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Interventions to prevent the onset of frailty in adults aged 60 and older (PRAE-Frail) : a systematic review and network meta-analysis

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2024

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Eidam, Annette
Durga, Jane
Bauer, Jürgen M.
Zimmermann, Samuel
Vey, Johannes A.
Rapp, Kilian
Cesari, Matteo
Benzinger, Petra

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Institutionen der Bundesrepublik Deutschland: 01EL2030

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European Geriatric Medicine. Springer. 2024, 15(5), S. 1169-1185. eISSN 1878-7657. Verfügbar unter: doi: 10.1007/s41999-024-01013-x

Zusammenfassung

Purpose Frailty in older adults is associated with multiple adverse health outcomes, while evidence on its successful prevention has been scarce. Therefore, we analyzed the effectiveness of different interventions for the prevention of frailty onset. Methods In this systematic review, eight databases were searched for randomized controlled trials of interventions in non-frail (i.e., robust or pre-frail) adults aged = 60 years that assessed frailty incidence at follow-up. Additive component network meta-analysis (CNMA) was conducted to isolate the effect of different intervention types on the main outcome of frailty incidence, reporting relative risk (RR) with 95% confidence intervals (CI). The effect on gait speed was analyzed as an additional outcome using a classic network meta-analysis and the standardized mean difference (SMD) with 95% CI. Results We screened 24,263 records and identified 11 eligible trials. Nine trials (842 participants, all categorized according to the physical phenotype) in pre-frail (seven RCTs) and robust/pre-frail (two RCTs) older adults were included in the CNMA. Physical exercise significantly reduced frailty incidence at follow-up (RR 0.26, 95% CI 0.08; 0.83), while this was not found for nutritional interventions (RR 1.16, 95% CI 0.33; 4.10). Interventions based on physical exercise also improved gait speed (SMD 1.55, 95% CI 1.16; 1.95). In addition, 22 eligible trial protocols without published results were identified. Conclusion Interventions based on physical exercise appear to be effective in preventing the onset of frailty in older adults. Although the available data are still limited, results from ongoing trials may add to the body of evidence in the foreseeable future.

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796 Sport

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Frailty prevention, Pre-frailty, Older adults, Geriatrics

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ISO 690EIDAM, Annette, Jane DURGA, Jürgen M. BAUER, Samuel ZIMMERMANN, Johannes A. VEY, Kilian RAPP, Michael SCHWENK, Matteo CESARI, Petra BENZINGER, 2024. Interventions to prevent the onset of frailty in adults aged 60 and older (PRAE-Frail) : a systematic review and network meta-analysis. In: European Geriatric Medicine. Springer. 2024, 15(5), S. 1169-1185. eISSN 1878-7657. Verfügbar unter: doi: 10.1007/s41999-024-01013-x
BibTex
@article{Eidam2024-07-26Inter-70562,
  year={2024},
  doi={10.1007/s41999-024-01013-x},
  title={Interventions to prevent the onset of frailty in adults aged 60 and older (PRAE-Frail) : a systematic review and network meta-analysis},
  number={5},
  volume={15},
  journal={European Geriatric Medicine},
  pages={1169--1185},
  author={Eidam, Annette and Durga, Jane and Bauer, Jürgen M. and Zimmermann, Samuel and Vey, Johannes A. and Rapp, Kilian and Schwenk, Michael and Cesari, Matteo and Benzinger, Petra}
}
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    <dcterms:abstract>Purpose 
Frailty in older adults is associated with multiple adverse health outcomes, while evidence on its successful prevention has been scarce. Therefore, we analyzed the effectiveness of different interventions for the prevention of frailty onset.
Methods 
In this systematic review, eight databases were searched for randomized controlled trials of interventions in non-frail (i.e., robust or pre-frail) adults aged = 60 years that assessed frailty incidence at follow-up. Additive component
network meta-analysis (CNMA) was conducted to isolate the effect of different intervention types on the main outcome of frailty incidence, reporting relative risk (RR) with 95% confidence intervals (CI). The effect on gait speed was analyzed as an additional outcome using a classic network meta-analysis and the standardized mean difference (SMD) with 95% CI.
Results 
We screened 24,263 records and identified 11 eligible trials. Nine trials (842 participants, all categorized according to the physical phenotype) in pre-frail (seven RCTs) and robust/pre-frail (two RCTs) older adults were included in the
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Conclusion 
Interventions based on physical exercise appear to be effective in preventing the onset of frailty in older adults. Although the available data are still limited, results from ongoing trials may add to the body of evidence in the foreseeable
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