A Community Program of Integrated Care for Frail Older Adults: +AGIL Barcelona

Laura Mónica Pérez Bazán, M. B. Enfedaque-Montes, M. Cesari, L. Soto-Bagaria, N. Gual, M. P. Burbano, F. J. Tarazona-Santabalbina, R. M. Casas, F. Díaz, E. Martín, A. Gómez, F. Orfila, M. Inzitari

Research output: Contribution to journalArticleResearch

1 Citation (Scopus)

Abstract

© 2019, The Author(s). 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.
Original languageEnglish
Pages (from-to)710-716
JournalJournal of Nutrition, Health and Aging
Volume23
DOIs
Publication statusPublished - 1 Aug 2019

Keywords

  • Frailty
  • integrated care
  • physical activity
  • primary care

Fingerprint Dive into the research topics of 'A Community Program of Integrated Care for Frail Older Adults: +AGIL Barcelona'. Together they form a unique fingerprint.

  • Cite this

    Pérez Bazán, L. M., Enfedaque-Montes, M. B., Cesari, M., Soto-Bagaria, L., Gual, N., Burbano, M. P., Tarazona-Santabalbina, F. J., Casas, R. M., Díaz, F., Martín, E., Gómez, A., Orfila, F., & Inzitari, M. (2019). A Community Program of Integrated Care for Frail Older Adults: +AGIL Barcelona. Journal of Nutrition, Health and Aging, 23, 710-716. https://doi.org/10.1007/s12603-019-1244-4