The Relationship Between Anaemia and Frailty: A Systematic Review and Meta-Analysis of Observational Studies

WP4 of the Joint Action Advantage

Research output: Contribution to journalReview article

11 Citations (Scopus)

Abstract

Background: There is increasing evidence that frailty may play a role in chronic diseases, but the associations with specific chronic disorders are still unclear. Objectives: To conduct a systematic review and meta-analysis assessing the association of anaemia and frailty in observational studies. Methods: The review was performed according to PRISMA guidelines. We searched PubMed, Web of Science, and Embase from 01/01/2002-10/09/2017. Pooled estimates were obtained through random effect models and Mantel-Haenszel weighting. Homogeneity was assessed with the I2 statistic. Publication bias was assessed with Egger’s and Begg’s tests. Results: Nineteen studies were included; two longitudinal, seventeen cross-sectional. All studies except three reported an association between anaemia and frailty. The pooled prevalence of prefrailty in individuals with anaemia was 49% (95% CI=38-59%; I2=89.96%) and 24% (95% CI=17-31%; I2= 94.78%) for frailty. Persons with anaemia had more than a twofold odds of frailty (pooled OR=2.24 95% CI=1.53-3.30; I2=91.8%). Only two studies longitudinally examined the association between anaemia and frailty, producing conflicting results. Conclusions: Frailty and prefrailty are common in anaemic persons. Older persons with anaemia have more than a two-fold increased odds of frailty. These results may have clinical implications, as they identify the need to assess frailty in anaemic people and investigate any potential negative effects associated with the co-occurrence of both conditions. Longitudinal research that examines temporal changes in anaemia and effect of treatment are needed to further clarify the relationship between anaemia and frailty.

Original languageEnglish
Pages (from-to)965-974
Number of pages10
JournalJournal of Nutrition, Health and Aging
Volume22
Issue number8
DOIs
Publication statusPublished - Oct 1 2018

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Observational Studies
Meta-Analysis
Anemia
Publication Bias
PubMed
Chronic Disease
Guidelines
Research

Keywords

  • ageing
  • anemic
  • chronic diseases
  • Frail
  • hemoglobin
  • vulnerable

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics
  • Geriatrics and Gerontology

Cite this

The Relationship Between Anaemia and Frailty : A Systematic Review and Meta-Analysis of Observational Studies. / WP4 of the Joint Action Advantage.

In: Journal of Nutrition, Health and Aging, Vol. 22, No. 8, 01.10.2018, p. 965-974.

Research output: Contribution to journalReview article

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title = "The Relationship Between Anaemia and Frailty: A Systematic Review and Meta-Analysis of Observational Studies",
abstract = "Background: There is increasing evidence that frailty may play a role in chronic diseases, but the associations with specific chronic disorders are still unclear. Objectives: To conduct a systematic review and meta-analysis assessing the association of anaemia and frailty in observational studies. Methods: The review was performed according to PRISMA guidelines. We searched PubMed, Web of Science, and Embase from 01/01/2002-10/09/2017. Pooled estimates were obtained through random effect models and Mantel-Haenszel weighting. Homogeneity was assessed with the I2 statistic. Publication bias was assessed with Egger’s and Begg’s tests. Results: Nineteen studies were included; two longitudinal, seventeen cross-sectional. All studies except three reported an association between anaemia and frailty. The pooled prevalence of prefrailty in individuals with anaemia was 49{\%} (95{\%} CI=38-59{\%}; I2=89.96{\%}) and 24{\%} (95{\%} CI=17-31{\%}; I2= 94.78{\%}) for frailty. Persons with anaemia had more than a twofold odds of frailty (pooled OR=2.24 95{\%} CI=1.53-3.30; I2=91.8{\%}). Only two studies longitudinally examined the association between anaemia and frailty, producing conflicting results. Conclusions: Frailty and prefrailty are common in anaemic persons. Older persons with anaemia have more than a two-fold increased odds of frailty. These results may have clinical implications, as they identify the need to assess frailty in anaemic people and investigate any potential negative effects associated with the co-occurrence of both conditions. Longitudinal research that examines temporal changes in anaemia and effect of treatment are needed to further clarify the relationship between anaemia and frailty.",
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author = "{WP4 of the Joint Action Advantage} and Katie Palmer and Vetrano, {D. L.} and A. Marengoni and Tummolo, {A. M.} and Villani, {E. R.} and N. Acampora and R. Bernabei and G. Onder",
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AU - Marengoni, A.

AU - Tummolo, A. M.

AU - Villani, E. R.

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AU - Bernabei, R.

AU - Onder, G.

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