%0 Journal Article
%T A pilot randomized controlled trial to improve geriatric frailty
%A Chan Ding-Cheng
%A Tsou Hsiao-Hui
%A Yang Rong-Sen
%A Tsauo Jau-Yih
%J BMC Geriatrics
%D 2012
%I BioMed Central
%R 10.1186/1471-2318-12-58
%X Background Few randomized controlled trials (RCTs) report interventions targeting improvement of frailty status as an outcome. Methods This RCT enrolled 117 older adults (65-79 years of age) in Toufen, Taiwan who scored 3-6 on The Chinese Canadian Study of Health and Aging Clinical Frailty Scale Telephone Version and then score ¡Ý1 on the Cardiovascular Health Study Phenotypic Classification of Frailty (CHS_PCF). With a two by two factorial design, subjects were randomly assigned to interventions (Exercise and nutrition, EN, n = 55 or problem solving therapy, PST, n = 57) or controls (non-EN, n = 62 or non-PST, n = 60). Educational booklets were provided to all. EN group subjects received nutrition consultation and a thrice-weekly exercise-training program while PST group subjects received 6 sessions in 3 month. Subjects were followed at 3, 6, and 12 months. Primary outcome was improvement of the CHS_PCF by at least one category (from pre-frail to robust, or from frail to pre-frail or robust) from baseline assessments. One hundred and one completed final assessments. Intention-to-treat analysis with the generalized estimating equation model was applied with adjustment for time and treatment-by-time interactions. Results Mean age was 71.4 ¡À 3.7 years, with 59% females. Baseline characteristic were generally comparable between groups. EN group subjects had a higher improvement rate on the primary outcome than non-EN group subjects (45% vs 27%, adjusted p = 0.008) at 3 months, but not 6 or 12 months. They also had more increase of serum 25(OH) vitamin D level (4.9 ¡À 7.7 vs 1.2 ¡À 5.4, p = 0.006) and lower percentage of osteopenia (74% vs 89% p = 0.042) at 12 months. PST group subjects had better improvement (2.7 ¡À 6.1 vs 0.2 ¡À 6.7, p = 0.035, 6-month) and less deterioration ( 3.5 ¡À 9.7 vs  7.1 ¡À 8.7, p = 0.036, 12-month) of dominant leg extension power than non-PST subjects. Some secondary outcomes were also improved in control groups (non-EN or non-PST). No adverse effects were reported. Conclusions The three-month EN intervention resulted in short-term (3-month) frailty status improvement and long-term effect on bone mineral density and serum vitamin D (12-month) among Taiwanese community-dwelling elders. The effect of PST was less pronounce. Trial registration ClinicalTrials.gov: EC0970301
%K Frailty
%K Aged
%K Intervention
%K Effectiveness
%K Community
%U http://www.biomedcentral.com/1471-2318/12/58