Effects of a multifactorial intervention comprising resistance exercise, nutritional and psychosocial programs on frailty and functional health in community-dwelling older adults: A randomized, controlled, cross-over trial

Abstract

Aim: To examine the effects of a multifactorial intervention on frailty and functional health among community-dwelling older adults, a 6-month randomized, controlled, cross-over trial was carried out within the Hatoyama Cohort Study.

Methods: A total of 77 pre-frail or frail older adults (mean age 74.6 years) were randomly allocated to an immediate intervention group (IIG; n = 38) or delayed intervention group (DIG; n = 39). The IIG participated in a twice-weekly multifactorial intervention comprising resistance exercise, nutritional education and psychosocial programs. No intervention was given to the DIG during the initial 3-month period, and both groups were crossed over for the latter 3-month period. Pre-frailty and frailty were determined by using the Check-List 15, which was validated against Fried's frailty criteria. Effects of the intervention on primary (Check-List 15 score and frailty status) and secondary outcomes (physical and psychosocial functions, and nutritional intake) were examined for both 3-month periods.

Results: As compared with the DIG, the IIG had significant reductions in Check-List 15 score (-0.36 points; 95% CI -0.74 to -0.03), frailty prevalence (-23.5%, 95% CI -40.4 to -6.7), Timed Up and Go test (-0.25 s, 95% CI -0.47 to -0.08), and Geriatric Depression Score (-0.92 points, 95% CI -1.44 to -0.39), and improvements in the Dietary Variety Score (0.65 points, 95% CI 0.05-1.25), and protein (1.9% E, 95% CI 1.1-2.7) and micronutrient intakes at 3 months, all of which, excluding protein and micronutrient intakes, persisted at 6 months. The DIG showed similar intervention effects in the latter 3-month period.

Conclusions: This 3-month multifactorial intervention reduced frailty and improved functional health. These intervention effects persisted for at least 3 months post-intervention. Geriatr Gerontol Int 2017; 17: 2034-2045.

Keywords: exercise; frailty; multifactorial intervention; nutrition; psychosocial.