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1. Multicomponent intervention to prevent mobility disability in frail older adults:randomised controlled trial (SPRINTT project)

Author

Bernabei, R. (Roberto), Landi, F. (Francesco), Calvani, R. (Riccardo), Cesari, M. (Matteo), Del Signore, S. (Susanna), Anker, S. D. (Stefan D.), Bejuit, R. (Raphael), Bordes, P. (Philippe), Cherubini, A. (Antonio), Cruz-Jentoft, A. J. (Alfonso J.), Di Bari, M. (Mauro), Friede, T. (Tim), Ayestaran, C. G. (Carmen Gorostiaga), Goyeau, H. (Harmonie), Jonsson, P. V. (Palmi, V), Kashiwa, M. (Makoto), Lattanzio, F. (Fabrizia), Maggio, M. (Marcello), Mariotti, L. (Luca), Miller, R. R. (Ram R.), Rodriguez-Manas, L. (Leocadio), Roller-Wirnsberger, R. (Regina), Ryznarova, I. (Ingrid), Scholpp, J. (Joachim), Schols, A. M. (Annemie M. W. J.), Sieber, C. C. (Cornel C.), Sinclair, A. J. (Alan J.), Skalska, A. (Anna), Strandberg, T. (Timo), Tchalla, A. (Achille), Topinkova, E. (Eva), Tosato, M. (Matteo), Vellas, B. (Bruno), von Haehling, S. (Stephan), Pahor, M. (Marco), Roubenoff, R. (Ronenn), Marzetti, E. (Emanuele), Bernabei, R. (Roberto), Landi, F. (Francesco), Calvani, R. (Riccardo), Cesari, M. (Matteo), Del Signore, S. (Susanna), Anker, S. D. (Stefan D.), Bejuit, R. (Raphael), Bordes, P. (Philippe), Cherubini, A. (Antonio), Cruz-Jentoft, A. J. (Alfonso J.), Di Bari, M. (Mauro), Friede, T. (Tim), Ayestaran, C. G. (Carmen Gorostiaga), Goyeau, H. (Harmonie), Jonsson, P. V. (Palmi, V), Kashiwa, M. (Makoto), Lattanzio, F. (Fabrizia), Maggio, M. (Marcello), Mariotti, L. (Luca), Miller, R. R. (Ram R.), Rodriguez-Manas, L. (Leocadio), Roller-Wirnsberger, R. (Regina), Ryznarova, I. (Ingrid), Scholpp, J. (Joachim), Schols, A. M. (Annemie M. W. J.), Sieber, C. C. (Cornel C.), Sinclair, A. J. (Alan J.), Skalska, A. (Anna), Strandberg, T. (Timo), Tchalla, A. (Achille), Topinkova, E. (Eva), Tosato, M. (Matteo), Vellas, B. (Bruno), von Haehling, S. (Stephan), Pahor, M. (Marco), Roubenoff, R. (Ronenn), and Marzetti, E. (Emanuele)

Abstract

Objective: To determine whether a multicomponent intervention based on physical activity with technological support and nutritional counselling prevents mobility disability in older adults with physical frailty and sarcopenia. Design: Evaluator blinded, randomised controlled trial. Setting: 16 clinical sites across 11 European countries, January 2016 to 31 October 2019. Participants: 1519 community dwelling men and women aged 70 years or older with physical frailty and sarcopenia, operationalised as the co-occurrence of low functional status, defined as a short physical performance battery (SPPB) score of 3 to 9, low appendicular lean mass, and ability to independently walk 400 m. 760 participants were randomised to a multicomponent intervention and 759 received education on healthy ageing (controls). Interventions: The multicomponent intervention comprised moderate intensity physical activity twice weekly at a centre and up to four times weekly at home. Actimetry data were used to tailor the intervention. Participants also received personalised nutritional counselling. Control participants received education on healthy ageing once a month. Interventions and follow-up lasted for up to 36 months. Main outcome measures: The primary outcome was mobility disability (inability to independently walk 400 m in <15 minutes). Persistent mobility disability (inability to walk 400 m on two consecutive occasions) and changes from baseline to 24 and 36 months in physical performance, muscle strength, and appendicular lean mass were analysed as pre-planned secondary outcomes. Primary comparisons were conducted in participants with baseline SPPB scores of 3–7 (n=1205). Those with SPPB scores of 8 or 9 (n=314) were analysed separately for exploratory purposes. Results: Mean age of the 1519 participants (1088 women) was 78.9 (standard deviation 5.8) years. The average follow-up was 26.4 (SD 9.5) months. Among participants with SPPB scores of 3–7, mobility disability occur

Published
2022

2. The 'Sarcopenia and Physical fRailty IN older people: multi-componenT Treatment strategies' (SPRINTT) randomized controlled trial:case finding, screening and characteristics of eligible participants

Author

Marzetti, E. (Emanuele), Cesari, M. (Matteo), Calvani, R. (Riccardo), Msihid, J. (Jérôme), Tosato, M. (Matteo), Rodriguez-Mañas, L. (Leocadio), Lattanzio, F. (Fabrizia), Cherubini, A. (Antonio), Bejuit, R. (Raphaël), Di Bari, M. (Mauro), Maggio, M. (Marcello), Vellas, B. (Bruno), Dantoine, T. (Thierry), Cruz-Jentoft, A. J. (Alfonso J.), Sieber, C. C. (Cornel C.), Freiberger, E. (Ellen), Skalska, A. (Anna), Grodzicki, T. (Tomasz), Sinclair, A. J. (Alan J.), Topinkova, E. (Eva), Rýznarová, I. (Ingrid), Strandberg, T. (Timo), Schols, A. M. (Annemie M.W.J.), Schols, J. M. (Jos M.G.A.), Roller-Wirnsberger, R. (Regina), Jónsson, P. V. (Pálmi V.), Ramel, A. (Alfons), Del Signore, S. (Susanna), Pahor, M. (Marco), Roubenoff, R. (Ronenn), Bernabei, R. (Roberto), and Landi, F. (Francesco)

Subjects
Mobility disability, Functional impairment, Prevention, Skeletal muscle, Recruitment, Physical performance
Abstract

Background: The ongoing “Sarcopenia and Physical fRailty IN older people: multi-componenT Treatment strategies (SPRINTT)” randomized controlled trial (RCT) is testing the efficacy of a multicomponent intervention in the prevention of mobility disability in older adults with physical frailty & sarcopenia (PF&S). Here, we describe the procedures followed for PF&S case finding and screening of candidate participants for the SPRINTT RCT. We also illustrate the main demographic and clinical characteristics of eligible screenees. Methods: The identification of PF&S was based on the co-occurrence of three defining elements: (1) reduced physical performance (defined as a score on the Short Physical Performance Battery between 3 and 9); (2) low muscle mass according to the criteria released by the Foundation for the National Institutes of Health; and (3) absence of mobility disability (defined as ability to complete the 400-m walk test in 15 min). SPRINTT was advertised through a variety of means. Site-specific case finding strategies were developed to accommodate the variability across centers in catchment area characteristics and access to the target population. A quick “participant profiling” questionnaire was devised to facilitate PF&S case finding. Results: During approximately 22 months, 12,358 prescreening interviews were completed in 17 SPRINTT sites resulting in 6710 clinic screening visits. Eventually, 1566 candidates were found to be eligible for participating in the SPRINTT RCT. Eligible screenees showed substantial physical function impairment and comorbidity burden. In most centers, project advertisement through mass media was the most rewarding case finding strategy. Conclusion: PF&S case finding in the community is a challenging, but feasible task. Although largely autonomous in daily life activities, older adults with PF&S suffer from significant functional impairment and comorbidity. This subset of the older population is therefore at high risk for disability and other negative health-related events. Key strategies to consider for successfully intercepting at-risk older adults should focus on mass communication methods.

Published
2018

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