Abstract
Objectives
The aim of this study was to examine the effects of a home-based and volunteer-administered
physical training and nutritional intervention program compared with social support
intervention on nutritional and frailty status in prefrail and frail community-dwelling
older persons.
Design
This was a randomized controlled trial in which community-dwelling persons (mean age = 83 years)
were recruited and randomly assigned to the physical training and nutritional intervention
group (PTN, n = 39) and the social support group (SoSu, n = 41). The study was conducted
by trained lay nonprofessionals.
Setting
The community-dwelling older persons in both groups were visited twice a week by trained
nonprofessional volunteers (buddies) in Vienna, Austria.
Participants
Eighty prefrail and frail adults aged 65 years or older.
Intervention
In the PTN group, both the buddies and older persons performed 6 strength exercises
within a circuit training session and discussed nutrition-related aspects. The active
control group (SoSu) had the opportunity to perform cognitive training in addition
to the social contact.
Measurements
Outcome measures as nutritional (Mini Nutritional Assessment long form [MNA-LF]) and
frailty status (Frailty Instrument for Primary Care of the Survey of Health, Ageing
and Retirement in Europe [SHARE-FI]) were obtained at baseline and after 12 weeks.
Results
Significant improvements in the MNA-LF score (1.54 points, 95% confidence interval
[CI] 0.51–2.56; P = .004) and the SHARE-FI score (−0.71 discrete factor score values, 95% CI −1.07, −0.35;
P < .001) were observed in the PTN group after 12 weeks. In both groups, the prevalence
of impaired nutritional status and frailty decreased significantly over time. The
prevalence of impaired nutritional status decreased by 25% in the PTN group and by
23% in the SoSu group. Moreover, the prevalence of frailty decreased by 17% in the
PTN group and by 16% in the SoSu group. The presence of impaired nutritional status
at baseline was independently associated with greater changes in the nutritional (adjusted
odds ratio [OR] 3.18, 95% CI 1.26–7.98; P = .014) and frailty status (adjusted OR 3.16, 95% CI 1.01–9.93; P = .049) after 12 weeks.
Conclusion
The results indicate that a home-based physical training, nutritional, and social
support intervention conducted by nonprofessionals is feasible and can help to tackle
malnutrition and frailty in older persons living at home. Furthermore, social support
alone also can result in improvement. In particular, older adults with impaired nutritional
status at baseline can benefit more from the intervention. Such a home visit program
might also have the potential to prevent future health risks and could allay isolation
and loneliness.
Keywords
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Article info
Footnotes
The authors declare no conflicts of interest.
The study was funded by a grant (Life Sciences Call 2012) from the Vienna Science and Technology Fund (reference number LS12–039) from March 2013 to August 2016. This is a noncommercial fund, which had no role in the design and conduct of the study; the collection, analysis, and interpretation of data; in the preparation of the manuscript; or in the review or approval of the manuscript.
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© 2016 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
