Frailty is a clinical syndrome characterized by diminished physiological reserves across multiple organ systems, leading to dysregulation and increased bodily vulnerability, ultimately compromising the ability to maintain homeostasis [1]. While the precise etiology of frailty remains elusive, mounting evidence suggests a strong association with inflammatory processes [2,3]. Given the similarities between inflammation and various debilitating syndromes, inflammation may be conceptualized as a frailty-related condition [4]. In this context, inflammation-induced alterations in immune system function play a crucial role in the development of frailty. Research has demonstrated that frailty progression strongly correlates with elevated total white blood cell counts [5,6] and increased levels of inflammatory markers, particularly pro-inflammatory T-lymphocytes [7]. These findings suggest that chronic inflammation may contribute to the development of frailty both directly and through various intermediate pathways.

Systemic lupus erythematosus (SLE) is a chronic systemic autoimmune disease characterized by inflammation and immune-mediated damage across multiple organ systems [8]. The pathogenesis of SLE involves systemic inflammation with elevated levels of type I interferons, while frailty is typically associated with increased inflammatory markers, particularly C-reactive protein (CRP) and interleukin-6 (IL-6) [9]. Low-grade chronic inflammation may contribute to an increased risk of frailty [10]. Consequently, the underlying disease characteristics of SLE inherently increase the risk of frailty. Studies have consistently demonstrated a higher prevalence of frailty among SLE patients compared to the general population [11]. Moreover, frailty carries a poor prognosis for SLE patients and can result in multiple adverse health outcomes [12]. SLE patients who develop frailty experience significantly greater limitations in both physical and emotional domains compared to the general population [13,14]. These patients also face higher rates of hospitalization [15]. Additionally, frailty has been shown to be associated with increased risk of cumulative organ damage [16] and mortality [17,18], with research demonstrating a mortality risk ratio of 1.31 and a risk ratio of 1.18 for cumulative organ damage [19]. Therefore, careful assessment of frailty in SLE patients should be a critical component of clinical care.

In summary, studies on the prevalence of frailty in SLE patients have shown considerable variation, primarily due to the diverse assessment tools employed and limited sample sizes. Given that frailty significantly contributes to adverse outcomes in SLE patients, understanding the frailty status in this population is crucial for predicting and managing these negative health consequences. To establish more definitive findings, we conducted a systematic review and meta-analysis to accurately determine the prevalence of both frailty and prefrailty among SLE patients. Early identification of frailty and prefrailty in SLE patients may enable timely implementation of targeted interventions and preventive strategies, which could help reduce adverse health outcomes and optimize the overall quality of care for these high-risk patients.