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Association of 3‐Year Multidomain Intervention and Omega‐3 Supplementation with Frailty Incidence
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International audience. OBJECTIVES To assess the associations of long‐term lifestyle multidomain intervention (MI) and omega‐3 supplementation with frailty level evolution and frailty incidence in community‐dwelling older persons. DESIGN Secondary analysis of the randomized controlled Multidomain Alzheimer Preventive Trial. SETTING Thirteen memory centers in France and Monaco between 2008 and 2011. PARTICIPANTS A total of 1588 community‐dwelling persons aged 70 years or older with memory complaints (without dementia), slow gait speed, or limitation in one instrumental activity of daily living. INTERVENTION A 3‐year MI (43 group sessions including cognitive training, physical activity, and nutrition advice and three preventive consultations) plus daily omega‐3 fatty acids, MI plus placebo, omega‐3 alone, or placebo alone. MEASUREMENTS The frailty phenotype (unintentional weight loss, exhaustion, low physical activity, slow gait, low handgrip strength: 0 to 5 score, higher is worse; a score of 3 or higher defines frailty) was assessed at baseline, 6, 12, 24, and 36 months. We used mixed‐effect models for frailty level (0‐5 score as an ordinal variable) and Cox models for frailty incidence. RESULTS No differences were found between the intervention groups and placebo on the 3‐year evolution of frailty level. Among 1394 non‐frail participants at baseline, frailty incidence occurred in 134 (9.6%) persons: 26 (7.6%) in the MI plus omega‐3 group, 34 (10%) in the omega‐3 alone group, 31 (8.5%) in the MI plus placebo group, and 43 (12.3%) in the placebo‐alone group). No differences regarding frailty incidence were found between intervention groups and placebo. After exclusion of 53 participants with incident frailty during the first year of follow‐up, MI plus omega‐3 was associated with a lower frailty incidence compared with placebo (hazard ratio = .43; 95% confidence interval = .22‐.81). CONCLUSION In community‐dwelling older persons, the combination of a long‐term lifestyle MI and omega‐3 supplementation did not reduce frailty level or incidence. The reduction of frailty incidence associated with the combined intervention in a sensitivity analysis needs to be further confirmed. J Am Geriatr Soc 67:1700–1706, 2019
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