Prevalence of frailty in Japan: A systematic review and meta-analysis

Abstract

Japan's population is aging more rapidly than that of any other country. Frailty has recently been recognized as an important priority. Understanding the basic epidemiology of frailty in Japan, which is an example of a rapidly aging society, will be beneficial for Japan as well as other countries expecting an aging population. A systematic literature search of 11 electronic databases was conducted in March 2016 using a comprehensive set of Medical Subject Heading and text terms for any studies published in 2000 or later that report the prevalence of frailty among Japanese community-dwelling older people aged 65 years or older. A total of 1529 studies were identified in the systematic search, of which five studies were included in this review. The pooled prevalence of frailty, prefrailty, and robustness was 7.4% (95% confidence interval [CI], 6.1%–9.0%), 48.1% (95% CI, 41.6%–54.8%), and 44.4% (95% CI, 37.2%–51.7%), respectively. A significant degree of heterogeneity was observed. There was no evidence of publication bias. Age-stratified meta-analyses of four studies showed the pooled prevalence of frailty was 1.9%, 3.8%, 10.0%, 20.4%, and 35.1% for those aged 65–69, 70–74, 75–79, 80–84, and ≥85 years, respectively. Pooled prevalence of frailty was 8.1% for women and 7.6% for men. This review showed an overall pooled prevalence of frailty among Japanese community-dwelling older people of 7.4%. The age-stratified analysis suggested that Japanese older people are less frail before their late 70's but frailer in later life than older people in other countries. These findings provide important basic information for all parties involved in Japanese frailty research.

Frailty and Associated Factors among Centenarians in the 5-COOP Countries

“…The results of the 5-COOP study confirm that frailty involves a majority of centenarians in a much larger sample and are in line with the above-mentioned studies [9,15,20,24]. This very high prevalence of frailty in centenarians raises the question of whether an additional category corresponding to people having 4-5 frailty criteria should be distinguished in order to discriminate "very frail" or "super-frail" people from frail people (still not dependent in ≥2 ADL for 25% of them).…”

“…A Spanish study reported that phenotypic frailty was present in 21% of 273 community-dwelling people aged 86 years participating in a clinical trial [23]. A meta-analysis of Japanese studies estimated the prevalence of frailty at 35% among 407 community-dwelling people aged 85 years and over [24]. A French study among 512 nonagenarians reported that 54% of the participants met the criteria for frailty, in the absence of disability in half of them [9].…”

“…We hypothesized that countries characterized by high longevity (i.e., Japan, followed by France and Switzerland) will have a higher prevalence of frailty compared to countries that ranked lower regarding life expectancy (i.e., Sweden and Denmark) [27]. This hypothesis is grounded on the assumption that people who live longer experience a lower level of selection, allowing them to accumulate health problems that will make them potentially frailer at old age [24].…”

Office-Based Physical Assessment in Patients Aged 75 Years and Older with Cardiovascular Disease

“…Frailty affects almost 1 in every 2 patients with heart failure [2], whereas only 7.4–10.7% of community-dwelling older adults were identified as frail [3, 4]. Physical frailty results in elevated rates of mortality, morbidity, functional decline, and major adverse cardiac and cerebrovascular events following cardiac surgery [5].…”

Frailty and mortality among dialysis patients

“…A systematic review and meta-analysis [2] identified five studies incorporating 11,940 Japanese people aged 65 years or older living in the community and demonstrated that the pooled prevalences of frailty, prefrailty, and robustness based on the Fried criteria were 7.4, 48.1, and 44.4%, respectively. Stratified analyses showed that women were frailer than men and that prevalence of frailty increased with age.…”