{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:46:01Z","timestamp":1791506761553,"version":"4.3.4"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2016,8,26]],"date-time":"2016-08-26T00:00:00Z","timestamp":1472169600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"National Health Research Institutes, Zhunan, Taiwan","award":["HD-097-SP-08"],"award-info":[{"award-number":["HD-097-SP-08"]}]},{"name":"National Health Research Institutes, Zhunan, Taiwan","award":["PH-98-SP-10"],"award-info":[{"award-number":["PH-98-SP-10"]}]},{"name":"National Health Research Institutes, Zhunan, Taiwan","award":["PH-99-SP-09"],"award-info":[{"award-number":["PH-99-SP-09"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Exercise, nutrition, and psychological interventions may all have positive impacts on frailty and sarcopenia. However, it is not known whether an integrated care programme with all three components can be beneficial and the intensity of such programme is also not certain. In this study, we aim to determine the effectiveness of two levels of integrated care on frailty and sarcopenia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A randomized control trial was conducted at two community hospitals in Taiwan. Older adults (65\u201379\u2009years of age, <jats:italic>N<\/jats:italic>\u2009=\u2009289) who scored \u22651 on the Cardiovascular Health Study Phenotypic Classification of Frailty (CHS_PCF) were enrolled in the trial. Low\u2010level care (LLC) participants received a 2\u2009h education course on frailty, sarcopenia, coping strategy, nutrition, and demonstration of study exercise programme. Educational multimedia material was distributed as reference for home practice with bi\u2010monthly telephone follow\u2010ups on adherences. High\u2010level care (HLC) participants, in addition to LLC instructions, received six sessions of on\u2010site problem solving therapy and 48 exercise sessions within 6\u2009months. Brief nutrition consultation was also provided during the exercise sessions. Primary outcome was improvement of the CHS_PCF by at least one category (from pre\u2010frail to robust, or from frail to pre\u2010frail or robust) from baseline. Secondary outcomes included changes of individual frailty, and sarcopenia indicators. Assessments were done at 3, 6, and 12\u2009months by trained research assistants blinded to randomization status. Intention\u2010to\u2010treat analysis was applied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mean age was 71.6\u2009\u00b1\u20094.3\u2009years, with 53% females. For the entire cohort, improvement of primary outcome was 35% at 3\u2009months, increased to 40% at 6\u2009months, and remained stable at 39% at 12\u2009months. Improvement rates were similar in both groups. Compared with the LLC group, HLC participants had greater improvements in the following indices: energy expenditure of walking, 5\u2009m walking time, dominant hand grip strength, timed\u2010up\u2010and\u2010go\u2010test, and one\u2010leg\u2010stand time \u2014 mainly at 6 and 12\u2009month assessments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The 6\u2009month integrated care improved frailty and sarcopenia status among community\u2010dwelling elders, with high\u2010intensity training yielding greater improvements. Low\u2010level care could be promoted as a basic intervention, while HLC could be reserved for those at high risk and with high motivation.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcsm.12132","type":"journal-article","created":{"date-parts":[[2016,8,26]],"date-time":"2016-08-26T09:10:09Z","timestamp":1472202609000},"page":"78-88","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":87,"title":["Integrated care for geriatric frailty and sarcopenia: a randomized control trial"],"prefix":"10.1002","volume":"8","author":[{"given":"Ding\u2010Cheng (Derrick)","family":"Chan","sequence":"first","affiliation":[{"name":"Department of Geriatrics and Gerontology, and Department of Internal Medicine National Taiwan University Hospital  Taipei Taiwan"},{"name":"Superintendent Office National Taiwan University Hospital Chu\u2010Tung Branch  Hsin\u2010Chu County 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Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jau\u2010Yih","family":"Tsauo","sequence":"additional","affiliation":[{"name":"School and Graduate Institute of Physical Therapy, College of Medicine National Taiwan University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ching\u2010Yu","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Family Medicine National Taiwan University Hospital  Taipei Taiwan"},{"name":"Division of Gerontology, Institute of Population Health Sciences National Health Research Institutes  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chin\u2010Fu","family":"Hsiao","sequence":"additional","affiliation":[{"name":"Division of Biostatistics and Bioinformatics, Institute of Population Health Sciences National Health Research Institutes  Zhunan Taiwan"},{"name":"Division of Clinical Trial Statistics, Institute of Population Health Sciences National Health Research Institutes  Zhunan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya\u2010Ting","family":"Hsu","sequence":"additional","affiliation":[{"name":"Division of Biostatistics and Bioinformatics, Institute of Population Health Sciences National Health Research Institutes  Zhunan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia\u2010Hui","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Shuang Ho Hospital Taipei Medical University  New Taipei City Taiwan"},{"name":"Division of Mental Health and Addiction Medicine, Institute of Population Health Sciences National Health Research Institutes  Zhunan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu\u2010Fang","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Nursing, College of Nursing National Taipei University of Nursing and Health Sciences  Taipei 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