Weight loss alone or exercise alone improves physical function and ameliorates frailty in obese older adults. However, a combination of weight loss and exercise provides greater benefit than either intervention alone.
Villareal and coworkers conducted a randomized controlled trial of 107 obese older adults. Patients were randomly assigned to a control, weight-management (diet), exercise, or weight-management-plus-exercise (diet-exercise) group. The primary outcome was the change in the score on the modified Physical Performance Test, a measure of frailty. Secondary outcomes included other measures of frailty, body composition, and quality of life.
The mean scores on the Physical Performance Test increased more in the diet-exercise group (21%) than in the diet (12%) or exercise group (15%); control group scores increased by 1%. The peak oxygen consumption improved more in the diet-exercise group (17%) than in the diet (10%) or exercise group (8%). The score on the Functional Status Questionnaire increased more in the diet-exercise group (10%) than in the diet group (4%). Body weight decreased by 10% in the diet group and by 9% in the diet-exercise group.
The authors noted that frailty is an important problem in older patients because it leads to loss of independence and increased morbidity and mortality.