Individualized home-based exercise and nutrition interventions improve frailty in older adults: a randomized controlled trial

Hsieh, Tsung-Jen; Su, Shin-Chang; Chen, Chun-Wei; Kang, Yaw-Wen; Hu, Ming-Hsia; Hsu, Li-Lin; Wu, Szu-Yun; Chen, Likwang; Chang, Hsing-Yi; Chuang, Shao-Yuan; Pan, Wen-Harn; Hsu, Chih-Cheng

doi:10.1186/s12966-019-0855-9

International Journal of Behavioral Nutrition and Physical Activity

Table 4 Intervention effects on physical performance and mental health outcomes during the 6-month study period

From: Individualized home-based exercise and nutrition interventions improve frailty in older adults: a randomized controlled trial

		Mean ± SD				Difference in difference: change from baseline in each intervention group minus change from baseline in control group (95% CI)			p for groups × time interaction	p for groups	p for time
Outcomes		Control	Exercise	Nutrition	Combination	Exercise	Nutrition	Combination	p for groups × time interaction	p for groups	p for time
Handgrip strength (kg)	n	80	79	82	77				0.004	0.023	< 0.001
	Baseline	25.0 ± 7.8	24.5 ± 7.7	24.9 ± 9.2	26.9 ± 8.5
	1 month	25.1 ± 7.8	25.4 ± 8.6	24.9 ± 9.2	27.6 ± 8.4	0.91 (0.06, 1.75)	−0.05 (− 0.89, 0.78)	0.65 (− 0.19, 1.50)
	3 months	25.1 ± 7.7	25.6 ± 8.8	25.8 ± 9.1	27.8 ± 8.5	1.10 (0.25, 1.94)^a	0.83 (− 0.01, 1.66)	0.81 (− 0.04, 1.66)
	6 months	25.3 ± 7.7	26.7 ± 8.7	26.3 ± 8.9	28.5 ± 8.7	2.00 (1.16, 2.84)^a	1.09 (0.26, 1.93)^a	1.30 (0.45, 2.14)^a
10-m gait speed (seconds)	n	80	79	83	77				0.159	0.226	< 0.001
	Baseline	10.7 ± 3.2	12.5 ± 7.7	13.0 ± 7.4	11.4 ± 4.3
	1 month	10.6 ± 3.2	12.2 ± 8.1	12.4 ± 6.9	11.1 ± 4.0	−0.21 (− 0.78, 0.35)	− 0.48 (−1.04, 0.08)	− 0.20 (− 0.77, 0.37)
	3 months	10.6 ± 3.3	12.3 ± 8.5	12.4 ± 6.8	10.9 ± 3.8	− 0.14 (− 0.70, 0.43)	− 0.56 (− 1.12, 0.003)	− 0.49 (− 1.06, 0.08)
	6 months	10.8 ± 3.4	12.1 ± 8.1	12.3 ± 6.5	10.7 ± 3.4	−0.41 (− 0.98, 0.16)	− 0.81 (− 1.37, − 0.25)^a	−0.81 (− 1.38, − 0.24)^a
Upper body flexibility (cm)	n	76	73	76	73				< 0.001	0.020	0.408
	Baseline	−13.9 ± 12.3	− 12.9 ± 16.7	−13.2 ± 12.0	−12.4 ± 12.5
	1 month	−14.6 ± 12.2	− 13.1 ± 14.5	−13.1 ± 12.4	−11.4 ± 12.4	0.49 (− 1.62, 2.60)	0.82 (− 1.27, 2.90)	1.71 (−0.40, 3.82)
	3 months	−15.8 ± 10.0	− 12.2 ± 13.3	−14.5 ± 10.0	−11.3 ± 13.3	2.54 (0.43, 4.65)	0.54 (− 1.55, 2.63)	3.07 (0.96, 5.18)^a
	6 months	−16.9 ± 10.5	−10.6 ± 12.7	−14.3 ± 10.3	−10.5 ± 12.5	5.21 (3.10, 7.31)^a	1.86 (− 0.23, 3.94)	4.92 (2.81, 7.03)^a
Lower body flexibility (cm)	n	76	75	79	74				0.037	0.020	0.810
	Baseline	−4.6 ± 8.9	−2.9 ± 8.5	−5.2 ± 8.1	−3.3 ± 7.6
	1 month	−5.5 ± 8.2	−2.1 ± 8.5	−5.4 ± 7.5	−3.0 ± 7.4	1.76 (0.39, 3.13)^a	0.69 (−0.66, 2.05)	1.27 (−0.11, 2.65)
	3 months	−5.5 ± 7.9	−2.0 ± 8.6	−5.6 ± 7.3	−2.2 ± 6.8	1.76 (0.39, 3.14)^a	0.45 (−0.90, 1.81)	2.00 (0.63, 3.38)^a
	6 months	−5.8 ± 8.1	−1.8 ± 9.0	−6.0 ± 7.4	−2.3 ± 7.2	2.33 (0.96, 3.70)^a	0.39 (−0.97, 1.74)	2.17 (0.79, 3.55)^a
Lower extremity strength (number)	n	69	61	70	64				< 0.001	< 0.001	< 0.001
	Baseline	1.6 ± 3.0	3.9 ± 5.2	2.0 ± 3.3	3.8 ± 4.3
	1 month	1.8 ± 3.1	5.3 ± 6.0	2.1 ± 3.5	5.7 ± 6.0	1.25 (0.30, 2.21)^a	−0.07 (−1.00, 0.85)	1.70 (0.76, 2.65)^a
	3 months	1.8 ± 3.0	5.8 ± 5.8	2.0 ± 3.4	6.9 ± 6.6	1.74 (0.78, 2.70)^a	−0.12 (−1.04, 0.81)	2.93 (1.99, 3.88)^a
	6 months	1.7 ± 2.9	6.9 ± 6.7	2.4 ± 3.5	8.0 ± 7.0	2.95 (1.99, 3.90)^a	0.34 (−0.58, 1.26)	4.05 (3.11, 5.00)^a
GDS (scores)	n	80	79	83	77				0.497	0.343	0.255
	Baseline	2.2 ± 1.7	2.5 ± 1.8	2.6 ± 1.9	2.4 ± 1.6
	1 month	2.4 ± 1.9	2.5 ± 1.7	2.6 ± 2.0	2.3 ± 1.4	−0.19 (−0.62, 0.25)	−0.20 (− 0.63, 0.23)	− 0.32 (− 0.76, 0.12)
	3 months	2.5 ± 1.8	2.6 ± 1.7	2.4 ± 1.8	2.3 ± 1.6	− 0.15 (− 0.58, 0.29)	−0.45 (− 0.89, − 0.02)	−0.37 (− 0.81, 0.07)
	6 months	2.4 ± 1.7	2.3 ± 1.6	2.4 ± 1.9	2.2 ± 1.6	−0.43 (− 0.86, 0.01)	− 0.42 (− 0.85, 0.01)	−0.38 (− 0.82, 0.06)
SF-12 MCS (scores)	n	80	79	83	76				0.567	0.624	< 0.001
	Baseline	53.8 ± 7.9	53.9 ± 8.1	53.4 ± 7.8	55.8 ± 7.0
	1 month	54.5 ± 7.7	54.4 ± 8.3	53.9 ± 8.0	56.3 ± 6.7	−0.22 (−1.87, 1.43)	−0.24 (−1.87, 1.39)	− 0.22 (− 1.89, 1.44)
	3 months	54.0 ± 7.7	55.2 ± 7.9	55.0 ± 6.1	57.0 ± 6.3	1.09 (− 0.56, 2.74)	1.33 (− 0.30, 2.96)	0.94 (− 0.73, 2.60)
	6 months	54.3 ± 7.1	55.9 ± 6.9	56.0 ± 5.9	57.3 ± 6.6	1.58 (−0.07, 3.23)	2.12 (0.49, 3.75)^a	1.05 (−0.61, 2.72)

CI confidence interval; GDS Geriatric Depression Scale; SF-12 MCS 12-Item Short Form Health Survey mental component summary; ^aPairwise comparisons (interventions vs. control) were significant at the post hoc significance level of 0.017

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