Cronin Thomas, Healy David, McCarthy Noel, Smith Susan M, Travers John
Irish College of General Practitioners / Discipline of Public Health and Primary Care, School of Medicine, Trinity College Dublin, Dublin, Ireland.
GP, Dublin, Ireland.
J Frailty Aging. 2025 Apr;14(2):100029. doi: 10.1016/j.tjfa.2025.100029. Epub 2025 Mar 4.
The experience of homelessness has been associated with premature ageing and an earlier onset of geriatric syndromes. Identification of frailty and appropriate intervention, may help improve health outcomes for people experiencing homelessness (PEH). This review aimed to identify prevalence, use of screening tools and risk factors for frailty in PEH.
A systematic review, conducted and reported following the PRISMA checklist, was undertaken investigating the prevalence and risk factors of frailty among PEH. Searches were conducted in Ovid MEDLINE, PsycInfo, Web of Science and CINAHL from inception to July 2024. A meta-analysis examining prevalence of frailty and pre-frailty was completed with a narrative synthesis of related risk factors.
A total of 1672 articles were screened for eligibility and 11 studies were included, containing 1017 participants from seven countries. Six different screening tools were employed to detect frailty in the included studies. The range of frailty prevalence was 16-70 % and pre-frailty prevalence was 18-60 %. The pooled frailty prevalence from studies employing the Fried Criteria was 39 % (95 % CI 15-66); the Clinical Frailty Scale: 37 % (95 % CI 24-51); the Edmonton Frailty Scale: 53 % (95 % CI 44-63); and the Tilburg Fraily Indicator: 31 % (95 % CI 8-60). High heterogeneity was observed between the studies. Identified risk factors for developing frailty in PEH included being female, increased years spent homeless, and drug addiction.
This study highlights a high prevalence of frailty and pre-frailty in PEH. The identified risk factors illustrate potential areas to target interventions to reverse frailty. Future research should focus on the role of screening for frailty in PEH and developing appropriate frailty detection tools in this group.
无家可归的经历与过早衰老和老年综合征的较早发病有关。识别衰弱并进行适当干预，可能有助于改善无家可归者的健康结局。本综述旨在确定无家可归者中衰弱的患病率、筛查工具的使用情况及危险因素。
按照PRISMA清单进行并报告了一项系统综述，调查无家可归者中衰弱的患病率和危险因素。从数据库建库至2024年7月，在Ovid MEDLINE、PsycInfo、Web of Science和CINAHL中进行检索。完成了一项关于衰弱和衰弱前期患病率的荟萃分析，并对相关危险因素进行了叙述性综合分析。
共筛选了1672篇文章以确定其是否符合纳入标准，纳入了11项研究，包含来自7个国家的1017名参与者。纳入研究中使用了6种不同的筛查工具来检测衰弱。衰弱患病率范围为16%-70%，衰弱前期患病率为18%-60%。采用Fried标准的研究汇总衰弱患病率为39%（95%CI 15-66）；临床衰弱量表：37%（95%CI 24-51）；埃德蒙顿衰弱量表：53%（95%CI 44-63）；蒂尔堡衰弱指标：31%（95%CI 8-60）。研究间观察到高度异质性。确定的无家可归者发生衰弱的危险因素包括女性、无家可归时间增加和药物成瘾。
本研究突出了无家可归者中衰弱和衰弱前期的高患病率。确定的危险因素说明了针对干预措施以逆转衰弱的潜在目标领域。未来的研究应关注在无家可归者中筛查衰弱的作用，并为该群体开发合适的衰弱检测工具。
