Casas Herrero, Álvaro
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Casas Herrero
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Álvaro
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Ciencias de la Salud
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Publication Open Access Multicomponent exercise program and functional capacity in institutionalized frail and cognitive impairment nonagerians(2013) Casas Herrero, Álvaro; Izquierdo Redín, Mikel; Rodríguez Mañas, Leocadio; Ciencias de la Salud; Osasun ZientziakThe conclusions of the present Doctoral Thesis were that: 1) Multicomponent exercise programs are efficient strategies to prevent disability and other frailty domains such falls, cognitive decline and depression in frail aged patients. However, it is necessary to explore optimal resistance training components and develop specific clinical guides of physical activity for this target population (Review article). 2) Frail oldest old with and without MCI share functional and neuromuscular outcomes (Study I). 3) Routine multicomponent exercise intervention should be prescribed to frail nonagenarians because overall physical outcomes are improved in this population. (Study II). 4) Systematic multicomponent exercise intervention improved muscle strength, balance and gait ability in frail elderly patients with dementia, even after long-term physical restraint, and these benefits were lost after training cessation (Study III).Publication Open Access Impact on physical function of the +AGIL Barcelona program in community-dwelling older adults with cognitive impairment: an interventional cohort study(BMC, 2023) Arnal, Cristina; Pérez, Mónica L.; Soto, Luis; Casas Herrero, Álvaro; Ars, Joan; Baró, Sonia; Díaz, Francisco; Abilla, Araceli; Enfedaque, M. Belén; Cesari, Matteo; Inzitari, Marco; Ciencias de la Salud; Osasun ZientziakBackground: Older adults with cognitive impairment (CI) have higher multimorbidity and frailty prevalence, lower functional status and an increased likelihood to develop dementia, non-cognitive deficits, and adverse health-related events. +AGIL, a real-world program for frail older adults in a primary care area of Barcelona, is a pragmatic, multi-component and integrated intervention implemented since 2016. It includes physical activity, nutrition, sleep hygiene, revision and adequacy of pharmacological treatment, detection of undesired loneliness and screening for CI; to improve physical function in community-dwelling older adults. We aimed to assess the + AGIL longitudinal impact on physical function among community-dwelling frail older persons with CI. Methods: An interventional cohort study included data from all the + AGIL consecutive participants from July 2016 until March 2020. Based on the comprehensive geriatric assessment, participants were offered a tailored multi-component community intervention, including a 10-week physical activity program led by an expert physical therapist. Physical performance was measured at baseline, three and six months follow-up. The pre-post impact on physical function was assessed by paired sample t-test for repeated samples. Linear mixed models were applied to analyze the + AGIL longitudinal impact. P-values < 0.05 were considered statistically significant. Results: 194 participants were included (82 with CI, based on previous diagnosis or the Mini-COG screening tool), 68% women, mean age 81.6 (SD = 5.8) yo. Participants were mostly independent in Activities of Daily Living (mean Barthel = 92.4, SD = 11.1). The physical activity program showed high adherence (87.6% attended ≥ 75% sessions). At three months, there was a clinically and statistically significant improvement in the Short Physical Performance Battery (SPPB) and its subcomponents in the whole sample and after stratification for CI [CI group improvements: SPPB = 1.1 (SD = 1.8) points, gait speed (GS) = 0.05 (SD = 0.13) m/s, Chair stand test (CST)=-2.6 (SD = 11.4) s. Non-CI group improvements: SPPB = 1.6 (SD = 1.8) points, GS = 0.08 (SD = 0.13) m/s, CST=-6.4 (SD = 12.1) seg]. SPPB and gait speed remained stable at six months in the study sample and subgroups. CI had no significant impact on SPPB or GS improvements. Conclusion: Our results suggest that older adults with CI can benefit from a multidisciplinary integrated and comprehensive geriatric intervention to improve physical function, a component of frailty.