This study aims to conduct a systematic review and meta-analysis of care coordination interventions for older adults with intersecting physical, cognitive and social needs, addressing a gap in the fragmented evidence base and the practical challenge of matching coordination to complexity.
Following PRISMA guidelines, ten controlled studies and three published syntheses (2015–2025) were identified; four randomised trials permitted back-calculation of standardised effect sizes for random-effects meta-analysis, sub-group analysis, leave-one-out sensitivity testing and triangulation against two independent syntheses.
The pooled effect (k = 4) was small and nonsignificant (Hedges’ g = 0.22, 95% confidence interval −0.13 to 0.58). Sub-group analysis revealed a significant divide between light-touch coordination overlays (g = −0.07) and intensive, multi-domain, technology-enabled interventions (g = 0.60; Q_between = 13.94, p < 0.001), corroborated by triangulation.
The core meta-analytic sample (k = 4) is smaller than conventional standards, reported transparently rather than concealed; intensity classification was applied by the reviewers rather than a validated instrument.
Effectiveness depends on whether intervention intensity is proportionate to need complexity, with direct implications for how health systems, regional care authorities and supportive-housing providers allocate coordination resources.
By showing that light-touch coordination may be insufficient for older people with intersecting physical, cognitive and social needs, this study highlights the risk of perpetuating care inequalities through under-resourced interventions. More intensive, multi-domain coordination can support independence, dignity and ageing in place while reducing burdens on carers. However, technology-enabled models must address digital exclusion among low-income, rural, cognitively impaired and homebound older adults. Equitable implementation therefore requires accessible technologies, workforce investment and coordination tailored to individual complexity.
To the best of the authors’ knowledge, this is the first quantitative synthesis to pool coordination-outcome effect sizes specifically for older adults with intersecting physical, cognitive and social needs, triangulating a small core sample against independently published evidence.
