Marital Status and Risk of Physical Frailty: A Systematic Review and Meta-analysis

被引:55
|
作者
Kojima, Gotaro [1 ,2 ,3 ]
Walters, Kate [2 ]
Iliffe, Steve [2 ]
Taniguchi, Yu [4 ]
Tamiya, Nanako [3 ]
机构
[1] Videbimus Toranomon Clin, Tokyo, Japan
[2] UCL, Dept Primary Care & Populat Hlth, London, England
[3] Univ Tsukuba, Hlth Serv Res & Dev Ctr, Tsukuba, Ibaraki, Japan
[4] Natl Inst Environm Studies, Ctr Hlth & Environm Risk Res, Tsukuba, Ibaraki, Japan
关键词
Frailty; frail elderly; marital status; systematic review; meta-analysis; DWELLING OLDER-PEOPLE; COMMUNITY; HEALTH; PREVALENCE; ASSOCIATION; POPULATION; ADULTS; DEPRESSION; PREDICTOR; COMORBIDITY;
D O I
10.1016/j.jamda.2019.09.017
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Objectives: Evidence on associations between marital status and frailty is limited. The objectives of this study were to perform a systematic review for associations between marital status and physical frailty and to perform a meta-analysis to combine findings. Design: Systematic review and meta-analysis. Setting and participants: Community-dwelling older people with mean age >= 60 years. Methods: Systematic literature search using 5 databases was conducted in February 2019 to identify longitudinal and cross-sectional studies examining associations between marital status and Fried's phenotype-based frailty status. Additional studies were searched for by reviewing the reference lists of relevant articles and conducting forward citation tracking of included articles. Odds ratio (OR) of marital status and frailty was pooled using a random-effects meta-analysis. Subgroup analysis and analyses stratified by gender and marital status (married, widowed, divorced or separated, and never married) were completed. Results: A total of 1565 studies were found, from which 3 studies with longitudinal data and 35 studies with cross-sectional data were included. Although longitudinal studies suggested that married men had lower frailty risks than unmarried men while married women had higher frailty risks than widowed women, meta-analysis was not possible because of different methodologies. Meta-analyses of cross-sectional data from 35 studies including 80,754 individuals showed that unmarried individuals were almost twice more likely to be frail than married individuals (pooled odds ratio = 1.88, 95% confidence interval = 1.70-2.07). A high degree of heterogeneity was observed (I-2 = 69%) and was partially explained by reasons for not being married and study location. Stratified analyses showed that pooled risks of frailty in the unmarried compared with the married were not statistically different between women and women (P for difference = .62). Conclusions and Implications: Three and 35 studies, respectively, were found providing longitudinal and cross-sectional data regarding associations between marital status and frailty among community-dwelling older people. A meta-analysis of cross-sectional data showed almost twice higher frailty risk in unmarried individuals compared with married individuals. Marital status should be recognized as an important factor, and more longitudinal studies controlling for potential confounding factors are needed. (C) 2019 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
引用
收藏
页码:322 / 330
页数:9
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