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dc.contributor.authorMacdonald, Stephen H-F
dc.contributor.authorTravers, John
dc.contributor.authorShé, Éidín Ní
dc.contributor.authorBailey, Jade
dc.contributor.authorRomero-Ortuno, Roman
dc.contributor.authorKeyes, Michael
dc.contributor.authorO'Shea, Diarmuid
dc.contributor.authorCooney, Marie Therese
dc.date.accessioned2020-09-08T11:29:51Z
dc.date.available2020-09-08T11:29:51Z
dc.date.issued2020-02-07
dc.identifier.pmid32032375
dc.identifier.doi10.1371/journal.pone.0228821
dc.identifier.urihttp://hdl.handle.net/10147/628244
dc.descriptionIntroduction: The best interventions to address frailty among older adults have not yet been fully defined, and the diversity of interventions and outcome measures makes this process challenging. Consequently, there is a lack of guidance for clinicians and researchers regarding which interventions are most likely to help older persons remain robust and independent. This paper uses meta-analysis to assess effectiveness of primary care interventions for physical frailty among community-dwelling adults aged 60+ and provides an up-to-date synthesis of literature in this area. Methods: PubMed, CINAHL, Cochrane Register of Controlled Trials, and PEDro databases were searched, and RCTs, controlled pilot studies, or trials with similar study designs addressing frailty in the primary care setting among persons aged 60+ were chosen. Study data was abstracted following PRISMA guidelines, then meta-analysis was performed using the random effects model. Results: 31 studies with a total of 4794 participants were analysed. Interventions using predominantly resistance-based exercise and nutrition supplementation seemed to improve frailty status versus control (RR = 0.62 (CI 0.48-0.79), I2 = 0%). Exercise plus nutrition education also reduced frailty (RR = 0.69 (CI 0.58-0.82), I2 = 0%). Exercise alone seemed effective in reducing frailty (RR = 0.63 (CI 0.47-0.84), I2 = 0%) and improving physical performance (RR = 0.43 (CI 0.18-0.67), I2 = 0%). Exercise alone also appeared superior to control in improving gait speed (SMD = 0.36 (CI 0.10-0.61, I2 = 74%), leg strength (SMD = 0.61 (CI 0.09-1.13), I2 = 87%), and grip strength (Mean Difference = 1.08 (CI 0.02-2.15), I2 = 71%) though a high degree of heterogeneity was observed. Comprehensive geriatric assessment (RR = 0.77 (CI 0.64-0.93), I2 = 0%) also seemed superior to control in reducing frailty. Conclusion: Exercise alone or with nutrition supplementation or education, and comprehensive geriatric assessment, may reduce physical frailty. Individual-level factors and health systems resource availability will likely determine configuration of future interventions.en_US
dc.language.isoenen_US
dc.relation.urlhttps://journals.plos.org/plosone/article?id=10.1371/journal.pone.0228821en_US
dc.subjectOLDER PEOPLEen_US
dc.subjectPRIMARY CAREen_US
dc.subjectAGEINGen_US
dc.subjectHEALTH NEEDS ASSESSMENTen_US
dc.titlePrimary care interventions to address physical frailty among community-dwelling adults aged 60 years or older: A meta-analysis.en_US
dc.typeArticleen_US
dc.typeOtheren_US
dc.identifier.eissn1932-6203
dc.identifier.journalPloS oneen_US
dc.source.journaltitlePloS one
dc.source.volume15
dc.source.issue2
dc.source.beginpagee0228821
dc.source.endpage
refterms.dateFOA2020-09-08T11:29:52Z
dc.source.countryUnited States


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