Physiotherapy Programme and Centre for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
TUM School of Medicine & Health, Department of Health and Sport Sciences, Technical University of Munich, Munich, Germany.
BMC Geriatr. 2024 Oct 31;24(1):903. doi: 10.1186/s12877-024-05457-5.
Cognitive frailty (CF) is an emerging concern among older persons, particularly within lower socioeconomic statuses (SES) populations. Currently, there is limited evidence on the potential reversibility of CF through multi-domain interventions within this demographic. This study aimed to investigate the effectiveness of the WE-RISE™ multi-domain intervention in addressing the potential reversibility of CF among community-dwelling older persons of lower SES, the intervention effects on multiple health dimensions, and to determine if WE-RISE™ is of low cost.
This 24-week randomised controlled trial included 55 community-dwelling older persons of lower SES with CF, who were randomised into either the WE-RISE™ intervention group (n = 27), or the control group receiving usual care (n = 28). The WE-RISE™ intervention comprised of 12 weeks of instructor led, community-based intervention, followed by 12 weeks of WE-RISE™@Home. CF status, cognitive and physical function, nutrition, disability, health-related quality of life, exercise self-efficacy and depression were assessed at baseline, 12th and 24th weeks. Changes in CF status was analysed descriptively, while intervention effects were analyzed with split plot ANOVA. The cost of the WE-RISE™ intervention was calculated using activity-based costing.
At baseline, all participants in both the intervention and control groups (100%) were classified as CF. Following 12 weeks of the WE-RISE™ intervention, 74.1% of participants in the experimental group no longer met the criteria for cognitive frailty, with 63% maintaining this improvement at 24 weeks. In contrast, the CF status of participants in the control group remained largely unchanged, with only 10.7% showing improvement at 12 weeks and falling to 3.6% at 24 weeks. Significant intervention effects were observed for cognition, physical function, body composition, disability, health-related quality of life and self-perceived exercise self-efficacy (p < 0.05) following participation in WE-RISE™. The cost per intervention session was RM4.06 (≈ RM3.88), and the cost per subject for 48 sessions was RM194.74 (≈ RM187.01).
The WE-RISE™ multi-domain intervention has demonstrated potential in reversing CF among older persons of lower SES, leading to significant improvements across multiple health dimensions at a low cost. WE-RISE™ shows promise to enrich the well-being of ageing societies, contribute to societal health, and ensure equitable access to healthcare, supporting broader implementation by enhancing equitable access to health programs and addressing the needs of older persons, WE-RISE™.
This trial was registered in the Australian New Zealand Clinical Trials Registry (ACTRN12619001055190) on the 29th of July 2019 - retrospectively registered.
认知脆弱（CF）是老年人中一个新出现的问题，尤其是在社会经济地位较低的人群中。目前，关于在这一人群中通过多领域干预来逆转 CF 的潜在可能性的证据有限。本研究旨在探讨 WE-RISE™多领域干预在解决社会经济地位较低的社区居住老年人 CF 的潜在可逆性、干预对多种健康维度的影响方面的有效性，并确定 WE-RISE™是否具有低成本。
这是一项为期 24 周的随机对照试验，纳入了 55 名患有 CF 的社会经济地位较低的社区居住老年人，他们被随机分为 WE-RISE™干预组（n=27）或接受常规护理的对照组（n=28）。WE-RISE™干预包括 12 周的指导员主导的社区基础干预，随后是 12 周的 WE-RISE™@Home。在基线、第 12 周和第 24 周评估 CF 状态、认知和身体功能、营养、残疾、健康相关生活质量、锻炼自我效能和抑郁情况。CF 状态的变化进行描述性分析，而干预效果则采用分割区组方差分析进行分析。使用基于活动的成本核算计算 WE-RISE™干预的成本。
基线时，干预组和对照组的所有参与者（100%）均被归类为 CF。在接受 WE-RISE™干预 12 周后，实验组有 74.1%的参与者不再符合认知脆弱的标准，63%的参与者在 24 周时保持了这一改善。相比之下，对照组参与者的 CF 状态基本保持不变，只有 10.7%的参与者在 12 周时有所改善，到 24 周时下降到 3.6%。在参与 WE-RISE™后，认知、身体功能、身体成分、残疾、健康相关生活质量和自我感知的锻炼自我效能方面观察到显著的干预效果（p<0.05）。每次干预的成本为 4.06 令吉（约 3.88 令吉），48 次干预的每位参与者的成本为 194.74 令吉（约 187.01 令吉）。
WE-RISE™多领域干预在逆转社会经济地位较低的老年人 CF 方面具有潜力，可带来多项健康指标的显著改善，且成本低廉。WE-RISE™有望丰富老龄化社会的福祉，为社会健康做出贡献，并确保公平获得医疗保健，通过增强公平获得健康计划的机会和满足老年人的需求来支持更广泛的实施。
