Multi-component health promotion and disease prevention for community-dwelling frail elderly persons: a systematic review

Research output: Contribution to journalReview article


The objective was to investigate definitions of frailty used in studies of multi-component health promotion and disease-preventive (HPDP) intervention programmes for community-dwelling frail elderly persons and to review the content, organisation and effects of HPDP interventions. A systematic review of 19 articles was made, and the International Classification of Functioning, Disability and Health (ICF) was used as a structural framework for the analysis. The result shows that a consensus was reached on including various aspects of impairments in body functions and structures as an integral part of the frailty concept, with the exception of one subgroup: mental/cognitive functions. Additionally, opinions varied quite consistently regarding aspects of activity limitations and participation restrictions, personal and environmental factors. Ten of the 14 HPDP programmes covered various intervention elements referring to all four ICF components. Eleven programmes involved registered personnel only, while a more divergent pattern was seen in the remaining organisational aspects of the interventions: length of interventions and location plus age segments, participatory approach and contextual information, as well as the theoretical foundation of the interventions. Measures of body functions and structures were significantly improved in 5 out of 17 (29%) targeted aspects. For activity and participation, 12 out of 32 (38%) targeted aspects were positively changed, while the score for environmental factors was 7 out of 22 (32%), and for personal factors 8 out of 22 (36%). Our review suggests that further research is needed to explore and disentangle the complex interrelationships between various interventions and outcomes.


  • Susanne Gustafsson
  • Anna-Karin Edberg
  • Boo Johansson
  • Synneve Dahlin-Ivanoff
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Gerontology, specializing in Medical and Health Sciences


  • ICF, Intervention, Vulnerability, Functional decline, team, Interdisciplinary
Original languageEnglish
Pages (from-to)315-329
JournalEuropean Journal of Ageing
Issue number4
Publication statusPublished - 2009
Publication categoryResearch

Bibliographic note

The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Division of Nursing (Closed 2012) (013065000)