Short and long-term prevention of frailty with multidomain lifestyle intervention among older adults

Abstract Background Frailty is a geriatric syndrome with declines in reserve and function resulting in increased vulnerability. Frail individuals face an increased risk for adverse health outcomes such as disability, hospitalization and mortality. The prevalence of frailty is increasing with ageing population. Lifestyle interventions have shown potential in preventing frailty, but earlier studies have been generally limited by short durations or single-domain approaches. We aimed to investigate whether a 2-year multidomain lifestyle intervention prevents phenotypic frailty. Methods The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) recruited 1259 community-dwelling adults (aged 60-77 years) at risk of dementia. Participants were randomized to a multidomain intervention (diet, exercise, cognitive training, vascular risk monitoring) or regular health advice for two years. Frailty was defined by modified Fried phenotype. Pre-frail and frail participants were grouped for analyses. We estimated the intervention effect on pre-frailty/frailty (baseline, 2, 7, and 11 years). Results The risk of pre-frailty/frailty was reduced by the intervention for 7 years. The prevalence of pre-frailty/frailty decreased in the intervention group from baseline (47%) to 2-year follow-up (42%), while increased and in the control group (45% to 49%), p = 0.007. After the active intervention period, the prevalence began to increase in both groups, but the difference in change remained in favor of the intervention group at 7 years (p = 0.049) but was attenuated at 11 years. Older age, lower protein intake, and a higher number of chronic diseases were strongly associated with pre-frailty/frailty. Conclusions A 2-year multimodal lifestyle intervention prevented pre-frailty/frailty up to 7 years. Support for healthy lifestyle should be implemented into healthcare for older adults at risk of dementia to decrease the frailty-related burden on healthcare systems. Key messages • Prevention of pre-frailty/frailty is possible with a multidomain lifestyle intervention. • Continous support for maintaining healthy lifestyle may be necessary to prevent pre-frailty/frailty in late life.