Regular exercise and expert dietary advice can improve mobility and physical performance among frail older people, new research suggests.

A combination of aerobic, strength, flexibility and balance training alongside nutritional counselling was found to reduce mobility disability by 22% over three years.

More than 1,500 participants were involved in the trial 

The study, published in The BMJ, looked at data from 1,519 men and women from 11 different European countries with an average age of 79 years, all of whom had physical frailty and sarcopenia. 

Around half of the participants were randomised to the intervention while the other half received education on health ageing (the control group).

The intervention group received twice weekly physical activity sessions (moderate in intensity) at a centre and up to four times weekly at home alongside personalised nutritional counselling.

The control group received education on healthy ageing once a month and a brief instructor led programme of upper body stretching exercises or relaxation techniques.

Women in the intervention group lost less muscle strength

Physical performance battery (SPPB) scores increased more in the intervention group than in the controls at both 24 and 36 months. 

Women in the intervention group also lost less muscle strength and muscle mass than control women, but no significant difference was seen in men.

The authors do note, however, that the risk of adverse events was higher among intervention participants (56%) than controls (50%).

They add that the study does have limitations. For example, only white people were included and none of the participant had cognitive deficits. The findings may therefore not be applicable to some groups.

Results suggest similar programmes could be used to preserve mobility in older people

Nevertheless, the retention and adherence to interventions were high compared with other similar trials and for this reason, the authors say such a programme could be a proposed strategy to preserve mobility in older people at risk of disability. 

The programme was also found to be cost effective in comparison to other commonly recommended medical treatments. 

In a linked editorial, Thomas Gill at Yale School of Medicine said that further research is now essential to strengthen the case for "developing, implementing, and supporting community based physical activity programmes to preserve independent mobility among vulnerable older people."