None listed
Conditions
Brief summary
The purpose of the study is to understand whether a supervised or a self-directed frailty program can slow frailty in older adults. We know that building muscle strength, eating a balanced diet and checking medications is best for healthy aging. We also know that being social or connecting with others can help improve or maintain quality of life. Both the supervised and self-directed programs are based on current clinical guidelines and best practice and include help with things we know can help slow or reduce frailty - exercise, diet, checking medicines, and social support and engagement. The study will also look at how easy these programs would be to put into practice in the real world, and to assess the cost of doing so. This study will be conducted in most states of Australia with a total of 390 participants Australia-wide.
Interventions
A 6-month supervised, health professional-directed frailty program encompassing exercise, nutrition, medication optimisation and social connectedness, with telephone health coach support (to set goals with participants, tailor behaviour-change strategies, review progress and motivate participation, plus web-based frailty information and resources to support self-management,
Participants in this group will receive:
- A personalised telehealth dietetics appointment to develop a unique nutrition
A 6-month supervised, health professional-directed frailty program encompassing exercise, nutrition, medication optimisation and social connectedness, with telephone health coach support (to set goals with participants, tailor behaviour-change strategies, review progress and motivate participation, plus web-based frailty information and resources to support self-management, Participants in this group will receive: - A personalised telehealth dietetics appointment to develop a unique nutrition plan - 1 appointment at program initiation, delivered by a registered dietitian lasting up to 60 minutes. Adherence will be monitored and supported by a health coach - Twice-weekly in-person progressive resistance training with a qualified exercise professional (exercise physiologist or physiotherapist with relevant training provided by our team). The exercise intervention will be delivered one-on-one or small groups (2-3 participants) with intensity and weight determined for each participant individually (example exercises: squats, tricep dips, plantar flexion). Sessions will last approximately 40-45 minutes, with balance training prescribed at home (4 days per week, 30 minutes). - Health coaching to remain on track with all four pillars (exercise, nutrition, medication optimisation and social engagement). Participants will be entitled to up to 11 health coaching calls over the 6 months, starting at 4x weekly, then 4x fortnightly, then 3x monthly. Each session will last up to 60 minutes. Health coaches will have an allied health background and prior health coaching training and experience. Additional training will be provided, if needed, by our health coach coordinator. - Medication optimisation will occur through a purpose-built website where participants will complete activities to uncover their goals of care (related to their medications), make a list of the medications they are currently taking, and be instructed to visit their GP to help align their medications with their goals. Participants only need to do this once, at the beginning of their program, and it will take approx. 30 - 60 mins. Adherence will be supported by the health coach. - Social engagement will consist of three components (1) inviting a 'buddy' to participate in components of the program with them, (2) attending group-based health coaching sessions, once per month, with other intervention group participants, delivered online, and (3) having access to a range of community activities and events to increase their social connectivity. These activities will be displayed on our fittest website and available for everyone to view. There is no minimum engagement for this component as it is determined by the needs of the participants and will be supported by the health coach during regular sessions. Our web-based frailty information is derived from the Asia Pacific Clinical Frailty Guidelines, but all materials have been specifically created for this study. Adherence to the intervention will be assessed by investigating the proportion of dietetics appointments attended, the proportion of exercise sessions attended, and the number of health coaching calls conducted.
Sponsors
The University of Queensland
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Were seen by a public or private Geriatrician in the preceding 12 months OR received a 75+ health assessment by their General Practitioner in the preceding 12 months; 2. Aged >=65 years, or >=55 years if Aboriginal or Torres Strait Islander; 3. Living in the community (i.e., not in aged care or hospitalised); 4. Have access and ability to use a computer or other electronic device with internet service (self-report); 5. Be able to travel to the exercise professional training sessions of their State; and 6. A frailty index between 0.15 and 0.35 (inclusive) as measured by Frailty Index Short Form.
Exclusion criteria
1. An estimated life expectancy of less than 12 months (e.g., due to a life-limiting condition) as assessed by their treating physician; 2. Are unable to participate in a supervised and self-directed program due to cognitive impairment or another reason; 3. Have had a self-reported in-patient hospital admission >24 hours in the past 3 months; 4. Unable or unwilling to provide informed consent; and; 5. Live in the same household as another participant
Outcome results
None listed