A hospital stay can take a serious toll on an older adult’s strength, mobility and independence. For people already living with frailty, the period after discharge can shape whether they are able to return home or need a higher level of care.
A small pilot study published in the Journal of the American Geriatrics Society suggests that recovery programs may be more effective when movement and nutrition are treated together. Researchers tested a program that combined individualized exercise sessions with targeted protein supplementation for frail older adults recovering in skilled nursing facilities after hospitalization. The study was designed to evaluate whether the approach was safe, feasible and acceptable, not to prove that it caused better recovery outcomes.
The program was offered at least five times a week during each participant’s stay in a skilled nursing facility. According to the researchers, 80% of participants were discharged back to the community rather than to long-term care or the hospital.
That finding is encouraging, but it needs context. Because this was a pilot study, the results cannot show that the exercise-and-protein program directly caused participants to return home. Larger studies will be needed to determine whether this kind of intervention can reduce rehospitalizations, shorten recovery time or improve long-term independence and quality of life.
Still, the study points to a recovery window that can be easy to overlook. Many older adults lose muscle, stamina and confidence during hospitalization, especially after serious illness or injury. Skilled nursing rehabilitation often focuses on helping people regain enough function to leave the facility, but frailty can make that process more complicated.
“The multicomponent design is particularly important because frailty is complex, and too often, frailty is treated as an inevitable part of aging and recovery after illness,” said Sandra Shi, MD, MPH, assistant scientist II at the Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife.
Frailty is not the same as simply getting older. It usually refers to a state of reduced physical reserve, where a person may be more vulnerable to falls, illness, disability or slow recovery after stress on the body. Muscle loss, poor appetite, inflammation, inactivity and chronic disease can all play a role.
That is why the combination of exercise and protein matters. Exercise can challenge muscles to work and adapt, while protein provides amino acids the body uses to maintain and repair muscle tissue. In older adults, illness, bed rest and low food intake can make it harder to preserve muscle during and after hospitalization.
“Exercise stimulates muscle function, while protein provides the building blocks needed for recovery and repair,” Shi said. “Pairing the two interventions may create a more effective strategy for improving resilience during the narrow but critical recovery period after hospitalization.”
The study does not mean protein supplements are a stand-alone solution for frailty. It also does not suggest that older adults should start intensive exercise or supplementation without medical guidance, especially after hospitalization. The intervention was delivered in a supervised skilled nursing setting and was tailored to participants’ needs.
The researchers reported that the additional exercises were safe and well tolerated among participants, including very vulnerable older adults. That feasibility question is important because programs that sound promising on paper may be difficult to deliver in real rehabilitation settings, where patients have varied medical conditions, different levels of mobility and limited recovery time.
“This pilot study shows that additional exercises are not only safe and well-tolerated in frail older adults, but even very vulnerable older adults may be able to regain strength and function when exercise and nutrition are intentionally combined during rehabilitation,” Shi said. “We owe it to our patients to help them to do more in order to successfully regain strength.”
The findings come as researchers and clinicians continue to look for ways to prevent hospitalization from becoming a turning point toward long-term disability. For many families, the question after a serious illness is not only whether an older adult survives, but whether they can return to daily life with enough strength and independence to live where they want to live.
Future research will need to test the approach in larger groups and compare outcomes more directly with standard rehabilitation. Those studies could help clarify whether structured frailty programs that pair nutrition and movement can change the course of recovery after hospitalization, or whether the early promise seen in this pilot study holds up under more rigorous testing.
The study was supported by federal aging research grants from the National Institutes of Health and the National Institute on Aging. The authors reported several professional and financial relationships outside this work, including a board role with Stone Rehabilitation and Senior Living and past personal fees from Pfizer, Alosa Health and VillageMD.