Integrated care improves frailty and functional ability in community-dwelling frail older adults but lacks consistent benefits for other outcomes

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Journal of advanced nursing Published June 1, 2026 Medically reviewed June 1, 2026 Study authors: Yu Jiaqi, Si Huaxin, Zhou Wendie, Yang Yang, Li Yanyan, Wang Xue, Chen Hejing, Wang Cuili PubMed ↗ DOI ↗ By Dr. Sofia Müller, MD · Lifespan & Whole-Person Care

Key Takeaway

Consider integrated care for frailty and functional ability in older adults, noting gaps in cost and caregiver data.

This systematic review and meta-analysis evaluated integrated care for community-dwelling frail older adults in high-income regions. The analysis included 6819 participants across multiple studies. Integrated care significantly improved frailty and functional ability but showed no significant effects on social function, hospitalization, nursing home admission, quality of life, mortality, or caregiver outcomes. Cost-effectiveness was not confirmed by limited evidence.

The authors note that outcomes of caregivers and professionals were rarely reported. Few studies have adopted a systematic approach to designing and conducting comprehensive process evaluations guided by scientific frameworks. These gaps limit the ability to fully understand the broader impact of integrated care models.

Practice relevance suggests that while integrated care improves frailty and functional ability, it lacks consistent benefits for other outcomes. The lack of evidence on cost-effectiveness and the caregiver and professional outcomes highlight critical gaps in current research. Clinicians should interpret these findings cautiously given the absence of reported adverse events or specific effect sizes.

Study Details

Study typeMeta analysis

EvidenceLevel 1

PublishedJun 2026

PMID41074465

View Original Abstract ↓

AIMS: To assess the effectiveness, process, and economic outcomes of integrated care for community-dwelling frail older adults. DESIGN: A systematic review and meta-analysis. DATA SOURCES: We searched nine databases, including PubMed, Web of Science, CINAHL, Embase, the Cochrane Library, CNKI, SinoMed, Wanfang, and VIP, three trial registers, grey literature, and reference lists up to April 2024, with an updated search in March 2025. REVIEW METHODS: Randomised controlled trials and non-randomised studies of interventions involving integrated care for community-dwelling frail older adults were included. Data analysis was conducted using the Comprehensive Meta-Analysis software. RESULTS: This review included 12 studies involving 6819 community-dwelling frail older adults from high-income regions. The results indicated that integrated care had significantly positive effects on frailty and functional ability, but not on social function, hospitalisation, nursing home admission, quality of life, and mortality. Outcomes of caregivers and professionals were rarely reported. The cost-effectiveness of integrated care has not been confirmed by limited evidence. Few studies have adopted a systematic approach to designing and conducting comprehensive process evaluations guided by scientific frameworks. CONCLUSION: Integrated care improves frailty and functional ability in community-dwelling frail older adults but lacks consistent benefits for other outcomes. The lack of evidence on cost-effectiveness and the caregiver and professional outcomes highlight critical gaps in current research. The absence of systematic process evaluations underscores the need for future studies to adopt rigorous frameworks to assess them. IMPACT: This implicates that more research, particularly in underserved regions that lack a high standard of usual medical services, should emphasise the outcomes of caregivers and healthcare professionals, process evaluation, and health economics. Policymakers and practitioners must consider these gaps when implementing integrated care programmes to ensure equitable and sustainable healthcare solutions. REPORTING METHOD: PRISMA 2020 Checklist. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. PROSPERO REGISTRATION NUMBER: CRD42024568811.