Frailty was Related with Fracture: a Systematic Review

Abstract

Background: The World Health Organization suggested that frailty is a critical indicator influencing successful aging. Previous studies have indicated a high correlation between frailty and bone fracture in older adults. However, few studies have investigated the correlation between the various stages of frailty with bone fracture risk. Purpose: This study investigated the correlation between frailty and bone fracture in older adults. In addition, the correlation between various frailty criteria and bone fracture was examined. Method: A systematic review and meta-analysis was conducted. According to the research purpose, publications were retrieved from the databases of Pub Med, Ovid, MEDLINE, CINAHL, and the Cochrane Library by using the following keywords: frailty or frail, and bone fracture. The start date of the publication time span was not limited; the end date was set as October 10, 2016. The title and abstract content of the publications were screened. The inclusion criteria were: (a) prospective study, and (b) relative risk and 95% confidence level. Publication quality was evaluated according to risk of bias, consistency, and the precision of survival estimates in order to examine the strength of evidence of the correlation suggested between frailty and bone fracture in the various publications. Results: This study collected 6 papers that analyze the correlation of stages of frailty (non-frail, pre-frail, and frail) with bone fracture. A literature analysis revealed that compared with non-frail older adults, frail older adults had the highest bone fracture risk, followed by pre-frail older adults. Notably, an analysis of secondary groups determined that for females, adults with hip bone fractures, and adults aged 65 years and above, frail adults attained the highest fracture risk, followed by pre-frail adults. In addition, the literature analysis also revealed that regardless of how frailty was categorise using different criteria, frail adults still showed the highest risk for fracture, followed by pre-frail adults. Conclusion: Frailty is a critical topic in geriatric assessment. The research findings can serve as a reference for case evaluations examining correlation between frailty and bone fracture, for formulating care strategies, and for evaluating care cases related to frailty.