Comprehensive geriatric intervention in community-dwelling older adults: a cluster-randomized controlled trial

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  • Watanabe Yuya
    Faculty of Health and Sports Science, Doshisha University Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine Section of Healthy Longevity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition
  • Yamada Yosuke
    Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine Section of Healthy Longevity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition Institute for Active Health, Kyoto University of Advanced Science
  • Yoshida Tsukasa
    Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine Section of Healthy Longevity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition Institute for Active Health, Kyoto University of Advanced Science Senior Citizen’s Welfare Section, Kameoka City Government
  • Yokoyama Keiichi
    Institute for Active Health, Kyoto University of Advanced Science Non-profit Organization Genki-up AGE Project
  • Miyake Motoko
    Department of Health and Sports Sciences, Kyoto University of Advanced Science
  • Yamagata Emi
    Faculty of Nursing, Doshisha Women’s College of Liberal Arts
  • Yamada Minoru
    Faculty of Human Sciences, University of Tsukuba
  • Yoshinaka Yasuko
    Non-profit Organization Genki-up AGE Project Center for Faculty Development, Kyoto University of Advanced Science
  • Kimura Misaka
    Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine Institute for Active Health, Kyoto University of Advanced Science Faculty of Nursing, Doshisha Women’s College of Liberal Arts
  • Kyoto-Kameoka Study Group

Bibliographic Information

Other Title
  • 地域在住高齢者を対象とした包括的介護予防プログラム：クラスター無作為化比較試験
  • 地域在住高齢者を対象とした包括的介護予防プログラム : クラスター無作為化比較試験 : Journal of Cachexia, Sarcopenia and Muscleに掲載された英語論文の日本語による二次出版
  • チイキ ザイジュウ コウレイシャ オ タイショウ ト シタ ホウカツテキカイゴヨボウ プログラム : クラスター ムサクイカ ヒカク シケン : Journal of Cachexia, Sarcopenia and Muscle ニ ケイサイ サレタ エイゴ ロンブン ノ ニホンゴ ニ ヨル ニジ シュッパン
  • Secondary publication in Japanese language of an original English article published in the Journal of Cachexia, Sarcopenia and Muscle
  • Journal of Cachexia, Sarcopenia and Muscleに掲載された英語論文の日本語による二次出版

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Abstract

<p>Background: In longevity societies, one of the most serious social issues is sarcopenia and/or frailty. Preventing them is important for maintaining independence and quality of life in the older population. This study investigated the effect of a self-monitoring comprehensive geriatric intervention programme (CGIP) on physical function and muscle size in community-dwelling older adults. We compared the effects of a CGIP using weekly class-styled (CS) sessions and a home-based (HB) programme.</p><p>Methods: The 526 participants were randomized into one of two groups (CS 251, HB 275) based on their residential districts. We conducted a 12 week CGIP, which consisted of low-load resistance exercise, physical activity increments, oral function improvements, and a nutritional guide. All participants were encouraged to attend two 90 min lectures that included instructions on the CGIP. They were provided with exercise materials (triaxialaccelerometers/pedometers, ankle weights, and elastic bands) and diary logs. The CS group attended 90 min weekly sessions and independently executed the programme on other days, whereas the HB group only received instructions on how to execute the programme. Physical functions, such as knee extension strength (KES), normal and maximum walking speed, the timed up-and-go test, and anterior thigh muscle thickness (MT), were measured and analysed using intention-to-treat analysis before and after the 12 week intervention.</p><p>Results: Of the 526 participants identified, 517 (CS 243 age 74.0 ± 5.4 women 57.2%, HB 274 age 74.0 ± 5.6 women 58.8%) were enrolled. Nine (CS 8, HB 1) were excluded from the analysis because they did not participate in the pre-intervention measurements. Both interventions significantly improved KES (CS 18.5%, HB 10.6%), normal walking speed (CS 3.7%, HB 2.8%), and MT (CS 3.2%, HB 3.5%). Greater improvement of KES was observed in the CS group (P = 0.003). Maximum walking speed (CS 4.7%, HB 1.8%; P = 0.001) and timed up-andgo (CS -4.7%, HB -0.2%; P < 0.001) significantly improved in the CS group only.</p><p>Conclusions: The intervention was effective in preventing sarcopenia and/or frailty. Most physical functions and MT improved after both interventions. The HB intervention is cost-effective and may help prevent sarcopenia and/or frailty in the large older population.</p>

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