# A Meal Delivery and Exercise Intervention to Increase Resilience in Homebound Older Adults

> **NIH NIH K23** · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · 2022 · $191,079

## Abstract

PROJECT SUMMARY/ABSTRACT
 Homebound older adults are often functionally dependent and at risk for placement in institutions such as
nursing homes. The majority of older adults would prefer to age in place in their homes so research is needed
to identify interventions that can help them maintain their autonomy. Frailty is an age-related syndrome highly
predictive of functional decline and mortality, which is very prevalent in our preliminary studies of homebound
older adults (56% frail, 44% prefrail, none were robust) and mainly driven by slow walking speed (88%).
 Because the homebound population is difficult to reach, there have been few studies and no clinical trials in
this population. In our pilot randomized controlled trial of an exercise program administered by Meals on
Wheels (MOW), 9 participants (5 treatment, 4 control) completed the 12-week study which showed that gait
speed and total frailty score improved in the treatment group. The improvement in gait speed is particularly
exciting given its prevalence in homebound older adults. In addition, there were no adverse events and the
participants enjoyed the exercises as well as the convenience of the meal deliveries.
 To further evaluate the clinical changes seen in our trial, we assessed potential novel frailty biomarkers.
These biomarkers could help identify frailty earlier than may be seen clinically and provide valuable information
about the effects of frailty interventions. Inflammatory biomarkers such as interleukin-6 (IL-6), C-reactive
protein (CRP), and tumor necrosis factor-alpha (TNF-α) have been associated with frailty status but not
correlated with treatments. We preliminarily tested heat shock protein (HSP) 70, which induces muscle wasting
in cancer cachexia, as well as macrophage inflammatory protein-1β (MIP-1β), and soluble interleukin-6
receptor (sIL-6R) to see if they could be more specific frailty biomarkers. Our exercise group had decreased
HSP70, MIP-1β, and sIL-6R when compared to the control group over 12 weeks.
 Thus we have 2 aims: 1) evaluate the effects of a home-based exercise program administered through
MOW on gait speed and frailty status in frail/prefrail homebound older adults, and 2) assess the association
between novel serum biomarkers (HSP70, MIP-1β, sIL-6R) and established but non-specific frailty biomarkers
(IL-6, CRP, TNF-α) in frail/prefrail homebound older adults before and after the exercise intervention.
 Data from this project will be the catalyst for an R01 or equivalent award involving multi-pronged frailty
interventions, targeting mechanistic and clinical pathways, with the goal of helping homebound older adults
age in place. This career award would also provide training and mentorship for Dr. Jessica Lee to develop into
a physician-scientist with independent funding. UTHealth has provided her with a supportive environment,
individualized career development plan, and expert mentors with long-standing experience in geriatrics, clinical
trials, ...

## Key facts

- **NIH application ID:** 10400086
- **Project number:** 5K23AG072042-02
- **Recipient organization:** UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
- **Principal Investigator:** Jessica Lan Lee
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $191,079
- **Award type:** 5
- **Project period:** 2021-05-01 → 2026-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10400086

## Citation

> US National Institutes of Health, RePORTER application 10400086, A Meal Delivery and Exercise Intervention to Increase Resilience in Homebound Older Adults (5K23AG072042-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10400086. Licensed CC0.

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