Changes in the Severity of Frailty Among Older Adults After 12 Months of Supervised Home-Based Physical Exercise: A Randomized Clinical Trial

Sara Suikkanen; Paula Soukkio; Hannu Kautiainen; Sanna Kääriä; Markku T Hupli; Sarianna Sipilä; Kaisu Pitkälä; Eeva Aartolahti; Katriina Kukkonen-Harjula

doi:10.1016/j.jamda.2022.07.010

Changes in the Severity of Frailty Among Older Adults After 12 Months of Supervised Home-Based Physical Exercise: A Randomized Clinical Trial

J Am Med Dir Assoc. 2022 Oct;23(10):1717.e9-1717.e15. doi: 10.1016/j.jamda.2022.07.010. Epub 2022 Aug 18.

Authors

Sara Suikkanen¹, Paula Soukkio², Hannu Kautiainen³, Sanna Kääriä⁴, Markku T Hupli⁵, Sarianna Sipilä⁶, Kaisu Pitkälä³, Eeva Aartolahti⁷, Katriina Kukkonen-Harjula⁵

Affiliations

¹ Rehabilitation, South Karelia Social and Health Care District, Lappeenranta, Finland; Faculty of Sport and Health Sciences, University of Jyväskylä, Finland. Electronic address: sara.suikkanen@lab.fi.
² Rehabilitation, South Karelia Social and Health Care District, Lappeenranta, Finland; Faculty of Sport and Health Sciences, University of Jyväskylä, Finland.
³ Department of General Practice, University of Helsinki, and Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland.
⁴ Raatimiehet Oy, Lappeenranta, Finland.
⁵ Rehabilitation, South Karelia Social and Health Care District, Lappeenranta, Finland.
⁶ Faculty of Sport and Health Sciences, University of Jyväskylä, Finland; Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
⁷ Institute of Rehabilitation, JAMK University of Applied Sciences, Jyväskylä, Finland.

PMID: 35985418
DOI: 10.1016/j.jamda.2022.07.010

Abstract

Objective: To investigate the effects of 12 months of physiotherapist-supervised, home-based physical exercise on the severity of frailty and on the prevalence of the 5 frailty phenotype criteria, using secondary analyses.

Design: Randomized clinical trial, with 1:1 allocation into 12-month home-based physical exercise, or usual care. The multicomponent exercise sessions (60 minutes) were supervised by the physiotherapist and included strength, balance, functional, and flexibility exercises twice a week at participants' homes.

Setting and participants: Home-dwelling older adults aged ≥65 years who were frail (meeting 3-5 criteria) or prefrail (1-2 criteria) according to frailty phenotype criteria.

Methods: The severity of frailty (nonfrail, prefrail, or frail) was assessed using frailty phenotype criteria, and the prevalence of each frailty criterion (weight loss, low physical activity, exhaustion, weakness, and slowness) were assessed at baseline and at 12 months.

Results: Two hundred ninety-nine persons were included in the analyses, of whom 184 were prefrail and 115 were frail at baseline. Their mean age was 82.5 (SD 6.3) years, and 75% were women. There was a significant difference between the exercise and usual care groups' transitions to different frailty states from baseline to 12 months among those who at baseline were prefrail (P = .032) and frail (P = .009). At 12 months, the mean number of frailty criteria had decreased in the exercise group (-0.27, 95% CI -0.47, -0.08) and remained unchanged in the usual care group (0.01, 95% CI -0.16, 0.18; P = .042). The prevalence of the exhaustion (P = .009) and the low physical activity (P < .001) criteria were lower at 12 months in the exercise group than in the usual care group.

Conclusions and implications: The severity of frailty can be reduced through 12-month supervised home-based exercise training. Exercise should be included in the care of older adults with signs of frailty.

Keywords: Frailty; older adults; physical exercise; rehabilitation.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Exercise
Exercise Therapy
Female
Frail Elderly
Frailty*
Humans
Male
Prevalence