Cerebrovascular diseases, dementia or cognitive decline, frailty, and fall are common risk factors for adverse health outcomes including long-term care needs among elderly people. This study aimed to evaluate the effectiveness of exercise and physical activity interventions designed to prevent or improve functional outcomes in people with such adverse events. We searched for eligible studies of randomized controlled trials and meta-analysis until April 2019. The primary outcomes were stroke, cognitive function, frailty, and fall. This review suggests that interventions targeting exercise and physical activity are effective to prevent stroke and fall in long-term care facilities, have positive influence on cognitive function in elderly people with dementia or cognitive impairment, and are able to prevent or reduce frailty status in frail and pre-frail population. However, future clinical and population-based trials are needed to elucidate the most effective exercise programs (type, intensity, duration, frequency, and environment) in community-based settings to prevent or reduce the risk of each sub-clinical condition.