Changes of multidimensional frailty among older adults during 2010-2023: A systematic review and cross-temporal meta-analysis

OBJECTIVE: This study aimed to explore the changing trend of multidimensional frailty among the elderly from 2010 to 2023 and its relationship with social changes. STUDY DESIGN: This is a cross-temporal meta-analysis study. METHODS: From the establishment of each database to October 2024, eight databases were systematically searched, including PubMed, Web of Science, Embase, CINAHL, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), Wanfang Database, and SinoMed Database. Two researchers independently screened the studies and extracted the data. Data analysis was conducted using SPSS version 26.0 through correlation analysis and linear regression. RESULTS: 96 studies involving 79,810 individuals were ultimately included. The results showed an increasing trend in multidimensional frailty in older adults over time (β= 0.088 to 0.225, all p-values <0.05), and the effect size d varied between 0.23 and 0.7. The predicted mean TFI total score increased from 5.49 in 2010 to 7.21 in 2023. Subgroup analyses showed a more pronounced increasing trend in the levels of multidimensional frailty in older adults in females (β=0.135), and that levels of multidimensional frailty in older adults in community-based (d = 0.55) and institutionalized settings (d=-0.53) were more strongly affected by the year, whereas hospital-sourced older adults (d = 0.39) were less affected. The level of multidimensional frailty among older adults in Asia has declined (β=-0.015), while Europe showed an upward trend (β=0.077). Meanwhile, lagged analyses showed that the correlations between multidimensional frailty scores and the three types of social indicators (economic status, social support, and health care) were mostly significantly positive. CONCLUSIONS: Between 2010 and 2023, multidimensional frailty in the elderly showed an upward trend, as well as economic status, social support, and medical care were associated with the rising level of multidimensional frailty in the elderly. Future research should integrate individual-level health management with macro-level social and economic policies, considering factors such as gender, region, and sample source, to develop personalized intervention programs that effectively enhance the overall health and well-being of older adults.