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Effects of comprehensive geriatric assessment on physical fitness in an acute medical setting for frail elderly patients
Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. NU Hospital Grp, Sweden.
Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Sahlgrens University Hospital, Sweden.
Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences. NU Hospital Grp, Sweden.
2017 (English)In: Clinical Interventions in Aging, ISSN 1176-9092, E-ISSN 1178-1998, Vol. 12, 1929-1939 p.Article in journal (Refereed) Published
Abstract [en]

Introduction: Frail elderly people often use emergency care. During hospitalization, physical decline is common, implying an increased risk of adverse health outcomes. Comprehensive Geriatric Assessment (CGA) has been shown to be beneficial for these patients in hospital care. However, there is very limited evidence about the effects on physical fitness. The aim was to compare effects on physical fitness in the acute care of frail elderly patients at a CGA unit versus conventional care, 3 months after discharge. Patients and methods: A clinical, prospective, controlled trial with two parallel groups was conducted. Patients aged $ 75 years, assessed as frail and in need of inpatient care, were assigned to a CGA unit or conventional care. Measurements of physical fitness, including handgrip strength (HS), timed up-and-go (TUG), and the 6-minute walk test (6-MWT) were made twice, at the hospital index care period and at the 3-month follow-up. Data were analyzed as the mean change from index to the 3-month follow-up, and dichotomized as decline versus stability/improvement in physical fitness. Results: In all, 408 participants, aged 85.7 +/- 5.4 years, were included. The intervention group improved significantly in all components of physical fitness. The controls improved in TUG and declined in HS and 6-MWT. When the changes were dichotomized the intervention group declined to a lesser extent; HS pamp;lt;0.001, 6-MWT pamp;lt;0.001, TUG pamp;lt;0.003. The regression analysis showed the following odds ratios (ORs) for how these outcomes were influenced by the intervention; HS OR 4.4 (confidence interval [CI] 95% 2.2-9.1), 6-MWT OR 13.9 (CI 95% 4.2-46.2), and TUG OR 2.5 (CI 95% 1.1-5.4). Conclusion: This study indicates that the acute care of frail elderly patients at a CGA unit is superior to conventional care in terms of preserving physical fitness at 3 months follow-up. CGA management may positively influence outcomes of great importance for these patients, such as mobility, strength, and endurance.

Place, publisher, year, edition, pages
DOVE MEDICAL PRESS LTD , 2017. Vol. 12, 1929-1939 p.
Keyword [en]
frail elderly; comprehensive geriatric assessment; physical fitness; outcomes
National Category
Geriatrics
Identifiers
URN: urn:nbn:se:liu:diva-143250DOI: 10.2147/CIA.S149665ISI: 000415128600002OAI: oai:DiVA.org:liu-143250DiVA: diva2:1160425
Note

Funding Agencies|NU Hospital Group, Department of Research and Development

Available from: 2017-11-27 Created: 2017-11-27 Last updated: 2017-11-27

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Åhlund, KristinaBäck, MariaÖberg, BirgittaEkerstad, Niklas
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Department of Medical and Health SciencesFaculty of Medicine and Health SciencesDivision of PhysiotherapyDivision of Health Care Analysis
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