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Specific multimorbidity patterns modify the impact of an exercise intervention in older hospitalized adults

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dc.contributor.authorMartínez Velilla, Nicolás
dc.contributor.authorGalbete Jiménez, Arkaitz
dc.contributor.authorRoso Llorach, Albert
dc.contributor.authorZambom Ferraresi, Fabrício
dc.contributor.authorLópez Sáez de Asteasu, Mikel
dc.contributor.authorIzquierdo Redín, Mikel
dc.contributor.authorVetrano, Davide L.
dc.contributor.authorCalderón Larrañaga, Amaia
dc.contributor.departmentCiencias de la Saludes_ES
dc.contributor.departmentOsasun Zientziakeu
dc.contributor.funderGobierno de Navarra / Nafarroako Gobernuaes
dc.date.accessioned2023-02-21T08:50:21Z
dc.date.available2023-02-21T08:50:21Z
dc.date.issued2022
dc.date.updated2023-02-21T08:38:03Z
dc.description.abstractBackground: 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 psychiatric/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.en
dc.description.sponsorshipThe author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article. This work was supported by the Gobierno de Navarra project grant 2186/2014 and acknowledged with the “Beca Ortiz de Landázuri” as the best research clinical project in 2014, as well as by a research grant PI17/01814 of the Ministerio de Economía, Industria y Competitividad (ISCIII, FEDER). Additional contributions: NM-V received funding from “la Caixa” Foundation (ID 100010434), under agreement LCF/PR/PR15/51100006.en
dc.format.mimetypeapplication/pdfen
dc.identifier.citationMartínez-Velilla, N., Galbete, A., Roso-Llorach, A., Zambom-Ferraresi, F., Sáez De Asteasu, M. L., Izquierdo, M., Vetrano, D. L., & Calderón-Larrañaga, A. (2022). Specific multimorbidity patterns modify the impact of an exercise intervention in older hospitalized adults. Journal of Multimorbidity and Comorbidity, 12, 263355652211454. https://doi.org/10.1177/26335565221145461en
dc.identifier.doi10.1177/26335565221145461
dc.identifier.issn2633-5565
dc.identifier.urihttps://academica-e.unavarra.es/handle/2454/44765
dc.language.isoengen
dc.publisherSAGEen
dc.relation.ispartofJournal of Multimorbidity and Comorbidity 12, 1-12en
dc.relation.projectIDinfo:eu-repo/grantAgreement/ISCIII/Plan Estatal de Investigación Científica y Técnica y de Innovación 2013-2016 (ISCIII)/PI17%2F01814/ES/en
dc.relation.publisherversionhttps://doi.org/10.1177/26335565221145461
dc.rightsCreative Commons Non Commercial CC BY-NCen
dc.rights.accessRightsinfo:eu-repo/semantics/openAccess
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0/
dc.subjectHospital admissionen
dc.subjectExercise interventionen
dc.subjectMultimorbidity patternsen
dc.titleSpecific multimorbidity patterns modify the impact of an exercise intervention in older hospitalized adultsen
dc.typeinfo:eu-repo/semantics/article
dc.type.versionVersión publicada / Argitaratu den bertsioaes
dc.type.versioninfo:eu-repo/semantics/publishedVersionen
dspace.entity.typePublication
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