Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
Institute of Gerontology, The University of Tokyo, Tokyo, Japan.
Geriatr Gerontol Int. 2017 Nov;17(11):2034-2045. doi: 10.1111/ggi.13016. Epub 2017 Apr 10.
To examine the effects of a multifactorial intervention on frailty and functional health among community-dwelling older adults, a 6-month randomized, controlled, cross-over trial was carried out within the Hatoyama Cohort Study.
A total of 77 pre-frail or frail older adults (mean age 74.6 years) were randomly allocated to an immediate intervention group (IIG; n = 38) or delayed intervention group (DIG; n = 39). The IIG participated in a twice-weekly multifactorial intervention comprising resistance exercise, nutritional education and psychosocial programs. No intervention was given to the DIG during the initial 3-month period, and both groups were crossed over for the latter 3-month period. Pre-frailty and frailty were determined by using the Check-List 15, which was validated against Fried's frailty criteria. Effects of the intervention on primary (Check-List 15 score and frailty status) and secondary outcomes (physical and psychosocial functions, and nutritional intake) were examined for both 3-month periods.
As compared with the DIG, the IIG had significant reductions in Check-List 15 score (-0.36 points; 95% CI -0.74 to -0.03), frailty prevalence (-23.5%, 95% CI -40.4 to -6.7), Timed Up and Go test (-0.25 s, 95% CI -0.47 to -0.08), and Geriatric Depression Score (-0.92 points, 95% CI -1.44 to -0.39), and improvements in the Dietary Variety Score (0.65 points, 95% CI 0.05-1.25), and protein (1.9% E, 95% CI 1.1-2.7) and micronutrient intakes at 3 months, all of which, excluding protein and micronutrient intakes, persisted at 6 months. The DIG showed similar intervention effects in the latter 3-month period.
This 3-month multifactorial intervention reduced frailty and improved functional health. These intervention effects persisted for at least 3 months post-intervention. Geriatr Gerontol Int 2017; 17: 2034-2045.
在 Hatoyama 队列研究中，开展了一项为期 6 个月的随机、对照、交叉试验，以检验多因素干预对社区居住的老年人虚弱和功能健康的影响。
共有 77 名虚弱前期或虚弱的老年人（平均年龄 74.6 岁）被随机分配到立即干预组（IIG；n=38）或延迟干预组（DIG；n=39）。IIG 每周接受两次包括抗阻运动、营养教育和心理社会方案的多因素干预。在最初的 3 个月期间，DIG 未接受任何干预，两组均在随后的 3 个月期间交叉干预。虚弱前期和虚弱状态通过使用经 Fried 虚弱标准验证的 Check-List 15 进行确定。在两个 3 个月期间，分别检查了干预对主要结局（Check-List 15 评分和虚弱状态）和次要结局（身体和心理社会功能以及营养摄入）的影响。
与 DIG 相比，IIG 的 Check-List 15 评分（-0.36 分；95%CI-0.74 至-0.03）、虚弱发生率（-23.5%；95%CI-40.4 至-6.7）、计时起立行走测试（-0.25 秒；95%CI-0.47 至-0.08）和老年抑郁量表（-0.92 分；95%CI-1.44 至-0.39）显著降低，而饮食多样性评分（0.65 分；95%CI0.05-1.25）和蛋白质（1.9%E；95%CI1.1-2.7）及微量营养素摄入量增加，所有这些变化在 3 个月时均存在，除了蛋白质和微量营养素摄入量外，在 6 个月时仍然存在。DIG 在随后的 3 个月期间显示出相似的干预效果。
这项为期 3 个月的多因素干预降低了虚弱程度并改善了功能健康。这些干预效果至少在干预后 3 个月内持续存在。
