Bandinelli Stefania, Lauretani Fulvio, Boscherini Vittorio, Gandi Francesca, Pozzi Martina, Corsi Anna Maria, Bartali Benedetta, Lova Raffaello Molino, Guralnik Jack M, Ferrucci Luigi
Geriatric Rehabilitation Unit, ASF, Tuscany Regional Health Agency, and Laboratory of Clinical Epidemiology, Italian National Institute of Research and Care of Aging, Firenze, Italy.
Aging Clin Exp Res. 2006 Oct;18(5):359-66. doi: 10.1007/BF03324831.
We describe the enrollment and intervention phases of FRASI (FRAilty, Screening and Intervention), a randomized controlled trial aimed at preventing ADL disability in frail older persons screened in primary care.
Patients, 70-85 years old, non-disabled and noncognitively impaired, were screened for frailty (score < or = 9 on the Short Physical Performance Battery, SPPB) during primary care visits. Of 447 eligible persons, 410 came to the study clinic and 251 were randomized into treatment (n=126) and control groups (n=125). The active group received an intensive medical intervention, and sixteen 90-minute supervised exercise sessions over 8 weeks. The primary outcome was time to ADL disability onset or death in the 12-month period after study enrollment.
The two study arms were similar for demographics, cognitive function, physical function and health status. Compared with a population-based sample selected according to FRASI inclusion criteria except SPPB score, FRASI participants had significantly worse health and functional status. Restricting the comparison to persons with SPPB < or = 9, all differences disappeared. The 99 participants (78.6% of 126) who completed the intervention participated in a mean of 15.3+/-1.6 exercise sessions.
Screening in primary care for non-disabled, older persons with SPPB < or = 9 yields individuals with substantial morbidity, impairments and functional limitations that can be successfully involved in an intensive medical and exercise intervention. Whether such an intervention effectively prevents new disability remains to be confirmed.
我们描述了FRASI（衰弱、筛查与干预）研究的入组和干预阶段，这是一项随机对照试验，旨在预防在初级保健中筛查出的体弱老年人出现日常生活活动能力障碍。
对年龄在70 - 85岁、无残疾且无认知障碍的患者，在初级保健就诊期间进行衰弱筛查（简短体能状况量表[SPPB]评分≤9分）。在447名符合条件的人中，410人来到研究诊所，251人被随机分为治疗组（n = 126）和对照组（n = 125）。干预组接受强化医疗干预，在8周内进行16次每次90分钟的有监督的锻炼课程。主要结局是研究入组后12个月内出现日常生活活动能力障碍或死亡的时间。
两个研究组在人口统计学、认知功能、身体功能和健康状况方面相似。与根据FRASI纳入标准（除SPPB评分外）选取的基于人群的样本相比，FRASI参与者的健康和功能状况明显更差。将比较限制在SPPB≤9分的人群中，所有差异均消失。完成干预的99名参与者（占126人的78.6%）平均参加了15.3±1.6次锻炼课程。
在初级保健中对SPPB≤9分的非残疾老年人进行筛查，会发现有大量发病情况、损伤和功能受限的个体，这些个体能够成功参与强化医疗和锻炼干预。这种干预是否能有效预防新的残疾情况仍有待证实。
