Effect of Multicomponent Intervention on Functional Decline in Chinese Older Adults: A Multicenter Randomized Clinical Trial - 10/12/24

Doi : 10.1007/s12603-023-2031-9 
B. Chen 1, 2, 3, #, M. Li 1, #, H. Zhao 1, 4, #, R. Liao 5, J. Lu 5, J. Tu 6, Y. Zou 6, X. Teng 1, Y. Huang 1, J. Liu 7, P. Huang 6, Jianqing Wu 1, 2, 3, 8
1 Department of Geriatrics, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China 
2 Jiangsu Provincial Key Laboratory of Gerontology & Geriatrics, Nanjing, China 
3 Jiangsu Provincial Innovation Center of Gerontology & Geriatrics, Nanjing, China 
4 Department of General Practice, The First People's Hospital of Lianyungang, Lianyungang Clinical College of Nanjing Medical University, Lianyungang, China 
5 Rehabilitation Medical Center, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China 
6 Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China 
7 Clinical Medicine Research Institution, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China 
8 Jiangsu Provincial Key Laboratory of Geriatrics, Department of Geriatrics, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, 210029, Nanjing, Jiangsu, P.R. China 

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Abstract

Objectives

To confirm whether multicomponent exercise following vivifrail recommendations was an effective method for improving physical ability, cognitive function, gait, balance, and muscle strength in Chinese older adults.

Methods

This was a multicenter and randomized clinical trial conducted in Jiangsu, China, from April 2021 to April 2022. Intervention lasted for 12 weeks and 104 older adults with functional declines were enrolled. All participants were randomly assigned to a control (usual care plus health education) or exercise group (usual care plus health education plus exercise). Primary outcomes were the change score of Short Physical Performance Battery (SPPB) and activities of daily living (ADL). The secondary outcomes included instrumental activities of daily living, Tinetti scores, Frailty score, short-form Mini Nutritional Assessment, Mini-Mental State Examination, Geriatric Depression Scale-15, the 12-item Short Form Survey, 4-meter gait speed test, 6-min walking distance, grip strength, and body composition analysis.

Results

Among the participants, the average age was 85 (82, 88) years. After 12 weeks of follow-up, the exercise group showed a significant improvement in SPPB, with a change of 2 points (95% confidence interval [0, 3.5], P<0.001) compared to control. In contrast, SPPB remained stable in the control group. Compared to the control group, ADL improved in the exercise group, as did instrumental activities of daily living, Tinetti, Frailty, Short Form Survey, 4-meter gait speed test, and 6-min walking distance. Although there was no significant difference between groups in body composition analysis after post-intervention, the exercise group still improved in soft lean mass (P=0.002), fat-free mass (P=0.002), skeletal muscle mass index (P<0.001), fat-free mass index (P=0.004), appendicular skeletal muscle mass (P<0.001), and leg muscle mass (P<0.001), while the control group had no significant increase. No difference was observed in adverse events during trial period.

Conclusions

The multicomponent exercise intervention following vivifrail recommendations is an effective method for older adults with functional decline and can reverse the functional decline and improve gait, balance, and muscle strength. Additionally, the 12-week multicomponent exercise method provides guidance for Chinese medical professionals working in the field of geriatrics and is a promising method to improve physical function in the general population.

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Key words : Multicomponent intervention, functional decline, randomized clinical trial


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Vol 27 - N° 11

P. 1063-1075 - novembre 2023 Retour au numéro
Article précédent Article précédent
  • Comparison of the Physical Function Trajectories in Three Birth Cohorts of Chinese Older Adults: A 14-Year Longitudinal Study
  • T.W. Auyeung, J.C.S. Leung, Zhi-Hui Lu, C. Tsang, J.S.W. Lee, T.C.Y. Kwok, J. Woo
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  • A.B. Bays-Moneo, M. Izquierdo, M.M. Antón, E.L. Cadore

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