Update on Interventions to Prevent or Reduce Frailty in Community-Dwelling Older Adults: a Scoping Review and Community Translation

Abstract

Purpose of ReviewWith increasing interest in frailty prevention and management globally, this scoping review provides an update to the current knowledge on interventions to reduce frailty in community-dwelling older adults and its state of translation in real-world settings.Recent FindingsUpdating previous findings of 14 studies from 2000 to 2016 by Puts et al., we reviewed 10 additional studies from 2016 to 2018 and found that up to date, 18 of 24 studies overall showed effective interventions in preventing or reducing frailty (as the intervention target) in community-dwelling older adults. Multidimensional frailty definitions and a multi-domain approach have been increasingly employed for frailty identification and intervention. The effective interventions included various modalities of exercise training, nutrition education/program, cognitive training, geriatric assessment, and management coupled with psychosocial interventions/support that may sustain program participation. While resistance training was the most commonly employed modality of physical training, we did not find evidence that it is more effective than other modalities. Effective interventions can be delivered in a primary care or other community settings by multi-disciplinary combination of professionals and volunteers. There has been better recognition of the need for community translation in frailty reduction in the developed countries, with initial policy efforts introduced in some countries.SummaryTo further the evidence-based and community translation, well-designed studies aimed at maximizing function and promoting aging in place using multi-domain interventions are essential. This will better inform comprehensive policies to address frailty prevention/reduction through appropriate health and social programs/services provision and financing.