BACKGROUND In longevity societies, one of the most serious social issues is sarcopenia and/or frailty. Preventing them is important for maintaining independence and quality of life in the older population. This study investigated the effect of a self-monitoring comprehensive geriatric intervention programme (CGIP) on physical function and muscle size in community-dwelling older adults. We compared the effects of a CGIP using weekly class-styled (CS) sessions and a home-based (HB) programme. METHODS The 526 participants were randomized into one of two groups (CS 251, HB 275) based on their residential districts. We conducted a 12 week CGIP, which consisted of low-load resistance exercise, physical activity increments, oral function improvements, and a nutritional guide. All participants were encouraged to attend two 90 min lectures that included instructions on the CGIP. They were provided with exercise materials (triaxial-accelerometers/pedometers, ankle weights, and elastic bands) and diary logs. The CS group attended 90 min weekly sessions and independently executed the programme on other days, whereas the HB group only received instructions on how to execute the programme. Physical functions, such as knee extension strength (KES), normal and maximum walking speed, the timed up-and-go test, and anterior thigh muscle thickness (MT), were measured and analysed using intention-to-treat analysis before and after the 12 week intervention. RESULTS Of the 526 participants identified, 517 (CS 243 age 74.0 ± 5.4 women 57.2%, HB 274 age 74.0 ± 5.6 women 58.8%) were enrolled. Nine (CS 8, HB 1) were excluded from the analysis because they did not participate in the pre-intervention measurements. Both interventions significantly improved KES (CS 18.5%, HB 10.6%), normal walking speed (CS 3.7%, HB 2.8%), and MT (CS 3.2%, HB 3.5%). Greater improvement of KES was observed in the CS group (P = 0.003). Maximum walking speed (CS 4.7%, HB 1.8%; P = 0.001) and timed up-and-go (CS -4.7%, HB -0.2%; P < 0.001) significantly improved in the CS group only. CONCLUSIONS The intervention was effective in preventing sarcopenia and/or frailty. Most physical functions and MT improved after both interventions. The HB intervention is cost-effective and may help prevent sarcopenia and/or frailty in the large older population.

中文翻译：

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对社区老年人的综合老年病干预：一项集群随机对照试验。

背景技术在长寿社会中，最严重的社会问题之一是肌肉减少症和/或虚弱。预防这些疾病对于维持老年人群的独立性和生活质量很重要。这项研究调查了在社区居住的老年人中进行自我监测的老年病综合干预计划（CGIP）对身体机能和肌肉大小的影响。我们使用每周一次的课堂式（CS）课和家庭式（HB）程序比较了CGIP的效果。方法根据居住地区，将526名参与者随机分为两组（CS 251，HB 275）之一。我们进行了为期12周的CGIP，包括低负荷抵抗运动，体力活动增加，口腔功能改善和营养指南。鼓励所有参与者参加两场90分钟的讲座，其中包括有关CGIP的说明。为他们提供了锻炼材料（三轴加速度计/计步器，脚踝负重和松紧带）和日记本。CS组每周参加90分钟的会议，并在其他几天独立执行该程序，而HB组仅收到有关如何执行该程序的说明。使用意向性治疗分析来测量和分析诸如膝关节伸展强度（KES），正常和最大步行速度，定时向上和向上测试以及大腿前肌厚度（MT）等身体功能12周的干预。结果在526名参与者中，有517名（CS 243年龄74.0±5.4女性57.2％，HB 274年龄74.0±5.6女性58.8％）被纳入研究。九（CS 8，HB 1）被排除在分析之外，因为它们不参与干预前的测量。两种干预措施均显着改善了KES（CS 18.5％，HB 10.6％），正常步行速度（CS 3.7％，HB 2.8％）和MT（CS 3.2％，HB 3.5％）。CS组的KES改善更大（P = 0.003）。仅CS组的最大步行速度（CS 4.7％，HB 1.8％; P = 0.001）和定时起步（CS -4.7％，HB -0.2％; P <0.001）显着改善。结论干预措施可有效预防肌肉减少症和/或体弱。两种干预后，大多数身体功能和MT均得到改善。HB干预具有成本效益，可以帮助预防大量老年人的肌肉减少症和/或虚弱。两种干预措施均显着改善了KES（CS 18.5％，HB 10.6％），正常步行速度（CS 3.7％，HB 2.8％）和MT（CS 3.2％，HB 3.5％）。CS组的KES改善更大（P = 0.003）。仅CS组的最大步行速度（CS 4.7％，HB 1.8％; P = 0.001）和定时起步（CS -4.7％，HB -0.2％; P <0.001）显着改善。结论该干预措施可有效预防肌肉减少症和/或体弱。两种干预后，大多数身体功能和MT均得到改善。HB干预具有成本效益，可以帮助预防大量老年人的肌肉减少症和/或虚弱。两种干预措施均显着改善了KES（CS 18.5％，HB 10.6％），正常步行速度（CS 3.7％，HB 2.8％）和MT（CS 3.2％，HB 3.5％）。CS组的KES改善更大（P = 0.003）。仅CS组的最大步行速度（CS 4.7％，HB 1.8％; P = 0.001）和定时起步（CS -4.7％，HB -0.2％; P <0.001）显着改善。结论该干预措施可有效预防肌肉减少症和/或体弱。两种干预后，大多数身体功能和MT均得到改善。HB干预具有成本效益，可以帮助预防大量老年人的肌肉减少症和/或虚弱。7％，HB -0.2％；P <0.001）仅在CS组显着改善。结论该干预措施可有效预防肌肉减少症和/或体弱。两种干预后，大多数身体功能和MT均得到改善。HB干预具有成本效益，可以帮助预防大量老年人的肌肉减少症和/或虚弱。7％，HB -0.2％；P <0.001）仅在CS组显着改善。结论该干预措施可有效预防肌肉减少症和/或体弱。两种干预后，大多数身体功能和MT均得到改善。HB干预具有成本效益，可以帮助预防大量老年人的肌肉减少症和/或虚弱。