Effects of multidomain interventions on health outcomes in older adults: A systematic review and meta-analysis.

BACKGROUND

With rising global aging, healthcare systems face challenges from multimorbidity, functional decline, and cognitive impairment. Multidomain interventions offer a promising approach to promoting healthy aging. This systematic review and meta-analysis evaluated the effects of multidomain interventions (≥3 domains) on motor-functional, cognitive, and psychological outcomes in older adults without moderate/severe dementia.

METHODS

Following PRISMA guidelines, PubMed and Embase were searched up to April 30, 2024. Eligible studies included clinical trials or observational studies involving adults ≥60 years receiving multidomain interventions versus control/standard care. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated.

RESULTS

Thirty-eight studies (57 comparisons) were included (median age: 75.3 intervention, 75.1 control; >60% female). Intervention lasted 2-36 months (median 6.0). All studies targeted the physical domain, 78.9% cognitive, 81.6% nutritional, and 84.2% additional domains. Motor-functional outcomes improved significantly (e.g., Short Physical Performance Battery: SMD = 0.40, 95% CI 0.14 to 0.66; Cardiovascular Health Study frailty criteria: SMD = -0.14, 95% CI -0.23 to -0.05), with diminishing effects over time. Other indicators (e.g., handgrip strength), showed modest improvements. Cognitive improvements were limited to Montreal Cognitive Assessment (MoCA; SMD = 0.23, 95% CI 0.06 to 0.40). Psychological benefits included reduced depressive symptoms (Geriatric Depression Scale: SMD = -0.35, 95% CI -0.57 to -0.12). Effect estimates for Timed Up and Go and RBANS were attenuated in sensitivity analysis excluding high-risk-of-bias studies.

CONCLUSIONS

Multidomain interventions improve motor-functional and psychological well-being. Moderate cognitive benefits are observed primarily using the MoCA. These findings support large-scale implementation in geriatric care and highlight the need for strategies to sustain long-term effectiveness.