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Effect of Multicomponent Intervention on Functional Decline in Chinese Older Adults: A Multicenter Randomized Clinical Trial

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

Abstract

Objectives

To confirm whether multicomponent exercise following vivifrail recommendations was an effective method for improving physical ability, cognitive function, gait, balance, and muscle strength in Chinese older adults.

Methods

This was a multicenter and randomized clinical trial conducted in Jiangsu, China, from April 2021 to April 2022. Intervention lasted for 12 weeks and 104 older adults with functional declines were enrolled. All participants were randomly assigned to a control (usual care plus health education) or exercise group (usual care plus health education plus exercise). Primary outcomes were the change score of Short Physical Performance Battery (SPPB) and activities of daily living (ADL). The secondary outcomes included instrumental activities of daily living, Tinetti scores, Frailty score, short-form Mini Nutritional Assessment, Mini-Mental State Examination, Geriatric Depression Scale-15, the 12-item Short Form Survey, 4-meter gait speed test, 6-min walking distance, grip strength, and body composition analysis.

Results

Among the participants, the average age was 85 (82, 88) years. After 12 weeks of follow-up, the exercise group showed a significant improvement in SPPB, with a change of 2 points (95% confidence interval [0, 3.5], P<0.001) compared to control. In contrast, SPPB remained stable in the control group. Compared to the control group, ADL improved in the exercise group, as did instrumental activities of daily living, Tinetti, Frailty, Short Form Survey, 4-meter gait speed test, and 6-min walking distance. Although there was no significant difference between groups in body composition analysis after post-intervention, the exercise group still improved in soft lean mass (P=0.002), fat-free mass (P=0.002), skeletal muscle mass index (P<0.001), fat-free mass index (P=0.004), appendicular skeletal muscle mass (P<0.001), and leg muscle mass (P<0.001), while the control group had no significant increase. No difference was observed in adverse events during trial period.

Conclusions

The multicomponent exercise intervention following vivifrail recommendations is an effective method for older adults with functional decline and can reverse the functional decline and improve gait, balance, and muscle strength. Additionally, the 12-week multicomponent exercise method provides guidance for Chinese medical professionals working in the field of geriatrics and is a promising method to improve physical function in the general population.

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Acknowledgments

The authors would like to thank the external reviewers for their work on the literature. We are grateful to the study participants for their consent to participate. We thank all the other physicians and nursing staff at the six nursing homes for their support during the study. We would like to thank Editage (www.editage.cn) for English language editing.

Funding

Funding: This study was supported by the National Key Research and Development Program of China (grant number 2018YFC2002100, and 2018YFC2002102), the Jiangsu Province Capability Improvement Project through Science, Technology and Education (grant number CXZX202228), the National Natural Science Foundation of China (grant number 81871115, and 82171516), the Natural Science Foundation of Jiangsu Province (grant number BK20211377), the Cadre Health Care Research Project of Jiangsu Province (grant number BJ20018), the Natural science research project of colleges and universities in Jiangsu Province (grant number 20KJB320002); and the Outstanding Young and Middle-aged Talents Support Program of the First Affiliated Hospital with Nanjing Medical University, the Six Talent Peaks Project in Jiangsu Province. Sponsors played no role in the undertaking of this study.

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  1. These authors contribute equally to this work

Authors and Affiliations

  1. Department of Geriatrics, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

    B. Chen, M. Li, H. Zhao, X. Teng, Y. Huang & Jianqing Wu

  2. Jiangsu Provincial Key Laboratory of Gerontology & Geriatrics, Nanjing, China

    B. Chen & Jianqing Wu

  3. Jiangsu Provincial Innovation Center of Gerontology & Geriatrics, Nanjing, China

    B. Chen & Jianqing Wu

  4. Department of General Practice, The First People’s Hospital of Lianyungang, Lianyungang Clinical College of Nanjing Medical University, Lianyungang, China

    H. Zhao

  5. Rehabilitation Medical Center, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

    R. Liao & J. Lu

  6. Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China

    J. Tu, Y. Zou & P. Huang

  7. Clinical Medicine Research Institution, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

    J. Liu

  8. Jiangsu Provincial Key Laboratory of Geriatrics, Department of Geriatrics, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu, 210029, P.R. China

    Jianqing Wu

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  1. B. Chen
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Correspondence to Jianqing Wu.

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Chen, B., Li, M., Zhao, H. et al. Effect of Multicomponent Intervention on Functional Decline in Chinese Older Adults: A Multicenter Randomized Clinical Trial. J Nutr Health Aging 27, 1063–1075 (2023). https://doi.org/10.1007/s12603-023-2031-9

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  • DOI: https://doi.org/10.1007/s12603-023-2031-9

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