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Comprehensive geriatric intervention in community‐dwelling older adults: a cluster‐randomized controlled trial

BACKGROUND: In longevity societies, one of the most serious social issues is sarcopenia and/or frailty. Preventing them is important for maintaining independence and quality of life in the older population. This study investigated the effect of a self‐monitoring comprehensive geriatric intervention...

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Autores principales: Watanabe, Yuya, Yamada, Yosuke, Yoshida, Tsukasa, Yokoyama, Keiichi, Miyake, Motoko, Yamagata, Emi, Yamada, Minoru, Yoshinaka, Yasuko, Kimura, Misaka
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7015250/
https://www.ncbi.nlm.nih.gov/pubmed/31997543
http://dx.doi.org/10.1002/jcsm.12504
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author Watanabe, Yuya
Yamada, Yosuke
Yoshida, Tsukasa
Yokoyama, Keiichi
Miyake, Motoko
Yamagata, Emi
Yamada, Minoru
Yoshinaka, Yasuko
Kimura, Misaka
author_facet Watanabe, Yuya
Yamada, Yosuke
Yoshida, Tsukasa
Yokoyama, Keiichi
Miyake, Motoko
Yamagata, Emi
Yamada, Minoru
Yoshinaka, Yasuko
Kimura, Misaka
author_sort Watanabe, Yuya
collection PubMed
description BACKGROUND: In longevity societies, one of the most serious social issues is sarcopenia and/or frailty. Preventing them is important for maintaining independence and quality of life in the older population. This study investigated the effect of a self‐monitoring comprehensive geriatric intervention programme (CGIP) on physical function and muscle size in community‐dwelling older adults. We compared the effects of a CGIP using weekly class‐styled (CS) sessions and a home‐based (HB) programme. METHODS: The 526 participants were randomized into one of two groups (CS 251, HB 275) based on their residential districts. We conducted a 12 week CGIP, which consisted of low‐load resistance exercise, physical activity increments, oral function improvements, and a nutritional guide. All participants were encouraged to attend two 90 min lectures that included instructions on the CGIP. They were provided with exercise materials (triaxial‐accelerometers/pedometers, ankle weights, and elastic bands) and diary logs. The CS group attended 90 min weekly sessions and independently executed the programme on other days, whereas the HB group only received instructions on how to execute the programme. Physical functions, such as knee extension strength (KES), normal and maximum walking speed, the timed up‐and‐go test, and anterior thigh muscle thickness (MT), were measured and analysed using intention‐to‐treat analysis before and after the 12 week intervention. RESULTS: Of the 526 participants identified, 517 (CS 243 age 74.0 ± 5.4 women 57.2%, HB 274 age 74.0 ± 5.6 women 58.8%) were enrolled. Nine (CS 8, HB 1) were excluded from the analysis because they did not participate in the pre‐intervention measurements. Both interventions significantly improved KES (CS 18.5%, HB 10.6%), normal walking speed (CS 3.7%, HB 2.8%), and MT (CS 3.2%, HB 3.5%). Greater improvement of KES was observed in the CS group (P = 0.003). Maximum walking speed (CS 4.7%, HB 1.8%; P = 0.001) and timed up‐and‐go (CS −4.7%, HB −0.2%; P < 0.001) significantly improved in the CS group only. CONCLUSIONS: The intervention was effective in preventing sarcopenia and/or frailty. Most physical functions and MT improved after both interventions. The HB intervention is cost‐effective and may help prevent sarcopenia and/or frailty in the large older population.
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spelling pubmed-70152502020-03-24 Comprehensive geriatric intervention in community‐dwelling older adults: a cluster‐randomized controlled trial Watanabe, Yuya Yamada, Yosuke Yoshida, Tsukasa Yokoyama, Keiichi Miyake, Motoko Yamagata, Emi Yamada, Minoru Yoshinaka, Yasuko Kimura, Misaka J Cachexia Sarcopenia Muscle Original Articles BACKGROUND: In longevity societies, one of the most serious social issues is sarcopenia and/or frailty. Preventing them is important for maintaining independence and quality of life in the older population. This study investigated the effect of a self‐monitoring comprehensive geriatric intervention programme (CGIP) on physical function and muscle size in community‐dwelling older adults. We compared the effects of a CGIP using weekly class‐styled (CS) sessions and a home‐based (HB) programme. METHODS: The 526 participants were randomized into one of two groups (CS 251, HB 275) based on their residential districts. We conducted a 12 week CGIP, which consisted of low‐load resistance exercise, physical activity increments, oral function improvements, and a nutritional guide. All participants were encouraged to attend two 90 min lectures that included instructions on the CGIP. They were provided with exercise materials (triaxial‐accelerometers/pedometers, ankle weights, and elastic bands) and diary logs. The CS group attended 90 min weekly sessions and independently executed the programme on other days, whereas the HB group only received instructions on how to execute the programme. Physical functions, such as knee extension strength (KES), normal and maximum walking speed, the timed up‐and‐go test, and anterior thigh muscle thickness (MT), were measured and analysed using intention‐to‐treat analysis before and after the 12 week intervention. RESULTS: Of the 526 participants identified, 517 (CS 243 age 74.0 ± 5.4 women 57.2%, HB 274 age 74.0 ± 5.6 women 58.8%) were enrolled. Nine (CS 8, HB 1) were excluded from the analysis because they did not participate in the pre‐intervention measurements. Both interventions significantly improved KES (CS 18.5%, HB 10.6%), normal walking speed (CS 3.7%, HB 2.8%), and MT (CS 3.2%, HB 3.5%). Greater improvement of KES was observed in the CS group (P = 0.003). Maximum walking speed (CS 4.7%, HB 1.8%; P = 0.001) and timed up‐and‐go (CS −4.7%, HB −0.2%; P < 0.001) significantly improved in the CS group only. CONCLUSIONS: The intervention was effective in preventing sarcopenia and/or frailty. Most physical functions and MT improved after both interventions. The HB intervention is cost‐effective and may help prevent sarcopenia and/or frailty in the large older population. John Wiley and Sons Inc. 2020-01-29 2020-02 /pmc/articles/PMC7015250/ /pubmed/31997543 http://dx.doi.org/10.1002/jcsm.12504 Text en © 2020 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of Society on Sarcopenia, Cachexia and Wasting Disorders This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Articles
Watanabe, Yuya
Yamada, Yosuke
Yoshida, Tsukasa
Yokoyama, Keiichi
Miyake, Motoko
Yamagata, Emi
Yamada, Minoru
Yoshinaka, Yasuko
Kimura, Misaka
Comprehensive geriatric intervention in community‐dwelling older adults: a cluster‐randomized controlled trial
title Comprehensive geriatric intervention in community‐dwelling older adults: a cluster‐randomized controlled trial
title_full Comprehensive geriatric intervention in community‐dwelling older adults: a cluster‐randomized controlled trial
title_fullStr Comprehensive geriatric intervention in community‐dwelling older adults: a cluster‐randomized controlled trial
title_full_unstemmed Comprehensive geriatric intervention in community‐dwelling older adults: a cluster‐randomized controlled trial
title_short Comprehensive geriatric intervention in community‐dwelling older adults: a cluster‐randomized controlled trial
title_sort comprehensive geriatric intervention in community‐dwelling older adults: a cluster‐randomized controlled trial
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7015250/
https://www.ncbi.nlm.nih.gov/pubmed/31997543
http://dx.doi.org/10.1002/jcsm.12504
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