Kojima, G;
Iliffe, S;
Jivraj, S;
Walters, K;
(2016)
Association between frailty and quality of life among community-dwelling older people: a systematic review and meta-analysis.
Journal of Epidemiology & Community Health
10.1136/jech-2015-206717.
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Abstract
BACKGROUND: With growing numbers of older people worldwide, improving and maintaining quality of life during the extended years of life are a major focus for healthcare providers and policymakers. Some studies have suggested frailty may be associated with worse quality of life. OBJECTIVES: To review the associations between frailty and quality of life among community-dwelling older people. METHODS: A systematic literature search was performed using five databases for cross-sectional and longitudinal studies examining associations between frailty and quality of life among community-dwelling older people published in 2000 or later. Reference lists of relevant studies were also manually searched. Authors were requested for data for a meta-analysis if necessary. Meta-analysis was attempted for studies using the same frailty criteria and quality-of-life instrument. Methodological quality, heterogeneity and publication bias were assessed. RESULTS: The systematic review identified 5145 studies, among which 11 cross-sectional studies and two longitudinal studies were included in this review. Meta-analysis including four cross-sectional studies using the Fried Phenotype and 36-Item Short Form Health Survey showed that those classified as frail and prefrail had significantly lower mental and physical quality-of-life scores than those classified as non-frail. High heterogeneity and possible publication bias were noted. CONCLUSIONS: This systematic review and meta-analysis has demonstrated the evidence of a consistent inverse association between frailty/prefrailty and quality of life among community-dwelling older people. Interventions targeted at reducing frailty may have the additional benefit of improving corresponding quality of life. More longitudinal analysis is required to determine this effect.
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