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Building resilience and reversing frailty: a randomised controlled trial of a primary care intervention for older adults.

dc.contributor.authorTravers, John
dc.contributor.authorRomero-Ortuno, Roman
dc.contributor.authorLangan, John
dc.contributor.authorMacNamara, Fergal
dc.contributor.authorMcCormack, Darren
dc.contributor.authorMcDermott, Christopher
dc.contributor.authorMcEntire, Jude
dc.contributor.authorMcKiernan, Joanne
dc.contributor.authorLacey, Seán
dc.contributor.authorDoran, Peter
dc.contributor.authorPower, Dermot
dc.contributor.authorCooney, Marie-Therese
dc.date.accessioned2024-10-17T14:18:25Z
dc.date.available2024-10-17T14:18:25Z
dc.date.issued2023-02
dc.identifier.pmid36849160
dc.identifier.doi10.1093/ageing/afad012
dc.identifier.urihttp://hdl.handle.net/10147/643130
dc.descriptionBackground: 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.en_US
dc.language.isoenen_US
dc.relation.ispartofseriesHSE Library Open Access Research Awards 2024en
dc.rights© The Author(s) 2023. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.
dc.rightsAttribution 4.0 International*
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/*
dc.subjectOLDER PEOPLEen_US
dc.subjectexerciseen_US
dc.subjectFrailtyen_US
dc.subjectOLDER PEOPLEen_US
dc.subjectprimary careen_US
dc.subjectproteinen_US
dc.subjectRESILIENCEen_US
dc.titleBuilding resilience and reversing frailty: a randomised controlled trial of a primary care intervention for older adults.en_US
dc.typeArticleen_US
dc.identifier.eissn1468-2834
dc.identifier.journalAge and ageingen_US
dc.source.journaltitleAge and ageing
dc.source.volume52
dc.source.issue2
refterms.dateFOA2024-10-17T14:18:26Z
dc.source.countryEngland


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© The Author(s) 2023. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.
Except where otherwise noted, this item's license is described as © The Author(s) 2023. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.