Multifactorial Intervention on Frailty in Vulnerable Older Adults (ASPRA-IS)

Asan Medical Center

Status: Completed

Conditions: Frailty

Treatments: Other: Usual care; Other: Multifactorial intervention

Study type: Interventional

Funder types: Other

Identifiers

NCT02554994

2015-0706

Details and patient eligibility

About

Frailty is a highly prevalent, progressive condition in older adults that is characterized by multisystem physiologic impairments and vulnerability to stressful events, leading to increased risk of geriatric conditions, disability, falls, hospitalization, and mortality. An effective public health intervention to improve frailty in a rural aging population with limited resources remains unknown. The purpose of our study is to evaluate the effectiveness of multidimensional public health intervention to reduce frailty and related geriatric conditions in older adults in rural communities. Our hypotheses are that a multidimensional intervention consisting of group exercise, nutritional support, depression management, polypharmacy, and home safety intervention over a 6-month period will improve frailty and selected geriatric conditions in older adults who are in low socioeconomic status or living alone in a rural community. Our primary outcome is short physical performance battery at 6 month. Secondary outcomes include frailty status, nutritional status, depression, falls, sarcopenia, and health care utilization. The investigators will conduct a designed delay trial by implementing our intervention in one town for the first 6 months (intervention group), while measuring the outcomes without any intervention in another town (serving as a control group); in the following 6 months, the investigators will implement the 6-month intervention in the control town. The findings from our study will inform us to find effective public health interventions to promote healthy aging in resource-limited, rural populations.

Enrollment: 187 patients

Sex: All

Ages: 65+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Currently living in the PyeongChang county, GangWon province, South Korea
2. Aged 65 years or older
3. Living alone or receiving Medical aid services
4. Sign informed consent

Exclusion criteria

1. Unable to walk 100 meters, with or without assistive devices
2. Institutionalized for the past 6 months
3. Known metastatic cancer, end-stage heart disease, end-stage renal disease
4. Moderate to severe cognitive impairment (MMSE ≤ 18)
5. Plan to move out of the current residence in the next 6 months

Trial design

Primary purpose: Health Services Research

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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187 participants in 2 patient groups

Intervention

Active Comparator group

Description:

ASPRA (Aging Study of PyeongChang Rural Area) cohort is a population-based, prospective cohort study of older adults living in PyeongChang County of South Korea. This cohort study is supported by public health center, named PyeongChang Health Center and Country Hospital managed by government, to improve the quality of aged public health services. All participants will be recruited from ASPRA cohort. After 6 months of usual care period, eligible participants are screened by characteristics of ASPRA database, and are assigned to a multifactorial intervention arm.

Treatment:

Other: Multifactorial intervention

Other: Usual care

usual care

Active Comparator group

Description:

The other participants enrolled to ASPRA cohort are acted as a control arm. The usual care according to ASPRA protocol will be maintained.

Treatment:

Other: Usual care