Landi Francesco, Cesari Matteo, Calvani Riccardo, Cherubini Antonio, Di Bari Mauro, Bejuit Raphael, Mshid Jerome, Andrieu Sandrine, Sinclair Alan J, Sieber Cornel C, Vellas Bruno, Topinkova Eva, Strandberg Timo, Rodriguez-Manas Leocadio, Lattanzio Fabrizia, Pahor Marco, Roubenoff Ronenn, Cruz-Jentoft Alfonso J, Bernabei Roberto, Marzetti Emanuele
Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart School of Medicine, Rome, Italy.
Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.
Aging Clin Exp Res. 2017 Feb;29(1):89-100. doi: 10.1007/s40520-016-0715-2. Epub 2017 Jan 31.
The sustainability of health and social care systems is threatened by a growing population of older persons with heterogeneous needs related to multimorbidity, frailty, and increased risk of functional impairment. Since disability is difficult to reverse in old age and is extremely burdensome for individuals and society, novel strategies should be devised to preserve adequate levels of function and independence in late life. The development of mobility disability, an early event in the disablement process, precedes and predicts more severe forms of inability. Its prevention is, therefore, critical to impede the transition to overt disability. For this reason, the Sarcopenia and Physical fRailty IN older people: multi-componenT Treatment strategies (SPRINTT) project is conducting a randomized controlled trial (RCT) to test a multicomponent intervention (MCI) specifically designed to prevent mobility disability in high-risk older persons. SPRINTT is a phase III, multicenter RCT aimed at comparing the efficacy of a MCI, based on long-term structured physical activity, nutritional counseling/dietary intervention, and an information and communication technology intervention, versus a healthy aging lifestyle education program designed to prevent mobility disability in 1500 older persons with physical frailty and sarcopenia who will be followed for up to 36 months. The primary outcome of the SPRINTT trial is mobility disability, operationalized as the inability to walk for 400 m within 15 min, without sitting, help of another person, or the use of a walker. Secondary outcomes include changes in muscle mass and strength, persistent mobility disability, falls and injurious falls, disability in activities of daily living, nutritional status, cognition, mood, the use of healthcare resources, cost-effectiveness analysis, quality of life, and mortality rate. SPRINTT results are expected to promote significant advancements in the management of frail older persons at high risk of disability from both clinical and regulatory perspectives. The findings are also projected to pave the way for major investments in the field of disability prevention in old age.
健康和社会护理系统的可持续性受到老年人口不断增长的威胁,这些老年人因多种疾病、身体虚弱以及功能障碍风险增加而有着多样化的需求。由于残疾在老年时难以逆转,且对个人和社会造成极大负担,因此应制定新策略,以在晚年维持适当的功能水平和独立性。行动能力残疾是残疾过程中的早期事件,它先于并预示着更严重的无能力形式。因此,预防行动能力残疾对于阻止向明显残疾的转变至关重要。出于这个原因,老年人肌肉减少症和身体虚弱:多成分治疗策略(SPRINTT)项目正在进行一项随机对照试验(RCT),以测试专门设计用于预防高危老年人行动能力残疾的多成分干预措施(MCI)。SPRINTT是一项III期多中心RCT,旨在比较基于长期结构化体育活动、营养咨询/饮食干预以及信息和通信技术干预的MCI与旨在预防行动能力残疾的健康老龄化生活方式教育项目的疗效,该项目针对1500名身体虚弱和患有肌肉减少症的老年人,随访时间长达36个月。SPRINTT试验的主要结局是行动能力残疾,定义为在15分钟内无法在不坐下、无需他人帮助或不使用助行器的情况下行走400米。次要结局包括肌肉量和力量的变化、持续性行动能力残疾、跌倒和伤害性跌倒、日常生活活动中的残疾、营养状况。认知、情绪、医疗资源的使用、成本效益分析、生活质量和死亡率。预计SPRINTT的结果将从临床和监管角度推动对高残疾风险虚弱老年人管理的重大进展。研究结果还预计将为老年残疾预防领域的重大投资铺平道路。
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