Tan, M, Bhanu, C and Frost, R (2023) The association between frailty and anxiety: A systematic review. International journal of geriatric psychiatry, 38 (5). ISSN 0885-6230

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Abstract

OBJECTIVES: Previous systematic reviews show a clear relationship between frailty and depression, however the association with anxiety is much less frequently explored. Previous single studies indicate evidence is mixed. We completed a systematic review and meta-analysis to identify the relationship between frailty and anxiety. METHODS: We searched five electronic databases for observational studies in older people in community, care home and outpatient settings with any/no health conditions that measured the association between anxiety and frailty using validated measures. Studies were screened by one reviewer with 10% checked by a second reviewer. The Mixed Methods Appraisal Tool was used to assess study quality. We used meta-analysis to aggregate study findings, with subgroup analyses to explore heterogeneity. RESULTS: Out of 1272 references, a total of 20 cross-sectional and 1 longitudinal studies were eligible. Older adults with frailty were substantially more likely to display anxiety symptoms than robust populations, across both dichotomous and continuous data sets (n = 10, OR = 3.48, 95% CI: 2.08, 5.81, p < 0.0001, I2  = 94%; N = 5, SMD = 3.13, 95% CI: 1.06, 5.21, I2  = 98%). Similarly, pre-frail older adults were more likely to have anxiety symptoms than robust older adults but to a lesser extent (N = 6, OR = 1.95, 95% CI: 1.41, 2.71, I2  = 63%; N = 3, SMD = 1.70, 95% CI: 0.01, 3.38, I2  = 98%). CONCLUSIONS: There is a clear association between pre-frailty/frailty and anxiety in older adults. However, data are heterogeneous and primarily from cross-sectional studies so causality cannot be determined. Future research should evaluate the effectiveness of anxiety screening and treatments in frail older adults.

Item Type:	Article
Uncontrolled Keywords:	Humans; Cross-Sectional Studies; Anxiety; Anxiety Disorders; Aged; Frail Elderly; Frailty; anxiety; frailty; meta-analysis; older people; systematic review; Aged; Humans; Anxiety; Anxiety Disorders; Cross-Sectional Studies; Frail Elderly; Frailty; 1103 Clinical Sciences; 1701 Psychology; 1702 Cognitive Sciences; Geriatrics
Subjects:	B Philosophy. Psychology. Religion > BF Psychology R Medicine > R Medicine (General) R Medicine > RA Public aspects of medicine R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Divisions:	Nursing & Allied Health
Publisher:	Wiley
SWORD Depositor:	A Symplectic
Date Deposited:	05 Dec 2023 11:30
Last Modified:	05 Dec 2023 11:31
DOI or ID number:	10.1002/gps.5918
URI:	https://researchonline.ljmu.ac.uk/id/eprint/22022

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