Presentation (CTI)

OBJECTIVES: To evaluate the effectiveness of community-based and home-based interventions designed to promote healthy aging among older adults in low- and middle-income countries (LMICs). This review aimed to synthesize evidence from randomized controlled trials (RCTs) examining physical, mental, cognitive, and quality-of-life outcomes and to assess the potential of community-delivered programs to support aging populations in resource-constrained settings.
METHODS: We conducted a systematic review guided by PRISMA and registered in PROSPERO (CRD42021229765). Searches were performed in PubMed, EMBASE, Scopus, and CINAHL for RCTs published between 2001 and 2021. Eligible studies included adults aged ≥50 years in LMICs receiving community-based or home-based interventions such as physical activity programs, progressive muscle relaxation, cognitive-behavioral strategies, health education, or social support. Two reviewers independently screened and extracted data and assessed risk of bias using RoB-2. A narrative synthesis was used due to heterogeneity in intervention types and outcome measures.
RESULTS: A total of 10 RCTs from China (n=6), Brazil (n=2), Iran (n=1), and Turkey (n=1) met inclusion criteria. Interventions ranged from 8 weeks to 18 months and targeted outcomes such as quality of life (QOL), depression, anxiety, sleep, mobility, fatigue, and social support. Across trials, community- and home-based programs resulted in consistent improvements in QOL, reductions in depressive and anxiety symptoms, better sleep quality, enhanced physical activity, and improved psychosocial well-being compared with control groups. Evidence certainty was rated very low due to small sample sizes, heterogeneous outcomes, and risk of bias related to blinding and allocation processes.
CONCLUSIONS: Community-based and home-based interventions demonstrate potential to improve physical, psychological, and social dimensions of healthy aging in LMICs. Despite positive results, the certainty of evidence remains low, underscoring the need for larger, rigorously designed trials that evaluate long-term outcomes, cost-effectiveness, and implementation strategies. Strengthening community-delivered aging interventions may help reduce health system burdens and support aging populations in resource-limited settings.