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多组分衰弱预防计划对社区居住的虚弱前期老年人的影响:一项随机对照试验。

Effects of a Multicomponent Frailty Prevention Program in Prefrail Community-Dwelling Older Persons: A Randomized Controlled Trial.

机构信息

Jockey Club Institute of Ageing, Chinese University of Hong Kong, Hong Kong SAR, China; Department of Medicine and Therapeutics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China.

Jockey Club Institute of Ageing, Chinese University of Hong Kong, Hong Kong SAR, China.

出版信息

J Am Med Dir Assoc. 2020 Feb;21(2):294.e1-294.e10. doi: 10.1016/j.jamda.2019.08.024. Epub 2019 Nov 7.

Abstract

OBJECTIVE

To examine the effects of a multicomponent frailty prevention program in community-dwelling older persons with prefrailty.

DESIGN

A randomized controlled trial.

SETTING

A community elderly center in Hong Kong.

PARTICIPANTS

Persons aged ≥50 years who scored 1-2 on a simple frailty questionnaire (FRAIL) METHODS: Participants (n = 127) were randomly assigned to a 12-week multicomponent frailty prevention program (exercise, cognitive training, board game activities) or to a wait-list control group. The primary outcomes were FRAIL scores, frailty status, and a combined frailty measure including subjective (FRAIL total score) and objective (grip strength, muscle endurance, balance, gait speed) measures. The secondary outcomes were verbal fluency assessed by dual-task gait speed, attention and memory assessed by digit span task, executive function assessed by the Frontal Assessment Battery, self-rated health, and life satisfaction. Assessments were conducted at baseline and at week 12.

RESULTS

The mean age of the participants was 62.2 years, and 88.2% were women. At week 12, the FRAIL score had decreased in the intervention group (-1.3, P < .001) but had increased in the control group (0.3, P < .01) (between-group differences P < .001). In addition, 83.3% and 1.6% of the intervention and control groups, respectively, had reversed from prefrailty to robust phenotype (between-group differences P < .001). Participants in the intervention group also had a greater reduction in the combined frailty score and greater improvements in muscle endurance, balance, verbal fluency, attention and memory, executive function, and self-rated health than those in the control group (all P < .05). There were no significant differences between the groups with respect to grip strength, gait speed, and life satisfaction.

CONCLUSIONS AND IMPLICATIONS

The multicomponent frailty prevention program reduced frailty and improved physical and cognitive functions, and self-rated health in community-dwelling older persons with prefrailty. Findings can provide insights into the consideration of incorporating frailty prevention programs into the routine practice of community elderly services.

摘要

目的

探讨多组分衰弱预防计划对衰弱前期社区老年人的影响。

设计

随机对照试验。

地点

香港社区老年中心。

参与者

年龄≥50 岁,简单衰弱问卷(FRAIL)评分为 1-2 分的老年人。

方法

将参与者(n=127)随机分为 12 周多组分衰弱预防计划(运动、认知训练、棋盘游戏活动)或等待名单对照组。主要结局指标为 FRAIL 评分、衰弱状况以及包括主观(FRAIL 总分)和客观(握力、肌肉耐力、平衡、步态速度)指标的综合衰弱指标。次要结局指标为双任务步态速度评估的言语流畅性、数字跨度任务评估的注意力和记忆力、额叶评估电池评估的执行功能、自我评估的健康和生活满意度。在基线和第 12 周进行评估。

结果

参与者的平均年龄为 62.2 岁,88.2%为女性。在第 12 周时,干预组的 FRAIL 评分下降(-1.3,P<.001),而对照组则增加(0.3,P<.01)(组间差异 P<.001)。此外,干预组和对照组分别有 83.3%和 1.6%的人从衰弱前期转变为强壮表型(组间差异 P<.001)。与对照组相比,干预组的综合衰弱评分降低更大,肌肉耐力、平衡、言语流畅性、注意力和记忆力、执行功能和自我评估的健康状况改善更大(均 P<.05)。两组在握力、步态速度和生活满意度方面无显著差异。

结论和意义

多组分衰弱预防计划可降低衰弱前期社区老年人的衰弱程度,并改善其身体和认知功能以及自我评估的健康状况。研究结果可为将衰弱预防计划纳入社区老年服务常规实践提供参考。

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