A pilot randomized controlled trial to improve geriatric frailty

BMC Geriatrics

Research Article

Ching-Yu Chen¹  Ding-Cheng Derrick Chan²  Rong-Sen Yang³  Hsiao-Hui Tsou⁴  Chao Agnes Hsiung⁴  Ken N Kuo⁵  Jau-Yih Tsauo⁶ 

[1] Department of Family Medicine, National Taiwan University Hospital, Taipei, No 7 ChungSan S. Rd, Taipei, Taiwan;Institute of Population Health Sciences, National Health Research Institutes, R440, 4 F, No. 17 Xu-Zhou Road, Taipei, Taiwan;Department of Geriatrics and Gerontology, and Department of Internal Medicine, National Taiwan University Hospital, No.7, ChongSan S. Rd, Taipei, Taiwan;Department of Orthopaedics, National Taiwan University Hospital, No.7, ChongSan S. Rd, Taipei, Taiwan;Division of Biostatistics and Bioinformatics, Institute of Population Health Sciences, National Health Research Institutes, 35 Keyan Road, Zhunan, Miaoli County, Taiwan;Institute of Population Health Sciences, National Health Research Institutes, 35 Keyan Road, Zhunan, Miaoli County, Taiwan;School and Graduate Institute of Phsical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan, Institution mailing address, Floor 3, No. 17, Xuzhou Rd, Taipei, Taiwan;

关键词: Frailty;    Aged;    Intervention;    Effectiveness;    Community;   

DOI  :  10.1186/1471-2318-12-58

 received in 2012-02-22, accepted in 2012-09-11,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundFew randomized controlled trials (RCTs) report interventions targeting improvement of frailty status as an outcome.MethodsThis RCT enrolled 117 older adults (65-79 years of age) in Toufen, Taiwan who scored 3-6 on The Chinese Canadian Study of Health and Aging Clinical Frailty Scale Telephone Version and then score ≥1 on the Cardiovascular Health Study Phenotypic Classification of Frailty (CHS_PCF). With a two by two factorial design, subjects were randomly assigned to interventions (Exercise and nutrition, EN, n = 55 or problem solving therapy, PST, n = 57) or controls (non-EN, n = 62 or non-PST, n = 60). Educational booklets were provided to all. EN group subjects received nutrition consultation and a thrice-weekly exercise-training program while PST group subjects received 6 sessions in 3 month. Subjects were followed at 3, 6, and 12 months. Primary outcome was improvement of the CHS_PCF by at least one category (from pre-frail to robust, or from frail to pre-frail or robust) from baseline assessments. One hundred and one completed final assessments. Intention-to-treat analysis with the generalized estimating equation model was applied with adjustment for time and treatment-by-time interactions.ResultsMean age was 71.4 ± 3.7 years, with 59% females. Baseline characteristic were generally comparable between groups. EN group subjects had a higher improvement rate on the primary outcome than non-EN group subjects (45% vs 27%, adjusted p = 0.008) at 3 months, but not 6 or 12 months. They also had more increase of serum 25(OH) vitamin D level (4.9 ± 7.7 vs 1.2 ± 5.4, p = 0.006) and lower percentage of osteopenia (74% vs 89% p = 0.042) at 12 months. PST group subjects had better improvement (2.7 ± 6.1 vs 0.2 ± 6.7, p = 0.035, 6-month) and less deterioration (−3.5 ± 9.7 vs −7.1 ± 8.7, p = 0.036, 12-month) of dominant leg extension power than non-PST subjects. Some secondary outcomes were also improved in control groups (non-EN or non-PST). No adverse effects were reported.ConclusionsThe three-month EN intervention resulted in short-term (3-month) frailty status improvement and long-term effect on bone mineral density and serum vitamin D (12-month) among Taiwanese community-dwelling elders. The effect of PST was less pronounce.Trial registrationClinicalTrials.gov: EC0970301

【 授权许可】

Unknown   
© Chan et al.; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.