Influencing factors for multi-dimensional frailty of older adults in community: A systematic review and meta-analysis

OBJECTIVE: To systematically evaluate the factors associated with multidimensional frailty assessed by the Tilburg Frailty Indicator among community-dwelling older adults. METHODS: A computerized search was conducted on ten databases, including CNKI, WanFang, VIP, CBM, PubMed, Web of Science, Embase, Scopus, Cochrane Library, and CINAHL, covering studies from inception to December 3, 2024. Literature screening, quality assessment, and data extraction were performed independently by two investigators, and meta-analysis was performed using STATA 18 software. The quality of the evidence was evaluated using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. RESULTS: A total of 28 articles with 138,924 participants were included, and 18 influencing factors were extracted. Meta-analysis results showed that: aged(OR=1.19), female(OR=1.53), marital status(no spouse) (OR=2.02), rural residence (OR=1.32), low education level(OR=2.53), fear of falling (OR=5.38), drinking (OR=1.20), smoking(OR=1.12), unhealthy lifestyle (OR=2.52), sleep disorders (OR=2.40), depression(OR=1.52), chronic diseases (OR=2.06), comorbidity (OR=2.08), self-rated poor health(OR=1.89), and hospitalization (OR=1.34) were risk factors for multidimensional frailty in community-dwelling older adults. Satisfaction with living conditions(OR=0.22), physical activity (OR=0.74), and consumption of tea (OR=0.53)were protective factors. CONCLUSION: There are many factors involved in the incidence of multidimensional frailty in community-dwelling older adults by a meta-analysis. Screening for multidimensional frailty in community-dwelling older adults can be carried out early based on their risk factors, and corresponding measures can be taken according to the factors that can be intervened in order to delay or reduce the multidimensional frailty in community-dwelling older adults.