Frailty, Fitness and Quality of Life Outcomes of a Healthy and Productive Aging Program (GrandMove) for Frail/Prefrail Older Adults: Findings of a cluster Randomized Controlled Trial
ABSTRACT
Background:
Exercise interventions can reverse frailty. However, their scalability and sustainability are limited by manpower, which is shrinking with population aging. GrandMove is a program that combines healthy and productive aging strategies to (1) train and employ robust older adults as exercise coaches; and (2) improve fitness and motivate adoption of exercise habit in frail and prefrail older adults.
Objective:
The study examined the effectiveness of GrandMove in improving frailty, fitness, and quality of life in frail and prefrail older adults.
Methods:
This cluster randomized controlled trial recruit frail and prefrail older adults (N=390) living in the community. The 18-month exercise program consisted of three 6-month phases of lifestyle education (E), resistance exercise (R), and aerobic exercise (A). Each group of participants was randomized into three intervention sequence arms: Group E-R-A, Group A-R-E, and Group R-A-E.
Results:
At 6-month, 29% of all participants became robust. Group A-R-E and Group R-A-E were no better than Group E-R-A as the active control in addressing frailty over the first 6 months. Compared to lifestyle education, resistance training and aerobic training over the first 6 months were associated with greater improvement in fitness measures of grip strength, arm curl test, and (in aerobic group) 2-minute step. The sequence of exercise interventions (Group R-A-E vs Group A-R-E) did not make a difference in physical outcomes at 12 months, but the R-A-E group showed better quality of life. Improved frailty outcome was maintained by the end of the study, but change in overall physical activity level was limited.
Conclusions:
Combining healthy and productive aging strategies is a scalable and sustainable way to improve frailty, fitness, and quality of life in frail and prefrail older adults. Different combinations of lifestyle education and physical interventions improved frailty. (292 words) Clinical Trial: The study was registered at HKU Clinical Trials Registry (reference number: HKUCTR-1964).
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