Tze Pin Ng1, Liang Feng2, Ma Shwe Zin Nyunt2, Lei Feng2, Mathew Niti3, Boon Yeow Tan4, Gribson Chan4, Sue Anne Khoo5, Sue Mei Chan5, Philip Yap5, Keng Bee Yap6. 1. Gerontology Research Programme, Department of Psychological Medicine, National University of Singapore, Singapore. Electronic address: pcmngtp@nus.edu.sg. 2. Gerontology Research Programme, Department of Psychological Medicine, National University of Singapore, Singapore. 3. Performance and Technology Assessment, Ministry of Health, Singapore. 4. St Luke's Hospital, Singapore. 5. Khoo Teck Puat Hospital, Singapore. 6. Alexandra Hospital, Singapore.
Abstract
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.
RCT Entities:
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.
Authors: Susan L Murphy; James K Richardson; Jennifer Blackwood; Beanna Martinez; Elliot B Tapper Journal: Dig Dis Sci Date: 2020-01-25 Impact factor: 3.199