Effects of a multidomain intervention on physical performance and sarcopenia in long-term care facility residents: The I-COUNT pilot randomized controlled trial

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BACKGROUND: Population aging requires multidimensional strategies to preserve physical function and prevent sarcopenia. The I-COUNT pilot study evaluated the effect of a multidomain intervention in long-term care facilities (LTCFs) residents, hypothesizing improvements in physical performance, muscle strength, and sarcopenia compared to usual care. METHODS: Residents aged ≥70 years from two Italian LTCFs were screened, and 90 participants were enrolled in a 6-month pilot cluster-randomized controlled trial and allocated to a multidomain intervention (physical training, cognitive stimulation, Mediterranean diet enriched with functional foods, and vaccination promotion) or usual care. Physical performance (Short Physical Performance Battery, SPPB), handgrip strength, body composition, and sarcopenia according to European Working Group on Sarcopenia in Older People (EWGSOP2) criteria were assessed at baseline and after 6 months. Changes over time were analyzed using mixed-effects models adjusted for age, sex, and study center. RESULTS: Baseline characteristics were comparable between groups. At 6 months, participants receiving the intervention showed significant improvements in physical performance (SPPB: +1.6 points vs. + 0.3 in controls; between-group difference: +1.8 points, p = 0.001), and muscle strength (handgrip: +3.2 kg vs. -0.1 kg in controls; between-group difference: +3.8 kg, p = 0.026). No significant between-group differences were found for the 6-minute walk test or anthropometric measures. Appendicular skeletal muscle mass (ASMM) tended to be preserved in the intervention group while declining in controls (between-group difference approaching +0.9 kg, p = 0.057). Sarcopenia prevalence decreased in the intervention group (37.1% to 15.4%) and remained stable in controls (28.4% to 29.9%), with a borderline group-by-time interaction (p = 0.109). CONCLUSIONS: A multidomain intervention is safe, feasible, and potentially effective for improving physical performance and preventing the progression of sarcopenia in LTCF residents. Given the pilot nature of this study, these findings warrant confirmation through larger randomized controlled trials. CLINICAL TRIAL NUMBER: NCT06820710.

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