Diet and Exercise for FRAILty (DEFRAIL):The effect of a standardised exercise and nutritional intervention on clinical and biochemical markers of frailty in older adults
thesisposted on 2022-01-24, 16:22 authored by Pádraig BambrickPádraig Bambrick
Introduction: Frailty in older adults is a growing challenge. There is now an evidence base for the role of exercise and protein supplementation in counteracting frailty, but this has not been adequately translated into practice.
Aims and Objectives: The aim of this study, Diet & Exercise for FRAILty (DEFRAIL), was to develop an effective intervention suitable for widespread uptake. Our first objective was to design an intervention suitable for a wide spectrum of older adults and deliverable in a community setting. The second was to evaluate its effect on frailty and related measures.
Methods: A modified Delphi process was conducted to develop a draft program, followed by a pilot trial with pre-frail participants. The final intervention (an eightweek program of multicomponent exercise and protein-supplemented milk) was evaluated in a single-group pre-test/post-test study. The primary outcome measure was the Fried frailty criteria (FFC), along with a range of secondary outcome measures. Comparison of change scores over the control period (regular activity) and intervention period (DEFRAIL program) allowed estimation of the treatment effect.
Results: 22 participants (16 females, 6 males) completed the intervention (mean age 84.5 years, mean FFC 3.55 prior to the intervention). An improvement of -2.05 points was observed in the mean FFC, along with improvements of -3.19 seconds in the mean Timed Up & Go and -1.41 points in the mean Geriatric Depression Scale (Short Form) score. No significant change was observed for measures of body mass composition, arterial stiffness, cognition, pain or quality-of-life. Dietary analysis demonstrated increased protein and Vitamin D intake but not carbohydrate or energy intake.
Conclusion: Our preliminary results suggest that the DEFRAIL program is feasible to deliver in an integrated setting and effective at reducing frailty. Given the growing prevalence of frailty, we feel there is an urgent need to incorporate an intervention such as this into public health policy.
RCSI (via StAR MD program)
First SupervisorProf John Cooke
Second SupervisorProf Ríona Mulcahy
Third SupervisorDr Michael Harrison
CommentsSubmitted for the Award of Doctor of Medicine to the Royal College of Surgeons in Ireland, 2021.
Published CitationBambrick P. Diet and Exercise for FRAILty (DEFRAIL):The effect of a standardised exercise and nutritional intervention on clinical and biochemical markers of frailty in older adults [MD Thesis] Dublin: Royal College of Surgeons in Ireland; 2021
Degree NameDoctor of Medicine (MD)
Date of award2021-05-31
- Doctor of Medicine (MD)