Effectiveness of Transitional Care from Hospital to Home in Frail Older Adults: A Systematic Review

Abstract Frail older adults are at high risk of negative consequences from hospitalization and are discharged without completely returning to their pre-existing health status. Transitional care is needed to maintain care continuity from hospital to home. This systematic review aimed to examine transitional care for frail older adults and its effectiveness. The Cochrane guidelines were followed, and search terms were determined by PICO: (P) frail older adults, not disease-specified; (I) transitional care initiated before discharge; (C) usual care; and (O) all health outcomes. Four databases were searched for English-written randomized controlled trials (inception to 2020), and eight trials were ultimately included. Frail older adults in eight trials (1996–2019) totaled 2,785, with a mean sample size of 310. The intervention components varied from hospital care (e.g., geriatric assessment, discharge planning, rehabilitation) to follow-up care after discharge (e.g., home visit, phone follow-up, community service). Most measured outcomes were readmission (n = 7), function (n = 4), quality of life (n = 4), self-rated health (n = 3), and mortality (n = 3). Statistical significance was reported in the following number of trials: readmission (n = 2), function (n = 2), quality of life (n = 1), self-rated health (n = 3), and mortality (n = 0). The effectiveness of the intervention on each outcome was inconsistent across the trials. Varied transitional care between hospital and home was implemented to improve health status; however, its effectiveness was controversial. A novel, yet evidence-based approach is needed to develop transitional care interventions for these vulnerable populations.

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The effect of exercise on quality of life and activities of daily life in frail older adults: A systematic review of randomised control trials

Experimental Gerontology ◽

10.1016/j.exger.2021.111287 ◽

2021 ◽

Vol 147 ◽

pp. 111287

Author(s):

Evan Campbell ◽

Fanny Petermann-Rocha ◽

Paul Welsh ◽

Carlos Celis-Morales ◽

Jill P. Pell ◽

...

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Older Adults ◽

Daily Life ◽

Frail Older Adults ◽

Activities Of Daily Life ◽

Randomised Control Trials

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A physical activity program versus usual care in the management of quality of life for pre-frail older adults with chronic pain in primary care: randomized controlled trial.

10.21203/rs.3.rs-33919/v1 ◽

2020 ◽

Author(s):

Pedro Otones ◽

Eva García ◽

Teresa Sanz ◽

Azucena Pedraz

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Older Adults ◽

Chronic Pain ◽

Usual Care ◽

Pain Intensity ◽

Physical Performance ◽

Frail Older Adults

Abstract Background Exercise have shown being effective for managing chronic pain and preventing frailty status in older adults but the effect of an exercise program in the quality of life of pre-frail older adults with chronic pain remains unclear. Our objective was to evaluate the effectiveness of multicomponent structured physical exercise program for pre-frail adults aged 65 years or more with chronic pain to improve their perceived health related quality of life, compared with usual care. Methods Open label randomized controlled trial. Participants were community-dwelling pre-frail older adults aged 65 years or older with chronic pain and non-dependent for basic activities of daily living attending a Primary Healthcare Centre. Forty-four participants were randomly allocated to a control group (n = 20) that received usual care or an intervention group (n = 24) that received an 8-week physical activity and education program. Frailty status (SHARE Frailty Index), quality of life (EuroQol-5D-5L), pain intensity (Visual Analogue Scale), physical performance (Short Physical Performance Battery) and depression (Yessavage) were assessed at baseline, after the intervention and after 3 months follow-up. The effect of the intervention was analysed by mean differences between the intervention and control groups. Results The follow-up period (3 months) was completed by 32 patients (73%), 17 in the control group and 15 in the intervention group. Most participants were women (78.1%) with a mean age (standard deviation) of 77.2 (5.9) years and a mean pain intensity of 48.1 (24.4) mm. No relevant differences were found between groups at baseline. After the intervention, mean differences in the EuroQol Index Value between control and intervention groups were significant (-0.19 95%CI(-0.33- -0.04)) and remained after three months follow-up (-0.21 95%CI(-0.37- -0.05)). Participants in the exercise group showed better results in pain intensity and frailty after the intervention, and an improvement in physical performance after the intervention and after three months. Conclusions An eight-week physical activity and education program for pre-frail older adults with chronic pain, compared with usual care, could be effective to improve quality of life after the intervention and after three-months follow-up. Study registration details: This study was retrospectively registered in ClinicalTrials.gov with the identifier NCT04045535.

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Effect of complementary therapies on functional capacity and quality of life among prefrail and frail older adults: A systematic review of randomized controlled trials

Archives of Gerontology and Geriatrics ◽

10.1016/j.archger.2020.104236 ◽

2020 ◽

Vol 91 ◽

pp. 104236

Author(s):

Marcele Stephanie de Souza Buto ◽

Marcos Paulo Braz de Oliveira ◽

Cristiano Carvalho ◽

Verena Vassimon-Barroso ◽

Anielle Cristhine de Medeiros Takahashi

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Older Adults ◽

Randomized Controlled Trials ◽

Functional Capacity ◽

Complementary Therapies ◽

Controlled Trials ◽

Frail Older Adults ◽

Randomized Controlled

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Dietary Patterns and Quality of Life in Older Adults: A Systematic Review

Nutrients ◽

10.3390/nu10080971 ◽

2018 ◽

Vol 10 (8) ◽

pp. 971 ◽

Cited By ~ 34

Author(s):

Thara Govindaraju ◽

Berhe Sahle ◽

Tracy McCaffrey ◽

John McNeil ◽

Alice Owen

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Older Adults ◽

Dietary Patterns ◽

Cross Sectional ◽

Self Rated Health ◽

Set Inclusion ◽

Demographic Shifts ◽

Meta Analyses

Dietary patterns may be related to quality of life (QoL) of older adults, although evidence from literature is conflicting. The demographic shifts toward ageing populations in many countries increases the importance of understanding the relationship between diet and QoL in older adults. This review was designed to investigate associations between dietary patterns and QoL in older adults. The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eight electronic databases were searched to identify articles published in English from January 1975 to March 2018 that investigated associations between dietary patterns and QoL in older adults. Relevant studies were identified based on set inclusion and exclusion criteria, data were extracted and analysed to examine the relationships and possible implications for public health recommendations. The systematic review included 15 articles (One randomized control trial, six prospective cohorts and eight cross sectional). The studies looked at correlations between different dietary patterns and/or adherence to particular dietary patterns and self-reported QoL or self-rated health status. Excluding two studies which showed no significant association, healthy dietary patterns were associated with better self-rated health and QoL in one or more domains, and adherence to healthy dietary patterns like the Mediterranean diet were significantly associated with improvement in at least one of the QoL domains.

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Transitional care from hospital to home for frail older adults: A systematic review and meta-analysis

Geriatric Nursing ◽

10.1016/j.gerinurse.2021.11.003 ◽

2022 ◽

Vol 43 ◽

pp. 64-76

Author(s):

Ji Yeon Lee ◽

Yong Sook Yang ◽

Eunhee Cho

Keyword(s):

Systematic Review ◽

Older Adults ◽

Transitional Care ◽

Meta Analysis ◽

Frail Older Adults ◽

Hospital To Home

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Changes in the Mental Health Status of Frail and Pre-Frail Older Adults Over a 1-year Period

10.21203/rs.3.rs-1030756/v1 ◽

2021 ◽

Author(s):

Claudia K. Y. Lai ◽

Justina Y. W. Liu ◽

Daphne S. K. Cheung ◽

Kenny C. W. Chin ◽

Mimi M. Y. Tse

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Older Adults ◽

Health Status ◽

Mental Health Status ◽

Functional Health ◽

World Health ◽

World Health Organization Quality ◽

Frail Older Adults

Abstract Background This prospective observational study examined changes in the mental health status of frail and pre-frail older adults over a 1-year period, a topic lacking in-depth exploration in the literature. Method Fried Frailty Index was used to differentiate frailty status in participants recruited from community centres and residential care facilities in Hong Kong. Demographic and clinical data were collected using face-to-face interview at baseline and repeated after 12 months. Results Physical functioning, comorbidities, and psychological and environment domains (World Health Organization Quality of Life instrument) impacted the cognitive functioning, depressive symptoms, and sense of loneliness in the sample (N=107). Functional health and vision had a significant impact on cognitive status; depression negatively associated with comorbidity, functional health, and quality of life domains (psychological and environment); loneliness was affected by both age and environment. Conclusion The findings showed that frail and pre-frail older adults have complex needs in relation to their mental health even just over a 1-year period. Intervention programs on frailty that focus on physical aspects will not suffice. Programs for frailty also need to incorporate mental health components to enhance health and wellbeing.

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A physical activity program versus usual care in the management of quality of life for pre-frail older adults with chronic pain: randomized controlled trial

BMC Geriatrics ◽

10.1186/s12877-020-01805-3 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Pedro Otones ◽

Eva García ◽

Teresa Sanz ◽

Azucena Pedraz

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Older Adults ◽

Chronic Pain ◽

Usual Care ◽

Pain Intensity ◽

Physical Performance ◽

Frail Older Adults

Abstract Background Exercise has shown being effective for managing chronic pain and preventing frailty status in older adults but the effect of an exercise program in the quality of life of pre-frail older adults with chronic pain remains unclear. Our objective was to evaluate the effectiveness of multicomponent structured physical exercise program for pre-frail adults aged 65 years or more with chronic pain to improve their perceived health related quality of life, compared with usual care. Methods Open label randomized controlled trial. Participants were community-dwelling pre-frail older adults aged 65 years or older with chronic pain and non-dependent for basic activities of daily living attending a Primary Healthcare Centre. Forty-four participants were randomly allocated to a control group (n = 20) that received usual care or an intervention group (n = 24) that received an 8-week physical activity and education program. Frailty status (SHARE Frailty Index), quality of life (EuroQol-5D-5L), pain intensity (Visual Analogue Scale), physical performance (Short Physical Performance Battery) and depression (Yessavage) were assessed at baseline, after the intervention and after 3 months follow-up. The effect of the intervention was analysed by mean differences between the intervention and control groups. Results The follow-up period (3 months) was completed by 32 patients (73%), 17 in the control group and 15 in the intervention group. Most participants were women (78.1%) with a mean age (standard deviation) of 77.2 (5.9) years and a mean pain intensity of 48.1 (24.4) mm. No relevant differences were found between groups at baseline. After the intervention, mean differences in the EuroQol Index Value between control and intervention groups were significant (− 0.19 95% CI(− 0.33- -0.04)) and remained after 3 months follow-up (− 0.21 95% CI(− 0.37- -0.05)). Participants in the exercise group showed better results in pain intensity and frailty after the intervention, and an improvement in physical performance after the intervention and after 3 months. Conclusions An eight-week physical activity and education program for pre-frail older adults with chronic pain, compared with usual care, could be effective to improve quality of life after the intervention and after three-months follow-up. Study registration details This study was retrospectively registered in ClinicalTrials.gov with the identifier NCT04045535.

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