Table 5.

Characteristics of the interventions described in included studies

Study	Experimental condition	Control condition	Duration of intervention
Behm, et al., 201540Gustafsson, et al., 201247	Multi-professional senior group meetings with one home visit Meetings with no more than six participants in each group, conducted by an occupational therapist, a physiotherapist, a registered nurse and a qualified social worker, focused on information and discussion about the aging process and possible health consequences and providing strategies for solving various problems that may arise in the home environment. The content of the group discussions varied according to the attending participants’ individual experiences and needs. After group meetings one follow-up home visit was provided.Single preventive home visitVisit from a trained professional (occupational therapist, physiotherapist, registered nurse or qualified social worker) including verbal and written information and advice about (i) local meeting places, activities run by local associations, physical training for seniors, and other services; (ii) kinds of help and support offered by volunteers or municipal professionals; and (iii) availability of assistive devices and housing modifications. Environmental fall risks in the home were identified, and advice on how to prevent them was included.	Ordinary range of community servicesServices offered by the municipal agency for care for the aged and provided when requested. They may include meals on wheels, help with cleaning and shopping, assistance with personal care, safety alarms, transportation services, and health care.	Duration of intervention: four weeksMulti-professional senior group meetings included four weekly meetings with 2-hour duration and a follow-up home visit conducted 2–3 weeks after the meetings.Preventive home visit was held once and had duration of 1.5 - 2 hours.
Bonnefoy, et al., 201222	Home based exercise program with dietary protein supplementationEvery dose of protein supplements contained 80% milk, soy and alfalfa protein, 10 g protein including 3.49 g of branched amino acids (2.41 g L-Leucin, 0.51 g L-isoleucin, 0.57 g L-valin), and 44.3 kcal.Exercises program included: (i) flexibility exercises (rotation of the neck to the right and left, flexion/extension, right and left turns of the trunk in a sitting position, and hip and shoulder movements); (ii) strength exercises (contraction of the back muscles, arm pushes while sitting, calf raises, elevation of the hips, and the get-up-and-go test); (iii) balance exercises (one-leg stands, sideways and tandem walking). For endurance, participants were also advised to walk for pleasure as often as possible.Before the intervention the physiotherapist prescribed the exercises and gave a booklet explaining how to perform these exercises and how to fill in compliance diaries. He/she also explained how to add protein supplements to regular food, and delivered the supplements for 1.5 months. During the intervention period home helpers encourage participants to exercise, verify that protein supplements were taken correctly, and make sure the diary was filled out.	No intervention	Period of intervention: four months.Each exercise session was supposed to last approximately 20 minutes and be performed once a day.
Cadore et al., 201441	Multicomponent exercise programMulticomponent exercise intervention composed of lower and upper body resistance training with progressively increased loads that optimized the muscle power output, combined with balance and gait retraining exercises that progressed in difficulty and functional exercises. All training sessions were supervised by one experienced physical trainer. The training sessions included 5 min of warm-up, 10 min balance and gait retraining, 20 min of resistance training, and 5 min of stretching (cool-down). A minimum of 2 days elapsed between consecutive training sessions. To reduce the participant dropout, music was played during all sessions.	Mobility exercisesExercises consisted of small active and passive movements applied as a series of stretches in a rhythmic fashion to the individual joints.	Period of intervention in experimental group: 12 weeks.Multicomponent exercise sessions with duration approximately of 40 minutes, performed twice a week. A minimum of 2 days elapsed between consecutive training sessions.Period of intervention in control group: 12 weeks.Mobility exercise sessions with duration of 30 minutes per day, performed at four days per week.
Chan et al., 201242	Exercise and nutrition consultationThe program included warm up exercise (15 minutes) with brisk walks followed by gentle stretching of major joints and muscles for 5 repetitions each (10 minutes). Resistance training (20–30 min) with rubber band and bottled water (0.6–1L) as weight for major muscles of upper and lower limbs with 10 to 15 repetitions for each. Postural control activities and balance training were also provided (10 minutes) by asking participants to perform tandem gaits and one leg standing with eyes open/close, step up and down stairs, toe walking and heel walking. Finally a cool down session (5 minutes) with gentle relaxation movements are done. During exercise sessions the participants were inquired about their dietary compliance and their dietary questions were answered.Problem solving therapyParticipants received therapy by trained case managers. This therapy focuses on how to solve the “here-and-now” problems contributing to participants’ mood-related conditions and helps increase their self-efficacy.	Educational bookletBooklet on frailty, healthy diets, exercise protocols, and self-coping strategies were given to participants. The participants were contacted monthly to check on how much they had read the booklet and how well they had complied with the suggested diet and exercise protocols.	Period of intervention: three monthsExercise and nutrition: thrice-weekly sessions with duration of one hourProblem solving therapy: 6 sessionsEducational booklet: once a month
Clegg, et al., 201443	Home-based exercise programProgram was delivered by community-based physiotherapists. Its core components are strengthening exercises for the muscle groups required for basic mobility skills. These exercises do not require special equipment and that can be performed without professional supervision; however they are graded in three levels, being their prescription dependent on participants’ individual ability. The number of exercise repetition increases with improvement of performance.Participants receive weekly support from physiotherapists through five face-to-face home visits and seven telephone calls.	Usual careParticipants continued to receive usual care from the primary healthcare team and, other than baseline and follow-up assessments, had no contact with the research team.	Period of intervention: 12 weeks.Participants were requested to complete the routine exercise with duration < 15 minutes three times a day on five days of the week.
Cohen, et al., 200244	Inpatient geriatric care in multidisciplinary evaluation and management unitsMultidisciplinary team consisted of a geriatrician, a social worker, and a nurse followed their standard protocols for geriatric evaluation and management, with specific instructions to complete the history taking and physical examination; develop a list of problems; assess the patient's functional, cognitive, affective, and nutritional status; evaluate the caregiver's capabilities; and assess the patient's social situation. The team met at least twice a week to discuss the plan of care. Preventive and management services (e.g., dietetics, physical and occupational therapy, and clinical pharmacy) were coordinated to address the problems identified, with a general emphasis on maintaining the patient's functional status.Usual inpatient care followed by care at outpatient geriatric clinicParticipants received all appropriate hospital services except for those provided by the team on the geriatric evaluation and management unit.	Usual inpatient care followed by usual outpatient careParticipants received all appropriate hospital services and after discharge were provided with at least one follow-up appointment in an appropriate clinic.	Not clear
Eklund, et al., 201329	Continuum care by multi-professional teamMulti-professional team for care and rehabilitation included professionals in nursing with geriatric competence (emergency department), occupational therapy, physiotherapy and social work (municipality). Continuum care components were: (i) frailty screening and geriatric assessment at emergency department; (ii) case-management in the municipality; (iii) hospital care and/or rehabilitation at hospital if needed; (iv) tracking of the patients in hospital wards and/or in the municipality; (v) care planning; (vi) rehabilitation in the municipality if assessed as needed at care planning; (vii) follows-up other than research, within a week after care planning and then at least every month for a year.Continuum of care had a person-centered approach and was created for the older person from the emergency department, through the hospital ward and on to their own homes.	Usual careOrdinary care including hospital care and/or rehabilitation at hospital if needed, care planning by multidisciplinary team (only for participants with need of hospital care), rehabilitation in the municipality if assessed as needed at care planning, follows-up other than research.	Not clear
Fairhall, et al., 201532	Multifactorial interdisciplinary intervention targeting identified frailty characteristicsThe intervention, delivered by an interdisciplinary team (two physiotherapists, a geriatrician, rehabilitation physician, dietician, and nurse), was individualized to each participant based on the frailty criteria present. It incorporated the principles of geriatric evaluation and management (including medication review and management of chronic health conditions). The participants also received visits from physiotherapists, and were prescribed a home program of lower limb balance and strength exercises. When needed, dietician assessment and management was provided. In addition, regular interdisciplinary case-conferences were conducted.	Usual careUsual care from community services and general practitioner, that may include assessment and delivery of care needs, and medical and allied health management.	Period of intervention: 12 months.Participants received 10 physiotherapy visits and were prescribed a home program of exercises to be undertaken for 20 to 30 minutes 3 to 5 times per week for 1 year.
Favela, et al., 201345	Nurse home visits aloneDuring the intervention medical history was performed and areas of potential improvement were identified. Then, possible lifestyle changes were discussed with patients and their relatives or caregivers (whenever possible) and specific methods to achieve these changes were negotiated. In addition, subjects’ pharmacological treatment was reviewed and adherence was encouraged.Nurse home visits including alert buttonsThe same as above. In addition, patients could contact their nurses whenever they felt the need by pressing the alert button.In both conditions, patients continued to receive usual care from family physicians at the clinic.	Usual careUsual care at the Family Medicine Clinic	Period of intervention: nine months.Nurse home visits were held weekly.
Giné-Garriga, et al., 201046	Functional circuit-training programSupervised intervention based on a combination of functional (static and dynamic) balance and strength-based exercises. Balance exercises were of increasing complexity, and when an easier step was achieved without assistance, the individual went on to perform the next more complex set of exercises. In case of strength exercises (rising from a chair, stair climbing, knee bends, floor transfer, lunges, leg squat, leg extension, leg flexion, calf raise, and abdominal curl using ankle weights), the number of repetitions and then the load were increased. Every session began with a warm-up, walking at usual pace for 10 min, and ended with cool-down, stretching for 5 min.During the exercise period, participants were instructed to continue their routine daily activities and not perform any new exercise except for the interventional program.	Health education meeting and usual careFour sessions including health topics relevant to older adults, such as nutrition, medication use, foot care, sleep hygiene, and other health-related areas.Usual care from the primary-care practice provided whenever needed.Participants were asked to continue their routine daily activities.	Period of intervention: 12 weeks.Functional circuit-training program: conducted twice a week/every session with duration of 45 minutes.Health education meeting: conducted once a week/every session with duration of 60 minutes.
Hars et al., 201448	Continued intervention of music-based multitask training The original trial consisted of 6-month music-based multitask exercise program based on Jaques-Dalcroze eurhythmics (a music education through movement method). This program included varied multitask exercises involving multiple-task practice which highly challenged motor-, cognitive- and social-related abilities, and was performed to the rhythm of improvised piano music.Extension study was held in various community locations, under the supervision of certified instructors who were involved in the original trial. Each class consisted of a warm-up followed by varied multitask exercises of progressive difficulty, sometimes involving the handling of objects (e.g., percussion instruments), performed individually, in pairs or more. Basic exercises consisted of walking following the piano music, responding directly or oppositely to changes in music's rhythmic patterns, phrases, form or other aspects.	Discontinued intervention of music-based multitask trainingDiscontinued participation after the original trial completion.	Period of original trial: 6 months.Period of extension study: 4 years, over 45 weeks per year.Sessions with duration of one hour were conducted once a week.
Kim, et al., 201549	Milk fat globule membrane (MFGM) supplementationThe supplement composition was 21.5% protein, 44.0% fat, 26.5% carbohydrate, 33.3% phospholipids, 6.4% ash, and 1.6% moisture. Each pill contained 167 mg of MFGM, and six pills (total 1 g) were ingested in the mornings, prior to activity. The pills were yogurt-flavored. In addition, participants were asked to fill out a daily diary on which they recorded whether or not they took the full amount of the supplement. These diary sheets were collected every two weeks.Exercise + placebo Training program of moderate intensity was conducted by one instructor and two assistant trainers in four small groups. The exercise session included a five minute warm-up, 30 minutes of strengthening exercises, 20 minutes of balance and gait training, followed by a five minute cool-down. The strengthening exercises were performed in a progressive sequence from the seated to standing positions, and progressive resistance was applied through the use of the Thera-bands, and increasing repetition of each time of exercise. Resistance or progression was only increased on a group basis, when no significant fatigue or loss of proper execution was observed.The placebo pills were of similar shape, taste, and texture of the MFGM pills, and they included whole milk powder (26.3% protein, 25.2% fat, 39.5% carbohydrate, 0.286% phospholipids, 5.7% ash, and 3.3% moisture) instead of MFGM.Exercise + milk fat globule membrane (MFGM) supplementationParticipants in this group underwent exercise program and take MFGM supplementation as described above.	PlaceboThe placebo group followed the same protocol as the MFGM supplementation group. The pills were of similar shape, taste, and texture of the MFGM pills, and they included whole milk powder (26.3% protein, 25.2% fat, 39.5% carbohydrate, 0.286% phospholipids, 5.7% ash, and 3.3% moisture) instead of MFGM.	Period of intervention: three months.Exercise program: conducted twice a week/every session with duration of 60 minutes.MFGM supplements and placebo: given daily.
Kim & Lee, 201323	Protein-energy supplementationParticipants were provided two 200-mL cans of commercial liquid formula (additional 400 kcal of energy, 25g of protein, 56g of carbohydrate 9.4g of essential amino acids, 9 g of lipid, 400 mL of water, and micronutrients) per day. Compliance was measured every 2 weeks during a home visit by the research dietitian. The participants were clearly instructed not to replace their usual meal with the liquid supplement; rather, they were encouraged to use the supplement to increase overall food intake.	No interventionThe participants did not receive any treatment or counseling during the study period, and home healthcare services provided by National Home Healthcare Services workers were suspended. The participants were visited by research dietitian and received small gift every month.	Period of intervention: 12 weeks.Nutritional supplements were given daily.
Li, et al., 201050	Screening evaluation and appropriate intervention based on screening resultsScreening evaluation was based on comprehensive geriatric evaluation. Two board-certified geriatricians independently reviewed the participants’ assessment results along with their present and past medical histories, current medication, and recent laboratory data. The intervention programs were conducted by medical professionals at the community hospital, as well as at appropriate community facilities. They included medication adjustment, exercise instruction, nutrition support, physical rehabilitation, social worker consultation, and/or specialty referrals.	Screening evaluationScreening evaluation was based on comprehensive geriatric evaluation.	Not clear
Monteserin et al., 201051	Recommendation about healthy habits and adherence to treatment in group sessions After comprehensive geriatric assessment, patients at non-risk of frailty were provided with recommendations about health promotion, disease prevention and self-care through the group session led by a trained nurse. They patients were also given the booklet containing health recommendations.Individual sessions with geriatricianAfter comprehensive geriatric assessment, patients at risk of frailty received an individual educational session by a geriatrician. The geriatrician informed each patient about specific health areas that could be improved through lifestyle changes, developing a shared plan to emphasize the reduction of disability raising main aspects like drug therapy, sensory impairment, instability and falls, incontinence aids, dietary modifications, inclusion in physical exercise programs, participation in senior center activities and psychological counselling. The geriatrician included in the medical record a health report detailing specific recommendations for evaluation and management that could be of interest to the patient's General Practitioner and nurse.	Usual careStandard care from the General Practitioner.	Period of intervention: interventions consisted of individual sessions, the period between the assessment and the intervention is not clearGroup session with duration of 45 minutes.Individual session with duration of over 30 minutes.
Muller et al., 200652	Atamestane + dehydroepiandrosterone (DHEA)Participants received a combination of atamestane (100 mg/d) and DHEA (50 mg/d). For each treatment period of 28 days, the volunteer received two glasses with 28 tablets each. Subjects were instructed to take the drugs during breakfast. To endure compliance, volunteers were required to return empty glasses and the remaining trial medication at each clinical visit. A pill count that indicated an overall compliance of less than 80% was registered as noncompliance.DHEAParticipants received DHEA (50 mg/d) and placebo. The protocol of the trial was the same as described for atamestane + DHEA group.AtamestaneParticipants received atamestane (100 mg/d) and placebo. The protocol of the trial was the same as described for atamestane + DHEA group.	PlaceboParticipants received two placebo tablets that had an outer appearance identical with that of either atamestane tablets or DHEA tablets. The protocol of the trial was the same as described for atamestane + DHEA group.	Period of intervention: 36 weeksTablets were taken on each day of the treatment period without a treatment-free interval during the 36 weeks.
Ng, et al., 201553	Nutritional supplements A multi-fiber commercial formula, iron and folate supplement, vitamin B6 and vitamin B12 supplement, and calcium and Vitamin D supplement, designed to augment caloric intake by about 20% and provide about one third of the recommended daily allowances of vitamins and minerals, were administrated by interventional nurse. Given the variability in individual energy requirements, participants were encouraged to attain the maximal tolerable energy intake to gain 0.5 kg per week.Physical training The exercise program included resistance exercises integrated with functional tasks; and balance training exercises involving functional strength, sensory input, and added attentional demands. These exercises were of moderate, gradually increasing intensity, and tailored to participants’ individual abilities. They were conducted by a qualified trainer. After 12 weeks participants were encouraged to continue the exercise program at home.Cognitive training In the first 12 weeks participants participated in cognitive-enhancing activities designed to stimulate short-term memory (learning strategies), and enhance attention and information-processing skills (tasks such as “spot the differences,” categorical naming, and coding), and reasoning and problem solving abilities (matrix reasoning exercises, mazes, and tangram-like games). In the subsequent 12 weeks “booster” sessions, focusing on the revision of the cognitive skills learned in the first 12 weeks, were conducted.Combination treatmentParticipants in this group underwent all three aforementioned interventions	Standard care + placeboStandard care from health and aged care services, including primary and secondary level care from government or private clinics and hospitals, and community-based social, recreational, and daycare rehabilitation services.Placebo capsules contained nondairy creamer, liquid caramel, sugar, and water, and were identical in appearance to the active nutritional supplements. They were administrated by interventional nurses. Participants were instructed to not replace their meals with supplements.	Period of intervention: six months.Nutritional supplements and placebo: taken daily.Physical training: 90-minute sessions conducted on two days per week during first 12 weeks; and individual sessions at home, supposed to be performed daily, during subsequent 12 weeks.Cognitive training: two-hour weekly sessions during first 12 weeks; and two-hour fortnightly sessions during subsequent 12 weeks.
Van Hout et al., 201054	Proactive home visits by trained community nursesThe home-visits program had a preventive function and consisted of (a) the assessment of the care needs with a multidimensional computerized geriatric instrument, which enabled direct identification of health risks; (b) identification of care priorities together with the person, with focus on home safety, fall prevention, medication adherence, and health promotion; (c) designing and execution of individually tailored care plans; (d) involvement of other visiting health professionals to add notes to the care plan; (e) execution and monitoring participants by telephone and on average three home visits, evaluation of changes in care needs and adaptation of the care plan when needed.	Usual careUsual care could involve visits from primary care physician, district nurse, physiotherapist and/or social worker, day care, meals on wheels or no care.	Period of intervention: 18 monthsNurse visit: (i) one assessment session with duration of 45–75 minutes, (ii) session(s) focused on designing of care plan, (iii) at least four visits dedicated to execution and monitoring of the care plan.After a year, the participants were reassessed and the protocol was repeated.
Vriendt, et al., 201621	Activity oriented and community based programThe intervention was delivered by occupational therapist according to standardized protocol. It was based on a systematic therapy process and includes 4 phases: (1) client-centered goal-setting (the assessment of functional problems and their impact on health related quality of life plus comprehensive geriatric assessment); (2) negotiating a therapy plan (based on choices and preferences of the participants); (3) the actual intervention (training of functions and skills, education of the primary care giver or professional care giver, advise and instruction in the use of assistive devices or a comprehensive intervention including all aforementioned); (4) an evaluation of the outcome and finally reporting to relevant others (as general practitioner and the community care team).	Community care as usual Support in housekeeping and self-care, healthcare support from a nurse and social support from social worker.	Period of intervention: eight to ten weeks.Frequency: not clear
Wolf et al., 200355	Tai ChiTai Chi classes emphasized all components of movement that typically become limited with aging. Specifically, the progression involved a gradual reduction of the base of standing support until single limb stance was achieved, increased body and trunk rotation, and reciprocal arm movements. Participants were encouraged to home practice, but this practice was not monitored.Computerized balance trainingTraining involving use of a Balance System, high technological approach, and being performed individually. During the task, the participant have to move the cursor seen on the screen at eye level into specific targets that can be placed anywhere on the screen. This task is successfully achieved by moving the center of mass with no foot displacement. The goal is to progressively increase sway to the limits of postural stability. Added to this paradigm is the capability of moving the floor upon which the pylons are placed at either linear or angular directions at varying velocities.The training period consisted of positioning progressively more difficult targets that required increased sway first in the absence of, and then with, concomitant floor movement. For each session, subjects were asked to practice these tasks with eyes open and then with eyes closed, thus demanding more dependence upon vestibular and somatosensory systems to maintain balance.	Education exercise-control conditionParticipants met with a gerontological nurse/researcher to discuss topics of interest, such as pharmacological management, sleep disorders, cognitive deficits coping with bereavement, and other. The participants were also instructed not to change their exercise level.	Period of intervention: 15 weeks.Tai Chi group: Participants were encouraged to practice at least 15 minutes twice a day.Computerized Balance Training group: frequency and duration of sessions not clear.Education group: weekly session with one-hour duration.