The Effect of Multidomain Lifestyle Intervention on Daily Functioning in Older People.

Autor: Kulmala J; Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland.; Division of Clinical Geriatrics, Center for Alzheimer Research, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden.; School of Health Care and Social Work, Seinäjoki University of Applied Sciences, Seinäjoki, Finland., Ngandu T; Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland.; Division of Clinical Geriatrics, Center for Alzheimer Research, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden., Havulinna S; Ageing, Disability and Functioning Unit, National Institute for Health and Welfare, Helsinki, Finland., Levälahti E; Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland., Lehtisalo J; Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland., Solomon A; Division of Clinical Geriatrics, Center for Alzheimer Research, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden.; Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland., Antikainen R; Center for Life Course Health Research, University of Oulu, Oulu, Finland.; Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland.; Oulu City Hospital, Oulu, Finland., Laatikainen T; Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland.; Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.; Joint Municipal Authority for North Karelia Social and Health Services (Siun Sote), Joensuu, Finland., Pippola P; Seinäjoki Health Centre, Seinäjoki, Finland., Peltonen M; Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland., Rauramaa R; Kuopio Research Institute of Exercise Medicine, Kuopio, Finland., Soininen H; Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland.; Neurocenter, Department of Neurology, Kuopio University Hospital, Kuopio, Finland., Strandberg T; Center for Life Course Health Research, University of Oulu, Oulu, Finland.; University of Helsinki and Helsinki University Hospital, Helsinki, Finland., Tuomilehto J; Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland.; Department of Public Health, University of Helsinki, Helsinki, Finland.; National School of Public Health, Madrid, Spain., Kivipelto M; Division of Clinical Geriatrics, Center for Alzheimer Research, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden.; Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland.; Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.; Neuroepidemiology and Ageing Research Unit, School of Public Health, Imperial College London, London, United Kingdom.
Jazyk: angličtina
Zdroj: Journal of the American Geriatrics Society [J Am Geriatr Soc] 2019 Jun; Vol. 67 (6), pp. 1138-1144. Date of Electronic Publication: 2019 Feb 26.
DOI: 10.1111/jgs.15837
Abstrakt: Objective: To investigate the effect of a 2-year multidomain lifestyle intervention on daily functioning of older people.
Design: A 2-year randomized controlled trial (ClinicalTrials.gov, NCT01041989).
Setting: Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability.
Participants: A total of 1260 older adults, with a mean age of 69 years at the baseline, who were at risk of cognitive decline.
Intervention: A multidomain intervention, including simultaneous physical activity intervention, nutritional counseling, vascular risk monitoring and management, and cognitive training and social activity.
Measurements: The ability to perform daily activities (activities of daily living [ADLs] and instrumental ADLs) and physical performance (Short Physical Performance Battery).
Results: The mean baseline ADL score was 18.1 (SD = 2.6) points; the scale ranges from 17 (no difficulties) to 85 (total ADL dependence). During the 2-year intervention, the ADL disability score slightly increased in the control group, while in the intervention group, it remained relatively stable. Based on the latent growth curve model, the difference in the change between the intervention and control groups was -0.95 (95% confidence interval [CI] = -1.61 to -0.28) after 1 year and -1.20 (95% CI = -2.02 to -0.38) after 2 years. In terms of physical performance, the intervention group had a slightly higher probability of improvement (from score 3 to score 4; P = .041) and a lower probability of decline (from score 3 to scores 0-2; P = .043) for chair rise compared to the control group.
Conclusion: A 2-year lifestyle intervention was able to maintain the daily functioning of the at-risk older population. The clinical significance of these results in this fairly well-functioning population remains uncertain, but the study results hold promise that healthy eating, exercise, and cognitive and social activity may have favorable effects on functional independence in older people.
(© 2019 The American Geriatrics Society.)
Databáze: MEDLINE
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