Analysis 1.30. Comparison 1 Rehabilitation versus control, Outcome 30 TUG Test (by gender).. .. .. .. Analysis 1.31. Comparison 1 Rehabilitation versus control, Outcome 31 Walking speed (by risk of bias).. .. . Analysis 1.32. Comparison 1 Rehabilitation versus control, Outcome 32 Walking speed (by duration of intervention). Analysis 1.33. Comparison 1 Rehabilitation versus control, Outcome 33 Walking speed (by mode of delivery).. . Analysis 1.34. Comparison 1 Rehabilitation versus control, Outcome 34 Walking speed (by baseline walking speed). Analysis 1.35. Comparison 1 Rehabilitation versus control, Outcome 35 Walking speed (by age).. .. .. .. Analysis 1.36. Comparison 1 Rehabilitation versus control, Outcome 36 Walking speed (by gender).. .. .. . Analysis 1.37. Comparison 1 Rehabilitation versus control, Outcome 37 Walking speed (by distance walked).. .. Analysis 1.38. Comparison 1 Rehabilitation versus control, Outcome 38 Death (by risk of bias).. .. .. .. Analysis 1.39. Comparison 1 Rehabilitation versus control, Outcome 39 Death (by duration of intervention).. .. Analysis 1.40. Comparison 1 Rehabilitation versus control, Outcome 40 Death (by mode of delivery).. .. .. Analysis 1.41. Comparison 1 Rehabilitation versus control, Outcome 41 Death (by age

Purpose Frailty is an important predictor of adverse health events in older people, and improving quality of life (QOL) is increasingly recognised as a focus for services in this population. This systematic review synthesised evidence of the relationship between frailty and QOL in community-dwelling older people, with an emphasis on how this relationship varied across QOL domains. Methods We conducted a systematic review with meta-analysis. We searched five databases for reports of QOL in older people with frailty and included studies based on pre-defined criteria. We conducted meta-analyses comparing “frail” and “not frail” groups for each QOL scale where data were available. We compared pooled results to distribution-based and known-group differences to enhance interpretation. We summarised reported cross-sectional and longitudinal analyses. Results Twenty-two studies (24,419 participants) were included. There were medium or larger standardised mean differences for 24 of 31 QOL scales between frail and not frail groups, with worse QOL for frail groups. These scales encompassed constructs of health-related quality of life as well as psychological and subjective well-being. There were similar findings from mean difference meta-analyses and within-study analyses. Conclusions The association between frailty and lower QOL across a range of constructs is clear and often substantial. Future research should establish whether causal mechanisms link the constructs, which aspects of QOL are most important to older people with frailty, and investigate their tractability. Services focused on measuring and improving QOL for older people with frailty should be introduced. Electronic supplementary material The online version of this article (10.1007/s11136-019-02149-1) contains supplementary material, which is available to authorized users.

Whilst informal carers can apply some of the interventions highlighted in the home setting at little or no cost to themselves or to health or social care services, others are likely to require training or instruction. Service providers and commissioners should explore current and future provision of more structured group activities for people with dementia; in particular the provision of group music therapy and group exercise activities that meet the needs of both the person with dementia and their carer.

physical rehabilitation may improve independence for elderly long-term care facility residents, but mean effects are small. It is unclear which interventions are most appropriate.