title: Effects of a multifactorial intervention comprising resistance exercise, nutritional and psychosocial programs on frailty and functional health in community-dwelling older adults: A randomized, controlled, cross-over trial.
abstract: OBJECTIVE
  To examine the effects of a multifactorial intervention on frailty and functional health among community-dwelling older adults, a 6-month randomized, controlled, cross-over trial was carried out within the Hatoyama Cohort Study.
  
  
  METHODS
  A total of 77 pre-frail or frail older adults (mean age 74.6 years) were randomly allocated to an immediate intervention group (IIG; n = 38) or delayed intervention group (DIG; n = 39). The IIG participated in a twice-weekly multifactorial intervention comprising resistance exercise, nutritional education and psychosocial programs. No intervention was given to the DIG during the initial 3-month period, and both groups were crossed over for the latter 3-month period. Pre-frailty and frailty were determined by using the Check-List 15, which was validated against Fried's frailty criteria. Effects of the intervention on primary (Check-List 15 score and frailty status) and secondary outcomes (physical and psychosocial functions, and nutritional intake) were examined for both 3-month periods.
  
  
  RESULTS
  As compared with the DIG, the IIG had significant reductions in Check-List 15 score (-0.36 points; 95% CI -0.74 to -0.03), frailty prevalence (-23.5%, 95% CI -40.4 to -6.7), Timed Up and Go test (-0.25 s, 95% CI -0.47 to -0.08), and Geriatric Depression Score (-0.92 points, 95% CI -1.44 to -0.39), and improvements in the Dietary Variety Score (0.65 points, 95% CI 0.05-1.25), and protein (1.9% E, 95% CI 1.1-2.7) and micronutrient intakes at 3 months, all of which, excluding protein and micronutrient intakes, persisted at 6 months. The DIG showed similar intervention effects in the latter 3-month period.
  
  
  CONCLUSIONS
  This 3-month multifactorial intervention reduced frailty and improved functional health. These intervention effects persisted for at least 3 months post-intervention. Geriatr Gerontol Int 2017; 17: 2034-2045.
authors.affiliation: Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Seino
authors.affiliation: Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
authors.forename: Mariko
authors.initials: M
authors.lastname: Nishi
authors.affiliation: Institute of Gerontology, The University of Tokyo, Tokyo, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Murayama
authors.affiliation: Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
authors.forename: Miki
authors.initials: M
authors.lastname: Narita
authors.affiliation: Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
authors.forename: Yuri
authors.initials: Y
authors.lastname: Yokoyama
authors.affiliation: Japan Association for Development of Community Medicine, Tokyo, Japan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Nofuji
authors.affiliation: Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Taniguchi
authors.affiliation: Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Amano
authors.affiliation: Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Kitamura
authors.affiliation: Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
authors.forename: Shoji
authors.initials: S
authors.lastname: Shinkai
mesh_terms: D000368:Aged; D015331:Cohort Studies; D018592:Cross-Over Studies; D016330:Frail Elderly / Q000523:psychology / Q000706:statistics & numerical data; D000073496:Frailty / Q000503:physiopathology* / Q000517:prevention & control*; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D057187:Independent Living; D015596:Nutrition Assessment; D015397:Program Evaluation; D011613:Psychotherapy; D055070:Resistance Training
keywords: exercise; frailty; multifactorial intervention; nutrition; psychosocial