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초록

Objectives To assess the effect of a 24-week comprehensive multicomponent intervention on institutionalization-free survival, physical performance, and frailty among older adults with sarcopenia.Design A post-hoc analysis of a prospective, non-randomized intervention study with 1:1 propensity score matching.Setting Community-dwelling, socioeconomically vulnerable older adults.Participants A total of 283 older adults with sarcopenia were included, with 145 in the intervention group and 138 in the control group. After propensity score matching, 102 pairs were analyzed. The mean age was 77.57 years (intervention) and 77.64 years (control), with 82.4 and 81.4% females in each group, respectively.Intervention The multicomponent intervention consisted of exercise, nutritional support, depression management, deprescribing, and home hazard reduction, implemented over 24 weeks.Measurements The primary outcome was 30-month institutionalization-free survival. Secondary outcomes included changes in physical performance (Short Physical Performance Battery [SPPB] scores, gait speed) and frailty index over 6, 18, and 30 months.Results Following propensity score matching, mortality and institutionalization occurred in 13 (12.7%) and 35 (34.3%) participants in the intervention and control groups, respectively. A significant difference in 30-months institutionalization-free survival was observed between the intervention and control groups (63.4% vs. 87.2%). The intervention group had significantly higher SPPB scores and improved gait speed at 6 months, 18 months, and 30 months. The intervention group showed a significantly lower frailty index only at 6 months but similar scores at 18 and 30 months.Conclusion The multicomponent intervention significantly improved long-term institutionalization-free survival and physical function in older adults with sarcopenia, highlighting its potential to enhance independence and reduce frailty in vulnerable populations.

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