meta-analysis, we searched 3 databases for observational studies investigating 4 sensory impairments-vision (VI), hearing (HI), smell (SI), and taste (TI)-and their relationships with frailty. We meta-analyzed the cross-sectional associations of VI/HI each with pre-frailty and frailty, investigated sources of heterogeneity using meta-regression and subgroup analyses, and assessed publication bias using Egger's test. RESULTS: We included 17 cross-sectional and 7 longitudinal studies in our review (N = 34,085) from 766 records. Our cross-sectional meta-analyses found that HI and VI were, respectively, associated with 1.5- to 2-fold greater odds of pre-frailty and 2.5- to 3-fold greater odds of frailty. Our results remained largely unchanged after subgroup analyses and meta-regression, though the association between HI and pre-frailty was no longer significant in 2 subgroups which lacked sufficient studies. We did not detect publication bias. Longitudinal studies largely found positive associations between VI/HI and frailty progression from baseline robustness, though they were inconclusive about frailty progression from baseline pre-frailty. Sparse literature and heterogenous methods precluded meta-analyses and conclusions on the SI/TI-frailty relationships. CONCLUSIONS: Our meta-analyses demonstrate significant cross-sectional associations between VI/HI with pre-frailty and frailty. Our review also highlights knowledge gaps on the directionality and modifiability of these relationships and the impact of SI/TI and multiple sensory impairments on frailty.
背景:与年龄相关的感觉丧失和虚弱是老年人常见的情况,但关于它们之间可能存在联系的流行病学研究结果尚无定论。明确这种关系很重要,因为感觉丧失可能是虚弱的一个具有临床意义的相关风险因素。
方法:在这项系统评价和荟萃分析中,我们在 3 个数据库中搜索了 4 种感觉障碍(视力、听力、嗅觉和味觉)及其与虚弱之间关系的观察性研究。我们对横断面研究中视力/听力障碍分别与虚弱前期和虚弱的关联进行了荟萃分析,利用荟萃回归和亚组分析研究了异质性的来源,并利用 Egger 检验评估了发表偏倚。
结果:我们从 766 份记录中纳入了本综述的 17 项横断面研究和 7 项纵向研究(共 34085 名参与者)。我们的横断面荟萃分析发现,听力和视力障碍分别使虚弱前期和虚弱的发生风险增加 1.5-2 倍和 2.5-3 倍。虽然在缺乏足够研究的 2 个亚组中,听力障碍与虚弱前期的关联不再显著,但在亚组分析和荟萃回归后,我们的结果基本保持不变。我们没有发现发表偏倚。纵向研究主要发现,从基线起,视力/听力障碍与虚弱的进展之间存在正相关,但它们对从基线虚弱前期开始的虚弱进展结论并不确定。文献稀少且方法各异,因此无法对嗅觉/味觉-虚弱关系进行荟萃分析和得出结论。
结论:我们的荟萃分析表明,视力/听力障碍与虚弱前期和虚弱之间存在显著的横断面关联。本综述还突出了这些关系的方向性和可修饰性以及嗅觉/味觉和多种感觉障碍对虚弱的影响方面的知识空白。
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