TY - JOUR
T1 - Effects of a primary care-based multifactorial intervention on physical and cognitive function in frail, elderly individuals
T2 - A randomized controlled trial
AU - Romera-Liebana, Laura
AU - Orfila, Francesc
AU - Segura, Josep Maria
AU - Real, Jordi
AU - Fabra, Maria Lluïsa
AU - Möller, Mercedes
AU - Lancho, Santiago
AU - Ramirez, Anna
AU - Marti, Nuria
AU - Cullell, Montserrat
AU - Bastida, Nuria
AU - Martinez, Dolors
AU - Giné, Maria
AU - Cendrós, Patricia
AU - Bistuer, Anna
AU - Perez, Elena
AU - Fabregat, Maria Assumpta
AU - Foz, Gonçal
N1 - Funding Information:
This study was supported by ISCIII,Ministry of Economy and Competitiveness, Spain, Technical, Scientific and Innovation Research National Plan 2008– 2011, cofunded with European Union ERDF funds; PI12/01503.
Publisher Copyright:
© The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America.
PY - 2018/11/10
Y1 - 2018/11/10
N2 - Background: Detecting and managing frailty at early stages can prevent disability and other adverse outcomes. The study aim was to evaluate whether a multifactorial intervention program could modify physical and cognitive frailty parameters in elderly individuals. Methods: We conducted a multicenter, randomized, single-blind, parallel-group trial in community-living prefrail/frail elderly individuals in Barcelona. A total of 352 patients, aged ≥65 years old with positive frailty screening, was randomized into two groups to receive a 12-week multidisciplinary intervention or usual care, with concealed allocation. The intervention consisted of: exercise training, intake of hyperproteic nutritional shakes, memory training, and medication review. Main outcome assessments with multivariate analysis were conducted at 3 and 18 months. Results: A total of 347 participants (98.6%) completed the study, mean age 77.3 years, 89 prefrail subjects (25.3%), and 75.3% female (n = 265). Eighteen-month assessments were performed in 76% of the sample. After 3 and 18 months, adjusted means difference between-groups showed significant improvements for the intervention group in all comparisons: Short Physical Performance Battery score improved 1.58 and 1.36 points (p < .001), handgrip strength 2.84 and 2.49 kg (p < .001), functional reach 4.3 and 4.52 cm (p < .001), and number of prescriptions decreased 1.39 and 1.09 (p < .001), respectively. Neurocognitive battery also showed significant improvements across all dimensions at 3 and 18 months. Conclusions: A physical, nutritional, neurocognitive, and pharmacological multifaceted intervention was effective in reversing frailty measures both at short-term and 18 months. Lasting benefits of a multi-intervention program among frail elderly individuals encourage its prioritization.
AB - Background: Detecting and managing frailty at early stages can prevent disability and other adverse outcomes. The study aim was to evaluate whether a multifactorial intervention program could modify physical and cognitive frailty parameters in elderly individuals. Methods: We conducted a multicenter, randomized, single-blind, parallel-group trial in community-living prefrail/frail elderly individuals in Barcelona. A total of 352 patients, aged ≥65 years old with positive frailty screening, was randomized into two groups to receive a 12-week multidisciplinary intervention or usual care, with concealed allocation. The intervention consisted of: exercise training, intake of hyperproteic nutritional shakes, memory training, and medication review. Main outcome assessments with multivariate analysis were conducted at 3 and 18 months. Results: A total of 347 participants (98.6%) completed the study, mean age 77.3 years, 89 prefrail subjects (25.3%), and 75.3% female (n = 265). Eighteen-month assessments were performed in 76% of the sample. After 3 and 18 months, adjusted means difference between-groups showed significant improvements for the intervention group in all comparisons: Short Physical Performance Battery score improved 1.58 and 1.36 points (p < .001), handgrip strength 2.84 and 2.49 kg (p < .001), functional reach 4.3 and 4.52 cm (p < .001), and number of prescriptions decreased 1.39 and 1.09 (p < .001), respectively. Neurocognitive battery also showed significant improvements across all dimensions at 3 and 18 months. Conclusions: A physical, nutritional, neurocognitive, and pharmacological multifaceted intervention was effective in reversing frailty measures both at short-term and 18 months. Lasting benefits of a multi-intervention program among frail elderly individuals encourage its prioritization.
KW - Clinical Trials
KW - Cognition
KW - Exercise
KW - Frailty
UR - http://www.scopus.com/inward/record.url?scp=85056353269&partnerID=8YFLogxK
U2 - 10.1093/gerona/glx259
DO - 10.1093/gerona/glx259
M3 - Article
C2 - 29346524
AN - SCOPUS:85056353269
SN - 1079-5006
VL - 73
SP - 1668
EP - 1674
JO - Journals of Gerontology - Series A Biological Sciences and Medical Sciences
JF - Journals of Gerontology - Series A Biological Sciences and Medical Sciences
IS - 12
ER -