Physical activity and nutritional supplementation to reduce frailty in community- dwelling older adults, searching for evidence: a systematic review of randomized controlled trials
Journal Title: Biomedicine & Prevention - Year 2017, Vol 2017, Issue 2
Abstract
Background Increase in ageing represent many opportunities and several public health challenges to which the health systems need to prepare for. Due to physiological aging, the elderly could be at risk of frailty. Clinically, frailty is a potentially reversible syndrome that determines an increased risk of adverse health outcomes when exposed to a stressor representing a major risk factor for negative health-related events in the elderly, including disability, falls, needing of long term care, hospitalization and death. The aim of this study was to evaluate the most effective intervention in reducing the frailty status, considering both physical activity and nutritional intervention in community-dwelling older adults, for highlight the better strategy in reducing the prevalence of frail elderly. Methods A systematic literature research, restricted to clinical trials published in the last 10 years, written in English, was performed in November 2016 through PubMed and Cochrane Central Register. Studies were considered eligible if included both gender population of frail community-dwelling. Selected articles had to evaluate the effect of active physical exercise programs, nutritional supplementation, or both on frailty status. Methodological quality of all the selected studies was evaluated using the CONSORT 2010 checklist for randomized trial. Results Of 602 articles eight papers met the inclusion criteria and were included in this review. Six selected articles were centered only on physical intervention, and two were based on both physical and nutritional intervention. No studies regarding only nutritional intervention were included. Five of the included trials evaluated the frailty status as an outcome and all the studies showed a significant improvement on specific frailty scores in the intervention group compared to the control one. Other relevant outcomes were observed, such as mobility, muscle strength, balance, quality of life, cognitive status and biochemical markers. Five authors showed a statistically significant improvement in several mobility parameters. Several muscle strength parameters were significantly improved in four trials, while in two studies intervention did not prove to have relevant effects. Balance scales were significantly improved in two articles in which a physical intervention was performed. Two authors evaluated a quality of life assessment with different scales with no statistically significant results at follow-up. Anthropometric parameters, such as BMI, were measured as outcomes in three trials and did not show a significant benefit. Different cognitive status scales were investigated in three trials reporting a significant better score after intervention. Conclusions This systematic review showed that physical intervention alone or combined with nutritional supplementation should improve the frailty status, but it is still uncertain the role of the nutritional intervention itself or in combination, then more studies are auspicial to understand its role in frailty modifications. Furthermore one of the utmost things to do is to standardize the tools to screening community-dwelling older people for frailty, to identified people that could benefit from prevention strategy or early interventions.
Authors and Affiliations
Laura Morciano, Gennaro Cerone, Francesco Cerruti, Francesca Di Gaspare, Claudia Alessandroni, Cristina Ambrosone, Mario Messinese, Giuseppe Liotta, Sandro Mancinelli, Leonardo Palombi
Keywords
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- EP ID EP335014
- DOI 10.19252/000000074
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