Effectiveness of non-pharmacological therapies for preventing frailty in older people: An umbrella review

Abstract

Purpose

This study aimed to synthesize and assess evidence on non-pharmacological interventions for older adults, including those with prefrailty and frailty.

Materials and Methods

A comprehensive review of randomized trials and cohort studies on non-pharmacological interventions for individuals aged ≥60 was conducted using MEDLINE, CENTRAL, and Web of Science through April 2023.

Results

Of the 285 papers screened, 13 met the eligibility criteria. Participants aged 62–98 years were studied across 42,917 individuals. Four systematic reviews (SR) focused on healthy older adults, seven on prefrailty, and eleven on frailty. Interventions included exercise therapy (7 articles), nutritional therapy (3 articles), exercise games (1 article), and combined exercise and nutritional therapy (2 articles). Non-pharmacological interventions showed improvement in frailty in 1 out of 1 SR and prevention of frailty progression in 3 out of 4 SRs. Improvements in physical function were noted in 9 out of 12 SRs, muscle strength in 8 out of 11, and muscle mass in 4 out of 6. Exercise interventions enhanced strength, mass, and function in older adults, including those with prefrailty or frailty, whether alone or combined with other components. Combined exercise and nutritional therapy were found to be more effective than monotherapy. Outcomes related to falls, cognitive function, and quality of life were controversial, and no positive effect on mortality was observed.

Conclusions

Exercise therapy, including multicomponent interventions, can prevent frailty and improve physical function, strength, and muscle mass. Nutritional therapy has some advantages, but its combination with exercise therapy is recommended.