| Resum: |
Objectives: To assess the 3-month impact on physical function of a program for community-dwelling frail older adults, based on the integration of primary care, geriatric medicine, and community resources, implemented in "real life". Design: Interventional cohort study. Setting: Primary care in Barcelona, Spain. Participants: Individuals aged ≥80 years (n=134), presenting at least one sign of frailty (i. e. , slow gait speed, weakness, memory complaints, involuntary weight loss, poor social support). Intervention: After frailty screening by the primary care team, candidates were referred to a geriatric team (geriatrician + physical therapist), who performed a comprehensive geriatric assessment and designed a tailored multidisciplinary intervention in the community, including a) multi-modal physical activity (PA) sessions, b) promotion of adherence to a Mediterranean diet c) health education and d) medication review. Measurements: Participants were assessed based on a comprehensive geriatric assessment including physical performance (Short Physical Performance Battery -SPPB- and gait speed), at baseline and at a three month follow-up. Results: A total of 112 (83. 6%) participants (mean age=80. 8 years, 67. 9% women) were included in this research. Despite being independent in daily life, participants' physical performance was impaired (SPPB=7. 5, SD=2. 1, gait speed=0. 71, SD=0. 20 m/sec). After three months, 90. 2% of participants completed ≥7. 5 physical activity sessions. The mean improvements were +1. 47 (SD 1. 64) points (p<0. 001) for SPPB, +0. 08 (SD 0. 13) m/sec (p<0. 001) for gait speed, −5. 5 (SD 12. 10) sec (p<0. 001) for chair stand test, and 53% (p<0. 001) improved their balance. Results remained substantially unchanged after stratifying the analyses according to the severity of frailty. Conclusions: Our results suggested that a "real-world" multidisciplinary intervention, integrating primary care, geriatric care, and community services may improve physical function, a marker of frailty, within 3 months. Further studies are needed to address the long-term impact and scalability of this implementation program. |
visitant ::
identificació
(Department of Clinical Sciences and Community Health. Università di Milano)
