Effect of digital health interventions on frailty prevention and surrogate markers in healthy older adults: A systematic review and meta-analysis

ABSTRACT Background: Digital health interventions have gained attention as potential strategies for frailty prevention. However, their effectiveness in nonfrail older adults remains unclear. Objectives: This systematic review and meta-analysis evaluated the effectiveness of digital health interventions in preventing frailty and improving surrogate markers in healthy older adults. Methods: A comprehensive search of the MEDLINE, Cochrane Library, and Web of Science databases was conducted for studies published between 2000 and 2023. Eligible studies included randomized controlled trials (RCTs) or cohort studies assessing the impact of digital health interventions on frailty incidence or surrogate markers in nonfrail older adults (≥60 years). Pooled effect estimates for each outcome were calculated using a random-effects meta-analysis. Methodological quality was assessed using the Cochrane Risk of Bias (RoB) 2.0. GRADE criteria were used to assess evidence certainty. Results: Three RCTs met the inclusion criteria and included 257 participants. Meta-analysis showed no significant reduction in frailty incidence (odds ratio [OR] = 0.58; 95% confidence interval [CI]: 0.14–2.43; P = 0.46). No significant improvements were observed in chair stand performance (mean difference [MD] = −0.18; 95% CI: −1.24–0.88; P = 0.74) or physical activity levels (MD = 40.46; 95% CI: −1052.31–1133.23; P = 0.94). All studies had a high RoB, short intervention durations, and considerable heterogeneity in intervention types. Conclusion: The current evidence remains insufficient to confirm the effectiveness of digital health interventions in preventing frailty or improving surrogate markers in healthy older adults.