title: Frailty and the Prediction of Negative Health Outcomes: A Meta-Analysis.
abstract: Frailty is one of the most important concerns regarding our aging population. Evidence grows that the syndrome is linked to several important health outcomes. A general overview of frailty concepts and a comprehensive meta-analysis of their relation with negative health outcomes still lacks in literature, making it difficult for health care professionals and researchers to recognize frailty and the related health risks on the one hand and on the other hand to appropriately follow up the frailty process and take substantiated action. Therefore, this study aims to give an overview of the predictive value of the main frailty concepts for negative health outcomes in community-dwelling older adults.
  
  
  
  This review and meta-analysis assembles prospective studies regarding the relation between frailty and any potential health outcome. Frailty instruments were subdivided into frailty concepts, so as to make comprehensive comparisons. Odds ratios (ORs), hazard ratios (HRs), and relative risk (RR) scores were extracted from the studies, and meta-analyses were conducted in OpenMeta Analyst software.
  
  
  
  In total, 31 articles retrieved from PubMed, Web of Knowledge, and PsycInfo provided sufficient information for the systematic review and meta-analysis. Overall, (pre)frailty increased the likelihood for developing negative health outcomes; for example, premature mortality (OR 2.34 [1.77-3.09]; HR/RR 1.83 [1.68-1.98]), hospitalization (OR 1.82 [1.53-2.15]; HR/RR 1.18 [1.10-1.28]), or the development of disabilities in basic activities of daily living (OR 2.05 [1.73-2.44]); HR/RR 1.62 [1.50-1.76]).
  
  
  
  Overall, frailty increases the risk for developing any discussed negative health outcome, with a 1.8- to 2.3-fold risk for mortality; a 1.6- to 2.0-fold risk for loss of activities of daily living; 1.2- to 1.8-fold risk for hospitalization; 1.5- to 2.6-fold risk for physical limitation; and a 1.2- to 2.8-fold risk for falls and fractures. The analyses presented in this study can be used as a guideline for the prediction of negative outcomes according to the frailty concept used, as well as to estimate the time frame within which these events can be expected to occur.
authors.affiliation: Gerontology Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium; Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium.
authors.forename: Sofie
authors.initials: S
authors.lastname: Vermeiren
authors.affiliation: Gerontology Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium; Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium; Geriatrics Department, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium.
authors.forename: Roberta
authors.initials: R
authors.lastname: Vella-Azzopardi
authors.affiliation: Gerontology Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium; Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium; Rehabilitation Sciences Research Department (RERE), Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: David
authors.initials: D
authors.lastname: Beckwée
authors.affiliation: Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium; Fundamental Rights and Constitutionalism Research Group (FRC), Vrije Universiteit Brussel (VUB), Elsene, Belgium.
authors.forename: Ann-Katrin
authors.initials: AK
authors.lastname: Habbig
authors.affiliation: Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium; Experimental Anatomy (EXAN), Vrije Universiteit Brussel (VUB), Brussels, Belgium.
authors.forename: Aldo
authors.initials: A
authors.lastname: Scafoglieri
authors.affiliation: Department of Electronics and Informatics ETRO, Vrije Universiteit Brussel (VUB), Elsene, Belgium.
authors.forename: Bart
authors.initials: B
authors.lastname: Jansen
authors.affiliation: Gerontology Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium; Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium; Geriatrics Department, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium. Electronic address: ivan.bautmans@vub.be.
authors.forename: Ivan
authors.initials: I
authors.lastname: Bautmans
mesh_terms: D000368:Aged; D019937:Diagnostic Techniques and Procedures / Q000295:instrumentation; D005260:Female; D016330:Frail Elderly; D000073496:Frailty / Q000175:diagnosis*; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests; D018570:Risk Assessment
keywords: Frailty; community-dwelling; elderly; meta-analysis; prospective risk outcomes