Aims: To investigate change in frailty 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 overweight or obese women with early stage breast cancer. Frailty was measured as a frailty index (FI) comprising 34 variables. Intervention targets included weight loss (5-10%), improved diet quality, and increasing physical activity to 210 minutes/week and resistance exercise to 2-3 times/week. A multilevel mixed model analysis was conducted to examine change in frailty status, adjusted for baseline FI, age, smoking status, tumour stage, and lymphoedema.
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 FI at baseline was 0.20 +/- 0.10. Mean FI improved significantly in both groups at 12 months (intervention: -0.04 [95%CI: -0.06, -0.03]; usual care:-0.02 [95%CI: -0.03, -0.00]), and the between-group difference was statistically significant (intervention minus usual care: -0.02 [95%CI: -0.04, 0.00; p = 0.038]).
Conclusions: Intervention participants experienced a larger and more meaningful reduction in frailty compared to the usual care group, at 12 months post intervention. This is one of the first studies to investigate the impact of a weight loss intervention on FI. In addition to the intervention targets in this study, future work 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.