Effectiveness of Interventions to Prevent Frailty in Older Adults: A Systematic Review and Meta-Analysis.

Objective

This systematic review and meta-analysis aimed to evaluate the effectiveness of interventions for preventing or managing frailty in adults aged 65 and over, based on evidence from randomized controlled trials.

Methods

A systematic search was conducted using the modified keywords "frailty," "older," and "intervention" across multiple databases, without publication year restrictions, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A total of 16 studies were included. The statistical analyses were performed using Comprehensive Meta-Analysis version 4 software. Heterogeneity was assessed using Cochran's Q test and the I2 statistic. Publication bias was examined using funnel plots and Egger's regression test.

Results

The meta-analysis yielded an overall effect size of -0.799 (Z = -2.524, SE = 0.32, 95% confidence interval [-1.420, 0.179]). Heterogeneity was high (Q = 561.205, p < .001, I2 = 97.32%). In subgroup analyses, combined interventions (Hedges' g = 2.843, SE = 1.651, 95% confidence interval [0.376, 6.062]) showed a larger effect size than other intervention types; however, subgroup analyses were not statistically significant (p = .080).

Conclusions

The effectiveness of exercise interventions to improve physical endurance depends on factors such as duration and frequency. Due to the multifactorial nature of frailty, additional approaches-including nutritional support, integrated care, and metformin treatment-also yielded beneficial outcomes.