Regular exercise and nutritional advice linked to improved mobility in frail elderly

Regular exercise and nutritional advice linked to improved mobility in frail elderly

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Found an experience posted by BMJ today.

Combining aerobic exercise (walking), strength, flexibility and balance along with personalized nutritional counseling reduced mobility impairment by 22% over three years.

US and EU data indicate that about 13% of adults aged 70 and over living in the community have a mobility impairment, which is associated with poor quality of life, admission to hospital or residential care, and death, as well as high costs of living in the community. Healthcare.

It is therefore important to find safe and effective ways to maintain the mobility of elderly people at risk of further deterioration.

So the researchers designed the SPRINTT trial to see if a combined intervention of physical activity with technology support and nutritional counseling prevents motor impairment in frail older adults compared to education about healthy aging.

Their findings are based on 1,519 men and women (median age 79) with physical impairment and muscular hypertrophy (a combination of decreased physical function and reduced muscle mass) recruited from 16 clinical sites across 11 European countries between 2016 and 2019.

Physical weakness and muscle hypertrophy were defined as having a 3- to 9-point SPPB (score range 0 to 12, with lower scores indicating poor physical function) and low levels of muscle mass, but able to walk normally. Independent 400 meters in 15 minutes.

In all, 760 participants were randomly assigned to the intervention, 759 participants received education on healthy aging (controls), and all were monitored for up to 36 months.

The intervention group received twice-weekly moderate-intensity physical activity sessions at a center and up to four times weekly at home along with personal nutritional counseling. Activity was measured with an acceter scale worn on the thigh.

Controls received education on healthy aging once a month and the coach led a brief program of upper body stretching or relaxation techniques.

Among participants with SPPB scores of 3 to 7 at the start of the trial, motor impairment occurred in 47% assigned to the intervention and 53% to the control group.

Persistent immobility (inability to walk 400 meters on two consecutive occasions) occurred in 21% of the intervention participants compared to 25% of controls.

SPPB scores in the intervention group increased more than the controls at both 24 months and 36 months (median differences 0.8 and 1 point, respectively).

Women in the intervention group lost less muscle strength (0.9 kg at 24 months) and less muscle mass (0.24 kg and 0.49 kg at 24 and 36 months, respectively) than control women, but no significant group differences were observed in men.

The risk of adverse events, however, was greater among the intervention participants (56%) than the control group (50%).

In a separate analysis of participants with better mobility (SPPB scores of 8 or 9 at the start of the trial), the intervention did not affect the risk of developing motor disability and had marginal effects on physical performance.

The researchers acknowledge some limitations. For example, older adults with significant cognitive impairment were not included, and nearly all participants were white, so the results may not apply to other racial groups.

However, retention and adherence to the interventions were high compared to other similar trials, and their use of validated tests in a geographically and culturally diverse group of vulnerable elderly across Europe, suggest that the results are robust.

As such, they concluded that such an intervention “can be proposed as a strategy for maintaining mobility in older adults at risk for disability”.

This new evidence confirms the benefits of organized physical activity in the community in which older adults live, says Thomas Gill of Yale University School of Medicine in an associated editorial.

He acknowledges that translating the results of better-designed trials into clinical practice can be challenging, but says that these findings, along with results from another large US trial (the LIFE study), “provide compelling evidence that community mobility can be maintained among the vulnerable.” .the elderly through organized physical activity, walking is the primary means.”

He notes that the cost-effectiveness of the LIFE program “was found to be comparable to that of many commonly recommended medical treatments”.

It concludes that confirmation of these findings in SPRINTT “would advance the case for developing, implementing and supporting community-based physical activity programs to maintain independent mobility among vulnerable older adults.”

A structured exercise program provides mobility benefits for all older patients, regardless of frailty status

more information:
A multicomponent intervention to prevent movement impairment in frail elderly: a randomized controlled trial (SPRINTT project), BMJ (2022). DOI: 10.1136 / bmj ‑ 2021‑068788

Submitted by the British Medical Journal

the quote: Regular exercise with nutritional advice linked to improved mobility in frail elderly (2022, May 11), retrieved May 12, 2022 from .html

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2022-05-11 22:30:03

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