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EFFECTS OF VITAMIN D, OMEGA-3 FATTY ACIDS AND A HOME EXERCISE PROGRAM ON PREVENTION OF PRE-FRAILTY IN OLDER ADULTS: THE DO-HEALTH RANDOMIZED CLINICAL TRIAL

M. Gagesch, M. Wieczorek, B. Vellas, R.W. Kressig, R. Rizzoli, J. Kanis, W.C. Willett, A. Egli, W. Lang, E.J. Orav, H.A. Bischoff-Ferrari

Background: The benefits of supplemental vitamin D3, marine omega-3 fatty acids, and a simple home exercise program (SHEP) on frailty prevention in generally healthy community-dwelling older adults are unclear. Objective: To test the effect of vitamin D3, omega-3s, and a SHEP, alone or in combination on incident pre-frailty and frailty in robust older adults over a follow-up of 36 months. Methods: DO-HEALTH is a multi-center, double-blind, placebo-controlled, 2x2x2 factorial randomized clinical trial among generally healthy European adults aged 70 years or older, who had no major health events in the 5 years prior to enrollment, sufficient mobility and intact cognitive function. As a secondary outcome of the DO-HEALTH trial, among the subset of participants who were robust at baseline, we tested the individual and combined benefits of supplemental 2,000 IU/day of vitamin D3, 1 g/day of marine omega-3s, and a SHEP on the odds of being pre-frail and frail over 3 years of follow-up. Results: At baseline, 1,137 out of 2,157 participants were robust (mean age 74.3 years, 56.5% women, mean gait speed 1.18 m/s). Over a median follow-up time of 2.9 years, 696 (61.2%) became pre-frail and 29 (2.6%) frail. Odds ratios for becoming pre-frail were not significantly lower for vitamin D3, or omega 3-s, or SHEP, individually, compared to control (placebo for the supplements and control exercise). However, the three treatments combined showed significantly decreased odds (OR 0.61 [95% CI 0.38-0.98; p=0.04) of becoming pre-frail compared to control. None of the individual treatments or their combination significantly reduced the odds of becoming frail. Conclusion: Robust, generally healthy and active older adults without major comorbidities, may benefit from a combination of high-dose, supplemental vitamin D3, marine omega-3s, and SHEP with regard to the risk of becoming pre-frail over 3 years.

CITATION:
M. Gagesch ; M. Wieczorek ; B. Vellas ; R.W. Kressig ; R. Rizzoli ; J. Kanis ; W.C. Willett ; A. Egli ; W. Lang ; E.J. Orav ; H.A. Bischoff-Ferrari ; (2022): Effects of Vitamin D, Omega-3 Fatty Acids and a Home Exercise Program on Prevention of Pre-Frailty in Older Adults: The DO-HEALTH Randomized Clinical Trial. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2022.48

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