Introduction. Today, it is important to create programs not only for geriatric, but also for gerontological prevention, which would include the capabilities of various services to achieve the maximum possible functionality of elderly and senile people. The purpose is to substantiate the domain principle of gerontological prevention programs. Material and methods. The effectiveness of gerontological prevention programs based on the domain principle was studied in 1115 elderly people (men-400 people, women-715 people, age from 60 to 74 years, average age 69.3+3.4 years). The functional status was assessed according to the ICOPE system and according to the results of a comprehensive geriatric assessment. Results. The domain principle of creating and implementing gerontological prevention programs makes it possible to have both a protective direct effect within the disturbed domain of individual viability, and a pleiotropic effect within other disturbed domains. For example, the implementation of psychological domain measures provides an increase in the prevalence of cases of absence of depression from 15.9 to 47.0 per 100 elderly people and a decrease in the prevalence of moderate depression and subdepression, respectively, from 30.3 to 13.9 and 41.3 to 29.7 per 100 elderly people. At the same time, there is an improvement in cognitive abilities within the cognitive domain of intrinsic capacity (r=+0.689, p=0.0195). Conclusion. The domain principle of creating and implementing gerontological prevention programs involves a set of measures within eight domains: six clinical (motor, cognitive, sensory, psychological, nutritional, somatic) and two organizational (medical and social). The domain approach in the implementation of gerontological prevention contributes to a significant reduction in the age discrimination of elderly people on the Palmore scale from 72.3 to 28.2 points and an increase in their health-related quality of life according to the SF-36 questionnaire from 58.4 to 78.2 points.