Frailty（虚弱）の在宅高齢者の有病割合

Frailty（虚弱）の在宅高齢者の有病割合をみた系統的レビューを紹介します。

Rose M. Collard, et al: Prevalence of Frailty in Community-Dwelling Older Persons: A Systematic Review. Journal of the American Geriatrics Society, Article first published online: 6 AUG 2012, DOI: 10.1111/j.1532-5415.2012.04054.x

結果ですが、有病割合は4.0–59.1%と大きな幅がありました。全体の発症割合は10.7%でした。身体面のFrailty（虚弱）は9.9%、その他のFrailty（虚弱）は13.6%でした。年齢とともに有病割合は高くなり、男性より女性に多いという結果でした。

結論として、特に後期高齢者にFrailty（虚弱）はよく認めるが、異なる定義・診断方法を用いているために研究館のばらつきが大きいです。同じような定義・診断方法を用いて、比較可能な研究を増やすことが重要としています。

ざっくりですが、地域在住高齢者のFrailty（虚弱）の有病割合は1割と言えます。日本ではもう少し多い可能性もありますが、判断基準によって大きく異なりそうです。個人的には、ロコモとFrailty（虚弱）が別々のまま進むのか、共通点を見出すのかが、かなり気になります。

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 (χ²) = 217.7, degrees of freedom (df)=1, P < .001). Prevalence increased with age (χ² = 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%; χ² = 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.