Objective  To evaluate the incidence and influencing factors of frailty among the elder adults in communities in China by Meta-analysis.

Methods  The databases of CNKI, VIP, Wan-Fang Date, CBM, PubMed, Embase, Web of Science and Cochrane Library were searched from inception to February, 2023. The Stata 12.0 and Rev Man 5.3 software were used to analysis the incidence and influencing factors of frailty among elderly residents in Chinese communities.

Results  A total of 17 literature were selected, involving 11,928 senior citizens. The incidence of frailty among the elderly was 16% [95%CI(12%, 20%)]. The risk factors with statistical significance were malnutrition [OR=6.68, 95%CI(3.35, 13.32)], comorbidity [OR=6.22, 95%CI(5.24, 7.38)], polypharmacy [OR=2.71, 95%CI(2.03, 3.63)], poor sleep quality [OR=2.54, 95%CI(1.66, 3.89)], depression [OR=3.42, 95%CI (1.78, 6.58)], using walking aid [OR=5.42, 95%CI(1.98,14.86)], impaired ability of daily activities [OR=8.07,  95%CI(5.21, 15.21)], and age ≥ 80 years old [OR=2.68, 95%CI(1.95, 3.69)]. Education level above primary school [OR=0.53, 95%CI(0.42,0.66)] was protective factors for frailty.

Conclusion  The incidence of frailty among elderly is high in the Chinese community, and there are many risk factors. Early frailty screening and targeted interventions should be carried out for erderly in the community to prevent the onset of frailty and promote the development of healthy aging.

1.Clegg A, Young J, Iliffe S, et al. Frailty in elderly people[J]. Lancet, 2013, 381(9868): 752-762. DOI: 10.1016/S0140-6736(12)62167-9.

2.Kojima G, Iliffe S, Jivraj S, et al. Association between frailty and quality of life among community-dwelling older people: a systematic review and Meta-analysis[J]. J Epidemiol Community Health, 2016, 70(7): 716-721. DOI: 10.1136/jech-2015-206717.

3.Morley JE, Vellas B, van Kan GA, et al. Frailty consensus: a call to action[J]. Am Med Dir Assoc, 2013, 14(6): 392-397. DOI: 10.1016/j.jamda.2013.03.022.

4.李柄辉, 訾豪, 李路遥, 等. 医学领域一次研究和二次研究的方法学质量（偏倚风险）评价工具[J]. 医学新知, 2021, 31(1): 51-58. [Li BH, Zi H, Li LY, et al. Methodological quality (risk of bias) assessment tools for primary and secondary medical studies: what are they and which is better?[J]. Yixue Xinzhi Zazhi, 2021, 31(1): 51-58.] DOI: 10.12173/j.issn.1004-5511.2021.01.07.

5.Wells G, Shea B, O'Connell D, et al. NewCastle-Ottawa Quality Assessment Scale-Case Control Studies[EB/OL]. [2012-06-15]. http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp

6.冯青青, 边萌, 杜毓锋. 社区老年人衰弱情况及其影响因素研究[J]. 中国全科医学, 2021, 24(24): 3032-3038. [Feng QQ, Bian M, Du YF. Prevalence and influencing factors of frailty among elderly people in the community[J]. Chinese General Practice, 2021, 24(24): 3032-3038.] DOI: 10.12114/j.issn.1007-9572.2021.00.530.

7.黎秀春, 毛延芳, 潘阿秀, 等. 海口市社区老年人的衰弱现状与其影响因素[J]. 中华老年多器官疾病杂志, 2021, 20(11): 829-833. [Li XC, Mao YF, Pan AX, et al. Frailty of the elderly in the communities of Haikou municipality and its influencing factors[J]. Chinese Journal of Multiple organ Diseases in the Elderly, 2021, 20(11): 829-833.] DOI: 10.11915/j.issn.1671-5403.2021.11.173.

8.郭朝唤, 侯莉明, 王宁, 等. 西安市某社区老年人群衰弱的相关危险因素分析[J]. 中华老年多器官疾病杂志, 2019, 18(8): 561-564. [Guo ZH, Hou LM, Wang N, et al. Risk factors for frailty among community-dwelling elderly in Xi′an[J]. Chinese Journal of Multiple Organ Diseases in the Elderly, 2019, 18(8): 561-564.] DOI: 10.11915/j.issn.1671-5403.2019.08.121.

9.周巧学, 周建荣, 库敏, 等. 社区高龄老年人衰弱状况及影响因素的研究[J]. 护理学杂志, 2019, 34(21): 68-72. [Zhou QX, Zhou JR, Ku M, et al. Prevalence and influencing factors of frailty among the oldest old in community[J]. Journal of Nursing Science, 2019, 34(21): 68-72.] DOI: 10.3870/1.issn.1001—4152.2019.21.068.

10.余静雅, 高静, 柏丁兮, 等. 成都市社区老年人衰弱现状与影响因素[J]. 中国老年学杂志, 2021, 41(9): 1972-1977. [Yu JY, Gao J, Bai DX, et al. Frailty of the elderly in the communities of Chengdu municipality and its influencing factors[J]. Chinese Journal of Gerontology, 2021, 41(9): 1972-1977.] DOI: 10.3969/j.issn.1005-9202. 2021.09.052.

11.许丽娟, 张丽虹, 叶丽娜, 等. 社区老年衰弱危险因素及风险预测模型构建[J]. 中国老年学杂志, 2021, 41(1): 170-173. [Xu LJ, Zhang LH, Ye LN, et al. Construction of risk factors and risk prediction model for senile frailty in community[J]. Chinese Journal of Gerontology, 2021, 41(1): 170-173.] DOI: 10.3969/ j.issn.1005-9202.2021.01.048.

12.奚兴, 郭桂芳. 社区老年人衰弱现状及其影响因素研究[J]. 中国护理管理, 2014, 14(12): 1315-1319. [Xi X, Guo GF. The current status and influencing factors of frailty among elders in community[J]. Chinese Nursing Management, 2014, 14(12): 1315-1319.] DOI: 10.3969/j.issn.1672-1756.2014.12.024.

13.王燕丽, 陈贺, 陈慧娟. 社区老年人群衰弱发生现状及影响因素研究[J]. 中国临床护理, 2022, 14(4): 203- 206. [Wang YL, Chen H, Chen HJ. Research on the status quo and influencing factors of frailty among the elderly in the community[J]. Chinese Clinical Nursing, 2022, 14(4): 203-206.] DOI: 10.3969/j.issn.1674-3768.2022.04.002.

14.王丽华, 肖艳, 杨秋莲. 广州市社区≥60岁人群衰弱现状及影响因素调查[J]. 华南预防医学, 2021, 47(10): 1312-1314, 1318. [Wang LH, Xiao Y, Yang QL. Investigation of frailty status and its influencing factors in community population aged≥60 years in Guangzhou[J]. South China Journal of Prevention Medicine, 2021, 47(10): 1312-1314, 1318.] DOI: 10.12183/j.scjpm.2021.1312.

15.邵章婷, 章妙玉, 高燕飞. 社区年龄≥70岁老年人衰弱相关影响因素分析[J]. 中国现代医生, 2022, 60(17): 114-117. [Shao ZT, Zhang MY, Gao YF. Analysis of related influencing factors of frailty in elderly aged 70 years and older in community[J]. China Modern Doctor, 2022, 60(17): 114-117.] https://d.wanfangdata.com.cn/periodical/ChlQZXJpb2RpY2FsQ0hJTmV3UzIwMjMxMjI2EhZ6d2tqemxtbC15eXdzMjAyMjE3MDMxGghmZnhtbnh2aw%3D%3D.

16.秦丽, 梁珍珍, 葛立宾, 等. 社区老年衰弱综合征的影响因素研究[J]. 中国全科医学, 2020, 23(5): 598-603. [Qin L, Liang ZZ, Ge LB, et al. Influencing factors of frailty syndrome in elderly people in the community[J]. Chinese General Practice, 2020, 23(5): 598-603.] DOI: 10.12114/j.issn.1007-9572.2020.00.060.

17.任晶晶. 社区老年人衰弱现状及影响因素的研究[D]. 兰州：兰州大学, 2020. [Ren JJ. Prevalence and associated factors for frailty among community-dwelling older[D]. Lanzhou: Lanzhou University, 2020.] DOI: 10.27204/d.cnki.glzhu.2020.001677.

18.侯百灵, 张会君. 社区老年人衰弱风险列线图模型的构建与验证[J]. 当代护士(上旬刊), 2022, 29(8): 1-6. [Hou BL, Zhang HJ. Construction and evaluation of a nomogram model for frailty in community-dwelling elderly people[J]. Modern Nurse, 2022, 29(8): 1-6.] DOI: 10.19791/j.cnki.1006-6411.2022.22.001.

19.李岚君. 内蒙古锡林郭勒盟某社区老年衰弱及其影响因素随访研究[D]. 呼和浩特：内蒙古医科大学, 2021. [Li LJ. Follow-up study on senile frailty and its influencing factors in a community in Xilin Gol League, Inner Mongolia[D]. Hohhot: Inner Mongolia Medical University, 2021.] DOI: 10.27231/d.cnki.gnmyc.2021.000281.

20.张治香,侯惠如.海南部分地区百岁老人衰弱现状及影响因素分析[J].解放军医学院学报, 2018,39(4):6.[Zhang ZX,Hou HR.Frailty in centenarians in parts of Hainan province andits influencing factors[J].Academic Journal of Chinese PLA Medical School,2018,39(4): 286-290,307.] DOI: 10.3969/j.issn.2095-5227.2018.04.005.

21.Chang CI, Chan DC, Kuo KN, et al. Prevalence and correlates of geriatric frailty in a northern Taiwan community[J]. Formos Med Assoc, 2011, 110(4): 247-257. DOI: 10.1016/S0929-6646(11)60037-5.

22.Woo J, Zheng Z, Leung J, et al. Prevalence of frailty and contributory factors in three Chinese populations with different socioeconomic and healthcare characteristics[J]. BMC Geriatr, 2015, 15: 163. DOI: 10.1186/s12877-015-0160-7.

23.Liljas AEM, Carvalho LA, Papachristou E, et al. Self-reported hearing impairment and incident frailty in english community-dwelling older adults: a 4-year follow-up study[J]. Am Geriatr Soc, 2017, 65(5): 958-965. DOI:  10.1111/jgs.14687.

24.刘云, 魏利荣, 刘晓凤, 等. 我国养老机构老年人衰弱患病率Meta分析[J]. 职业与健康, 2022, 38(22): 3120-3124, 3128. [Liu Y, Wei LR, Liu XF, et al. Meta-analysis on prevalence of frailty among elderly people in elderly care institutions in China[J]. Occupation and Health, 2022, 38(22): 3120-3124, 3128.] DOI: 10.13329/j.cnki.zyyjk.2022.0646.

25.Verschoor CP, Tamim H. Frailty is inversely related to age at menopause and elevated in women who have had a hysterectomy: an analysis of the Canadian longitudinal study on aging[J]. Gerontol A Biol Sci Med Sci, 2019, 74(5): 749. DOI: 10.1093/gerona/gly286.

26.郝秋奎, 中华医学会老年医学分会, 李小鹰, 等. 老年患者衰弱评估与干预中国专家共识[C]. 中华老年医学杂志, 2018, 36(3): 251-256. [Hao Qk, Geriatric Medicine Branch of Chinese Medical Association, Li XY, et al. Chinese experts consensus on assessment and intervention for elderly patients with frailty[C]. Chinese Journal of Geriatrics, 2018, 36(3): 251-256.] DOI: 10.3760/cma.j.issn.0254-9026.2017.03.007.

27.王洪梅, 李娜, 王红, 等. 住院老年眩晕患者衰弱现状及影响因素研究[J]. 中华护理杂志, 2023, 58(2): 205-210. [Wang HM, Li N, Wang H, et al. The current situation and influential factors of frailty in elderly patients with vertigo[J]. Chinese Journal of Nursing, 2023, 58(2): 205-210.] DOI: 10.3761/j.issn.0254-1769.2023.02.011.

28.罗如珍, 杨洋, 张春梅, 等. 社区老年人衰弱水平及影响因素研究[J]. 中国实用护理杂志, 2017, 33(15): 1169-1173. [Luo RZ, Yang Y, Zhang CM, et al. Study on frailty level and influencing factors of the elderly in community[J]. Chinese Journal of Practical Nursing, 2017, 33(15): 1169-1173.] DOI: 10.3760/cma.j.issn.1672-7088.2017.15.012.

29.Park D, Kim HS. The factors affecting frailty among the elderly in Korea: a study using the frailty cohort[J]. Int J Environ Res Public Health, 2022, 20(1): 670. DOI: 10.3390/Ijerph20010670.

30.Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype[J]. Gerontol A Biol Sci Med Sci, 2001, 56(3): M146-156. DOI: 10.1093/gerona/56.3.m146.

31.侯晓琳, 高静, 吴晨曦, 等. 养老机构老年人衰弱现状及分析[J]. 中华护理杂志, 2018, 53(1): 88-93. [Hou XL, Gao J, Wu CX, et al. Prevalence and factors associated lrith frailty among institutional older adult[J]. Chinese Journal of Nursing, 2018, 53(1): 88-93.] DOI: 10.3761/j.issn.0254-1769.2018.01.016.

32.Davis DH, Rockwood MR, Mitnitski AB, et al. Impairments in mobility and balance in relation to frailty[J]. Arch Gerontol Geriatr, 2011, 53(1): 79-83. DOI: 10.1016/j.archger.2010.06.013.

33.Lorber M, Kmetec S, Davey A, et al. Associations between sleep quality, frailty, and quality of life among older adults in community and nursing home settings[J]. Int J Environ Res Public Health, 2023, 20(6): 4937. DOI: 10.3390/ijerph20064937.

34.Pourmotabbed A, Boozari B, Babaei A, et al. Sleep and frailty risk: a systematic review and Meta-analysis[J]. Sleep Breath, 2020, 24(3): 1187-1197. DOI: 10.1007/s11325-020-02061-w.

35.Lau BH, Kwan J, Cheung KS. Overlap of frailty, comorbidity, disability, and poor self-rated health in community-dwelling near-centenarians and centenarians[J]. Am Geriatr Soc, 2016, 64(4): 900-901. DOI: 10.1111/jgs.14063.

36.慈莉娅, 杨长春, 郑鹏远, 等. 医养结合机构衰弱老年人多重用药安全管理中国专家共识(2022版)[J]. 中国心血管杂志, 2022, 27(5): 403-410. [Ci LY, Yang CC, Zheng PY, et al. Chinese expert consensus on safety management of polypharmacy for frail elderly people in the institutions of combination of medical and senior health care (2022 version)[J]. Chin J Cardiovasc Med, 2022, 27(5): 403-410.] DOI: 10.3969/j.issn.1007-5410.2022.05.002.

37.方向阳, 陈清, 侯原平, 等. 社区老年人抑郁症状与衰弱相关性[J]. 中国老年学杂志, 2022, 42(1): 211-214. [Fang XY, Chen Q, Hou YP, et al. Correlation between depressive symptoms and frailty in elderly people in community[J]. Chinese Journal of Gerontology, 2022, 42(1): 211-214.] DOI: 10.3969/j.issn.1005-9202.2022.01.056.

38.Vaughan L, Corbin AL, Goveas JS. Depression and frailty in later life: a systematic review[J]. Clin Interv Aging, 2015, 10: 1947-1958. DOI: 10.2147/CIA.S69632.

39.Feng Z, Lugtenberg M, Franse C, et al. Risk factors and protective factors associated with incident or increase of frailty among community-dwelling older adults: a systematic review of longitudinal studies[J]. PLoS One, 2017, 12(6): e0178383. DOI: 10.1371/journal.pone.0178383.

40.Alexopoulos GS, Morimoto SS. The inflammation hypothesis in geriatric depression[J]. Int J Geriatr Psychiatry, 2011, 26(11): 1109-1118. DOI: 10.1002/gps.2672.

41.Soysal P, Stubbs B, Lucato P, et al. Inflammation and frailty in the elderly: a systematic review and Meta-analysis[J]. Ageing Res Rev, 2016, 31: 1-8. DOI: 10.1016/j.arr.2016.08.006.

42.Bales CW, Ritchie CS. Sarcopenia, weight loss, and nutritional frailty in the elderly[J]. Annu Rev Nutr, 2002, 22: 309-323. DOI: 10.1146/annurev.nutr.22.010402.102715.