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一项针对急性住院超高龄老年糖尿病患者的个体化运动干预效果的辅助分析。

Effects of a Tailored Exercise Intervention in Acutely Hospitalized Oldest Old Diabetic Adults: An Ancillary Analysis.

机构信息

Navarrabiomed, Complejo Hospitalario de Navarra-Universidad Pública de Navarra, Institute for Health Research of Navarre (IdiSNA), Pamplona, Spain.

Networking Biomedical Research Center (CIBER) of Frailty and Healthy Aging, Instituto de Salud Carlos III, Madrid, Spain.

出版信息

J Clin Endocrinol Metab. 2021 Jan 23;106(2):e899-e906. doi: 10.1210/clinem/dgaa809.

Abstract

OBJECTIVE

To analyze the effects of a tailored exercise intervention in acutely hospitalized elderly diabetic patients.

RESEARCH DESIGN AND METHODS

This is an ancillary analysis of a randomized controlled trial (RCT). A total of 103 acutely hospitalized elderly adults (mean age ~87 years) with type II diabetes were randomized to an intervention (exercise, n = 54) or control group (usual care, n = 49). The primary endpoint was change in functional status from baseline to hospital discharge as assessed with the Barthel Index and the Short Physical Performance Battery (SPPB). Secondary endpoints comprised cognitive function and mood status, quality of life (QoL), incidence of delirium, and handgrip strength. Exercise-related side effects, length of hospital stay, and incidence of falls during hospitalization were also assessed, as well as transfer to nursing homes, hospital readmission, and mortality during a 3-month follow-up.

RESULTS

The median length of stay was 8 days (interquartile range, 4) for both groups. The intervention was safe and provided significant benefits over usual care on SPPB (2.7 [95% confidence interval (CI) 1.8, 3.5]) and Barthel Index (8.5 [95% CI: 3.9, 13.1]), as well as on other secondary endpoints such as cognitive status, depression, QoL, and handgrip strength (all P < 0.05). No significant between-group differences were found for the remainder of secondary endpoints.

CONCLUSIONS

An in-hospital individualized multicomponent exercise intervention was safe and effective for the prevention of functional and cognitive decline in acutely hospitalized elderly diabetic patients, although it had no influence on other endpoints assessed during hospitalization or at the 3-month follow-up after discharge.

摘要

目的

分析针对急性住院老年糖尿病患者的定制运动干预的效果。

研究设计和方法

这是一项随机对照试验(RCT)的辅助分析。共有 103 名急性住院的老年 2 型糖尿病患者(平均年龄~87 岁)被随机分为干预组(运动,n=54)或对照组(常规护理,n=49)。主要终点是使用巴氏指数和简短身体表现电池(SPPB)评估从基线到出院时的功能状态变化。次要终点包括认知功能和情绪状态、生活质量(QoL)、谵妄发生率以及握力。还评估了与运动相关的副作用、住院时间、住院期间跌倒的发生率,以及在 3 个月随访期间转移到养老院、医院再入院和死亡率。

结果

两组的中位住院时间均为 8 天(四分位距,4)。干预措施是安全的,与常规护理相比,在 SPPB(2.7 [95%置信区间(CI)1.8,3.5])和巴氏指数(8.5 [95% CI:3.9,13.1])上提供了显著的益处,以及在其他次要终点,如认知状态、抑郁、QoL 和握力(均 P <0.05)。在其余次要终点上,两组之间没有发现显著差异。

结论

住院期间个体化多组分运动干预对预防急性住院老年糖尿病患者的功能和认知能力下降是安全有效的,尽管它对住院期间或出院后 3 个月随访期间评估的其他终点没有影响。

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