A multicentre randomised trial found that a three-week supervised, individualised, multimodal prehabilitation programme did not reduce care dependency at 12 months in older adults with frailty or prefrailty undergoing elective surgery. The authors conclude that short-duration supervised prehabilitation should not serve as a universal preoperative pathway, and that longer, behaviour-change-oriented interventions with better engagement warrant priority.
Key Points
- Three-week prehabilitation failed to reduce 12-month care dependency after surgery
- Supervised short programmes not recommended as universal preoperative pathway
- Longer behaviour-change interventions and responsive subgroups identified as priorities
Longevity Analysis
Functional reserve in frail older adults is built over months and years, not compressed into the weeks before a scheduled operation — a duration problem as much as a content problem. The result reframes preoperative conditioning as a question of sustained adherence and physiological adaptation across muscle, circulatory capacity, and recovery capacity, rather than a discrete clinical intervention delivered on a surgical timeline. It also sharpens the case for identifying which patients retain the adaptive headroom to respond, instead of applying a single protocol across a heterogeneous frail population.
Original published by The Lancet Healthy Longevity, by Claudia Spies, Katrin Schmidt, Jörn Kiselev, Stefan Buchka, Manfred Blobner, Friedrich Borchers, Maria Fabian, Verena Loidl, Ursula Marschall, Rudolf Mörgeli, Carla Nau, Mareike Otto, Tanja Rombey, Thomas Saller, Mareike Schulz, Sascha Treskatsch, Reinhard Busse, Ulrich Mansmann, Stefan J Schaller, PRAEP-GO consortium and PRAEP-GO investigators.