journal articles
THE IMPACT OF INTEGRATED CARE ON QUALITY OF LIFE IN COMMUNITY-DWELLING OLDER ADULTS WITH FRAILTY: A SYSTEMATIC REVIEW AND MIXED METHOD SYNTHESIS
Joanne Boyce, Declan Patton, Chanel Watson, Tom O’Connor, Zena Moore, Linda Nugent
J Frailty Aging 2026;15(3)
BACKGROUND: Frailty among older adults is an escalating public health challenge, often associated with poorer quality of life (QoL) and increased pressure on healthcare systems. Integrated care is proposed as a strategy to meet the complex needs of this population, though evidence of its effectiveness remains inconclusive.
OBJECTIVES: To determine the impact of integrated care on the quality of life of frail, community-dwelling older adults.
DESIGN: Systematic review and mixed-methods synthesis, including meta-analysis and narrative synthesis.
SETTING: Community-based healthcare systems across six international studies.
PARTICIPANTS: A total of 5498 frail, community-dwelling older adults across six studies: four randomised controlled trials and two quasi-experimental designs.
INTERVENTION: Integrated care interventions tailored to frailty, including person-centred, multidisciplinary, and value-based models.
MEASUREMENTS: Quality of Life was the primary outcome. Secondary outcomes included social functioning and healthcare costs. Standardised tools such as SF-12, SF-36, ICECAP-O, and EQ-5D were used across studies.
RESULTS: The meta-analysis showed a small, non-significant improvement in QoL (SMD = 0.13, 95 % CI: -0.09 to 0.35, p = 0.24) with high heterogeneity (I² = 91 %). Tailored, multidimensional models showed greater effects, particularly in preserving social functioning. Findings on cost-effectiveness were inconsistent; some studies reported reduced hospital use, while others found increased primary care visits without cost savings.
CONCLUSIONS: . Integrated care may support social functioning but does not demonstrate a consistent improvement in overall QoL. Future trials should standardise QoL measurement, report intervention components clearly, include economic evaluations, and assess longer-term outcomes.
CITATION:
Joanne Boyce ; Declan Patton ; Chanel Watson ; Tom O’Connor ; Zena Moore ; Linda Nugent (2025): The impact of integrated care on quality of life in community-dwelling older adults with frailty: A systematic review and mixed method synthesis. The Journal of Prevention of Alzheimer’s Disease (JPAD). https://doi.org/10.1016/j.tjfa.2026.100150