The relationship between diabetes and frailty in older adults: A systematic review and meta-analysis

Background: Diabetes mellitus and frailty are significant public health challenges in older populations. Objectives: This systematic review and meta-analysis aimed to investigate the relationship between diabetes and frailty in older adults. Methods: A comprehensive search was conducted across PubMed, Scopus, SpringerLink, ProQuest, and EBSCO (2009–2024). Studies were appraised using the Joanna Briggs Institute tools. Random-effects meta-analysis calculated pooled odds ratios (ORs) with 95% confidence intervals (CIs). Heterogeneity was assessed by I 2 statistics. Subgroup analyses explored study design, age, frailty measurement tools, and settings. Publication bias was assessed using Egger’s and Begg’s test, and sensitivity analyses were used trim and fill method. Results: Sixteen studies, including 10 cohort and 6 cross-sectional studies involving 201,842 participants from 10 countries, were included in the study. The pooled analysis revealed a significant association between diabetes and frailty (OR: 1.886; 95% CI: 1.308–2.720; P = 0.001). A random effect model was used because of high heterogeneity ( I 2 = 91.33%) and publication bias (Begg’s test: P = 0.207; Egger’s test: P <0.001) were observed. Conclusion: Diabetes was found significantly increase the risk of frailty in older adults. Future research should prioritize longitudinal designs and analyzing the factors that may moderate this relationship.