Good nutrition, physical training and mental exercises can reverse physical frailty in the elderly: study

June 19, 2017
A study led by Associate Professor Ng Tze Pin (second from left) from the National University of Singapore showed that good nutrition, physical training and mental exercises can reverse physical frailty in the elderly. Credit: National University of Singapore

Physical frailty is common among the elderly and is strongly associated with cognitive impairment, dementia and adverse health outcomes such as disability, hospitalisation, and mortality. A four-year study conducted by researchers from the National University of Singapore (NUS) showed that a combination of nutritional, physical and cognitive interventions can reverse physical frailty in elderly people.

Associate Professor Ng Tze Pin, who is from the Department of Psychological Medicine at the NUS Yong Loo Lin School of Medicine, and the leader of the research team, said that earlier research findings from the Singapore Longitudinal Ageing Studies (SLAS) by his team showed that physically frail elderly persons compared to their robust counterparts are eight times as likely to be cognitive impaired at the same time, and if they are not cognitively impaired, they are more than five times at risk of becoming cognitively impaired on follow up three years later.

"In addition, physically frail elderly persons are two to 10 times as likely to become functionally disabled on daily living activities, hospitalised and die earlier than their robust counterparts. When physical and are present together in the same individual, he or she is more than 20 times as likely to become disabled, hospitalised or die earlier. With such compelling evidence, if it is possible to reduce or even reverse physical frailty in the elderly, we could greatly improve their quality of life," Assoc Prof Ng explained.

Assoc Prof Ng and his team conducted a four-year trial between 2010 and 2013, involving 250 community-living older persons in Singapore who were 65 years old and above and who showed signs of frailty.

"Our study shows that it is feasible to identify pre-frail and frail older persons in the community and primary care settings and provide them with lifestyle interventions to reverse frailty. We found that better nutrition, physical training and mental exercises can reverse frailty, enhance muscle strength and gait speed, reduce depressive symptoms and improve . As such, these interventions can go a long way to reducing the high prevalence of physical disability, hospitalisation and mortality in an ageing society like Singapore," Assoc Prof Ng added.

Fighting frailty in elderly people

Participants for the trial were recruited from October 2009 to August 2012 from various senior activity centres in Singapore. They were randomly allocated to receive in one of five groups for a period of six months. Three groups of participants were provided with either physical training, nutritional enhancement or cognitive training, while the fourth group received a combination of all three interventions. The last group was a control group which did not receive any intervention. The trial was conducted in collaboration with Khoo Teck Puat Hospital and St Luke's Hospital.

Assessment of the participants' frailty and other outcomes were made before the start of intervention. During the six-month trial, the participants' progress were measured after three months and six months. A follow-up assessment was also conducted six months after the trial (i.e. 12 months after the start of intervention).

The NUS researchers found that the three types of intervention, as well as a combination of all three approaches, were able to reduce frailty and depressive symptoms, and improve cognitive functioning of the elderly.

Assoc Prof Ng noted, "The important message from our studies is that frailty is not an inevitable part of ageing. There is much that older people can do for themselves to avoid becoming frail and disabled, so it is vital that they pay attention to good quality diet and nutrition, engage in physical exercise, and participate in socially and cognitively stimulating activities."

Intervention programmes to benefit the elderly

Following the encouraging findings from the trial, the research team is working with the Geriatric Education and Research Institute (GERI) and social service organisations to develop and implement pilot frailty screening and multi-domain lifestyle intervention community programmes. They hope that such programmes when successfully scaled up for mass can help improve the physical, psychological and cognitive well-being of large numbers of senior citizens.

Explore further: Higher anabolic hormone levels predict lower risk of worsening frailty in men

Related Stories

Higher anabolic hormone levels predict lower risk of worsening frailty in men

April 3, 2017
A new study suggests that middle-age and elderly men are less likely to develop worsening frailty if they have high levels of certain anabolic hormones, which are muscle- and bone-building hormones. The study results will ...

Questionnaire-based approach valid for identifying frailty

April 11, 2017
(HealthDay)—A questionnaire-based approach seems to be valid for identifying adults in the intensive care unit with a frailty phenotype, according to a study published online March 30 in the Annals of the American Thoracic ...

Frailer patients at much greater risk of institutional care and death after discharge from hospital

June 3, 2017
Independent of age, frail patients are almost twice as likely to die in the year following admission to critical care, and even more likely to need nursing home care after discharge from hospital, compared with patients who ...

Physical training and social support reduce frailty and malnutrition

August 17, 2016
A training program for the reactivation of older and frail people established by MedUni Vienna has achieved remarkable success. It was revealed that physical training and addressing nutrition-relevant aspects with the aid ...

Weight loss plus aerobic and resistance exercise can reduce frailty in obese older adults

May 18, 2017
Although losing weight is generally considered a helpful step toward leading a healthier life, for obese older adults it can actually have adverse health consequences that can include accelerating age-related loss of muscle ...

Recommended for you

To reduce postoperative pain, consider sleep—and caffeine

August 18, 2017
Sleep is essential for good mental and physical health, and chronic insufficient sleep increases the risk for several chronic health problems.

Despite benefits, half of parents against later school start times

August 18, 2017
Leading pediatrics and sleep associations agree: Teens shouldn't start school so early.

Doctors exploring how to prescribe income security

August 18, 2017
Physicians at St. Michael's Hospital are studying how full-time income support workers hired by health-care clinics can help vulnerable patients or those living in poverty improve their finances and their health.

Schoolchildren who use e-cigarettes are more likely to try tobacco

August 17, 2017
Vaping - or the use of e-cigarettes - is widely accepted as a safer option for people who are already smoking.

Federal snack program does not yield expected impacts, researchers find

August 17, 2017
A well-intentioned government regulation designed to offer healthier options in school vending machines has failed to instill better snacking habits in a sample of schools in Appalachian Virginia, according to a study by ...

Study shows cigarette makers shifted stance on nicotine patches, gum

August 17, 2017
The use of nicotine patches, gum, lozenges, inhalers or nasal sprays—together called "nicotine replacement therapy," or NRT—came into play in 1984 as prescription medicine, which when combined with counseling, helped ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.