PREPA PREvention of Loss of Autonomy

Civil Hospices of Lyon

Status: Active, not recruiting

Conditions: Physical Activity; Mobility Limitation

Treatments: Diagnostic Test: Multidimensional assessments; Other: Follow-up at T3 + 6 months and T3 + 12 months; Other: Multicomponent group-based and supervised exercise program

Study type: Interventional

Funder types: Other

Identifiers

NCT03667664

69HCL16_0324

Details and patient eligibility

About

According to several reports, the proportion of people aged 80yrs or older will be doubled within the next 25y, reaching 10% of the global population. Furthermore, the health life expectancy at 65y is 10.4y which remains much lower than the general life expectancy. As a result, there is a constant need of developing preventive strategies through multimodal programs.

Among the predictive factors of mobility disability with age, muscular weakness and decreased physical function are major components. These two factors are known of being responsible for falls and fractures that lead to decrease the quality of life and an increase in mortality.

Exercise and nutrition are the only components that have proven their efficacy to struggle mobility disability risk. It is important to integrate these two components in a sustained intervention within a multidimensional prevention program. However, there is a lack of implementation of these programs in primary care.

Indeed, neither the screening of older adults at risk of mobility disability, nor the preventive actions are usually implemented for this population. The implementation of a prevention care pathway, with personalized intervention and a sustained follow-up, along with supervised exercise training combined with nutritional counselling, is the public health imperatives.

Based on prevention care pathway that designed for community-dwelling older adults screened at risk of mobility disability. The purpose of this open cohort study was to highlight the efficacy and the feasibility of a multimodal program implemented on real-life setting specifically on the physical function and risk of mobility loss, along with their maintenance at 6-months and 1-year follow-up.

Enrollment: 530 estimated patients

Sex: All

Ages: 70+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patient eligible for the "mobility loss prevention" program

• At least one of the following signs:

  • Difficulty carrying a loaded shopping basket (about 4.5 kg)
  • Difficulty rising from a chair without using the arms
  • Difficulty climbing one flight of stairs (10 steps)
  • Difficulty moving around
  • Slowed walking
  • Difficulty walking more than 400 meters without stopping
  • Walking time < 30 minutes/day
  • Fatigue during mild physical efforts: running errands, household chores; fear of falling and/or at least one fall in the past year
  • Recent unintentional weight loss: weight loss ≥ 5% in 6 months or BMI < 22 kg/m²

Exclusion criteria

• Patient who has not given consent to participate
• Patient under guardianship in retrospective phase
• Locomotor disability
• expectancy of life being under 12 months
• BMI ≥ 35 Kg/m2

Trial design

Primary purpose: Prevention

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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530 participants in 1 patient group

Multicomponent group-based supervised exercise program

Other group

Description:

Community-dwelling older adults aged of \>70y, screened at risk of mobility disability risk factors and assessed with at least 1 mobility disability risk factor (see intervention 1). These subjects are included in the protocol and participate in a multicomponent exercise program.

Treatment:

Other: Follow-up at T3 + 6 months and T3 + 12 months

Other: Multicomponent group-based and supervised exercise program

Diagnostic Test: Multidimensional assessments