Department of Health and Welfare, College of City Management, University of Taipei, Taipei City, Taiwan.
Department of Gerontological Care and Management, College of Nursing, Chang Gung University of Science and Technology, Taoyuan City, Taiwan.
BMC Geriatr. 2022 Jul 5;22(1):559. doi: 10.1186/s12877-022-03246-6.
Previous research has shown that frailty leads to falls, institutionalization, hospitalization, and the loss of functional capacity. While numerous intervention methods aim to reverse frailty, the most effective in older adults is multicomponent exercise. Physical performance has been highlighted as a key factor in mobility, independence, and the burden of chronic disease. Several studies have demonstrated an association between physical performance and frailty; however, the relation between the two over the long term has not yet been fully investigated. Therefore, the current study aims to examine how aspects of physical performance are associated with frailty in the long run for older adults in Taiwan.
This nine-month longitudinal study employed the generalized estimating equation (GEE) modeling to identify measures associated with frailty trajectory. A sample of 159 community-dwelling older adults was recruited through purposive sampling in 12 community care centers in Taiwan. A quasi-experimental approach was adopted in which participants were assigned to the control group or to receive a multicomponent exercise intervention and examined sociodemographic, physical performance, and other factors at the baseline, post intervention (3 months), and follow up (6 months) levels. The multicomponent exercise program was designed based on the principles of the American College of Sports Medicine and comprised aerobic exercise, muscle-strengthening activities, balance training, and stretching exercises once per week for 2 h per session for 12 weeks.
After intervention, we found that the multicomponent exercise group exhibited better performance in the 2-minute step test than the control group (p < 0.05). Regarding long-term effects on frailty trajectories, the study finds that age progression, being female, and longer completion time in the timed up and go test increase the probability of frailty (p < 0.05). Conversely, more steps in the 2-minute step test and undertaking the multicomponent exercise program reduced the long-term probability of frailty (p < 0.05).
This study is the first to explore the relation between indicators of physical performance and frailty trajectory among older adults in Taiwan. Furthermore, we provided support for the efficacy of the multicomponent exercise program in improving frailty status.
先前的研究表明，衰弱会导致跌倒、住院、住院和丧失功能能力。虽然有许多干预方法旨在逆转衰弱，但对老年人最有效的方法是多组分运动。身体表现已被强调为移动性、独立性和慢性病负担的关键因素。多项研究表明身体表现与虚弱之间存在关联；然而，两者之间的长期关系尚未得到充分研究。因此，本研究旨在探讨身体表现的各个方面如何与台湾老年人的长期衰弱相关。
本研究采用广义估计方程（GEE）模型，以确定与虚弱轨迹相关的措施。通过在台湾的 12 个社区护理中心进行的有目的抽样，招募了 159 名社区居住的老年人。采用准实验方法，将参与者分为对照组或接受多组分运动干预组，并在基线、干预后（3 个月）和随访（6 个月）时检查社会人口统计学、身体表现和其他因素。多组分运动方案基于美国运动医学学院的原则设计，包括有氧运动、肌肉强化活动、平衡训练和伸展运动，每周一次，每次 2 小时，共 12 周。
干预后，我们发现多组分运动组在 2 分钟踏步测试中的表现优于对照组（p<0.05）。关于虚弱轨迹的长期影响，研究发现，年龄增长、女性和计时起立行走测试的完成时间较长会增加虚弱的可能性（p<0.05）。相反，2 分钟踏步测试中的步数更多和进行多组分运动方案会降低长期虚弱的可能性（p<0.05）。
本研究首次探讨了台湾老年人身体表现指标与虚弱轨迹之间的关系。此外，我们为多组分运动方案改善虚弱状况的疗效提供了支持。
