Geriatric Diseases Institute of Chengdu, Department of Geriatrics, Chengdu Fifth People's Hospital, Chengdu, 611137, China.
The Second Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China.
BMC Geriatr. 2022 Sep 2;22(1):725. doi: 10.1186/s12877-022-03404-w.
The associations of frailty with all-cause and cause-specific mortality remain unclear. Therefore, we performed this meta-analysis to fill this gap.
We searched the PubMed and Embase databases through June 2022. Prospective cohort studies or clinical trials examining frailty were evaluated, and the multiple adjusted risk estimates of all-cause and cause-specific mortality, such as death from cardiovascular disease (CVD), cancer, respiratory illness, dementia, infection, and coronavirus disease 2019 (COVID-19), were included. A random effects model was used to calculate the summary hazard ratio (HR).
Fifty-eight studies were included for the qualitative systematic review, of which fifty-six studies were eligible for the quantitative meta-analysis, and the studies included a total of 1,852,951 individuals and more than 145,276 deaths. Compared with healthy adults, frail adults had a significantly higher risk of mortality from all causes (HR 2.40; 95% CI 2.17-2.65), CVD (HR 2.64; 95% CI 2.20-3.17), respiratory illness (HR 4.91; 95% CI 2.97-8.12), and cancer (HR 1.97; 95% CI 1.50-2.57). Similar results were found for the association between prefrail adults and mortality risk. In addition, based on the studies that have reported the HRs of the mortality risk per 0.1 and per 0.01 increase in the frailty index, we obtained consistent results.
The present study demonstrated that frailty was not only significantly related to an increased risk of all-cause mortality but was also a strong predictor of cause-specific mortality from CVD, cancer, and respiratory illness in community-dwelling adults. More studies are warranted to clarify the relationship between frailty and cause-specific mortality from dementia, infection, and COVID-19.
PROSPERO (CRD42021276021).
虚弱与全因和特定原因死亡率的关系仍不清楚。因此，我们进行了这项荟萃分析以填补这一空白。
我们通过 2022 年 6 月检索了 PubMed 和 Embase 数据库。评估了检查虚弱的前瞻性队列研究或临床试验，并纳入了全因和特定原因死亡率的多因素调整风险估计，例如心血管疾病 (CVD)、癌症、呼吸疾病、痴呆、感染和 2019 年冠状病毒病 (COVID-19) 导致的死亡。使用随机效应模型计算汇总危害比 (HR)。
进行了定性系统评价，共纳入 58 项研究，其中 56 项研究符合定量荟萃分析的条件，这些研究共纳入了 1852951 人，超过 145276 人死亡。与健康成年人相比，虚弱成年人全因死亡率（HR 2.40；95%CI 2.17-2.65）、CVD（HR 2.64；95%CI 2.20-3.17）、呼吸疾病（HR 4.91；95%CI 2.97-8.12）和癌症（HR 1.97；95%CI 1.50-2.57）的风险显著更高。虚弱前成年人与死亡率风险之间也存在类似的关联。此外，基于报告虚弱指数每增加 0.1 和 0.01 时死亡率风险 HR 的研究，我们得到了一致的结果。
本研究表明，虚弱不仅与全因死亡率增加显著相关，而且还是社区居住成年人 CVD、癌症和呼吸疾病特定原因死亡率的强有力预测因素。需要更多的研究来阐明虚弱与痴呆、感染和 COVID-19 特定原因死亡率之间的关系。
PROSPERO（CRD42021276021）。
