TOPLINE:

Older adults with limited resources who participated in a 24-week intervention to manage frailty survived longer, had lower eligibility for long-term care insurance over 66 months, and saved over eight times the program cost.

METHODOLOGY:

• Researchers evaluated whether a comprehensive intervention for frailty improved health outcomes and reduced healthcare costs among older adults in rural Korea.
• They conducted a post hoc analysis of data from a nonrandomized clinical trial that included adults aged 65 years or older who were socioeconomically disadvantaged and lived alone or received medical aid between August 2015 and January 2017.
• A total of 119 older adults who participated in the intervention were propensity-score matched with an equal number of those who refused to participate and received usual care (overall, 68.9% aged 75 years or older; 74.4% women).
• The 24-week intervention included structured exercise sessions twice a week, provided nutritional supplements and depression care, deprescribed unnecessary medicines, and reduced hazards at home.
• The outcome was a composite of all-cause mortality and eligibility for long-term care insurance over 66 months. Cost outcomes included cumulative costs of using health services and cost-to-benefit ratios.

TAKEAWAY:

• At 66 months, participants of the intervention survived 6.53 months longer without experiencing the composite outcome than nonparticipants (P = .01).
• Participants saved $3390 per person in cumulative costs of using health services by 30 months (P = .008), which increased to $7688 by 66 months (P = .01).
• The intervention cost $872 per participant and yielded a 3.89-fold return on investment at 30 months and an 8.82-fold return at 66 months.
• Initial savings were mainly from reduced medical costs (57.9%). By 66 months, most of the savings came from reduced costs of long-term care (66.1%).

IN PRACTICE:

“[The study] findings support the broader implementation of frailty-targeted interventions, particularly when formulating healthcare policies for aging populations in resource-limited settings,” the authors of the study wrote.

SOURCE:

This study was led by Sunghwan Ji, MD, MS, of Asan Medical Center at University of Ulsan College of Medicine in Seoul, South Korea. It was published online on November 12, 2025, in JAMA Network Open.

LIMITATIONS:

This nonrandomized study involved individuals who refused to participate as control participants, which may have introduced selection bias. The results may apply only to individuals included after propensity-score matching. The sample size was relatively small.

DISCLOSURES:

This study received support from the Korean Geriatric Society, the Ministry of Health and Welfare of the Republic of Korea, and the Asan Institute for Life Sciences. Nutritional supplements used in the original study were provided free of cost by Maeil Dairies Co. One author reported receiving grants from one of the funding agencies. Another author reported receiving personal fees from Maeil Dairies Co. and grants from the funding agencies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.