Strength training plus protein supplementation can delay or prevent frailty

Reference

Travers J, Romero-Ortuno R, Bailey J, Cooney MT. Delaying and reversing frailty: a systematic review of primary care interventions. Br J Gen Pract 2019;69(678):e61-e69.

Synopsis

Frailty is a complex construct that encompasses many domains—physical, social, physiologic, and so forth—that makes patients (the elderly, especially) vulnerable and less able to adapt to external stresses resulting in a greater risk of illness, falls, disability, and death. These authors searched several databases to identify randomized trials or cohort studies with controls that assessed interventions aimed at preventing or treating frailty in primary care settings. The studies had to report quantifiable measures of frailty to be included. The authors don't describe searching for unpublished studies, the mechanics of how they chose articles, or any assessment of the methodologic quality of the included studies. However, they developed a framework that assessed each interventions' ease of implementation and relative effectiveness. Ultimately, they included 45 studies with 15,690 patients. All but 4 of the studies were published after 2010. The authors report that the included studies used 17 different methods of assessing frailty. Thirty studies used more than one intervention: 23 incorporated physical exercises; 10 used health education; 8 used nutritional supplements; 8 incorporated medication management; 7 used home visits; 4 used hormone supplements; 4 used counseling; and 1 used acupressure. The authors don't report numeric data for the individual interventions. Based on their framework, interventions that used a combination of strength training and protein supplementation had the best combination of relative effectiveness and ease of implementation. Unfortunately, the authors don't provide much data on how many adverse outcomes, such as falls or hospitalizations, were avoided, and don't provide any data on the potential harms of the interventions.