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Community-Based Care Interventions for Frail Older Adults: A Scoping Review of Multidimensional Strategies Across
I-Chun Chen1,2,3, Yi-Hsuan Chen4, Anuchit Phanumartwiwath2
1College of Population Studies, Chulalongkorn University, Bangkok, Thailand.
Objective:
This scoping review evaluates the effectiveness of community-based interventions addressing frailty's multidimensional impacts (physical, nutritional, and psychosocial) in older adults, emphasizing nurses' roles in crisis-responsive care during pandemics.
Design:
A scoping review was conducted using Arksey & O'Malley's framework and PRISMA-ScR guidelines.
Sample:
Thirty-one studies were from 2019 to 2023, sourced from PubMed and Scopus, spanning five continents.
Measurements:
Study quality was assessed with the Newcastle-Ottawa Scale; outcomes included frailty reduction and quality-of-life metrics.
Intervention:
Interventions included physical rehabilitation (e.g., Otago Exercise Program), nutritional optimization, psychosocial support, technology-enhanced models (e.g., telemedicine), and social engagement.
Results:
Multicomponent interventions outperformed single-domain approaches, improving gait speed, reducing frailty progression, and mitigating depression. Telemedicine maintained 78% care continuity during lockdowns. Asian family-centered models excelled, but 84% of evidence came from high-income countries, highlighting low- and middle-income country (LMIC) gaps.
Conclusions:
Gerontological nurses are pivotal in delivering culturally adapted care by coordinating interprofessional home-based teams, integrating gerotechnology in resource-limited settings, and advocating for policy reforms to bridge urban-rural disparities. These findings underscore nursing's role in equitable, resilient frailty management.
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