Comprehensive geriatric assessment and primary care based interventions for managing frailty in older adults: An...

Frailty is a geriatric syndrome leading to adverse health outcomes, but can be managed through targeted interventions and potentially reversed. Primary care settings play a pivotal role in identifying and addressing frailty. This review aims to assess the effective primary care interventions and strategies to manage frailty.

This review mapped evidence to evaluate systematic reviews of randomized controlled trials in older adults (≥60 years) on primary care-based interventions for managing frailty. Data were extracted from databases including MEDLINE, Embase, CINAHL, PsycINFO, and Cochrane CENTRAL, covering publications up to September 11, 2024. Interventions in primary care, community-based, or home-based settings were included, excluding hospitalized or bedridden individuals. The AMSTAR 2 tool assessed review quality, and interventions were categorized by type, setting, and effectiveness.

From the 3152 studies extracted, 17 systematic reviews met the inclusion criteria. Interventions were classified into physical, nutritional, pharmacological, e-health/telemedicine, and multicomponent approaches. Multicomponent interventions, combining physical, nutritional, and cognitive strategies, demonstrated effectiveness, with significant benefits reported in 15 reviews. Community and home-based settings dominated, emphasizing accessibility. However, the quality of evidence varied, with seven reviews rated as critically low and six as high. Most studies were conducted in high-income countries, limiting their generalizability to LMICs.

Multicomponent interventions delivered in community settings show significant promise for managing frailty in older adults. However, evidence gaps suggest the need for context-specific research to adapt these interventions into primary care, which can improve the health status and quality of life for ageing populations globally.