Frailty and function recovery in fragility fractures:a Meta-analysis

WANG Ling-xiao; ZHANG Xia; GUAN Li-juan; PENG Yang; DENG Ming-hong; ZHOU Li-hua; ZHOU Zheng

doi:10.3969/j.issn.2095-252X.2026.03.012

Abstract：Objective To comprehensively evaluate the frailty and function recovery in fragility fractures.Methods A comprehensive literature search was undertaken in PubMed,Web of Science,Embase,and The Cochrane Library,with the aim of identifying observational studies relevant to the association between frailty and functional outcomes in elderly patients with fragility fractures.The search encompassed a chronological range from January 2000 to May 2024.Utilizing a random-effects model that incorporated heterogeneity,the findings were analyzed.Six subgroup analyses were conducted,encompassing country,study design,statistical analyses,follow-up durations,frailty criteria and fragility fracture sites.Results Our review encompassed eighteen distinct studies,with a combined total of 47 054 participants.After adjustment,frail patients exhibited a significantly elevated risk of experiencing limitations in ADL(adjusted OR=1.80,95%CI:1.27-2.56,I2=97%,P=0.001)and ambulation(adjusted OR=1.79,95%CI:1.43-2.24,I2=62%,P<0.001)compared to non-frail counterparts.The subgroup analysis has demonstrated that the association between frailty and both disability(including ADL impairment,poor usual activities,and decreased physical performance)as well as limitations in ambulation were particularly pronounced in studies with a six-month follow-up period.Conclusions The meta-analysis indicates that frailty serves as a notable indicator of diminished functional recovery in older patients following fragility fractures,particularly in investigations with a six-month observation period.Consistent evaluation of frailty throughout the course of treatment has the potential to alleviate lasting functional impairments.