Abstract
BackgroundDue to the demographic ageing process and the increasing number of pre-frail and frail individuals, new lifestyle interventions to enhance the quality of life (QoL) in community-dwelling older adults are necessary. Therefore, we performed a randomised controlled trial (RCT) to compare effects of a lay-led home-based physical and nutritional intervention programme with social support alone on different QoL domains in community-dwelling pre-frail and frail older adults.MethodsIn this analysis within a RCT (12 weeks), lay volunteers visited one-on-one pre-frail or frail older adults at home twice a week. Participants in the physical training and nutritional intervention (PTN) group performed six strength exercises and discussed main nutritional issues during each visit. The social support (SOSU) group received home visits twice a week for social exchanges. The QoL was assessed with the WHOQOL-BREF and the WHOQOL-OLD instruments. Analyses of covariance (ANCOVA) were used to examine differences between groups with baseline values as the covariate. Changes within groups were assessed with paired t-tests.ResultsEighty participants (n = 39 in the PTN group and n = 41 in the SOSU group) were included. No significant differences were found between the two groups except in past, present and future activities domain [β = 3.66 (95% confidence interval 0.13 to 7.18)] in favour of the PTN group. However, there was some evidence of greater within group improvements in the PTN group particularly in overall QoL, social relations and social participation. In the SOSU group, no significant effect was observed in any QoL domain.ConclusionA combination of a home-based physical and nutritional intervention was not more effective compared to social support alone, on QoL in community-dwelling pre-frail and frail older adults. However, the small but significant improvement within the PTN group suggests that a home-based physical and nutritional intervention delivered by volunteers may influence the QoL in a positive way.Trial registrationThe study protocol was registered on 6 November 2013 at ClinicalTrials.gov (identifier: NCT01991639).
Highlights
Due to the demographic ageing process and the increasing number of pre-frail and frail individuals, new lifestyle interventions to enhance the quality of life (QoL) in community-dwelling older adults are necessary
Several studies have shown that functional disabilities and limitations on independency, caused by the frailty syndrome are associated with poor quality of life (QoL) [2,3,4], while others studies have shown that low QoL among older adults is linked with various negative health outcomes, including falls and nursing home placement [5]
Several multiple linear regression analyses were used to estimate the association between changes from baseline to follow-up in the nutrition and physically related parameters (MNA®-LF score, Short Physical Performance Battery (SPPB) score, maximum handgrip strength, Physical Activity Scale for the Elderly (PASE) score), group, sex and age with change in various QoL domains. We used those QoL domains, where we found a significant improvement in the physical training and nutritional intervention (PTN) group at follow-up
Summary
Due to the demographic ageing process and the increasing number of pre-frail and frail individuals, new lifestyle interventions to enhance the quality of life (QoL) in community-dwelling older adults are necessary. Several studies have shown that functional disabilities and limitations on independency, caused by the frailty syndrome are associated with poor quality of life (QoL) [2,3,4], while others studies have shown that low QoL among older adults is linked with various negative health outcomes, including falls and nursing home placement [5]. In this context, numerous studies reflect that a broad majority of older people want to remain in their own homes as long as possible. A broad-ranging evaluation of QoL has become an essential component of many clinical studies across a wide range of patient populations [11]
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