Risk of death in elderly persons based on the frailty phenotype and the frailty index: a review study

Abstract Objective: to systematize studies evaluating the relationship between frailty and mortality in community-dwelling elderly persons. Method: Frailty was defined according to the frailty phenotype proposed by Fried et al. and the frailty index described by Rockwood et al. The study included epidemiologic population-based studies, cohort surveys, systematic reviews and meta-analyses published in English between 2006 and March 2016 based on the use of the terms: "frail elderly" and "mortality". Only study samples that exclusively comprised adults 65 years old or older who lived in the community were included. Studies investigating hospitalized and institutionalized elderly persons, and those examining the relationship between frailty and mortality through a disease-specific target were excluded. Results: a total of 244 studies were identified, of which 17 met the inclusion criteria. Thirteen studies used the frailty phenotype and four studies used the frailty index. Conclusion: both assessment measures found that frail elderly persons have a higher risk of death than robust elderly persons.

摘要
研究目的：系统化梳理针对社区居住老年人衰弱与死亡率相关性的相关研究。
研究方法：衰弱的定义采用Fried等人提出的衰弱表型（frailty phenotype）以及Rockwood等人描述的衰弱指数（frailty index）。本次研究纳入2006年至2016年3月间发表的英文文献，检索词为“衰弱老年人（frail elderly）”与“死亡率（mortality）”，纳入的文献类型涵盖基于人群的流行病学研究、队列调查、系统综述及荟萃分析（meta-analyses）。仅纳入研究对象为65岁及以上社区居住老年人的文献；排除针对住院老年人、机构养老老年人的研究，以及针对特定疾病探讨衰弱与死亡率相关性的研究。
结果：共检索到244项相关研究，其中17项符合纳入标准。13项研究采用衰弱表型法，4项研究采用衰弱指数法。
结论：两种评估方法均证实，衰弱老年人的死亡风险高于健壮老年人。