Frailty and multimorbidity

A systematic review and meta-analysis

Davide L. Vetrano, Katie Palmer, Alessandra Marengoni, Emanuele Marzetti, Fabrizia Lattanzio, Regina Roller-Wirnsberger, Luz Lopez Samaniego, Leocadio Rodríguez-Mañas, Roberto Bernabei, Graziano Onder

Research output: Contribution to journalReview article

22 Citations (Scopus)

Abstract

Background: Multimorbidity and frailty are complex syndromes characteristics of aging. We reviewed the literature and provided pooled estimations of any evidence regarding (a) the coexistence of frailty and multimorbidity and (b) their association. Methods: We searched PubMed and Web of Science for relevant articles up to September 2017. Pooled estimates were obtained through random effect models and Mantel-Haenszel weighting. Homogeneity (I2), risk of bias, and publication bias were assessed. PROSPERO registration: 57890. Results: A total of 48 studies involving 78,122 participants were selected, and 25 studies were included in one or more meta-analyses. Forty-five studies were cross-sectional and 3 longitudinal, with the majority of them including community-dwelling participants (n = 35). Forty-three studies presented a moderate risk of bias and five a low risk. Most of the articles defined multimorbidity as having two or more diseases and frailty according to the Cardiovascular Health Study criteria. In meta-analyses, the prevalence of multimorbidity in frail individual was 72% (95% confidence interval = 63%-81%; I2 = 91.3%), and the prevalence of frailty among multimorbid individuals was 16% (95% confidence interval = 12%-21%; I2 = 96.5%). Multimorbidity was associated with frailty in pooled analyses (odds ratio = 2.27; 95% confidence interval = 1.97-2.62; I2 = 47.7%). The three longitudinal studies suggest a bidirectional association between multimorbidity and frailty. Conclusions: Frailty and multimorbidity are two related conditions in older adults. Most frail individuals are also multimorbid, but fewer multimorbid ones also present frailty. Our findings are not conclusive regarding the causal association between the two conditions. Further longitudinal and well-designed studies may help to untangle the relationship between frailty and multimorbidity.

Original languageEnglish
Pages (from-to)659-666
Number of pages8
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Volume74
Issue number5
DOIs
Publication statusPublished - May 1 2019

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Meta-Analysis
Comorbidity
Confidence Intervals
Independent Living
Publication Bias
PubMed
Longitudinal Studies
Cross-Sectional Studies
Odds Ratio
Health

Keywords

  • Chronic diseases
  • Frailty
  • Multimorbidity
  • Older people
  • Personalized medicine

ASJC Scopus subject areas

  • Ageing
  • Geriatrics and Gerontology

Cite this

Frailty and multimorbidity : A systematic review and meta-analysis. / Vetrano, Davide L.; Palmer, Katie; Marengoni, Alessandra; Marzetti, Emanuele; Lattanzio, Fabrizia; Roller-Wirnsberger, Regina; Samaniego, Luz Lopez; Rodríguez-Mañas, Leocadio; Bernabei, Roberto; Onder, Graziano.

In: Journals of Gerontology - Series A Biological Sciences and Medical Sciences, Vol. 74, No. 5, 01.05.2019, p. 659-666.

Research output: Contribution to journalReview article

Vetrano, Davide L. ; Palmer, Katie ; Marengoni, Alessandra ; Marzetti, Emanuele ; Lattanzio, Fabrizia ; Roller-Wirnsberger, Regina ; Samaniego, Luz Lopez ; Rodríguez-Mañas, Leocadio ; Bernabei, Roberto ; Onder, Graziano. / Frailty and multimorbidity : A systematic review and meta-analysis. In: Journals of Gerontology - Series A Biological Sciences and Medical Sciences. 2019 ; Vol. 74, No. 5. pp. 659-666.
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AU - Roller-Wirnsberger, Regina

AU - Samaniego, Luz Lopez

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