Exercise and frailty in later life: A systematic review and bibliometric analysis of research themes and scientific collaborations
Exercise is a promising intervention for frailty, but optimal protocols and implementation approaches remain unclear. In this review, a bibliometric analysis was conducted to synthesize research growth, collaborations, intellectual structure, and gaps in the literature on frailty and exercise over the past two decades. The Web of Science and Scopus databases were searched for relevant publications from 1987 – 2024. The bibliometric analysis examined publication trends over time, contributing countries, institutions, authors, journals, research themes and hotspots, collaboration patterns, and evidence gaps. Data visualization and mapping were conducted using VOSviewer, Biblioshiny, and ScientoPy. A total of 447 publications were included in the analysis. The results indicate that research output has grown rapidly since 2010, led by the United States of America (USA), China, Japan, Spain, and Italy. The University of Valencia (n = 12) and the School of Medicine, USA (n = 11) were the most prolific institutions. Five key research clusters were identified through keyword analysis: (i) Frailty assessment, (ii) clinical trials, (iii) cognition, (iv) exercise protocols, and (v) physical outcomes. Regional collaborations were prominent between European, North American, and East Asia-Pacific countries. The bibliometric analysis revealed a surge in publications, with research concentrated in a few productive hubs. There is potential for newer institutions to emerge through international collaborations. Addressing gaps in qualitative, psychosocial, economic, implementation, and translational research could accelerate the translation of evidence into policy and practice. Continued knowledge sharing and partnerships focused on priority gaps can optimize exercise interventions amidst global population aging. This review synthesized the growth, collaborative landscape, and intellectual structure of research on frailty and exercise over nearly four decades. The findings provide insights to inform future research directions and facilitate the translation of evidence into optimized exercise protocols that can be implemented at scale to benefit frail older adults.
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