TY - JOUR
T1 - Individualized Hospital to Home, Exercise-Nutrition Self-Managed Intervention for Pre-Frail and Frail Hospitalized Older Adults
T2 - The INDEPENDENCE Randomized Controlled Pilot Trial
AU - Han, Chad Yixian
AU - Sharma, Yogesh
AU - Yaxley, Alison
AU - Baldwin, Claire
AU - Woodman, Richard
AU - Miller, Michelle
PY - 2023/5/17
Y1 - 2023/5/17
N2 - Purpose: Pre-frailty and frailty in older adults are associated with poor health outcomes and increase health-care costs, and further worsening during hospitalization. This study aimed to examine the effect of an individualized hospital to home, exercise-nutrition selfmanaged intervention for pre-frail and frail hospitalized older adults. Patients and Methods: Older adults admitted to an acute medical unit of a tertiary hospital in South Australia who were pre-frail or frail were recruited from September 2020 to June 2021, randomized to either control or intervention group and followed up at 3 and 6 months. The outcome variables were program adherence, frailty status by the Edmonton Frail Scale (EFS) score, lower extremity physical function, handgrip strength, nutritional status, cognition, mood, health-related quality of life, risk of functional decline, unplanned readmissions. Results: Participants were 79.2 ±6.6 years old, 63% female, mostly frail (67%), with EFS of 8.6±1.9. Adherence to the inpatient and home visits/telehealth intervention were high (91±13% and 92±21%, respectively). Intention-to-treat analysis using linear regression models showed that participants in the intervention group had significantly greater reduction in EFS at 3 (−3.0; 95% CI: −4.8 to −3.0) and 6 months (−2.5; 95% CI: −3.8 to −1.0, P<0.001 for both) compared to the control group; particularly the functional performance component. There were also improvements in overall Short Physical Performance Battery score at 3 (4.0; 95% CI: 1.3 to 6.6) and 6 months (3.9; 95% CI: 1.0 to 6.9, P<0.05 for both), mini-mental state examination (2.6; 95% 0.3–4.8, P=0.029) at 3 months and handgrip strength (3.7; 95% CI: 0.2–7.1, P=0.039) and Geriatric Depression Scale, at 6 months (−2.2; 95% CI: −4.1 to −0.30, P=0.026) in the intervention group as compared to control. Conclusion: This study provided evidence of acceptability to a patient self-managed exercise-nutrition program that may benefit and alleviate pre-frailty and frailty in hospitalised older adults.
AB - Purpose: Pre-frailty and frailty in older adults are associated with poor health outcomes and increase health-care costs, and further worsening during hospitalization. This study aimed to examine the effect of an individualized hospital to home, exercise-nutrition selfmanaged intervention for pre-frail and frail hospitalized older adults. Patients and Methods: Older adults admitted to an acute medical unit of a tertiary hospital in South Australia who were pre-frail or frail were recruited from September 2020 to June 2021, randomized to either control or intervention group and followed up at 3 and 6 months. The outcome variables were program adherence, frailty status by the Edmonton Frail Scale (EFS) score, lower extremity physical function, handgrip strength, nutritional status, cognition, mood, health-related quality of life, risk of functional decline, unplanned readmissions. Results: Participants were 79.2 ±6.6 years old, 63% female, mostly frail (67%), with EFS of 8.6±1.9. Adherence to the inpatient and home visits/telehealth intervention were high (91±13% and 92±21%, respectively). Intention-to-treat analysis using linear regression models showed that participants in the intervention group had significantly greater reduction in EFS at 3 (−3.0; 95% CI: −4.8 to −3.0) and 6 months (−2.5; 95% CI: −3.8 to −1.0, P<0.001 for both) compared to the control group; particularly the functional performance component. There were also improvements in overall Short Physical Performance Battery score at 3 (4.0; 95% CI: 1.3 to 6.6) and 6 months (3.9; 95% CI: 1.0 to 6.9, P<0.05 for both), mini-mental state examination (2.6; 95% 0.3–4.8, P=0.029) at 3 months and handgrip strength (3.7; 95% CI: 0.2–7.1, P=0.039) and Geriatric Depression Scale, at 6 months (−2.2; 95% CI: −4.1 to −0.30, P=0.026) in the intervention group as compared to control. Conclusion: This study provided evidence of acceptability to a patient self-managed exercise-nutrition program that may benefit and alleviate pre-frailty and frailty in hospitalised older adults.
KW - exercise
KW - frailty
KW - nutrition therapy
KW - self-management
UR - http://www.scopus.com/inward/record.url?scp=85159966852&partnerID=8YFLogxK
U2 - 10.2147/CIA.S405144
DO - 10.2147/CIA.S405144
M3 - Article
C2 - 37220521
AN - SCOPUS:85159966852
SN - 1176-9092
VL - 18
SP - 809
EP - 825
JO - Clinical Interventions in Aging
JF - Clinical Interventions in Aging
ER -