Prevalence and risk factors of frailty in older patients with coronary heart disease: A systematic review and meta-analysis.

OBJECTIVE

To quantitatively synthesise evidence on the prevalence of and risk factors of frailty in older patients with coronary heart disease.

METHODS

Nine electronic databases were searched from the inception to July 20th 2024. Random-effects model was performed to calculate to estimate the prevalence of frailty in older patients with coronary heart disease. Meta-regression analysis and subgroup analysis were conducted to explore the potential sources of heterogeneity. Sensitivity analysis was conducted using a study-by-study exclusion method. Meta-analysis of risk factors was performed using the Mantel-Haenszel or inverse variance method and only on the risk factors that have been reported in a minimum of two studies.

RESULTS

A total of 42 studies from 5 countries met the inclusion criteria, involving 11954 older patients. The pooled prevalence in older adults with coronary heart disease was 36% (95%CI: 31%-40%) for frailty. We found a higher prevalence of frailty among older patients with coronary heart disease in females, ≥80 years, case-control studies, EFS evaluation tool and acute coronary syndrome. Age, female, cardiac classification, malnutrition, fall within 1 year, sleep disorder, hypoproteinemia (albumin<35g/L), low level of literacy, depression, anxiety, low BMI, polypharmacy, comorbidities, CCI, diabetes, hypertension, high level of BNP, ADL disability, gait speed, living alone, low level of 25(OH)D were risk factors of frailty among older patients with coronary heart disease.

CONCLUSIONS

Coronary heart disease patients have a significantly higher prevalence of frailty. Early screening and timely prevention of frailty by medical practitioners are needed to provide more targeted measures for CHD patients.