Ethnicity and frailty: A systematic review of association with prevalence, incidence, trajectories and risks

IF 12.5 1区医学 Q1 CELL BIOLOGY

Ageing Research Reviews Pub Date : 2025-04-28 DOI:10.1016/j.arr.2025.102759

Maryam Khan, Barbara I. Nicholl, Peter Hanlon

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引用次数: 0

Abstract

Background

Ethnic variations in frailty are not fully understood. This systematic review examined ethnic differences in the prevalence, incidence and trajectories of frailty; associations between frailty and sociodemographic/lifestyle risk-factors; and health-related outcomes of frailty.

Methods

We searched four electronic databases from 2000 to July 2023 using terms for ethnicity and frailty. Inclusion criteria: observational studies assessing frailty in adults ≥ 18 years from community-based settings, including care homes; ethnicity defined by race, country of birth, language, ancestry, or culture. We supplemented searches with manual citation and reference list searches. Outcomes included prevalence, incidence, and transitions of frailty; factors associated with frailty; and health-related outcomes (e.g., mortality). Two reviewers independently screened all articles.

Results

We included 82 studies, representing data from 13 countries plus two multi-national samples. Across the included countries, frailty prevalence was higher in minority groups compared to majority groups. Ethnic differences appear sensitive to methods used to measure frailty. Two United States-based studies found that ethnic differences were independent of sociodemographic differences such as income or education. Six studies from the United States or United Kingdom showed that Black and South-Asian people, respectively, had higher frailty incidence or more rapid frailty progression. Two studies showed that frailty was associated with mortality across ethnic groups but with some small differences in magnitude between groups.

Conclusion

Ethnic disparities in frailty prevalence persist across community-based settings in different countries and are not fully explained by known inequalities. Addressing these disparities will likely require careful frailty measurement and assessment; confronting structural inequalities; and tailoring interventions to the needs of minoritised populations.

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种族和脆弱：与患病率、发病率、轨迹和风险相关的系统综述

不同种族在体质上的差异还没有被完全了解。这一系统综述研究了在患病率、发病率和衰弱轨迹方面的种族差异；脆弱与社会人口/生活方式风险因素之间的关系；以及与健康相关的虚弱结果。方法检索2000年至2023年7月的4个电子数据库，使用人种和体质相关术语。纳入标准：观察性研究评估≥ 18岁社区环境成人的脆弱性，包括养老院；民族：由种族、出生国、语言、祖先或文化界定的民族我们用人工引文和参考文献列表搜索来补充搜索。结果包括患病率、发病率和虚弱的转变；与虚弱有关的因素；以及与健康相关的结果（如死亡率）。两名审稿人独立筛选了所有文章。结果我们纳入了82项研究，代表了来自13个国家和两个跨国样本的数据。在纳入的国家中，与多数群体相比，少数群体的虚弱患病率更高。种族差异似乎对衡量脆弱程度的方法很敏感。两项基于美国的研究发现，种族差异与收入或教育等社会人口统计学差异无关。来自美国或英国的六项研究表明，黑人和南亚人分别有更高的衰弱发生率或更快的衰弱进展。两项研究表明，在不同的种族群体中，虚弱与死亡率有关，但在程度上存在一些细微差异。结论：在不同国家的社区环境中，虚弱患病率的种族差异持续存在，并不能完全用已知的不平等来解释。解决这些差异可能需要仔细衡量和评估脆弱性；应对结构性不平等；并根据少数群体的需要调整干预措施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ageing Research Reviews 医学-老年医学

CiteScore

19.80

自引率

2.30%

发文量

216

审稿时长

55 days

期刊介绍： With the rise in average human life expectancy, the impact of ageing and age-related diseases on our society has become increasingly significant. Ageing research is now a focal point for numerous laboratories, encompassing leaders in genetics, molecular and cellular biology, biochemistry, and behavior. Ageing Research Reviews (ARR) serves as a cornerstone in this field, addressing emerging trends. ARR aims to fill a substantial gap by providing critical reviews and viewpoints on evolving discoveries concerning the mechanisms of ageing and age-related diseases. The rapid progress in understanding the mechanisms controlling cellular proliferation, differentiation, and survival is unveiling new insights into the regulation of ageing. From telomerase to stem cells, and from energy to oxyradical metabolism, we are witnessing an exciting era in the multidisciplinary field of ageing research. The journal explores the cellular and molecular foundations of interventions that extend lifespan, such as caloric restriction. It identifies the underpinnings of manipulations that extend lifespan, shedding light on novel approaches for preventing age-related diseases. ARR publishes articles on focused topics selected from the expansive field of ageing research, with a particular emphasis on the cellular and molecular mechanisms of the aging process. This includes age-related diseases like cancer, cardiovascular disease, diabetes, and neurodegenerative disorders. The journal also covers applications of basic ageing research to lifespan extension and disease prevention, offering a comprehensive platform for advancing our understanding of this critical field.