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. 2021 Mar;69(3):806-812.
doi: 10.1111/jgs.16959. Epub 2020 Dec 4.

An Age-Friendly Health System

Janice Lundy  1 , Deborah Hayden  2 , Stephanie Pyland  1 , Marla Berg-Weger  3 , Theodore K Malmstrom  4 , John E Morley  5
Affiliations

An Age-Friendly Health System

Janice Lundy et al. J Am Geriatr Soc. 2021 Mar.

Abstract

Background/objectives: To describe a screening and intervention program for geriatric syndromes instituted at a rural healthcare system that utilizes the 4Ms of an age-friendly health system, and to provide exercise and cognitive stimulation therapy (CST) as part of an age-friendly health program.

Design: Retrospective evaluation of clinical data.

Setting: Rural primary healthcare system.

Participants: Older adults aged 65 years and older in Perry County, Missouri.

Measurements: Screening for geriatric syndromes was done using the Rapid Geriatric Assessment (RGA), which includes the FRAIL, SARC-F, Simplified Nutritional Appetite Questionnaire (SNAQ), and Rapid Cognitive Screen (RCS). Outcomes for exercise and CST included the Five Times Sit to Stand (FTSS) and Timed Up and Go (TUG) tests, Cornell Scale for Depression in Dementia (CSDD), Saint Louis University Mental Status Examination (SLUMS), and Quality of Life in Alzheimer's Disease (QoL-AD) measures.

Results: The RGA was administered to 1,326 individuals of which 36.5% were frail, 42.1% were sarcopenic, 26.1% were at risk for anorexia, and 20.8% had dementia. Of these receiving exercise therapy, both the FTSS and the TUG were improved at 3 months and 12 to 24 months. In the CST group, SLUMS, QoL-AD, and CSDD were improved at 7 weeks and 6 to 12 months.

Conclusion: It is feasible to introduce a screening program for geriatric syndromes and respond to the results with successful exercise and cognitive stimulation therapy programs.

Keywords: cognitive dysfunction; cognitive stimulation therapy; exercise; frailty; geriatric syndromes; nutrition; older adults; primary care; rural healthcare; sarcopenia.

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References

REFERENCES

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    1. World Health Organization. Integrated Care for Older People: Guidelines on Community-Level Interventions to Manage Declines in Intrinsic Capacity. Geneva: World Health Organization; 2017.
    1. The John A. Hartford Foundation. Age-friendly health systems initiative. https://www.johnahartford.org/age-friendly-health-systems-initiative/. Accessed September 1, 2020.
    1. Morley JE. Rapid geriatric assessment: secondary prevention to stop age-associated disability. Clin Geriatr Med. 2017;33(3):431-440.
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