Multicomponent nurse-led programmes integrating physical activity, nutrition, and psychosocial support appear most promising for frailty and functional outcomes, while low-intensity interventions show limited effectiveness, and no primary studies addressed nurse-led vaccination coaching.
Key Findings
Methods
Twenty-five primary studies were included in the scoping review, predominantly randomised or cluster-randomised trials across community, primary care, home care, and transitional care settings.
Databases searched included PubMed, Scopus, and Web of Science, restricted to English-language publications from the last 10 years.
The review followed JBI methodology and the PRISMA-ScR checklist.
Included studies targeted older adults aged 60 years or older.
Settings spanned community, home care, primary care, territorial, and long-term care environments.
Results
Nursing interventions mapped predominantly to Pillar 4 (frailty monitoring and prevention of functional decline) and Pillar 2 (physical activity and exercise support), with Pillar 1 (nutrition and immunonutrition support) less frequently represented.
Pillar 1 interventions, when present, were usually part of multicomponent programmes rather than standalone nursing interventions.
No primary studies were identified that specifically targeted Pillar 3 (nursing vaccination coaching).
The four-pillar conceptual framework organised interventions into: nursing nutrition and immunonutrition support, physical activity and exercise support, nursing vaccination coaching, and frailty monitoring and prevention of functional decline.
Results
Structured, multicomponent nurse-led programmes combining exercise with nutritional and psychosocial components showed the most consistent benefits on frailty, functional outcomes, and well-being.
Effectiveness appeared driven more by intervention intensity and integration than by frailty identification alone.
Multicomponent programmes integrating physical activity, nutrition, and psychosocial support were identified as most promising.
Benefits were observed across frailty status, functional outcomes, and well-being measures.
Results
Low-intensity preventive consultations and Comprehensive Geriatric Assessment (CGA)-based models often showed limited improvements over usual care.
CGA-based models were noted to frequently show limited improvements when compared to usual care conditions.
Low-intensity interventions were less effective regardless of whether they involved frailty identification.
This contrasted with higher-intensity multicomponent programmes that demonstrated more consistent clinical benefits.
Results
Nurse-led vaccination coaching represents an evidence gap, with no primary studies identified addressing this intervention pillar.
Despite vaccination being a key strategy related to immunosenescence in older adults, no primary studies on nurse-led vaccination coaching in community or primary care settings were found.
This absence was identified as a significant gap in the literature.
The review authors note this finding calls for future research specifically targeting nurse-led vaccination promotion.
Background
Immunosenescence is characterised by progressive decline in immune function and increased chronic inflammation ('inflammaging'), with clinical implications including frailty, functional decline, multimorbidity, and higher risk of adverse events in older adults.
Immunosenescence is described as 'a complex biological process associated with aging.'
The condition is linked to 'inflammaging,' defined as increased chronic inflammation accompanying immune decline.
Clinical correlates include frailty, functional decline, multimorbidity, and increased risk of adverse events.
Community and primary care nurses are described as playing 'a central role in preventive and health promotion interventions that may indirectly influence these processes.'
Conclusions
Future research should incorporate biological and immunological markers alongside clinical outcomes in studies of nurse-led interventions targeting immunosenescence.
Current included studies focused on clinical outcomes rather than biological or immunological markers of immunosenescence.
The authors identify the inclusion of such markers as a priority for future research.
This gap limits the ability to directly link nurse-led interventions to immunological mechanisms of aging.