A Systematic Review of the Association Between Ethnicity and Frailty Prevalence, Incidence, Trajectories and Risks

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Maryam Khan, Barbara I Nicholl, Sara Macdonald, Peter Hanlon
1. School of Health and Wellbeing, University of Glasgow, UK
Demographics
Frailty

Abstract

Ethnic variations in frailty lack comprehensive understanding 1. This systematic review examined ethnic variations in the prevalence, incidence, and trajectories of frailty; associations between frailty and sociodemographic/lifestyle risk factors; and health-related outcomes of frailty.

Methods: MEDLINE, Embase, Web of Science Core Collection, and CINAHL were searched (2000–July 2023). Searches supplemented by forward citation searching and hand-searching reference lists. Inclusion criteria: observational studies (using any frailty measure) in adults (>18 years) assessing frailty prevalence, trajectories, or association with health-related outcomes by ethnicity.

1. Frailty Prevalence

•Heterogeneous, varying by region, ethnicity, and frailty measurement tools.
•Higher frailty prevalence in ethnic minorities worldwide.
•Ethnic differences sensitive to  methods used to measure frailty.

2. Ethnic Variations in Frailty Transitions

•Ethnic differences were independent of Sociodemographic & Lifestyle factors.
•Frailty progression was rapid in Blacks (in the U.S.) and South Asians (in the U.K.)

3. Ethnicity, Frailty, and Health Outcomes

•Ethnic differences were independent of Sociodemographic & Lifestyle factors.
•Frailty progression was rapid in Blacks (in the U.S.) and South Asians (in the U.K.).
•No significant differences in the outcomes of frailty (risk of mortality) between ethnic groups.

Conclusion: Frailty is disproportionately high among minoritised ethnic groups globally, driven by social inequalities and structural disadvantage. Effective responses require culturally sensitive interventions and policy-level actions to address the root causes of these health disparities.

Reference: Usher T, Buta B, Thorpe RJ, Huang J, Samuel LJ, Kasper JD, Bandeen-Roche K. Dissecting the Racial/Ethnic Disparity in Frailty in a Nationally Representative Cohort Study with Respect to Health, Income, and Measurement. J Gerontol A Biol Sci Med Sci. 2021 Jan 1;76(1):69-76. doi: 10.1093/gerona/glaa061. PMID: 32147727; PMCID: PMC7756712.

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