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Meta-Analysis
. 2018 Oct 20;18(1):249.
doi: 10.1186/s12877-018-0936-7.

Interventions for frail community-dwelling older adults have no significant effect on adverse outcomes: a systematic review and meta-analysis

Michael Van der Elst  1 , Birgitte Schoenmakers  2 , Daan Duppen  3 , Deborah Lambotte  3 , Bram Fret  3 , Bert Vaes  2   4 , Jan De Lepeleire  2 ; D-SCOPE Consortium
Affiliations
Meta-Analysis

Interventions for frail community-dwelling older adults have no significant effect on adverse outcomes: a systematic review and meta-analysis

Michael Van der Elst et al. BMC Geriatr. .

Abstract

Background: According to some studies, interventions can prevent or delay frailty, but their effect in preventing adverse outcomes in frail community-dwelling older people is unclear. The aim is to investigate the effect of an intervention on adverse outcomes in frail older adults.

Methods: A systematic review and meta-analysis of Medline, Embase, the Cochrane Library, and Social Sciences Citation Index. Randomized controlled studies that aimed to treat frail community-dwelling older adults, were included. The outcomes were mortality, hospitalization, formal health costs, accidental falls, and institutionalization. Several sub-analyses were performed (duration of intervention, average age, dimension, recruitment).

Results: Twenty-five articles (16 original studies) were included. Six types of interventions were found. The pooled odds ratios (OR) for mortality when allocated in the experimental group were 0.99 [95% CI: 0.79, 1.25] for case management and 0.78 [95% CI: 0.41, 1.45] for provision information intervention. For institutionalization, the pooled OR with case management was 0.92 [95% CI: 0.63, 1.32], and the pooled OR for information provision intervention was 1.53 [95% CI: 0.64, 3.65]. The pooled OR for hospitalization when allocated in the experimental group was 1.13 [95% CI: 0.95, 1.35] for case management. Further sub-analyses did not yield any significant findings.

Conclusion: This systematic review and meta-analysis does not provide sufficient scientific evidence that interventions by frail older adults can be protective against the included adverse outcomes. A sub-analysis for some variables yielded no significant effects, although some findings suggested a decrease in adverse outcomes.

Trial registration: Prospero registration CRD42016035429 .

Keywords: Frailty - Intervention - Community-dwelling - RCT - Review - Older adults.

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Conflict of interest statement

Ethics approval and consent to participate

This study was conducted according to the ethical guidelines laid down in the Declaration of Helsinki, and because no human subjects were involved; no informed consent was necessary and no ethics committee was involved.

Consent for publication

not applicable.

Competing interests

The authors declare that they have no competing interests.

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