The Efficacy of Health Promotion Interventions for Pre-frail Older Adults: A Systematic Review

The growing population of pre-frail older adults is increasingly becoming a priority in health care services within aging nations. This study was designed to assess the effect of health-promoting interventions on clinical efficacy in prefrail older adult populations and to undertake a preliminary exploration of their associated cost-effectiveness.

Systematic review.

Pre-frail older people aged ≥60 years who conform to 1 or 2 of the criteria within Fried's frailty phenotype, in any setting.

A comprehensive search of 7 databases (PubMed, Web of Science, Embase, CINAHL, The Cochrane Library, CNKI, and Wanfang) was conducted from database inception through March 2025. Inclusion criteria encompassed randomized controlled trials investigating multidimensional health outcomes for older adults with prefrailty. Dual independent processes were implemented for both data extraction and methodologic quality assessment using the Cochrane risk of bias tool.

This review included 7 randomized controlled trials (N = 1323) with intervention periods spanning 3 to 26 months. Health promotion strategies comprised 3 main categories: multicomponent exercise, theory-driven approaches, and multidisciplinary interventions. Despite variations in outcome measurements, the study results preliminarily suggest that health-promoting interventions have demonstrated a certain degree of positive impact on both the health status and cost-effectiveness of pre-frail older adults.

Health promotion interventions can improve clinical outcome indicators for pre-frail older adults and possess potential advantages in terms of cost-effectiveness. However, the benefits largely depend on the type and duration of the intervention. When assessing these factors together, home-based health promotion interventions seem to be a particularly beneficial strategy, offering both cost efficiency and meaningful improvements in pre-frailty status.