Changes in the Severity of Frailty Among Older Adults After 12 Months of Supervised Home-Based Physical Exercise: A Randomized Clinical Trial

Objective: To investigate the effects of 12 months of physiotherapist-supervised, home-based physical exercise on the severity of frailty and on the prevalence of the 5 frailty phenotype criteria, using secondary analyses. Design: Randomized clinical trial, with 1:1 allocation into 12-month home-based physical exercise, or usual care. The multicomponent exercise sessions (60 minutes) were supervised by the physiotherapist and included strength, balance, functional, and flexibility exercises twice a week at participants' homes. Setting and Participants: Home- dwelling older adults aged >= 65 years who were frail (meeting 3-5 criteria) or prefrail (1-2 criteria) according to frailty phenotype criteria. Methods: The severity of frailty (nonfrail, prefrail, or frail) was assessed using frailty phenotype criteria, and the prevalence of each frailty criterion (weight loss, low physical activity, exhaustion, weakness, and slowness) were assessed at baseline and at 12 months. Results: Two hundred ninety-nine persons were included in the analyses, of whom 184 were prefrail and 115 were frail at baseline. Their mean age was 82.5 (SD 6.3) years, and 75% were women. There was a significant difference between the exercise and usual care groups' transitions to different frailty states from baseline to 12 months among those who at baseline were prefrail (P = .032) and frail (P = .009). At 12 months, the mean number of frailty criteria had decreased in the exercise group (-0.27, 95% CI -0.47, -0.08) and remained unchanged in the usual care group (0.01, 95% CI -0.16, 0.18; P = .042). The prevalence of the exhaustion (P = .009) and the low physical activity (P <.001) criteria were lower at 12 months in the exercise group than in the usual care group. Conclusions and Implications: The severity of frailty can be reduced through 12-month supervised homebased exercise training. Exercise should be included in the care of older adults with signs of frailty. (C) 2022 AMDA - The Society for Post-Acute and Long-Term Care Medicine.

Automated summary

This study investigated the effects of 12 months of physiotherapist-supervised, home-based physical exercise on frailty severity and the prevalence of frailty phenotype criteria. The results showed that exercise can reduce frailty severity and decrease the prevalence of low physical activity and exhaustion.