Prevalence of frailty in community-dwelling older persons: a systematic review
Abstract
Objectives: To systematically compare and pool the prevalence of frailty, including prefrailty, reported in community‐dwelling older people overall and according to sex, age, and definition of frailty used. Design: Systematic review of the literature using the key words elderly, aged, frailty, prevalence, and epidemiology. Setting: Cross‐sectional data from community‐based cohorts. Participants: Community‐dwelling adults aged 65 and older. Measurements: In the studies that were found, frailty and prefrailty were measured according to physical phenotype and broad phenotype, the first defining frailty as a purely physical condition and the second also including psychosocial aspects. Results: Reported prevalence in the community varies enormously (range 4.0–59.1%). The overall weighted prevalence of frailty was 10.7% (95% confidence interval ( CI ) = 10.5–10.9; 21 studies; 61,500 participants). The weighted prevalence was 9.9% for physical frailty (95% CI = 9.6–10.2; 15 studies; 44,894 participants) and 13.6% for the broad phenotype of frailty (95% CI = 13.2–14.0; 8 studies; 24,072 participants) (chi‐square (χ 2 ) = 217.7, degrees of freedom ( df )=1, P < .001). Prevalence increased with age (χ 2 = 6067, df = 1, P < .001) and was higher in women (9.6%, 95% CI = 9.2–10.0%) than in men (5.2%, 95% CI = 4.9–5.5%; χ 2 = 298.9 df = 1, P < .001). Conclusion: Frailty is common in later life, but different operationalization of frailty status results in widely differing prevalence between studies. Improving the comparability of epidemiological and clinical studies constitutes an important step forward.
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The prevalence of frailty may be higher in older Hispanic and African Americans.
“and older Hispanic and African Americans (3, 89)”
From Frailty in elderly people (2013) · cites this paper as [89]
The level of frailty in this cohort is substantially lower than that reported for hospitalized older patients.
“our level of frailty is substantially lower than that reported for hospitalized older patients (13,24).”
From Frailty as determined by a comprehensive geriatric assessment-derived deficit-accumulation index in older patients with cancer who receive chemotherapy (2016) · cites this paper as [24]
Hospitalizations are often predictive of subsequent poor outcomes including mortality.
“Since we know that hospitalizations are often predictive of subsequent poor outcomes including mortality”
From Frailty as determined by a comprehensive geriatric assessment-derived deficit-accumulation index in older patients with cancer who receive chemotherapy (2016) · cites this paper as [24]
The frequency of frailty and pre-frailty in this older cancer cohort is similar to but slightly lower than that reported for community-dwelling older adults.
“The frequency of frailty and pre-frailty in our older cancer patients is similar to, but slightly lower than, that reported for community dwelling older adults.(15,24)”
From Frailty as determined by a comprehensive geriatric assessment-derived deficit-accumulation index in older patients with cancer who receive chemotherapy (2016) · cites this paper as [24]
The lower frailty prevalence in this cohort may reflect selection bias toward healthier patients chosen for treatment.
“This may reflect a selection bias in choosing the healthiest appearing patients for treatment since our level of frailty is substantially lower than that reported for hospitalized older patients (13,24).”
From Frailty as determined by a comprehensive geriatric assessment-derived deficit-accumulation index in older patients with cancer who receive chemotherapy (2016) · cites this paper as [24]
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- Authors
- Collard, R. M., Boter, H., Schoevers, R. A., & Oude Voshaar, R. C.
- Affiliations
- Radboud University Medical Center (NL)
- University Medical Center Groningen (NL)
- Department of Psychiatry University Medical Centre St. Radboud Nijmegen the Netherlands
- Corresponding author
- Collard, Rose M.
- Venue
- Journal of the American Geriatrics Society
- Publisher
- Wiley
- Published
- 2012-08
- Volume
- 60
- Issue
- 8
- Pages
- 1487-1492
- ISSN
- 0002-8614 (ISSN-L)
- 1532-5415
- OpenAlex
- W1975412844
- Cited by
- 3,073
- References
- 29
- Citations by year
- 2026: 176 · 2025: 239 · 2024: 302 · 2023: 293 · 2022: 335 · 2021: 320 · 2020: 311 · 2019: 274 · 2018: 223 · 2017: 209 · 2016: 153 · 2015: 118 · 2014: 76 · 2013: 37 · 2012: 4
- FWCI
- 6.37
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the American Geriatrics Society (publishedVersion)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Keywords
- frailty, pre-frailty, prevalence, community-dwelling older adults, physical frailty, sex differences, age differences, frailty definition
- MeSH terms
- Aged, Cross-Sectional Studies, Female, Humans, Male, Residence Characteristics, Prevalence, Frail Elderly
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