Li Pei-Shan, Hsieh Chia Jung, Miao Nae-Fang, Tsai Chuan-Hsiu, Liu Chieh-Yu, Lin Hung-Ru, Wu Shu-Fang Vivienne, Koh Jordan
Department of Long-Term Care, College of Health Technology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan,
School of Nursing, College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
Gerontology. 2025;71(4):273-291. doi: 10.1159/000543909. Epub 2025 Feb 5.
Frailty poses a significant concern among older adults residing in the community, impacting their health and quality of life. This study investigated the effectiveness of the Fitness and Nutrition Program for Seniors (FANS) in addressing frailty and enhancing health-related quality of life. The study aimed to evaluate the effects of a 6-month FANS on frailty status and health-related quality of life in community-dwelling frail older adults, and to compare the effects on fall efficacy, pain intensity, daily activities, stages of physical activity and nutrition behavior change, and satisfaction following the intervention.
A quasi-experimental design was used to assess the FANS among frail older adults (ClinicalTrials.gov Identifier NCT05242549). The intervention, based on the Transtheoretical Model, was conducted in a mixed setting, combining in-person sessions held at a community care center and remote group care delivered through the LINE app. The experimental group (43 individuals) received the FANS intervention, while the control group (38 individuals) continued with standard health promotion activities provided at the same community care center. Intention-to-treat analysis evaluated the intervention's impact. Measurements were taken before the intervention and at the 3-month and 6-month marks to assess changes in frailty status (using Cardiovascular Health Study criteria), health-related quality of life (Short Form-12), fall efficacy (Short Falls Efficacy Scale International), pain intensity (Pain Visual Analogue Scale), and daily activities (Instrumental Activities of Daily Living scale). Behavior change stages and satisfaction were monitored using the Fitness and Nutrition for Seniors Behavior Change Stages and Satisfaction Scale.
Within the experimental group, significant improvements were observed over time across multiple measures, indicating intragroup effects, including frailty, overall health-related quality of life, fall efficacy, pain intensity, and daily activities. Between-group effects demonstrated statistically significant differences in daily activities. Time and group effects showed statistically significant improvements in frailty at 3 months and 6 months post-intervention. Following the intervention, a substantial percentage of participants in the experimental group progressed in behavior change stages related to physical activity and diet, with 83.72% in the action and maintenance stages for physical activity behavior change and 81.40% in those for dietary behavior change. The overall satisfaction rating for the program was 9.25 out of 10 (mean ± SD: 9.25 ± 0.24).
The FANS is a feasible and innovative community health promotion initiative tailored specifically for frail older adults residing in the community, particularly during a pandemic. This program has demonstrated significant improvements in frailty status, health-related quality of life, fall efficacy, pain intensity, and daily activities among community-dwelling frail older adults. Moreover, the program has facilitated notable advancements in behavior change stages, supporting community-dwelling frail older adults in adopting and maintaining healthy behaviors effectively.
衰弱是社区老年人群体中一个重大问题，影响着他们的健康和生活质量。本研究调查了老年人健身与营养计划（FANS）在解决衰弱问题和提高健康相关生活质量方面的有效性。该研究旨在评估为期6个月的FANS对社区居住的衰弱老年人衰弱状况和健康相关生活质量的影响，并比较干预后在跌倒效能、疼痛强度、日常活动、身体活动阶段和营养行为变化以及满意度方面的影响。
采用准实验设计评估FANS对衰弱老年人的影响（ClinicalTrials.gov标识符NCT05242549）。基于跨理论模型的干预在混合环境中进行，结合在社区护理中心举行的面对面课程和通过LINE应用程序提供的远程小组护理。实验组（43人）接受FANS干预，而对照组（38人）继续在同一社区护理中心进行标准的健康促进活动。意向性分析评估干预的影响。在干预前以及3个月和6个月时进行测量，以评估衰弱状况（使用心血管健康研究标准）、健康相关生活质量（简短健康调查问卷-12）、跌倒效能（国际简短跌倒效能量表）、疼痛强度（疼痛视觉模拟量表）和日常活动（日常生活活动工具量表）的变化。使用老年人健身与营养行为变化阶段及满意度量表监测行为变化阶段和满意度。
在实验组中，随着时间推移，多项指标均有显著改善，表明存在组内效应，包括衰弱、整体健康相关生活质量、跌倒效能、疼痛强度和日常活动。组间效应显示日常活动存在统计学显著差异。时间和组效应显示干预后3个月和6个月时衰弱状况有统计学显著改善。干预后，实验组中很大比例的参与者在与身体活动和饮食相关的行为变化阶段取得进展，身体活动行为变化处于行动和维持阶段的比例为83.72%，饮食行为变化的这一比例为81.40%。该计划的总体满意度评分为9.25分（满分10分，均值±标准差：9.25±0.24）。
FANS是一项可行且创新的社区健康促进举措，专门针对社区居住的衰弱老年人，尤其是在疫情期间。该计划已证明社区居住的衰弱老年人在衰弱状况、健康相关生活质量、跌倒效能、疼痛强度和日常活动方面有显著改善。此外，该计划在行为变化阶段取得了显著进展，支持社区居住的衰弱老年人有效采用和维持健康行为。
