Older persons with signs of frailty in a home-based physical exercise intervention: baseline characteristics of an RCT
Increasing the level of physical activity among persons with signs of frailty improves physical functioning. There is a lack of long-term supervised physical exercise intervention studies including a validated definition of frailty.
To present baseline characteristics of persons with signs of frailty participating in a randomized long-term home-based physical exercise trial (HIPFRA), and to study associations between the severity of frailty, functional independence and health-related quality-of-life (HRQoL).
Three hundred persons, ≥ 65 years old and with signs of frailty (assessed by Fried´s phenotype criteria) were recruited from South Karelia, Finland and randomized to a 12-month physiotherapist-supervised home-based physical exercise program (n = 150), and usual care (n = 150). Assessments at the participants’ homes at baseline, and after 3, 6 and 12 months included the Short Physical Performance Battery (SPPB), the Functional Independence Measure (FIM), HRQoL (15D) and the Mini-Mental State Examination (MMSE).
Eligibility was screened among 520 persons; 300 met the inclusion criteria and were randomized. One person withdrew consent after randomization. A majority (75%) were women, 182 were pre-frail and 117 frail. The mean age was 82.5 (SD 6.3) years, SPPB 6.2 (2.6), FIM 108.8 (10.6) and MMSE 24.4 (3.1) points, with no significant differences between the study groups. Inverse associations between the severity of frailty vs. FIM scores and HRQoL (p < 0.001 for both) were found.
Our participants showed marked physical frailty without major disabilities. The severity of frailty seems to be associated with impaired functional independence and HRQoL.
Trial registration: ClinicalTrials.gov NCT02305433
KeywordsFrailty Exercise Disability Health-related quality-of-life Community-dwelling older people
The HIPFRA study is funded by the South Karelia Social and Health Care District (Eksote, register number 1236/00.01.05.01/2013), by two governmental funding sources; The Social Insurance Institution of Finland (SII, register number 94/331/2013) and State Research Funding for Academic Health Research (Ministry of Social Affairs and Health), and by the Vyborg Foundation Against Tuberculosis. The funding bodies had no role in the design of the study, in collection, analysis and interpretation of the data, or in writing the manuscript.
Compliance with ethical standards
Conflicts of interest
The authors declare that they have no conflicts of interest.
All the procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
A written informed consent was obtained from all individual participants included in the study.
- 9.Tarazona-Santabalbina FJ, Gómez-Cabrera MC, Pérez-Ros P et al (2016) A Multicomponent exercise intervention that reverse frailty and improves cognition, emotion and social networking in the community-dwelling frail elderly: a randomized clinical trial. J Am Med Dir Assoc 17:426–433CrossRefGoogle Scholar
- 14.de Vries NM, van Ravensberg CD, Hobbelen JSM, Olde Rikkert MGM, Staal JB, Nijhuis-Van der Sanden MWG (2012) Effects of physical exercise therapy on mobility, physical functioning, physical activity and quality of life in community-living older adults with impaired mobility, physical disability and/or multi-morbidity: a meta-analysis. Ageing Res Rev 11:136–149CrossRefGoogle Scholar
- 16.Soukkio P, Suikkanen S, Kääriä S et al (2018) Effects of home-based physiotherapy on duration of living at home and functional capacity among older persons with signs of frailty or with recent hip fracture—protocol of a randomized controlled trial (HIPFRA study). BMC Geriatrics 18:232CrossRefGoogle Scholar
- 21.Sheikh JI, Yesavage JA (1986) Geriatric Depression Scale (GDS): Recent evidence and development of a shorter version. In: Brink TL (ed) Clinical gerontology: a guide to assessment and intervention. The Haworth Press, New York, pp 165–173Google Scholar
- 22.Vellas B, Villars H, Abellan G et al (2006) Overview of the MNA®—its history and challenges. J Nutr Health Aging. 10:456–465Google Scholar
- 23.Sintonen H (1994) The 15D-measure of health-related quality of life. I. Reliability, validity and sensitivity of its health state descriptive system. National centre for health program evaluation, working paper 41, Melbourne, Australia https://pdfs.semanticscholar.org/64d2/f291b61e8f7ca83cf890736cf52d2ead0a71.pdf Accessed Feb 21, 2019
- 25.Helldán A, Helakorpi S (2014) Health behaviour and health among the Finnish elderly, Spring 2013, with trends 1993–2013. National institute for health and welfare (THL), Report 15/2014. https://urn.fi/URN:ISBN:978-952-302-188-4. Accessed Feb 21 2019
- 28.Pahor M, Guralnik J, Ambrosius WT et al (2018) Effect of structured physical activity on prevention of major mobility disability in older adults: the LIFE study randomized clinical trial. JAMA 18:2387–2396Google Scholar