Frailty as a Predictor of Future Fracture in Older Adults: A Systematic Review and Meta ‐Analysis

ABSTRACT
BackgroundStudies have identified frailty as an effective predictor of fracture; however, the correlation between frailty and fracture differs between various stages of frailty.
ObjectivesThe main aim is to determine the correlation between various stages of frailty and fracture risk; a secondary purpose is to determine the correlation between subgroups (e.g., females, females with a hip fracture, or aged 65 years or older) within the stages of frailty and fracture risk. Finally, effect of frailty criteria on the association between stages of frailty and fracture risk was tested.
MethodsWe conducted a systematic review and meta‐analysis. The inclusion criteria were as follows: (a) a prospective study design; (b) subjects aged 55 years or older; (c) a division into robust, prefrail, and frail groups; and (d) reported confidence intervals of hazard ratio. Two investigators independently assessed quality and discussed their findings to reach consensus. The quality of the literature was assessed and the level of evidence was also determined.
ResultsIn total, five studies included 103,783 older people and recorded 2,960 fractures. The results identified that the risk of fracture in the frail people was higher than that in both the robust people (summary HR: 1.67; 95% CI [1.46–1.91]) and prefrail people (summary HR: 1.28; 95% CI [1.16–1.40], and that the risk of fracture in the prefrail people was higher than that in the robust people (summary HR: 1.30; 95% CI [1.20�...

Source: Worldviews on Evidence-Based Nursing - April 27, 2017 Category: Nursing Authors: Kuo ‐Wei Chen, Shu‐Fang Chang, Pei‐Ling Lin Tags: Evidence Review Source Type: research