Physical Performance Outcomes and Programme Delivery Costs of ELDERPLAY, a Community-Based Multicomponent Exercise and Recreational Intervention for Older Adults: A Non-Randomized Controlled Evaluation

Background/Objectives: This study examined the association between participation in a community-based multicomponent physical and recreational programme (ELDERPLAY) and changes in physical performance and frailty-related outcomes in adults aged 65 years and older, and estimated programme delivery costs. The study was designed as a quasi-experimental, non-randomized controlled evaluation conducted in a community setting. Methods: Community-dwelling older adults (n = 184) were allocated to an intervention group (n = 103) or a control group (n = 81) through voluntary enrolment and geographic matching. Participant enrolment and data collection were carried out between July 2022 and December 2023, after ethics approval had been obtained. The intervention consisted of 20 supervised sessions (two per week) combining Vivifrail-based multicomponent exercises with simple recreational activities. Primary outcomes were physical performance and frailty-related function, assessed using the Short Physical Performance Battery and the Timed Up and Go test. Secondary exploratory outcomes included actigraphy-derived daily step count, heart rate, and sleep parameters, recorded over seven consecutive days at a single intermediate assessment point. Analyses were conducted using analysis of covariance and generalized estimating equations adjusted for cholesterol, COVID-19 vaccination and Barthel Index score. Programme costs were estimated using an activity-based costing approach. Results: Compared with the control group, participants in the intervention group showed greater improvement over time in balance, gait performance, chair-stand performance and overall physical performance (time × group interaction: gait performance p < 0.001, partial eta squared 0.450; chair-stand performance p < 0.001, 0.306; SPPB total score p < 0.001, 0.361; Timed Up and Go p < 0.001, 0.224). At 10 weeks, the adjusted mean SPPB total score was 9.62 (95% CI 9.25–10.00) in the intervention group and 7.80 (95% CI 7.37–8.23) in the control group, and the adjusted mean Timed Up and Go was 8.85 s (95% CI 8.08–9.62) versus 12.04 s (95% CI 11.15–12.92). Higher daily step counts were also observed in the intervention group; heart rate and sleep parameters were recorded cross-sectionally at a single intermediate assessment point that coincided with the delivery of the programme and are reported only as descriptive values. The programme was delivered at a mean cost of €92.3 per participant, or €62.3 per participant when the research monitoring devices are excluded. Conclusions: Participation in a community-based multicomponent exercise programme incorporating recreational activities was associated with improvements in clinically relevant physical performance outcomes in community-dwelling older adults. The programme was delivered in full at a mean delivery cost of €92.3 per participant in a real-world community setting. Because allocation was not randomized, the groups differed at baseline, and outcome assessment was carried out by a single unblinded assessor who designed and coordinated the programme but did not deliver the sessions, these findings are associative and require confirmation in a randomized trial. Trial registration: ClinicalTrials.gov NCT07864831 (retrospectively registered).