Prehabilitation Cuts Postsurgical Disability in Older Adults With Frailty

THURSDAY, Dec. 11, 2025 (HealthDay News) — Prehabilitation can reduce disability after surgery in older adults with frailty, according to a study published online Dec. 3 in JAMA Surgery.

Daniel I. McIsaac, M.D., from University of Ottawa in Ontario, Canada, and colleagues evaluated the effectiveness of offering coach-supported, home-based prehabilitation to older surgical patients with frailty. The analysis included 705 participants 60 years and older with frailty who underwent planned surgery and were assigned to either home-based prehabilitation focused on exercise and nutrition for at least three weeks before surgery (353 patients) or usual care (352 patients).

The researchers found that participants assigned to prehabilitation reported a mean postoperative disability score of 23.5 versus 24.7 for usual care (adjusted mean difference, −1.4; 97.5 percent confidence interval [CI], −4.9 to 2.0; P = 0.36). Complications were similar between the two groups (50.1 versus 47.7 percent; adjusted odds ratio, 1.05; 97.5% CI, 0.73 to 1.49; P = 0.78). Among prehabilitation participants completing >75 percent of prescribed exercises, disability scores were significantly lower (mean difference, −4.9; 97.5 percent CI, −9.8 to −0.01; P = 0.02). However, there was no significant difference in complications (odds ratio, 1.06; 97.5 percent CI, 0.67 to 1.67; P = 0.79). Competing priorities and motivation were the primary barriers to adherence.

“This study shows that older adults with frailty who have enough time before surgery, along with the internal and external support to fully engage in a prehab program, are likely to experience a better recovery and less disability after surgery,” McIsaac said in a statement. “The study also shows that we need to continue to optimize and integrate prehab programs so that everyone can fully participate and ultimately benefit.”

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