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Cost-Consequences Analysis Following Different Exercise Interventions in Institutionalized Oldest Old: A Pilot Study
A B Bays-Moneo1, M Izquierdo, M M Antón
1Mikel Izquierdo, PhD, Department of Health Sciences, Public University of Navarra, Avda. Barañain s/n 31008 Pamplona (Navarra) Spain, Tel + 34 948 417876, mikel.izquierdo@gmail.com.
Objectives:
to investigate the effects of two different exercise interventions on cost of care, functional capacity, falls occurrence, muscle strength, and executive function in institutionalized oldest old.
Design:
A pilot study of a randomized clinical trial investigating 12 months of two exercise interventions compared to a usual care group in oldest old residents of a nursing home.
Setting And Participants:
69 older patients (mean age 89.4 ±5.1 years) completed the full baseline and post intervention measurements. Participants were randomly allocated into multicomponent exercise group (MG, n=23), calisthenics group (CALG, n = 23), and usual care group (UCG, n=23).
Methods:
Primary outcome was individual cost of care, and secondary outcomes included different physical and cognitive functioning tests, as well as number of falls.
Results:
MG reduced the cost of care compared to the pre-intervention period, with the greatest difference from baseline achieved in month 12 [mean change 95% confidence interval (CI)=-330.43 (-527.06, -133.80), P=0.006], while UCG increased this outcome, with the greatest difference from baseline observed in month 12 [mean change (95%CI)=300.00 (170.27, 429.72), P=0.013]. In addition, MG significantly improved SPPB score [mean change (95% CI) = 1.21 (0.55, 1.88), P<0.001], whereas the UCG exhibited a decline in scores [mean change (95% CI) = -1.43 (-1.90, -0.97), P<0.001]. Moreover, MG group demonstrated an improvement in the number of falls [mean change (CI 95%) = -1.0 (-1.73, -0.27), P=0.003], while no significant changes were observed in UCG. Additionally, MG exhibited a significant increase in the handgrip strength (HGS) and leg press strength (P<0.001), while a decrease was observed in UCG (P<0.001). No significant changes were observed in the CALG.
Conclusions And Implications:
a one-year multicomponent exercise intervention reduced the cost of care, improved functional capacity and muscle strength, as well as reduced falls in institutionalized oldest old.
