Specific multimorbidity patterns modify the impact of an exercise intervention in older hospitalized adults
Background Different multimorbidity patterns present with different prognoses, but it is unknown to what extent they may influence the effectiveness of an individualized multicomponent exercise program offered to hospitalized older adults. Methods This study is a secondary analysis of a randomized c...
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2022-12-01
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| Series: | Journal of Multimorbidity and Comorbidity |
| Online Access: | https://doi.org/10.1177/26335565221145461 |
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| author | Nicolas Martínez-Velilla MD, PhD Arkaitz Galbete PhD Albert Roso-Llorach MSc Fabricio Zambom-Ferraresi PhD Mikel L Sáez de Asteasu PhD Mikel Izquierdo PhD Davide L Vetrano MD, PhD Amaia Calderón-Larrañaga MPH PhD |
| author_facet | Nicolas Martínez-Velilla MD, PhD Arkaitz Galbete PhD Albert Roso-Llorach MSc Fabricio Zambom-Ferraresi PhD Mikel L Sáez de Asteasu PhD Mikel Izquierdo PhD Davide L Vetrano MD, PhD Amaia Calderón-Larrañaga MPH PhD |
| author_sort | Nicolas Martínez-Velilla MD, PhD |
| collection | DOAJ |
| description | Background Different multimorbidity patterns present with different prognoses, but it is unknown to what extent they may influence the effectiveness of an individualized multicomponent exercise program offered to hospitalized older adults. Methods This study is a secondary analysis of a randomized controlled trial conducted in the Department of Geriatric Medicine of a tertiary hospital. In addition to the standard care, an exercise-training multicomponent program was delivered to the intervention group during the acute hospitalization period. Multimorbidity patterns were determined through fuzzy c-means cluster analysis, over 38 chronic diseases. Functional, cognitive and affective outcomes were considered. Results Three hundred and six patients were included in the analyses (154 control; 152 intervention), with a mean age of 87.2 years, and 58.5% being female. Four patterns of multimorbidity were identified: heart valves and prostate diseases (26.8%); metabolic diseases and colitis (20.6%); psychiatric, cardiovascular and autoimmune diseases (16%); and an unspecific pattern (36.6%). The Short Physical Performance Battery (SPPB) test improved across all patterns, but the intervention was most effective for patients in the metabolic/colitis pattern (2.48-point difference between intervention/control groups, 95% CI 1.60-3.35). Regarding the Barthel Index and the Mini Mental State Examination (MMSE), the differences were significant for all multimorbidity patterns, except for the psychiatric/cardio/autoimmune pattern. Differences concerning quality of life were especially high for the p sychiatric/cardio/autoimmune pattern (16.9-point difference between intervention/control groups, 95% CI 4.04, 29.7). Conclusions Patients in all the analyzed multimorbidity patterns improved with this tailored program, but the improvement was highest for those in the metabolic pattern. Understanding how different chronic disease combinations are associated with specific functional and cognitive responses to a multicomponent exercise intervention may allow further tailoring such interventions to older patients’ clinical profile. |
| format | Article |
| id | doaj-art-666f8697805a45d5b31b4e0f061e052e |
| institution | OA Journals |
| issn | 2633-5565 |
| language | English |
| publishDate | 2022-12-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Multimorbidity and Comorbidity |
| spelling | doaj-art-666f8697805a45d5b31b4e0f061e052e2025-08-20T02:33:31ZengSAGE PublishingJournal of Multimorbidity and Comorbidity2633-55652022-12-011210.1177/26335565221145461Specific multimorbidity patterns modify the impact of an exercise intervention in older hospitalized adultsNicolas Martínez-Velilla MD, PhDArkaitz Galbete PhDAlbert Roso-Llorach MScFabricio Zambom-Ferraresi PhDMikel L Sáez de Asteasu PhDMikel Izquierdo PhDDavide L Vetrano MD, PhDAmaia Calderón-Larrañaga MPH PhDBackground Different multimorbidity patterns present with different prognoses, but it is unknown to what extent they may influence the effectiveness of an individualized multicomponent exercise program offered to hospitalized older adults. Methods This study is a secondary analysis of a randomized controlled trial conducted in the Department of Geriatric Medicine of a tertiary hospital. In addition to the standard care, an exercise-training multicomponent program was delivered to the intervention group during the acute hospitalization period. Multimorbidity patterns were determined through fuzzy c-means cluster analysis, over 38 chronic diseases. Functional, cognitive and affective outcomes were considered. Results Three hundred and six patients were included in the analyses (154 control; 152 intervention), with a mean age of 87.2 years, and 58.5% being female. Four patterns of multimorbidity were identified: heart valves and prostate diseases (26.8%); metabolic diseases and colitis (20.6%); psychiatric, cardiovascular and autoimmune diseases (16%); and an unspecific pattern (36.6%). The Short Physical Performance Battery (SPPB) test improved across all patterns, but the intervention was most effective for patients in the metabolic/colitis pattern (2.48-point difference between intervention/control groups, 95% CI 1.60-3.35). Regarding the Barthel Index and the Mini Mental State Examination (MMSE), the differences were significant for all multimorbidity patterns, except for the psychiatric/cardio/autoimmune pattern. Differences concerning quality of life were especially high for the p sychiatric/cardio/autoimmune pattern (16.9-point difference between intervention/control groups, 95% CI 4.04, 29.7). Conclusions Patients in all the analyzed multimorbidity patterns improved with this tailored program, but the improvement was highest for those in the metabolic pattern. Understanding how different chronic disease combinations are associated with specific functional and cognitive responses to a multicomponent exercise intervention may allow further tailoring such interventions to older patients’ clinical profile.https://doi.org/10.1177/26335565221145461 |
| spellingShingle | Nicolas Martínez-Velilla MD, PhD Arkaitz Galbete PhD Albert Roso-Llorach MSc Fabricio Zambom-Ferraresi PhD Mikel L Sáez de Asteasu PhD Mikel Izquierdo PhD Davide L Vetrano MD, PhD Amaia Calderón-Larrañaga MPH PhD Specific multimorbidity patterns modify the impact of an exercise intervention in older hospitalized adults Journal of Multimorbidity and Comorbidity |
| title | Specific multimorbidity patterns modify the impact of an exercise intervention in older hospitalized adults |
| title_full | Specific multimorbidity patterns modify the impact of an exercise intervention in older hospitalized adults |
| title_fullStr | Specific multimorbidity patterns modify the impact of an exercise intervention in older hospitalized adults |
| title_full_unstemmed | Specific multimorbidity patterns modify the impact of an exercise intervention in older hospitalized adults |
| title_short | Specific multimorbidity patterns modify the impact of an exercise intervention in older hospitalized adults |
| title_sort | specific multimorbidity patterns modify the impact of an exercise intervention in older hospitalized adults |
| url | https://doi.org/10.1177/26335565221145461 |
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