Research Unit, Consorci Sanitari del Maresme, Mataró, Barcelona, Spain.
Centro de Investiación Biomédica en Red de EnfermedadesHepáticas y Digestivas (CIBEREHD), ISCIII, Madrid, Spain.
Age Ageing. 2017 May 1;46(3):401-407. doi: 10.1093/ageing/afw242.
evidence on the effectiveness of interventions to prevent frailty is scarce.
to assess the effect of an intervention in preventing frailty progression in pre-frail older people.
a randomised, open label, controlled trial with two parallel arms.
community-dwelling pre-frail older people (≥70 years) consulting in primary care.
nutritional assessment (and derivation to a Nutritional Unit for usual care in the event of nutritional risk) and a physical activity programme including aerobic exercise and a set of mixed strengthening, balance and coordination exercises.
patients receiving the usual care.
prevalence of frailty (Fried criteria) at 12 months.
functional capacity (Barthel index), falls and nutritional status (Short-Form Mini Nutritional Assessment) on follow-up at 12 months.
one hundred and seventy-two participants were recruited and randomised (mean age: 78.3 years; mean number of Fried criteria: 1.45). Thirty-nine participants (22.6%) were dropped out during the study. At follow-up, 4.9% of the intervention group and 15.3% of the control group had evolved to frailty, for a crude odds ratio (OR) of 0.29 (95% confidence interval [CI]: 0.08-1.08; P = 0.052) and an adjusted (by age, gender and number of co-morbidities) OR of 0.19 (95% CI: 0.04-0.95; P = 0.044). Intervention group showed a higher outdoors walking hour per day (0.97 versus 0.73; P = 0.019) but no difference was observed in muscle strength, gait speed or other functional indicators.
an intervention focused on physical exercise and maintaining good nutritional status may be effective in preventing frailty in community-dwelling pre-frail older individuals.
CLINICALTRIALS.GOV IDENTIFIER: NCT02138968.
干预措施预防虚弱的有效性证据有限。
评估干预措施预防虚弱前期老年人虚弱进展的效果。
一项随机、开放标签、对照试验，分为两个平行组。
社区居住的虚弱前期老年人（≥70 岁），在初级保健中就诊。
营养评估（并根据营养风险转至营养单位进行常规护理）和一项身体活动计划，包括有氧运动和一组混合增强力量、平衡和协调的练习。
接受常规护理的患者。
12 个月时虚弱的发生率（Fried 标准）。
12 个月时的功能能力（巴氏指数）、跌倒和营养状况（简短形式迷你营养评估）。
共招募了 172 名参与者并进行了随机分组（平均年龄：78.3 岁；平均 Fried 标准数：1.45）。39 名参与者（22.6%）在研究期间退出。随访时，干预组的 4.9%和对照组的 15.3%发展为虚弱，粗比值比（OR）为 0.29（95%置信区间 [CI]：0.08-1.08；P = 0.052），调整（按年龄、性别和共病数量）后的 OR 为 0.19（95% CI：0.04-0.95；P = 0.044）。干预组每天户外活动时间更长（0.97 与 0.73；P = 0.019），但肌肉力量、步态速度或其他功能指标无差异。
关注身体锻炼和保持良好营养状态的干预措施可能有效预防社区居住的虚弱前期老年人的虚弱。
临床试验.gov 标识符：NCT02138968。
