Evidence on non-pharmacological interventions for preventing or reversing physical frailty in community-dwelling older adults aged over 50 years: overview of systematic reviews.

IF 3.8 2区 医学 Q2 GERIATRICS & GERONTOLOGY BMC Geriatrics Pub Date : 2025-03-17 DOI:10.1186/s12877-025-05768-1
Annemarie Money, Aylish MacKenzie, Amelia Parchment, Gill Norman, Danielle Harris, Saima Ahmed, Lisa McGarrigle, Helen Hawley-Hague, Chris Todd
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Abstract

Background: A large proportion of older adults are pre-frail. Interventions aimed at this group provide opportunity to reduce progression of physical frailty. The aim of this overview of reviews is to evaluate evidence for non-pharmacological interventions for the prevention/reversal of physical frailty in community-dwelling adults aged ≥ 50 years.

Methods: Medline, Embase, CINAHL, Cochrane Database of Systematic Reviews, Google Scholar and Social Science Citation Index were searched for non-pharmacological interventions that used a validated frailty measurement tool. Review quality was assessed using AMSTAR-2 and a Synthesis Without Meta-analysis (SWiM) approach was adopted.

Results: Twenty-three reviews were included, six of which were of high quality. This included 18,768 unique participants from 98 unique primary studies. Physical activity containing an aspect of resistance training, for a minimum of twice per week, was evidenced as being beneficial for reversing frailty (28 primary studies and 3,246 unique participants). However, one randomised controlled trial (RCT) showed resistance training by pre-frail adults (n = 66) for eight weeks was not effective at reversing frailty status. Nutrition interventions combined with physical activity that include resistance training (9 studies, 1,812 participants) were effective at reversing/preventing frailty.

Conclusion: The evidence synthesised in this overview of reviews suggests physical activity containing an aspect of resistance training is beneficial at reversing frailty status and preventing frailty progression. Nutrition interventions alone were inconclusive. It is recommended that future studies include a validated tool to assess frailty status, report samples by frailty status and make recommendations based on dose (frequency/duration of minutes per session) and adherence to dose.

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非药物干预预防或逆转50岁以上社区老年人身体虚弱的证据:系统综述
背景:很大一部分老年人处于体弱前期。针对这一群体的干预措施为减少身体虚弱的进展提供了机会。本综述的目的是评估非药物干预预防/逆转≥50岁社区居民身体虚弱的证据。方法:检索Medline、Embase、CINAHL、Cochrane系统评价数据库、谷歌Scholar和社会科学引文索引,检索使用经过验证的脆弱性测量工具的非药物干预措施。采用AMSTAR-2评价评价质量,采用综合无meta分析(SWiM)方法。结果:共纳入23篇综述,其中6篇为高质量综述。这包括来自98项独特的初级研究的18768名独特的参与者。包含抗阻训练的体育活动,每周至少两次,被证明有利于扭转虚弱(28项初步研究和3,246名独特参与者)。然而,一项随机对照试验(RCT)显示,体弱前成年人(n = 66)进行8周的抗阻训练并不能有效扭转体弱状态。营养干预与包括抗阻训练在内的身体活动相结合(9项研究,1812名参与者)在逆转/预防虚弱方面是有效的。结论:本综述综合的证据表明,包含抗阻训练的体育活动有利于扭转虚弱状态和预防虚弱进展。单独的营养干预是不确定的。建议未来的研究包括一个有效的工具来评估虚弱状态,根据虚弱状态报告样本,并根据剂量(每次治疗的频率/持续时间分钟)和剂量依从性提出建议。
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来源期刊
BMC Geriatrics
BMC Geriatrics GERIATRICS & GERONTOLOGY-
CiteScore
5.70
自引率
7.30%
发文量
873
审稿时长
20 weeks
期刊介绍: BMC Geriatrics is an open access journal publishing original peer-reviewed research articles in all aspects of the health and healthcare of older people, including the effects of healthcare systems and policies. The journal also welcomes research focused on the aging process, including cellular, genetic, and physiological processes and cognitive modifications.
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