Enhancing Intrinsic Capacity and Related Biomarkers in Community-Dwelling Multimorbid Older Adults Through Integrated Multidomain Interventions: Ancillary Findings From the Taiwan Integrated Geriatric (TIGER) Trial

Abstract

ObjectiveThis study aimed to evaluate the efficacy of integrated multidomain interventions and primary health care on intrinsic capacity (IC) and related biomarkers. DesignAn ancillary analysis from the Taiwan Integrated Geriatric Care (TIGER) study: a randomized controlled trial. Setting and ParticipantsA total of 398 community-dwelling older adults aged ≥65 years with ≥3 chronic conditions. MethodsParticipants were randomized into the 12-month pragmatic multidomain intervention or usual care groups. The primary outcome was the change in IC and its subdomains (locomotion, cognition, vitality, psychological, and sensory) at baseline and 3-, 6-, 9-, and 12-month follow-ups. Generalized linear mixed models were used to evaluate the multidomain intervention effects on these changes. ResultsThe intervention arm had greater improvement in IC than the usual care arm (overall difference 1.5; 95% CI 0.5–2.5; P = .005), mainly from subdomains of locomotion (overall difference 1.4; 95% CI 0.5–2.4; P = .004) and cognition (2.9; 95% CI 2.1–3.7; P < .001). Changes in neutrophil-to-lymphocyte ratio (NLR −2.4; 95% CI −3.9 to −0.8, P = .003), serum levels of albumin (35.1; 95% CI 23.1–47.2; P < .001), dehydroepiandrosterone sulfate (DHEA-S 2.8; 95% CI 1.9–3.8; P < .001), free androgen index (FAI 1.5; 95% CI 1.1–1.9; P < .001), and vitamin D (4.0; 95% CI 2.0–6.1; P < .001) were associated with changes in IC over time. Conclusions and ImplicationsThe incorporation of multidomain interventions into primary health care significantly enhanced IC over the 12-month program. Changes in NLR, FAI, and serum levels of albumin, DHEA-S, vitamin D were associated with changes in IC over time. Trial registrationClinicalTrials.gov Identifier: NCT03528005.