Mobility problems in frail, elderly people can be reduced through regular exercise and expert dietary advice, a European study reports today.
It found that combining walking, strength, flexibility and balance exercises alongside personalised nutritional counselling reduced mobility disability by 22% over three years.
The SPRINTT (Sarcopenia and Physical Frailty in Older People: multicomponent treatment strategies) trial was launched to find out if a combined intervention of physical activity with technological support and nutritional counselling prevents mobility disability in frail older adults compared with education on healthy ageing.
The findings are based on 1,519 men and women, with an average age of 79 years, who have physical frailty and sarcopenia. All participants were recruited from 16 clinical sites in 11 European countries between 2016 and 2019.
Participants were randomly split into two groups, with 760 receiving the intervention and 759 in a control group receiving education on healthy ageing. They were monitored for up to 36 months.
An actimeter worn on the thigh monitored the activity levels of individuals in the intervention group and they all received moderate intensity physical activity sessions twice a week at a centre and up to four times weekly at home alongside personalised nutritional counselling.
By comparison, the control group received education on healthy ageing once a month and an instructor led programme of upper body stretching exercises or relaxation techniques.
Writing in *The BMJ*, the authors say among participants with short physical performance battery (SPPB) scores of 3-7 at the start of the trial, mobility disability occurred in 47% assigned to the intervention and 53% controls.
Persistent mobility disability – defined as being unable to walk 400 metres on two consecutive occasions – occurred in 21% of intervention participants compared with 25% of controls.
SPPB scores increased more in the intervention group than in controls at both 24 months and 36 months, with average differences of 0.8 and 1 point, respectively.
Women in the intervention group lost less muscle strength at 0.9 kg at 24 months and less muscle mass (0.24 kg and 0.49 kg at 24 months and 36 months, respectively) than women in the control group, but no significant group differences were seen in men.
In a separate analysis of participants with better mobility – those who had SPPB scores of 8 or 9 at the start of the trial – the intervention was not found to affect the risk of developing mobility disability and had marginal effects on physical performance.
While the study had some limitations, the authors say retention and adherence to interventions were high compared with other similar trials, and their use of validated tests in a geographically and culturally diverse group of frail older people across Europe, suggests solid results.
Bernabei R, Landi F, Calvani R et al. Multicomponent intervention to prevent mobility disability in frail older adults: randomised controlled trial (SPRINTT project). *BMJ* 12 May 2022; doi: 10.1136/bmj 2021 068788
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