Contributory factors to frailty among prisoners in Nigeria: a scoping review of the call for policy reforms and strategic public health interventions

Frailty is an age-related syndrome characterized by reduced physiological reserve and increased vulnerability to adverse health outcomes. Older prisoners are at heightened risk of frailty due to the cumulative effects of chronic disease, poor living conditions, and limited healthcare access. However, evidence on factors contributing to frailty among prisoners in Nigeria remains fragmented. This scoping review aimed to map and synthesize available evidence on contributory factors to frailty among prisoners in Nigeria. A scoping review was conducted following Arksey and O’Malley’s framework and reported according to PRISMA-ScR guidelines. Searches were performed in PubMed, Scopus, ScienceDirect, Frontiers, BMC, and African Journals Online, supplemented by grey literature searches. Eligible studies were conducted in Nigerian prison settings and reported findings related to older inmates or frailty-related domains. Data were extracted, critically appraised using Joanna Briggs Institute tools, and synthesized narratively. Six studies met the inclusion criteria. Five interconnected themes were identified: nutritional deficiencies and sarcopenic risk, physical inactivity and deconditioning, multimorbidity and unmanaged chronic disease, mental health burden and psychosocial isolation, and systemic and environmental barriers to care. Findings showed widespread food inadequacy, poor healthcare access, depression, chronic disease burden, declining physical fitness, and overcrowded living conditions. No included study used a validated frailty assessment instrument, highlighting a significant evidence gap. Frailty among Nigerian prisoners is driven by modifiable institutional and health-system factors. Integrating frailty screening, nutritional support, physical activity programs, mental health services, and geriatric-sensitive correctional policies may reduce health inequities and improve outcomes for older incarcerated adults.

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