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. 2019;23(8):710-716.
doi: 10.1007/s12603-019-1244-4.

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

L M Pérez  1 , 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
Affiliations

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

L M Pérez et al. J Nutr Health Aging. 2019.

Abstract

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.

Keywords: Frailty; integrated care; physical activity; primary care.

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Conflict of interest statement

The authors have no financial or personal conflicts to disclose.

Figures

Figure 1
Figure 1
Population follow chart PA: Physical activity.
See this image and copyright information in PMC

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