Journal of frailty, sarcopenia and falls最新文献

Objectives: The Benchmarking Exercise Programme for Older People (BEPOP) service improvement project seeks to determine and promote the exercise training characteristics associated with positive outcomes for resistance exercise for older people living with, or at risk of, sarcopenia or physical frailty.

Methods: Mixed-methods service improvement project. Ten UK National Health Service physiotherapist-led therapy services delivering exercise interventions for older people submitted anonymized data for up to 20 consecutive patients. A multidisciplinary expert panel generated a report and recommendations with site-specific benchmarking data and feedback. In parallel, participating physiotherapy team members were interviewed to elicit feedback on BEPOP rationale, processes and perceived value.

Results: Data from 188 patients were included, mean age 80 years (range 60-101). 115 (61%) received objective assessment of strength-based physical performance. Bodyweight exercises (173 [92%]) and resistance bands (49 [26%]) were the commonest exercise modalities. Exercises progressed predominantly through increased repetitions (163 [87%]) rather than increased load. 50 (30%) had no reassessment of outcomes; only 68 (41%) were signposted to follow-on exercise services. Staff interviews identified themes around knowledge, diagnosis, data collection and practice reflection.

Conclusion: BEPOP was feasible to deliver and generated actionable insights for service improvement via improved diagnosis, measurement and progression of resistance exercise.

Objectives: Sarcopenia is a skeletal muscle mass (SMM) disease characterized by loss of strength with generalized loss of SMM. The aim of this study is to evaluate the effects of a 12-week intervention on SMM, strength, and functionally in older adults.

Methods: This is a retrospective analysis of an intervention protocol with older adults at risk of sarcopenia who performed a daily intake of oral nutritional supplements (ONS) and resistance training exercise (RET), 3 times a week. Calf circumference (CC), bioelectrical impedance analysis (BIA), handgrip strength (HGS) and Timed Up and Go (TUG) were performed at baseline and at 12 weeks.

Results: Fifty-one older adults were included. The mean age was 76.3 ± 8.3 years and 68.6% were women. After 12 weeks, the study showed an increase of CC in cm (1.9 ± 2.5, p < 0.001), increase of strength in kg (5.4 ± 2.1, p < 0.001), reduction of TUG in seconds (-2.4 ± 4.8, p = 0.001), increase of free-fat mass in kg (1.0 ± 1.3, p < 0.001) and SMM in kg (0.9 ± 0.5, p < 0.001).

Conclusions: Nutritional intervention with ONS associated with RET, can increase muscle strength, SMM and functionality among older adults at risk for sarcopenia.

Objective: To conduct an economic cost analysis and budget impact assessment (BIA) of implementing the Frailty Care Bundle (FCB) intervention nationally over five-years for hip fracture patients. The FCB was designed to reduce hospital associated decline in older hospitalised patients.

Methods: The FCB was delivered in two Irish hospitals on two wards per hospital. A micro level cost analysis, from the Irish health service perspective was undertaken. Direct costs of the FCB were considered (personnel, training, resources), expressed in Euros (2020). For the BIA national population estimates for hip fracture and costs avoided were based on 18% difference in patients returning to their baseline capability in the post compared to pre-intervention group, valued using cost estimates of functional decline.

Results: We estimated total intervention costs at €53,619 (89% for personnel) and the average cost per patient was €156.03. The expected costs of implementing the FCB nationally over 12-months was €57,274 per hospital (€72.92 per patient). The BIA for an expected targeted population (16,000 over 5 years), estimated that the cost of implementing the FCB (€1.2m) was less than the expected value of functional decline avoided owing to the intervention (€3.6m), suggesting a positive net effect (€2.4m).

Conclusion: Investment in the FCB can be offset with more rapid patient return to baseline functional capability, reducing health care costs. Trial and Protocol Registration (retrospective): BMC ISRCTN 15145850, (https://doi.org/10.1186/ISRCTN15145850).