Effectiveness of social and community health interventions in older adults with frailty, pre-frailty, or at risk of frailty: An overview of systematic reviews

Background Population aging creates challenges for healthcare systems and public policy, and frailty predicts disability and care needs among older adults. Objective To describe the effectiveness of social and community health interventions for older adults with frailty, pre-frailty, or at risk of frailty. Methods We conducted an overview of systematic reviews of social and community health interventions for older adults with frailty, pre-frailty, or at risk of frailty. Searches were conducted in Medline, Embase, Cochrane, Lilacs and Google Scholar from inception through October 17, 2025, without language restrictions. The protocol was registered in PROSPERO (CRD42023465689). Results The overview identified 3,363 records, of which 112 were considered potentially eligible for full-text screening, and 54 systematic reviews were included. Most reviews focused on older adults with frailty, while others included individuals with pre-frailty or at risk of frailty. Ten intervention categories were identified: physical exercise (37.0%), comprehensive geriatric assessment (16.7%), combined exercise and nutrition (11.1%), case management (9.3%), respite care or home-based support and home- or community-based health promotion (7.4%), multiple interventions (7.4%), nutrition (5.6%), community-based occupational therapy (1.9%), digital/telehealth interventions (1.9%), and medication review (1.9%). Intervention duration ranged from two weeks to five years. Outcomes included frailty status, functional and physical capacity, mobility, and social participation. Conclusions Managing older adults with frailty, pre-frailty, or at risk of frailty may require multidimensional approaches integrating physical, nutritional, cognitive, and community-based interventions. However, the evidence remains heterogeneous, and further research using standardized frailty definitions and assessment methods is needed.