Effectiveness of a combined lifestyle intervention for older people in long-term care: A randomized controlled trial.

Andrea Conti, Diego Concina, Annalisa Opizzi, Agatino Sanguedolce, Carmela Rinaldi, Sophia Russotto, Elena Grossini, Carla Maria Gramaglia, Patrizia Zeppegno, Massimiliano Panella

Journal: Archives of gerontology and geriatrics 2024;120():105340

PMID: 38295616

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Plain Language Summary

The global phenomenon of population aging, known as the Third Demographic Transition, has led to a substantial rise in the utilisation of long-term care (LTC) services. The aim of this study was to assess the effectiveness of a lifestyle medicine-based intervention aimed to improve functionality in older people. This study was a pragmatic two-arm, parallel group study. Fifty-four participants were included in the study who were mostly normal-weight women with a mean age of 84.06 years. Results showed that the intervention group was engaged in more structured physical activity, introduced fewer carbohydrates, and received more psychological support than the control group. Furthermore, lifestyle medicine interventions were effective in older participants, also in the complex setting of LTC. Significant results are achievable in a short timeframe. Authors concluded that a three-months lifestyle medicine intervention combining group physical exercise, a healthy diet, and psychological wellbeing sessions was effective in improving functionality in older people living in LTC.

Abstract

PURPOSE

Lifestyle medicine interventions combining physical, nutritional, and psychological components have been found effective in general older population. However, evidence from the long-term care (LTC) is scarce.

METHODS

We conducted a pragmatic, two-arm, parallel group, superiority randomized controlled trial. Residents living in a LTC facility for one or more years, able to discern and to express informed consent, and requiring nursing care were considered eligible. The three-months intervention combined bi-weekly physical exercise groups, a healthy diet, and weekly psychological wellbeing sessions. Patients of the control group were subjected to routine care. At the end of the study participants were assessed using Barthel Index, Katz Activities of Daily Living, and Tinetti scales.

RESULTS

A total of 54 patients with a mean age of 84 years took part to the study. Physical exercise and psychological wellbeing sessions were mostly attended by all the subjects of the intervention group. Both groups took less calories than planned in the diets; in addition, the intervention group showed a lower energy and carbohydrates intake than the control group. At the end of the study, the intervention group showed a significant improvement in the total scores of all the scales.

CONCLUSIONS

This intervention was effective in improving functionality in older people living in the LTC setting. Results were achieved in a short timeframe, likely due to synergistic interactions between components. However, a further exploration of underlying factors is needed, to better understand the barriers that hampered a complete intervention delivery in this context.

Address: Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy; Doctoral Program in Food, Health, and Longevity, Università del Piemonte Orientale, Novara, Italy. Electronic address: [email protected].; Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy; Doctoral Program in Food, Health, and Longevity, Università del Piemonte Orientale, Novara, Italy; Anteo Impresa Sociale, Biella, Italy.; Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy.; Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy; Education and Research area, Health Professions' Direction, Maggiore Della Carità Hospital, Novara, Italy.; Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy; Doctoral Program in Sports and Health - Patient Safety line, Universitas Miguel Hernandez, Alicante, Spain; Residency Program of Psychiatry, Università del Piemonte Orientale, Novara, Italy.

DOI: 10.1016/j.archger.2024.105340