Ayeni Ayodele, Sharples Adrienne, Hewson David
Institute for Health Research, University of Bedfordshire, Luton LU1 3JU, UK.
Hertfordshire Partnership University National Health Service (NHS) Foundation Trust, Hatfield AL10 8YE, UK.
Geriatrics (Basel). 2022 Sep 26;7(5):104. doi: 10.3390/geriatrics7050104.
The aim of this systematic literature review was to determine whether social vulnerability is associated with frailty in older people. Databases were searched for literature from January 2001 to March 2022. Hand searches of reference lists of the selected articles were also used to identify other relevant studies. Studies that met the inclusion criteria were selected. Two independent reviewers assessed the methodological quality using an established tool. Eleven eligible studies from Canada, Europe, USA, Tanzania, Mexico, and China were selected. The level of social vulnerability measured by the Social Vulnerability Index (SVI) from a meta-analysis was 0.300 (95% CI: 0.242, 0.358), with the highest SVI in Tanzania (0.49), while the lowest level of SVI was reported in China (0.15). The highest frailty level of 0.32 was observed in both Tanzania and Europe, with the lowest frailty reported in a USA study from Hawaii (0.15). In all studies, social vulnerability was a significant predictor of mortality for both sexes at subsequent data collection points. The association between SVI and frailty was high in Tanzania (r = 0.81), with other studies reporting stronger correlations for females compared to males, but at small to moderate levels. In one study, an increase of 1SD in SVI was linked to a 20% increase in frailty score at a subsequent evaluation. Additional study is warranted to determine a potential causality between social vulnerability and frailty.
本系统文献综述的目的是确定社会脆弱性是否与老年人的衰弱相关。检索了2001年1月至2022年3月的数据库文献。还通过手工检索所选文章的参考文献列表来识别其他相关研究。选择符合纳入标准的研究。两名独立评审员使用既定工具评估方法学质量。选取了来自加拿大、欧洲、美国、坦桑尼亚、墨西哥和中国的11项符合条件的研究。荟萃分析中通过社会脆弱性指数（SVI）衡量的社会脆弱性水平为0.300（95%置信区间：0.242，0.358），坦桑尼亚的SVI最高（0.49），而中国的SVI水平最低（0.15）。坦桑尼亚和欧洲的衰弱水平最高，均为0.32，美国夏威夷的一项研究报告的衰弱水平最低（0.15）。在所有研究中，社会脆弱性是后续数据收集点两性死亡率的显著预测因素。坦桑尼亚的SVI与衰弱之间的关联度较高（r = 0.81），其他研究报告女性的相关性比男性更强，但处于小到中等水平。在一项研究中，SVI每增加1个标准差，在后续评估中衰弱评分就会增加20%。有必要进行更多研究以确定社会脆弱性与衰弱之间的潜在因果关系。
