Risk factors of skin barrier dysfunction in older adults: A systematic review

Abstract

Aim

Skin barrier dysfunction can trigger various skin disorders in older adults. Skin barrier assessment is essential for nurses and caregivers to prevent skin disorders; however, the evidence available for clinical assessment is limited. This systematic review aimed to clarify the risk factors of skin barrier dysfunction in older adults.

Methods

This review adhered to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. The four databases were searched using multiple terms related to “aged” and “skin barrier.” The search was initially run on April 19, 2023, and rerun on October 12, 2023. Peer-reviewed quantitative studies in English were included, with no publication time limit being set. Two reviewers assessed the risk of bias in a blinded and independent manner using JBI tools. Owing to the heterogeneity of the results, a narrative synthesis was performed.

Results

Among the database-identified 4833 studies, 20 studies were included. The extracted factors were categorized as demographic characteristics, functional characteristics, chronic diseases, nutritional status, skin condition, and environmental factors. However, owing to high risk of bias and inconsistent results across studies, only chronic kidney disease and dry skin were considered risk factors for skin barrier dysfunction in older adults.

Conclusions

Assessment of chronic kidney disease and dry skin in daily skin care may guide the development of personalized skincare programs to maintain skin integrity in older adults. Furthermore, cohort studies that consider confounding factors and the reliability of measurements are needed for an in-depth investigation into skin barrier dysfunction and more risk factors.