Table 7.
Effectiveness of interventions described in the included studies for secondary outcomes
| Study | Intervention/control condition | Secondary outcomes | Significance |
| Bonnefoy, et al., 201222 | Home based exercise program with dietary protein supplementation (n = 53) | At baseline (Median, 1st quartile; 3rd quartile):- BMI (kg/m2): 24.3 (21.0; 27.0); Fat free mass: 0.54 (0.52; 0.59); Mini nutritional assessment: 25.8 (23.3; 27.0) - ADL score: 6 (5.5; 6); instrumental ADL score: 7 (6; 8) - Get up and go test (mn): 21 (18; 27); Walking speed (m/s): 0.7 (0.5; 0.9)After 4-month intervention (% variation from baseline, 1st and 3rd quartiles): - BMI (kg/m2): 0.0 (−2.4; 2.2); Fat free mass: −1.50 (−5.9; 5.7); Fat free mass: 0.4 (−4.7; 6.8); Mini nutritional assessment: 0.0 (−5.9; 6.0) - ADL score: 9 (17.3% degradation); instrumental ADL score: 11 (22.9% degradation) - Get up and go test (mn): 5.45 (−17.2; 13.2); Walking speed (m/s): 0.0 (−13.7; 16.1); Time for 6-step raise: 0.0 (0.0; 16.7); Number chair rise in 1 min: 0.0 (−18.2; 18.2) | Between group difference:Body mass index remained stable in the intervention group and increased in the control group (for age and sex adjusted analysis p = .026)Mini nutritional assessment remained stable in the intervention group and decreased in the control group (for age and sex adjusted analysis p = .009)Control group also reduced significantly instrumental ADL (for age and sex adjusted analysis p = .05)Predictors of good compliance:Significant association between instrumental ADL and good compliance was found (p = .0011) |
| No intervention (n = 49) | At baseline (Median, 1st quartile; 3rd quartile): - BMI (kg/m2): 25.0 (23.5; 28.7); Fat free mass: 0.55 (0.51; 0.64); Mini nutritional assessment: 26.0 (24.0; 27.5) - ADL score: 6 (5.5; 6); instrumental ADL score: 7 (5; 8) - Get up and go test (mn): 23 (17; 36); Walking speed (m/s): 0.55 (0.4;0.9)After 4-month intervention (% variation from baseline, 1st and 3rd quartiles): - BMI (kg/m2): 0.8 (−1.3; 2.2); Fat free mass: 0.0 (−5.4; 3.9); Fat free mass: −0.4 (−6.2; 2.6); Mini nutritional assessment: −1.9 (−5.4; 5.8) - ADL score: 6 (13% degradation); instrumental ADL score: 15 (34.9% degradation) - Get up and go test (mn): 0.0 (−11.5; 15.5); Walking speed (m/s): 0.0 (−19.5; 15.9); Time for 6-step raise: 0.0 (−16.7; 25.0); Number chair rise in 1 min: 0.0 (−16.7; 15.4) | ||
| Cadore et al., 201441 | Multicomponent exercise program (n = 11) | At baseline (mean ± SD): - TUGT (s): 19.9 ± 8.0; Raise from a chair: 6.2 ± 4.1; Balance: 0.44 ± 0.5 - Gait velocity arithmetic task (m s−1):0.60 ± 0.08; Cognitive score (arithmetic): 2.1 ± 0.9; Gait velocity verbal task (m s−1): 0.53 ± 0.06; Cognitive score (verbal): 5.6 ± 1.7 - TUGT arithmetic task (m s−1):23.8 ± 11.4; Cognitive score (arithmetic): 2.3 ± 0.9; TUG verbal task (m s−1): 25.7 ± 11.5; Cognitive score (verbal): 6.2 ± 3.0 - Falls incidence: 0.77 ± 0.44 - Muscle cross sectional area quadriceps femoris total (mm2): 6.738 ± 1.609; Muscle cross sectional area knee flexor total (mm2): 2.256 ± 725After 12-week intervention (mean ± SD): - TUGT (s): 18.8 ± 7.9; Raise from a chair: 9.8 ± 6.0; Balance: 0.66 ± 0.5 - Gait velocity arithmetic task (m s−1):0.61 ± 0.07; Cognitive score (arithmetic): 2.6 ± 0.5; Gait velocity verbal task (m s−1): 0.59 ± 0.06; Cognitive score (verbal): 5.6 ± 1.0 - TUGT arithmetic task (m s−1):20.7 ± 7.0; Cognitive score (arithmetic): 2.4 ± 1.0; TUG verbal task (m s−1): 22.4 ± 8.5; Cognitive score (verbal): 6.5 ± 2.7 - Falls incidence: 0.0 ± 0.0 - Barthel Index deterioration 0.09 ± 0.30 - Muscle cross sectional area quadriceps femoris total (mm2): 7.004 ± 1.700; Muscle cross sectional area knee flexor total (mm2): 2.436 ± 685 | Group x time interaction:TUGT p < .01Rise from a chair p < .01Balance p < .05TUGT verbal task p < .01Incidence of falls p < .001Muscle cross sectional area quadriceps femoris total p < .05Muscle cross sectional area knee flexor total p < .01Between group difference:After training the control group was shown to be significantly more deteriorated on ADLs and to have significantly higher incidence of falls (p < 0.001).Within group change: In the intervention group improvement on TUGT e TUGT verbal task (both p < .05), raise from a chair (p < .01) and falls incidence (p < .001), and increase in muscle cross sectional area quadriceps femoris total (p < .05) and muscle cross sectional area knee flexor total (p < .01)In the control group decrease in gait velocity arithmetic and verbal tasks (both p < .05) |
| Mobility exercises (n = 13) | At baseline (mean ± SD): - TUGT (s): 18.4 ± 5.1; Raise from a chair: 6.3 ± 3.4; Balance: 0.36 ± 0.5 - Gait velocity arithmetic task (m s−1):0.56 ± 0.05; Cognitive score (arithmetic): 2.2 ± 0.8; Gait velocity verbal task (m s−1): 0.50 ± 0.05; Cognitive score (verbal): 5.5 ± 1.8 - TUGT arithmetic task (m s−1):22.7 ± 6.2; Cognitive score (arithmetic): 1.8 ± 1.0; TUG verbal task (m s−1): 22.8 ± 5.0; Cognitive score (verbal): 6.7 ± 2.7 - Falls incidence: 0.93 ± 0.3 - Muscle cross sectional area quadriceps femoris total (mm2): 6.879 ± 1.107; Muscle cross sectional area knee flexor total (mm2): 2.485 ± 679After 12-week intervention (mean ± SD): - TUGT (s): 21.8 ± 6.3; Raise from a chair: 5.4 ± 3.9; Balance: 0.3 ± 0.5 - Gait velocity arithmetic task (m s−1):0.49 ± 0.06; Cognitive score (arithmetic): 2.1 ± 0.9; Gait velocity verbal task (m s−1): 0.46 ± 0.06; Cognitive score (verbal): 5.6 ± 1.7 - TUGT arithmetic task (m s−1):23.5 ± 7.4; Cognitive score (arithmetic): 1.9 ± 0.8; TUG verbal task (m s−1): 26.1 ± 8.2; Cognitive score (verbal): 6.6 ± 1.0 - Falls incidence: 0.8 ± 0.4 - Barthel Index deterioration 0.60 ± 0.52 - Muscle cross sectional area quadriceps femoris total (mm2): 6.720 ± 1.071; Muscle cross sectional area knee flexor total (mm2): 2.375 ± 561 | ||
| Chan et al., 201242 | Exercise and nutrition consultation (n = 55) | At baseline (mean ± SD): - MMSE: 24.8 ± 3.9; PRIME-MD: 2.1 ± 3.2; Barthel Index: 98.8 ± 3.7; EQ-5D: 0.94 ± 0.08; Health resource utilization: 1.5 ± 1.7 - BMI (kg/m2): 25.0 ± 3.3; Fat free mass: 42.3 ± 7.0 - Bone mineral density > -1: 25%; Bone mineral density ≤ -1: 75% - Left one leg stand time (sec): 5.7 ± 6.9; Dominant leg extension power: 26.3 ± 5.1 - 25(OH) Vitamin D (ng/mL): 17.8 ± 5.3After 3-month intervention (change from baseline, mean ± SD): - PRIME-MD: −0.96 ± 2.92; Barthel Index: 1.09 ± 3.81; EQ-5D: 0.02 ± 0.08; Health resource utilization: 0.04 ± 1.36 - Left one leg stand time (sec): 2.86 ± 9.19; Dominant leg extension power: 3.06 ± 7.136 months after baseline assessment (change from baseline, mean ± SD): - PRIME-MD: −0.05 ± 2.84; Barthel Index: 0.36 ± 2.33; EQ-5D: −0.004 ± 0.12; Health resource utilization: 0.60 ± 1.81 - Left one leg stand time (sec): 2.57 ± 8.39; Dominant leg extension power: 3.69 ± 9.1512 months after baseline assessment (change from baseline, mean ± SD): - MMSE: −0.15 ± 2.53; PRIME-MD: −0.16 ± 3.17; Barthel Index: 0.55 ± 2.99; EQ-5D: 0.01 ± 0.09; Health resource utilization: 0.05 ± 1.8 - BMI (kg/m2): −0.31 ± 1.19; Fat free mass: −0.46 ± 1.36 - Bone mineral density > −1: 26%; Bone mineral density ≤ −1: 74% - Left one leg stand time (sec): 3.69 ± 9.15; Dominant leg extension power: −6.44 ± 10.08 - 25(OH) Vitamin D (ng/mL): 4.85 ± 7.69 | Between group change: Exercise and nutrition consultation vs educational booklet - Bone mineral density - 25(OH) Vitamin DProblem solving therapy vs educational booklet - Dominant leg extension power at 6 and 12 monthsWithin group change from baseline:Exercise and nutrition consultation group: - at 3 months Barthel Index, one leg stand time (both p < .05), dominant leg extension power (p < .01) - at 6 months one leg stand time (p < .05) - at 12 months BMI, fat free mass (both p < .05), one leg stand time (p < .01), dominant leg extension power and 25(OH) Vitamin D (both p < .001)Problem solving therapy group: - at 3 months PRIME-MD, Barthel Index (both p < .05), dominant leg extension power (p < .001) - at 6 months one leg stand time (p < .05), and dominant leg extension power (p < .01) - at 12 months BMI (p < .05), fat free mass and dominant leg extension power (both p < .01), one leg stand time and 25(OH) Vitamin D (p < .001)Educational booklet group (control condition for exercise and nutrition and consultation): - at 3 months EQ-5D and dominant leg extension power (both p < .05), PRIME-MD and Barthel Index (both p < .01) - at 12 months fat free mass and one leg stand time (both p < .01), dominant leg extension power (p < .001)Educational booklet group (control condition for problem solving therapy): - at 3 months EQ-5D and Barthel Index (both p < .01) - at 12 months fat free mass and one leg stand time (both p < .05), 25(OH) Vitamin D (p < .001), dominant leg extension power (p < .001) |
| Problem solving therapy (n = 57) | At baseline (mean ± SD): - MMSE: 24.7 ± 3.8; PRIME-MD: 2.7 ± 3.3; Barthel Index: 98.2 ± 5.4; EQ-5D: 0.95 ± 0.08; Health resource utilization: 1.6 ± 1.7 - BMI (kg/m2): 25.0 ± 3.8; Fat free mass: 42.2 ± 7.3 - Bone mineral density > −1: 23%; Bone mineral density ≤ −1: 77% - Left one leg stand time (sec): 5.3 ± 6.7; Dominant leg extension power: 23.9 ± 6.5 - 25(OH) Vitamin D (ng/mL): 17.9 ± 5.5After 3-month intervention (change from baseline, mean ± SD): - PRIME-MD: −1.32 ± 3.64; Barthel Index: 1.05 ± 3.98; EQ-5D: 0.01 ± 0.09; Health resource utilization: −0.07 ± 1.67 - Left one leg stand time (sec): 2.38 ± 8.91; Dominant leg extension power: 3.42 ± 7.366 months after baseline assessment (change from baseline, mean ± SD): - PRIME-MD: −0.42 ± 2.96; Barthel Index: 0.88 ± 4.13; EQ-5D: 0.0001 ± 0.09; Health resource utilization: 0.42 ± 1.74 - Left one leg stand time (sec): 3.10 ± 8.93; Dominant leg extension power: 2.71 ± 6.0812 months after baseline assessment (change from baseline, mean ± SD): - MMSE: −0.05 ± 2.35; PRIME-MD: −0.77 ± 3.27; Barthel Index: 0.88 ± 3.29; EQ-5D: 0.01 ± 0.07; Health resource utilization: 0.39 ± 2.05 - BMI (kg/m2): −0.36 ± 1.15; Fat free mass: −0.59 ± 1.30 - Bone mineral density > −1: 20%; Bone mineral density ≤ −1: 80% - Left one leg stand time (sec): 4.31 ± 10.23; Dominant leg extension power: −3.52 ± 9.65 - 25(OH) Vitamin D (ng/mL): 3.4 ± 7.80 | ||
| Educational booklet (control condition for exercise and nutrition consultation) (n = 62) | At baseline (mean ± SD): - MMSE: 24.1 ± 3.9; PRIME-MD: 2.8 ± 3.5; Barthel Index: 97.9 ± 5.4; EQ-5D: 0.94 ± 0.08; Health resource utilization: 1.7 ± 2.2 - BMI (kg/m2): 25.8 ± 3.9; Fat free mass: 43.6 ± 7.9 - Bone mineral density > −1: 16%; Bone mineral density ≤ −1: 84% - Left one leg stand time (sec): 5.8 ± 5.9; Dominant leg extension power: 25.2 ± 6.8 - 25(OH) Vitamin D (ng/mL): 17.2 ± 6.2After 3-month intervention (change from baseline, mean ± SD): - PRIME-MD: −1.29 ± 4.50; Barthel Index: 1.53 ± 4.11; EQ-5D: 0.03 ± 0.08; Health resource utilization: −0.35 ± 2.70 - Left one leg stand time (sec): 0.92 ± 9.01; Dominant leg extension power: 1.72 ± 6.66 months after baseline assessment (change from baseline, mean ± SD): - PRIME-MD: −0.65 ± 4.03; Barthel Index: 0.73 ± 4.78; EQ-5D: 0.004 ± 0.12; Health resource utilization: 0.03 ± 2.55 - Left one leg stand time (sec): 1.81 ± 8.47; Dominant leg extension power: 1.35 ± 7.0012 months after baseline assessment (change from baseline, mean ± SD): - MMSE: 0.06 ± 2.52; PRIME-MD: −0.77 ± 3.65; Barthel Index: 0.89 ± 3.68; EQ-5D: 0.02 ± 0.10; Health resource utilization: 0.03 ± 2.44 - BMI (kg/m2): −0.18 ± 1.05; Fat free mass: −0.62 ± 1.84 - Bone mineral density > −1: 11%; Bone mineral density ≤ −1: 89% - Left one leg stand time (sec): 3.43 ± 9.15; Dominant leg extension power: −4.44 ± 8.59 - 25(OH) Vitamin D (ng/mL): 1.19 ± 5.41 | ||
| Educational booklet (control condition for problem solving therapy) (n = 60) | At baseline (mean ± SD): - MMSE: 24.2 ± 4.0; PRIME-MD: 2.3 ± 3.4; Barthel Index: 98.4 ± 4.0; EQ-5D: 0.93 ± 0.08; Health resource utilization: 1.7 ± 2.2 - BMI (kg/m2): 25.8 ± 3.5; Fat free mass: 43.7 ± 7.6 - Bone mineral density > −1: 17%; Bone mineral density ≤ -1: 83% - Left one leg stand time (sec): 6.2 ± 6.0; Dominant leg extension power: 27.4 ± 5.1 - 25(OH) Vitamin D (ng/mL): 17.2 ± 6.0After 3-month intervention (change from baseline, mean ± SD): - PRIME-MD: −0.97 ± 4.03; Barthel Index: 1.58 ± 3.96; EQ-5D: 0.03 ± 0.08; Health resource utilization: −0.27 ± 2.58 - Left one leg stand time (sec): 1.34 ± 9.34; Dominant leg extension power: 1.33 ± 6.326 months after baseline assessment (change from baseline, mean ± SD): - PRIME-MD: −0.32 ± 4.00; Barthel Index: 0.25 ± 3.50; EQ-5D: 0.001 ± 0.14; Health resource utilization: 0.18 ± 2.65 - Left one leg stand time (sec): 1.30 ± 7.84; Dominant leg extension power: 0.18 ± 6.6812 months after baseline assessment (change from baseline, mean ± SD): - MMSE: −0.02 ± 2.69; PRIME-MD: −0.22 ± 3.58; Barthel Index: 0.58 ± 3.46; EQ-5D: 0.02 ± 0.11; Health resource utilization: −0.28 ± 2.25 - BMI (kg/m2): −0.13 ± 1.08; Fat free mass: −0.50 ± 1.90 - Bone mineral density > −1: 17%; Bone mineral density ≤ −1: 83% - Left one leg stand time (sec): 2.84 ± 7.92; Dominant leg extension power: −7.14 ± 8.74 - 25(OH) Vitamin D (ng/mL): 2.49 ± 5.85 | ||
| Clegg, et al., 201443 | Home-based exercise program (n = 40) | At baseline (mean ± SD): - Barthel Index: 15.9 ± 3.7; EQ-5D: 0.53 ± 0.30; GDS-15: 3.8 ± 2.7After 12-week intervention (mean ± SD): - Barthel Index: 15.6 ± 4.0; EQ-5D: 0.51 ± 0.34; GDS-15: 3.4 ± 3.3 | Between group change: no significant difference |
| Usual care (n = 30) | At baseline (mean ± SD): - Barthel Index: 15.8 ± 4.1; EQ-5D: 0.52 ± 0.25; GDS-15: 5.0 ± 3.2After 12-week intervention (mean ± SD): - Barthel Index: 15.0 ± 4.0; EQ-5D: 0.46 ± 0.26; GDS-15: 4.8 ± 3.0 | ||
| Cohen, et al., 200244 | Inpatient geriatric care in multidisciplinary evaluation and management units (not clear) | At baseline vs After intervention (mean change in score): - SF-36 subscales Physical Functioning: −1.5; Physical limitations: 4.5; Emotional limitations: 13.0; Bodily pain: 15.3; Energy: 0.8; Mental health: −0.3; Social activity: 2.7; General health: −0.02At baseline vs 12 months after randomization (mean change in score): - SF-36 subscales Physical Functioning: 6.7; Physical limitations: 34.0; Emotional limitations: 22.0; Bodily pain: 24.9; Energy: 4.5; Mental health: 4.5; Social activity: 18.3; General health: −5.5 - Probability of survival: 78.4% ± 1.6; - Number of days in the hospital: 35.3 ± 1.4; number of days of initial hospitalization: 23.2 ± 1; number of medical consultations: 2.8 (SD not provided); number of surgical consultations: 2.1 (SD not provided); number of days in long-term care: 15.0 ± 1.8 | Between group change:In the inpatient groups - at discharge: physical functioning (p = .006), bodily pain (p = .001), energy (p = .01), and general health (p = .006) - at 12 months: bodily pain (p = .01) - intervention group had greater number of days in the hospital and longer initial hospitalization (both p < .001), and also higher number of medical and surgical consultations (both p < .001), but lower number of days in long term care (p = 0.03)In the outpatient groups - at discharge: energy (p = .02) and general health (p = .04) - at 12 months: energy (p = .009), mental health (p = .001) and general health (p = .01) |
| Outpatient care in geriatric evaluation and management clinics (not clear) | At baseline vs after intervention (mean change in score): - SF-36 subscales Physical Functioning: −3.7; Physical limitations: 5.9; Emotional limitations: 13.4; Bodily pain: 11.9; Energy: 0.8; Mental health: −0.6; Social activity: 2.4; General health: −0.5At baseline vs 12 months after randomization (mean change in score): - SF-36 subscales Physical Functioning: 6.8; Physical limitations: 31.3; Emotional limitations: 22.1; Bodily pain: 21.9; Energy: 5.4; Mental health: 6.3; Social activity: 18.3; General health: −4.4 - Probability of survival: 78.0% ± 1.6 - Number of days in long-term care: 15.4 ± 1.8 | ||
| Usual inpatient care (not clear) | At baseline vs after intervention (mean change in score): - SF-36 subscales Physical Functioning: −5.4; Physical limitations: 4.7; Emotional limitations: 12.0; Bodily pain: 9.2; Energy: −2.6; Mental health: −1.5; Social activity: 1.0; General health: −3.4At baseline vs 12 months after randomization (mean change in score): - SF-36 subscales Physical Functioning: 4.5; Physical limitations: 29.8; Emotional limitations: 20.3; Bodily pain: 20.0; Energy: 1.8; Mental health: 2.5; Social activity: 16.4; General health: −7.1 - Probability of survival: 78.8% ± 1.6 - Number of days in the hospital: 28.3 ± 1.4; number of days of initial hospitalization: 15.0 ± 0.9; number of medical consultations: 1.3 (SD not provided); number of surgical consultations: 1.2 (SD not provided); number of days in long-term care: 17.1 ± 1.8 | ||
| Usual outpatient care (not clear) | At baseline vs after intervention (mean change in score): - SF-36 subscales Physical Functioning: −3.2; Physical limitations: 3.2; Emotional limitations: 11.6; Bodily pain: 12.8; Energy: −2.5; Mental health: −1.2; Social activity: 1.2; General health: −2.9At baseline vs 12 months after randomization (mean change in score): - SF-36 subscales Physical Functioning: 4.5; Physical limitations: 32.5; Emotional limitations: 20.2; Bodily pain: 22.9; Energy: 1.0; Mental health: 0.8; Social activity: 16.4; General health: −8.2 - Probability of survival: 79.2% ± 1.5 - Number of days in long-term care: 16.8 ± 1.8 | ||
| Eklund, et al., 201329 | Continuum Care by multi-professional team (n = 85) | At baseline: - ADL independent in all activities: 20%3 months after discharge: - ADL improvement: 42%; ADL maintained level: 38%; ADL decrease: 20%6 months after discharge: - ADL improvement: 36%; ADL maintained level: 32%; ADL decrease: 31%12 months after discharge: - ADL improvement: 39% ADL maintained level: 24%; ADL decrease: 38% | Between group change:Intervention group as compared to controls was more likely to improve degree of ADL independence at 3 and 12 months (OR = 2.37, 95% CI 1.20–4.68; OR = 2.04, 95% CI 1.03–4.06, respectively), and less likely to decrease degree of ADL independence at 3 and 6 months (OR = 0.51, 95% CI 0.25–1.04; OR = 0.52, 95% CI 0.27–0.98, respectively) |
| Usual care (n = 76) | At baseline: - ADL independent in all activities: 26%3 months after discharge: - ADL improvement: 24%; ADL maintained level: 43%; ADL decrease: 33%6 months after discharge: - ADL improvement: 28%; ADL maintained level: 26%; ADL decrease: 46%12 months after discharge: - ADL improvement: 24%; ADL maintained level: 29%; ADL decrease: 47% | ||
| Fairhall, et al., 201532 | Multifactorial interdisciplinary intervention (n = 120) | At baseline: (mean ± SD): - EQ-5D: 0.67 ± 0.23At 3 months: - EQ-5D: 0.56 ± 0.31At 12 months: - EQ-5D: 0.49 ± 0.32 | Between group change: no significant difference |
| Usual care (n = 121) | At baseline: (mean ± SD): - EQ-5D: 0.66 ± 0.23At 3 months: - EQ-5D: 0.47 ± 0.34At 12 months: - EQ-5D: 0.47 ± 0.34 | ||
| Giné-Garriga, et al., 201046 | Functional circuit-training program (n = 22) | At baseline (mean ± SD): - Balance - semitandem (s): 6.67 ± 0.63; tandem (s): 3.21 ± 0.67; single leg (s): 2.39 ± 0.57 - Gait – normal speed (m/s): 0.82 ± 0.04; fast speed (m/s): 1.11 ± 0.06 - Modified TUGT – assessment questionnaire: 9.32 ± 0.40; total time (s): 38.04 ± 1.32; stand up (s): 2.59 ± 0.17; ball kick time (s): 3.00 ± 0.28; kick 8 m (s): 14.76 ± 0.80; total time kick (s): 24.28 ± 0.83; left knee extensor maximal voluntary contraction (Nm/kg): 0.77 ± 0.06After 12-week intervention (mean ± SD): - Balance - semitandem (s): 9.27 ± 0.63; tandem (s): 6.60 ± 0.67; single leg (s): 6.60 ± 0.57 - Gait – normal speed (m/s): 0.94 ± 0.04; fast speed (m/s): 1.28 ± 0.06 - Modified TUGT – assessment questionnaire: 11.82 ± 0.40; total time (s): 35.04 ± 1.32; stand up (s): 2.02 ± 0.17; ball kick time (s): 2.80 ± 0.28; kick 8 m (s): 12.27 ± 0.80; total time kick (s): 22.77 ± 0.83; left knee extensor maximal voluntary contraction (Nm/kg): 0.92 ± 0.06At 36 weeks (mean ± SD): - Balance - semitandem (s): 8.49 ± 0.68; tandem (s): 5.40 ± 0.72; single leg (s): 3.10 ± 0.64 - Gait – normal speed (m/s): 0.88 ± 0.04; fast speed (m/s): 1.23 ± 0.06 - Modified TUGT – assessment questionnaire: 10.28 ± 0.42; total time (s): 37.50 ± 1.32; stand up (s): 2.55 ± 0.18; ball kick time (s): 2.97 ± 0.30; kick 8 m (s): 13.90 ± 0.81; total time kick (s): 23.40 ± 0.85; left knee extensor maximal voluntary contraction (Nm/kg): 0.82 ± 0.06 | Group x time interaction:Semitandem p < .01 For week 0 – week 12 p < .001 For week 0 – week 36 p = .021Tandem p = .003 For week 0 – week 12 p < .001 For week 0 – week 36 p = .001Single leg p < .001 For week 0 – week 12 p < .001 For week 12 – week 36 p < .001Gait normal speed p < .001 For week 0 – week 12 p < .001 For week 0 – week 36 p = .003 For week 12 – week 36 p = .002Gait fast speed p < .001 For week 0 – week 12 p < .001 For week 0 – week 36 p < .001TUGT assessment questionnaire p < .001 For week 0 – week 12 p < .001 0 – week 36 p = .009 For week 12 – week 36 p < .001TUGT total time p < .001 For week 0 – week 12 p < .001 For week 0 – week 36 p = .01 12 – week 36 p < .001TUGT stand up p = .001 For week 0 – week 12 p = .001 For week 12 – week 36 p = .005TUGT kick 8 m p < .001 For week 0 – week 12 p < .001 For week 12 – week 36 p < .001TUGT total time kick p < .001 For week 0 – week 12 p = .001Left knee extensor maximal voluntary contraction p < .001 For week 0 – week 12 p < .001 For week 12 – week 36 p = .031 |
| Health education meeting and usual care (n = 19) | At baseline (mean ± SD): - Balance - semitandem (s): 7.26 ± 0.68; tandem (s): 3.11 ± 0.73; single leg (s): 2.05 ± 0.62 - Gait – normal speed (m/s): 0.82 ± 0.04; fast speed (m/s): 1.13 ± 0.06 - Modified TUGT – assessment questionnaire: 8.63 ± 0.44; total time (s): 39.34 ± 1.42; stand up (s): 2.91 ± 0.18; ball kick time (s): 3.73 ± 0.31; kick 8 m (s): 14.22 ± 0.86; total time kick (s): 25.44 ± 0.89; left knee extensor maximal voluntary contraction (Nm/kg): 0.75 ± 0.06After 12-week intervention (mean ± SD): - Balance - semitandem (s): 6.23 ± 0.68; tandem (s): 1.98 ± 0.73; single leg (s): 1.98 ± 0.62 - Gait – normal speed (m/s): 0.80 ± 0.04; fast speed (m/s): 1.07 ± 0.06 - Modified TUGT – assessment questionnaire: 8.37 ± 0.44; total time (s): 41.34 ± 1.42; stand up (s): 3.18 ± 0.18; ball kick time (s): 3.82 ± 0.31; kick 8 m (s): 14.75 ± 0.86; total time kick (s): 26.59 ± 0.89; left knee extensor maximal voluntary contraction (Nm/kg): 0.71 ± 0.06At 36 weeks (mean ± SD): - Balance - semitandem (s): 4.34 ± 0.97; tandem (s): 1.64 ± 0.96; single leg (s): 0.38 ± 0.65 - Gait – normal speed (m/s): 0.81 ± 0.04; fast speed (m/s): 1.08 ± 0.07 - Modified TUGT – assessment questionnaire: 8.37 ± 0.55; total time (s): 41.95 ± 1.44; stand up (s): 3.44 ± 0.25; ball kick time (s): 3.86 ± 0.38; kick 8 m (s): 14.66 ± 0.95; total time kick (s): 26.27 ± 1.01; left knee extensor maximal voluntary contraction (Nm/kg): 0.61 ± 0.07 | ||
| Gustafsson, et al., 201247 | Multi-professional senior group (n = 171) | At baseline vs 3 months after intervention: - No deterioration in self-related health: 88% - No deterioration in ADLs: 79% | Between group change:Preventive visit group as compared to controls was more likely to no deteriorate in self-rated health (OR = 2.21, 95% CI 1.12–4.37, p = .02);Senior meetings group as compared to controls was more likely to no deteriorate in self-rated health (OR = 1.81, 95% CI 0.93–3.49, p = .08) and ADLs (OR = 1.95, 95% CI 1.14–3.33, p = .01)Senior meetings group as compared to preventive visit group was more likely to maintain independence in ADLs (OR = 1.92, 95% CI 1.19–3.12, p = .01) |
| Single preventive home visit (n = 174) | At baseline vs 3 months after intervention: - No deterioration in self-related health: 90%- No deterioration in ADLs: 66% | ||
| Ordinary range of community services (n = 114) | At baseline vs 3 months after intervention: - No deterioration in self-related health: 81% - No deterioration in ADLs: 66% | ||
| Hars et al., 201448 | Continued intervention of music-based multitask training (n = 23) | At baseline (mean ± SD): - BMI (kg/m2): 25.3 ± 4.0 - History of falls after 65 years: 96%; falls in the past 12 months: 57%; medication > 4: 39% - Physical activity level (kcal/week): 2304 ± 1010; SF-12: 31.4 ± 1.9; Mini Nutritional Assessment: 12.8 ± 1.3; HADS: 10.7 ± 5.8; MMSE: 27.1 ± 2.4; Clock-drawing test: 9.0 ± 1.7; self-rated health status: 2.6 ± 0.8 - Single Task Condition - Gait speed velocity (cm/s): 111.5 ± 19.4; Dynamic balance double support phase (%): 22.6 ± 3.2; Dynamic balance support base (cm): 7.1 ± 2.5 - Dual Task Condition - Gait speed velocity (cm/s): 93.2 ± 27.2; - One-legged stance task (s): 7.3 ± 3.3; TUGT (s): 9.7 ± 2.2; Simplified Tinetti test: 0.3 ± 0.5After 1-year intervention (mean ± SD): - BMI (kg/m2): 25.1 ± 3.8 - History of falls after 65 years: 96%; falls in the past 12 months: 52%; medication > 4: 43% - Physical activity level (kcal/week): 2312 ± 999; SF-12: 31.9 ± 2.3; Mini Nutritional Assessment: 12.5 ± 1.8; HADS: 9.4 ± 4.9; MMSE: 28.0 ± 2.2; Clock-drawing test: 8.4 ± 1.7; self-rated health status: 2.7 ± 0.9 - Single Task Condition - Gait speed velocity (cm/s): 113.3 ± 19.0; Dynamic balance double support phase (%): 20.5 ± 3.9; Dynamic balance support base (cm): 6.7 ± 2.3 - Dual Task Condition - Gait speed velocity (cm/s): 97.9 ± 19.5; - One-legged stance task (s): 8.8 ± 2.0; TUGT (s): 9.3 ± 1.9; Simplified Tinetti test: 0.0 ± 0.2; Five-times-sit-to-stand test (s): 11.8 ± 3.43 years after intervention (mean ± SD): - BMI (kg/m2): 24.2 ± 3.8 - History of falls after 65 years: 96%; falls in the past 12 months: 22%; participants with ≥ 1 falls: 70%; participants with ≥ 2 falls: 35%; medication > 4: 35% - Physical activity level (kcal/week): 2022 ± 789; SF-12: 31.8 ± 3.1; Mini Nutritional Assessment: 13.2 ± 1.2; HADS: 8.0 ± 4.8; MMSE: 27.4 ± 2.3; Clock-drawing test: 8.9 ± 1.4; self-rated health status: 2.7 ± 0.6 - Single Task Condition - Gait speed velocity (cm/s): 118.3 ± 21.1; Dynamic balance double support phase (%): 25.5 ± 3.0; Dynamic balance support base (cm): 7.4 ± 3.0 - Dual Task Condition - Gait speed velocity (cm/s): 102.7 ± 22.1; - One-legged stance task (s): 9.3 ± 2.0; TUGT (s): 10.0 ± 2.0; Simplified Tinetti test: 0.1 ± 0.5; Five-times-sit-to-stand test (s): 11.8 ± 2.6 | Between group change:Continued intervention group as compared to discontinued intervention group had lower relative risk of falls (= 0.69, 95%CI 0.53–0.91, p = .008) and multiple falls (= 0.53, 95%CI 0.29–0.99, p = .045)Within group change from baseline to 4-year follow-up:Continued intervention - gait velocity in single-task and dual-task conditions, dynamic balance - double support phase, Simplified Tinetti test (all p < .05)Discontinued intervention - dynamic balance - double support phase and support base, TUGT (all p < .05)Linear mixed-effect analysis on change from 1 year to 4 years: - Single-task condition gait speed p < .001 - Dynamic balance double support phase p = .022 - Dual-task condition gait speed p = .012 - One-legged stance task p = .013 - TUGT p = .001 - Five-times-sit-to-stand test p < .001 |
| Discontinued intervention of music-based multitask training (n = 29) | At baseline (mean ± SD): - BMI (kg/m2): 26.4 ± 3.5 - History of falls after 65 years: 83%; falls in the past 12 months: 59%; medication > 4: 34% - Physical activity level (kcal/week): 2501 ± 1191; SF-12: 30.8 ± 2.8; Mini Nutritional Assessment: 12.6 ± 1.5; HADS: 10.1 ± 5.3; MMSE: 25.9 ± 3.1; Clock-drawing test: 8.8 ± 1.0; self-rated health status: 2.7 ± 0.8 - Single Task Condition - Gait speed velocity (cm/s): 102.1 ± 16.5; Dynamic balance double support phase (%): 24.0 ± 3.4; Dynamic balance support base (cm): 8.4 ± 3.5 - Dual Task Condition - Gait speed velocity (cm/s): 78.5 ± 17.6; - One-legged stance task (s): 6.7 ± 3.4; TUGT (s): 10.5 ± 2.1; Simplified Tinetti test: 1.0 ± 1.1After 1-year intervention (mean ± SD): - BMI (kg/m2): 26.3 ± 4.1 - History of falls after 65 years: 90%; falls in the past 12 months: 66%; medication > 4: 45% - Physical activity level (kcal/week): 2586 ± 1216; SF-12: 31.9 ± 2.2; Mini Nutritional Assessment: 12.6 ± 1.7; HADS: 9.3 ± 3.8; MMSE: 27.6 ± 1.6; Clock-drawing test: 8.7 ± 1.5; self-rated health status: 2.8 ± 0.8 - Single Task Condition - Gait speed velocity (cm/s): 108.5 ± 17.4; Dynamic balance double support phase (%): 22.5 ± 3.0; Dynamic balance support base (cm): 8.9 ± 3.4 - Dual Task Condition - Gait speed velocity (cm/s): 88.1 ± 15.9; - One-legged stance task (s): 8.2 ± 2.6; TUGT (s): 9.8 ± 1.8; Simplified Tinetti test: 0.7 ± 1.1; Five-times-sit-to-stand test (s): 12.3 ± 2.63 years after intervention (mean ± SD): - BMI (kg/m2): 25.0 ± 4.9 - History of falls after 65 years: 93%; falls in the past 12 months: 48%; participants with ≥ 1 falls: 86%; participants with ≥ 2 falls: 66%; medication > 4: 17% - Physical activity level (kcal/week): 2379 ± 1138; SF-12: 31.1 ± 2.7; Mini Nutritional Assessment: 13.1 ± 1.0; HADS: 8.6 ± 3.4; MMSE: 26.9 ± 2.3; Clock-drawing test: 9.2 ± 1.2; self-rated health status: 2.8 ± 0.6 - Single Task Condition - Gait speed velocity (cm/s): 97.9 ± 17.4; Dynamic balance double support phase (%): 29.6 ± 4.2; Dynamic balance support base (cm): 9.4 ± 3.7 - Dual Task Condition - Gait speed velocity (cm/s): 81.5 ± 18.8; - One-legged stance task (s): 6.8 ± 3.4; TUGT (s): 12.7 ± 3.7; Simplified Tinetti test: 1.0 ± 1.0; Five-times-sit-to-stand test (s): 14.7 ± 4.1 | ||
| Kim, et al., 201549 | Milk fat globule membrane (MFGM) supplementation (n = 32) | At baseline (mean ± SD): - Skeletal muscle mass (kg): 13.4 ± 1.7; leg muscle mass (kg): 10.1 ± 1.3 - Grip strength (kg): 17.5 ± 2.7; knee extension strength (N): 185.2 ± 52.1; usual walking speed (s): 4.9 ± 1.2; TUGT (s): 8.8 ± 2.8 - BDNF (ng/ml): 6.97 ± 0.94; (IGFBP3/IGF1)x100: 3.97 ± 1.36After 3-month intervention: - Skeletal muscle mass (kg): 13.27 ± 1.63; leg muscle mass (kg): 9.23 ± 3.01 - Grip strength (kg): 18.37 ± 1.92; knee extension strength (N): 186.42 ± 60.47; usual walking speed (s): 1.08 ± 0.23; TUGT (s): 10.53 ± 2.77 - BDNF (ng/ml): 7.11 ± 1.05; (IGFBP3/IGF1)x100: 4.11 ± 1.624 months after intervention: - Skeletal muscle mass (kg): 13.54 ± 1.76; leg muscle mass (kg): 10.23 ± 1.37 - Grip strength (kg): 16.75 ± 2.24; knee extension strength (N): 181.26 ± 51.38; usual walking speed (s): 1.11 ± 0.20; TUGT (s): 7.76 ± 1.52 - BDNF (ng/ml): 7.39 ± 1.47; (IGFBP3/IGF1)x100: 4.24 ± 1.51 | Group x Time interaction:Usual walking speed p = .005 (exercise + MFGM > MFGM)TUGT p < .001 (exercise + MFGM, exercise + placebo > MFGM, placebo)(IGFBP3/IGF1)x100 p = .013 (Ex+MFGM > placebo) |
| Exercise + placebo (n = 33) | At baseline (mean ± SD): - Skeletal muscle mass (kg): 13.8 ± 1.7; leg muscle mass (kg): 10.5 ± 1.3 - Grip strength (kg): 17.8 ± 2.8; knee extension strength (N): 179.1 ± 40.9; usual walking speed (s): 4.6 ± 0.9; TUGT (s): 8.2 ± 2.0 - BDNF (ng/ml): 6.37 ± 1.44; (IGFBP3/IGF1)x100: 4.18 ± 1.46After 3-month intervention: - Skeletal muscle mass (kg): 14.04 ± 1.77; leg muscle mass (kg): 10.34 ± 2.40 - Grip strength (kg): 18.36 ± 3.28; knee extension strength (N): 188.45 ± 47.82; usual walking speed (s): 1.26 ± 0.27; TUGT (s): 7.87 ± 1.83 - BDNF (ng/ml): 7.07 ± 1.01; (IGFBP3/IGF1)x100: 4.90 ± 2.464 months after intervention: - Skeletal muscle mass (kg): 14.31 ± 2.08; leg muscle mass (kg): 10.93 ± 1.68 - Grip strength (kg): 17.75 ± 2.9; knee extension strength (N): 190.32 ± 46.2; usual walking speed (s): 1.21 ± 0.22; TUGT (s): 7.04 ± 1.45 - BDNF (ng/ml): 7.03 ± 1.66; (IGFBP3/IGF1)x100: 5.36 ± 1.73 | ||
| Exercise + milk fat globule membrane (MFGM) supplementation (n = 33) | At baseline (mean ± SD): - Skeletal muscle mass (kg): 13.2 ± 1.5; leg muscle mass (kg): 10.1 ± 1.1 - Grip strength (kg): 17.1 ± 3.9; knee extension strength (N): 178.8 ± 55.2; usual walking speed (s): 4.5 ± 0.9; TUGT (s): 7.7 ± 1.7 - BDNF (ng/ml): 6.60 ± 1.54; (IGFBP3/IGF1)x100: 5.50 ± 2.28After 3-month intervention: - Skeletal muscle mass (kg): 13.51 ± 1.61; leg muscle mass (kg): 10.30 ± 1.21 - Grip strength (kg): 17.83 ± 4.05; knee extension strength (N): 191.52 ± 54.81; usual walking speed (s): 1.25 ± 0.24; TUGT (s): 7.98 ± 1.44 - BDNF (ng/ml): 7.18 ± 1.09; (IGFBP3/IGF1)x100: 5.02 ± 1.964 months after intervention: - Skeletal muscle mass (kg): 13.64 ± 1.69; leg muscle mass (kg): 10.41 ± 1.36 - Grip strength (kg): 17.00 ± 3.88; knee extension strength (N): 178.72 ± 45.92; usual walking speed (s): 1.23 ± 0.21; TUGT (s): 6.93 ± 1.61 - BDNF (ng/ml): 7.68 ± 1.17; (IGFBP3/IGF1)x100: 4.63 ± 1.89 | ||
| Placebo (n = 32) | At baseline (mean ± SD): - Skeletal muscle mass (kg): 13.4 ± 1.6; leg muscle mass (kg): 10.1 ± 1.2 - Grip strength (kg): 18.7 ± 3.2; knee extension strength (N): 184.7 ± 50.1; usual walking speed (s): 4.7 ± 1.5; TUGT (s): 8.5 ± 3.5 - BDNF (ng/ml): 6.10 ± 1.47; (IGFBP3/IGF1)x100: 4.65 ± 1.72After 3-month intervention: - Skeletal muscle mass (kg): 13.55 ± 1.67; leg muscle mass (kg): 10.28 ± 1.30 - Grip strength (kg): 19.18 ± 3.50; knee extension strength (N): 194.32 ± 54.14; usual walking speed (s): 1.13 ± 0.22; TUGT (s): 10.0 ± 4.32 - BDNF (ng/ml): 6.36 ± 1.31; (IGFBP3/IGF1)x100: 5.38 ± 1.934 months after intervention: - Skeletal muscle mass (kg): 13.70 ± 1.75; leg muscle mass (kg): 10.39 ± 1.38 - Grip strength (kg): 18.08 ± 2.92; knee extension strength (N): 199.95 ± 52.65; usual walking speed (s): 1.18 ± 0.23; TUGT (s): 7.99 ± 3.79 - BDNF (ng/ml): 6.52 ± 1.33; (IGFBP3/IGF1)x100: 5.20 ± 1.91 | ||
| Kim & Lee, 201323 | Protein-energy supplementation (n = 41) | At baseline (mean ± SD): - Usual gait speed (m/s): 0.35 ± 0.13; TUGT (s): 22.2 ± 12.4; grip strength (kg): 15.3 ± 4.6; one-legged stance (s): 3.4 ± 2.8 - Mid-arm circumference: 24.7 ± 3.3 - Serum blood urea nitrogen (mgl/dL): 17.3 ± 8.4; creatinine clearance (mL/min): 36.2 ± 12.7After 12-week intervention (mean ± SD): - Usual gait speed (m/s): 0.35 ± 0.13; TUGT (s): 21.4 ± 12.2; grip strength (kg): 15.1 ± 4.8; one-legged stance (s): 2.6 ± 1.9 - Mid-arm circumference: 25.8 ± 2.7 - Serum blood urea nitrogen (mgl/dL): 19.3 ± 8.2; creatinine clearance (mL/min): 39.1 ± 15.5 | Between group change: Gait speed p = .039;TUGT p = .038 |
| No intervention (n = 43) | At baseline (mean ± SD): - Usual gait speed (m/s): 0.38 ± 0.13; TUGT (s): 21.5 ± 12.7; grip strength (kg): 16.3 ± 5.0; one-legged stance (s): 3.9 ± 3.5 - Mid-arm circumference: 23.2 ± 2.6 - Serum blood urea nitrogen (mgl/dL): 19.0 ± 12.1; creatinine clearance (mL/min): 34.9 ± 13.5After 12-week intervention (mean ± SD): - Usual gait speed (m/s): 0.32 ± 0.14; TUGT (s): 26.4 ± 25.3; grip strength (kg): 16.4 ± 5.3; one-legged stance (s): 3.5 ± 3.5 - Mid-arm circumference: 24.3 ± 2.7 - Serum blood urea nitrogen (mgl/dL): 19.9 ± 9.9; creatinine clearance (mL/min): 36.7 ± 13.8 | ||
| Li, et al., 201050 | Screening evaluation and intervention (n = 129) | At baseline (mean ± SD): - ADL: 95.7 ± 15.76 months after baseline assessment: - ADL maintained level: 86.3%; ADL improvement: 4.6%; ADL decrease: 9.2% | Deterioration in ADL: no significant differences |
| Screening evaluation (n = 140) | At baseline (mean ± SD): - ADL: 92.8 ± 19.46 months after baseline assessment: - ADL maintained level: 88.6%; ADL improvement: 1.4%; ADL decrease: 10.o% | ||
| Monteserin et al., 201051 | Group sessions (n = 157) | At baseline: - GDS-5 > 1: 21.8%; - comorbidity: without 47.1%, slight: 26.6%; moderate: 12.3%; severe: 14.0%After 18-month intervention: - GDS-5 > 1: 26.7%; - Death or admission to nursing home or admission to home care program: 15.9%, but for subgroup at risk of frailty: 16.3% | Between group change:For all participants - GDS-5 (p = .048), with control group > intervention groupFor participants at risk of frailty - death or admission to nursing home or admission to home care program (p = .028), with control group > intervention group |
| Individual sessions with geriatrician (n = 151) | |||
| Usual care (n = 312, from which 134 at risk of frailty and 178 at non-risk of frailty) | At baseline: - GDS-5 > 1: 22.1% - comorbidity: without 50.6%, slight: 24.7%; moderate: 16.7%; severe: 8.0%After 18-month intervention: - GDS-5 > 1: 35.8%; - Death or admission to nursing home or admission to home care program: 17.4%, but for subgroup at risk of frailty: 28.4% | ||
| Muller et al., 200652 | Atamestane + dehydroepiandrosterone (DHEA) (n = 26) | At baseline (mean ± SD): - ADL (HAQ score): 10.7 ± 4.4; MMSE: 27.7 ± 2.4 - Bone mineral density (total body): 1.16 ± 0.07 - Fat mass (kg): 20.4 ± 5.9; Lean mass (kg): 49.0 ± 46.1; BMI (kg/m2): 24.9 ± 3.1 - Atherosclerosis (mm) – common carotid: 1.01 ± 0.14; bifurcation: 1.36 ± 0.56 - Blood pressure (mm Hg) – systolic: 156.7 ± 19.3; diastolic: 84.2 ± 10.7 - DHEA (nmol/liter): 17.7 ± 14.5; total testosterone (nmol/liter): 12.8 ± 3.3; Estriadol (pmol/liter): 132 ± 36; IGF-I: 105 ± 28 (μg/liter); IGFBP-1: 46.9 ± 22 (μg/liter); IGFBP-3: 2.8 ± 0.6 (μg/liter)After 36-week intervention (differences between placebo and study agent, mean, 95% CI): - ADL (HAQ score): 1.28 (−0.60; 3.15); MMSE: 0.10 (−0.68; 0.88) - Bone mineral density (total body): −0.004 (−0.014; 0.006) - Fat mass (kg): −0.56 (−1.69; 0.57); Lean mass (kg): 0.40 (−1.87; 2.68); BMI (kg/m2): 0.14 (−0.29; 0.57) - Atherosclerosis (mm) – common carotid: −0.006 (−0.060; 0.048); bifurcation: 0.038 (-−0.249; 0.324) - DHEA (nmol/liter): 11.6 (−4.1; 27.3); total testosterone (nmol/liter): 8.5 (5.9; 11.1); Estriadol (pmol/liter): 44 (13; 75); IGF-I (μg/liter): 9.3 (1.3; 17.3); IGFBP-1 (μg/liter): 3.6 (−4.7; 11.9); IGFBP-3 (μg/liter): −0.1 (−0.3; 0.1) | Between group difference: Placebo group showed significant decrease in BMI. Compared with the placebo group, both the atamestane and DHEA groups increased BMI (p value was not provided) |
| DHEA(n = 25) | At baseline (mean ± SD): - ADL (HAQ score): 10.4 ± 3.9; MMSE: 27.8 ± 2.2 - Bone mineral density (total body): 1.14 ± 0.10 - Fat mass (kg): 20.3 ± 4.8; Lean mass (kg): 49.4 ± 5.2; BMI (kg/m2): 24.3 ± 2.2 - Atherosclerosis (mm) – common carotid: 1.00 ± 0.14; bifurcation: 1.43 ± 0.57 - Blood pressure (mm Hg) – systolic: 154.4 ± 23.9; diastolic: 86.0 ± 9.6 - DHEA (nmol/liter): 14.9 ± 11.6; total testosterone (nmol/liter): 11.5 ± 2.8; Estriadol (pmol/liter): 124 ± 44; IGF-I: 106 ± 30 (μg/liter); IGFBP-1: 44.6 ± 17.4 (μg/liter); IGFBP-3: 2.7 ± 0.7 (μg/liter)After 36-week intervention (differences between placebo and study agent, mean, 95% CI): - ADL (HAQ score): −0.17 (−2.10; 1.75); MMSE: −0.11 (−0.91; 0.69) - Bone mineral density (total body): −0.000 (−0.010; 0.011) - Fat mass (kg): −0.02 (−1.16; 1.13); Lean mass (kg): −0.76 (−3.05; 1.54); BMI (kg/m2): 0.81 (0.37; 1.25) - Atherosclerosis (mm) – common carotid: −0.006 (−0.061; 0.048); bifurcation: 0.113 (−0.204; 0.430) - DHEA (nmol/liter): 24.6 (8.5; 40.7); total testosterone (nmol/liter): 3.5 (0.8; 6.2); Estriadol (pmol/liter): 65 (34; 97); IGF-I (μg/liter): 0.4 (−7.7; 8.5); IGFBP-1 (μg/liter): 0.2 (−8.2; 8.6); IGFBP-3 (μg/liter): −0.1 (−0.3; 0.1) | ||
| Atamestane (n = 25) | At baseline (mean ± SD): - ADL (HAQ score): 11.1 ± 3.9; MMSE: 27.0 ± 2.2 - Bone mineral density (total body): 1.15 ± 0.12 - Fat mass (kg): 21.0 ± 6.6; Lean mass (kg): 48.2 ± 5.2; BMI (kg/m2): 25.0 ± 2.9 - Atherosclerosis (mm) – common carotid: 1.02 ± 0.13; bifurcation: 1.35 ± 0.39 - Blood pressure (mm Hg) – systolic: 154.6 ± 20.7; diastolic: 80.4 ± 12.9 - DHEA (nmol/liter): 13.4 ± 6.6; total testosterone (nmol/liter): 11.6 ± 3.7; Estriadol (pmol/liter): 131 ± 48; IGF-I: 104 ± 28 (μg/liter); IGFBP-1: 45.8 ± 14.8 (μg/liter); IGFBP-3: 2.9 ± 0.8 (μg/liter)After 36-week intervention (differences between placebo and study agent, mean, 95% CI): - ADL (HAQ score): −1.44 (−3.35; 0.48); MMSE: 0.51 (−0.31; 1.32) - Bone mineral density (total body): −0.005 (−0.015; 0.005) - Fat mass (kg): 0.34 (−0.79; 1.48); Lean mass (kg): 0.13 (−2.13; 2.39); BMI (kg/m2): 0.36 (−0.08; 0.80) - Atherosclerosis (mm) – common carotid: −0.013 (−0.068; 0.041); bifurcation: 0.176 (−0.121; 0.473) - DHEA (nmol/liter): 1.2 (−14.7; 17.1); total testosterone (nmol/liter): 4.9 (2.2; 7.5); Estriadol (pmol/liter): −18 (−50; 13); IGF-I (μg/liter): 0.8 (−7.4; 8.9); IGFBP-1 (μg/liter): 2.3 (−6.2; 10.8); IGFBP-3 (μg/liter): 0.0 (−0.2; 0.2) | ||
| Placebo (n = 24) | At baseline (mean ± SD): - ADL (HAQ score): 10.9 ± 4.3; MMSE: 28.3 ± 1.1 - Bone mineral density (total body): 1.14 ± 0.10 - Fat mass (kg): 21.0 ± 7.2; Lean mass (kg): 49.1 ± 6.4; BMI (kg/m2): 24.8 ± 3.7 - Atherosclerosis (mm) – common carotid: 0.96 ± 0.12; bifurcation: 1.09 ± 0.26 - Blood pressure (mm Hg) – systolic: 148.1 ± 21.1; diastolic: 82.2 ± 10.1 - DHEA (nmol/liter): 14.4 ± 10.3; total testosterone(nmol/liter): 12.2 ± 4.4; Estriadol (pmol/liter): 135 ± 58; IGF-I: 103 ± 32 (μg/liter); IGFBP-1: 45.6 ± 21.1 (μg/liter); IGFBP-3: 2.7 ± 0.7 (μg/liter)After 36-week intervention (changes from baseline (placebo), mean, 95%CI): - ADL (HAQ score): 0.54 (−0.46; 1.55); MMSE: 0.17 (−0.49; 0.83) - Bone mineral density (total body): −0.004 (−0.012; 0.004) - Fat mass (kg): −0.18 (−1.04; 0.69); Lean mass (kg): −0.57 (−1.58; 0.43); BMI (kg/m2): −0.62 (−0.99; −0.25) - Atherosclerosis (mm) – common carotid: −0.003 (−0.034; 0.029); bifurcation: 0.047 (−0.067; 0.160) - DHEA (nmol/liter): −0.3 (−3.7; 0.7); total testosterone (nmol/liter): −1.3 (−2.4; −0.2); Estriadol (pmol/liter): −26 (−39; −13); IGF-I (μg/liter): −0.6 (−6.6; 5.3); IGFBP-1 (μg/liter): −3.3 (−11.1; 4.4); IGFBP-3 (μg/liter): −0.3 (−0.4; −0.2) | ||
| Ng, et al., 201553 | Nutritional supplements (n = 49) | At baseline (mean ± SD): - Instrumental ADL – ADL dependency: 1 ± 2.0 - Hospitalization in past 12 months: 1 ± 2.0At 3 months: - Instrumental ADL – ADL dependency (point-prevalence frequency): 2.1% - Hospitalization in past 12 months (cumulated frequency): 2.1%; any fall (cumulated frequency): 2.1%After 6-month intervention: - Instrumental ADL – ADL dependency (point-prevalence frequency): 4.6% - Hospitalization in past 12 months (cumulated frequency): 2.1%; any fall (cumulated frequency): 4.3%At 12 months: - Instrumental ADL – ADL dependency (point-prevalence frequency): 6.7% - Hospitalization in past 12 months (cumulated frequency): 2.1%; any fall (cumulated frequency): 8.3% | Between group difference: no significant difference |
| Physical training (n = 48) | At baseline (mean ± SD): - Instrumental ADL – ADL dependency: 0 ± 0.0 - Hospitalization in past 12 months: 6 ± 12.5At 3 months: - Instrumental ADL – ADL dependency (point-prevalence frequency): 2.1% - Hospitalization in past 12 months (cumulated frequency): 2.1%; any fall (cumulated frequency): 4.2%After 6-month intervention: - Instrumental ADL – ADL dependency (point-prevalence frequency): 8.3% - Hospitalization in past 12 months (cumulated frequency): 2.1%; any fall (cumulated frequency): 6.3%At 12 months: - Instrumental ADL – ADL dependency (point-prevalence frequency): 8.7% - Hospitalization in past 12 months (cumulated frequency): 6.3%; any fall (cumulated frequency): 6.3% | ||
| Cognitive training (n = 50) | At baseline (mean ± SD): - Instrumental ADL – ADL dependency: 1 ± 2.0 - Hospitalization in past 12 months: 3 ± 6.0At 3 months: - Instrumental ADL – ADL dependency (point-prevalence frequency): 2.1% - Hospitalization in past 12 months (cumulated frequency): 6.4%; any fall (cumulated frequency): 2.1%After 6-month intervention: - Instrumental ADL – ADL dependency (point-prevalence frequency): 2.2% - Hospitalization in past 12 months (cumulated frequency): 6.3%; any fall (cumulated frequency): 2.1%At 12 months: - Instrumental ADL – ADL dependency (point-prevalence frequency): 4.4% - Hospitalization in past 12 months (cumulated frequency): 10.2%; any fall (cumulated frequency): 4.1% | ||
| Combination treatment (n = 49) | At baseline (mean ± SD): - Instrumental ADL – ADL dependency: 1 ± 2.0 - Hospitalization in past 12 months: 3 ± 6.1At 3 months: - Instrumental ADL – ADL dependency (point-prevalence frequency): 4.2% - Hospitalization in past 12 months (cumulated frequency): 0.0%; any fall (cumulated frequency): 2.1%After 6-month intervention: - Instrumental ADL – ADL dependency (point-prevalence frequency): 4.3% - Hospitalization in past 12 months (cumulated frequency): 8.3%; any fall (cumulated frequency): 2.1%At 12 months: - Instrumental ADL – ADL dependency (point-prevalence frequency): 4.4% - Hospitalization in past 12 months (cumulated frequency): 12.2%; any fall (cumulated frequency): 4.1% | ||
| Standard care + placebo (n = 50) | At baseline (mean ± SD): - Instrumental ADL – ADL dependency: 4 ± 8.0 - Hospitalization in past 12 months: 1 ± 2.0At 3 months: - Instrumental ADL – ADL dependency (point-prevalence frequency): 10.4% - Hospitalization in past 12 months (cumulated frequency): 2.1%; any fall (cumulated frequency): 10.4%After 6-month intervention: - Instrumental ADL – ADL dependency (point-prevalence frequency): 4.3% - Hospitalization in past 12 months (cumulated frequency): 4.2%; any fall (cumulated frequency): 10.4%At 12 months: - Instrumental ADL – ADL dependency (point-prevalence frequency): 6.5% - Hospitalization in past 12 months (cumulated frequency): 4.2%; any fall (cumulated frequency): 10.4% | ||
| Van Hout et al., 201054 | Proactive home visits by trained community nurses (n = 331) | After 18-month intervention: - Hospital admittance ≥ 1: 49.2%; acute hospital visit ≥ 1: 32.3%; institutionalization: 13.4%; mortality: 6.4% | Between group difference: In subgroups of participants with poorest EQ-5D (<55): - intervention group had higher risk to be admitted to hospital (OR = 1.95, 95% CI 1.2–3.1, p = .005)In subgroup of participants with two or more chronic disease: - intervention group had higher risk on acute hospital visits (OR = 1.6, 95% CI 1.04–2.4, p = .03) |
| Usual care (n = 320) | After 18-month intervention: - Hospital admittance ≥ 1: 55.9%; acute hospital visit ≥ 1: 28.8%; institutionalization: 11.8%; mortality: 6.9% | ||
| Vriendt, et al., 201621 | Activity oriented and community based program (Baseline: n = 86Follow-up: n = 82) | At baseline (mean ± SD):-SF36 physical functioning: 23 ± 27; SF36 physical role functioning: 57 ± 44; SF36 bodily pain: 47 ± 27; SF36 mental health: 61 ± 24; SF36 vitality: 50 ± 21After 8–10-week intervention (mean difference): - SF36 physical functioning: 3.0; SF36 physical role functioning: 7.4; SF36 bodily pain: 4.5; SF36 mental health: −0.1; SF36 vitality: 1.2 | Between group difference: SF36 bodily pain subscale: p = 0.049 |
| Community care as usual (Baseline: n = 82Follow-up: n = 80) | At baseline (mean ± SD):-SF36 physical functioning: 19 ± 23; SF36 physical role functioning: 52 ± 45; SF36 bodily pain: 55 ± 29; SF36 mental health: 60 ± 24; SF36 vitality: 52 ± 22After 8–10-week intervention (mean difference): - SF36 physical functioning: 1.4; SF36 physical role functioning: 4.4; SF36 bodily pain: −5.1; SF36 mental health: −0.1; SF36 vitality: −1.3 | ||
| Wolf et al., 200355 | Tai Chi (n = 72) | Follow-up: - Distribution of falls according to FICSIT definition: 56; distribution of falls according to Atlanta Site Definition: 29; Average follow-up time: 171 days | Between group difference:Tai Chi group: - unadjusted risk ratio for time to one or more falls according to FICSIT definition (RR = 0.632, 95%CI 0.45–0.89, p = .009) - adjusted risk ratio for time to one or more falls according to FICSIT definition (RR = 0.511, 95%CI 0.361–0.725, p = .017) - adjusted risk ratio for time to one or more falls according to Atlanta Site definition (RR = 0.525, 95%CI 0.321–0.860, p = .010)Risk of falls associated with falls last year (FICSIT: p = .0006; Atlanta Site: p = .0003), fear of falling (FICSIT: p = .0004; Atlanta Site: p = .0002), and trouble falling asleep (FICSIT: p = .00006; Atlanta Site: p = .00003).Risk of injurious falls associated with falls last year (p = .003) and fear of falling (p = .029) |
| Computerized Balance Training (n = 64) | Follow-up: - Distribution of falls according to FICSIT definition: 76; distribution of falls according to Atlanta Site Definition: 44; Average follow-up time: 164 days | ||
| Education exercise-control condition (n = 64) | Follow-up: - Distribution of falls according to FICSIT definition: 77; distribution of falls according to Atlanta Site Definition: 37; Average follow-up time: 164 days |
ADL, Activities of daily living; BDNF, brain-derived neurotrophic factor; BMI, body mass index; DHEA, dehydroepiandrosterone; EQ-5D, EuroQol Quality of Life Scale; FICSIT, Frailty and Injuries, Cooperative Studies of Intervention Techniques; GDS, Geriatric Depression Scale; HADS, Hospital Anxiety and Depression Scale; HAQ, Stanford Health Assessment Questionnaire; IGF, insulin-like growth factor; IGFBP, insulin-like growth factor binding protein; MMSE, Mini-Mental State Examination; PRIME-MD, Primary Care Evaluation of Mental Disorders; SD, standard deviation; SF-36, Short Form 36 Health Survey; TUGT, Timed Up and Go Test.