Effectiveness of an intervention to prevent frailty in pre-frail community-dwelling older people consulting in primary care: a randomised controlled trial.

BACKGROUND

evidence on the effectiveness of interventions to prevent frailty is scarce.

OBJECTIVE

to assess the effect of an intervention in preventing frailty progression in pre-frail older people.

STUDY DESIGN

a randomised, open label, controlled trial with two parallel arms.

POPULATION

community-dwelling pre-frail older people (≥70 years) consulting in primary care.

INTERVENTION

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.

CONTROL GROUP

patients receiving the usual care.

MAIN OUTCOME MEASURE

prevalence of frailty (Fried criteria) at 12 months.

SECONDARY OUTCOMES MEASURES

functional capacity (Barthel index), falls and nutritional status (Short-Form Mini Nutritional Assessment) on follow-up at 12 months.

RESULTS

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.

CONCLUSION

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.