Building resilience and reversing frailty: a randomised controlled trial of a primary care intervention for older adults
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2023Author:
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Travers J, Romero-Ortuno R, Langan J, MacNamara F, McCormack D, McDermott C, McEntire J, McKiernan J, Lacey S, Doran P, Power D, Cooney MT, Building resilience and reversing frailty: a randomised controlled trial of a primary care intervention for older adults, Age and Ageing, 2023, 52: 1–9Download Item:
Abstract:
Background: There is a need for effective primary care interventions that help older people combat frailty and build resilience.
Objective: To study the effectiveness of an optimised exercise and dietary protein intervention.
Design: Multicentre, randomised-controlled, parallel-arm trial.
Setting: Six primary care practices, Ireland.
Methods: Six general practitioners enrolled adults aged 65+ with Clinical Frailty Scale score ≤5 from December 2020 to
May 2021. Participants were randomised to intervention or usual care with allocation concealed until enrolment. Intervention
comprised a 3-month home-based exercise regime, emphasising strength, and dietary protein guidance (1.2 g/kg/day).
Effectiveness was measured by comparing frailty levels, based on the SHARE-Frailty Instrument, on an intention-to-treat
basis. Secondary outcomes included bone mass, muscle mass and biological age measured by bioelectrical impedance analysis.
Ease of intervention and perceived health benefit were measured on Likert scales.
Results: Of the 359 adults screened, 197 were eligible and 168 enrolled; 156 (92.9%) attended follow-up (mean age 77.1;
67.3% women; 79 intervention, 77 control). At baseline, 17.7% of intervention and 16.9% of control participants were frail
by SHARE-FI. At follow-up, 6.3 and 18.2% were frail, respectively. The odds ratio of being frail between intervention and
control groups post-intervention was 0.23 (95% confidence interval: 0.07–0.72; P = 0.011), adjusting for age, gender and
site. Absolute risk reduction was 11.9% (CI: 0.8%–22.9%). Number needed to treat was 8.4. Grip strength (P < 0.001) and
bone mass (P = 0.040) improved significantly. 66.2% found the intervention easy, 69.0% reported feeling better.
Conclusion: A combination of exercises and dietary protein significantly reduced frailty and improved self-reported health.
Sponsor
Grant Number
Health Research Board (HRB)
CTN-2014-011
Science Foundation Ireland (SFI)
18/FRL/6188
Author's Homepage:
http://people.tcd.ie/romeroor
Author: Romero-Ortuno, Roman
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Age and Ageing;Availability:
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Frailty, Resilience, Primary care, Exercise, Protein, Older peopleSubject (TCD):
AgeingDOI:
https://doi.org/10.1093/ageing/afad012Metadata
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