Andrew P Clegg1, Sally E Barber1, John B Young1, Anne Forster1, Steve J Iliffe2. 1. Academic Unit of Elderly Care & Rehabilitation, Bradford Institute for Health Research, Temple Bank House, Bradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, Bradford, BD9 6RJ, UK. 2. Department of Primary Care and Population Health, University College London, Gower Street, London, WC1E 6BT, UK.
Abstract
BACKGROUND: Frailty is common in older age, and is associated with important adverse health outcomes including increased risk of disability and long-term care admission. OBJECTIVES: To evaluate whether home-based exercise interventions improve outcomes for frail older people. DATA SOURCES: We searched systematically for randomised controlled trials (RCTs) and cluster RCTs, with literature searching to February 2010. STUDY SELECTION: All trials that evaluated home-based exercise interventions for frail older people were eligible. Primary outcomes were mobility, quality of life and daily living activities. Secondary outcomes included long-term care admission and hospitalisation. RESULTS: Six RCTs involving 987 participants met the inclusion criteria. Four trials were considered of high quality. One high quality trial reported improved disability in those with moderate but not severe frailty. Meta-analysis of long-term care admission rates identified a trend towards reduced risk. Inconsistent effects on other primary and secondary outcomes were reported in the other studies. CONCLUSIONS: There is preliminary evidence that home-based exercise interventions may improve disability in older people with moderate, but not severe, frailty. There is considerable uncertainty regarding effects on important outcomes including quality of life and long-term care admission. Home-based exercises are a potentially simple, safe and widely applicable intervention to prevent dependency decline for frail older people.
BACKGROUND: Frailty is common in older age, and is associated with important adverse health outcomes including increased risk of disability and long-term care admission. OBJECTIVES: To evaluate whether home-based exercise interventions improve outcomes for frail older people. DATA SOURCES: We searched systematically for randomised controlled trials (RCTs) and cluster RCTs, with literature searching to February 2010. STUDY SELECTION: All trials that evaluated home-based exercise interventions for frail older people were eligible. Primary outcomes were mobility, quality of life and daily living activities. Secondary outcomes included long-term care admission and hospitalisation. RESULTS: Six RCTs involving 987 participants met the inclusion criteria. Four trials were considered of high quality. One high quality trial reported improved disability in those with moderate but not severe frailty. Meta-analysis of long-term care admission rates identified a trend towards reduced risk. Inconsistent effects on other primary and secondary outcomes were reported in the other studies. CONCLUSIONS: There is preliminary evidence that home-based exercise interventions may improve disability in older people with moderate, but not severe, frailty. There is considerable uncertainty regarding effects on important outcomes including quality of life and long-term care admission. Home-based exercises are a potentially simple, safe and widely applicable intervention to prevent dependency decline for frail older people.
Authors: Jeremy Walston; Evan C Hadley; Luigi Ferrucci; Jack M Guralnik; Anne B Newman; Stephanie A Studenski; William B Ershler; Tamara Harris; Linda P Fried Journal: J Am Geriatr Soc Date: 2006-06 Impact factor: 5.562
Authors: L P Fried; C M Tangen; J Walston; A B Newman; C Hirsch; J Gottdiener; T Seeman; R Tracy; W J Kop; G Burke; M A McBurnie Journal: J Gerontol A Biol Sci Med Sci Date: 2001-03 Impact factor: 6.053
Authors: Lesley D Gillespie; M Clare Robertson; William J Gillespie; Sarah E Lamb; Simon Gates; Robert G Cumming; Brian H Rowe Journal: Cochrane Database Syst Rev Date: 2009-04-15
Authors: Luigi Ferrucci; Jack M Guralnik; Stephanie Studenski; Linda P Fried; Gordon B Cutler; Jeremy D Walston Journal: J Am Geriatr Soc Date: 2004-04 Impact factor: 5.562
Authors: Simon J G Richards; Frank A Frizelle; John A Geddes; Tim W Eglinton; Mark B Hampton Journal: Int J Colorectal Dis Date: 2018-09-14 Impact factor: 2.571
Authors: David X Marquez; Susan Aguiñaga; Priscilla M Vásquez; David E Conroy; Kirk I Erickson; Charles Hillman; Chelsea M Stillman; Rachel M Ballard; Bonny Bloodgood Sheppard; Steven J Petruzzello; Abby C King; Kenneth E Powell Journal: Transl Behav Med Date: 2020-10-12 Impact factor: 3.046
Authors: Andrew Christopher Nixon; Theodoros M Bampouras; Helen J Gooch; Hannah M L Young; Kenneth William Finlayson; Neil Pendleton; Sandip Mitra; Mark E Brady; Ajay P Dhaygude Journal: BMJ Open Date: 2020-06-22 Impact factor: 2.692