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Title: A physical activity intervention to treat the frailty syndrome in older persons-results from the LIFE-P study

Author
item CESARI, MATTEO - Toulouse University Hospital
item VELLAS, BRUNO - Toulouse University Hospital
item HSU, FANG-CHI - Wake Forest University
item NEWMAN, ANNE - University Of Pittsburgh
item DOSS, HANNI - University Of Florida
item KING, ABBY - Stanford University
item MANINI, TODD - University Of Florida
item CHURCH, TIMOTHY - Louisana State University
item GILL, THOMAS - Yale University
item MILLER, MICHAEL - Wake Forest University
item PAHOR, MARCO - Stanford University

Submitted to: Journals of Gerontology
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 6/1/2014
Publication Date: 2/11/2015
Citation: Cesari, M., Vellas, B., Hsu, F., Newman, A.B., Doss, H., King, A.C., Manini, T.M., Church, T., Gill, T.M., Miller, M., Pahor, M.S. 2015. A physical activity intervention to treat the frailty syndrome in older persons-results from the LIFE-P study. Journals of Gerontology. 70(2):216-222.

Interpretive Summary: Frailty is a complex syndrome of advancing age characterized by increased vulnerability to stressor events and is associated with increased morbidity and mortality. This study used data from the LIFE-pilot study (LIFE-P), a randomized controlled trial enrolling 424 community-dwelling persons (mean age=76.8 years). Participants were randomized to a 12-month physical activity intervention versus a successful aging education group. We found a significantly lower frailty prevalence at 12 months in the PA intervention group (10.0%) compared to the successful aging group (19.1%). These results provide preliminary evidence that physical exercise may lower the risk of frailty in older community-dwelling adults.

Technical Abstract: BACKGROUND: The frailty syndrome is as a well-established condition of risk for disability. Aim of the study is to explore whether a physical activity (PA) intervention can reduce prevalence and severity of frailty in a community-dwelling elders at risk of disability. METHODS: Exploratory analyses from the Lifestyle Interventions and Independence for Elders pilot, a randomized controlled trial enrolling 424 community-dwelling persons (mean age=76.8 years) with sedentary lifestyle and at risk of mobility disability. Participants were randomized to a 12-month PA intervention versus a successful aging education group. The frailty phenotype (ie, >/=3 of the following defining criteria: involuntary weight loss, exhaustion, sedentary behavior, slow gait speed, poor handgrip strength) was measured at baseline, 6 months, and 12 months. Repeated measures generalized linear models were conducted. RESULTS: A significant (p = .01) difference in frailty prevalence was observed at 12 months in the PA intervention group (10.0%; 95% confidence interval = 6.5%, 15.1%), relative to the successful aging group (19.1%; 95% confidence interval = 13.9%,15.6%). Over follow-up, in comparison to successful aging participants, the mean number of frailty criteria in the PA group was notably reduced for younger subjects, blacks, participants with frailty, and those with multimorbidity. Among the frailty criteria, the sedentary behavior was the one most affected by the intervention. CONCLUSIONS: Regular PA may reduce frailty, especially in individuals at higher risk of disability. Future studies should be aimed at testing the possible benefits produced by multidomain interventions on frailty.