A pilot randomized controlled trial to improve geriatric frailty
<p>Abstract</p> <p>Background</p> <p>Few randomized controlled trials (RCTs) report interventions targeting improvement of frailty status as an outcome.</p> <p>Methods</p> <p>This RCT enrolled 117 older adults (65-79 years of age) in Toufen, Taiw...
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doaj-8d3bd214595f4c43ab8eee2a55d96c262020-11-25T01:38:55ZengBMCBMC Geriatrics1471-23182012-09-011215810.1186/1471-2318-12-58A pilot randomized controlled trial to improve geriatric frailtyChan Ding-ChengTsou Hsiao-HuiYang Rong-SenTsauo Jau-YihChen Ching-YuHsiung ChaoKuo Ken N<p>Abstract</p> <p>Background</p> <p>Few randomized controlled trials (RCTs) report interventions targeting improvement of frailty status as an outcome.</p> <p>Methods</p> <p>This RCT enrolled 117 older adults (65-79 years of age) in Toufen, Taiwan who scored 3-6 on The Chinese Canadian Study of Health and Aging Clinical Frailty Scale Telephone Version and then score ≥1 on the Cardiovascular Health Study Phenotypic Classification of Frailty (CHS_PCF). With a two by two factorial design, subjects were randomly assigned to interventions (Exercise and nutrition, EN, n = 55 or problem solving therapy, PST, n = 57) or controls (non-EN, n = 62 or non-PST, n = 60). Educational booklets were provided to all. EN group subjects received nutrition consultation and a thrice-weekly exercise-training program while PST group subjects received 6 sessions in 3 month. Subjects were followed at 3, 6, and 12 months. Primary outcome was improvement of the CHS_PCF by at least one category (from pre-frail to robust, or from frail to pre-frail or robust) from baseline assessments. One hundred and one completed final assessments. Intention-to-treat analysis with the generalized estimating equation model was applied with adjustment for time and treatment-by-time interactions.</p> <p>Results</p> <p>Mean age was 71.4 ± 3.7 years, with 59% females. Baseline characteristic were generally comparable between groups. EN group subjects had a higher improvement rate on the primary outcome than non-EN group subjects (45% vs 27%, adjusted p = 0.008) at 3 months, but not 6 or 12 months. They also had more increase of serum 25(OH) vitamin D level (4.9 ± 7.7 vs 1.2 ± 5.4, p = 0.006) and lower percentage of osteopenia (74% vs 89% p = 0.042) at 12 months. PST group subjects had better improvement (2.7 ± 6.1 vs 0.2 ± 6.7, p = 0.035, 6-month) and less deterioration (−3.5 ± 9.7 vs −7.1 ± 8.7, p = 0.036, 12-month) of dominant leg extension power than non-PST subjects. Some secondary outcomes were also improved in control groups (non-EN or non-PST). No adverse effects were reported.</p> <p>Conclusions</p> <p>The three-month EN intervention resulted in short-term (3-month) frailty status improvement and long-term effect on bone mineral density and serum vitamin D (12-month) among Taiwanese community-dwelling elders. The effect of PST was less pronounce.</p> <p>Trial registration</p> <p>ClinicalTrials.gov: EC0970301</p> http://www.biomedcentral.com/1471-2318/12/58FrailtyAgedInterventionEffectivenessCommunity |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Chan Ding-Cheng Tsou Hsiao-Hui Yang Rong-Sen Tsauo Jau-Yih Chen Ching-Yu Hsiung Chao Kuo Ken N |
spellingShingle |
Chan Ding-Cheng Tsou Hsiao-Hui Yang Rong-Sen Tsauo Jau-Yih Chen Ching-Yu Hsiung Chao Kuo Ken N A pilot randomized controlled trial to improve geriatric frailty BMC Geriatrics Frailty Aged Intervention Effectiveness Community |
author_facet |
Chan Ding-Cheng Tsou Hsiao-Hui Yang Rong-Sen Tsauo Jau-Yih Chen Ching-Yu Hsiung Chao Kuo Ken N |
author_sort |
Chan Ding-Cheng |
title |
A pilot randomized controlled trial to improve geriatric frailty |
title_short |
A pilot randomized controlled trial to improve geriatric frailty |
title_full |
A pilot randomized controlled trial to improve geriatric frailty |
title_fullStr |
A pilot randomized controlled trial to improve geriatric frailty |
title_full_unstemmed |
A pilot randomized controlled trial to improve geriatric frailty |
title_sort |
pilot randomized controlled trial to improve geriatric frailty |
publisher |
BMC |
series |
BMC Geriatrics |
issn |
1471-2318 |
publishDate |
2012-09-01 |
description |
<p>Abstract</p> <p>Background</p> <p>Few randomized controlled trials (RCTs) report interventions targeting improvement of frailty status as an outcome.</p> <p>Methods</p> <p>This RCT enrolled 117 older adults (65-79 years of age) in Toufen, Taiwan who scored 3-6 on The Chinese Canadian Study of Health and Aging Clinical Frailty Scale Telephone Version and then score ≥1 on the Cardiovascular Health Study Phenotypic Classification of Frailty (CHS_PCF). With a two by two factorial design, subjects were randomly assigned to interventions (Exercise and nutrition, EN, n = 55 or problem solving therapy, PST, n = 57) or controls (non-EN, n = 62 or non-PST, n = 60). Educational booklets were provided to all. EN group subjects received nutrition consultation and a thrice-weekly exercise-training program while PST group subjects received 6 sessions in 3 month. Subjects were followed at 3, 6, and 12 months. Primary outcome was improvement of the CHS_PCF by at least one category (from pre-frail to robust, or from frail to pre-frail or robust) from baseline assessments. One hundred and one completed final assessments. Intention-to-treat analysis with the generalized estimating equation model was applied with adjustment for time and treatment-by-time interactions.</p> <p>Results</p> <p>Mean age was 71.4 ± 3.7 years, with 59% females. Baseline characteristic were generally comparable between groups. EN group subjects had a higher improvement rate on the primary outcome than non-EN group subjects (45% vs 27%, adjusted p = 0.008) at 3 months, but not 6 or 12 months. They also had more increase of serum 25(OH) vitamin D level (4.9 ± 7.7 vs 1.2 ± 5.4, p = 0.006) and lower percentage of osteopenia (74% vs 89% p = 0.042) at 12 months. PST group subjects had better improvement (2.7 ± 6.1 vs 0.2 ± 6.7, p = 0.035, 6-month) and less deterioration (−3.5 ± 9.7 vs −7.1 ± 8.7, p = 0.036, 12-month) of dominant leg extension power than non-PST subjects. Some secondary outcomes were also improved in control groups (non-EN or non-PST). No adverse effects were reported.</p> <p>Conclusions</p> <p>The three-month EN intervention resulted in short-term (3-month) frailty status improvement and long-term effect on bone mineral density and serum vitamin D (12-month) among Taiwanese community-dwelling elders. The effect of PST was less pronounce.</p> <p>Trial registration</p> <p>ClinicalTrials.gov: EC0970301</p> |
topic |
Frailty Aged Intervention Effectiveness Community |
url |
http://www.biomedcentral.com/1471-2318/12/58 |
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