Baduanjin Exercise, With or Without Vitamin D, Outperforms Vitamin D Alone in Reducing Frailty Among Institutionalized Older Adults: A Cluster-Based Randomized Controlled Trial

Background: Frailty is a common condition among older adults residing in long-term care facilities and is associated with adverse health outcomes. Physical exercise and vitamin D supplementation have been proposed as preventive and therapeutic strategies, yet the combined effects of the two interventions remain uncertain. This cluster-based randomized controlled trial evaluated the independent and combined effects of Baduanjin exercise and vitamin D supplementation on frailty among residents of long-term care facilities. Methods: Sixty-four participants from three long-term care facilities in Jinan, China, were cluster-based randomized into a Baduanjin group (n = 23), a vitamin D group (n = 17), or a combined group (n = 24) for a 3-month intervention. The primary outcome was the frailty phenotype score, and the secondary outcome was serum 1,25(OH)₂D₃ concentration. Group comparisons were conducted using analysis of covariance (ANCOVA). Results: After the 3-month intervention, frailty phenotype scores were significantly lower in the Baduanjin (1.43 ± 0.90, p < 0.05) and combined (1.08 ± 1.10, p < 0.05) groups compared with the vitamin D group (2.65 ± 0.79), while no significant difference was observed between the Baduanjin and combined groups (p = 0.470). No significant between-group differences were found in the changes in 1,25(OH)₂D₃ levels (p = 0.215), whereas they were significantly increased from baseline in both the vitamin D (from 15.04 ± 2.67 to 18.43 ± 3.70, p < 0.05) and combined groups (from 14.77 ± 2.15 to 16.86 ± 2.50, p < 0.05). Conclusions: Baduanjin exercise, either alone or combined with vitamin D supplementation, effectively mitigated frailty among older adults residing in long-term care facilities.