Interventions to prevent and treat frailty in community-dwelling older adults: a scoping review of the literature and international policies
This study aimed to find out what information was available in regards to helping to prevent or reduce frailty. This was done by use of a scoping review, where peer-reviewed journal articles were systematically searched to find ways other researchers used to prevent or reduce the level of frailty.
Findings: Our review identified 14 studies that focused on reducing the level of frailty in community-dwelling older adults. The type of interventions studied included: physical activity interventions; physical activity combined with nutritional interventions; home modifications and/or exercise; the use of a comprehensive assessment of health and well-being and active follow-up for the health issues identified; a comprehensive assessment of health and well-being combined with home visits; and a combination of physical activity, nutrition and memory training.
The interventions that significantly reduced the number of frailty markers/level of frailty included the physical activity interventions (all types and combinations), and the prehab study. The home modification study had a non-significant effect and the comprehensive geriatric assessment studies had mixed findings. All interventions of physical activity alone and physical activity combined with nutrition and/or memory training significantly reduced the level of frailty. The comprehensive assessment interventions had mixed findings. None of the studies involved the caregiver in the intervention, and several studies excluded participants with cognitive impairment.
Impact of findings: Physical activity combined with nutrition and/or memory training seemed to be most effective in reducing frailty. While the physical activity interventions showed few adverse events, it is important to assess the safety of the environment and the health of the patient before beginning any activity, as most studies excluded participants with serious/unstable health conditions.
Publications, presentations and webinars
About the Project
As we age, and particularly as we become elderly, we are more vulnerable to setbacks such as illness, injury (e.g. falls) and other stresses. We recover more slowly from these events because of the physical process of aging. This vulnerability, which we often call ‘frailty’, can mean elderly people use the health care system more, but may experience negative outcomes, possibly related to treatment and possibly related to the problems causing the vulnerabilities themselves.
Prior to this study, there was no overview of tools or methods health care providers in the community could use to prevent frailty or make it less severe. For this reason we planned to review any interventions and/or policies that had been published and what they did for frail older people.
For more details on the project rationale, objectives and research plan, click here.
Martine Puts, RN, PhD -- University of Toronto
Katherine McGilton, RN, PhD -- University of Toronto
Melissa Andrew, MD, MSc -- Dalhousie University
Maureen Ashe, PhD, PT -- University of British Columbia
Ana Patricia Ayala, MSc -- University of Toronto
Howard Bergman, MD -- McGill University
Jenny Ploeg, RN, PhD -- McMaster University
Knowledge Users and Partners:
Christine Brenchley, OT -- Ontario Society of Occupational Therapists
Francine Lemire, MD -- The College of Family Physicians Canada
Barbara Liu, MD -- Toronto Regional Geriatric Program
Mimi Lowi-Young, MHA, DBA, FACHE, FCCHL -- Alzheimer Society Canada
Lorna MacGregor -- Care Watch
Greg McIntosh -- CBI Health
José Morais, MD -- McGill University
Sandra McKay, PhD -- VHA Home Health Care
Cheryl Reid-Haughian, RN, MHScN, CCHN(C) -- Paramed Home Health Care
Gayle Seddon, RN -- Toronto Central CCAC
Chris Sulway -- Toronto Central LHIN
Suzan VanderBent, BA, BSW, MSW, MHSc, CHE -- Home Care Ontario
Project Contact: Martine Puts -- firstname.lastname@example.org
Key words: frail elderly; aged; intervention; scoping review; community