Multicomponent Exercise Program Reduces Frailty and Inflammatory Biomarkers and Improves Physical Performance in Community-Dwelling Older Adults: A Randomized Controlled Trial.

Uratcha Sadjapong,Penprapa Siviroj,Somporn Sungkarat,Supachai Yodkeeree

doi:10.3390/ijerph17113760

Abstract

The efficacy of exercise to reverse frailty in the aging population has not been extensively investigated. This study aimed to investigate the effectiveness of a multicomponent exercise program (MCEP) on frailty, physical performance (handgrip strength, Berg Balance Scale (BBS), Timed Up and Go test (TUG), and VO2Max), blood biomarkers (Interleukin-6 (IL-6) and C-reactive protein (CRP)) in frail older adults. A randomized controlled trial using an allocation concealment method, included 64 older adults (77.78 ± 7.24 years), were divided into two parallel groups using block randomization: an MCEP group (n = 32) and a control group (n = 32). The combined center- and home-based MCEP training consisted of chair aerobic, resistance, and balance, which was carried out 3 days per week for 24 weeks. A mixed model repeated measure ANOVA demonstrated significant interaction effects of group x time for BBS, TUG and frailty scores (p < 0.001). Additionally, the post-hoc analysis revealed that the MCEP group showed significantly improved BBS, TUG, and frailty scores (p < 0.01), at both 12- and 24-weeks. When compared with controls at 12-weeks, the MCEP group decreased IL-6 and CRP levels (p < 0.05). The combined center- and home-based MCEP were effective in reversing frailty to pre-frailty and improving physical performance especially balance in the older population.

Highlights

There is an increase in the aging population in Thailand as there are developed and improved health care services and medical technology
We aimed to study the effects of a Multicomponent Exercise Program (MCEP) and usual care on frail community-dwelling older adults
The multicomponent exercise program (MCEP) group attended a center based program based on an average of 34 of the 36 exercise sessions (94.4%) and home-based programs on average 21 of the 36 exercise sessions (57.5%)

Summary

Introduction

There is an increase in the aging population in Thailand as there are developed and improved health care services and medical technology. Aging is frequently associated with a progressive decline in the ability to resist stress, damage, disease, and physical function [3]. The physical status of the elderly is generally classed as vulnerable to poor health outcomes. Frailty is a well-known physical vulnerability status that is increasing [4]. Frailty is a biological syndrome associated with age defined as decreasing in the biological functional reserve and resistance to stressors’ physical status, resulting from accumulative declines in multiple physiological functions and increased adverse health outcomes as fall risk, hospitalization, disability, and death [5,6]. Fried et al [4] defined five criteria of a phenotype of frailty as weight

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