PMID- 37949432
OWN - NLM
STAT- MEDLINE
DCOM- 20240501
LR  - 20240501
IS  - 1538-9375 (Electronic)
IS  - 1525-8610 (Linking)
VI  - 25
IP  - 5
DP  - 2024 May
TI  - Enhancing Intrinsic Capacity and Related Biomarkers in Community-Dwelling 
      Multimorbid Older Adults Through Integrated Multidomain Interventions: Ancillary 
      Findings From the Taiwan Integrated Geriatric (TIGER) Trial.
PG  - 757-763.e4
LID - S1525-8610(23)00847-2 [pii]
LID - 10.1016/j.jamda.2023.10.006 [doi]
AB  - OBJECTIVE: This study aimed to evaluate the efficacy of integrated multidomain 
      interventions and primary health care on intrinsic capacity (IC) and related 
      biomarkers. DESIGN: An ancillary analysis from the Taiwan Integrated Geriatric 
      Care (TIGER) study: a randomized controlled trial. SETTING AND PARTICIPANTS: A 
      total of 398 community-dwelling older adults aged >/=65 years with >/=3 chronic 
      conditions. METHODS: Participants were randomized into the 12-month pragmatic 
      multidomain intervention or usual care groups. The primary outcome was the change 
      in IC and its subdomains (locomotion, cognition, vitality, psychological, and 
      sensory) at baseline and 3-, 6-, 9-, and 12-month follow-ups. Generalized linear 
      mixed models were used to evaluate the multidomain intervention effects on these 
      changes. RESULTS: The intervention arm had greater improvement in IC than the 
      usual care arm (overall difference 1.5; 95% CI 0.5-2.5; P = .005), mainly from 
      subdomains of locomotion (overall difference 1.4; 95% CI 0.5-2.4; P = .004) and 
      cognition (2.9; 95% CI 2.1-3.7; P < .001). Changes in neutrophil-to-lymphocyte 
      ratio (NLR -2.4; 95% CI -3.9 to -0.8, P = .003), serum levels of albumin (35.1; 
      95% CI 23.1-47.2; P < .001), dehydroepiandrosterone sulfate (DHEA-S 2.8; 95% CI 
      1.9-3.8; P < .001), free androgen index (FAI 1.5; 95% CI 1.1-1.9; P < .001), and 
      vitamin D (4.0; 95% CI 2.0-6.1; P < .001) were associated with changes in IC over 
      time. CONCLUSIONS AND IMPLICATIONS: The incorporation of multidomain 
      interventions into primary health care significantly enhanced IC over the 
      12-month program. Changes in NLR, FAI, and serum levels of albumin, DHEA-S, 
      vitamin D were associated with changes in IC over time. TRIAL REGISTRATION: 
      ClinicalTrials.gov Identifier: NCT03528005.
CI  - Copyright (c) 2023 AMDA - The Society for Post-Acute and Long-Term Care Medicine. 
      Published by Elsevier Inc. All rights reserved.
FAU - Lee, Wei-Ju
AU  - Lee WJ
AD  - Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung 
      University, Taipei, Taiwan; Department of Family Medicine, Taipei Veterans 
      General Hospital Yuanshan Branch, Yi-Lan County, Taiwan. Electronic address: 
      leewju@gmail.com.
FAU - Peng, Li-Ning
AU  - Peng LN
AD  - Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung 
      University, Taipei, Taiwan; Center for Geriatrics and Gerontology, Taipei 
      Veterans General Hospital, Taipei, Taiwan.
FAU - Lin, Ming-Hsien
AU  - Lin MH
AD  - Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung 
      University, Taipei, Taiwan; Center for Geriatrics and Gerontology, Taipei 
      Veterans General Hospital, Taipei, Taiwan.
FAU - Kim, Sunyoung
AU  - Kim S
AD  - Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, 
      Republic of Korea.
FAU - Hsiao, Fei-Yuan
AU  - Hsiao FY
AD  - Graduate Institute of Clinical Pharmacy, National Taiwan University, Taipei, 
      Taiwan; Department of Pharmacy, National Taiwan University Hospital, Taipei, 
      Taiwan.
FAU - Chen, Liang-Kung
AU  - Chen LK
AD  - Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung 
      University, Taipei, Taiwan; Center for Geriatrics and Gerontology, Taipei 
      Veterans General Hospital, Taipei, Taiwan; Taipei Municipal Gan-Dau Hospital 
      (Managed by Taipei Veterans General Hospital), Taipei, Taiwan.
LA  - eng
SI  - ClinicalTrials.gov/NCT03528005
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20231107
PL  - United States
TA  - J Am Med Dir Assoc
JT  - Journal of the American Medical Directors Association
JID - 100893243
RN  - 0 (Biomarkers)
SB  - IM
MH  - Humans
MH  - Aged
MH  - Male
MH  - Female
MH  - Taiwan
MH  - *Independent Living
MH  - *Biomarkers/blood
MH  - *Geriatric Assessment/methods
MH  - Aged, 80 and over
MH  - *Multimorbidity
MH  - Primary Health Care
OTO - NOTNLM
OT  - Multidomain interventions
OT  - biomarkers
OT  - integrated geriatric care
OT  - intrinsic capacity
COIS- Disclosure The authors declare no conflicts of interest.
EDAT- 2023/11/11 11:43
MHDA- 2024/05/02 00:48
CRDT- 2023/11/10 19:20
PHST- 2023/09/05 00:00 [received]
PHST- 2023/10/03 00:00 [revised]
PHST- 2023/10/05 00:00 [accepted]
PHST- 2024/05/02 00:48 [medline]
PHST- 2023/11/11 11:43 [pubmed]
PHST- 2023/11/10 19:20 [entrez]
AID - S1525-8610(23)00847-2 [pii]
AID - 10.1016/j.jamda.2023.10.006 [doi]
PST - ppublish
SO  - J Am Med Dir Assoc. 2024 May;25(5):757-763.e4. doi: 10.1016/j.jamda.2023.10.006. 
      Epub 2023 Nov 7.