Multicomponent intervention to prevent mobility disability in frail older adults: randomised controlled trial (SPRINTT project)

Bernabei R, Landi F, Calvani R, Cesari M, Del Signore S, Anker SD, Bejuit R, Bordes P, Cherubini A, Cruz-Jentoft AJ, Di Bari M, Friede T, Gorostiaga Ayestarán C, Goyeau H, Jónsson PV, Kashiwa M, Lattanzio F, Maggio M, Mariotti L, Miller RR, Rodriguez-Mañas L, Roller-Wirnsberger R, Rýznarová I, Scholpp J, Schols AM, Sieber C, Sinclair AJ, Skalska A, Strandberg T, Tchalla A, Topinková E, Tosato M, Vellas B, von Haehling S, Pahor M, Roubenoff R, Marzetti E (2022)

Publication Type: Journal article

Publication year: 2022


Book Volume: 377

Pages Range: e068788-

DOI: 10.1136/bmj-2021-068788


OBJECTIVE: To determine whether a multicomponent intervention based on physical activity with technological support and nutritional counselling prevents mobility disability in older adults with physical frailty and sarcopenia. DESIGN: Evaluator blinded, randomised controlled trial. SETTING: 16 clinical sites across 11 European countries, January 2016 to 31 October 2019. PARTICIPANTS: 1519 community dwelling men and women aged 70 years or older with physical frailty and sarcopenia, operationalised as the co-occurrence of low functional status, defined as a short physical performance battery (SPPB) score of 3 to 9, low appendicular lean mass, and ability to independently walk 400 m. 760 participants were randomised to a multicomponent intervention and 759 received education on healthy ageing (controls). INTERVENTIONS: The multicomponent intervention comprised moderate intensity physical activity twice weekly at a centre and up to four times weekly at home. Actimetry data were used to tailor the intervention. Participants also received personalised nutritional counselling. Control participants received education on healthy ageing once a month. Interventions and follow-up lasted for up to 36 months. MAIN OUTCOME MEASURES: The primary outcome was mobility disability (inability to independently walk 400 m in <15 minutes). Persistent mobility disability (inability to walk 400 m on two consecutive occasions) and changes from baseline to 24 and 36 months in physical performance, muscle strength, and appendicular lean mass were analysed as pre-planned secondary outcomes. Primary comparisons were conducted in participants with baseline SPPB scores of 3-7 (n=1205). Those with SPPB scores of 8 or 9 (n=314) were analysed separately for exploratory purposes. RESULTS: Mean age of the 1519 participants (1088 women) was 78.9 (standard deviation 5.8) years. The average follow-up was 26.4 (SD 9.5) months. Among participants with SPPB scores of 3-7, mobility disability occurred in 283/605 (46.8%) assigned to the multicomponent intervention and 316/600 (52.7%) controls (hazard ratio 0.78, 95% confidence interval 0.67 to 0.92; P=0.005). Persistent mobility disability occurred in 127/605 (21.0%) participants assigned to the multicomponent intervention and 150/600 (25.0%) controls (0.79, 0.62 to 1.01; P=0.06). The between group difference in SPPB score was 0.8 points (95% confidence interval 0.5 to 1.1 points; P<0.001) and 1.0 point (95% confidence interval 0.5 to 1.6 points; P<0.001) in favour of the multicomponent intervention at 24 and 36 months, respectively. The decline in handgrip strength at 24 months was smaller in women assigned to the multicomponent intervention than to control (0.9 kg, 95% confidence interval 0.1 to 1.6 kg; P=0.028). Women in the multicomponent intervention arm lost 0.24 kg and 0.49 kg less appendicular lean mass than controls at 24 months (95% confidence interval 0.10 to 0.39 kg; P<0.001) and 36 months (0.26 to 0.73 kg; P<0.001), respectively. Serious adverse events occurred in 237/605 (39.2%) participants assigned to the multicomponent intervention and 216/600 (36.0%) controls (risk ratio 1.09, 95% confidence interval 0.94 to 1.26). In participants with SPPB scores of 8 or 9, mobility disability occurred in 46/155 (29.7%) in the multicomponent intervention and 38/159 (23.9%) controls (hazard ratio 1.25, 95% confidence interval 0.79 to 1.95; P=0.34). CONCLUSIONS: A multicomponent intervention was associated with a reduction in the incidence of mobility disability in older adults with physical frailty and sarcopenia and SPPB scores of 3-7. Physical frailty and sarcopenia may be targeted to preserve mobility in vulnerable older people. TRIAL REGISTRATION: NCT02582138.

Authors with CRIS profile

Involved external institutions

Hospital Universitario de Getafe ES Spain (ES) Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS) ES Spain (ES) Hospital Center University De Limoges Dupuytren FR France (FR) The Silesian Hospital in Opava CZ Czech Republic (CZ) Servier ES Spain (ES) Blue Companion Ltd. GB United Kingdom (GB) Istituto Nazionale di Riposo e Cura per Anziani (IRCCS INRCA) IT Italy (IT) Fondazione Policlinico Universitario Agostino Gemelli IRCCS IT Italy (IT) University of Florida US United States (USA) (US) Centre Hospitalier Universitaire (CHU) de Toulouse FR France (FR) Univerzita Karlova v Praze / Charles University in Prague CZ Czech Republic (CZ) Jagiellonian University Medical College PL Poland (PL) Landspítali / National University Hospital of Iceland IS Iceland (IS) University of Parma / Università degli Studi di Parma IT Italy (IT) Diabetes Frail Ltd GB United Kingdom (GB) Helsingin yliopisto / University of Helsinki FI Finland (FI) Universitätsklinikum Göttingen DE Germany (DE) Boehringer Ingelheim Pharma GmbH & Co. KG DE Germany (DE) Sanofi-Aventis Groupe FR France (FR) Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK e.V.) DE Germany (DE) Università degli studi di Milano IT Italy (IT) Novartis Institutes for BioMedical Research, Inc. US United States (USA) (US) Maastricht University Medical Center (UMC+) NL Netherlands (NL) Catholic University of the Sacred Heart / Università Cattolica del Sacro Cuore IT Italy (IT) Berliner Institut für Gesundheitsforschung (BIH) DE Germany (DE) Medizinische Universität Graz AT Austria (AT) Astellas Pharma Inc. / アステラス製薬株式会社 JP Japan (JP) Università degli Studi di Firenze / University of Florence IT Italy (IT) Novartis AG CH Switzerland (CH)

How to cite


Bernabei, R., Landi, F., Calvani, R., Cesari, M., Del Signore, S., Anker, S.D.,... Marzetti, E. (2022). Multicomponent intervention to prevent mobility disability in frail older adults: randomised controlled trial (SPRINTT project). British Medical Journal, 377, e068788-.


Bernabei, Roberto, et al. "Multicomponent intervention to prevent mobility disability in frail older adults: randomised controlled trial (SPRINTT project)." British Medical Journal 377 (2022): e068788-.

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