Thomas Cronin, David Healy, Noel McCarthy, Susan M Smith, John Travers
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A meta-analysis examining prevalence of frailty and pre-frailty was completed with a narrative synthesis of related risk factors.</p><p><strong>Results: </strong>A total of 1672 articles were screened for eligibility and 11 studies were included, containing 1017 participants from seven countries. Six different screening tools were employed to detect frailty in the included studies. The range of frailty prevalence was 16-70 % and pre-frailty prevalence was 18-60 %. The pooled frailty prevalence from studies employing the Fried Criteria was 39 % (95 % CI 15-66); the Clinical Frailty Scale: 37 % (95 % CI 24-51); the Edmonton Frailty Scale: 53 % (95 % CI 44-63); and the Tilburg Fraily Indicator: 31 % (95 % CI 8-60). High heterogeneity was observed between the studies. 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引用次数: 0
摘要
背景：无家可归的经历与过早衰老和老年综合征的早期发病有关。确定脆弱和适当的干预可能有助于改善无家可归者的健康结果（PEH）。本综述旨在确定PEH的患病率、筛查工具的使用和虚弱的危险因素。方法：根据PRISMA检查表进行系统回顾，调查PEH的患病率和虚弱的危险因素。从成立到2024年7月，在Ovid MEDLINE， PsycInfo， Web of Science和CINAHL中进行了检索。通过对相关危险因素的叙述综合，完成了一项检查脆弱患病率和脆弱前患病率的荟萃分析。结果：共筛选了1672篇文章，纳入了11项研究，包括来自7个国家的1017名受试者。在纳入的研究中，采用了六种不同的筛选工具来检测虚弱。虚弱患病率为16- 70%，虚弱前患病率为18- 60%。采用弗里德标准的研究的综合虚弱患病率为39% (95% CI 15-66)；临床衰弱量表：37% (95% CI 24-51)；埃德蒙顿虚弱量表：53% (95% CI 44-63)；蒂尔堡衰弱指数：31% （95% CI 8-60）。研究之间存在高度异质性。已确定的PEH中出现虚弱的风险因素包括女性、无家可归的时间增加和吸毒成瘾。结论：本研究强调了PEH中虚弱和虚弱前期的高患病率。已确定的风险因素说明了为扭转脆弱性而进行干预的潜在领域。未来的研究应侧重于脆弱性筛查在PEH中的作用，并在这一群体中开发适当的脆弱性检测工具。
Prevalence and risk factors of frailty in people experiencing homelessness: A systematic review and meta-analysis.
Background: The experience of homelessness has been associated with premature ageing and an earlier onset of geriatric syndromes. Identification of frailty and appropriate intervention, may help improve health outcomes for people experiencing homelessness (PEH). This review aimed to identify prevalence, use of screening tools and risk factors for frailty in PEH.
Method: A systematic review, conducted and reported following the PRISMA checklist, was undertaken investigating the prevalence and risk factors of frailty among PEH. Searches were conducted in Ovid MEDLINE, PsycInfo, Web of Science and CINAHL from inception to July 2024. A meta-analysis examining prevalence of frailty and pre-frailty was completed with a narrative synthesis of related risk factors.
Results: A total of 1672 articles were screened for eligibility and 11 studies were included, containing 1017 participants from seven countries. Six different screening tools were employed to detect frailty in the included studies. The range of frailty prevalence was 16-70 % and pre-frailty prevalence was 18-60 %. The pooled frailty prevalence from studies employing the Fried Criteria was 39 % (95 % CI 15-66); the Clinical Frailty Scale: 37 % (95 % CI 24-51); the Edmonton Frailty Scale: 53 % (95 % CI 44-63); and the Tilburg Fraily Indicator: 31 % (95 % CI 8-60). High heterogeneity was observed between the studies. Identified risk factors for developing frailty in PEH included being female, increased years spent homeless, and drug addiction.
Conclusion: This study highlights a high prevalence of frailty and pre-frailty in PEH. The identified risk factors illustrate potential areas to target interventions to reverse frailty. Future research should focus on the role of screening for frailty in PEH and developing appropriate frailty detection tools in this group.
期刊介绍：
The Journal of Frailty & Aging is a peer-reviewed international journal aimed at presenting articles that are related to research in the area of aging and age-related (sub)clinical conditions. In particular, the journal publishes high-quality papers describing and discussing social, biological, and clinical features underlying the onset and development of frailty in older persons. The Journal of Frailty & Aging is composed by five different sections: - Biology of frailty and aging In this section, the journal presents reports from preclinical studies and experiences focused at identifying, describing, and understanding the subclinical pathophysiological mechanisms at the basis of frailty and aging. - Physical frailty and age-related body composition modifications Studies exploring the physical and functional components of frailty are contained in this section. Moreover, since body composition plays a major role in determining physical frailty and, at the same time, represents the most evident feature of the aging process, special attention is given to studies focused on sarcopenia and obesity at older age. - Neurosciences of frailty and aging The section presents results from studies exploring the cognitive and neurological aspects of frailty and age-related conditions. In particular, papers on neurodegenerative conditions of advanced age are welcomed. - Frailty and aging in clinical practice and public health This journal’s section is devoted at presenting studies on clinical issues of frailty and age-related conditions. This multidisciplinary section particularly welcomes reports from clinicians coming from different backgrounds and specialties dealing with the heterogeneous clinical manifestations of advanced age. Moreover, this part of the journal also contains reports on frailty- and age-related social and public health issues. - Clinical trials and therapeutics This final section contains all the manuscripts presenting data on (pharmacological and non-pharmacological) interventions aimed at preventing, delaying, or treating frailty and age-related conditions.The Journal of Frailty & Aging is a quarterly publication of original papers, review articles, case reports, controversies, letters to the Editor, and book reviews. Manuscripts will be evaluated by the editorial staff and, if suitable, by expert reviewers assigned by the editors. The journal particularly welcomes papers by researchers from different backgrounds and specialities who may want to share their views and experiences on the common themes of frailty and aging.The abstracting and indexing of the Journal of Frailty & Aging is covered by MEDLINE (approval by the National Library of Medicine in February 2016).
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