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Preventing Frailty and Improving Quality of Life in Older Adults:...
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Preventing Frailty and Improving Quality of Life in Older Adults: Perspectives on Exercise and Nutrition Medicine

A special issue of Healthcare (ISSN 2227-9032).

Deadline for manuscript submissions: 31 July 2026 | Viewed by 7427

Special Issue Editor

Prof. Dr. Jerónimo González-Bernal

E-Mail Website
Guest Editor
Department of Health Sciences, University of Burgos, 09001 Burgos, Spain
Interests: disabilities; neurology (neuroscience); pediatrics; sports medicine; telemedicine; applied psychology; geriatrics
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Frailty in older adults is now recognized as a complex geriatric syndrome that significantly affects quality of life, functionality, and the independence of older individuals. Its proper management represents one of the greatest challenges for modern healthcare systems due to its diverse clinical presentations and the high prevalence of associated comorbidities.

For this Special Issue, we are especially interested in receiving original research that addresses the assessment of frailty using different scales and methods across clinical, community, and residential settings, as well as within specific populations. Our aim is to gather evidence that will help us better understand the true scope and dimension of frailty across various environments and groups, identifying patterns, risk factors, and intervention strategies.

This Special Issue also places emphasis on the key role of nutrition and exercise medicine in the prevention and management of frailty. We invite the submission of research papers, systematic reviews, intervention studies, and clinical experiences that explore, from an interdisciplinary approach, the relationship between frailty and nutritional status—including malnutrition, sarcopenia, and nutrient intake—as well as the impact of physical exercise or rehabilitation on the prevention, reversal, or slowing of frailty.

The link between frailty and comorbidity will also be one of the central themes of this Special Issue, given that multimorbidity influences both the onset and evolution of frailty and is a fundamental aspect for comprehensive clinical management.

Therefore, we encourage the scientific community to submit studies—from clinical, applied, or basic research—that provide new insights into evaluation methods, mechanisms, modifiable factors, prevention and treatment strategies, or interventions based on exercise, nutrition, or both. Likewise, articles exploring related variables, such as quality of life, cognitive function, or psychosocial aspects linked to frailty, will be welcomed.

We hope that this Special Issue will become a reference point for updated knowledge and multidisciplinary discussion on frailty prevention in older adults, promoting the exchange of experiences, international collaboration, and the generation of new ideas for active and healthy aging.

I would like to thank in advance all potential authors for their interest and contributions, and I remain available for any additional queries or support you may need during the submission and peer review process.

Prof. Dr. Jerónimo González-Bernal
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-blind 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 assessment
  • frailty scale
  • nutrition and frailty
  • exercise medicine
  • sarcopenia
  • multimorbidity
  • malnutrition
  • rehabilitation interventions
  • quality of life
  • aging prevention

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Published Papers (3 papers)

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15 pages, 2530 KB  
Article
A Survey of Knowledge, Clinical Practice, and Barriers Related to Sarcopenia in Korean Physical Therapists: A Cross-Sectional Survey
by Jaehyun Lim, Byeonggeun Kim and Ahyoung Choi
Healthcare 2026, 14(7), 921; https://doi.org/10.3390/healthcare14070921 - 1 Apr 2026
Viewed by 731
Abstract
Background/Objectives: Rapid population aging has increased the need for effective sarcopenia management. Physical therapists are expected to play a key role in screening and intervention. This study aimed to assess sarcopenia awareness, current clinical practice, and barriers among Korean physical therapists to [...] Read more.
Background/Objectives: Rapid population aging has increased the need for effective sarcopenia management. Physical therapists are expected to play a key role in screening and intervention. This study aimed to assess sarcopenia awareness, current clinical practice, and barriers among Korean physical therapists to inform future education and policy improvements. Methods: A cross-sectional survey was conducted in Korea from 14 August to 31 December 2025. The questionnaire was developed through a two-step process, including a qualitative survey and cognitive interviews with physical therapists, and consisted of items on demographics, sarcopenia knowledge, screening, treatment, and care environment factors. Results: A total of 236 participants were included in the analysis. Although awareness of sarcopenia was high, implementation in clinical practice remained limited. Most participants were familiar with sarcopenia and considered it important in patient management, yet only 16.9% reported screening for sarcopenia and 23.7% reported providing treatment. Among those who performed screening, half were unsure which guideline was being followed. Resistance exercise was the most commonly used intervention, whereas nutritional support was the most frequently identified additional need. Collaboration with nutrition professionals was rare, and fewer than half reported team-based treatment. The main barriers were lack of knowledge, lack of workplace training, and limited exposure to internal sarcopenia-related education. Conclusions: Despite high awareness, sarcopenia-related practice among Korean physical therapists remained limited. These findings highlight the need for standardized screening and treatment guidelines, structured continuing education programs, workplace-based training opportunities, and reimbursement policies that support routine sarcopenia screening and management. Full article
(This article belongs to the Special Issue Preventing Frailty and Improving Quality of Life in Older Adults: Perspectives on Exercise and Nutrition Medicine)
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15 pages, 603 KB  
Article
Loneliness and Its Association with Depression, Aspiration Risk, and Conversation in Japanese Older Adults
by Naoki Maki, Hitomi Matsuda, Sachie Eto, Akihiro Araki, Toshifumi Takao and Thomas Mayers
Healthcare 2026, 14(2), 190; https://doi.org/10.3390/healthcare14020190 - 12 Jan 2026
Viewed by 1082
Abstract
Background/Objectives: Loneliness is a critical public health concern associated with adverse mental and physical health outcomes in later life. However, few large-scale studies have examined loneliness in relation to depression, aspiration risk, frailty, and social participation among Japanese older adults. This study examined [...] Read more.
Background/Objectives: Loneliness is a critical public health concern associated with adverse mental and physical health outcomes in later life. However, few large-scale studies have examined loneliness in relation to depression, aspiration risk, frailty, and social participation among Japanese older adults. This study examined associations between loneliness and psychosocial and health-related factors among older adults. Methods: This cross-sectional study involved a secondary analysis of data obtained from online surveys conducted in 2018 and 2021 among 1000 community-dwelling Japanese adults (≥65 years). Loneliness was assessed using the UCLA Loneliness Scale Version 3 and dichotomized at the median to define a high-loneliness group. Depressive symptoms, aspiration risk, frailty, conversation frequency, and volunteering participation were assessed using validated scales. Multivariable logistic regression was used to identify factors associated with loneliness and interaction terms were examined to assess effect modification. Results: High loneliness was observed in 52.2% of participants. Greater loneliness was significantly associated with depressive symptoms (GDS ≥ 5; OR = 4.69, 95% CI: 2.84–7.76), higher dysphagia risk (DRACE score; OR = 1.08, 95% CI: 1.00–1.16), and lower daily conversation frequency (OR = 0.76, 95% CI: 0.67–0.86); however, volunteering (OR = 0.475, 95% CI: 0.23–0.87) was a protective factor. Conclusions: Loneliness among Japanese older adults is closely linked to depressive symptoms and aspiration risk, while frequent conversations and volunteer participation appear to be protective. Community-based interventions promoting social engagement and oral health may mitigate loneliness and its health consequences and improve quality of life for older adults. Given the cross-sectional design, the observed associations should not be interpreted as causal. Full article
(This article belongs to the Special Issue Preventing Frailty and Improving Quality of Life in Older Adults: Perspectives on Exercise and Nutrition Medicine)
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15 pages, 1040 KB  
Systematic Review
Heat Tolerance in Older Adults: A Systematic Review of Thermoregulation, Vulnerability, Environmental Change, and Health Outcomes
by Sandra Núñez-Rodríguez, Carla Collazo-Riobó, Javier Sedano, Ana Isabel Sánchez-Iglesias and Josefa González-Santos
Healthcare 2025, 13(21), 2785; https://doi.org/10.3390/healthcare13212785 - 3 Nov 2025
Cited by 15 | Viewed by 5055
Abstract
Background: Exposure to heat is a growing health concern in the context of climate change. Older adults (people aged 600 years or older) are particularly vulnerable due to age-related physiological changes that compromise thermoregulation. Objective: To systematically review the evidence on thermoregulatory alterations [...] Read more.
Background: Exposure to heat is a growing health concern in the context of climate change. Older adults (people aged 600 years or older) are particularly vulnerable due to age-related physiological changes that compromise thermoregulation. Objective: To systematically review the evidence on thermoregulatory alterations in older adults exposed to heat and their association with adverse clinical outcomes. Methods: Following PRISMA guidelines, a systematic search was conducted in PubMed, Web of Science, ScienceDirect, and Scopus. Twenty-four original studies met the inclusion criteria, including experimental studies in controlled environments and epidemiological studies on heat-related outcomes. Data on study characteristics, thermophysiological responses, clinical outcomes, and methodological quality (assessed with JBI tools) were extracted and synthesized. Results: Experimental studies showed that older adults exhibit reduced sweating and cutaneous vasodilation, attenuated cardiovascular and autonomic adjustments, impaired hydration status, and altered thermal perception. These limitations resulted in greater heat storage, faster increases in core temperature, and a higher risk of dehydration and fatigue compared with younger adults. Epidemiological evidence confirmed a significant association between high ambient temperatures and increased hospitalizations and mortality among older populations, particularly at advanced ages, in women, and in those with comorbidities or socioeconomic vulnerability. Conclusions: Heat exposure and climatic conditions—particularly high ambient temperatures, humidity, and poor air quality—reduce thermoregulatory efficiency and increase risks of dehydration, cardiovascular strain, and mortality in older adults. Integrated public health actions addressing both environmental and physiological factors are essential for preventing heat-related illness among older adults. Full article
(This article belongs to the Special Issue Preventing Frailty and Improving Quality of Life in Older Adults: Perspectives on Exercise and Nutrition Medicine)
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