Severity of frailty and the outcome of exercise intervention among participants with Alzheimer disease: A sub-group analysis of a randomized controlled trial

Abstract

IntroductionTo investigate how frailty status affects the outcome of exercise intervention among home-dwelling participants with Alzheimer disease (AD). MethodsThis is a sub-group analysis of a randomized controlled trial. In this trial, home-dwelling participants with AD received either home-based or group-based exercise twice a week for one year (n=129); the control group received normal care (n=65). Both the intervention and control group were subdivided into two groups according to modified Fried criteria: prefrail (0–1 criteria) and advanced frailty (2–5 criteria). The Functional Independence Measure (FIM) and number of falls per person-years served as outcome measures. ResultsWhereas there was no significant difference in FIM between the prefrail intervention (PRI) and control (PRC) groups at 3 or 6 months, the PRI group deteriorated significantly slower at 12 months (−6.6 [95% CI −8.6 to −4.5] for PRI and −11.1 [95% CI −13.9 to −8.3] for PRC; P=0.010). Similarly, there was no significant difference between the advanced frailty intervention (AFI) and control (AFC) groups at 3 months, but the difference became significant at 6 months (−8.1 [95% CI −11.1 to −5.2] for AFI and −15.5 [95% CI −20.0 to −11.1] for AFC; P=0.007) and at 12 months (−8.9 [95% CI −11.9 to −5.9] for AFI and −15.3 [95% CI −20.2 to −10.3] for AFC; P=0.031). There was also a significant difference in the number of falls in favor of PRI and AFI groups compared to their respective control groups. ConclusionA long-term exercise intervention benefited people with AD regardless of their stage of frailty. Trial registration: ACTRN12608000037303.