Frail Elderly Syndrome Clinical Trial
Official title:
Exercise Mediation on Hormonal, Immune and Psychological Well-being in Institutionalized Frail Older Women.
Frailty syndrome is a complex aging expression determined by ontogenetic and phylogenetic
factors. Chronic stress has been shown to have immunosuppressive effects, to accelerate
immunosenescence and to cause cumulative disorders in many physiological systems, resulting
in frail state. In a recent approach, Linda Fried and colleagues have developed a construct
whose bases are muscle loss, negative energy balance and physical inactivity, called 'Frailty
Cycle'. They identified five dimensions in the construct: weakness, low resistance to an
effort, slowness, low physical activity, and weight loss, which were operationalized on five
criteria to identify the Physical Frailty (PF), and divide the population in frail, pre-frail
and non-frail. Recently, epidemiological studies reported that cognitive impairments, low
immune expression, and others global health dimensions have a powerful association with
physical frailty. However, there is a need for the search for new correlated markers for the
frail condition, for a better understanding of the phenomenon. On the other hand, exercise
has been shown as a co-adjuvant treatment to have positive effects on several factors linked
to physical frailty (e.g. improve immunity and prevent chronic diseases), because of it's
potential effect on hormonal mediation. Looking at Fried PF Phenotype construct, their
dimensions share biological 'commonalities' that can be explained by studying the
biopsychological mechanisms with exercise being a key factor in the study of these
relationships.
The current research was designed to investigate and characterize the prevalence of the PF in
a cross-sectional Portuguese samples (institutionalized participants), to examine the
relationship between PF and each one of the general health status domain such as physical
fitness and functioning status; neuroendocrine and immune parameters; psychological and
cognitive ability of these populations; and to verified the impact of different types of
exercise in each domain of general health status. However, this doctoral thesis is presented
in the form of articles, divided into five sections and their respective chapters. In total,
3 preliminary studies (2 systematic reviews of studies 1 and 2 and one exercise-intervention
pilot study 3), 5 cross-sectional studies (4,5,6,7, and 8) and 3 intervention studies (9,10
and 11) were completed. The cross-sectional design consisted of the assessment of 140 older
women (≥75 years old), living in different centres of heath care and social support, located
in the city of Coimbra, Portugal. The participants were selected using a non-probabilistic
convenience sampling based on the geographical area of the center region of Coimbra city.
This research protocol was planned for approximately 13 months, involving a trained research team and it is built in different phases, according to the type of studies: cross- sectional and experimental. The cross-sectional study (4 weeks' duration) consisted in the evaluation of older people (65 years old), living in different centres of heath care and social support (HCS), located in the city of Coimbra, Portugal. The participants were selected using a non-probalistic convenience sampling based on the geographical area of center region of Coimbra city. The experimental phase characterized as an intervention study with two different chair-based exercise programs, designed to assess the effect of strength/elastic band and multimodal interventions on biopsychological outcomes in frail e pre- frail individuals. Participants in these groups was attended a 45 minutes' exercise session, two-three times per week during 28 weeks and were extracted using the Physical Frailty status from the cross-sectional study design. ;
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