A pilot randomized controlled trial to improve geriatric frailty

Ding Cheng Derrick Chan, Hsiao Hui Tsou, Rong Sen Yang, Jau Yih Tsauo, Ching Yu Chen, Chao Agnes Hsiung, Ken N. Kuo

Research output: Contribution to journalArticlepeer-review

115 Citations (Scopus)

Abstract

Background: Few randomized controlled trials (RCTs) report interventions targeting improvement of frailty status as an outcome. Methods. This RCT enrolled 117 older adults (65-79years 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 3month. Subjects were followed at 3, 6, and 12months. 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. Results: Mean age was 71.43.7years, 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 3months, but not 6 or 12months. They also had more increase of serum 25(OH) vitamin D level (4.97.7 vs 1.25.4, p=0.006) and lower percentage of osteopenia (74% vs 89% p=0.042) at 12months. PST group subjects had better improvement (2.76.1 vs 0.26.7, p=0.035, 6-month) and less deterioration (3.59.7 vs 7.18.7, 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. Conclusions: 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. Trial registration. ClinicalTrials.gov: EC0970301.

Original languageEnglish
Article number58
JournalBMC Geriatrics
Volume12
DOIs
Publication statusPublished - 2012
Externally publishedYes

Keywords

  • Aged
  • Community
  • Effectiveness
  • Frailty
  • Intervention

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Fingerprint

Dive into the research topics of 'A pilot randomized controlled trial to improve geriatric frailty'. Together they form a unique fingerprint.

Cite this