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Physical and nutritional interventions may reduce the level of frailty among older adults living in the community

Puts MTE, Toubasi S, Andrew MK, et al.  Interventions to prevent or reduce the level of frailty in community-dwelling older adults: A scoping review of the literature and international policies  Age and Ageing. 2017; 46(3): 383-392.

Review question

• What is known about interventions designed to prevent or reduce the level of frailty among older adults living in the community?

Background

• Frail older adults are at greater risk for falls, mobility decline, hospitalizations and mortality.
• Many interventions such as physiotherapy, nutrition control and home modification are used to help frail older adults live in the community. 
• This systematic review seeks to explore what is known about interventions designed to prevent or reduce the level of frailty in older adults living in the community.

How the review was done

• A detailed search of a number of electronic databases for studies published from 2000 up to February 2016 was conducted. Studies that focused on interventions to reduce the level of frailty among older adults were included in the review.
• A total of 13,641 studies were identified in the initial database search, and 14 were included in the review.
• The review was funded by the Elderly Network (TVN) and the Canadian Institutes of Health Research. 

What the researchers found

• Most interventions such as physical activity, physiotherapy and nutrition plans were generally effective at reducing the level of frailty among older adults. However, the authors indicated the need to proceed with caution, as higher-quality studies are needed to confirm these conclusions.
• Effectiveness of home modifications in reducing frailty was unclear.
• The long-term effectiveness of health-promotion interventions and geriatric assessments was mixed.

Conclusion

• Most interventions such as physical activity, physiotherapy and nutrition plans were effective in reducing frailty among older adults living in the community.
• Effectiveness of home modifications, health-promotion interventions, and geriatric assessment were unclear or mixed. Further research is needed to confirm these conclusions.