Effects of a Combined Physical Training and Nutrition Intervention on Physical Performance and Health-Related Quality of Life in Prefrail Older Women Living in the Community: A Randomized Controlled Trial

Kwon, Jinhee; Yoshida, Yuko; Yoshida, Hideyo; Kim, Hunkyung; Suzuki, Takao; Lee, Yunhwan

doi:10.1016/j.jamda.2014.12.005

Cited by 93 publications

(206 citation statements)

References 39 publications

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“…We included parallel-group RCTs, 30,31,33,35 one pilot RCT, 32 one randomised crossover trial 36 and one secondary analysis of a RCT 38 in our review, including 506 randomised participants (sample size range 23-194 participants) from a range of countries (see Table 1). Five trials used pre-frailty, defined through the Fried phenotype 10 or modifications of this, to identify eligible older adults or women.…”

Section: Description Of Included Randomised Controlled Trialsmentioning

confidence: 99%

“…Five trials used pre-frailty, defined through the Fried phenotype 10 or modifications of this, to identify eligible older adults or women. 32,[34][35][36]38 Two defined mild-moderate frailty according to the modified physical performance test, 31 with two additional fitness and activities of daily living (ADL) criteria in one study. 30 Participants' mean ages ranged from 72 to 83 years (inclusion criteria ranging from ≥ 60 to ≥ 78 years).…”

Section: Description Of Included Randomised Controlled Trialsmentioning

confidence: 99%

“…Most interventions were community-based group exercise (eight interventions reported in six studies [30][31][32][34][35][36] ), with one three-arm study containing an additional exercise and nutrition group. 35 Exercise interventions were supervised by trained instructors, exercise physiologists or physiotherapists and delivered in 45-to 60-minute sessions one to three times per week over 12-36 weeks.…”

Section: Description Of Included Randomised Controlled Trialsmentioning

confidence: 99%

“…35 Exercise interventions were supervised by trained instructors, exercise physiologists or physiotherapists and delivered in 45-to 60-minute sessions one to three times per week over 12-36 weeks. Control groups were usual activity, 32,34,36 a low intensity flexibility home exercise programme 30,31 and monthly general health education sessions.…”

Section: Description Of Included Randomised Controlled Trialsmentioning

confidence: 99%

“…Control groups were usual activity, 32,34,36 a low intensity flexibility home exercise programme 30,31 and monthly general health education sessions. 35 One study contained an 8-week run-in phase of vitamin D supplementation prior to randomisation. 34 Upatising et al…”

Section: Description Of Included Randomised Controlled Trialsmentioning

confidence: 99%

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Home-based health promotion for older people with mild frailty: the HomeHealth intervention development and feasibility RCT

Walters

Frost

Kharicha

et al. 2017

Health Technol Assess

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Background Mild frailty or pre-frailty is common and yet is potentially reversible. Preventing progression to worsening frailty may benefit individuals and lower health/social care costs. However, we know little about effective approaches to preventing frailty progression. Objectives (1) To develop an evidence- and theory-based home-based health promotion intervention for older people with mild frailty. (2) To assess feasibility, costs and acceptability of (i) the intervention and (ii) a full-scale clinical effectiveness and cost-effectiveness randomised controlled trial (RCT). Design Evidence reviews, qualitative studies, intervention development and a feasibility RCT with process evaluation. Intervention development Two systematic reviews (including systematic searches of 14 databases and registries, 1990–2016 and 1980–2014), a state-of-the-art review (from inception to 2015) and policy review identified effective components for our intervention. We collected data on health priorities and potential intervention components from semistructured interviews and focus groups with older people (aged 65–94 years) (n = 44), carers (n = 12) and health/social care professionals (n = 27). These data, and our evidence reviews, fed into development of the ‘HomeHealth’ intervention in collaboration with older people and multidisciplinary stakeholders. ‘HomeHealth’ comprised 3–6 sessions with a support worker trained in behaviour change techniques, communication skills, exercise, nutrition and mood. Participants addressed self-directed independence and well-being goals, supported through education, skills training, enabling individuals to overcome barriers, providing feedback, maximising motivation and promoting habit formation. Feasibility RCT Single-blind RCT, individually randomised to ‘HomeHealth’ or treatment as usual (TAU). Setting Community settings in London and Hertfordshire, UK. Participants A total of 51 community-dwelling adults aged ≥ 65 years with mild frailty. Main outcome measures Feasibility – recruitment, retention, acceptability and intervention costs. Clinical and health economic outcome data at 6 months included functioning, frailty status, well-being, psychological distress, quality of life, capability and NHS and societal service utilisation/costs. Results We successfully recruited to target, with good 6-month retention (94%). Trial procedures were acceptable with minimal missing data. Individual randomisation was feasible. The intervention was acceptable, with good fidelity and modest delivery costs (£307 per patient). A total of 96% of participants identified at least one goal, which were mostly exercise related (73%). We found significantly better functioning (Barthel Index +1.68; p = 0.004), better grip strength (+6.48 kg; p = 0.02), reduced psychological distress (12-item General Health Questionnaire –3.92; p = 0.01) and increased capability-adjusted life-years [+0.017; 95% confidence interval (CI) 0.001 to 0.031] at 6 months in the intervention arm than the TAU arm, with no differences in other outcomes. NHS and carer support costs were variable but, overall, were lower in the intervention arm than the TAU arm. The main limitation was difficulty maintaining outcome assessor blinding. Conclusions Evidence is lacking to inform frailty prevention service design, with no large-scale trials of multidomain interventions. From stakeholder/public perspectives, new frailty prevention services should be personalised and encompass multiple domains, particularly socialising and mobility, and can be delivered by trained non-specialists. Our multicomponent health promotion intervention was acceptable and delivered at modest cost. Our small study shows promise for improving clinical outcomes, including functioning and independence. A full-scale individually RCT is feasible. Future work A large, definitive RCT of the HomeHealth service is warranted. Study registration This study is registered as PROSPERO CRD42014010370 and Current Controlled Trials ISRCTN11986672. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 21, No. 73. See the NIHR Journals Library website for further project information.

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Section: Description Of Included Randomised Controlled Trialsmentioning

confidence: 99%

Section: Description Of Included Randomised Controlled Trialsmentioning

confidence: 99%

Section: Description Of Included Randomised Controlled Trialsmentioning

confidence: 99%

Section: Description Of Included Randomised Controlled Trialsmentioning

confidence: 99%

Section: Description Of Included Randomised Controlled Trialsmentioning

confidence: 99%

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Home-based health promotion for older people with mild frailty: the HomeHealth intervention development and feasibility RCT

Walters

Frost

Kharicha

et al. 2017

Health Technol Assess

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Olfactory decline develops in parallel with frailty in older US adults with obstructive lung diseases

Wang,

Wroblewski,

McClintock

et al. 2023

Int Forum Allergy Rhinol

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BackgroundFrailty is prevalent among older adults with asthma or chronic obstructive pulmonary disease (obstructive lung diseases [OLDs]). Frailty and OLD's co‐occurrence is associated with increased hospitalization/mortality. Chemosensory dysfunction is closely connected to both OLD and frailty. We evaluated the utility of olfactory decline as a biomarker of frailty in the setting of OLD.MethodsWe performed a prospective, longitudinal, nationally representative study of community‐dwelling older US adults in the National Social Life, Health and Aging Project, an omnibus in‐home survey. Respondents reported a physician's diagnosis of OLD. Decline in odor identification and sensitivity over 5 years and frailty (adapted fried frailty phenotype criteria) were measured using standard tools. Multivariate logistic regressions evaluated the association between OLD status, olfactory decline, and frailty.ResultsWe compared individuals with OLD (n = 98; mean age 71.2 years, 59.2% women) and those without OLD (n = 1036; mean age 69.5 years, 58.9% women). Olfactory identification decline was associated with developing frailty over the 5‐year follow‐up period in individuals with OLD (odds ratio [OR] = 9.1, 95% confidence interval [CI] = 2.1–38.6, p = 0.003). Olfactory decline predicted incidence of frailty in individuals with OLD (identification: OR = 4.8, 95% CI = 1.3–17.5, P = 0.018; sensitivity: OR = 6.1, 95%CI = 1.2–31.0, p = 0.030) but not in those without OLD adjusting for demographics, heavy alcohol use, current smoking, and comorbidity. Results were robust to different thresholds for olfactory decline and frailty development.ConclusionsOlder adults with OLD who experience olfactory decline face higher odds of developing frailty. Use of olfactory decline as a biomarker to identify frailty could allow earlier intervention and decrease adverse outcomes for high‐risk older adults with OLD.

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Muscle wasting in ageing and chronic illness

et al. 2015

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Present approaches to muscle wasting disease include exercise training, nutritional support, and drugs, although particularly the latter remain currently restricted to clinical studies. Optimizing skeletal muscle mass and function in ageing and chronic illness including heart failure is one of the chapters that are far from finished and gains future potential for new therapeutic interventions to come.

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Effects of a Combined Physical Training and Nutrition Intervention on Physical Performance and Health-Related Quality of Life in Prefrail Older Women Living in the Community: A Randomized Controlled Trial

Cited by 93 publications

References 39 publications

Home-based health promotion for older people with mild frailty: the HomeHealth intervention development and feasibility RCT

Home-based health promotion for older people with mild frailty: the HomeHealth intervention development and feasibility RCT

Olfactory decline develops in parallel with frailty in older US adults with obstructive lung diseases

Muscle wasting in ageing and chronic illness

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