González-Mariscal Andrea, Corral-Pérez Juan, Vázquez-Sánchez María Ángeles, Ávila-Cabeza-de-Vaca Laura, Costilla Manuel, Casals Cristina
ExPhy Research Group, Department of Physical Education, Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Universidad de Cádiz, Spain.
Department of Nursing, Faculty of Health Sciences, PASOS Research Group, UMA REDIAS Network of Law and Artificial Intelligence Applied to Health and Biotechnology, University of Malaga, Spain.
Int J Nurs Stud. 2025 Feb;162:104955. doi: 10.1016/j.ijnurstu.2024.104955. Epub 2024 Nov 9.
There is an urgent demand for nurses to expand their knowledge and skills in managing frailty in primary care. Frailty is a multifaceted condition that is prevalent among older adults and often leads to reduced functional capacity. Currently, there is a limited understanding of the effectiveness of educational interventions aimed at improving functional capacity among community-dwelling frail older adults in a primary care setting.
This study aimed to evaluate the impact of an educational program on functional capacity among pre-frail and frail older adults living in the community.
A 12-month, multicenter, randomized controlled trial.
The FRAGSALUD study was conducted across 14 healthcare centers situated within the regions of Cadiz and Malaga, Spain.
A total of 199 frail/pre-frail community-dwelling older adults (74.2 ± 6.4 years).
Participants who met at least one Fried's criteria were assigned to either the control group (n = 90), which received usual healthcare assistance, or the intervention group (n = 109). The 6-month intervention comprised four group sessions and six telephone calls conducted by professional nurses, sport scientists, and nutritionists. This educational program focused on guidelines for physical activity, nutritional habits, cognition, and psychosocial well-being. Functional capacity was assessed using questionnaires for basic (Barthel Index) and instrumental (Lawton and Brody Scale) activities of daily living. All outcome measures were evaluated at baseline, immediately after the intervention (6-month), and six months after the intervention as a follow-up (12-month). Differences in functional capacity (Barthel Index and Lawton and Brody Scale scores) across the three time points were analyzed using Friedman's ANOVA, with Wilcoxon signed-rank test for pairwise comparisons.
At both 6-month and 12-month assessments, the control group showed a statistically significant decline in basic and instrumental activities of daily living compared to the intervention group, which maintained similar levels, preventing this age-related decline.
The educational intervention, designed for easy implementation within healthcare systems, especially for nurses, successfully maintained levels of functional capacity in basic and instrumental activities of daily living, while the control group experienced a decline in functional capacity during the 12-month follow-up. Thus, educational interventions are encouraged for preserving the functional independence of frail/pre-frail older adults living in the community.
This trial was registered at ClinicalTrials.gov (Identifier: NCT05610605) and the first participant was registered in March 2022.
The FRAGSALUD educational intervention prevents the age-related decline in functional independence over 12 months in frail older adults.
迫切需要护士扩展其在初级保健中管理衰弱的知识和技能。衰弱是一种多方面的状况，在老年人中普遍存在，且常常导致功能能力下降。目前，对于旨在提高初级保健环境中社区居住的衰弱老年人功能能力的教育干预措施的有效性了解有限。
本研究旨在评估一项教育计划对社区居住的衰弱前期和衰弱老年人功能能力的影响。
一项为期12个月的多中心随机对照试验。
FRAGSALUD研究在西班牙加的斯和马拉加地区的14个医疗中心进行。
共有199名社区居住的衰弱/衰弱前期老年人（74.2±6.4岁）。
符合至少一项弗里德标准的参与者被分配到对照组（n = 90），接受常规医疗保健援助，或干预组（n = 109）。为期6个月的干预包括由专业护士、运动科学家和营养师进行的四次小组会议和六次电话随访。该教育计划侧重于身体活动、营养习惯、认知和心理社会福祉方面的指导方针。使用日常生活基本活动（巴氏指数）和工具性活动（洛顿和布罗迪量表）问卷评估功能能力。所有结局指标在基线、干预后立即（6个月）以及干预后6个月作为随访（12个月）时进行评估。使用弗里德曼方差分析分析三个时间点功能能力（巴氏指数和洛顿和布罗迪量表得分）的差异，并使用威尔科克森符号秩检验进行两两比较。
在6个月和12个月的评估中，与维持相似水平从而防止与年龄相关下降的干预组相比，对照组在日常生活基本活动和工具性活动方面均出现了统计学上的显著下降。
该教育干预措施设计为易于在医疗系统内实施，特别是对护士而言，成功维持了日常生活基本活动和工具性活动的功能能力水平，而对照组在12个月的随访期间功能能力出现下降。因此，鼓励采取教育干预措施以保持社区居住的衰弱/衰弱前期老年人的功能独立性。
本试验在ClinicalTrials.gov（标识符：NCT05610605）注册，第一名参与者于2022年3月注册。
FRAGSALUD教育干预可防止衰弱老年人在12个月内出现与年龄相关的功能独立性下降。
