Evidence-based Prevention of Frailty in Older Adults

The prevalence of frailty increases with age, leading to higher risk of disability, institutionalization, and mortality in late life. Approaches to prevent frailty include health risk appraisals to delay the onset of frailty (primary prevention), early detection and management of the prefrail to prevent the progression to frailty (secondary prevention), and interventions to avoid adverse outcomes of those who are frail (tertiary prevention). Accumulating evidence supports potential benefits of physical activity, nutritional supplementation, and individually tailored comprehensive geriatric assessment and management in frailty prevention. More recently, large scale multicomponent trials that combine exercise, nutritional therapy, cognitive training, and geriatric evaluation and management interventions are being conducted. However, the current evidence is insufficient to conclude which frailty preventive strategies are most effective. Promoting cohort studies and clinical trials, developing community-based preventive programs and clinical guidelines, and prioritizing national policy and initiating action plans for the prevention of frailty are urgently needed.