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Pre Frail 80: Multifactorial Intervention to Prevent Progression of Pre-Frailty to Frailty in The Elderly

  • L. Gené Huguet
  • M. Navarro González
  • B. Kostov
  • M. Ortega Carmona
  • C. Colungo Francia
  • M. Carpallo Nieto
  • A. Hervás Docón
  • R. Vilarrasa Sauquet
  • R. García Prado
  • A. Sisó-Almirall
Article

Abstract

Objectives

Preventing or delaying frailty has important benefits in the elderly, and in health and social services. Studies have demonstrated the effectiveness of multifactorial interventions in the frail elderly, but there are fewer studies on community-dwelling pre-frail individuals. Identifying pre-frail individuals susceptible to intervention could prevent or delay frailty and its consequences and associated disability and might reverse the state from pre-frail to robust. To evaluate a multifactorial, interdisciplinary primary care intervention in community-dwelling pre-frail elderly patients aged ≥ 80 years.

Design

Randomized clinical trial in a Barcelona primary healthcare centre.

Setting

We included 200 community-dwelling subjects aged ≥ 80 years meeting the Fried pre-frailty criteria. Participants were randomized to intervention and control groups.

Intervention

The intervention group received a 6-month interdisciplinary intervention based on physical exercise, Mediterranean diet advice, assessment of inadequate prescribing in polypharmacy patients and social assessment, while the control group received standard primary healthcare treatment.

Results

173 pre-frail participants (86.5%) completed the study; mean age 84.5 years, 64.5% female. At twelve months, frailty was lower in the intervention group (RR 2.90; 95%CI 1.45 to 8.69). Reversion to robustness was greater in the intervention group (14.1% vs.1.1%, p <0.001). Functional and nutritional status, adherence to Mediterranean diet, quality of life, and functional mobility were improved in the intervention group (p ≤0.001).

Conclusion

A multifactorial, interdisciplinary primary healthcare intervention focused on physical exercise, nutrition, review of polypharmacy and social assessment prevented frailty in pre-frail elderly patients, and improved functional capacity, quality of life and adherence to the Mediterranean diet.

Key words

Frailty multifactorial intervention exercise Mediterranean diet primary health care 

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Copyright information

© Serdi and Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  • L. Gené Huguet
    • 1
  • M. Navarro González
    • 1
    • 7
  • B. Kostov
    • 4
    • 7
  • M. Ortega Carmona
    • 2
  • C. Colungo Francia
    • 2
    • 7
  • M. Carpallo Nieto
    • 3
  • A. Hervás Docón
    • 1
  • R. Vilarrasa Sauquet
    • 5
  • R. García Prado
    • 6
  • A. Sisó-Almirall
    • 7
    • 8
  1. 1.Specialist family physician, Centro de Salud BorrellConsorci d’Atenció Primària de Salut Barcelona Esquerra (CAPSBE)BarcelonaSpain
  2. 2.Department of Nursing, Centro de Salud BorrellConsorci d’Atenció Primària de Salut Barcelona Esquerra (CAPSBE)BarcelonaSpain
  3. 3.Social worker, Centro de Salud BorrellConsorci d’Atenció Primària de Salut Barcelona Esquerra (CAPSBE)BarcelonaSpain
  4. 4.Department of Statistics and Operations ResearchUniversitat Politècnica de CatalunyaBarcelonaSpain
  5. 5.Physical medicine and rehabilitation specialistServicio de Rehabilitación, ICEMEQ, Hospital ClínicBarcelonaSpain
  6. 6.Family physician, Centro de Salud BorrellConsorci d’Atenció Primària de Salut Barcelona Esquerra (CAPSBE)BarcelonaSpain
  7. 7.Primary Healthcare Transversal Research GroupInstitut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)BarcelonaSpain
  8. 8.Research Director, Centro de Salud Les CortsConsorci d’Atenció Primària de Salut Barcelona Esquerra (CAPSBE)BarcelonaSpain

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