Table 6.
Effectiveness of interventions described in the included studies for outcome of frailty
| Study | Intervention/control condition | Primary outcome – frailty | Significance |
| Behm, et al., 201540 | Multi-professional senior group meetings with one home visit (n = 171) | At baseline: - Sum of indicators: 14% non-frail, 70% pre-frail, 16% frail - Tiredness in daily activities: 6%One year after intervention - Deterioration on frailty: 49% - Frail ≤ 3 indicators: 34% - Tiredness in daily activities: 22%Two years after intervention - Deterioration on frailty: 60% - Frail ≤ 3 indicators: 47% - Tiredness in daily activities: 32% | Between group change on frailty status:Decrease on frailty status measures as tiredness in daily activities was higher in the control group than in the senior meetings group p = .029 or in the preventive visit group p = .006 |
| Single preventive home visit (n = 174) | At baseline: - Sum of indicators: 13% non-frail, 67% pre-frail, 20% frail - Tiredness in daily activities: 6%1 year after intervention - Deterioration on frailty: 44% - Frail ≤ 3 indicators: 34% - Tiredness in daily activities: 19%2 years after intervention - Deterioration on frailty: 58% - Frail ≤ 3 indicators: 52% - Tiredness in daily activities: 30% | ||
| Ordinary range of community services (n = 114) | At baseline: - Sum of indicators: 11% non-frail, 70% pre-frail, 19% frail - Tiredness in daily activities: 6%1 year after intervention - Deterioration on frailty: 38% - Frail ≤ 3 indicators: 39% - Tiredness in daily activities: 33%2 years after intervention - Deterioration on frailty: 68% - Frail ≤ 3 indicators: 59% - Tiredness in daily activities: 39% | ||
| Bonnefoy, et al., 201222 | Home based exercise program with dietary protein supplementation (n = 53) | At baseline (Median, 1st and 3rd quartiles): - Maximal walking distance (m): 1000 (450; 1750) - Maximal walking time (mn): 30 (15; 60) - PASE score: 33.6 (30.0; 65.5)After 4-month intervention (% from baseline, 1st and 3rd quartiles): - Variation in maximal walking distance (%): 0.00 (−55.0; 33.3) - Variation in maximal walking time (%): 0.00 (−33.3; 50.0) - Variation in PASE score (%): 0.00 (−20.9; 6.0) | Between group change:Maximum walking time kept stable in the intervention group and decreased in the control group p = .009 (for age and sex adjusted analysis p = .015)In subgroup of good compliers with intervention program (n = 23) also significant between group differences on maximum walking distance and maximum walking time were found (p = .007; p = .004, respectively) |
| No intervention (n = 49) | At baseline - Maximal walking distance (m): 1000 (300; 2000) - Maximal walking time (mn): 30 (15; 60) - PASE score: 33.6 (27.1; 55.0)After 4-month intervention (% from baseline, 1st and 3rd quartiles): - Variation in maximal walking distance (%): −16.7 (−40.0; 0.0) - Variation in maximal walking time (%): −25.0 (−50.0; 0.00) - Variation in PASE score (%): 0.00 (−16.7; 31.7) | ||
| Cadore et al., 201441 | Multicomponent exercise program(n = 11) | At baseline (mean ± SD): - Gait velocity (ms−1): 0.76 ± 0.07; - Hand grip (N): 165 ± 63 - Hip flexion strength (N):1.057 ± 262 - Knee extension strength (N): 1.451 ± 441After 12-week intervention (mean ± SD): - Gait velocity (ms−1): 0.80 ± 0.08 - Hand grip (N): 183 ± 52 - Hip flexion strength (N): 1.284 ± 203 - Knee extension strength (N): 1.745 ± 460 | Group x time interaction:Gait velocity p < .05Hip flexion strength p < .05 (intervention group > control group)Hand grip p < .01 (intervention group > control group)Knee extension strength p < .01 (intervention group > control group)Within group change in frailty components: In the intervention group improvement on hip flexion strength p < .01 and knee extension strength p < .05In the control group decrease in gait speed p < .05, hand grip p < .05 and knee extension strength p < .05 |
| Mobility exercises (n = 13) | At baseline (mean ± SD): - Gait velocity (ms−1): 0.68 ± 0.06 - Hand grip (N): 157 ± 64 - Hip flexion strength (N): 865 ± 268 - Knee extension strength (N): 1.206 ± 336After 12-week intervention (mean ± SD): - Gait velocity (ms−1): 0.60 ± 0.07 - Hand grip (N): 130 ± 58 - Hip flexion strength (N): 834 ± 382 - Knee extension strength (N): 1.042 ± 353 | ||
| Chan et al., 201242 | Exercise and nutrition consultation (n = 55) | At baseline: - Pre-frail: 84%; Frail: 16% - Weight loss: 33%; Exhaustion: 45%; Low activity level: 5%; Slowness: 18%; Weakness: 60%After 3-month intervention: - Improvement in frailty: 45% - Weight loss: 16%; Exhaustion: 29%; Low activity level: 4%; Slowness: 11%; Weakness: 20%6 months after baseline assessment: - Improvement in frailty: 42% - Weight loss: 15%; Exhaustion: 31%; Low activity level: 4%; Slowness: 7%; Weakness: 16%12 months after baseline assessment: - Improvement in frailty: 40% - Weight loss: 20%; Exhaustion: 35%; Low activity level: 4%; Slowness: 11%; Weakness: 13% | Between group change on frailty status:At 3 months the improvement in frailty status was higher in the exercise and nutrition consultation group than in the respective control group p = .008Between group change on frailty components: no significant difference |
| Problem solving therapy (n = 57) | At baseline: - Pre-frail: 84%; Frail: 16% - Weight loss: 21%; Exhaustion: 39%; Low activity level: 9%; Slowness: 26%; Weakness: 74%After 3-month intervention: - Improvement in frailty: 44% - Weight loss: 12%; Exhaustion: 28%; Low activity level: 5%; Slowness: 9%; Weakness: 30%6 months after baseline assessment: - Improvement in frailty: 35% - Weight loss: 11%; Exhaustion: 28%; Low activity level: 5%; Slowness: 11%; Weakness: 16%12 months after baseline assessment: - Improvement in frailty: 35% - Weight loss: 14%; Exhaustion: 28%; Low activity level: 5%; Slowness: 12%; Weakness: 21% | ||
| Educational booklet (control condition for exercise and nutrition consultation) (n = 62) | At baseline: - Pre-frail: 90%; Frail: 10% - Weight loss: 19%; Exhaustion: 37%; Low activity level: 10%; Slowness: 9%; Weakness: 81%After 3-month intervention: - Improvement in frailty: 27% - Weight loss: 10%; Exhaustion: 27%; Low activity level: 6%; Slowness: 3%; Weakness: 27%6 months after baseline assessment: - Improvement in frailty: 26% - Weight loss: 13%; Exhaustion: 29%; Low activity level: 6%; Slowness: 5%; Weakness: 26%12 months after baseline assessment: - Improvement in frailty: 31% - Weight loss: 15%; Exhaustion: 32%; Low activity level: 6%; Slowness: 5%; Weakness: 27% | ||
| Educational booklet (control condition for problem solving therapy) (n = 60) | At baseline: - Pre-frail: 90%; Frail: 10% - Weight loss: 3%; Exhaustion: 43%; Low activity level: 7%; Slowness: 12%; Weakness: 68%After 3-month intervention: - Improvement in frailty: 28% - Weight loss: 13%; Exhaustion: 28%; Low activity level: 5%; Slowness: 5%; Weakness: 18%6 months after baseline assessment: - Improvement in frailty: 32% - Weight loss: 17%; Exhaustion: 42%; Low activity level: 5%; Slowness: 2%; Weakness: 27%12 months after baseline assessment: - Improvement in frailty: 35% - Weight loss: 20%; Exhaustion: 38%; Low activity level: 5%; Slowness: 3%; Weakness: 20% | ||
| Clegg, et al., 201443 | Home-based exercise program (n = 40) | At baseline (mean ± SD): - TUGT Score: 52.0 ± 62.4After 12-week intervention (mean ± SD): - TUGT Score: 62.4 ± 77.7 | Between group change: no significant difference |
| Usual care (n = 30) | At baseline (mean ± SD): - TUGT Score: 57.9 ± 74.1After 12-week intervention (mean ± SD): - TUGT Score: 97.0 ± 116.7 | ||
| Cohen, et al., 200244 | Inpatient geriatric care in multidisciplinary evaluation and management units (not clear) | At baseline vs After intervention (mean change in score): - Basic ADL score: 0.23; Instrumental ADL score: −0.30 - Physical Performance Test score: 3.12 At baseline vs 12 months after randomization (mean change in score): - Basic ADL score: 0.27; Instrumental ADL score: −0.20 - Physical Performance Test score: 4.50 | Between group changeIn the inpatient groups - basic ADL at discharge p < .001 (evaluation and management group > usual care group) - physical performance at discharge p < .001 (evaluation and management group > usual care group)In the outpatient groups - physical performance at 12 months (adjusted for the length of stay) p = .003 (evaluation and management group > usual care group) |
| Outpatient care in geriatric evaluation and management clinics (not clear) | At baseline vs After intervention (mean change in score): - Basic ADL score: 0.20; Instrumental ADL score: −0.28 - Physical Performance Test score: 2.34 At baseline vs 12 months after randomization (mean change in score/values adjusted for the length of stay): - Basic ADL score: 0.27/0.05; Instrumental ADL score: −0.18/0.09 - Physical Performance Test score: 4.67/2.13 | ||
| Usual inpatient care (not clear) | At baseline vs After intervention (mean change in score): - Basic ADL score: 0.15; Instrumental ADL score: −0.30 - Physical Performance Test score: 1.75 At baseline vs 12 months after randomization (mean change in score): - Basic ADL score: 0.25; Instrumental ADL score: −0.20 - Physical Performance Test score: 4.24 | ||
| Usual outpatient care (not clear) | At baseline vs After intervention (mean change in score): - Basic ADL score: 0.20; Instrumental ADL score: −0.30 - Physical Performance Test score: 2.60 At baseline vs 12 months after randomization (mean change in score/values adjusted for the length of stay): - Instrumental ADL score: 0.25/0.03; Basic ADL score: −0.21/0.08 - Physical Performance Test score: 4.07/1.30 | ||
| Eklund, et al., 201329 | Continuum Care by multi-professional team(n = 85) | At baseline: - Non-frail: 5%; pre-frail: 26%; frail: 69%3 months after discharge: - Improvement: 8%; Maintained level: 78%; Decrease: 14%6 months after discharge: - Improvement: 12%; Maintained level: 74%; Decrease: 14%12 months after discharge: - Improvement: 12% Maintained level: 74%; Decrease: 14% | Between group change in frailty status: no significant difference |
| Usual care (n = 76) | At baseline: - Non-frail: 0%; pre-frail: 24%; frail: 76%3 months after discharge: - Improvement: 13%; Maintained level: 76%; Decrease: 11%6 months after discharge: - Improvement: 17%; Maintained level: 75%; Decrease: 8%12 months after discharge: - Improvement: 22%; Maintained level: 68%; Decrease: 9% | ||
| Fairhall, et al., 201532 | Multifactorial interdisciplinary intervention targeting identified frailty characteristics (n = 120) | At baseline: - Frailty prevalence: 100% (3 frailty criteria: 64%; 4 frailty criteria: 28%; 5 frailty criteria: 8%)At 3 months: - Frailty prevalence: 64%At 12 months: - Frailty prevalence: 62% | Between group change in frailty prevalence (adjusted for month 0):At 12 months frailty prevalence was lower in the intervention group than in the control group p = .02 |
| Usual care (n = 121) | At baseline: - Frailty prevalence: 100% (3 frailty criteria: 65%; 4 frailty criteria: 25%; 5 frailty criteria: 10%)At 3 months: - Frailty prevalence: 75%At 12 months: - Frailty prevalence: 77% | ||
| Favela, et al., 201345 | Nurse home visits alone (n = 44) | At baseline: - Frail: 43.2% - Weight loss: 18.2%; Exhaustion: 25.0%; Weakness: 50.0%; Slow walking speed: 95.5%; Low activity level: 52.3%After 9-month intervention: - Frail: more than 65% (exact data not provided) - Improvement in frailty: about 11% (exact data not provided) - Development of frailty: 24.3% | Between group change in frailty prevalence:In post-intervention assessment nurse home visits + alert buttons group less frail than control group p < .05 (either for observed in those followed up, or estimated including deaths and losses to follow-up) |
| Nurse home visits including alert buttons (n = 45) | At baseline: - Frail: 46.7% - Weight loss: 15.6%; Exhaustion: 33.3%; Weakness: 60.0%; Slow walking speed: 97.8%; Low activity level: 57.8%After 9-month intervention: - Frail: 23.3% - Improvement in frailty: 12.8% - Development of frailty: 5.1% | ||
| Usual care (n = 44) | At baseline: - Frail: 45.5% - Weight loss: 20.5%; Exhaustion: 18.2%; Weakness: 52.3%; Slow walking speed: 100%; Low activity level: 43.2%After 9-month intervention: - Frail: 58.3% - Improvement in frailty: about 10% (exact data not provided) - Development of frailty: 12.8% | ||
| Giné-Garriga, et al., 201046 | Functional circuit-training program (n = 22) | At baseline (mean ± SD; 95%CI): - Barthel Index Score: 73.41 ± 2.35 (68.67; 78.15) - Rapid Gait test (s): 11.73 ± 0.60 (10.52; 12.93) - Stand-up test (s): 19.55 ± 0.71 (18.12; 20.97)After 12-week intervention (mean ± SD; 95%CI): - Barthel Index Score: 79.32 ± 2.35 (74.58; 84.06) - Rapid Gait test (s): 9.20 ± 0.60 (7.99; 10.41) - Stand-up test (s): 15.55 ± 0.66 (14.21; 16.89)At 36 weeks (mean ± SD; 95%CI): - Barthel Index Score: 77.0 ± 2.38 (72.19; 81.80) - Rapid Gait test (s): 10.05 ± 0.62 (8.82; 11.29) - Stand-up test (s): 17.81 ± 0.68 (16.43; 19.18) | Group x time interaction:Barthel Index p < .001 (intervention group > control group)For week 0 – week 12 p < .001For week 0 – week 36 p = .001For week 12 – week 36 p = .049Rapid gait test p < .001 (intervention group > control group)For week 0 – week 12 p < .001For week 0 – week 36 p < .001For week 12 – week 36 p = .031Stand-up test p < .001 (intervention group > control group)For week 0 – week 12 p < .001For week 0 – week 36 p = .002For week 12 – week 36 p < .001Within group change: In the intervention group improvement from baseline to week 12 and from baseline to week 36 in Barthel Index, Rapid Gait test and Stand-up test p < .05 |
| Health education meeting and usual care (n = 19) | At baseline (mean ± SD; 95%CI): - Barthel Index Score: 70.79 ± 2.53 (65.69; 75.89) - Rapid Gait test (s): 11.87 ± .065 (10.57; 13.16) - Stand-up test (s): 17.05 ± 0.93 (15.16; 18.93)After 12-week intervention (mean ± SD; 95%CI): - Barthel Index Score: 67.90 ± 2.53 (62.79; 73.00) - Rapid Gait test (s): 12.39 ± 0.65 (11.10; 13.69) - Stand-up test (s): 17.93 ± 0.92 (16.07; 19.79)At 36 weeks (mean ± SD; 95%CI): - Barthel Index Score: 66.73 ± 2.73 (61.26; 72.21) - Rapid Gait test (s): 12.76 ± 0.74 (11.29; 14.23) - Stand-up test (s): 17.47 ± 1.08 (15.31; 19.63) | ||
| Gustafsson, et al., 201247 | Multi-professional senior group meetings with one home visit (n = 171) | At baseline vs 3 months after intervention:- No progression of frailty between baseline and follow-up: 64% | Between group change in frailty status: No significant difference |
| Single preventive home visit (n = 174) | At baseline vs 3 months after intervention:- No progression of frailty between baseline and follow-up: 70% | ||
| Ordinary range of community services (n = 114) | At baseline vs 3 months after intervention:- No progression of frailty between baseline and follow-up: 71% | ||
| Hars et al., 201448 | Continued intervention of music-based multitask training (n = 23) | At baseline: - Number of frailty components (mean ± SD): 0.5 ± 0.6 - Weight loss: 4%; Exhaustion: 26%; Low activity level: 0%; Slow walking speed: 9%; Weakness: 13%After 1-year intervention: - Number of frailty components (mean ± SD): 0.7 ± 0.6 - Weight loss: 0%; Exhaustion: 9%; Low activity level: 0%; Slow walking speed: 9%; Weakness: 48%3 years after intervention: - Number of frailty components (mean ± SD): 0.5 ± 0.8 - Weight loss: 0%; Exhaustion: 9%; Low activity level: 0%; Slow walking speed: 9%; Weakness: 35% | Within group change from baseline to 4-year follow-up:Gait speed and gait velocity in the continued intervention p < .05Gait velocity in the discontinued intervention p < .05Between group changeGait speed p = .006 (continued intervention > discontinued intervention)Handgrip strength p = .018 (continued intervention > discontinued intervention)Change on frailty status: Pre-frail participants from the continued intervention group were more likely to become robust at 4 years than participants from the discontinued intervention group (p = 0.004) |
| Discontinued intervention of music-based multitask training (n = 29) | At baseline: - Number of frailty components (mean ± SD): 1 ± 0.7 - Weight loss: 21%; Exhaustion: 17%; Low activity level: 0%; Slow walking speed: 14%; Weakness: 48%After 1-year intervention: - Number of frailty components (mean ± SD): 0.9 ± 0.6 - Weight loss: 0%; Exhaustion: 10%; Low activity level: 0%; Slow walking speed: 7%; Weakness: 69%3 years after intervention: - Number of frailty components (mean ± SD): 1.3 ± 0.8 - Weight loss: 3%; Exhaustion: 10%; Low activity level: 0%; Slow walking speed: 34%; Weakness: 79% | ||
| Kim, et al., 201549 | Milk fat globule membrane (MFGM) supplementation (n = 32) | At baseline: - Number of frailty components (mean ± SD): 3.7 ± 0.7 (3 frailty criteria: 43.8%; 4 frailty criteria: 40.6%; 5 frailty criteria: 15.6%) - Weight loss: 62.5%; Exhaustion: 62.5%; Low activity level: 93.8%; Weakness: 65.6%;Slow walking speed: 68.8%After 3-month intervention: - Reversal rate of frailty: 28.1% - Reversal rate from baseline to post-intervention for Weight loss: −18.7%; Exhaustion: 18.7%; Low activity level: 40.6%; Weakness: −12.5%;Slow walking speed: −12.5%4 months after intervention: - Reversal rate of frailty: 25.0% - Reversal rate from baseline to follow-up for Weight loss: 15.6%; Exhaustion: 25.0%; Low activity level: 9.4%; Weakness: −9.4%;Slow walking speed: 15.6% | Within group change from baseline to post-intervention:Weight loss in placebo group p < .05Exhaustion in exercise + placebo, exercise + MFGM, and placebo groups p < .05Physical activity in all intervention and placebo groups p < .05Within group change from baseline to follow-up:Weight loss in exercise + MFGM, and exercise + placebo groups p < .05Exhaustion in all intervention groups p < .05Physical activity in exercise + MFGM group p < .05Walking speed in exercise + MFGM group p < .05Between group change in post intervention assessment:Weight loss p = .007 (exercise + MFGM < MFGM, placebo)Exhaustion p < .001 (exercise + MFGM, MFGM, and placebo groups < exercise + placebo)Between group change in follow-up assessment:Weight loss p = .005 (exercise + MFGM > MFGM, placebo; exercise + placebo > placebo)Exhaustion p = .007 (exercise + MFGM, exercise + placebo, MFGM > placebo)Physical activity p = .004 (exercise + MFGM > exercise + placebo, MFGM, placebo)Walking speed p < .001 (exercise + MFGM > exercise + placebo; MFGM > placebo) |
| Exercise + placebo (n = 33) | At baseline: - Number of frailty components (mean ± SD): 3.6 ± 0.7 (3 frailty criteria: 54.4%; 4 frailty criteria: 30.3%; 5 frailty criteria: 15.2%) - Weight loss: 60.6%; Exhaustion: 84.8%; Low activity level: 75.8%; Weakness: 72.7%;Slow walking speed: 60.6%After 3-month intervention: - Reversal rate of frailty: 51.5% - Reversal rate from baseline to post-intervention for Weight loss: −12.1%; Exhaustion: 69.7%; Low activity level: 57.6%; Weakness: 3.0%;Slow walking speed: 9.1%4 months after intervention: - Reversal rate of frailty: 39.4% - Reversal rate from baseline to follow-up for Weight loss: 33.3%; Exhaustion: 42.4%; Low activity level: 9.1%; Weakness: −3.1%;Slow walking speed: 18.2% | ||
| Exercise + milk fat globule membrane (MFGM) supplementation (n = 33) | At baseline: - Number of frailty components (mean ± SD): 3.8 ± 0.7 (3 frailty criteria: 33.3%; 4 frailty criteria: 48.5%; 5 frailty criteria: 18.2%) - Weight loss: 72.7%; Exhaustion: 60.6%; Low activity level: 90.9%; Weakness: 69.7%;Slow walking speed: 66.7%After 3-month intervention: - Reversal rate of frailty: 57.6% - Reversal rate from baseline to post-intervention for Weight loss: 0.00%; Exhaustion: 30.3%; Low activity level: 54.5%; Weakness: 6.1%;Slow walking speed: 18.2%4 months after intervention: - Reversal rate of frailty: 45.5% - Reversal rate from baseline to follow-up for Weight loss: 39.4%; Exhaustion: 33.3%; Low activity level: 36.4%; Weakness: 3.0%;Slow walking speed: 42.4% | ||
| Placebo (n = 32) | At baseline: - Number of frailty components (mean ± SD): 3.5 ± 0.6 (3 frailty criteria: 51.5%; 4 frailty criteria: 45.5%; 5 frailty criteria: 3.0%) - Weight loss: 45.5%; Exhaustion: 60.6%; Low activity level: 90.9%; Weakness: 63.6%;Slow walking speed: 57.6%After 3-month intervention: - Reversal rate of frailty: 30.3% - Reversal rate from baseline to post-intervention for Weight loss: −30.3%; Exhaustion: 30.3%; Low activity level: 30.3%; Weakness: 6.1%;Slow walking speed: −3.0%4 months after intervention: - Reversal rate of frailty: 15.2% - Reversal rate from baseline to follow-up for Weight loss: −6.1%; Exhaustion: −6.1%; Low activity level: 9.1%; Weakness: −9.1%;Slow walking speed: 0.0% | ||
| Kim & Lee, 201323 | Protein-energy supplementation (n = 41) | At baseline (mean ± SD): - Physical Functioning score: 17.0 ± 5.3 - SPPB score: 5.5 ± 1.5 - Energy intake (kcal/day): 965 ± 309; Protein (g/day): 35.4 ± 15.9; Essential amino acid (g/day): 9.1 ± 4.1; Adequacy ratio for the intake of energy, protein and micronutrients: 55.4 ± 20.2; Body weight (kg): 47.4 ± 9.3After 12-week intervention (mean ± SD): - Physical Functioning score: 18.2 ± 4.9 - SPPB score: 5.8 ± 1.6 - Energy intake (kcal/day): 1124 ± 315; Protein (g/day): 54.7 ± 21.2; Essential amino acid (g/day): 16.9 ± 6.0; Adequacy ratio for the intake of energy, protein and micronutrients: 87.4 ± 24.2; Body weight (kg): 49.0 ± 9.4 | Between group change in frailty components:SPPB p = .039;Energy intake p = .008;Protein p < .001;Essential amino acid p < .001Adequacy ratio p < .001There was a modest correlation between relative change in physical functioning with relative change in protein intake (rs = .23, p = .037) and mean adequacy ratio (rs = .25, p = .023).Change in Short Physical Performance Battery correlated significantly with change in mid-arm circumference (rs = .31; p = .004). |
| No intervention (n = 43) | At baseline (mean ± SD): - Physical Functioning score: 18.4 ± 5.8 - SPPB score: 5.7 ± 1.8 - Energy intake (kcal/day): 951 ± 331; Protein (g/day): 35.9 ± 15.0; Essential amino acid (g/day): 10.4 ± 4.9; Adequacy ratio for the intake of energy, protein and micronutrients: 60.4 ± 23.6; Body weight (kg): 44.4 ± 7.7After 12-week intervention (mean ± SD): - Physical Functioning score: 18.4 ± 6.1 - SPPB score: 5.4 ± 2.2 - Energy intake (kcal/day): 896 ± 277; Protein (g/day): 32.7 ± 10.3; Essential amino acid (g/day): 9.0 ± 3.7; Adequacy ratio for the intake of energy, protein and micronutrients: 56.2 ± 18.8; Body weight (kg): 45.8 ± 8.0 | ||
| Li, et al., 201050 | Screening evaluation and intervention based on screening results (n = 129) | At baseline: - Non-frail: 0%; Pre-frail: 82.9%; Frail: 17.1%6 months after baseline assessment: - Non-frail: 3.9%; Pre-frail: 78.3%; Frail: 17.8% | Deterioration in frailty status: no significant differences |
| Screening evaluation (n = 140) | At baseline: - Non-frail: 0%; Pre-frail: 80.4%; Frail: 19.6%6 months after baseline assessment: - Non-frail: 2.1%; Pre-frail: 73.6%; Frail: 24.3% | ||
| Monteserin et al., 201051 | Group sessions (n = 157) | At baseline: - 49% at risk of frailtyAfter 18-month intervention: - Reversal rate of frailty: 27.9% - Rate of becoming at risk of frailty: 20.4% | Between group change in frailty status:From not at risk to at risk status p = .023 (control group > intervention group)From at risk to not at risk status p = .027 (control group < intervention group) |
| Individual sessions with geriatrician (n = 151) | |||
| Usual care (n = 312) | At baseline: - 42.9% at risk of frailtyAfter 18-month intervention: - Reversal rate of frailty: 13.5% - Rate of becoming at risk of frailty: 33.8% | ||
| Muller et al., 200652 | Atamestane + dehydroepiandrosterone (DHEA) (n = 26) | At baseline (mean ± SD): - Isometric grip strength (kg): 33.3 ± 6.3 - Leg extension power (Nm): 105.7 ± 17.6 - Physical performance score: 8.35 ± 2.35After 36-week intervention (differences between placebo and study agent, mean, 95% CI): - Isometric grip strength (kg): 0.0 (−1.9; 1.9) - Leg extension power (Nm): −1.8 (−8.7; 5.0) - Physical performance score: 0.2 (−0.7; 1.2) | No differences in change of isometric grip strength and physical performance for the treatment groups, compared with placebo groupLeg extension power declined in all intervention groupsTime effect on frailty measures: no significant |
| DHEA(n = 25) | At baseline (mean ± SD): - Isometric grip strength (kg): 32.7 ± 5.2 - Leg extension power (Nm): 110.8 ± 14.7 - Physical performance score: 7.80 ± 2.35After 36-week intervention (differences between placebo and study agent, mean, 95% CI): - Isometric grip strength (kg): 1.3 (−0.6; 3.2) - Leg extension power (Nm): −5.4 (−12.4; 1.6) - Physical performance score: 0.7 (−0.3; 1.7) | ||
| Atamestane (n = 25) | At baseline (mean ± SD): - Isometric grip strength (kg): 33.8 ± 6.3 - Leg extension power (Nm): 101.9 ± 13.4 - Physical performance score: 8.48 ± 2.14After 36-week intervention (differences between placebo and study agent, mean, 95% CI): - Isometric grip strength (kg): 0.2 (−1.8; 2.1) - Leg extension power (Nm): −1.9 (−8.9; 5.0) - Physical performance score: 0.2 (−0.8; 1.2) | ||
| Placebo (n = 24) | At baseline (mean ± SD): - Isometric grip strength (kg): 34.0 ± 7.1 - Leg extension power (Nm): 103.0 ± 13.5 - Physical performance score: 8.58 ± 2.12After 36-week intervention (changes from baseline (placebo), mean, 95%CI): - Isometric grip strength (kg): −1.2 (−2.4; −0.0) - Leg extension power (Nm): 6.4 (−0.1; 12.7) - Physical performance score: −0.1 (−0.9; 0.7) | ||
| Ng, et al., 201553 | Nutritional supplements (n = 50) | At baseline (mean ± SD): - Number of frailty components: 2.1 ± 0.78; pre-frail: 67.4%; frail 32.7% - Weight loss: 4.1%; Slowness: 40.8%; Weakness: 53.1%;Exhaustion: 14.3%; Low activity level: 18.4% - BMI (kg/m2): 24.0 ± 4.31; knee strength (kg): 14.0 ± 5.27; physical activity: 165.7 ± 104.7; gait speed (s): 5.8 ± 1.81; energy: 10.7 ± 1.23At 3 months (mean ± SD): - Number of frailty components: 1.5 ± 1.06 - BMI (kg/m2): 24.3 ± 4.33; knee strength (kg): 15.8 ± 5.38; physical activity: 201.5 ± 119.2; gait speed (s): 4.8 ± 1.21; energy: 11.4 ± 1.79After 6-month intervention (mean ± SD): - Number of frailty components 1.4 ± 0.78 - BMI (kg/m2): 23.9 ± 4.47; knee strength (kg): 15.1 ± 4.77; physical activity: 264.5 ± 134.9; gait speed (s): 5.0 ± 1.02; energy: 11.2 ± 1.56At 12 months (mean ± SD): - Number of frailty components: 1.5 ± 0.91; Frailty reduction: 35.6% - BMI (kg/m2): 24.2 ± 4.23; knee strength (kg): 15.0 ± 4.34; physical activity: 279.1 ± 139.0; gait speed (s): 5.2 ± 1.21; energy: 11.6 ± 1.85 | Mean change from baseline for frailty score: Nutritional supplements at 12 months p < .05Cognitive training at 12 months p < .05Physical training at 3 months p < .05, at 6 and 12 months p < .01Combined treatment at 3 and 6 months p < .05, at 12 months p < .01Mean change from baseline for frailty prevalence:All intervention groups p < .01Time effect on frailty components: BMI p = .001;knee strength, physical activity, gait speed, energy p < .001Group effect on frailty components: no significantGroup x time interaction on frailty components: knee strength p = .009;physical activity p = .038 |
| Physical training (n = 48) | At baseline (mean ± SD): - Number of frailty components: 2.2 ± 0.85; pre-frail: 60.4%; frail 39.6% - Weight loss: 6.3%; Slowness: 47.9%; Weakness: 54.2%;Exhaustion: 14.6%; Low activity level: 22.9% - BMI (kg/m2): 23.5 ± 3.03; knee strength (kg): 14.1 ± 4.63; physical activity: 162.5 ± 117.2; gait speed (s): 6.1 ± 2.08; energy: 10.8 ± 1.10At 3 months (mean ± SD): - Number of frailty components: 1.2 ± 0.75 - BMI (kg/m2): 23.5 ± 2.92; knee strength (kg): 16.0 ± 4.00; physical activity: 185.8 ± 116.9; gait speed (s): 4.8 ± 0.89; energy: 11.7 ± 1.68After 6-month intervention (mean ± SD): - Number of frailty components: 1.3 ± 0.87 - BMI (kg/m2): 23.7 ± 3.06; knee strength (kg): 16.9 ± 5.47; physical activity: 220.1 ± 139.7; gait speed (s): 5.0 ± 1.04; energy: 11.5 ± 1.71At 12 months (mean ± SD): - Number of frailty components: 1.4 ± 0.80; Frailty reduction: 41.3% - BMI (kg/m2): 23.4 ± 3.23; knee strength (kg): 15.5 ± 5.19; physical activity: 202.0 ± 134.6; gait speed (s): 4.9 ± 0.99; energy: 11.4 ± 1.89 | ||
| Cognitive training (n = 50) | At baseline (mean ± SD): - Number of frailty components: 2.0 ± 0.91; pre-frail: 74.0%; frail 26.0% - Weight loss: 4.0%; Slowness: 26.0%; Weakness: 56.0%;Exhaustion: 20.0%; Low activity level: 24.0% - BMI (kg/m2): 23.1 ± 2.70; knee strength (kg): 12.9 ± 3.88; physical activity: 179.3 ± 113.3; gait speed (s): 5.4 ± 1.16; energy: 10.5 ± 1.20At 3 months (mean ± SD): - Number of frailty components: 1.3 ± 0.81 - BMI (kg/m2): 23.3 ± 3.01; knee strength (kg): 14.9 ± 4.41; physical activity: 194.8 ± 118.6; gait speed (s): 4.7 ± 0.97; energy: 11.7 ± 1.78After 6-month intervention (mean ± SD): - Number of frailty components: 1.4 ± 0.78 - BMI (kg/m2): 23.4 ± 2.97; knee strength (kg): 15.2 ± 5.20; physical activity: 194.8 ± 115.4; gait speed (s): 4.6 ± 0.80; energy: 11.3 ± 1.71At 12 months (mean ± SD): - Number of frailty components: 1.4 ± 0.94; Frailty reduction: 35.6% - BMI (kg/m2): 23.0 ± 3.52; knee strength (kg): 15.0 ± 4.35; physical activity: 227.1 ± 98.7; gait speed (s): 5.2 ± 1.05; energy: 11.5 ± 2.07 | ||
| Combination treatment (n = 49) | At baseline (mean ± SD): - Number of frailty components: 2.1 ± 0.81; pre-frail: 73.5%; frail 26.5% - Weight loss: 2.0%; Slowness: 34.7%; Weakness: 51.0%;Exhaustion: 16.3%; Low activity level: 32.7% - BMI (kg/m2): 24.4 ± 3.79; knee strength (kg): 14.9 ± 5.50; physical activity: 160.6 ± 115.9; gait speed (s): 5.4 ± 1.25; energy: 10.7 ± 1.38At 3 months (mean ± SD): - Number of frailty components: 1.3 ± 0.84 - BMI (kg/m2): 24.4 ± 3.78; knee strength (kg): 16.8 ± 5.82; physical activity: 201.6 ± 115.3; gait speed (s): 4.7 ± 1.20; energy: 11.9 ± 1.67After 6-month intervention (mean ± SD): - Number of frailty components: 1.4 ± 0.87 - BMI (kg/m2): 24.6 ± 3.64; knee strength (kg): 17.5 ± 6.40; physical activity: 197.2 ± 139.4; gait speed (s): 4.8 ± 1.13; energy: 11.8 ± 1.71At 12 months (mean ± SD): - Number of frailty components: 1.2 ± 1.07; Frailty reduction: 47.8% - BMI (kg/m2): 24.1 ± 3.83; knee strength (kg): 17.2 ± 6.59; physical activity: 201.0 ± 138.0; gait speed (s): 5.3 ± 2.17; energy: 12.0 ± 1.81 | ||
| Standard care + placebo (n = 50) | At baseline (mean ± SD): - Number of frailty components: 1.8 ± 0.80; pre-frail: 86.0%; frail 14.0% - Weight loss: 6.0%; Slowness: 30.0%; Weakness: 40.8%;Exhaustion: 12.0%; Low activity level: 10.0% - BMI (kg/m2): 23.6 ± 3.35; knee strength (kg): 15.5 ± 4.73; physical activity: 176.9 ± 111.0; gait speed (s): 5.6 ± 2.07; energy: 10.6 ± 1.55At 3 months (mean ± SD): - Number of frailty components: 1.3 ± 0.85 - BMI (kg/m2): 24.1 ± 3.33; knee strength (kg): 16.5 ± 4.68; physical activity: 183.5 ± 114.6; gait speed (s): 5.1 ± 2.09; energy: 11.2 ± 1.99After 6-month intervention (mean ± SD): - Number of frailty components: 1.4 ± 1.06 - BMI (kg/m2): 24.1 ± 3.61; knee strength (kg): 15.0 ± 4.53; physical activity: 195.0 ± 103.0; gait speed (s): 4.9 ± 1.47; energy: 11.3 ± 1.68At 12 months (mean ± SD): - Number of frailty components: 1.6 ± 0.97; Frailty reduction: 15.2% - BMI (kg/m2): 23.8 ± 3.58; knee strength (kg): 14.8 ± 4.47; physical activity: 209.7 ± 123.3; gait speed (s): 5.2 ± 1.72; energy: 10.9 ± 1.67 | ||
| Van Hout et al., 201054 | Proactive home visits by trained community nurses (n = 331) | At baseline (mean ± SD): - SF-36 physical component: 31.8 ± 10.0; SF-36 mental component: 44.2 ± 11.4; GARS: ± 55.5 (9.8)At 6 months (mean ± SD): - SF-36 physical component: 31.4 ± 9.3; SF-36 mental component: 44.5 ± 10.5After 18-month intervention (mean ± SD): - SF-36 physical component: 30.7 ± 9.2; SF-36 mental component: 43.9 ± 11.2; GARS: 51.8 ± 10.4 | Group x time interaction: no significant difference |
| Usual care (n = 320) | At baseline (mean ± SD): - SF-36 physical component: 31.9 ± 9.9; SF-36 mental component: 45.0 ± 11.3; GARS: 56.8 ± 9.8At 6 months (mean ± SD): - SF-36 physical component: 32.1 ± 9.4; SF-36 mental component: 45.4 ± 10.6After 18-month intervention (mean ± SD): - SF-36 physical component: 32.2 ± 9.3; SF-36 mental component: 45.2 ± 11.2; GARS: 53.0 ± 10.5 | ||
| Vriendt, et al., 201621 | Activity oriented and community based program (Baseline: n = 86Follow-up: n = 82) | At baseline (mean ± SD): - basic ADL: 66 ± 25After 8–10-week intervention (mean difference): - basic ADL: 3.6 | Between group difference: p = 0.013 |
| Community care as usual (Baseline: n = 82Follow-up: n = 80) | At baseline (mean ± SD): - basic ADL: 69 ± 23After 8–10-week intervention (mean difference): - basic ADL: -3.1 | ||
| Wolf et al., 200355 | Tai Chi (n = 72) | At baseline (mean ± SD): - Grip strength left: 23.2 ± 8.2; systolic blood pressure post walk (mmHg): 172.1 ± 27.7; distance (miles): 0.57 ± 0.09 - Fear of falling: 56%; Intrusiveness (agree): 79%After 15-week intervention (mean ± SD): - Grip strength left: 22.5 ± 8.5; systolic blood pressure post walk (mmHg): 158.9 ± 27.4; distance (miles): 0.55 ± 0.10 - Fear of falling: 48%; Intrusiveness (agree): 83%4 months after intervention (mean ± SD): - Grip strength left: 22.8 ± 8.1 - Fear of falling: 53%; Intrusiveness (agree): 85% | Group x time interaction:Grip strength left p = .025Tukey test:Tai Chi group less likely to decline over time than other groups Group x time interaction:Walk distance p = .040Tukey test:Tai Chi group < other groupsChanges in pre to post intervention scores for Tai Chi and Education groups:Fear of falling p = .046 |
| Computerized Balance Training (n = 64) | At baseline (mean ± SD): - Grip strength left: 24.8 ± 8.1; systolic blood pressure post walk (mmHg): 170.5 ± 33.0; distance (miles): 0.56 ± 0.09 - Fear of falling: 71%; Intrusiveness (agree): 82%After 15-week intervention (mean ± SD): - Grip strength left: 23.8 ± 8.0; systolic blood pressure post walk (mmHg): 165.5 ± 25.8; distance (miles): 0.57 ± 0.08 - Fear of falling: 73%; Intrusiveness (agree): 80%4 months after intervention (mean ± SD): - Grip strength left: 23.1 ± 8.0 - Fear of falling: 67%; Intrusiveness (agree): 82% | ||
| Education exercise-control condition (n = 64) | At baseline (mean ± SD): - Grip strength left: 23.8 ± 6.5; systolic blood pressure post walk (mmHg): 164.0 ± 26.8; distance (miles): 0.57 ± 0.08 - Fear of falling: 55%; Intrusiveness (agree): 85%After 15-week intervention (mean ± SD): - Grip strength left: 22.0 ± 6.2; systolic blood pressure post walk (mmHg): 162.3 ± 27.3; distance (miles): 0.58 ± 0.11 - Fear of falling: 64%; Intrusiveness (agree): 78%4 months after intervention (mean ± SD): - Grip strength left: 22.2 ± 6.6; - Fear of falling: 60%; Intrusiveness (agree): 84% |
ADL, Activities of daily living; BMI, body mass index; BMI, body mass index; GARS, Groningen Activity Restriction Scale; OR, odds ratio; PASE, Physical Activity Scale for the Elderly; SD, standard deviation; SF-36, Short Form 36 Health Survey; SPPB, Short Physical Performance Battery; TUGT, Timed Up and Go Test.