Interventions to minimise, reverse or prevent the progression of frailty in older adults represent a potentially viable route to improving quality of life and care needs in older adults. Intervention methods used across European Innovation Partnership on Active and Healthy Ageing collaborators were analysed, along with findings from literature reviews to determine ‘what works for whom in what circumstances’. A realist review of FOCUS study literature reviews, ‘real-world’ studies and grey literature was conducted according to RAMESES (Realist and Meta-narrative Evidence Synthesis: Evolving Standards), and used to populate a framework analysis of theories of why frailty interventions worked, and theories of why frailty interventions did not work. Factors were distilled into mechanisms deriving from theories of causes of frailty, management of frailty and those based on the intervention process. We found that studies based on resolution of a deficiency in an older adult were only successful when there was indeed a deficiency. Client-centred interventions worked well when they had a theoretical grounding in health psychology and offered choice over intervention elements. Healthcare organisational interventions were found to have an impact on success when they were sufficiently different from usual care. Compelling evidence for the reduction of frailty came from physical exercise, or multicomponent (exercise, cognitive, nutrition, social) interventions in group settings. The group context appears to improve participants’ commitment and adherence to the programme. Suggested mechanisms included commitment to co-participants, enjoyment and social interaction. In conclusion, initial frailty levels, presence or absence of specific deficits, and full person and organisational contexts should be included as components of intervention design. Strategies to enhance social and psychological aspects should be included even in physically focused interventions.

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现实主义者的评论，旨在了解旨在最小化，逆转或预防脆弱发展的干预措施的功效和结果

尽量减少，逆转或预防老年人的脆弱发展的干预措施是改善老年人的生活质量和护理需求的潜在可行途径。分析了欧洲创新合作伙伴针对活跃和健康的衰老合作伙伴使用的干预方法，以及文献综述的发现，以确定“在什么情况下对谁有效”。对FOCUS的现实主义评论研究文献评论，“现实世界”研究和灰色文献是根据RAMESES（现实主义和元叙事证据综合：不断发展的标准）进行的，并用于填充对脆弱干预为何起作用的理论以及其原因的框架分析虚弱的干预行不通。从脆弱原因的理论，脆弱管理的理论以及基于干预过程的理论中，将因素提炼成各种机制。我们发现，只有在确实存在缺陷的情况下，基于解决老年人缺陷的研究才能成功。以客户为中心的干预措施具有健康心理学的理论基础，并且可以选择干预因素，因此效果很好。当医疗保健组织干预与常规护理有很大不同时，就会发现它们会对成功产生影响。减少体弱的有力证据来自体育锻炼或小组环境中的多成分（运动，认知，营养，社会）干预。小组背景似乎可以提高参与者对计划的承诺和遵守程度。建议的机制包括对共同参与者的承诺，享受和社会互动。总之，应将最初的身体虚弱水平，是否存在特定缺陷以及个人和组织的完整背景作为干预措施设计的组成部分。甚至在以身体为重点的干预措施中，也应包括增强社会和心理方面的策略。减少体弱的有力证据来自体育锻炼或小组环境中的多成分（运动，认知，营养，社会）干预。小组背景似乎可以提高参与者对计划的承诺和遵守程度。建议的机制包括对共同参与者的承诺，享受和社会互动。总之，应将最初的身体虚弱水平，是否存在特定缺陷以及个人和组织的完整背景作为干预措施设计的组成部分。甚至在以身体为重点的干预措施中，也应包括增强社会和心理方面的策略。减少体弱的有力证据来自体育锻炼或小组环境中的多成分（运动，认知，营养，社会）干预。小组背景似乎可以提高参与者对计划的承诺和遵守程度。建议的机制包括对共同参与者的承诺，享受和社会互动。总之，应将最初的身体虚弱水平，是否存在特定缺陷以及个人和组织的完整背景作为干预措施设计的组成部分。甚至在以身体为重点的干预措施中，也应包括增强社会和心理方面的策略。小组背景似乎可以提高参与者对计划的承诺和遵守程度。建议的机制包括对共同参与者的承诺，享受和社会互动。总之，应将最初的身体虚弱水平，是否存在特定缺陷以及个人和组织的完整背景作为干预措施设计的组成部分。甚至在以身体为重点的干预措施中，也应包括增强社会和心理方面的策略。小组背景似乎可以提高参与者对计划的承诺和遵守程度。建议的机制包括对共同参与者的承诺，享受和社会互动。总之，应将最初的身体虚弱水平，是否存在特定缺陷以及个人和组织的完整背景作为干预措施设计的组成部分。甚至在以身体为重点的干预措施中，也应包括增强社会和心理方面的策略。