A Systematic Review of Frailty Interventions in Community-Based Low and Middle-Income Settings

Area of Science:

• Gerontology and Public Health
• Geriatric Medicine
• Evidence Synthesis

Background:

• Frailty is a significant health concern among community-dwelling older adults, particularly in low and middle-income countries (LMICs).
• Effective interventions are crucial to mitigate the adverse outcomes associated with frailty in this vulnerable population.

Purpose of the Study:

• To systematically review and synthesize the existing evidence on the effectiveness of frailty interventions.
• To focus specifically on prefrail and frail community-dwelling older adults residing in LMICs.

Main Methods:

• A systematic review was conducted, searching four major electronic databases (Embase, Ovid MEDLINE, Global Health, APA PsycINFO) up to September 25, 2023.
• Inclusion criteria focused on randomized controlled trials and other intervention types for community-dwelling older adults (≥60 years) with prefrailty or frailty in LMICs.
• A meta-analysis was not feasible due to the heterogeneity of the included frailty interventions.

Main Results:

• Fifteen studies were included, comprising eleven single-domain interventions (e.g., exercise, nutrition, nurse home visits) and four multidomain interventions (e.g., exercise plus nutrition/mindfulness).
• High-quality evidence suggests that physical exercise interventions are effective in addressing frailty.
• The review identified a limited number of studies evaluating frailty interventions in LMICs.

Conclusions:

• There is a notable scarcity of evidence regarding the effectiveness of various frailty interventions specifically within LMICs.
• The heterogeneity of interventions makes a comprehensive evaluation challenging.
• Further research is essential to investigate specific types of frailty interventions in these settings.