{"title":"Exercise prescription prescriptions for frailty improvement in older adults: An evidence-based approach based on the 2024 older adult compendium","authors":"Wanli Zang , Mingqing Fang , Lingyue Meng , Lingyu Kong , Ningkun Xiao , Jingxian Xue , Ziyi Liu , Jiarong Wu , Yue Zhang , Xinhui Wei , Zijun Zhang , Qiuxia Zhang","doi":"10.1016/j.archger.2024.105717","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>This study explored the dose-response relationship of exercise prescriptions for improving frailty in older adults, based on the 2024 Older Adult Compendium. It aims to provide evidence-based support for developing frailty intervention programs and their clinical application.</div></div><div><h3>Methods</h3><div>A comprehensive search was conducted in PubMed, OVID, Cochrane Library, Web of Science, and Scopus from inception to November 5th, 2024. Randomized controlled trials (RCTs) related to exercise interventions in older adults were included. Relevant studies meeting the inclusion criteria were selected, and data were extracted for further analysis. The quality of the included studies was assessed. Meta-analysis was performed using R, and the standardized mean difference (SMD) with 95 % confidence intervals (95 % CI) was used to quantify effect sizes.</div></div><div><h3>Results</h3><div>A total of 16 eligible RCTs comprising 2,716 older adults were included. The meta-analysis revealed that exercise significantly improved frailty among older adults [SMD = -0.81, 95 % CI (-1.25, -0.38), <em>P</em> < 0.001]. However, high-intensity exercise did not demonstrate a significant effect on frailty improvement [SMD = -0.45, 95 % CI (-0.96, 0.06), <em>P</em> = 0.3]. The analysis indicated a nonlinear dose-response relationship between exercise and frailty improvement. The predicted values for frailty improvement at the minimum and maximum exercise doses recommended by the World Health Organization (600 MET-minutes/week and 1200 MET-minutes/week, respectively) were -0.79 (95 % CI [-1.17, -0.41]) and -1.39 (95 % CI [-2.62, -0.15]), respectively.</div></div><div><h3>Conclusion</h3><div>Low- to moderate-intensity exercise significantly improves frailty among older adults, while high-intensity exercise programs are not recommended.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"130 ","pages":"Article 105717"},"PeriodicalIF":3.5000,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of gerontology and geriatrics","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0167494324003923","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
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Abstract
Objective
This study explored the dose-response relationship of exercise prescriptions for improving frailty in older adults, based on the 2024 Older Adult Compendium. It aims to provide evidence-based support for developing frailty intervention programs and their clinical application.
Methods
A comprehensive search was conducted in PubMed, OVID, Cochrane Library, Web of Science, and Scopus from inception to November 5th, 2024. Randomized controlled trials (RCTs) related to exercise interventions in older adults were included. Relevant studies meeting the inclusion criteria were selected, and data were extracted for further analysis. The quality of the included studies was assessed. Meta-analysis was performed using R, and the standardized mean difference (SMD) with 95 % confidence intervals (95 % CI) was used to quantify effect sizes.
Results
A total of 16 eligible RCTs comprising 2,716 older adults were included. The meta-analysis revealed that exercise significantly improved frailty among older adults [SMD = -0.81, 95 % CI (-1.25, -0.38), P < 0.001]. However, high-intensity exercise did not demonstrate a significant effect on frailty improvement [SMD = -0.45, 95 % CI (-0.96, 0.06), P = 0.3]. The analysis indicated a nonlinear dose-response relationship between exercise and frailty improvement. The predicted values for frailty improvement at the minimum and maximum exercise doses recommended by the World Health Organization (600 MET-minutes/week and 1200 MET-minutes/week, respectively) were -0.79 (95 % CI [-1.17, -0.41]) and -1.39 (95 % CI [-2.62, -0.15]), respectively.
Conclusion
Low- to moderate-intensity exercise significantly improves frailty among older adults, while high-intensity exercise programs are not recommended.
目的：本研究基于2024年《老年人纲目》，探讨改善老年人虚弱的运动处方的剂量-反应关系。旨在为制定虚弱干预方案及其临床应用提供循证支持。方法：综合检索PubMed、OVID、Cochrane Library、Web of Science、Scopus等数据库，检索时间自成立至2024年11月5日。包括与老年人运动干预相关的随机对照试验（rct）。选择符合纳入标准的相关研究，提取数据进行进一步分析。评估纳入研究的质量。采用R进行meta分析，采用95%置信区间（95% CI）的标准化平均差（SMD）量化效应量。结果：共纳入16项符合条件的随机对照试验，包括2716名老年人。荟萃分析显示，运动显著改善老年人的虚弱[SMD = -0.81, 95% CI (-1.25, -0.38), P < 0.001]。然而，高强度运动并没有显示出明显的虚弱改善效果[SMD = -0.45, 95% CI (-0.96, 0.06), P = 0.3]。分析表明运动与虚弱改善之间存在非线性剂量-反应关系。世界卫生组织推荐的最小和最大运动剂量（分别为600 met -分钟/周和1200 met -分钟/周）的虚弱改善预测值分别为-0.79 （95% CI[-1.17, -0.41]）和-1.39 （95% CI[-2.62, -0.15]）。结论：低到中等强度的运动可以显著改善老年人的虚弱，而不推荐高强度的运动项目。
期刊介绍：
Archives of Gerontology and Geriatrics provides a medium for the publication of papers from the fields of experimental gerontology and clinical and social geriatrics. The principal aim of the journal is to facilitate the exchange of information between specialists in these three fields of gerontological research. Experimental papers dealing with the basic mechanisms of aging at molecular, cellular, tissue or organ levels will be published.
Clinical papers will be accepted if they provide sufficiently new information or are of fundamental importance for the knowledge of human aging. Purely descriptive clinical papers will be accepted only if the results permit further interpretation. Papers dealing with anti-aging pharmacological preparations in humans are welcome. Papers on the social aspects of geriatrics will be accepted if they are of general interest regarding the epidemiology of aging and the efficiency and working methods of the social organizations for the health care of the elderly.
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