Aguado Ortego Ruth, Gómez González Lucía, Gómez Rubiano Montserrat, Fernández Rodriguez Esperanza, Baztán Cortés Juan José, Gómez-Pavón Javier
Servicio de Geriatría, Hospital Central de La Cruz Roja San José y Santa Adela, Madrid, España.
Servicio de Geriatría, Hospital Central de La Cruz Roja San José y Santa Adela, Madrid, España.
Rev Esp Geriatr Gerontol. 2025 Mar-Apr;60(2):101625. doi: 10.1016/j.regg.2025.101625. Epub 2025 Feb 12.
The greatest challenge in healthcare is maintaining the functional capacity of the elderly through prevention and reversal programs for situations of physical fragility before crossing the threshold of disability. The aim of this study is to describe the functional evolution of frail and pre-frail elderly people in the community, after a multifactorial intervention based on comprehensive geriatric assessment followed by an outpatient multicomponent exercise program.
Longitudinal observational study, from May 27, 2021 to January 15, 2023, which included patients with physical frailty (Short Physical Performance Battery [SPPB] < 10) from the Frailty and Fall Prevention Clinic, to carry out an outpatient multicomponent exercise program for 12 weeks, supervised by a multidisciplinary team made up of geriatrics, physiotherapy and specialized nursing. The degree of frailty was assessed using the SPPB (10-12 points: robust, 7-9 points: pre-frail, 4-6 points: frail, 0-3 points: disability). The outcome variables were the pre- and post-intervention difference in SPPB, gait speed, grip strength and quality of life (EuroQoL EQ-5D), compared by Student's T test for paired samples.
A total of 46 patients were included (82.3 years±5.47; 73.91% women). Before the intervention, 39.13% of the patients were categorized as frail and 60.87% as pre-frail. After the intervention, a gain of 3.56 points in the SPPB was achieved (P<.001), being 85.37% of the patients categorized as robust, 14.63% as pre-frail, and none of them as frail. Furthermore, the gait speed improved 0.38m/s (P<.001); the grip strength increased 2.84 kg in women (P<.05) and 3.91 kg in men (P<.05); and the EuroQoL score raised 29.15 points (P<.001).
Multicomponent exercise on an outpatient basis, combined with comprehensive geriatric assessment performed in a geriatric department by a multidisciplinary team, contributes to the reversal of frailty.
医疗保健领域最大的挑战是通过针对身体虚弱状况的预防和逆转计划，在老年人跨越残疾门槛之前维持其功能能力。本研究的目的是描述在基于综合老年评估的多因素干预后，接着进行门诊多组分运动计划的情况下，社区中虚弱和衰弱前期老年人的功能演变。
纵向观察性研究，从2021年5月27日至2023年1月15日，纳入了来自衰弱与跌倒预防诊所的身体虚弱患者（简易体能状况量表[SPPB]<10），进行为期12周的门诊多组分运动计划，由老年医学、物理治疗和专科护理组成的多学科团队监督。使用SPPB评估虚弱程度（10 - 12分：强健，7 - 9分：衰弱前期，4 - 6分：虚弱，0 - 3分：残疾）。通过配对样本的学生t检验比较干预前后SPPB、步速、握力和生活质量（欧洲生活质量EQ - 5D）的差异作为结果变量。
共纳入46例患者（82.3岁±5.47；73.91%为女性）。干预前，39.13%的患者被归类为虚弱，60.87%为衰弱前期。干预后，SPPB增加了3.56分（P<.001），85.37%的患者被归类为强健，14.63%为衰弱前期，无患者为虚弱。此外，步速提高了0.38m/s（P<.001）；女性握力增加2.84kg（P<.05），男性增加3.91kg（P<.05）；欧洲生活质量评分提高了29.15分（P<.001）。
门诊多组分运动，结合老年医学科由多学科团队进行的综合老年评估，有助于逆转虚弱。
