Short- and Long-Term Effect of Multidomain Lifestyle Intervention on Frailty: Post Hoc Analysis of an RCT

Johanna Pöyhönen; Hanna-Maria Roitto; Jenni Lehtisalo; Esko Levälahti; Timo Strandberg; Miia Kivipelto; Jenni Kulmala; Riitta Antikainen; Hilkka Soininen; Jaakko Tuomilehto; Tiina Laatikainen; Tiia Ngandu

doi:10.1111/jgs.19552

Short- and Long-Term Effect of Multidomain Lifestyle Intervention on Frailty: Post Hoc Analysis of an RCT

J Am Geriatr Soc. 2025 May 30. doi: 10.1111/jgs.19552. Online ahead of print.

Authors

Johanna Pöyhönen^{1

2}, Hanna-Maria Roitto^{1

2

3}, Jenni Lehtisalo^{1

4}, Esko Levälahti¹, Timo Strandberg^{2

3

5}, Miia Kivipelto^{1

6

7

8

9}, Jenni Kulmala^{1

6

10}, Riitta Antikainen^{5

11}, Hilkka Soininen^{4

12}, Jaakko Tuomilehto^{13

14

15}, Tiina Laatikainen^{7

16}, Tiia Ngandu^{1

6

7}

Affiliations

¹ Department of Public Health, Finnish Institute for Health and Welfare (THL), Helsinki, Finland.
² Department of Medicine, Clinicum, University of Helsinki, Helsinki, Finland.
³ Department of Geriatrics, Helsinki University Hospital, Helsinki, Finland.
⁴ Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland.
⁵ Center for Life Course Health Research, University of Oulu, Oulu, Finland.
⁶ Division of Clinical Geriatrics, Center for Alzheimer Research, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden.
⁷ Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.
⁸ Ageing Epidemiology Research Unit (AGE), School of Public Health, Imperial College London, London, United Kingdom of Great Britain and Northern Ireland.
⁹ Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden.
¹⁰ Faculty of Social Sciences (Health Sciences) and Gerontology Research Center (GEREC), Tampere University, Tampere, Finland.
¹¹ Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland.
¹² Neurocenter, Department of Neurology, Kuopio University Hospital, Kuopio, Finland.
¹³ Department of International Health, National School of Public Health, Madrid, Spain.
¹⁴ South Ostrobothnia Central Hospital, Seinäjoki, Finland.
¹⁵ Department of Public Health, University of Helsinki, Helsinki, Finland.
¹⁶ North Karelia Wellbeing Service County (Siun Sote), Joensuu, Finland.

PMID: 40444985
DOI: 10.1111/jgs.19552

Abstract

Background: The prevalence of frailty is increasing as the population ages. Lifestyle interventions have shown potential in frailty prevention. Intervention studies have been generally limited by short interventions and follow-ups or by focusing on single-domain approaches. We aimed to investigate whether a 2-year multidomain lifestyle intervention prevents phenotypic pre-frailty or frailty and whether baseline factors predict phenotypic pre-frailty or frailty.

Methods: A total of 1259 participants (aged 60-77 years) in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) were randomized to a multidomain intervention group or to a regular health advice group for 2 years. Frailty was defined by modified Fried phenotype. Pre-frail and frail participants were grouped for analyses. The prevalence of pre-frailty/frailty at baseline and at 2, 7, and 11 years, the change in prevalence from baseline, and the difference in these changes between intervention and control groups were estimated using a mixed-effects logistic regression model.

Results: The intervention reduced the risk of pre-frailty/frailty up to 7 years. The prevalence decreased in the intervention group from baseline (47%) to 2 years (42%), while it increased in the control group (45% to 49%), resulting in a -9.6-percentage point difference in the change (p = 0.007). After the active intervention period, the prevalence began to increase in both groups, but the difference in the change remained in favor of the intervention group at 7 years (-6.2 percentage points, p = 0.049). The beneficial effect was no longer evident at 11 years. Older age, lower protein intake, and a higher number of chronic diseases were strongly associated with pre-frailty/frailty.

Conclusions: A 2-year multimodal lifestyle intervention effectively prevented phenotypic pre-frailty/frailty, with sustained benefits observed up to 7 years. Continuous support for a healthy lifestyle may be necessary to prevent late-life pre-frailty or frailty.

Keywords: frailty; multidomain lifestyle intervention; pre‐frailty; protein intake.

Abstract

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