CAN HRT AMELIORATE PHYSICAL FRAILTY IN OLD WOMEN?

激素替代疗法（HRT）可以改善老年女性的身体虚弱吗？

• 批准号: 6336219
• 负责人: Wendy M Kohrt
• 金额: $ 13.13万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-09-01 至 2002-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6336219
• 关键词: aerobic exercise; balance; behavioral /social science research tag; blood pressure; body physical activity; bone density; cardiovascular function; cognition; estrogens; exercise; female; frail elderly; functional ability; glucose tolerance; health care cost /financing; hormone therapy; human old age (65+); human subject; human therapy evaluation; insulin sensitivity /resistance; medical rehabilitation related tag; muscle proteins; muscle strength; physical therapy; protein metabolism; psychomotor reaction time; quality of life

DESCRIPTION: (Adapted from applicant's abstract). The major research focus of the OAIC is on the reduction of physical frailty resulting in a decrease in the risk of loss of independence and nursing home admission. The overall goals of this intervention study, IS-2, are to determine: whether 9 months of hormone replacement therapy (HRT) can bring about a reduction in frailty in physically frail women over 78 years of age; and whether exercise training results in greater improvements in functional capacity as reflected in strength, flexibility, balance, coordination, reaction time, aerobic power, and instrumental activities of daily living (IADL) and advanced ADL (AADL), as well as in muscle mass, cardiovascular function, and bone quantity and quality, in women who have been on HRT than in sex hormone-deficient women. Exercise training will begin after the women have been on HRT for 9 months, and will have three phases, consisting of 3 months of physical therapy exercises, 3 months of weight lifting superimposed on physical therapy exercises, and 3 months of aerobic exercise superimposed on physical therapy and weight lifting exercises. The first goal of IS-2 is to determine whether HRT can reduce frailty. The aims relative to this goal are to determine whether HRT can: a) increase skeletal muscle strength; b) increase capacity for aerobic exercise and improve cardiovascular function; c) increase bone quantity and quality; d) improve cognitive function and central processing speed; e) improve reaction time, balance, coordination, flexibility, and ability to perform IADL and AADL; f) decrease insulin resistance and improve glucose tolerance and plasma lipid and lipoprotein levels; and g) improve quality of life. Relative to the second goal, which is to determine if women who have adapted to 9 months of HRT have an enhanced adaptive response to the exercise program, the investigators will compare the magnitude of the adaptations to exercise plus HRT with the effect of HRT alone and with the effect of exercise alone in the women in IS-1. The specific aims relative to this goal are to determine whether HRT plus exercise is more effective than the exercise program alone or HRT alone in improving: a) flexibility, gait, balance, and coordination; b) strength of all major muscle groups, whole body and skeletal muscle protein anabolism, and muscle mass; c) oxygen uptake capacity; d) arterial elasticity; e) blood pressure in those with mild hypertension; f) bone mineral density in the proximal femur, spine, and other regions of the skeleton; g) cognitive function and central processing speed; and h) candidate of life. The plan is also to investigate mechanisms underlying any improvements in oxygen uptake capacity, muscle strength, blood pressure, and bone mass. Before discharge from the study, participants will be encouraged to continue HRT if there are no contraindications, and will be given individualized exercise prescriptions to follow at home. They will be helped to put together home gyms or referred to a convenient exercise facility. The investigative group will stay in contact with the graduates by means of monthly phone calls, and will bring them back to our exercise facility once per month for a training session and periodic evaluations of functional capacity using simple measures such as the standardized Physical Performance Test. Cost effectiveness and cost-utility analysis will be used to evaluate the relative costs and benefits of HRT and exercise.

描述：（改编自申请人的摘要）。主要研究 OAIC的重点是减少身体脆弱，导致 失去独立和疗养院的风险降低 入场。这项干预研究的总体目标是IS-2，是 确定：9个月的激素替代疗法（HRT）是否可以 减少了78岁以上身体虚弱的妇女的脆弱性 年龄；运动训练是否会导致更大 强度反映的功能能力的提高， 灵活性，平衡，协调，反应时间，有氧力量，并且 日常生活的乐器活动（IADL）和高级ADL（AADL）， 以及肌肉质量，心血管功能和骨骼数量 和质量，在曾在HRT上的女性比性激素缺陷的女性 女性。妇女曾在HRT上进行锻炼训练 9个月，将有三个阶段，包括3个月的身体 治疗练习，3个月举重叠加在身体上 治疗运动，三个月的有氧运动叠加 物理疗法和举重运动。 IS-2的第一个目标 是确定HRT是否可以减少脆弱性。相对于 该目标是确定HRT是否可以：a）增加骨骼肌肉 力量; b）增加有氧运动的能力并改善 心血管功能； c）增加骨骼数量和质量； d） 提高认知功能和中心处理速度； e）改进 反应时间，平衡，协调，灵活性和能力 执行IADL和AADL； f）降低胰岛素抵抗并改善 葡萄糖耐受性，血浆脂质和脂蛋白水平；和g）改进 生活质量。相对于第二个目标，即确定是否 适应9个月HRT的女性具有增强的适应性 对锻炼计划的回应，调查人员将比较 锻炼的适应大小以及HRT的效果 单独并独自在IS-1中的妇女中进行运动的效果。这 相对于此目标的具体目标是确定HRT Plus是否是否 锻炼比单独锻炼计划或仅HRT更有效 改进：a）灵活性，步态，平衡和协调； b） 所有主要肌肉组的力量，全身和骨骼肌肉 蛋白质合物和肌肉质量； c）氧气吸收能力； d） 动脉弹性； e）轻度高血压患者的血压； f）股骨近端，脊柱和其他区域的骨矿物质密度 骨骼； g）认知功能和中央处理速度；和 h）生命的候选人。该计划还将调查机制 氧气吸收能力，肌肉力量，肌肉强度的任何改善的基础 血压和骨骼质量。从研究中解除之前， 如果没有 禁忌症，并将获得个性化的锻炼 处方要在家中。他们将得到帮助 家庭健身房或提到便利的运动设施。这 调查小组将通过 每月电话，并将它们带回我们的锻炼设施 每月一次进行培训和定期评估 使用简单措施（例如标准化）的功能能力 身体绩效测试。成本效益和成本效益分析 将用于评估HRT的相对成本和收益 锻炼。