Frailty Intervention through Nutrition Education and Exercise (FINE). A Health Promotion Intervention to Prevent Frailty and Improve Frailty Status among Pre-Frail Elderly—A Study Protocol of a Cluster Randomized Controlled Trial

Abstract

The ageing process has been associated with various geriatric issues including frailty. Without early prevention, frailty may cause multiple adverse outcomes. However, it potentially may be reversed with appropriate interventions. The aim of the study is to assess the effectiveness of nutritional education and exercise intervention to prevent frailty among the elderly. A 3-month, single-blind, two-armed, cluster randomized controlled trial of the frailty intervention program among Malaysian pre-frail elderly will be conducted. A minimum of total 60 eligible respondents from 8 clusters (flats) of Program Perumahan Rakyat (PPR) flats will be recruited and randomized to the intervention and control arm. The intervention group will receive a nutritional education and a low to moderate multi-component exercise program. To date, this is the first intervention study that specifically targets both the degree of frailty and an improvement in the outcomes of frailty using both nutritional education and exercise interventions among Malaysian pre-frail elderly. If the study is shown to be effective, there are major potential benefits to older population in terms of preventing transition to frailty. The findings from this trial will potentially provide valuable evidence and serve as a model for similar future interventions designed for elderly Malaysians in the community.

A Logical Framework (MYGERYFS) for Hospital Foodservice to Prevent Malnutrition Among Geriatric Patients in Hospitals, Malaysia: Protocol for a Feasibility Study

“…The percentage of older patients in hospitals in the Klang Valley who responded to the MNA-SF questionnaire-which was divided into 3 scores of "Normal" (12)(13)(14), "At Risk" (8)(9)(10)(11), and "Malnutrition" (0-7)-was 27.9% (n=65) normal, 54.9% (n=128) at risk, and 17% (n=40) malnutrition, which is the lowest. Thus, most patients were at risk of malnutrition.…”

“…Other risk factors include the presence of comorbidities [ 7 , 8 ], poor dental status [ 9 ], and inadequate dietary intake [ 7 , 10 , 11 ]; moreover, those living in health care institutions often complain of having poor foodservice experience [ 12 , 13 ]. Older people with malnutrition often find themselves in a state of dependency, having prolonged hospital stays, an increase in infection rate that eventually diminishes their quality of life, and an increase in health care costs and mortality [ 6 , 7 , 14 ].…”

Recent clinical trials with stem cells to slow or reverse normal aging processes

“…Therapeutic interventions for physical frailty have focused on exercise and nutritional supplementation ( Dent et al, 2019 ; Mohd Suffian et al, 2020 ; Zheng et al, 2022 ). The ICFSR-CPGs ( Dent et al, 2019 ) recommend a multi-component physical activity programme as first-line therapy for physical frailty in older adults, and protein/caloric supplementation when there is weight loss or malnutrition.…”

Effectiveness of a complex intervention of group-based nutrition and physical activity to prevent frailty in pre-frail older adults (SUPER): a randomised controlled trial

“…Our study does not support the combined strategies being better than either strategy alone, and suggests that long-term (ie, beyond 6 months) positive effects on frailty are 4 or have involved intensive supervised activity several times a week. 43 There are several trials of similar combinations of interventions yet to be published, [44][45][46][47][48][49][50] which are needed to further clarify the effectiveness of such interventions in preventing and reversing frailty. 51 Applying the NNT to our data showed that for one pre-frail person to become robust in the SC group at 6 months after the intervention, 6 (95% CI 3-19) would need to be treated, while for the SAYGO group, 9 (4-289) would need to be treated.…”