Prevention and Mitigation of Frailty Syndrome in Institutionalised Older Adults Through Physical Activity: A...

Background/Objectives: Frailty syndrome significantly impacts the health and quality of life of institutionalised older adults, increasing the risk of adverse outcomes such as disability and mortality. This systematic review aimed to evaluate the effectiveness of physical activity interventions in preventing and mitigating frailty syndrome among institutionalised older adults and to identify key intervention characteristics influencing their effectiveness. Methods: A systematic search following PRISMA guidelines was conducted in the Web of Science, PubMed, and Cochrane databases to identify randomised controlled trials published from 2001 to June 2024. Studies involving institutionalised adults aged 60 or older, assessing the impact of physical activity interventions on frailty using validated measures, were included. A narrative synthesis approach was employed to analyse the findings due to the heterogeneity of interventions and settings. Results: Twelve randomised controlled trials comprising 1223 participants were included. Multicomponent exercise programmes-combining resistance exercises, balance, and aerobic training-consistently improved frailty indicators, including muscle strength, gait speed, and balance, among others parameters. Frailty reversal occurred in 36% of participants, with interventions showing a reduction in frailty criteria and improved functional autonomy. Programmes integrating physical activity with cognitive or nutritional components demonstrated high efficacy. The control groups showed minimal improvement, highlighting the unique impact of tailored interventions. Despite variability in intervention design, frailty was consistently shown to be reversible in pre-frail and frail individuals, where the benefits were evident including for individuals over 85 years old. Conclusions: Physical activity interventions, particularly multicomponent exercise programmes, are effective in reducing frailty and improving health outcomes in institutionalised older adults. Future research should focus on optimising intervention characteristics and exploring the long-term sustainability of benefits in diverse populations. These findings reinforce the importance of exercise as a cornerstone in frailty management.