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Healthcare
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Challenges and Interventions for Frailty Among Community-Dwelling Older Adults
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Challenges and Interventions for Frailty Among Community-Dwelling Older Adults

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Public Health and Preventive Medicine".

Deadline for manuscript submissions: 31 December 2026 | Viewed by 1552

Editor

Prof. Dr. David Conde-Caballero

E-Mail Website
Guest Editor
Department of Nursing, University of Extremadura, 10003 Cáceres, Spain
Interests: food; culture; health; aging; demographic challenge

Special Issue Information

Dear Colleagues,

Frailty is a complex and multifaceted syndrome that poses significant challenges for healthcare systems, professionals, and caregivers, and this Special Issue seeks to explore the phenomenon of frailty among community-dwelling older adults from an interdisciplinary perspective, integrating insights from medicine, nursing, social work, social sciences, psychology, public health, and related fields. Despite increasing research attention, frailty remains a difficult condition to define, detect, and prevent. Its dynamic nature, heterogeneity, and interaction with social and environmental determinants demand a broad and open approach. This Special Issue aims to gather together contributions that deepen our understanding of frailty’s underlying mechanisms, risk factors, early identification strategies, and interventions at both individual and community levels. We welcome original research articles, reviews, and case studies that address frailty not only as a biomedical condition but also as a social and psychological challenge.

Topics of interest include—but are not limited to—preventive strategies, integrated care models, health disparities, technological innovations, and ethical considerations in the care of older adults at risk of frailty.

Prof. Dr. David Conde-Caballero
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • frailty
  • older adults
  • interdisciplinary approach
  • preventive strategies
  • integrated care

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Published Papers (3 papers)

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Research

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12 pages, 424 KB  
Article
Preliminary Psychometric Evaluation of the Economic Living Standards Index Short Form (ELSI-SF) Among Spanish Older Adults
by Celia Álvarez-Bueno, María Eugenia Visier-Alfonso, Mar de Miguel-Brox, Blanca Zuheros-Lara, María Frontelo-García and Beatriz Rodríguez-Martín
Healthcare 2026, 14(17), 2673; https://doi.org/10.3390/healthcare14172673 (registering DOI) - 22 Aug 2026
Abstract
Objective: To examine the reliability, construct validity, and discriminative capacity of the Spanish version of the Economic Living Standards Index Short Form (ELSISF) in a sample of older adults in Spain. Methods: This analysis was conducted using baseline data from 133 [...] Read more.
Objective: To examine the reliability, construct validity, and discriminative capacity of the Spanish version of the Economic Living Standards Index Short Form (ELSISF) in a sample of older adults in Spain. Methods: This analysis was conducted using baseline data from 133 participants (mean age = 66.2 years, SD = 5.6; 53.8% women) recruited from community health and social centers in the provinces of Cuenca, Albacete, and Toledo within the PEPE cohort. Participants completed the ELSISF (25 items), sociodemographic measures, the SF-12 Health Survey, and the International Fitness Scale (IFIS). Internal consistency was assessed using Cronbach’s alpha. Convergent validity was examined through correlations between ELSISF scores and education, occupation, physical and mental health, and perceived fitness. Discriminative ability for health-related variables was analyzed using ANOVA and partial η2. The internal structure was explored using exploratory factor analysis (EFA) and subsequently examined against the original four-factor theoretical model using confirmatory factor analysis (CFA), based on polychoric correlations and estimation methods appropriate for ordinal data. Results: The mean ELSISF score was 23.0 ± 3.9, with most participants classified as having comfortable or good living standards. Internal consistency was acceptable for the total scale (α = 0.779), whereas the ownership restrictions (α = 0.441) and self-rating (α = 0.319) subscales showed low reliability. Significant associations were observed between the ELSISF total score and selected socioeconomic and health-related measures. Factor-analytic findings provided only partial support for the original four-domain structure. Although CFA showed favorable CFI, TLI, and RMSEA values, the elevated SRMR and instability of the self-rating factor warrant cautious interpretation of the factorial solution. Conclusions: The Spanish ELSISF provides preliminary psychometric evidence supporting the use of its total score among relatively socioeconomically advantaged older adults. However, limitations in subscale reliability, factorial stability, and the restricted socioeconomic variability of the sample preclude definitive validation across the full spectrum of material living standards. Further evaluation in larger, independent, and more socioeconomically heterogeneous samples, particularly including older adults experiencing material deprivation, is required. Full article
(This article belongs to the Special Issue Challenges and Interventions for Frailty Among Community-Dwelling Older Adults)
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15 pages, 260 KB  
Article
Clinical Blindness to Eating Disorders in Older Adults: A Qualitative Study of Primary Care Nurses’ Perspectives
by Adriana V. Muñoz-Ortega, Lorenzo Mariano Juárez, Mikaela Willmer, Paula Conroy, Maria Engström and David Conde Caballero
Healthcare 2026, 14(16), 2586; https://doi.org/10.3390/healthcare14162586 - 17 Aug 2026
Viewed by 115
Abstract
Background/Objectives: Eating disorders (EDs) have historically been associated with young women, and their presence in older adults remains poorly recognized despite evidence that they can persist, recur, or emerge in later life. Primary care nurses are strategically positioned for community-based detection, yet [...] Read more.
Background/Objectives: Eating disorders (EDs) have historically been associated with young women, and their presence in older adults remains poorly recognized despite evidence that they can persist, recur, or emerge in later life. Primary care nurses are strategically positioned for community-based detection, yet their perspective has been scarcely explored. This study aimed to examine the experiences, perceptions, and described practices of primary care nurses regarding EDs and disordered eating in older adults, identifying patterns, barriers to detection, and training needs. Methods: A qualitative study with a descriptive design was conducted in three Primary Health Care Centers from different health areas of Spain. Thirty-two registered practicing nurses participated in three focus groups, guided by a clinical vignette and a semi-structured interview guide. Data were analyzed following Braun and Clarke’s reflexive thematic analysis, supported by ATLAS.ti software (version 24.2, 2024). Results: EDs in older adults frequently remained invisible to professionals, sustained by three interrelated mechanisms: the cultural hegemony of the biomedical paradigm, which reframes symptoms as organic or cognitive; a selective historicization that attributes altered eating to the postwar “hunger years”; and an “ageism of care” that normalizes warning signs as expected features of aging. Notably, when the diagnostic possibility was explicitly named, participants retrospectively reinterpreted cases they had previously explained in other terms. Conclusions: This invisibility stems not from an absence of clinical signs, but from professional, cultural, and institutional interpretive frameworks. Findings underscore the need for specific training, adapted screening tools, and a critical perspective on ageism in nursing practice. Full article
(This article belongs to the Special Issue Challenges and Interventions for Frailty Among Community-Dwelling Older Adults)

Other

Jump to: Research

17 pages, 839 KB  
Systematic Review
Person-Centered Health Intervention Programs Provided at Home to Older Adults with Multimorbidities and Their Caregivers: A Systematic Review
by Vânia Nascimento, Mauro G. Lopes, Miguel M. Leitão, César Fonseca, Elisabete Alves, Isabel Bico and Lara Guedes de Pinho
Healthcare 2026, 14(6), 815; https://doi.org/10.3390/healthcare14060815 - 22 Mar 2026
Viewed by 956
Abstract
There is a high rate of morbidity and considerable functional dependence in older adults, requiring care from informal caregivers. Person-centered care is a personalized approach that meets the person’s needs, taking their context into account. Objectives: Our aim was to assess the available [...] Read more.
There is a high rate of morbidity and considerable functional dependence in older adults, requiring care from informal caregivers. Person-centered care is a personalized approach that meets the person’s needs, taking their context into account. Objectives: Our aim was to assess the available evidence on Person-Centered Health Intervention Programs (PCHCIPs) in a home setting among older adults with multimorbidity and their informal caregivers, namely regarding their main characteristics and respective health outcomes. Methods: A systematic literature review was conducted in accordance with the PRISMA guidelines. Bibliographic searches were performed in five databases (CINAHL, MEDLINE, MedicLatina, Scopus, and Psychology and Behavioral Sciences Collection) in November 2024, including studies published between January 2014 and November 2024. Inclusion criteria: Randomized Controlled Trials of person-centered health intervention programs delivered to older adults and their caregivers in home care settings, and scientific articles published betweeen 2014 and 2024. The review protocol was registered in PROSPERO (registration number: CRD42022303687. Results: Twelve articles were included (n = 12). The PCHCIPs provides psychoeducational training and empowerment with physical, psychological, and social interventions that result in health outcomes for the dependent older adults (decreased health-related events and increased social involvement), for the caregiver (improved QoL, reduced burden), and for both participants (increased life satisfaction and reduced costs in health). Conclusions: PCHCIPs covering different areas of intervention (physical, psychosocial and economic) demonstrate positive health outcomes for older adults and their caregivers. It is important to explore more programs that encompass both participants. Full article
(This article belongs to the Special Issue Challenges and Interventions for Frailty Among Community-Dwelling Older Adults)
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