Does the Impact of Frailty on All-Cause Mortality in Older Persons Differ Between Women and Men? A Meta-Analysis

Objective: Sex-specific impact of frailty on all-cause mortality in older age population remains controversial. This meta-analysis aimed to evaluate the association between frailty and all-cause mortality in older age women vs men from the general population. Design: Meta-analysis. Setting and Participants: PubMed and Embase databases were searched until March 25, 2020 for studies reporting sex-specific association of frailty phenotype or index with all-cause mortality among the older general population (age >= 60 years) in the same study. Measurements: All-cause mortality for the frail vs robust individuals. Results: Eight studies enrolling a total of 87, 000 individuals were identified. Using the frailty phenotype, the pooled risk ratio of all-cause mortality was 2.41 [95% confidence interval (CI) 2.07-2.80] for frail women and 2.94 (95% CI 2.12-4.09) for frail men. Using the frailty index, the pooled risk ratio of all-cause mortality was 3.23 (95% CI 2.16-4.83) for frail women and 2.63 (95% CI 2.33-2.98) for frail men. The pooled female-to-male ratio of relative risks was 0.93 (95% CI 0.76-1.13) for the frailty phenotype and 1.22 (95% CI 0.79-1.88) for the frailty index. Conclusions and Implications: Older men and women with frailty confer a higher risk of all-cause mortality in the general population from the same source. However, there is no significant sex difference in the association between phenotype or index and all-cause mortality. (C) 2020 AMDA e The Society for Post-Acute and Long-Term Care Medicine.