Community-Based Care Interventions for Frail Older Adults: A Scoping Review of Multidimensional Strategies Across Pandemic Eras.

Abstract

Objective: This scoping review evaluates the effectiveness of community-based interventions addressing frailty's multidimensional impacts (physical, nutritional, and psychosocial) in older adults, emphasizing nurses' roles in crisis-responsive care during pandemics.

Design: A scoping review was conducted using Arksey & O'Malley's framework and PRISMA-ScR guidelines.

Sample: Thirty-one studies were from 2019 to 2023, sourced from PubMed and Scopus, spanning five continents.

Measurements: Study quality was assessed with the Newcastle-Ottawa Scale; outcomes included frailty reduction and quality-of-life metrics.

Intervention: Interventions included physical rehabilitation (e.g., Otago Exercise Program), nutritional optimization, psychosocial support, technology-enhanced models (e.g., telemedicine), and social engagement.

Results: Multicomponent interventions outperformed single-domain approaches, improving gait speed, reducing frailty progression, and mitigating depression. Telemedicine maintained 78% care continuity during lockdowns. Asian family-centered models excelled, but 84% of evidence came from high-income countries, highlighting low- and middle-income country (LMIC) gaps.

Conclusions: Gerontological nurses are pivotal in delivering culturally adapted care by coordinating interprofessional home-based teams, integrating gerotechnology in resource-limited settings, and advocating for policy reforms to bridge urban-rural disparities. These findings underscore nursing's role in equitable, resilient frailty management.