Nutritional, Physical, Cognitive, and Combination Interventions and Frailty Reversal Among Older Adults: A Randomized Controlled Trial - 22/10/15
, Liang Feng, PhD a, Ma Shwe Zin Nyunt, PhD a, Lei Feng, PhD a, Mathew Niti, PhD b, Boon Yeow Tan, MMED c, Gribson Chan, MSc c, Sue Anne Khoo, MPsych(Clin) d, Sue Mei Chan, MHlthSc (Mgmt) d, Philip Yap, MRCP d, Keng Bee Yap, FRCP(Edin) eAbstract |
Background |
It is important to establish whether frailty among older individuals is reversible with nutritional, physical, or cognitive interventions, singly or in combination. We compared the effects of 6-month-duration interventions with nutritional supplementation, physical training, cognitive training, and combination treatment vs control in reducing frailty among community-dwelling prefrail and frail older persons.
Methods |
We conducted a parallel group, randomized controlled trial in community-living prefrail and frail old adults in Singapore. The participants' mean age was 70.0 years, and 61.4% (n = 151) were female. Five different 6-month interventions included nutritional supplementation (n = 49), cognitive training (n = 50), physical training (n = 48), combination treatment (n = 49), and usual care control (n = 50). Frailty score, body mass index, knee extension strength, gait speed, energy/vitality, and physical activity levels and secondary outcomes (activities of daily living dependency, hospitalization, and falls) were assessed at 0 months, 3 months, 6 months, and 12 months.
Results |
Frailty score and status over 12 months were reduced in all groups, including control (15%), but were significantly higher (35.6% to 47.8%) in the nutritional (odds ratio [OR] 2.98), cognition (OR 2.89), and physical (OR 4.05) and combination (OR 5.00) intervention groups. Beneficial effects were observed at 3 months and 6 months, and persisted at 12 months. Improvements in physical frailty domains (associated with interventions) were most evident for knee strength (physical, cognitive, and combination treatment), physical activity (nutritional intervention), gait speed (physical intervention), and energy (combination intervention). There were no major differences with respect to the small numbers of secondary outcomes.
Conclusions |
Physical, nutritional, and cognitive interventional approaches were effective in reversing frailty among community-living older persons.
El texto completo de este artículo está disponible en PDF.Keywords : Cognitive training, Frailty, Nutritional supplementation, Physical exercise
Esquema
| Trial Registration: clinicaltrials.gov; Identifier: NCT00973258. |
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| Funding: The study was supported by a research grant NMRC/1108/2007 from the National Medical Research Council. |
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| Conflict of Interest: None reported. |
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| Authorship: TPN had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. He formulated the hypothesis, performed literature review, designed the study, reviewed the data, and drafted and reviewed the manuscript. Liang Feng reviewed the literature, analyzed the data and drafted and reviewed the manuscript. MN, MSZN, Lei Feng, GC, SAK, SMC, PY and KBY participated in the review of the literature, study design, and data collection, and the review of the data and manuscript drafts. |
Vol 128 - N° 11
P. 1225 - novembre 2015 Regresar al número
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