Interactive effects of exercise and sleep on frailty severity in community-dwelling older adults: a cross-sectional study

Psychophysiological effects of a supervised home-based resistance band exercise program in pre-frail older patients with type 2 diabetes mellitus: a randomized controlled trial

BACKGROUND

Frailty is a syndrome as with aging in the population of type 2 diabetes mellitus (T2DM) and exercise has become an essential non-pharmacological tool especially in the pre-frail stage. Notably, the form of supervised home-based exercise program has been strongly recommended in recent years. This study aimed to verify the potential effects of the supervised home-based elastic band exercise in pre-frail older T2DM patients in China.

METHODS

A total of 100 participants were included and randomly divided into intervention group (IG) (n = 50) and control group (CG) (n = 50). The CG received a routine care, while the IG received an extra home-based elastic band training under online and offline supervisions sustaining 12-weeks. The glycosylated hemoglobin (HbA1c), blood lipids, body composition, physical function, scales of Diabetes specificity quality of life scale (DSQL), Pittsburgh sleep quality index (PSQI) and short form geriatric depression scale (GDS-15) of the participants were evaluated before and after intervention.

RESULTS

The average age of the participants were 66.01 ± 4.76 with 55% male and average BMI 24.75 ± 3.51 kg/m2. The clinical characteristics of the two groups were comparable. After 12 weeks' training, muscle mass of the limbs (P < 0.05), physical function indicators including grip strength, chair stands (both P < 0.05), walking time (P < 0.01), HbA1c (P < 0.05), frailty score (P < 0.05), subjective sleep quality (P < 0.05), total DSQL scores (P < 0.01) and the depressive status (P < 0.01) improved significantly in IG when compared with CG.

CONCLUSION

Supervised home-based elastic band exercise could improve limb muscle mass, physical fitness, glucose and lipid control and quality of life in pre-frail older T2DM patients.

TRIAL REGISTRATION NUMBER

ChiCTR2300070726; Registration date: 21/04/2023.

Prevalence of physical frailty and its associated factors among elderly patients undergoing hepatobiliary pancreatic surgery in China

Frailty is a geriatric syndrome characterized by a multisystem physiological decline, increased vulnerability to stressors, and adverse clinical outcomes. However, there is a knowledge gap regarding the association between frailty and its influencing factors. This study aimed to understand the current status of preoperative frailty in elderly patients with hepatobiliary pancreatic disease (HBP) and analyze debilitation-related factors. We enrolled 220 participants aged ≥ 65 years who underwent HBP surgery at two hospitals in China between December 2023 and February 2024. The physical frailty of elderly participants in communities with different characteristics was compared using Kruskal-Wallis and chi-square tests. Ordinal logistic regression analysis was used to analyze the factors influencing preoperative frailty. A total of 212 patients were included in the analysis based on the inclusion and exclusion criteria, with an overall prevalence of frailty at 53 (25%). Ordinal logistic regression analysis results showed that current smoking (odds ratio [OR] = 2.584, p = 0.006) was an independent risk factor for preoperative frailty in elderly participants with HBP. In contrast, exercise habits (OR = 0.323, p < 0.001), two or more multimorbidity statuses (OR = 0.495, p = 0.033), and independent status (OR = 0.216, p < 0.001) were protective factors. Our results suggest that having good exercise habits, not smoking, and independent status can prevent frailty progression in older adults who require HBP surgery. Interventions for frail elderly patients should be supported preoperatively by strengthening exercises to improve tolerance to surgery.

Association between recovery of frailty state and the nonparametric rest-activity rhythm patterns in the elderly community-dwellers: A 6-month follow-up study during Covid-19 pandemic

Reversibility of frailty in the elderly has been discussed comprehensively and but association between recovery of frail state and rest-activity rhythm (RAR) patterns remains unclear. The aim of the current study was to examine a predictor of RAR patterns at the baseline against change of frail state after the intervention in the elderly community-dwellers. This study was performed during Covid-19 pandemic, at the period from April in 2020 to March in 2022. Participants were publicly recruited from senior's exercise program hosted by Akita city or Yurihonjo city. The revised Japanese version of the Cardiovascular Health Study criteria (revised J-CHS criteria) was used to assess frail state in each participant before and after the 6-month intervention. To measure the nonparametric RAR parameters consisting of interdaily stability (IS), intra-daily variability (IV), relative amplitude (RA) and average physical activity for the most active 10-h span (M10) or for the least active 5-h span (L5) over the average 24-h profile, an Actiwatch Spectrum Plus device was worn on each participant's non-dominant wrist for seven continuous days. The final samples were 75 participants except for persons with uncompleted data, classified into the improved group (n = 12), the maintained group (n = 53) and the deteriorated group (n = 10) according to frail alteration after the six-month intervention. As a result of the multinomial logistic regression analysis with the reference of the maintained group, the improvement of frail state associated with a low value of IS and total night-sleep time at the baseline, and M10 and L5 at the initial time were also able to predict worsening of frail state after the six-months intervention. A result of this follow-up study provides grounds for our proposal that alterations of RAR patterns in the elderly could be observed in association with recovery or worsening of frail state after the intervention. The potential finding, however, warrants further longitudinal investigation.