A Program to Prevent Functional Decline in Physically Frail, Elderly Persons Who Live at Home

Gill, Thomas M.; Baker, Dorothy I.; Gottschalk, Margaret; Peduzzi, Peter; Allore, Heather G.; Byers, Amy L.

doi:10.1056/nejmoa020423

Cited by 745 publications

(607 citation statements)

References 26 publications

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“…However, the remarkable increase in life span has also led to an important increase in frailty and dependency (Gill et al 2002). It is clear now that we must aim at increasing health span.…”

Section: Introductionmentioning

confidence: 99%

Age associated low mitochondrial biogenesis may be explained by lack of response of PGC-1α to exercise training

Derbré

Gómez-Cabrera

Nascimento

et al. 2011

AGE

114

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Low mitochondriogenesis is critical to explain loss of muscle function in aging and in the development of frailty. The aim of this work was to explain the mechanism by which mitochondriogenesis is decreased in aging and to determine to which extent it may be prevented by exercise training. We used aged rats and compared them with peroxisome proliferator-activated receptor-γ coactivator-1α deleted mice (PGC-1α KO). PGC-1α KO mice showed a significant decrease in the mitochondriogenic pathway in muscle. In aged rats, we found a loss of exercise-induced expression of PGC-1α, nuclear respiratory factor-1 (NRF-1), and of cytochrome C. Thus muscle mitochondriogenesis, which is activated by exercise training in young animals, is not in aged or PGC-1α KO ones. Other stimuli to increase PGC-1α synthesis apart from exercise training, namely cold induction or thyroid hormone treatment, were effective in young rats but not in aged ones. To sum up, the low mitochondrial biogenesis associated with aging may be due to the lack of response of PGC-1α to different stimuli. Aged rats behave as PGC-1α KO mice. Results reported here highlight the role of PGC-1α in the loss of mitochondriogenesis associated with aging and point to this important transcriptional coactivator as a target for pharmacological interventions to prevent age-associated sarcopenia.

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Section: Introductionmentioning

confidence: 99%

Age associated low mitochondrial biogenesis may be explained by lack of response of PGC-1α to exercise training

Derbré

Gómez-Cabrera

Nascimento

et al. 2011

AGE

114

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“…The mean age of all participants was 79 years, and 69% of the participants were women (supplementary materials/appendix 1). The methodological quality of included trials varied; seven trials (Hall et al 1992;Leveille et al 1998;Mann et al 1999;Dalby et al 2000;Rockwood et al 2000;Chin et al 2001;Phelan et al 2004;Holland et al 2005) were of low quality according to the criteria (van Tulder et al 2003), and seven trials were of high quality (Dalby et al 2000;Stuck et al 2000;van Haastregt et al 2000;Hebert et al 2001;Gill et al 2002Gill et al , 2004Gitlin et al 2006a;b;Markle-Reid et al 2006) ( Table 1).…”

Section: Resultsmentioning

confidence: 99%

“…Finally, a total of 19 articles (Hall et al 1992;Leveille et al 1998;Mann et al 1999;Dalby et al 2000;Rockwood et al 2000;Stuck et al 2000;van Haastregt et al 2000;Chin et al 2001;Hebert et al 2001;Chin et al 2002;Gill et al 2002Gill et al , 2004Phelan et al 2004;Holland et al 2005;Gitlin et al 2006a;b;Markle-Reid et al 2006;Bouman et al 2008a, b), all RCTs concerning communitydwelling persons 65 years or older identified as frail, vulnerable, at risk of functional decline, having disabilities or chronic conditions and receiving multi-component HPDP interventions were included for detailed review (Fig. 1).…”

Section: Literature Searchmentioning

confidence: 99%

“…Two trials included impaired cognitive functions in the concept of frailty (Hall et al 1992;Rockwood et al 2000), and one of them specified dementia as a common condition among frail older people (Rockwood et al 2000). In contrast, a number of articles stated that included participants should not be cognitively impaired (Mann et al 1999;Holland et al 2005;Gitlin et al 2006a, b), or should be without dementia (Leveille et al 1998;Gill et al 2002Gill et al , 2004Phelan et al 2004). …”

Section: Frailty and Impairments In Body Functions And Structuresmentioning

confidence: 99%

“…The concept of frailty can be expanded by accumulating functional decline or disability, including activity limitations and participation restrictions (Hall et al 1992;Mann et al 1999;Dalby et al 2000;Rockwood et al 2000;Chin et al 2001;Hebert et al 2001;Chin et al 2002;Gill et al 2002Gill et al , 2004Markle-Reid et al 2006). As a corollary, physically frail older people are considered to present high rates of impairments, activity limitations and participation restrictions (Gill et al 2004), which in a deterministic way produce loss of autonomy (Hebert et al 2001).…”

Section: Frailty and Activity Limitations And Participation Restrictionsmentioning

confidence: 99%

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Multi-component health promotion and disease prevention for community-dwelling frail elderly persons: a systematic review

et al. 2009

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The objective was to investigate definitions of frailty used in studies of multi-component health promotion and disease-preventive (HPDP) intervention programmes for community-dwelling frail elderly persons and to review the content, organisation and effects of HPDP interventions. A systematic review of 19 articles was made, and the International Classification of Functioning, Disability and Health (ICF) was used as a structural framework for the analysis. The result shows that a consensus was reached on including various aspects of impairments in body functions and structures as an integral part of the frailty concept, with the exception of one subgroup: mental/cognitive functions. Additionally, opinions varied quite consistently regarding aspects of activity limitations and participation restrictions, personal and environmental factors. Ten of the 14 HPDP programmes covered various intervention elements referring to all four ICF components. Eleven programmes involved registered personnel only, while a more divergent pattern was seen in the remaining organisational aspects of the interventions: length of interventions and location plus age segments, participatory approach and contextual information, as well as the theoretical foundation of the interventions. Measures of body functions and structures were significantly improved in 5 out of 17 (29%) targeted aspects. For activity and participation, 12 out of 32 (38%) targeted aspects were positively changed, while the score for environmental factors was 7 out of 22 (32%), and for personal factors 8 out of 22 (36%). Our review suggests that further research is needed to explore and disentangle the complex interrelationships between various interventions and outcomes.

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Transitions Between Frailty States Among Community-Living Older Persons

Gill¹

2006

Archives of Internal Medicine

341

370

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A Program to Prevent Functional Decline in Physically Frail, Elderly Persons Who Live at Home

Abstract: A home-based program targeting underlying impairments in physical abilities can reduce the progression of functional decline among physically frail, elderly persons who live at home.

Cited by 745 publications

References 26 publications

Age associated low mitochondrial biogenesis may be explained by lack of response of PGC-1α to exercise training

Age associated low mitochondrial biogenesis may be explained by lack of response of PGC-1α to exercise training

Multi-component health promotion and disease prevention for community-dwelling frail elderly persons: a systematic review

Transitions Between Frailty States Among Community-Living Older Persons

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