Is Sensory Loss an Understudied Risk Factor for Frailty? A Systematic Review and Meta-analysis

Abstract

<jats:title>Abstract</jats:title> <jats:sec> <jats:title>Background</jats:title> <jats:p>Age-related sensory loss and frailty are common conditions among older adults, but epidemiologic research on their possible links has been inconclusive. Clarifying this relationship is important because sensory loss may be a clinically relevant risk factor for frailty.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>In this systematic review and meta-analysis, we searched 3 databases for observational studies investigating 4 sensory impairments—vision (VI), hearing (HI), smell (SI), taste (TI)—and their relationships with frailty. We meta-analyzed the cross-sectional associations of VI/HI each with pre-frailty and frailty, investigated sources of heterogeneity using meta-regression and subgroup analyses, and assessed publication bias using Egger’s test.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>We included 17 cross-sectional and 7 longitudinal studies in our review (N=34,085) from 766 records. Our cross-sectional meta-analyses found that HI and VI were respectively associated with 1.5 to 2-fold greater odds of pre-frailty and 2.5 to 3-fold greater odds of frailty. Our results remained largely unchanged after subgroup analyses and meta-regression, though the association between HI and pre-frailty was no longer significant in 2 subgroups which lacked sufficient studies. We did not detect publication bias. Longitudinal studies largely found positive associations between VI/HI and frailty progression from baseline robustness, though they were inconclusive about frailty progression from baseline pre-frailty. Sparse literature and heterogenous methods precluded meta-analyses and conclusions on the SI/TI-frailty relationships.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Our meta-analyses demonstrate significant cross-sectional associations between VI/HI with pre-frailty and frailty. Our review also highlights knowledge gaps on the directionality and modifiability of these relationships, and the impact of SI/TI and multiple sensory impairments on frailty.</jats:p> </jats:sec>

Self-Reported Vision Impairment and Frailty among Older People with Low Cognitive Performance in Central Africa: EPIDEMCA Population-Based Study

“…Although this meta-analysis did not include/retrieve studies conducted in such a specific population as ours, results from our study show that people with low cognitive performance who self-reported VI were also more likely to be frail. The underlying mechanisms of the association between VI and frailty remain to be clarified [10]. Several consequences (nonexclusive) of VI such as depression, anxiety, cognitive disorders, loneliness, physical inactivity, and falls are risk factors for frailty [2,[25][26][27][28].…”

“…However, it is recognized that self-reported responses provide valid information about participants' perceived health and therefore have a real scientific value. Despite the fact that the accuracy of self-reported VI measurement may be discussed according to cultural and socioeconomic context [33,34], it should be noted that previous studies using both self-reported and measured VI had found significant association between VI and frailty in older people [6][7][8]10]. In addition, similar to Fried's phenotype, it has been shown that the SOF index is able to predict adverse outcomes of frailty such as falls, disability, and mortality [12,14].…”

“…Several studies have shown that VI is associated with the occurrence of multiple negative health outcomes such as cognitive disorders [2,3], disability [4], and poor quality of life [5] in older people. Using objective or subjective (self-reported) assessment methods of VI, evidence shows that older people with VI are up to 3-fold more likely to experience pre-frailty and/ or frailty or to develop it over time [6][7][8][9][10].…”

“…SSA is one of the lower-middle-income country regions with the highest number of people with VI [1]. Yet, no study has explored effect of VI on physical frailty in SSA older people [10], especially among the most vulnerable groups. In the current study, we investigated whether central African older people with low cognitive performance who self-reported VI were more likely to present frailty than those who reported no VI.…”

Capacidade funcional e perda sensorial em um grupo de idosos usuários de um plano de saúde

“…Deve-se ressaltar que a incapacidade comunicativa vem sendo estudada em idosos a pouco tempo, daí existirem insuficientes estudos que avaliem as necessidades específicas das pessoas idosas com DPS (Tan et al, 2020). Daí, necessidades de várias ordens, como as relativas à comunicação, à orientação, à mobilidade, ao trabalho, a atividades Research, Society andDevelopment, v. 10, n. 2, e16410212287, 2021 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v10i2.12287 socioculturais, ao acesso de informações sobre o que ocorre no mundo, todas essenciais para poder manter a autonomia pessoal e fazer com que esta pessoa possa continuar a sentir-se incluída no ambiente familiar e social, ainda serem pouco trabalhadas no setor saúde (Viljanen & Tormäkangas &Vestergaard, 2014).…”