Meta-analysis of the prevalence of frailty and its influencing factors in elderly patients with comorbid diabetes mellitus
LI Shijiao
LIU Yuhan
TI Yongzhaohan
FENG Li
JING Kunjuan
Abstract：Objective To systematically review the prevalence and influencing factors of frailty in elderly patients with diabetes and comorbidities.Methods CNKI,VIP,Wanfang,CBM,Embase,The Cochrane Library,Web of Sci‐ence,and PubMed were searched for randomized controlled trials,cross-sectional studies,and cohort studies on the preva‐lence and influencing factors of frailty in elderly patients with diabetes and comorbidities.The search period was from the inception of each database to April 9,2025.Two researchers independently screened the literature,assessed the quality,and extracted relevant data.Meta-analysis was conducted using RevMan 5.4 software.Results A total of 20 studies were included,comprising 18 cross-sectional studies and 2 cohort studies.Among older adults with diabetes comorbidi‐ties,there were 3 115 cases of frailty and 158 cases of pre-frailty.Meta-analysis showed that the overall incidence of frailty in older adults with diabetes comorbidities was 50%(95%CI:32%-78%,P=0.002).The following factors were the influ‐encing factors for frailty in older adults with diabetes comorbidities:age(OR=1.42,95%CI:1.22-1.65,P<0.001),smoking history(OR=2.44,95%CI:1.80-3.31,P<0.001),depression(OR=2.02,95%CI:1.27-3.22,P=0.003),glycated hemoglobin(OR=1.68,95%CI:1.07-2.62,P=0.02),social support(OR=2.41,95%CI:2.27-2.55,P<0.001),moderate dependence in activities of daily living(OR=3.52,95%CI:1.97-6.32,P<0.001),severe depen‐dence in activities of daily living(OR=6.47,95%CI:3.38-12.40,P<0.001),cardiovascular disease(OR=1.59,95%CI:1.07-2.35,P=0.02),osteoporosis(OR=1.18,95%CI:1.01-1.37,P=0.03),white blood cell count(OR=1.05,95%CI:1.01-1.10,P=0.02),erythrocyte sedimentation rate(OR=1.01,95%CI:1.00-1.03,P=0.02),and health literacy(OR=0.93,95%CI:0.90-0.96,P<0.001).The results of the sensitivity analysis showed that,age(OR=2.58,95%CI:1.83-3.63),malnutrition(OR=4.26,95%CI:2.83-6.43),depression(OR=2.27,95%CI:1.78-2.88),physical function(OR=3.16,95%CI:2.08-4.80),cardiovas cular disease(OR=2.64,95%CI:1.72-4.04)and mental activity(OR=0.12,95%CI:0.06-0.24)were the influencing factors for frailty in older adults with diabetes co‐morbidities(all P<0.01).Conclusions Frailty in elderly patients with diabetes and comorbidities is influenced by mul‐tiple aspects,including physiological,psychological,and social factors.Age,smoking history,depression,glycated he‐moglobin,social support,activities of daily living,cardiovascular diseases,osteoporosis,white blood cells,erythrocyte sedimentation rate,malnutrition and body function are risk factors for frailty in elderly patients with diabetes comorbidi‐ties,while health literacy and mental activity are protective factors for frailty.Healthcare professionals should conduct a comprehensive assessment of patients,individually screen for relevant factors,and intervene early to prevent the occur‐rence of frailty.
Keywords：diabetescomorbidityfrailtymeta-analysisevidence-based nursingaged
Publication Date：2026-02-25
Online Publishing Date：2026-03-19(First online date of this platform, not the publication date of the document)
Pages：7( 33-39 )