# SHIP-AGE: Frailty, renal function, and multi-component primary care in rural Mecklenburg-West Pomerania (MV-FIT)- study protocol

## TL;DR

This study explores how chronic kidney disease affects frailty in older adults in rural Germany and tests strategies to prevent frailty.

## Contribution

The study introduces a multi-component primary care program to prevent frailty in elderly individuals with chronic kidney disease.

## Key findings

- The study will clarify the role of CKD in frailty progression.
- It will evaluate multi-component healthcare strategies for frailty and fall prevention.
- Findings will contribute to evidence-based strategies for aging populations in rural primary care.

## Abstract

Background. Chronic kidney disease (CKD) is a leading risk factor for cardiovascular disease and all-cause mortality among older adults. Mecklenburg-West Pomerania has the highest CKD prevalence in Germany and Europe, however, its impact on frailty prevention strategies in primary care remains poorly understood. The SHIP-AGE/MV-FIT study aims to investigate the role of CKD in frailty incidence.

Methods. The SHIP-AGE/MV-FIT cohort is a prospective, longitudinal, population-based observational study targeting individuals ≥ 65 years with mGFR >30 mL/min. The cohort will consist of approximately 820 elderly participants who will be monitored over a three-year period. They will undergo a comprehensive, multi-factorial geriatric assessment, along with a structured monitoring and management program aimed at preventing frailty. The program incorporates evidence-based, multi-component care, including physical activity, medication review, nutritional optimization, and fall prevention strategies.

Discussion. SHIP-AGE/MV-FIT will clarify CKD’s role in frailty progression and identify mechanisms underlying frailty and pre-frailty. Additionally, the study aims to implement and evaluate multi-component healthcare strategies for frailty and fall prevention, assess patient adherence and quality of life, and explore elderly individuals’ experiences with primary care interventions. By integrating SHIP-AGE data with findings from the SHIP (Study of Health in Pomerania) cohorts in our region, this research will contribute to evidence-based strategies for maintaining health, independence, and well-being in aging populations, particularly in rural primary care settings, such as Mecklenburg-West Pomerania.