The effect of multidomain lifestyle intervention on daily functioning in older people
Kulmala, Jenni; Ngandu, Tiia; Havulinna, Satu; Levälahti, Esko; Lehtisalo, Jenni; Solomon, Alina; Antikainen, Riitta; Laatikainen, Tiina; Pippola, Pauliina; Peltonen, Markku; Rauramaa, Rainer; Soininen, Hilkka; Strandberg, Timo; Tuomilehto, Jaakko; Kivipelto, Miia (2019-02-26)
Kulmala, J., Ngandu, T., Havulinna, S., Levälahti, E., Lehtisalo, J., Solomon, A., Antikainen, R., Laatikainen, T., Pippola, P., Peltonen, M., Rauramaa, R., Soininen, H., Strandberg, T., Tuomilehto, J., & Kivipelto, M. (2019). The Effect of Multidomain Lifestyle Intervention on Daily Functioning in Older People. Journal of the American Geriatrics Society, 67(6), 1138–1144. https://doi.org/10.1111/jgs.15837
© 2019 The American Geriatrics Society. This is the peer reviewed version of the following article: Kulmala, J., Ngandu, T., Havulinna, S., Levälahti, E., Lehtisalo, J., Solomon, A., Antikainen, R., Laatikainen, T., Pippola, P., Peltonen, M., Rauramaa, R., Soininen, H., Strandberg, T., Tuomilehto, J., & Kivipelto, M. (2019). The Effect of Multidomain Lifestyle Intervention on Daily Functioning in Older People. Journal of the American Geriatrics Society, 67(6), 1138–1144, which has been published in final form at https://doi.org/10.1111/jgs.15837. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
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https://urn.fi/URN:NBN:fi-fe2020102085776
Tiivistelmä
Abstract
Objective:To investigate the effect of a 2‐year multidomain lifestyle intervention on daily functioning of older people.
Design:A 2‐year randomized controlled trial (ClinicalTrials.gov, NCT01041989).
Setting:Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability.
Participants:A total of 1260 older adults, with a mean age of 69 years at the baseline, who were at risk of cognitive decline.
Intervention:A multidomain intervention, including simultaneous physical activity intervention, nutritional counseling, vascular risk monitoring and management, and cognitive training and social activity.
Measurements:The ability to perform daily activities (activities of daily living [ADLs] and instrumental ADLs) and physical performance (Short Physical Performance Battery).
Results:The mean baseline ADL score was 18.1 (SD = 2.6) points; the scale ranges from 17 (no difficulties) to 85 (total ADL dependence). During the 2‐year intervention, the ADL disability score slightly increased in the control group, while in the intervention group, it remained relatively stable. Based on the latent growth curve model, the difference in the change between the intervention and control groups was −0.95 (95% confidence interval [CI] = −1.61 to −0.28) after 1 year and −1.20 (95% CI = −2.02 to −0.38) after 2 years. In terms of physical performance, the intervention group had a slightly higher probability of improvement (from score 3 to score 4; P = .041) and a lower probability of decline (from score 3 to scores 0‐2; P = .043) for chair rise compared to the control group.
Conclusions:A 2‐year lifestyle intervention was able to maintain the daily functioning of the at‐risk older population. The clinical significance of these results in this fairly well‐functioning population remains uncertain, but the study results hold promise that healthy eating, exercise, and cognitive and social activity may have favorable effects on functional independence in older people.
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