Short- and Long-Term Effect of Multidomain Lifestyle Intervention on Frailty: Post Hoc Analysis of an RCT
Pöyhönen, Johanna; Roitto, Hanna-Maria; Lehtisalo, Jenni; Levälahti, Esko; Strandberg, Timo; Kivipelto, Miia; Kulmala, Jenni; Antikainen, Riitta; Soininen, Hilkka; Tuomilehto, Jaakko; Laatikainen, Tiina; Ngandu, Tiia (2025-05-30)
John Wiley & Sons
30.05.2025
Pöyhönen, J., Roitto, H.-M., Lehtisalo, J., Levälahti, E., Strandberg, T., Kivipelto, M., Kulmala, J., Antikainen, R., Soininen, H., Tuomilehto, J., Laatikainen, T. and Ngandu, T. (2025), Short- and Long-Term Effect of Multidomain Lifestyle Intervention on Frailty: Post Hoc Analysis of an RCT. J Am Geriatr Soc. https://doi.org/10.1111/jgs.19552
https://creativecommons.org/licenses/by/4.0/
© 2025 The Author(s). Journal of the American Geriatrics Society published by Wiley Periodicals LLC on behalf of The American Geriatrics Society. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
https://creativecommons.org/licenses/by/4.0/
© 2025 The Author(s). Journal of the American Geriatrics Society published by Wiley Periodicals LLC on behalf of The American Geriatrics Society. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
https://creativecommons.org/licenses/by/4.0/
Julkaisun pysyvä osoite on
https://urn.fi/URN:NBN:fi:oulu-202506024069
https://urn.fi/URN:NBN:fi:oulu-202506024069
Tiivistelmä
Abstract
Background:
The prevalence of frailty is increasing as the population ages. Lifestyle interventions have shown potential in frailty prevention. Intervention studies have been generally limited by short interventions and follow-ups or by focusing on single-domain approaches. We aimed to investigate whether a 2-year multidomain lifestyle intervention prevents phenotypic pre-frailty or frailty and whether baseline factors predict phenotypic pre-frailty or frailty.
Methods:
A total of 1259 participants (aged 60–77 years) in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) were randomized to a multidomain intervention group or to a regular health advice group for 2 years. Frailty was defined by modified Fried phenotype. Pre-frail and frail participants were grouped for analyses. The prevalence of pre-frailty/frailty at baseline and at 2, 7, and 11 years, the change in prevalence from baseline, and the difference in these changes between intervention and control groups were estimated using a mixed-effects logistic regression model.
Results:
The intervention reduced the risk of pre-frailty/frailty up to 7 years. The prevalence decreased in the intervention group from baseline (47%) to 2 years (42%), while it increased in the control group (45% to 49%), resulting in a −9.6-percentage point difference in the change (p = 0.007). After the active intervention period, the prevalence began to increase in both groups, but the difference in the change remained in favor of the intervention group at 7 years (−6.2 percentage points, p = 0.049). The beneficial effect was no longer evident at 11 years. Older age, lower protein intake, and a higher number of chronic diseases were strongly associated with pre-frailty/frailty.
Conclusions:
A 2-year multimodal lifestyle intervention effectively prevented phenotypic pre-frailty/frailty, with sustained benefits observed up to 7 years. Continuous support for a healthy lifestyle may be necessary to prevent late-life pre-frailty or frailty.
Background:
The prevalence of frailty is increasing as the population ages. Lifestyle interventions have shown potential in frailty prevention. Intervention studies have been generally limited by short interventions and follow-ups or by focusing on single-domain approaches. We aimed to investigate whether a 2-year multidomain lifestyle intervention prevents phenotypic pre-frailty or frailty and whether baseline factors predict phenotypic pre-frailty or frailty.
Methods:
A total of 1259 participants (aged 60–77 years) in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) were randomized to a multidomain intervention group or to a regular health advice group for 2 years. Frailty was defined by modified Fried phenotype. Pre-frail and frail participants were grouped for analyses. The prevalence of pre-frailty/frailty at baseline and at 2, 7, and 11 years, the change in prevalence from baseline, and the difference in these changes between intervention and control groups were estimated using a mixed-effects logistic regression model.
Results:
The intervention reduced the risk of pre-frailty/frailty up to 7 years. The prevalence decreased in the intervention group from baseline (47%) to 2 years (42%), while it increased in the control group (45% to 49%), resulting in a −9.6-percentage point difference in the change (p = 0.007). After the active intervention period, the prevalence began to increase in both groups, but the difference in the change remained in favor of the intervention group at 7 years (−6.2 percentage points, p = 0.049). The beneficial effect was no longer evident at 11 years. Older age, lower protein intake, and a higher number of chronic diseases were strongly associated with pre-frailty/frailty.
Conclusions:
A 2-year multimodal lifestyle intervention effectively prevented phenotypic pre-frailty/frailty, with sustained benefits observed up to 7 years. Continuous support for a healthy lifestyle may be necessary to prevent late-life pre-frailty or frailty.
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