Lo Yu-Tai, Su Hui-Chen, Chuenchomnoy Chanisara, Liao Ting-Wei, Wu Yi-Lin, Tam Sin-Hang, Liu Chieh-Hsiu, Chou Chih-Wen, Yang Yi-Ching, Chen Yen-Hsu, Chen Yen-Chin
Department of Geriatrics and Gerontology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Ageing Res Rev. 2025 Jun;108:102742. doi: 10.1016/j.arr.2025.102742. Epub 2025 Apr 5.
This study aims to synthesize existing evidence on the effectiveness of nonpharmacological interventions designed to increase the intrinsic capacity (IC) of community-dwelling older adults.
An umbrella review of systematic reviews from 2015 to October 31, 2024, with no language restrictions, was conducted. The review included five databases, including Embase, Ovid MEDLINE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Cochrane Central Register of Controlled Trials (CENTRAL), and the Joanna Briggs Institute (JBI) Library. Studies followed the preferred reporting items for overviews of reviews (PRIOR) statement. Eligible studies were systematic review and meta-analysis (SRMAs) that included any type of research aimed at enhancing IC in community-dwelling older adults (aged ≥60 years). The interventions covered seven domains: locomotion, vitality, cognitive function, psychological health, sensory function, sleep, and continence. Risk of bias and study quality were extracted via the AMSTAR tool, and GRADE approach was applied to assess the certainty of evidence.
Out of 6407 initially identified articles, 29 SRMAs comprising 400 studies with a total sample size of 43,849 participants were included. Mobility-focused interventions were the most studied among the seven domains of IC. Moderate to low-quality evidence supports the effectiveness of intrinsic foot muscle strengthening and gait/muscle training for improving locomotor functions in older adults with frailty or acute functional decline. Nonpharmacological interventions targeting cognitive and psychological functions ranked second in the volume of available evidence. No effective sensory or continence interventions were identified. Overall, interventions have demonstrated varying effectiveness, with impacts ranging from moderate to very low across the domains of IC.
This umbrella review provides a comprehensive assessment of nonpharmacological interventions for enhancing IC in older adults, highlighting the effectiveness of mobility/muscle strength training for improving locomotor function among frail older adult or those experiencing functional decline. However, the evidence for interventions targeting other IC domains remains limited, particularly for sensory function, and continence management. Future research should prioritize high-quality trials evaluating interventions in these areas to develop evidence-based guidelines for improving overall IC and promoting healthy aging in older adults.
本研究旨在综合现有证据，探讨旨在提高社区居住老年人内在能力（IC）的非药物干预措施的有效性。
对2015年至2024年10月31日的系统评价进行了一项伞形综述，无语言限制。该综述包括五个数据库，即Embase、Ovid MEDLINE、护理及相关健康文献累积索引（CINAHL）、Cochrane对照试验中心注册库（CENTRAL）和乔安娜·布里格斯研究所（JBI）图书馆。研究遵循综述概述的首选报告项目（PRIOR）声明。符合条件的研究是系统评价和荟萃分析（SRMA），包括任何旨在提高社区居住老年人（年龄≥60岁）IC的研究类型。干预措施涵盖七个领域：运动、活力、认知功能、心理健康、感觉功能、睡眠和大小便失禁。通过AMSTAR工具提取偏倚风险和研究质量，并应用GRADE方法评估证据的确定性。
在最初识别的6407篇文章中，纳入了29项SRMA，包括400项研究，总样本量为43849名参与者。在IC的七个领域中，以移动性为重点的干预措施研究最多。中低质量证据支持内在足部肌肉强化和步态/肌肉训练对改善体弱或急性功能下降的老年人运动功能的有效性。针对认知和心理功能的非药物干预措施在现有证据数量上排名第二。未发现有效的感觉或大小便失禁干预措施。总体而言，干预措施已显示出不同的有效性，在IC各领域的影响从中度到极低不等。
本伞形综述对提高老年人IC的非药物干预措施进行了全面评估，强调了移动性/肌肉力量训练对改善体弱老年人或功能下降老年人运动功能的有效性。然而，针对其他IC领域的干预措施的证据仍然有限，特别是对于感觉功能和大小便失禁管理。未来的研究应优先进行高质量试验，评估这些领域的干预措施，以制定基于证据的指南，改善老年人的整体IC并促进健康老龄化。
