Do home-based exercise interventions improve outcomes for frail older people? Findings from a systematic review

Abstract

SummaryFrailty is common in older age, and is associated with important adverse health outcomes, including increased risk of disability and long-term care admission.This study aims to evaluate whether home-based exercise interventions improve outcomes for frail older people.We searched systematically for randomized controlled trials (RCTs) and cluster RCTs, with literature searching to February 2010.All trials that evaluated home-based exercise interventions for frail older people were eligible. Primary outcomes were mobility, quality of life and daily living activities. Secondary outcomes included long-term care admission and hospitalization.Six RCTs involving 987 participants met the inclusion criteria. Four trials were considered of high quality. One high-quality trial reported improved disability in those with moderate but not severe frailty. Meta-analysis of long-term care admission rates identified a trend towards reduced risk. Inconsistent effects on other primary and secondary outcomes were reported in the other studies.There is preliminary evidence that home-based exercise interventions may improve disability in older people with moderate, but not severe, frailty. There is considerable uncertainty regarding effects on important outcomes including quality of life and long-term care admission. Home-based exercises are a potentially simple, safe and widely applicable intervention to prevent dependency decline for frail older people.