Introduction The World Health Organisation recently defined the construct of intrinsic capacity (IC), a function-based marker of older adult’s health encompassing all mental and physical capacities of the individual. Multicomponent physical exercise (MCE) is a potential intervention capable to maintain/increase IC at older age; however, evidence is scarce on the effects of MCE on IC in cognitively impaired pre-frail/frail older adults. Methods Secondary analyses of a randomised clinical trial. One hundred and eighty-eight older outpatients (age = 84.06 ± 4.77, 70.2% women) presenting with pre-frailty/frailty (according to Fried Criteria) and mild cognitive impairment (MCI)/mild dementia were recruited in the Geriatric clinics of three tertiary hospitals in Spain. Subjects were randomised to participate in the 12-week home-based individualised Vivifrail MCE or usual care. An IC index was created based on the z-score of the locomotion (Short Physical Performance Battery), cognitive (Montreal Cognitive Assessment), psychology (15-item Geriatric Depression Scale Yesavage) and vitality (handgrip strength) domains. Results After the 3-month intervention, linear mixed models showed significant between-group differences in the evolution of the IC composite score (β=0.48; 95% confidence interval [CI] = 0.24, 0.74; P < 0.001), IC Locomotion (β = 0.42; 95% CI = 0.10, 0.74; P < 0.001), IC Cognition (β = 0.45; 95% CI = 0.03, 0.87; P < 0.05) and IC Vitality domains (β = 0.50; 95% CI = 0.25, 0.74 at 3-month) favouring the MCE group. Conclusions The 12-week Vivifrail multicomponent exercise program is an effective strategy to enhance IC, especially in terms of locomotion, cognition and vitality IC domains in community-dwelling older adults with pre-frailty/frailty and MCI/mild dementia, compared to usual care.
Background Nursing home‐acquired pneumonia (NHAP) and related hospitalizations might lead to abrupt functional declines, especially among nursing home residents. Intrinsic capacity is a novel construct proposed by the World Health Organization specifically designed to capture the physical and cognitive capacities of the aging individual to design personalized interventions. This study aimed to investigate the associations of NHAP and related hospitalizations with several intrinsic capacity domains among nursing home residents. Methods We used data from the INCUR study (n = 754; mean age = 86.1 ± 7.4; 75.2% female). Four intrinsic capacity domains were assessed through the Short Physical Performance Battery (SPPB, locomotion), Abbreviated Mental Test (cognition), 10‐items Geriatric Depression scale (GDS‐10, mood), the Mini‐Nutritional Assessment Short‐Form (vitality) at three time‐points along 1‐year. Linear mixed models were used to analyze longitudinal evolution in the intrinsic capacity domains according to NHAP diagnosis and hospitalization. Results A total of 161 (21.4%) were diagnosed with NHAP, and 46 of them (28.6%) required hospitalization. NHAP was significantly associated with declines in the intrinsic capacity vitality domain (β = −0.51; 95% CI −0.84; −0.18). The association was also found for NHAP‐related hospitalization (β = −0.97; 95% CI −1.46; −0.48). NHAP‐related hospitalization was also associated with worsening in the psychological domain (β = 0.56; 95% CI 0.08; 1.04). No other significant associations were found. Conclusions NHAP and related hospitalization are associated with the deterioration of intrinsic capacity vitality and psychology domains. Prevention of pneumonia may result in better functional evolution in very old and vulnerable nursing home residents.
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