Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
This pilot study tested whether a new program for older adults with frailty could realistically be carried out in primary health care. That is why the main objective of this study was to evaluate the viability and feasibility of the newly designed frailty intervention.
People over 65 were recruited in two health centers and invited to join a 3 month program combining group exercise, a medication review by a pharmacist, and nutrition workshops. The study also collected information on mobility, strength, nutrition, mood, cognition, and quality of life. Most measures were taken at the start and again four and eight months later.
The results will help refine the program and guide the design of a larger clinical trial.
The study assessed the viability and feasibility of a frailty intervention in routine clinical practice through a prospective one-arm pilot conducted in two primary care centers in Donostia (Gipuzkoa, Basque Country, Spain). Participants were adults aged 65 or older, functionally independent (Barthel >90) and classified as frail (Short Physical Performance Battery <10), who received a 12-week physical exercise program, nutritional counseling, and a pharmacological review.
Not provided
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention: physical exercise, polypharmacy review and nutritional care | Experimental | The arm is composed of people aged >65, independent (≥95 points) and frail (Short Physical Performance Battery <10 points). The entire arm group receives the multi-component intervention based on physical exercise, polypharmacy review and nutritional care. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Multi-component intervention: physical exercise, polypharmacy review and nutritional care | Other | Physical exercise: one-hour group sessions, twice a week for 12 consecutive weeks, at the Municipal Sports centre led by a licensed sports instructor. All sessions followed a standardized structure consisting of a warm-up phase of approximately 25 minutes, a strengthening phase of about 25 minutes adjusted to each participant's physical condition, and a final 10-minute relaxation phase including flexibility and balance exercises. Polypharmacy review: a primary care pharmacist reviewed the pharmacological treatments of each participant in order to detect potentially inappropriate prescriptions, following the STOPP/START criteria. Nutritional care: the dietary intervention consisted of three group workshops, one per month, lasting for an hour each. The three workshops, led by a nutritionist, covered the basics of healthy eating, dietary adaptations for specific conditions with recipe ideas, and strategies to prevent malnutrition and sarcopenia. |
| Measure | Description | Time Frame |
|---|---|---|
| Recruitment rates | The numbers of pre-selected participants who met the inclusion criteria and eventually agreed to participate, as well as the drop-outs and their reasons were registered. | Baseline |
| Time required to recruit the sample | The time required to recruit the sample needed for the study was recorded. | Baseline |
| Participants evaluation time | The professionals recorded the evaluation time each participant required | From baseline to 8 months |
| Professionals' opinion on the difficulty and adequacy of the process | Professionals who performed the baseline and follow-up assessments completed a questionnaire on the difficulty and adequacy of the process | From baseline to 8 months |
| Adherence to the intervention | Number of attended sessions was registered | From baseline to 4 months |
| Participant satisfaction | Satisfaction was measured with an anonymous ad-hoc questionnaire, containing a total of 25 questions: The physical exercise and the nutritional components were evaluated with six questions each; general health improvements obtained during the intervention with 11; two last questions asked about the intention to keep exercising after the intervention ended and whether they would recommend this program to others. | Month 4 |
| Measure | Description | Time Frame |
|---|---|---|
| Change from Baseline in Functional Capacity at 4 and 8 months | The Timed Up and Go (TUG) test was used to assess functional capacity. TUG is a simple functional assessment used to evaluate mobility, balance, and fall risk. Participants are timed while standing up from a chair, walking three meters, turning, returning, and sitting down. Shorter times (in seconds) indicate better functional mobility, while longer times suggest impaired performance. |
Not provided
Inclusion Criteria:
Exclusion Criteria:
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Biogipuzkoa Health Research Institute. Primary Care Group. Epidemiology, Public Health and Primary Care Area. | San Sebastián | Gipuzkoa | 20014 | Spain |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36764033 | Background | Tao A, Ho KHM, Yang C, Chan HYL. Effects of non-pharmacological interventions on psychological outcomes among older people with frailty: A systematic review and meta-analysis. Int J Nurs Stud. 2023 Apr;140:104437. doi: 10.1016/j.ijnurstu.2023.104437. Epub 2023 Jan 14. | |
| 39558234 | Background | Sirikul W, Buawangpong N, Pinyopornpanish K, Siviroj P. Impact of multicomponent exercise and nutritional supplement interventions for improving physical frailty in community-dwelling older adults: a systematic review and meta-analysis. BMC Geriatr. 2024 Nov 18;24(1):958. doi: 10.1186/s12877-024-05551-8. |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| ID | Term |
|---|---|
| D000073496 | Frailty |
| ID | Term |
|---|---|
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
Not provided
Not provided
| ID | Term |
|---|---|
| D044623 | Nutrition Therapy |
| ID | Term |
|---|---|
| D013812 | Therapeutics |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
|
| From baseline to 8 months |
| Change from Baseline in Physical Activity at 4 and 8 months | Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ). It is a standardized instrument used to assess physical activity performed during the previous seven days, including walking, moderate activity, vigorous activity, and sedentary behavior. The questionnaire applies Metabolic Equivalent of Task (MET) values to estimate weekly energy expenditure and classify participants into low, moderate, or high physical activity levels. The unit of measurement is MET. | From baseline to 8 months |
| Change from Baseline in Handgrip Strength at 4 and 8 months | Handgrip strength measured with a dynamometer. Three dominant hand consecutive measurement were taken per participant. The finally considered values per follow-up were the means of those three. The unit of measurement is kg. | From baseline to 8 months |
| Change from Baseline in Eating Habits at 4 and 8 months | The Predimed questionnaire is a validated 14-item tool used to assess adherence to the Mediterranean diet, by asking about key dietary habits. Its score oscillates between 0-14 points, with higher values indicating greater adherence. | From baseline to 8 months |
| Change from Baseline in Nutritional Status at 4 and 8 months | The 6-item Mini Nutritional Assessment-Short Form (MNA-SF) was applied to evaluate the nutritional status of patients. The Mini Nutritional Assessment (MNA) is an 18-item validated tool used to evaluate nutritional status in older adults. The unit of measurement is points. | From Baseline to 8 months |
| Change from Baseline in Blood tests at 4 months | Complete blood count, biochemistry (glucose, urea, creatinine, thyroid hormones, vitamins B12 and D, ions, iron profile), albumin, and C-reactive protein were collected. | Frome baseline to 4 months |
| Change from Baseline in Pharmacological treatments at 4 months | Change in the number of pharmacological treatments. | From Baseline to 4 months |
| Change from Baseline in the Health-related quality of life at 4 and 8 months | The Euroqol Visual Analog Scale (EQ-VAS) was used for assessing self-reported quality of life. It is a vertical 0-100 line measuring overall health "today", with 100 being the best possible health. | From baseline to 8 months |
| Change from Baseline in Cognitive Status at 4 and 8 months | The Abbreviated Mini-Mental State Examination (MMSE-Short Form) was performed to assess the global cognitive function of the participants. It evaluates orientation, memory, attention, and language in 21 items, and provides a rapid estimate of cognitive status, with lower scores indicating greater impairment. | From baseline to 8 months |
| Change from Baseline in Anxiety and Depression Status at 4 and 8 months | Anxiety and depression was determined by the Goldberg Anxiety and Depression Scale. A brief screening instrument used to identify symptoms of anxiety and depression in adults. It consists of two subscales with nine items each, and the total scores help detect individuals at risk of clinically relevant emotional distress. Lower values indicate less anxiety and depression. | From baseline to 8 months |
| Change from Baseline in Dependence at 4 and 8 months | Lawton instrumental activities of daily living based on 8 items, with higher values indicating more independence. | From Baseline to 8 months |
| Change from Baseline in Social Connectedness at 4 and 8 months | The Lubben Social Networks Scale is a brief, standardised tool used to assess social connectedness in older people. It measures the number and frequency of contacts within family and friends and the perception on the availability of support. The family and friends sub-scales account for a maximum of 15 points each, with the total scale score ranging from 0 to 30 points. Higher values indicate more social ties. | From baseline to 8 months |
| 37672495 | Background | Morin KH. Clarifying the Importance of Pilot Studies. J Nurs Educ. 2023 Sep;62(9):487-488. doi: 10.3928/01484834-20230712-03. Epub 2023 Sep 1. No abstract available. |
| 29575094 | Background | Gutierrez-Valencia M, Izquierdo M, Cesari M, Casas-Herrero A, Inzitari M, Martinez-Velilla N. The relationship between frailty and polypharmacy in older people: A systematic review. Br J Clin Pharmacol. 2018 Jul;84(7):1432-1444. doi: 10.1111/bcp.13590. Epub 2018 May 3. |
| 31038679 | Background | Rashidi Pour Fard N, Amirabdollahian F, Haghighatdoost F. Dietary patterns and frailty: a systematic review and meta-analysis. Nutr Rev. 2019 Jul 1;77(7):498-513. doi: 10.1093/nutrit/nuz007. |
| 39426607 | Background | Yang X, Li S, Xu L, Liu H, Li Y, Song X, Bao J, Liao S, Xi Y, Guo G. Effects of multicomponent exercise on frailty status and physical function in frail older adults: A meta-analysis and systematic review. Exp Gerontol. 2024 Nov;197:112604. doi: 10.1016/j.exger.2024.112604. Epub 2024 Oct 21. |
| 35659258 | Background | Nan J, Duan Y, Wu S, Liao L, Li X, Zhao Y, Zhang H, Zeng X, Feng H. Perspectives of older adults, caregivers, healthcare providers on frailty screening in primary care: a systematic review and qualitative meta-synthesis. BMC Geriatr. 2022 Jun 3;22(1):482. doi: 10.1186/s12877-022-03173-6. |
| 31637940 | Background | Rivas-Ruiz F, Machon M, Contreras-Fernandez E, Vrotsou K, Padilla-Ruiz M, Diez Ruiz AI, de Mesa Berenguer Y, Vergara I; Group GIFEA. Prevalence of frailty among community-dwelling elderly persons in Spain and factors associated with it. Eur J Gen Pract. 2019 Oct;25(4):190-196. doi: 10.1080/13814788.2019.1635113. Epub 2019 Oct 22. |
| 33068107 | Background | O'Caoimh R, Sezgin D, O'Donovan MR, Molloy DW, Clegg A, Rockwood K, Liew A. Prevalence of frailty in 62 countries across the world: a systematic review and meta-analysis of population-level studies. Age Ageing. 2021 Jan 8;50(1):96-104. doi: 10.1093/ageing/afaa219. |