Movement-Based Interventions in Pre-Frail and Frail Older Adults: An Integrative Review of Clinical, Digital, and Implementation Evidence

针对衰弱前期和衰弱老年人的运动干预:临床、数字化和实施证据的综合综述

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Abstract

BACKGROUND: Pre-frailty and frailty are dynamic and potentially reversible conditions in older adults, associated with increased risks of disability, hospitalization, and mortality. Evidence supports movement-based interventions as effective strategies to prevent and mitigate these outcomes. OBJECTIVE: This mini narrative review synthesizes recent scientific evidence on movement-based interventions for pre-frail and frail older adults, with emphasis on clinical outcomes, barriers to implementation, and digital innovations. METHODS: A structured and iterative search was conducted using the AI-based Consensus platform, which integrates major biomedical databases. From 1,049 identified records, 281 were screened, 205 assessed in full text, and 36 studies (systematic reviews, meta-analyses, and randomized controlled trials published between 2019 and 2025) met the inclusion criteria. Eligible studies evaluated movement-based interventions reporting outcomes such as strength, mobility, cognition, mood, or quality of life. RESULTS: Multicomponent, resistance, and mind-body exercises consistently improved muscle strength, balance, mobility, executive function, and psychological well-being. Digital strategies, including exergames and mobile applications, showed comparable effectiveness to traditional programs and enhanced accessibility. However, implementation remains constrained by adherence challenges, infrastructural and professional limitations, and the digital divide. Research gaps persist in institutionalized populations, long-term follow-up, and standardized protocols. CONCLUSION: Movement-based interventions are safe, clinically effective, and scalable strategies to promote healthy aging in frail populations. To maximize their real-world impact, future research should prioritize standardized protocols, pragmatic long-term trials, inclusive recruitment, and equity-focused digital strategies aligned with global healthy aging policies.

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