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Effect of a Nutrition Supplement and Physical Activity Program on Pneumonia and Walking Capacity in Chilean Older People: A Factorial Cluster Randomized Trial

Authordc.contributor.authorDangour, Alan D. 
Authordc.contributor.authorAlbala Brevis, Cecilia es_CL
Authordc.contributor.authorAllen, Elizabeth es_CL
Authordc.contributor.authorGrundy, Emily es_CL
Authordc.contributor.authorWalker, Damian G. es_CL
Authordc.contributor.authorAedo, Cristian es_CL
Authordc.contributor.authorSánchez, Hugo es_CL
Authordc.contributor.authorFletcher, Olivia es_CL
Authordc.contributor.authorElbourne, Diana es_CL
Authordc.contributor.authorUauy Dagach-Imbarack, Ricardo es_CL
Admission datedc.date.accessioned2011-06-14T14:13:25Z
Available datedc.date.available2011-06-14T14:13:25Z
Publication datedc.date.issued2011-04
Cita de ítemdc.identifier.citationPLOS MEDICINE Volume: 8 Issue: 4 Article Number: e1001023 Published: APR 2011es_CL
Identifierdc.identifier.issn1549-1277
Identifierdc.identifier.otherDOI: 10.1371/journal.pmed.1001023
Identifierdc.identifier.urihttp://repositorio.uchile.cl/handle/2250/123982
General notedc.descriptionArtículo de publicación ISIes_CL
Abstractdc.description.abstractBackground: Ageing is associated with increased risk of poor health and functional decline. Uncertainties about the health-related benefits of nutrition and physical activity for older people have precluded their widespread implementation. We investigated the effectiveness and cost-effectiveness of a national nutritional supplementation program and/or a physical activity intervention among older people in Chile. Methods and Findings: We conducted a cluster randomized factorial trial among low to middle socioeconomic status adults aged 65-67.9 years living in Santiago, Chile. We randomized 28 clusters health centers) into the study and recruited 2,799 individuals in 2005 (similar to 100 per cluster). The interventions were a daily micronutrient-rich nutritional supplement, or two 1-hour physical activity classes per week, or both interventions, or neither, for 24 months. The primary outcomes, assessed blind to allocation, were incidence of pneumonia over 24 months, and physical function assessed by walking capacity 24 months after enrolment. Adherence was good for the nutritional supplement (similar to 75%), and moderate for the physical activity intervention (similar to 43%). Over 24 months the incidence rate of pneumonia did not differ between intervention and control clusters 32.5 versus 32.6 per 1,000 person years respectively; risk ratio = 1.00; 95% confidence interval 0.61-1.63; p = 0.99). In intention-to-treat analysis, after 24 months there was a significant difference in walking capacity between the intervention and control clusters mean difference 33.8 meters; 95% confidence interval 13.9-53.8; p = 0.001). The overall cost of the physical activity intervention over 24 months was US$164/participant; equivalent to US$4.84/extra meter walked. The number of falls and fractures was balanced across physical activity intervention arms and no serious adverse events were reported for either intervention. Conclusions: Chile's nutritional supplementation program for older people is not effective in reducing the incidence of pneumonia. This trial suggests that the provision of locally accessible physical activity classes in a transition economy population can be a cost-effective means of enhancing physical function in later life.es_CL
Patrocinadordc.description.sponsorshipWellcome Trust 075219 Ministry of Health Chilees_CL
Lenguagedc.language.isoenes_CL
Publisherdc.publisherPUBLIC LIBRARY SCIENCEes_CL
Keywordsdc.subjectUSUAL GAIT SPEEDes_CL
Títulodc.titleEffect of a Nutrition Supplement and Physical Activity Program on Pneumonia and Walking Capacity in Chilean Older People: A Factorial Cluster Randomized Triales_CL
Document typedc.typeArtículo de revistaes_CL


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