PREPA PREvention of Loss of Autonomy

"Evaluation carried out during a day hospital at T0 (initial assessment) and T3 following the exercise program including:~1. Clinical assessment by a geriatrician~2. Nutritional assessment~3. Physical capacity assessment~Following initial assessment (T0), older adults are included in the multicomponent exercise program if they present mobility disability risk factors including :~* At least pre-frailty regarding Fried frailty criteria AND/OR~* At least probable sarcopenia regarding EWGSOP2 algorithm AND/OR~* The presence of at least an intermediate fall risk AND/OR~* The presence of a fear of falling Following the exercise program (T3), all participants are re-assessed in the same way as T0. Investigators then set goals in physical activity with participants to maintain benefits and foster self-engagement in an healthy lifestyle. Additionnally, participants are orientated to exercise facilities and received an individualized booklet of exercises for home-based training."

The intervention consists in a progressive multicomponent exercise training protocol. There are 2 sessions per week of 1 hour each for a total of 12 weeks. Sessions involve functional, resistance and balance exercises. Intensity is based on rating perceived effort (Borg's scale CR1-10) and volume towards 1 to 3 sets of 6 to 15 repetitions. Progressiveness in intensity and volume was based on effort tolerance, contraction regimen, velocity and load. Training schedule is described elsewhere (Delaire et al, 2023 ; doi.org/10.3390/nu15194100). Participants are allocated to an homogenous group based on functional status and cardiorespiratory comorbidities. Trained kinesiologists supervised the exercise program. Participants used free weights and elastic bands.

"Follow-up at T3+6 months:~Investigators interviewed participants for 30 minutes. During the interview, data collection include:record of undesirable events in the interval T3 / T3+6 (falls, unscheduled hospitalization, illness, institutionalization), medication changes, ADL, IADL, FES-I, and RAPA. Goal-settings at T3 are adjusted if not reach. Finally, investigators stimulate intrinsic motivation for PA.~Follow-up at T3 + 12 months:~Investigators re-assessed physical capacity, physical activity level, quality of life, fall risk and frailty for the last visit. Data collection include:~* SPPB~* Handgrip test and maximal isometric strength of the quadriceps~* Questionnaires : SarQoL©, FES-I, RAPA~* Gait quality analysis using inertial sensors~* Undesirable events in the interval T3+6 / T3+12 (falls, unscheduled hospitalization, illness, institutionalization)~* Medication changes~* Body mass index~* ADL and IADL At last, goals in physical activity are adjusted if they are still not reach"