AIM: To investigate change in the frailty index (FI) following a 12-month intervention targeting diet and physical activity in Australian breast cancer survivors diagnosed with stage I-III breast cancer.
METHODS: The Living Well after Breast Cancer study was a two-arm pragmatically-designed randomised controlled trial of a 12-month telephone-delivered weight loss intervention versus usual care in women (aged 18-75 years; body mass index [BMI] 25-45kg/m2) following treatment for early-stage (I-III) breast cancer. Intervention targets included: modest weight loss (5-10%), 500kcal/day reduction in energy intake and increasing diet quality, and increasing physical activity to 210 minutes/week and resistance exercise to 2-3 times/week. Regression analyses, adjusted for baseline FI, age, smoking status, marital status and time since diagnosis were used to assess the intervention effects on change in FI.
RESULTS: Data for participants with complete data (n=127) were analysed (age [mean±SD]: 56.4±9.0 years; BMI: 31.5±5.1 kg/m2). Mean weight loss was significantly higher (p < 0.001) in the intervention group (-4.2±5.4 kg) compared to the usual care group (-0.01±4.2 kg). Mean FI at baseline was 0.19±0.09. Mean FI improved significantly in both groups (intervention: -0.018 [95%CI: -0.027, -0.009]; usual care: -0.010 [95%CI: -0.019, -0.000]), although the between-group difference was not statistically significant (intervention minus usual care: -0.008 [95%CI: -0.021, 0.005]).
CONCLUSION: Intervention participants experienced a larger mean reduction in their FI compared to the usual care group, although this was not statistically significant. This is one of the first studies to investigate the impact of a weight loss intervention on the FI. In addition to the intervention targets in this study, future interventions should aim to target more health factors that contribute to the FI, such as social, cognitive and mental health, and medication use. Factors associated with the improvement of the FI in the usual care group also warrant further exploration.