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关于衰弱的全国性见解:对印度基于社区的患病率研究的系统评价和荟萃分析。

Nationwide insights into frailty: Systematic review and meta-analysis of community-based prevalence studies from India.

作者信息

Gupta Sunanda, Debnath Aninda, Yadav Ankit, Mondal Anubhav, Charag Shweta, Kishore Jugal

机构信息

Department of Community Medicine, VMMC and Safdarjung Hospital, New Delhi 110029, India.

出版信息

J Frailty Aging. 2025 Apr;14(2):100032. doi: 10.1016/j.tjfa.2025.100032. Epub 2025 Mar 11.

Abstract

Frailty, a biologic syndrome of decreased reserve and resistance to stressors, affects 5 % to 17 % of older adults and is linked to factors like low BMI, female sex, and low exercise levels. With India's older population expected to double by 2050, frailty presents major public health and economic challenges. This study summarizes the prevalence of frailty among community-dwelling Indians. This systematic review and meta-analysis followed PRISMA guidelines to determine the prevalence of frailty among adults in India. We conducted a comprehensive search across multiple databases, including PubMed, Scopus, EMBASE, and Web of Science, up to January 16, 2024, excluding hospital-based studies and reviews. Data were analyzed using STATA software with a random-effects model, and quality was assessed using the JBI Critical Appraisal Checklist. The meta-analysis revealed a pooled frailty prevalence of 36 % (95 % CI: 29 % to 44 %) among 330,007 community-dwelling adults in India, with significant heterogeneity across studies (I² = 99.95 %). Frailty prevalence varied by assessment method, with 48 % using the frailty index and 31 % using the Fried phenotype. Subgroup analyses indicated significant variability in frailty prevalence by gender, data source, and assessment tool, with no significant publication bias detected. This meta-analysis found a pooled frailty prevalence of 36 % and pre-frailty prevalence of 48 % among adults in India, with higher frailty in women (45 %) than men (35 %) and variation across assessment tools. Future research should focus on longitudinal studies and developing tailored frailty assessment tools.

摘要

衰弱是一种生物综合征,表现为储备能力下降和对应激源的抵抗力降低,影响5%至17%的老年人,且与低体重指数、女性性别和低运动水平等因素相关。预计到2050年印度老年人口将翻番,衰弱带来了重大的公共卫生和经济挑战。本研究总结了印度社区居住人群中衰弱的患病率。这项系统评价和荟萃分析遵循PRISMA指南,以确定印度成年人中衰弱的患病率。我们在多个数据库中进行了全面检索,包括PubMed、Scopus、EMBASE和Web of Science,截至2024年1月16日,排除基于医院的研究和综述。使用STATA软件采用随机效应模型分析数据,并使用JBI批判性评价清单评估质量。荟萃分析显示,在印度330,007名社区居住成年人中,合并的衰弱患病率为36%(95%CI:29%至44%),各研究之间存在显著异质性(I² = 99.95%)。衰弱患病率因评估方法而异,使用衰弱指数的为48%,使用弗里德表型的为31%。亚组分析表明,按性别、数据来源和评估工具划分,衰弱患病率存在显著差异,未检测到明显的发表偏倚。这项荟萃分析发现,印度成年人中合并的衰弱患病率为36%,衰弱前期患病率为48%,女性(45%)的衰弱率高于男性(35%),且不同评估工具之间存在差异。未来的研究应侧重于纵向研究和开发针对性的衰弱评估工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7909/12183940/036f8768fe25/gr1.jpg

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