Abstract

Abstract Background People who are homeless are more likely to experience poor health with acceleration of ageing commonly reported. The concept of frailty is related to age acceleration and research has shown that appropriate exercise and nutritional supplementation strategies can delay or even reverse frailty. This has not been tested in the homeless population. The aim of this study was to explore the feasibility and preliminary efficacy of an exercise intervention with protein supplementation to target physical functioning deficits and frailty in people experiencing homelessness. Methods A low-threshold, 'drop-in' exercise programme with protein supplementation was delivered once weekly for 16 weeks. The main recruitment site was a day-service centre for people who are homeless and have addiction issues. A one-day programme was also delivered to a connected female-only centre to offer a more inclusive service. Primary outcome was feasibility, which included recruitment and retention of participants. Secondary outcomes included frailty and nutritional status, physical function and self-reported pain. Results Thirty-one participants were recruited, 13 of whom were aged over 50 years. Of these older participants, there was a 100% retention rate to the main recruitment centre, with at least one repeat visit to the exercise intervention. The majority of the older participants presented as frail (6/13) or pre-frail (3/13), with 4/13 non-frail. One of these participants was malnourished, six were at risk of malnourishment and six had normal nutritional status. The possible presence of sarcopenia (eight or less on the Short Physical Performance Battery) was noted in 3/13 of participants. The majority of participants (10/13) reported chronic pain. Conclusion This study highlights a high level of frailty and poor physical and nutritional health in older people experiencing homelessness. High retention indicates interest in this intervention. There is a need to establish and roll out targeted interventions to optimise outcomes for this socially excluded group.

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