{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T14:46:39Z","timestamp":1790952399989,"version":"4.1.0"},"reference-count":46,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,3,5]],"date-time":"2020-03-05T00:00:00Z","timestamp":1583366400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100011912","name":"Taipei Veterans General Hospital","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100011912","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100013227","name":"Health Promotion Administration, Ministry of Health and Welfare","doi-asserted-by":"publisher","award":["MOHW105\u2010HPA\u2010H\u2010124\u2010144101"],"award-info":[{"award-number":["MOHW105\u2010HPA\u2010H\u2010124\u2010144101"]}],"id":[{"id":"10.13039\/100013227","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Frailty is the pre\u2010eminent exigency of aging. Although frailty\u2010related impairments are preventable, and multidomain interventions appear more effective than unimodal ones, the optimal components remain uncertain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We devised multidomain interventions against physical and cognitive decline among prefrail\/frail community\u2010dwelling \u226565\u2010year\u2010olds and evaluated these in complementary cluster\u2010randomized trials of efficacy and participant empowerment. The <jats:italic>Efficacy Study<\/jats:italic> compared ~3\u2010monthly telephone consultations vs. 16, 2 h sessions\/year comprising communally partaken physical and cognitive training plus nutrition and disease education; the <jats:italic>Empowerment Study<\/jats:italic> compared the standard <jats:italic>Efficacy Study<\/jats:italic> multidomain intervention (Sessions 1\u201310) vs. an enhanced version redesigned to empower and motivate individual participants. Changes from baseline in physical, functional, and cognitive performance were measured after 6 and 12 months in the <jats:italic>Efficacy Study<\/jats:italic> and after 6 months in the <jats:italic>Empowerment Study<\/jats:italic>, with post\u2010intervention follow\u2010up at 9 months. Primary outcomes are as follows: Cardiovascular Health Study frailty score; gait speed; handgrip strength; and Montreal Cognitive Assessment (MoCA). Secondary outcomes are as follows: instrumental activities of daily living; metabolic equivalent of task (MET); depressed mood (Geriatric Depression Scale\u20105 \u22652); and malnutrition (Mini\u2010Nutritional Assessment short\u2010form \u226411). Intervention effects were analyzed using a generalized linear mixed model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p><jats:italic>Efficacy Study<\/jats:italic> participants (<jats:italic>n<\/jats:italic> = 1082, 40 clusters) were 75.1 \u00b1 6.3 years old, 68.7% women, and 64.7% prefrail\/frail; analytic clusters: 19 intervention (410\/549 completed) vs. 21 control (375\/533 completed). <jats:italic>Empowerment Study<\/jats:italic> participants (<jats:italic>n<\/jats:italic> = 440, 14 clusters) were 75.9 \u00b1 7.1 years old, 83.6% women, and 56.7% prefrail\/frail; analytic clusters: seven intervention (209\/230 completed) vs. seven control (189\/210 completed). The standard and enhanced multidomain interventions both reduced frailty and significantly improved aspects of physical, functional, and cognitive performance, especially among \u226575\u2010year\u2010olds. Standard multidomain intervention decreased depression [odds ratio 0.56, 95% confidence interval (CI) 0.32, 0.99] and malnutrition (odds ratio 0.45, 95% CI 0.26, 0.78) by 12 months and improved concentration at Months 6 (0.23, 95% CI 0.04, 0.42) and 12 (0.46, 95% CI 0.22, 0.70). Participant empowerment augmented activity (4.67 MET\/h, 95% CI 1.64, 7.69) and gait speed (0.06 m\/s, 95% CI 0.00, 0.11) at 6 months, with sustained improvements in delayed recall (0.63, 95% CI 0.20, 1.06) and MoCA performance (1.29, 95% CI 0.54, 2.03), and less prevalent malnutrition (odds ratio 0.39, 95% CI 0.18, 0.84), 3 months after the intervention ceased.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Pragmatic multidomain intervention can diminish physical frailty, malnutrition, and depression and enhance cognitive performance among community\u2010dwelling elders, especially \u226575\u2010year\u2010olds; this might supplement healthy aging policies, probably more effectively if participants are empowered.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcsm.12534","type":"journal-article","created":{"date-parts":[[2020,3,5]],"date-time":"2020-03-05T12:42:03Z","timestamp":1583412123000},"page":"650-662","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":133,"title":["Efficacy of multidomain interventions to improve physical frailty, depression and cognition: data from cluster\u2010randomized controlled trials"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2387-8508","authenticated-orcid":false,"given":"Liang\u2010Kung","family":"Chen","sequence":"first","affiliation":[{"name":"Center for Geriatrics and Gerontology Taipei Veterans General Hospital  Taipei Taiwan"},{"name":"Aging and Health Research Center National Yang Ming University  Taipei Taiwan"},{"name":"Department of Geriatric Medicine National Yang Ming University School of Medicine  Taipei 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Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li\u2010Ning","family":"Peng","sequence":"additional","affiliation":[{"name":"Center for Geriatrics and Gerontology Taipei Veterans General Hospital  Taipei Taiwan"},{"name":"Aging and Health Research Center National Yang Ming University  Taipei Taiwan"},{"name":"Department of Geriatric Medicine National Yang Ming University School of Medicine  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming\u2010Hsien","family":"Lin","sequence":"additional","affiliation":[{"name":"Center for Geriatrics and Gerontology Taipei Veterans General Hospital  Taipei Taiwan"},{"name":"Aging and Health Research Center National Yang Ming University  Taipei Taiwan"},{"name":"Department of Geriatric Medicine National Yang Ming University School of Medicine  Taipei 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