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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT02082171
Other study ID # C12-55
Secondary ID 2013-A00380-45
Status Completed
Phase N/A
First received
Last updated
Start date October 16, 2013
Est. completion date January 27, 2016

Study information

Verified date August 2021
Source Institut National de la Santé Et de la Recherche Médicale, France
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

Prevention of physical disability represents a major priority for the public health system. Physical disability is the final result of a complex cascade of negative events occurring at different levels (i.e., environmental, social, biological, and clinical). The heterogeneity of the underlying mechanisms responsible for the onset of physical disability may require the adoption of preventive interventions affecting multiple domains. Although several studies suggest that single or different combinations of preventive interventions (in particular, physical activity, cognitive training, and healthy diet) might provide beneficial effects in preventing functional loss (and its related features, such as pain or reduced quality of life), very limited evidence coming from clinical trials is currently available on the topic. Intervention trials are usually designed to test the effect of a specific monodimensional intervention on a very selected population, so to reduce the risk of biased results. This approach, although legitimate and methodologically correct, may 1) be insufficient to target the multiple and heterogeneous physiopathological mechanisms underlying the onset of physical disability, and 2) cause a population selection bias leading to difficulties in implementing the study results to the overall older population (thus, determining the "evidence-based medicine" issue in the elderly). To our knowledge, there are no available data from clinical trials evaluating the effects of a multidomain intervention based on lifestyle modifications (e.g., physical activity, cognitive training, nutritional modification) for preventing mobility disability (a very early phase of the disabling process) in community-dwelling older persons. In the present project (Multidomain Intervention to preveNt Disability in ElDers, MINDED), we propose to conduct a pilot study aimed at estimating the effects of a multidomain person-tailored preventive intervention (based on physical activity, cognitive training, and nutritional modifications) on frailty status, physical performance, cognitive function, nutritional status, health-related quality of life, and use of health care services. In addition, we will perform cost-effectiveness analyses of the proposed intervention. The project will yield the necessary preliminary data to design a definitive full-scale Phase 3 randomized clinical trial. By providing a conclusive answer about the effectiveness of a multidimensional preventive program in the primary prevention of major health-related outcomes, the results of the full-scale trial will have relevant clinical and public health implications, and will promote the practicing of a truly evidence-based geriatric medicine.


Recruitment information / eligibility

Status Completed
Enrollment 210
Est. completion date January 27, 2016
Est. primary completion date January 2016
Accepts healthy volunteers No
Gender All
Age group 60 Years and older
Eligibility Inclusion Criteria: - Age of 60 years and older; - Willingness to be randomized to either treatment group; - Pre-frailty or frailty status according to the phenotype described by Fried and colleagues Exclusion Criteria: - Failure to provide informed consent; - Inability to complete a 400-meter walk test (primary outcome of the study); - Living in nursing home; - Living outside of the area of interest, or planning to move out of the area in next 3 years, or planning to leave the area for more than 3 months during the next year; - Relevant cognitive impairment (defined as a known diagnosis of dementia); - Severe progressive, degenerative neurologic disease (e.g., multiple sclerosis); - Severe rheumatologic or orthopaedic diseases (e.g., awaiting joint replacement); - Terminal illness with life expectancy less than 12 months; - Severe pulmonary disease (e.g., oxygen therapy or chronic use of steroids); - Severe cardiac disease (e.g., New York Heart Association Class III or IV heart failure, clinically significant aortic stenosis, history of cardiac arrest, uncontrolled angina); - Other significant comorbid conditions that would impair the ability to participate in the multidomain intervention (e.g., renal failure on hemodialysis, severe psychiatric disorder, excessive alcohol use). To be noted: persons with depression will not be excluded.

Study Design


Intervention

Other:
Multidomain intervention
Multidomain preventive intervention designed by a multidisciplinary team on the basis of results of a comprehensive geriatric assessment

Locations

Country Name City State
France Centre de Rééducation Fonctionnelle "La Roseraie" Montfaucon

Sponsors (2)

Lead Sponsor Collaborator
Institut National de la Santé Et de la Recherche Médicale, France National Research Agency, France

Country where clinical trial is conducted

France, 

Outcome

Type Measure Description Time frame Safety issue
Primary 400-meter walk test Incident inability to complete the 400-meter walk test in the two randomization groups 12 months
Secondary Participants' adherence/retention to the intervention protocol and control groups Participants' adherence/retention to the intervention protocol 12 months
Secondary Intercurrent illnesses rates Intercurrent illnesses rates in the two randomization groups 12 months
Secondary Serious fall injuries Incident fall injuries occurred in the two randomization groups 12 months
Secondary Hospitalizations and institutionalization rates Incidence of acute care hospitalizations and nursing home admissions in the two randomization groups 12 months
Secondary Mortality Overall mortality rate in the two randomization groups 12 months
Secondary Health-related quality of life Modifications of health-related quality of life in the two randomization groups 12 months
Secondary Body composition modifications Body composition modifications (assessed using bioimpedance analysis) in the two randomization groups 12 months
Secondary Modification of Pain Modification of pain symptoms in the two randomization groups 12 months
Secondary Fatigue Modification of the fatigue symptom in the two randomization groups 12 months
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