Hajek André, Kretzler Benedikt, König Hans-Helmut
Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany.
Front Med (Lausanne). 2022 Apr 22;9:870714. doi: 10.3389/fmed.2022.870714. eCollection 2022.
Various studies have identified the prevalence of prefrailty and frailty among older adults in Germany. Nevertheless, there is no review systematically synthesizing these studies. Thus, our aim was to close this gap in knowledge. Moreover, another aim was to perform a meta-analysis to synthesize the pooled prevalence of prefrailty and frailty. A further aim was to explore potential sources of heterogeneity based on a meta-regression.
A number of three electronic databases (PubMed, PsycINFO, and CINAHL) were searched (plus an additional hand search). The observational studies that determine the prevalence of frailty among older adults aged 65 years and above in Germany were included, whereas disease-specific samples were excluded. Data extraction included the description of the sample, operationalization of frailty, statistical analysis, sample characteristics and main findings. The established Joanna Briggs Institute (JBI) standardized critical appraisal instrument for prevalence studies was used for evaluating the quality of the studies. Important steps were performed by two reviewers.
In sum, a number of 12 studies were included. The prevalence of frailty varied from about 2.4 to 25.6%. The pooled prevalence of frailty was 13.7% (95% CI: 9.0 to 18.5%). There was a significant heterogeneity among the studies ( = 98.9%, < 0.001). The pooled prevalence of prefrailty was 40.2% (95% CI: 28.3 to 52.1%; = 99.6%, < 0.001). Some evidence of a publication bias exists. Meta-regressions showed that some of the heterogeneity was explained by the tool to quantify frailty and the average age of the respective sample.
Particularly, the high prevalence of prefrailty should be highlighted since it is important to prevent individuals in old age from developing to frail status. This knowledge is important for the German society as a whole and for relevant stakeholders.
PROSPERO, identifier: CRD42021293648.
多项研究已确定德国老年人中衰弱前期和衰弱的患病率。然而，尚无系统综合这些研究的综述。因此，我们的目标是填补这一知识空白。此外，另一个目标是进行荟萃分析，以综合衰弱前期和衰弱的合并患病率。进一步的目标是基于荟萃回归探索异质性的潜在来源。
检索了三个电子数据库（PubMed、PsycINFO和CINAHL）（另加手工检索）。纳入了确定德国65岁及以上老年人衰弱患病率的观察性研究，而特定疾病样本被排除。数据提取包括样本描述、衰弱的操作化、统计分析、样本特征和主要发现。采用已建立的乔安娜·布里格斯研究所（JBI）患病率研究标准化批判性评价工具来评估研究质量。重要步骤由两名评审员执行。
总共纳入了12项研究。衰弱的患病率在约2.4%至25.6%之间变化。衰弱的合并患病率为13.7%（95%置信区间：9.0%至18.5%）。研究之间存在显著异质性（I² = 98.9%，P < 0.001）。衰弱前期的合并患病率为40.2%（95%置信区间：28.3%至52.1%；I² = 99.6%，P < 0.001）。存在一些发表偏倚的证据。荟萃回归表明，部分异质性可由量化衰弱的工具和各样本的平均年龄来解释。
尤其应强调衰弱前期的高患病率，因为防止老年人发展为衰弱状态很重要。这一知识对整个德国社会和相关利益攸关方都很重要。
PROSPERO，标识符：CRD42021293648
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