The impact of frailty on clinical outcomes among older adults with diabetes: A systematic review and meta-analysis

Author:

Cheng Min12ORCID,He Mei2ORCID,Ning Liping12,Gan Haoyue12,Liu Qin12,Liu Hangcheng12,Shi Feifei12,Luo Ying12

Affiliation:

1. School of Nursing, North Sichuan Medical University, Nanchong, China

2. Nursing Department of Mianyang Central Hospital/School of Medicine Affiliated to University of Electronic Science and Technology of China, Mianyang, China.

Abstract

Background: Frailty has been identified as a risk factor for adverse outcomes in older adults with diabetes. This study aimed to investigate the impact of frailty on the prognosis of older adults with diabetes through a systematic review and meta-analysis, with the goal of offering insights for clinical decision-making. Methods: PubMed, Web of Science, Embase, Cochrane were systematically searched from inception to September 10th, 2023. Reviewers independently selected studies, extracted data and evaluated the quality of studies. Stata 15.1 Software was used to perform the meta-analysis. The primary outcomes of this study were mortality, hospitalization and disability, and the secondary outcomes were diabetes complications (including nephropathy, microvascular complications, macroangiopathy, cardiovascular events, hypoglycemia) and urolithiasis. Results: A total of 14 studies were included in this study, with low risk of bias and moderate to good quality. The results showed that frailty increased the risk of mortality (HR 1.91, 95% CI 1.55–2.35, P < .001), hospitalization (HR 2.19, 95% CI 1.53–3.13, P < .001), and disability in older adults with diabetes (HR 3.84, 95% CI 2.35–6.28, P < .001). In addition, frailty was associated with diabetes complications (including nephropathy, microvascular complications, macroangiopathy, cardiovascular events, hypoglycemia), urolithiasis. Conclusions: Frailty is an important predictor of adverse outcomes, such as mortality, hospitalization, and disability in older adults with diabetes. Accurate assessment of the frailty in older adults with diabetes can help improve the adverse outcomes of patients.

Publisher

Ovid Technologies (Wolters Kluwer Health)

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