Frailty Is a Risk Factor for Falls in the Older Adults: A Systematic Review and Meta-Analysis

Yang, Zongcheng; Lin, Hui; Jiang, Guang; Chu, Ying‐Hao; Gao, Jia; Tong, Zhihui; Wang, Zhi-Hao

doi:10.1007/s12603-023-1935-8

Cited by 25 publications

(4 citation statements)

References 58 publications

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“…Frailty encompasses many physical changes related to fall propensity such as impaired balance, sarcopenia, and musculoskeletal dysfunction [6]. The frailty phenotype is often related to muscle loss and has signi cant negative effects on muscle mass, strength, and physical performance which may affect physical abilities, gait speed, endurance, and balance in the older adults, and all of those have been linked to falls [33]. Furthermore, among the older adults, aging and frailty reinforce each other in a vicious cycle that makes frailty more prone to falls [33].…”

Section: Discussionmentioning

confidence: 99%

Mendelian randomization to evaluate the relationship between frailty index and the risk of osteoporosis, falls and fractures

Zhao,

Zhang,

et al. 2023

Preprint

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Background Observational research suggested a suggestive relationship between frailty index (FI) and osteoporosis, falls and fractures. Aims This study aimed to explore genetic causality and identified that higher genetically predicted FI positively correlated with increased risks of osteoporosis, falls, and fractures. Methods Genome-wide association study summary data were used to identify genetic variants strongly related to FI. GWAS data of Heel Bone mineral density, osteoporosis, fall risk and fracture at different site was considered as outcome. Inverse variance-weighted (IVW) analysis was mainly applied; MR-Egger and the weighted median were also used to obtain robust estimates. A series of sensitivity analyses were used to detect pleiotropy or heterogeneity. Then, we adjustment of Body Mass Index (BMI) and type 2 diabetes (T2DM) using multivariable Mendelian randomization (MVMR). Results In the main analysis, a genetically predicted higher Frailty index was associated with a higher risk of Osteoporosis and fall. What’s more, frailty index significantly contributed to an increased risk of Heel Body Mass Density (BMD). In MVMR, after correcting for type 2 diabetes, the causal relationship between FI and Heel BMD has turned into negative regulation. Results of comprehensive sensitivity analysis were consistent with the main causality estimate. Horizontal pleiotropy and heterogeneity were absent in our MR study. Discussion The results provide evidence that offering avenues for interventions alleviates the burden of FI associated with these health concerns. Conclusions Our results suggest a potentially causal relationship between FI and osteoporosis, falls, and fractures.

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Section: Discussionmentioning

confidence: 99%

Mendelian randomization to evaluate the relationship between frailty index and the risk of osteoporosis, falls and fractures

Zhao,

Zhang,

et al. 2023

Preprint

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“…Due to its multidimensional nature, frailty origin responds to the interaction of physical, biological, psychological, genetic, environmental, and social factors [ 117 , 118 , 119 , 120 ]. Frailty increases the body’s susceptibility to acute illness and stressors, raising the risk for disability, institutionalization, falls, fractures, and mortality [ 121 , 122 ]. These features are somewhat reminiscent of osteosarcopenia.…”

Section: Frailty An Expression Of Aging: Do the Kynurenines Have Some...mentioning

confidence: 99%

“…Indeed, several studies have linked physical frailty, frailty index, and some physical parameters with some components of the kynurenine pathway. High KYN/Trp ratio levels have been associated with frailty in older adults diagnosed according to Fried’s criteria [ 121 , 123 , 124 ]. Along the same line, high levels of KYN have been seen in the serum of frail patients diagnosed using both Fried and Rockwood criteria, also obtaining significant associations by analyzing KYN interaction with physical parameters, including time to complete five chair stands, grip strength, and gait speed [ 125 ].…”

Section: Frailty An Expression Of Aging: Do the Kynurenines Have Some...mentioning

confidence: 99%

The Role of the Kynurenine Pathway in the Pathophysiology of Frailty, Sarcopenia, and Osteoporosis

2023

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Tryptophan is an essential nutrient required to generate vitamin B3 (niacin), which is mainly involved in energy metabolism and DNA production. Alterations in tryptophan metabolism could have significant effects on aging and musculoskeletal health. The kynurenine pathway, essential in tryptophan catabolism, is modulated by inflammatory factors that are increased in older persons, a process known as inflammaging. Osteoporosis, sarcopenia, osteosarcopenia, and frailty have also been linked with chronically increased levels of inflammatory factors. Due to the disruption of the kynurenine pathway by chronic inflammation and/or changes in the gut microbiota, serum levels of toxic metabolites are increased and are associated with the pathophysiology of those conditions. In contrast, anabolic products of this pathway, such as picolinic acid, have demonstrated a positive effect on skeletal muscle and bone. In addition, physical activity can modulate this pathway by promoting the secretion of anabolic kynurenines. According to the evidence collected, kynurenines could have a promising role as biomarkers for osteoporosis sarcopenia, osteosarcopenia, and frailty in older persons. In addition, some of these metabolites could become important targets for developing new pharmacological treatments for these conditions.

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“… 1 , 2 Living alone, the loss of family or friends, chronic disease, and hearing loss are challenges that older people confront more frequently than other groups, putting them at a higher risk of social isolation. 13 , 14 , 15 …”

Section: Introductionmentioning

confidence: 99%

Cultural engagement and prevalence of pain in socially isolated older people: a longitudinal modified treatment policy approach

Miki,

Cooray,

Kanai

et al. 2024

eClinicalMedicine

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Frailty Is a Risk Factor for Falls in the Older Adults: A Systematic Review and Meta-Analysis

Cited by 25 publications

References 58 publications

Mendelian randomization to evaluate the relationship between frailty index and the risk of osteoporosis, falls and fractures

Mendelian randomization to evaluate the relationship between frailty index and the risk of osteoporosis, falls and fractures

The Role of the Kynurenine Pathway in the Pathophysiology of Frailty, Sarcopenia, and Osteoporosis

Cultural engagement and prevalence of pain in socially isolated older people: a longitudinal modified treatment policy approach

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