Vivifrail Exercise Program in Nonagenarians: Effects on Function, Muscle, and Cognition

This randomized clinical trial investigates the effects of a home-based multicomponent exercise program (Vivifrail) on physical function, muscle morphology, and cognition in community-dwelling adults aged 90 years and older. Participants are randomized into three groups: Vivifrail at least twice a week, Vivifrail at least three times a week, or a control group. Outcomes are assessed at baseline, 12 weeks, and 24 weeks. The primary outcome is physical function measured by the Short Physical Performance Battery (SPPB).

Inclusion Criteria: * Aged 90 years or older * Living in the community (own or family home) * Able to walk independently or with a walking aid (cane or walker), without third-party assistance * Minimum cognitive capacity to understand and perform the exercises (MMSE, education-adjusted cutoffs) * Adequate home conditions to perform the program * Availability of a family member or caregiver to support the sessions * Signed informed consent (with legal guardian assistance when needed) Exclusion Criteria: * \- Total inability to walk or permanent bedridden condition * Severe cognitive impairment preventing safe understanding and execution of exercises * Severe orthopedic, neurological, or rheumatological conditions preventing exercise * Concurrent participation in another structured exercise program * Anticipated unavailability (relocation, planned hospitalization, or institutionalization) during the intervention * Refusal to sign informed consent or absence of a legal guardian when required