Pöyhönen Johanna, Roitto Hanna-Maria, Lehtisalo Jenni, Levälahti Esko, Strandberg Timo, Kivipelto Miia, Kulmala Jenni, Antikainen Riitta, Soininen Hilkka, Tuomilehto Jaakko, Laatikainen Tiina, Ngandu Tiia
Department of Public Health, Finnish Institute for Health and Welfare (THL), Helsinki, Finland.
Department of Medicine, Clinicum, University of Helsinki, Helsinki, Finland.
J Am Geriatr Soc. 2025 Aug;73(8):2457-2465. doi: 10.1111/jgs.19552. Epub 2025 May 30.
The prevalence of frailty is increasing as the population ages. Lifestyle interventions have shown potential in frailty prevention. Intervention studies have been generally limited by short interventions and follow-ups or by focusing on single-domain approaches. We aimed to investigate whether a 2-year multidomain lifestyle intervention prevents phenotypic pre-frailty or frailty and whether baseline factors predict phenotypic pre-frailty or frailty.
A total of 1259 participants (aged 60-77 years) in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) were randomized to a multidomain intervention group or to a regular health advice group for 2 years. Frailty was defined by modified Fried phenotype. Pre-frail and frail participants were grouped for analyses. The prevalence of pre-frailty/frailty at baseline and at 2, 7, and 11 years, the change in prevalence from baseline, and the difference in these changes between intervention and control groups were estimated using a mixed-effects logistic regression model.
The intervention reduced the risk of pre-frailty/frailty up to 7 years. The prevalence decreased in the intervention group from baseline (47%) to 2 years (42%), while it increased in the control group (45% to 49%), resulting in a -9.6-percentage point difference in the change (p = 0.007). After the active intervention period, the prevalence began to increase in both groups, but the difference in the change remained in favor of the intervention group at 7 years (-6.2 percentage points, p = 0.049). The beneficial effect was no longer evident at 11 years. Older age, lower protein intake, and a higher number of chronic diseases were strongly associated with pre-frailty/frailty.
A 2-year multimodal lifestyle intervention effectively prevented phenotypic pre-frailty/frailty, with sustained benefits observed up to 7 years. Continuous support for a healthy lifestyle may be necessary to prevent late-life pre-frailty or frailty.
随着人口老龄化，衰弱的患病率正在上升。生活方式干预在预防衰弱方面已显示出潜力。干预研究通常受到干预和随访时间短或侧重于单领域方法的限制。我们旨在研究为期两年的多领域生活方式干预是否能预防表型前衰弱或衰弱，以及基线因素是否能预测表型前衰弱或衰弱。
芬兰老年干预预防认知障碍和残疾研究（FINGER）中共有1259名年龄在60 - 77岁的参与者被随机分为多领域干预组或常规健康建议组，为期2年。衰弱由改良的弗里德表型定义。将前衰弱和衰弱参与者分组进行分析。使用混合效应逻辑回归模型估计基线、2年、7年和11年时前衰弱/衰弱的患病率、与基线相比患病率的变化以及干预组和对照组在这些变化上的差异。
该干预降低了长达7年的前衰弱/衰弱风险。干预组的患病率从基线时的47%降至2年时的42%，而对照组则从45%增至49%，变化差异为 - 9.6个百分点（p = 0.007）。在积极干预期后，两组的患病率均开始上升，但在7年时变化差异仍有利于干预组（ - 6.2个百分点，p = 0.049）。在11年时，有益效果不再明显。年龄较大、蛋白质摄入量较低和慢性病数量较多与前衰弱/衰弱密切相关。
为期两年的多模式生活方式干预有效预防了表型前衰弱/衰弱，在长达7年的时间里都观察到了持续的益处。为预防晚年的前衰弱或衰弱，可能需要持续支持健康的生活方式。
