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Clinical Efficacy of Multidomain Interventions among Multimorbid Older People Stratified by the Status of Physio-Cognitive Declines: A Secondary Analysis from the Randomized Controlled Trial for Healthy Aging

  • Original Research
  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

To investigate the clinical efficacy of integrated multidomain intervention among community-living older adults with multimorbidity and physio-cognitive decline syndrome (PCDS).

Design, Setting and Participants

This is the secondary analysis from a randomized controlled trial that data of 340 participants with Montreal Cognitive Assessment (MoCA) scores≥18 were excerpted for analysis.

Intervention

Sixteen 2-hour sessions per year were provided for participants, including physical exercise, cognitive training, dietician education and individualized integrated care for multimorbidity.

Measurements

Handgrip strength, 6-m walking speed, MoCA (total score and sub-domains), Cardiovascular Health Study (CHS) frailty score, quality of life, and serum biochemistry biomarkers.

Results

Overall, 96/340 (28.2%) of all participants have PCDS, and the integrated multidomain intervention significantly improved global cognitive performance (overall difference 1.1, 95% CI 0.4–1.8, p=0.003), and domains of concentration (overall difference 0.3, 95%CI 0.1–0.5, p=0.011), language (overall difference 0.2, 95%CI 0.1–0.3, p=0.006), abstract thinking (overall difference 0.1, 95%CI 0.0–0.3, p=0.027), and orientation(overall difference 0.2, 95%CI 0.0–0.4, p=0.013) across all timepoints among those with PCDS. Besides, interventions also significantly reduced frailty score among those with cognitive impairment no dementia (overall difference −0.3, 95%CI −0.5 − −0.1, p=0.011) and mobility impairment no disability (overall difference −0.3, 95%CI −0.4 − −0.1, p=0.004). and improved quality of life at domain of physical role limitation among those with PCDS (overall difference 5.3, 95%CI 0.3–10.4, p=0.038).

Conclusions

The integrated multidomain lifestyle intervention plus multimorbidity management significantly improved cognitive function, and enhanced quality of life among older adults with multimorbidity and PCDS in the communities.

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Acknowledgments

We sincerely thank all participants in the TIGER study for joining the project; research nurses, nutritionists, pharmacists, and physicians who conducted field work; and all other members of the TIGER study who collaborated in data collection, staff training, and management. This study was supported by the National Health Research Institutes, Taiwan (NHRI-107A1-PHCO-04181803).

Author information

Authors and Affiliations

  1. Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan

    W.-J. Lee, L.-N. Peng, M.-H. Lin & Liang-Kung Chen

  2. Department of Geriatric Medicine, National Yang Ming Chiao Tung University, School of Medicine, Taipei, Taiwan

    W.-J. Lee, L.-N. Peng, M.-H. Lin & Liang-Kung Chen

  3. Department of Family Medicine, Taipei Veterans General Hospital Yuanshan Branch, Yi-Lan County, Taiwan

    W.-J. Lee

  4. Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Rd., Taipei, 11217, Taiwan

    L.-N. Peng, M.-H. Lin & Liang-Kung Chen

  5. President Office, National Yang Ming Chiao Tung University, Hsinchu City, Taiwan

    C.-H. Lin

  6. Taipei Municipal Gan-Dau Hospital (Managed by Taipei Veterans General Hospital), Taipei, Taiwan

    Liang-Kung Chen

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  1. W.-J. Lee
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Correspondence to Liang-Kung Chen.

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The institutional review boards of National Yang-Ming University (YM107042F), Taipei Veterans General Hospital (2018-05-002CC), Hualien Tzu Chi Hospital (IRB 107-90-B), and National Yang-Ming University Hospital (2018A023) approved the study. All participants provided written informed consent after careful explanation. The study design and procedures were conducted under guidance with the Declaration of Helsinki and later amendments.

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Lee, WJ., Peng, LN., Lin, MH. et al. Clinical Efficacy of Multidomain Interventions among Multimorbid Older People Stratified by the Status of Physio-Cognitive Declines: A Secondary Analysis from the Randomized Controlled Trial for Healthy Aging. J Nutr Health Aging 26, 909–917 (2022). https://doi.org/10.1007/s12603-022-1843-3

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