Su Tai-Te, Barclay Ruth, Moineddin Rahim, Salbach Nancy M
Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada.
School and Graduate Institute of Physical Therapy, National Taiwan University, Taipei, Taiwan.
PLoS One. 2025 Sep 12;20(9):e0323923. doi: 10.1371/journal.pone.0323923. eCollection 2025.
Diverse strategies are needed to reduce frailty. This study evaluated the effects of two behavioural interventions targeting outdoor walking on reducing the level of frailty among community-dwelling older adults with mobility limitations.
Data from two participant cohorts of the Getting Older Adults Outdoors (GO-OUT) study were analyzed. After baseline evaluations, 190 participants were invited to a one-day educational workshop and were then randomized to either a 10-week supervised outdoor walk group (n = 98) or a 10-week telephone weekly reminders group (n = 92). Frailty was assessed using Fried's frailty index at 0, 3, and 5.5 months. Mixed-effects linear and ordinal regression models were used to evaluate change in frailty score and phenotype over time after accounting for age, sex, study site, participation on own or with a partner, and cohort.
At baseline, participant mean age was 74.5 ± 7.1 years; 73% were female, 7% were frail, and 59% were pre-frail. Total frailty scores decreased, on average, by 0.13 points (b = -0.13, 95% CI: -0.26 to -0.01; p = .036) across all participants from 0 to 3 months (immediately post-intervention). Participants were 55% less likely to progress to more severe frailty phenotypes at 3 months compared to baseline (OR=0.45; 95% CI: 0.25 to 0.81; p = .008). No significant between-group differences or long-term effects were observed.
A short-term reduction in frailty was observed in older adults with mobility limitations following participation in behavioural interventions aimed at improving outdoor walking; neither intervention was superior. Supervised outdoor walk group and telephone weekly reminder interventions to increase outdoor walking may have the potential to mitigate frailty in older adults with mobility limitations.
需要多种策略来减少衰弱。本研究评估了两种针对户外步行的行为干预措施对降低社区居住的行动不便老年人衰弱水平的效果。
对“让老年人走出户外”（GO - OUT）研究的两个参与者队列的数据进行了分析。在基线评估后，190名参与者被邀请参加为期一天的教育研讨会，然后被随机分为10周有监督的户外步行组（n = 98）或10周每周电话提醒组（n = 92）。在0、3和5.5个月时使用弗里德衰弱指数评估衰弱情况。在考虑年龄、性别、研究地点、独自或与同伴参与以及队列因素后，使用混合效应线性和有序回归模型来评估衰弱评分和表型随时间的变化。
在基线时，参与者的平均年龄为74.5±7.1岁；73%为女性，7%为衰弱，59%为衰弱前期。在0至3个月（干预后立即），所有参与者的总衰弱评分平均下降了0.13分（b = -0.13，95%置信区间：-0.26至-0.01；p = 0.036）。与基线相比，参与者在3个月时进展为更严重衰弱表型的可能性降低了55%（OR = 0.45；95%置信区间：0.25至0.81；p = 0.008）。未观察到显著的组间差异或长期影响。
行动不便的老年人在参与旨在改善户外步行的行为干预后，衰弱情况出现了短期改善；两种干预措施效果相当。有监督的户外步行组和每周电话提醒干预措施以增加户外步行，可能有减轻行动不便老年人衰弱的潜力。
