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Volume 330:1769-1775 June 23, 1994 Number 25 Next

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ABSTRACT

Background Although disuse of skeletal muscle and undernutrition are often cited as potentially reversible causes of frailty in elderly people, the efficacy of interventions targeted specifically at these deficits has not been carefully studied.

Methods We conducted a randomized, placebo-controlled trial comparing progressive resistance exercise training, multinutrient supplementation, both interventions, and neither in 100 frail nursing home residents over a 10-week period.

Results The mean (±SE) age of the 63 women and 37 men enrolled in the study was 87.1 ±0.6 years (range, 72 to 98); 94 percent of the subjects completed the study. Muscle strength increased by 113 ±8 percent in the subjects who underwent exercise training, as compared with 3 ±9 percent in the nonexercising subjects (P<0.001). Gait velocity increased by 11.8 ±3.8 percent in the exercisers but declined by 1.0 ±3.8 percent in the nonexercisers (P = 0.02). Stair-climbing power also improved in the exercisers as compared with the nonexercisers (by 28.4 ±6.6 percent vs. 3.6 ±6.7 percent, P = 0.01), as did the level of spontaneous physical activity. Cross-sectional thigh-muscle area increased by 2.7 ±1.8 percent in the exercisers but declined by 1.8 ±2.0 percent in the nonexercisers (P = 0.11). The nutritional supplement had no effect on any primary outcome measure. Total energy intake was significantly increased only in the exercising subjects who also received nutritional supplementation.

Conclusions High-intensity resistance exercise training is a feasible and effective means of counteracting muscle weakness and physical frailty in very elderly people. In contrast, multinutrient supplementation without concomitant exercise does not reduce muscle weakness or physical frailty.

Source Information

From the Hebrew Rehabilitation Center for Aged, Roslindale, Mass. (M.A.F., E.F.O., K.M.C., L.A.L.); and the Department of Agriculture Human Nutrition Research Center on Aging, Tufts University (M.A.F., N.D.R., M.E.N., S.B.R., J.J.K., W.J.E.); the Division on Aging, Harvard Medical School (M.A.F., L.A.L.); the Department of Medicine, Beth Israel Hospital (M.A.F., L.A.L.); the Gerontology Division, Brigham and Women's Hospital (M.A.F., L.A.L.); and the Division of Medical Physics, Department of Radiation Oncology, New England Medical Center (G.R.S.) -- all in Boston. Presented in part at the meeting of the American College of Sports Medicine, Orlando, Fla., May 29-June 1, 1991, and at the symposia of the American Geriatrics Society, New Orleans, Nov. 15-19, 1993, and the Gerontological Society of America, New Orleans, Nov. 19-23, 1993.The contents of this article do not necessarily reflect the views or policies of the U.S. Department of Agriculture, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. government.

Address reprint requests to Dr. Fiatarone at the Human Nutrition Research Center on Aging, 711 Washington St., Boston, MA 02111.

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Exercise Training for Very Elderly People
Leveille S. G., LaCroix A. Z., Moore G. E., Fiatarone M. A.
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N Engl J Med 1994; 331:1237-1238, Nov 3, 1994. Correspondence

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