Multi-component health promotion and disease prevention for community-dwelling frail elderly persons: a systematic review

Abstract

The objective was to investigate definitions of frailty used in studies of multi-component health promotion and disease-preventive (HPDP) intervention programmes for community-dwelling frail elderly persons and to review the content, organisation and effects of HPDP interventions. A systematic review of 19 articles was made, and the International Classification of Functioning, Disability and Health (ICF) was used as a structural framework for the analysis. The result shows that a consensus was reached on including various aspects of impairments in body functions and structures as an integral part of the frailty concept, with the exception of one subgroup: mental/cognitive functions. Additionally, opinions varied quite consistently regarding aspects of activity limitations and participation restrictions, personal and environmental factors. Ten of the 14 HPDP programmes covered various intervention elements referring to all four ICF components. Eleven programmes involved registered personnel only, while a more divergent pattern was seen in the remaining organisational aspects of the interventions: length of interventions and location plus age segments, participatory approach and contextual information, as well as the theoretical foundation of the interventions. Measures of body functions and structures were significantly improved in 5 out of 17 (29%) targeted aspects. For activity and participation, 12 out of 32 (38%) targeted aspects were positively changed, while the score for environmental factors was 7 out of 22 (32%), and for personal factors 8 out of 22 (36%). Our review suggests that further research is needed to explore and disentangle the complex interrelationships between various interventions and outcomes.

Health‐Promoting Interventions for Persons Aged 80 and Older Are Successful in the Short Term—Results from the Randomized and Three‐Armed Elderly Persons in the Risk Zone Study

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Multi-professional and multi-dimensional group education – a key to action in elderly persons

“…The findings show that the participants experienced that they had received a holistic picture of the topics discussed with the different professionals at the meetings, and that it contributed to their learning a preventive approach. A recent literature review shows that a multi-dimensional program requires a diversity of professionals in order to be effective [46]. The authors concluded that the different professionals probably had their own way of "framing the problem", which means that a multi-professional approach is desirable in view of the complexity of health promotion and disease prevention for elderly persons.…”

Effects on leisure activities and social participation of a case management intervention for frail older people living at home: a randomised controlled trial

“…Common outcome measures on trials of case management interventions have captured clinical outcomes such as self‐rated health, depression, quality of life, cognitive functioning, medical conditions, and IADL and ADL ability, or healthcare consumption outcomes such as hospital admissions and costs (Rahm Hallberg & Kristensson , Eklund & Wilhelmson , Gustavsson et al . , You et al . ).…”