3734 The impact of digital interventions to reverse frailty—systematic review and meta-analysis

Abstract Introduction Frailty is defined as a clinically recognised state of increased vulnerability, reflecting a decline in an individual’s psychological and physical reserves. Digital interventions, such as smartwatches, are increasingly utilised to monitor and support the health of older adults. Evidence on the effectiveness of digital interventions in reducing or reversing frailty is limited. This systematic review aimed to investigate the types of digital interventions tested and the resulting outcomes. Method The following databases: Medline, CINAHL, Scopus, PsychInfo and Embase were searched from time of origin until July 2024. A search strategy was designed to identify randomised controlled trials assessing the impact of digital interventions on older adults. Outcome measures explored include frailty, wellbeing and quality of life. Narrative synthesis was performed for all studies and meta-analysis was performed for outcomes reported in four or more studies. Risk of bias was conducted using Cochrane Risk of Bias-2 tool. Results From 4476 titles and abstracts screened, 17 studies were included following full text review. Overall, 12 studies included exercises as a component or the sole form of intervention. The mean duration of intervention was 4.04 (SD 2.56) months. Mean adherence to the intervention was 59%. The most reported frailty-specific outcome was walking speed (n = 8), while the least reported outcome was self-reported exhaustion level (n = 2). Meta-analysis showed non-exercise-based interventions showed significant improvements in SPPB. There was no statistically significant change in TUG and handgrip strength. Narrative synthesis indicates there was insufficient evidence to evaluate the impact of digital interventions on frailty, cognition, wellbeing, activities of daily living and health-related quality of life. Conclusions The findings suggest low technological readiness and adherence among digital interventions for older adults. Narrative synthesis of overall frailty and outcome measures showed mixed results and insufficient evidence on the impact of digital interventions on frailty and outcomes reviewed.