运动对急性住院老年人内在能力的影响:两项随机对照试验的汇总分析

IF 6 2区 医学 Q1 GERIATRICS & GERONTOLOGY
Pedro L Valenzuela, Mikel Izquierdo, Nicolás Martinez-Velilla, Fabricio Zambom-Ferraresi, Eduardo Lusa Cadore, Robinson Ramírez-Vélez, Mikel L Sáez de Asteasu
{"title":"运动对急性住院老年人内在能力的影响:两项随机对照试验的汇总分析","authors":"Pedro L Valenzuela, Mikel Izquierdo, Nicolás Martinez-Velilla, Fabricio Zambom-Ferraresi, Eduardo Lusa Cadore, Robinson Ramírez-Vélez, Mikel L Sáez de Asteasu","doi":"10.1093/ageing/afaf082","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Hospitalisation often results in adverse effects in older adults, particularly an increased risk of functional and cognitive decline. Although in-hospital exercise interventions have shown benefits, their impact on intrinsic capacity (IC) remains unknown.</p><p><strong>Objective: </strong>To assess the effects of multicomponent exercise training on IC in acutely hospitalised older adults.</p><p><strong>Design: </strong>Pooled analysis of two randomised clinical trials.</p><p><strong>Setting: </strong>Three Acute Care for Elders units.</p><p><strong>Subjects: </strong>Hospitalised older adults (≥75 years).</p><p><strong>Methods: </strong>The control group received standard care, whereas the exercise group participated in an in-hospital multicomponent exercise program. The primary outcome was IC assessed using a composite score (0-100) across five domains: vitality (handgrip strength), cognition (Mini-Mental State Examination), psychological health (Yesavage Geriatric Depression Scale), locomotion (Short Physical Performance Battery) and sensory function (self-reported vision and hearing). Adverse outcomes were evaluated 1 year after discharge, including emergency visits, hospital re-admission and mortality.</p><p><strong>Results: </strong>A total of 570 patients (age 87.3 ± 4.8 years) were enrolled during acute hospitalisation [median duration 8 (interquartile range = 3) days] and randomised to the exercise (n = 288) or control group (n = 282). The exercise intervention significantly improved IC compared to the control group [7.74 points, 95% confidence interval (CI) 6.45-9.03, P < .001], with benefits observed in all IC domains. IC score at discharge was inversely associated with mortality risk during follow-up (OR = 0.98 per each increase in IC score at discharge, 95% CI = 0.96, 0.99, P = .010), although no association was found with emergency visits (P = .866) or re-admissions (P = .567).</p><p><strong>Conclusions: </strong>In-hospital exercise is an effective strategy to enhance IC in hospitalised older adults. Additionally, the IC score at discharge was inversely related to the mortality risk within 1 year of discharge.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 4","pages":""},"PeriodicalIF":6.0000,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Exercise effects on intrinsic capacity in acutely hospitalised older adults: a pooled analysis of two randomised controlled trials.\",\"authors\":\"Pedro L Valenzuela, Mikel Izquierdo, Nicolás Martinez-Velilla, Fabricio Zambom-Ferraresi, Eduardo Lusa Cadore, Robinson Ramírez-Vélez, Mikel L Sáez de Asteasu\",\"doi\":\"10.1093/ageing/afaf082\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Hospitalisation often results in adverse effects in older adults, particularly an increased risk of functional and cognitive decline. Although in-hospital exercise interventions have shown benefits, their impact on intrinsic capacity (IC) remains unknown.</p><p><strong>Objective: </strong>To assess the effects of multicomponent exercise training on IC in acutely hospitalised older adults.</p><p><strong>Design: </strong>Pooled analysis of two randomised clinical trials.</p><p><strong>Setting: </strong>Three Acute Care for Elders units.</p><p><strong>Subjects: </strong>Hospitalised older adults (≥75 years).</p><p><strong>Methods: </strong>The control group received standard care, whereas the exercise group participated in an in-hospital multicomponent exercise program. The primary outcome was IC assessed using a composite score (0-100) across five domains: vitality (handgrip strength), cognition (Mini-Mental State Examination), psychological health (Yesavage Geriatric Depression Scale), locomotion (Short Physical Performance Battery) and sensory function (self-reported vision and hearing). Adverse outcomes were evaluated 1 year after discharge, including emergency visits, hospital re-admission and mortality.</p><p><strong>Results: </strong>A total of 570 patients (age 87.3 ± 4.8 years) were enrolled during acute hospitalisation [median duration 8 (interquartile range = 3) days] and randomised to the exercise (n = 288) or control group (n = 282). The exercise intervention significantly improved IC compared to the control group [7.74 points, 95% confidence interval (CI) 6.45-9.03, P < .001], with benefits observed in all IC domains. IC score at discharge was inversely associated with mortality risk during follow-up (OR = 0.98 per each increase in IC score at discharge, 95% CI = 0.96, 0.99, P = .010), although no association was found with emergency visits (P = .866) or re-admissions (P = .567).</p><p><strong>Conclusions: </strong>In-hospital exercise is an effective strategy to enhance IC in hospitalised older adults. Additionally, the IC score at discharge was inversely related to the mortality risk within 1 year of discharge.</p>\",\"PeriodicalId\":7682,\"journal\":{\"name\":\"Age and ageing\",\"volume\":\"54 4\",\"pages\":\"\"},\"PeriodicalIF\":6.0000,\"publicationDate\":\"2025-03-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Age and ageing\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/ageing/afaf082\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"GERIATRICS & GERONTOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Age and ageing","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/ageing/afaf082","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
引用次数: 0

摘要

背景:住院治疗往往导致老年人的不良反应,特别是功能和认知能力下降的风险增加。虽然住院运动干预已显示出益处,但其对内在能力(IC)的影响尚不清楚。目的:评价多组分运动训练对急性住院老年人IC的影响。设计:两项随机临床试验的合并分析。设置:三个急症护理长者单位。研究对象:住院老年人(≥75岁)。方法:对照组接受标准护理,运动组参加院内多组分运动方案。主要结果是通过五个领域的综合得分(0-100)来评估IC:活力(握力)、认知(迷你精神状态检查)、心理健康(Yesavage老年抑郁量表)、运动(短体能表现电池)和感觉功能(自我报告的视力和听力)。出院后1年评估不良结局,包括急诊、再入院和死亡率。结果:在急性住院期间共纳入570例患者(年龄87.3±4.8岁)[中位持续时间8(四分位数间距= 3)天],随机分为运动组(n = 288)和对照组(n = 282)。与对照组相比,运动干预显著改善了IC[7.74分,95%可信区间(CI) 6.45-9.03, P]。结论:住院运动是提高住院老年人IC的有效策略。此外,出院时的IC评分与出院后1年内的死亡风险呈负相关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Exercise effects on intrinsic capacity in acutely hospitalised older adults: a pooled analysis of two randomised controlled trials.

Background: Hospitalisation often results in adverse effects in older adults, particularly an increased risk of functional and cognitive decline. Although in-hospital exercise interventions have shown benefits, their impact on intrinsic capacity (IC) remains unknown.

Objective: To assess the effects of multicomponent exercise training on IC in acutely hospitalised older adults.

Design: Pooled analysis of two randomised clinical trials.

Setting: Three Acute Care for Elders units.

Subjects: Hospitalised older adults (≥75 years).

Methods: The control group received standard care, whereas the exercise group participated in an in-hospital multicomponent exercise program. The primary outcome was IC assessed using a composite score (0-100) across five domains: vitality (handgrip strength), cognition (Mini-Mental State Examination), psychological health (Yesavage Geriatric Depression Scale), locomotion (Short Physical Performance Battery) and sensory function (self-reported vision and hearing). Adverse outcomes were evaluated 1 year after discharge, including emergency visits, hospital re-admission and mortality.

Results: A total of 570 patients (age 87.3 ± 4.8 years) were enrolled during acute hospitalisation [median duration 8 (interquartile range = 3) days] and randomised to the exercise (n = 288) or control group (n = 282). The exercise intervention significantly improved IC compared to the control group [7.74 points, 95% confidence interval (CI) 6.45-9.03, P < .001], with benefits observed in all IC domains. IC score at discharge was inversely associated with mortality risk during follow-up (OR = 0.98 per each increase in IC score at discharge, 95% CI = 0.96, 0.99, P = .010), although no association was found with emergency visits (P = .866) or re-admissions (P = .567).

Conclusions: In-hospital exercise is an effective strategy to enhance IC in hospitalised older adults. Additionally, the IC score at discharge was inversely related to the mortality risk within 1 year of discharge.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Age and ageing
Age and ageing 医学-老年医学
CiteScore
9.20
自引率
6.00%
发文量
796
审稿时长
4-8 weeks
期刊介绍: Age and Ageing is an international journal publishing refereed original articles and commissioned reviews on geriatric medicine and gerontology. Its range includes research on ageing and clinical, epidemiological, and psychological aspects of later life.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信