PMID- 36341237
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20221108
IS  - 2296-858X (Print)
IS  - 2296-858X (Electronic)
IS  - 2296-858X (Linking)
VI  - 9
DP  - 2022
TI  - Intrinsic capacity rather than intervention exposure influences reversal to 
      robustness among prefrail community-dwelling older adults: A non-randomized 
      controlled study of a multidomain exercise and nutrition intervention.
PG  - 971497
LID - 10.3389/fmed.2022.971497 [doi]
LID - 971497
AB  - BACKGROUND: The differential risk profiles associated with prefrailty may be 
      attributable to underlying intrinsic capacity (IC). OBJECTIVES: We examine (i) 
      effect of a multi-domain physical exercise and nutrition intervention on 
      pre-frailty reversal in community-dwelling older adults at 1-year, and (ii) 
      whether IC contributes to pre-frailty reversal. METHODS: Prefrail participants in 
      this non-randomized study were invited to attend a 4-month exercise and 
      nutritional intervention following a frailty screen in the community. Prefrailty 
      was operationalized as (i) FRAIL score 1-2 or (ii) 0 positive response on FRAIL 
      but with weak grip strength or slow gait speed based on the Asian Working Group 
      for Sarcopenia cut-offs. Participants who fulfilled operational criteria for 
      prefrailty but declined enrolment in the intervention programme served as the 
      control group. All participants completed baseline IC assessment: locomotion 
      (Short Physical Performance Battery, 6-minute walk test), vitality (nutritional 
      status, muscle mass), sensory (self-reported hearing and vision), cognition 
      (self-reported memory, age- and education adjusted cognitive performance), 
      psychological (Geriatric Depression Scale-15, self-reported anxiety/ depression). 
      Reversal of prefrailty was defined as achieving a FRAIL score of 0, with 
      unimpaired grip strength and gait speed at 1-year follow-up. RESULTS: Of 81 
      participants (70.0 +/- 6.6 years, 79.0% female), 52 participants (64.2%) were 
      enrolled in the multi-domain intervention, and 29 participants (35.8%) who 
      declined intervention constituted the control group. There was no difference in 
      age, gender and baseline composite IC between groups. Reversal to robustness at 
      1-year was similar between intervention and control groups (30.8% vs. 44.8% 
      respectively, p = 0.206). Reduced prevalence of depression was observed among 
      participants in the intervention group at 1-year relative to baseline (7.8% vs. 
      23.1%, p = 0.022). In multiple logistic regression, intervention had no effect on 
      prefrailty reversal, while higher composite IC exhibited reduced likelihood of 
      remaining prefrail at 1-year (OR = 0.67, 95% CI 0.45-1.00, p = 0.049). 
      CONCLUSION: Focusing only on the locomotion and vitality domains through a 
      combined exercise and nutritional intervention may not adequately address 
      component domain losses to optimize prefrailty reversal. Future studies should 
      examine whether an IC-guided approach to target identified domain declines may be 
      more effective in preventing frailty progression.
CI  - Copyright (c) 2022 Tay, Tay, Mah, Latib and Ng.
FAU - Tay, Laura
AU  - Tay L
AD  - Geriatric Medicine, Department of General Medicine, Sengkang General Hospital, 
      Singapore, Singapore.
AD  - Geriatric Education and Research Institute, Singapore, Singapore.
FAU - Tay, Ee-Ling
AU  - Tay EL
AD  - Department of Physiotherapy, Sengkang General Hospital, Singapore, Singapore.
FAU - Mah, Shi Min
AU  - Mah SM
AD  - Department of Physiotherapy, Sengkang General Hospital, Singapore, Singapore.
FAU - Latib, Aisyah
AU  - Latib A
AD  - Centre for Population Health Research and Implementation, SingHealth, Singapore, 
      Singapore.
FAU - Ng, Yee-Sien
AU  - Ng YS
AD  - Geriatric Education and Research Institute, Singapore, Singapore.
AD  - Department of Rehabilitation Medicine, Singapore General Hospital, Singapore, 
      Singapore.
LA  - eng
PT  - Journal Article
DEP - 20221021
PL  - Switzerland
TA  - Front Med (Lausanne)
JT  - Frontiers in medicine
JID - 101648047
PMC - PMC9634412
OTO - NOTNLM
OT  - elderly
OT  - exercise
OT  - frailty
OT  - intrinsic capacity
OT  - nutrition
OT  - prefrailty
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2022/11/08 06:00
MHDA- 2022/11/08 06:01
PMCR- 2022/10/21
CRDT- 2022/11/07 05:14
PHST- 2022/06/17 00:00 [received]
PHST- 2022/10/06 00:00 [accepted]
PHST- 2022/11/07 05:14 [entrez]
PHST- 2022/11/08 06:00 [pubmed]
PHST- 2022/11/08 06:01 [medline]
PHST- 2022/10/21 00:00 [pmc-release]
AID - 10.3389/fmed.2022.971497 [doi]
PST - epublish
SO  - Front Med (Lausanne). 2022 Oct 21;9:971497. doi: 10.3389/fmed.2022.971497. 
      eCollection 2022.