Long-term outcome for ADL following the health-promoting RCT--elderly persons in the risk zone

Gerontologist. 2013 Aug;53(4):654-63. doi: 10.1093/geront/gns121. Epub 2012 Aug 30.

Abstract

Purpose: To examine independence in activities of daily living (ADL) at the 1- and 2-year follow-ups of the health-promoting study Elderly Persons in the Risk Zone.

Design and method: A randomized, three-armed, single-blind, and controlled study. A representative sample of 459 independent and community-dwelling older adults, 80 years and older, were included. A preventive home visit was compared with four weekly multiprofessional senior group meetings including a follow-up home visit.

Results: Analysis showed a significant difference in favor of the senior meetings in postponing dependence in ADL at the 1-year follow-up (odds ratio [OR] = 1.92, 95% confidence interval [CI] = 1.19-3.10) and also in reducing dependence in three (OR = 0.52, 95% CI = 0.31-0.86) and four or more ADL (OR = 0.40, 95% CI = 0.22-0.72) at the 2-year follow-up. A preventive home visit reduced dependence in two (OR = 0.40, 95% CI = 0.24-0.68) and three or more ADL (OR = 0.37, 95% CI = 0.17-0.80) after 1 year.

Implications: A long-term evaluation of Elderly Persons in the Risk Zone showed that both senior meetings and a preventive home visit reduced the extent of dependence in ADL after 1 year. The senior meetings were superior to a preventive home visit since additional significant effects were seen after 2 years. To further enhance the long-term effects of the senior meetings and support the process of self-change in health behavior, it is suggested that booster sessions might be a good way of reinforcing the intervention.

Keywords: Activities of daily living (ADL); Frail elderly; Intention-to-treat analyses; Randomized controlled trial.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living*
  • Aged, 80 and over
  • Disabled Persons
  • Female
  • Follow-Up Studies
  • Frail Elderly*
  • Health Promotion / methods*
  • Home Care Services*
  • Humans
  • Male
  • Patient Education as Topic / methods*
  • Single-Blind Method
  • Statistics, Nonparametric
  • Sweden