Exercise training and nutritional supplementation for physical frailty in very elderly people.
Level 2 - randomized trial
Individual randomized controlled trial
PubMed 8190152 · doi:10.1056/NEJM199406233302501
What was done
A 10-week randomized, placebo-controlled trial evaluated progressive resistance exercise training, multinutrient supplementation, both, or neither in 100 frail nursing home residents. Participants included 63 women and 37 men with a mean age of 87.1 years (range 72 to 98). Primary outcomes included muscle strength, gait velocity, stair-climbing power, thigh-muscle cross-sectional area, spontaneous physical activity, and total energy intake.
What was found
A total of 94 percent of subjects completed the 10-week intervention. Muscle strength increased by 113 +/- 8 percent in exercisers compared with 3 +/- 9 percent in nonexercisers (P < 0.001). Gait velocity improved by 11.8 +/- 3.8 percent in exercisers and declined by 1.0 +/- 3.8 percent in nonexercisers (P = 0.02). Stair-climbing power increased by 28.4 +/- 6.6 percent versus 3.6 +/- 6.7 percent (P = 0.01), and spontaneous physical activity improved in exercisers. Thigh-muscle cross-sectional area increased by 2.7 +/- 1.8 percent in exercisers versus a 1.8 +/- 2.0 percent decline in nonexercisers, which was not statistically significant (P = 0.11). Multinutrient supplementation alone had no effect on primary outcome measures; total energy intake increased significantly only in participants receiving both exercise and supplementation.
Why it matters
This study demonstrates that profound muscle weakness and functional mobility deficits in nonagenarian nursing home residents remain responsive to high-intensity resistance training, whereas nutritional supplementation alone does not improve physical frailty.
Limits
The sample size was relatively small (100 participants) and restricted to institutionalized, frail older adults in a single setting, limiting generalizability to community-dwelling elderly. The 10-week duration was short, leaving long-term maintenance of gains, fall rates, and clinical outcomes unmeasured. Thigh-muscle cross-sectional area changes did not achieve statistical significance.
Cited by
- supports Scientific evidence demonstrates that individuals in their 80s and 90s can build muscle mass from resistance training.