{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T03:30:10Z","timestamp":1792207810208,"version":"4.4.0"},"reference-count":63,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T00:00:00Z","timestamp":1757030400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Older adults often face frailty as they age, characterized by a decline in physical and mental health, leading to increased reliance on caregiving services, particularly in nursing homes. Exercise interventions have emerged as an effective means of improving health outcomes, but their efficacy for this population remains unclear. The aim of this study was to investigate the effects of exercise interventions on physical function, cognitive function and quality of life of frail older people in a nursing facility.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data were systematically collected from five major databases and analyzed using RevMan 5.4 and Stata 17.0. Standardized mean differences (SMD) with 95% confidence intervals were calculated to evaluate health outcomes\u2014including physical function, cognitive function, and quality of life\u2014among frail older adults, and heterogeneity was assessed using the <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> statistic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 16 studies comprising 1,444 participants (mean age ranging from 73.3\u202f\u00b1\u202f6.4 to 87.3\u202f\u00b1\u202f5.3\u202fyears) were included in the meta-analysis. The findings consistently demonstrated that exercise interventions produced significant improvements across multiple domains, including physical performance [<jats:italic>SMD<\/jats:italic>\u202f=\u202f0.54, 95% CI (0.38, 0.70), <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001], mobility [<jats:italic>SMD<\/jats:italic>\u202f=\u202f\u22122.42, 95% CI (\u22123.96, \u22120.87), <jats:italic>Z<\/jats:italic>\u202f=\u202f3.07, <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.05], muscle strength [<jats:italic>SMD<\/jats:italic>\u202f=\u202f2.00, 95% CI [0.32, 3.68], <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.05], quality of life [<jats:italic>SMD<\/jats:italic>\u202f=\u202f1.94, 95% CI (0.37, 3.51), <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.05], and cognitive function [<jats:italic>SMD<\/jats:italic>\u202f=\u202f0.64, 95% CI (0.13, 1.15), <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.05]. Notably, physical activity yielded pronounced benefits in alleviating depression [<jats:italic>SMD<\/jats:italic>\u202f=\u202f\u22120.78, 95% CI (\u22121.07, \u22120.49), <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001] and frailty [<jats:italic>SMD<\/jats:italic>\u202f=\u202f\u22121.44, 95% CI (\u22121.74, \u22121.15), <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study demonstrated that exercise interventions significantly improve physical function, mobility, grip strength, and lower limb strength. The results also showed positive effects on alleviating depressive symptoms and improving frailty status. With effect sizes indicating a substantial impact. Furthermore, subgroup analysis revealed that a regimen of at least three sessions per week, each lasting no less than 40\u202fmin, was associated with the most favorable outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Systematic review registration<\/jats:title><jats:p><jats:uri>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD42024614885<\/jats:uri>, ID: 614537.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpsyg.2025.1679734","type":"journal-article","created":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T13:15:09Z","timestamp":1757078109000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":8,"title":["Effects of exercise interventions on physical function, cognitive function and quality of life of frail older adults in nursing homes: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"16","author":[{"given":"Yingbo","family":"Zhu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhijuan","family":"Du","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,5]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"101513","DOI":"10.1016\/j.redox.2020.101513","article-title":"Physical activity and exercise: strategies to manage frailty","volume":"35","author":"Angulo","year":"2020","journal-title":"Redox Biol."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"3125","DOI":"10.3390\/ijerph16173125","article-title":"Effectiveness of a combined intervention on psychological and physical capacities of frail older adults: a cluster randomized controlled trial","volume":"16","author":"Ap\u00f3stolo","year":"2019","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1016\/j.exger.2018.01.008","article-title":"A multicomponent exercise program improves physical function in long-term nursing home residents: a randomized controlled trial","volume":"103","author":"Arrieta","year":"2018","journal-title":"Exp. Gerontol."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"105271","DOI":"10.1016\/j.jamda.2024.105271","article-title":"Feasibility and effectiveness of a 12-week concurrent exercise training on physical performance, muscular strength, and myokines in frail individuals living in nursing homes: a cluster randomized crossover trial","volume":"25","author":"Barros","year":"2024","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"755","DOI":"10.1093\/oxfordjournals.aje.a009520","article-title":"Epidemiology of sarcopenia among the elderly in New mexico","volume":"147","author":"Baumgartner","year":"1998","journal-title":"Am. J. Epidemiol."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1693","DOI":"10.1007\/s40279-015-0385-9","article-title":"Dose\u2013response relationships of resistance training in healthy old adults: a systematic review and meta-analysis","volume":"45","author":"Borde","year":"2015","journal-title":"Sports Med."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1106","DOI":"10.1016\/j.jagp.2014.12.191","article-title":"A 9-week aerobic and strength training program improves cognitive and motor function in patients with dementia: a randomized, controlled trial","volume":"23","author":"Bossers","year":"2015","journal-title":"Am. J. Geriatr. Psychiatr."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"S446","DOI":"10.1097\/00005768-200106001-00013","article-title":"Individual differences in response to regular physical activity","volume":"33","author":"Bouchard","year":"2001","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1106","DOI":"10.3390\/nu13041106","article-title":"Effect of training-detraining phases of multicomponent exercises and BCAA supplementation on inflammatory markers and albumin levels in frail older persons","volume":"13","author":"Caldo-Silva","year":"2021","journal-title":"Nutrients"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"362","DOI":"10.1186\/s13063-019-3426-0","article-title":"Effect of a multicomponent exercise programme (VIVIFRAIL) on functional capacity in frail community elders with cognitive decline: study protocol for a randomized multicentre control trial","volume":"20","author":"Casas-Herrero","year":"2019","journal-title":"Trials"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1123\/japa.2016-0040","article-title":"Physical activity intervention effects on physical function among community-dwelling older adults: a systematic review and Meta-analysis","volume":"25","author":"Chase","year":"2017","journal-title":"J. Aging Phys. Act."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"jocn.15964","DOI":"10.1111\/jocn.15964","article-title":"Otago exercise programme for physical function and mental health among older adults with cognitive frailty during COVID-19: a randomised controlled trial","author":"Chen","year":"2021","journal-title":"J. Clin. Nurs."},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1510","DOI":"10.1249\/MSS.0b013e3181a0c95c","article-title":"Exercise and physical activity for older adults","volume":"41","author":"Chodzko-Zajko","year":"2009","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref14","doi-asserted-by":"publisher","first-page":"111799","DOI":"10.1016\/j.exger.2022.111799","article-title":"Physical fitness and frailty status of frail older adults in long-term care facilities after acupunch exercises: a cluster-randomized controlled trial","volume":"163","author":"Chou","year":"2022","journal-title":"Exp. Gerontol."},{"key":"ref15","doi-asserted-by":"publisher","first-page":"752","DOI":"10.1016\/S0140-6736(12)62167-9","article-title":"Frailty in elderly people","volume":"381","author":"Clegg","year":"2013","journal-title":"Lancet"},{"key":"ref16","year":""},{"key":"ref17","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1016\/j.jamda.2016.01.021","article-title":"Recommendations on physical activity and exercise for older adults living in long-term care facilities: a taskforce report","volume":"17","author":"De Souto Barreto","year":"2016","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"102082","DOI":"10.1016\/j.arr.2023.102082","article-title":"Recent developments in frailty identification, management, risk factors and prevention: a narrative review of leading journals in geriatrics and gerontology","volume":"91","author":"Dent","year":"2023","journal-title":"Ageing Res. Rev."},{"key":"ref19","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.ejim.2016.03.007","article-title":"Frailty measurement in research and clinical practice: a review","volume":"31","author":"Dent","year":"2016","journal-title":"Eur. J. Intern. Med."},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1376","DOI":"10.1016\/S0140-6736(19)31785-4","article-title":"Management of frailty: opportunities, challenges, and future directions","volume":"394","author":"Dent","year":"","journal-title":"Lancet"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"771","DOI":"10.1007\/s12603-019-1273-z","article-title":"Physical frailty: ICFSR international clinical practice guidelines for identification and management","volume":"23","author":"Dent","year":"","journal-title":"J. Nutr. Health Aging"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"e000682","DOI":"10.1136\/bmjoq-2019-000682","article-title":"Testing a proactive approach to frailty identification: the electronic frailty index","volume":"8","author":"Devereux","year":"2019","journal-title":"BMJ Open Qual."},{"key":"ref23","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1186\/1741-7015-10-120","article-title":"Effect of a multifactorial interdisciplinary intervention on mobility-related disability in frail older people: randomised controlled trial","volume":"10","author":"Fairhall","year":"2012","journal-title":"BMC Med."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"2225","DOI":"10.1519\/JSC.0b013e318278f0db","article-title":"Effects of different resistance training frequencies on the muscle strength and functional performance of active women older than 60 years","volume":"27","author":"Farinatti","year":"2013","journal-title":"J. Strength Cond. Res."},{"key":"ref25","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2018\/7218102","article-title":"Effects of a 12-week exercise training program on physical function in institutionalized frail elderly","volume":"2018","author":"Ferreira","year":"2018","journal-title":"J. Aging Res."},{"key":"ref26","doi-asserted-by":"publisher","first-page":"1147","DOI":"10.1152\/jappl.1988.65.3.1147","article-title":"Role of muscle loss in the age-associated reduction in VO2 max","volume":"65","author":"Fleg","year":"1988","journal-title":"J. Appl. Physiol."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"2019","DOI":"10.1519\/jsc.0000000000003230","article-title":"Resistance training for older adults: position statement from the national strength and conditioning association","volume":"33","author":"Fragala","year":"2019","journal-title":"J. Strength Cond. Res."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"M146","DOI":"10.1093\/gerona\/56.3.M146","article-title":"Frailty in older adults: evidence for a phenotype","volume":"56","author":"Fried","year":"2001","journal-title":"J. Gerontol. Ser. A Biol. Med. Sci."},{"key":"ref29","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1519\/JPT.0000000000000326","article-title":"Effectiveness of a supervised group-based Otago exercise program on functional performance in frail institutionalized older adults: a multicenter randomized controlled trial","volume":"46","author":"Garc\u00eda-Gollarte","year":"2023","journal-title":"J. Geriatr. Phys. Ther."},{"key":"ref30","doi-asserted-by":"publisher","first-page":"212","DOI":"10.1016\/j.jshs.2021.05.003","article-title":"Comparative efficacy of various exercise interventions on cognitive function in patients with mild cognitive impairment or dementia: a systematic review and network meta-analysis","volume":"11","author":"Huang","year":"2022","journal-title":"J. Sport Health Sci."},{"key":"ref31","doi-asserted-by":"publisher","first-page":"824","DOI":"10.1007\/s12603-021-1665-8","article-title":"International exercise recommendations in older adults (ICFSR): expert consensus guidelines","volume":"25","author":"Izquierdo","year":"2021","journal-title":"J. Nutr. Health Aging"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1186\/s12877-017-0430-7","article-title":"Life-space and movement behavior in nursing home residents: results of a new sensor-based assessment and associated factors","volume":"17","author":"Jansen","year":"2017","journal-title":"BMC Geriatr."},{"key":"ref33","doi-asserted-by":"publisher","first-page":"1340","DOI":"10.1249\/MSS.0000000000001945","article-title":"Physical activity promotion: highlights from the 2018 physical activity guidelines advisory committee systematic review","volume":"51","author":"King","year":"2019","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref34","doi-asserted-by":"publisher","first-page":"940","DOI":"10.1016\/j.jamda.2015.06.025","article-title":"Prevalence of frailty in nursing homes: a systematic review and meta-analysis","volume":"16","author":"Kojima","year":"2015","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref35","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1186\/s12877-020-01795-2","article-title":"The role and attitude of senior leaders in promoting group-based community physical activity: a qualitative study","volume":"20","author":"Komatsu","year":"2020","journal-title":"BMC Geriatr."},{"key":"ref36","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1093\/geronb\/gbs069","article-title":"Benefits of physical exercise training on cognition and quality of life in frail older adults","volume":"68","author":"Langlois","year":"2013","journal-title":"J. Gerontol. Ser. B Psychol. Sci. Soc. Sci."},{"key":"ref37","doi-asserted-by":"publisher","first-page":"e947105","DOI":"10.12659\/MSM.947105","article-title":"Effects of remote exercise on physical function in pre-frail older adults: a randomized controlled trial","volume":"31","author":"Lee","year":"2024","journal-title":"Med. Sci. Monit."},{"key":"ref38","doi-asserted-by":"publisher","first-page":"1795","DOI":"10.1111\/jocn.16196","article-title":"Effects of multicomponent exercise on the muscle strength, muscle endurance and balance of frail older adults: a meta-analysis of randomised controlled trials","volume":"32","author":"Li","year":"2023","journal-title":"J. Clin. Nurs."},{"key":"ref39","doi-asserted-by":"publisher","first-page":"589","DOI":"10.1186\/s12877-024-05150-7","article-title":"Community-based exercises improve health status in pre-frail older adults: a systematic review with meta-analysis","volume":"24","author":"Lim","year":"2024","journal-title":"BMC Geriatr."},{"key":"ref40","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1007\/s12603-022-1745-4","article-title":"The effects of an integrated exercise intervention on the attenuation of frailty in elderly nursing homes: a cluster randomized controlled trail","volume":"26","author":"Liu","year":"2022","journal-title":"J. Nutr. Health Aging"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"1439","DOI":"10.1152\/japplphysiol.00174.2013","article-title":"Eccentric exercise in aging and diseased skeletal muscle: good or bad?","volume":"116","author":"Lovering","year":"2014","journal-title":"J. Appl. Physiol."},{"key":"ref42","doi-asserted-by":"publisher","first-page":"172","DOI":"10.14306\/renhyd.18.3.114","article-title":"\u00cdtems de referencia para publicar revisiones sistem\u00e1ticas y metaan\u00e1lisis: La declaraci\u00f3n PRISMA","volume":"18","author":"Moher","year":"2014","journal-title":"Rev. Esp. Nutr. Hum. Diet."},{"key":"ref43","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1016\/j.archger.2019.05.003","article-title":"The effects of different types of physical exercise on physical and cognitive function in frail institutionalized older adults with mild to moderate cognitive impairment. A randomized controlled trial","volume":"83","author":"Mollinedo Cardalda","year":"2019","journal-title":"Arch. Gerontol. Geriatr."},{"key":"ref44","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1007\/s40279-020-01361-1","article-title":"Frailty and physical fitness in elderly people: a systematic review and meta-analysis","volume":"51","author":"Navarrete-Villanueva","year":"2021","journal-title":"Sports Med."},{"key":"ref45","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1016\/j.gerinurse.2022.10.014","article-title":"The effectiveness of a group-based Otago exercise program on physical function, frailty and health status in older nursing home residents: a systematic review and meta-analysis","volume":"49","author":"Peng","year":"2023","journal-title":"Geriatr. Nurs."},{"key":"ref46","doi-asserted-by":"publisher","first-page":"2020","DOI":"10.1001\/jama.2018.14854","article-title":"The physical activity guidelines for americans","volume":"320","author":"Piercy","year":"2018","journal-title":"JAMA"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"438","DOI":"10.1093\/geront\/gnx041","article-title":"The impact of the physical environment on depressive symptoms of older residents living in care homes: a mixed methods study","volume":"58","author":"Potter","year":"2018","journal-title":"Gerontologist"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1123\/japa.2018-0436","article-title":"Physical exercise training improves quality of life in healthy older adults: a Meta-analysis","volume":"28","author":"Raafs","year":"2020","journal-title":"J. Aging Phys. Act."},{"key":"ref49","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1186\/s12877-020-01847-7","article-title":"Impact of morbidity on care need increase and mortality in nursing homes: a retrospective longitudinal study using administrative claims data","volume":"20","author":"Reber","year":"2020","journal-title":"BMC Geriatr."},{"key":"ref50","doi-asserted-by":"publisher","first-page":"2642","DOI":"10.1001\/jama.299.22.2642","article-title":"Effect of bright light and melatonin on cognitive and noncognitive function in elderly residents of group care facilities: a randomized controlled trial","volume":"299","author":"Riemersma-van der Lek","year":"2008","journal-title":"JAMA"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"1668","DOI":"10.1093\/gerona\/glx259","article-title":"Effects of a primary care-based multifactorial intervention on physical and cognitive function in frail, elderly individuals: a randomized controlled trial","volume":"73","author":"Romera-Liebana","year":"2018","journal-title":"J. Gerontol. A Biol. Sci. Med. Sci."},{"key":"ref52","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1097\/MRR.0000000000000285","article-title":"Effect of low-intensity versus high-intensity resistance training on the functioning of the institutionalized frail elderly","volume":"41","author":"Sahin","year":"2018","journal-title":"Int. J. Rehabil. Res."},{"key":"ref53","doi-asserted-by":"publisher","first-page":"639","DOI":"10.1210\/jc.2009-1251","article-title":"Effects of testosterone on muscle strength, physical function, body composition, and quality of life in intermediate-frail and frail elderly men: a randomized, double-blind, placebo-controlled study","volume":"95","author":"Srinivas-Shankar","year":"2010","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref54","doi-asserted-by":"publisher","first-page":"364","DOI":"10.1123\/japa.2021-0130","article-title":"A randomized controlled feasibility trial evaluating a resistance training intervention with frail older adults in residential care: the keeping active in residential elderly trial","volume":"30","author":"Swales","year":"2022","journal-title":"J. Aging Phys. Act."},{"key":"ref55","doi-asserted-by":"publisher","first-page":"438","DOI":"10.1007\/s12603-023-1928-7","article-title":"Impact of exercise and cognitive stimulation therapy on physical function, cognition and muscle mass in pre-frail older adults in the primary care setting: a cluster randomized controlled trial","volume":"27","author":"Tan","year":"2023","journal-title":"J. Nutr. Health Aging"},{"key":"ref56","doi-asserted-by":"publisher","first-page":"720","DOI":"10.1016\/j.jamda.2012.07.005","article-title":"Protein supplementation improves physical performance in frail elderly people: a randomized, double-blind, placebo-controlled trial","volume":"13","author":"Tieland","year":"2012","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref57","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1016\/S0140-6736(13)60649-2","article-title":"Exercise for depression in elderly residents of care homes: a cluster-randomised controlled trial","volume":"382","author":"Underwood","year":"2013","journal-title":"Lancet"},{"key":"ref58","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1007\/BF03344799","article-title":"Calo ponderale, esercizio o entrambi ed efficienza fisica in soggetti anziani obesi","volume":"12","author":"Villareal","year":"2011","journal-title":"L'Endocrinologo"},{"key":"ref59","doi-asserted-by":"publisher","first-page":"4481","DOI":"10.1210\/jcem.85.12.7021","article-title":"The response of muscle protein anabolism to combined hyperaminoacidemia and glucose-induced hyperinsulinemia is impaired in the elderly1","volume":"85","author":"Volpi","year":"2000","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref60","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1123\/japa.2020-0400","article-title":"Psychological effects of whole-body vibration training in frail older adults: an open, randomized control trial","volume":"30","author":"Wadsworth","year":"2022","journal-title":"J. Aging Phys. Act."},{"key":"ref61","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1186\/s12877-025-05885-x","article-title":"Effects of protein supplementation on muscle mass, muscle strength, and physical performance in older adults with physical inactivity: a systematic review and meta-analysis","volume":"25","author":"Zhang","year":"2025","journal-title":"BMC Geriatr."},{"key":"ref62","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1016\/j.gerinurse.2019.10.006","article-title":"Exercise interventions for improving physical function, daily living activities and quality of life in community-dwelling frail older adults: a systematic review and meta-analysis of randomized controlled trials","volume":"41","author":"Zhang","year":"2020","journal-title":"Geriatr. Nurs."},{"key":"ref63","doi-asserted-by":"publisher","first-page":"105397","DOI":"10.1016\/j.jamda.2024.105397","article-title":"Effects of virtual reality\u2013based activities of daily living rehabilitation training in older adults with cognitive frailty and activities of daily living impairments: a randomized controlled trial","volume":"26","author":"Zheng","year":"2025","journal-title":"J. Am. Med. Dir. Assoc."}],"container-title":["Frontiers in Psychology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2025.1679734\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T13:15:10Z","timestamp":1757078110000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2025.1679734\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,5]]},"references-count":63,"alternative-id":["10.3389\/fpsyg.2025.1679734"],"URL":"https:\/\/doi.org\/10.3389\/fpsyg.2025.1679734","relation":{},"ISSN":["1664-1078"],"issn-type":[{"value":"1664-1078","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,5]]},"article-number":"1679734"}}