Weighted vest interventions in older adults: a mini-review of implementation, benefits, and limitations

Weighted vests (WVs) enable adjustable external loading during daily activities and exercise. Although experimental studies in older adults exist, their findings have not been comprehensively integrated. This narrative review summarizes implementation, main findings, and limitations. In October 2025, we searched Web of Science, PubMed, and EBSCOhost and conducted backward and forward citation searching. Eligible studies were peer-reviewed, English-language reports in adults aged ≥60 years. Fifteen articles were included and synthesized qualitatively. Implementation should begin with assessment and safety screening. WV use follows two modes-wear-only and task-based-and should emphasize conservative starts, gradual loading, and ongoing monitoring and adjustment. Across the limited available studies, benefits tended to be observed in task-based, progressively loaded prescriptions, including improvements in selected neuromuscular measures and, in some settings, maintenance of hip bone mineral density. Across available studies, low-load wear-only protocols generally did not demonstrate measurable improvements in musculoskeletal outcomes. Psychological gains, when present, were modest and setting-specific, and broad improvements in health-related quality of life were not observed. Although adverse events were generally mild, usability challenges and a higher number of recorded falls in one trial justify cautious implementation. Given persistent limitations in sample size, reliance on self-report, and protocol heterogeneity, adequately powered multicenter trials with objective wear-time assessment, harmonized outcomes, and extended follow-up are warranted.