Frailty Prevention and Reversal: Trials, Implementation, and Real-World Outcomes

Frailty is a major driver of falls, fractures, disability, poor recovery after illness or surgery, and loss of independence in older adults. It sits at the intersection of musculoskeletal aging, sarcopenia, multimorbidity, impaired tissue repair, and functional decline. While strong evidence supports frailty prevention and improvement—especially through exercise, rehabilitation, nutrition support, and coordinated multidisciplinary care—translation into routine clinical pathways and community programs remains uneven. Real-world barriers such as limited workforce capacity, variable adherence, access inequities, comorbidity burden, and fragmented care pathways often determine whether an intervention succeeds outside controlled trials.This Research Topic will focus on frailty prevention and reversal with an emphasis on (1) pragmatic evidence and implementation, and (2) intervention engineering and translational strategies that improve function and resilience in real-world settings. We welcome submissions that connect biological or technology-enabled advances in recovery and regeneration to measurable outcomes that matter to patients and health systems—helping move frailty care from “effective in theory” to “workable at scale.”We welcome pragmatic and hybrid effectiveness–implementation trials, real-world evaluations, quality improvement initiatives, and health services research that test scalable models for identifying and managing frailty in settings such as primary care, orthopedic and fracture liaison services, rehabilitation, perioperative care, long-term care, and community programs. Priority areas include multicomponent exercise and progressive resistance training delivered at scale; prehabilitation and perioperative pathways for older adults at risk of poor surgical outcomes; post-acute and community reablement models; integrated falls prevention linked to strength, balance, and mobility; and team-based care that includes physiotherapy, geriatrics, nutrition, pharmacy, and social care. In addition, we encourage translational and engineering-informed approaches that support functional recovery—such as biomaterials- or device-enabled rehabilitation, strategies that enhance tissue repair and homeostasis, and interventions designed to improve durability of response and repeatability in real-world care.We particularly encourage studies that report implementation outcomes (reach, adoption, fidelity, sustainability), patient-centered outcomes (function, mobility, ADLs, quality of life, pain, fatigue), and system outcomes (hospitalizations, institutionalization, health care use, and cost-effectiveness). Work addressing equity, access, and culturally adapted delivery—including digital, home-based, and remote models—is strongly encouraged.By centering on “what works, for whom, and in which real-world contexts,” this Research Topic aims to strengthen the evidence base for scalable frailty prevention and reversal strategies that preserve musculoskeletal function, improve recovery capacity, and support healthy aging. Topic editors: Sashank Reddy Source: https://www.frontiersin.org/research-topics/77566/frailty-prevention-and-reversal-trials-implementation-and-real-world-outcomes