Multimodal Intervention for Older Adults After an Earthquake

Kahramanmaraş Sütçü İmam University (KSU)

Status: Completed

Conditions: Falls (Accidents) in Old Age; Depression in Adults; Post-Traumatic Stress Disorder in Old Age; Malnutrition Elderly; Frailty at Older Adults

Treatments: Other: Multimodal intervention

Study type: Interventional

Funder types: Other

Identifiers

NCT07273253

EARTHQUAKE_GERIARTRIC_1

Details and patient eligibility

About

This randomized controlled study was conducted among older adults (≥65 years) living in temporary container housing in Kahramanmaraş after the February 2023 earthquakes. A total of 60 participants meeting inclusion criteria were recruited and randomized into two groups: an intervention group (n=30) and a control group (n=30). Randomization was performed using a sealed envelope method following minimization based on frailty scores (Edmonton Frailty Scale ≥4).

The intervention group received a 12-week health management program designed with a holistic approach, addressing physical, mental, and nutritional health needs. Individualized exercise prescriptions (balance, strength, range of motion, posture correction), lifestyle counseling, nutrition education, and medication use training were provided under professional supervision. The control group received no active intervention and only underwent assessments at baseline and at the end of the study.

Measurements were performed at baseline and after 12 weeks. Primary assessments included frailty status (Edmonton Frailty Scale), balance and mobility (Berg Balance Scale, Timed Up and Go Test, Functional Reach Test, Gyko postural sway analysis), physical activity level (PASE questionnaire), physical performance (Short Physical Performance Battery), muscle strength (hand dynamometer, pinch meter, digital force measurement), posture (PostureScreen app), and nutritional status (Mini Nutritional Assessment, anthropometric measures). Cognitive and mental health were evaluated using the Mini-Mental State Examination (MMSE) and the Geriatric Anxiety Scale. Quality of life was assessed with the Nottingham Health Profile.

The study aims to determine whether a structured, holistic health management plan can improve balance, physical activity, and overall health outcomes compared with control in older adults living in post-disaster temporary housing. Findings are expected to inform rehabilitation and preventive health strategies for vulnerable elderly populations in disaster settings.

Full description

This randomized controlled trial was designed to address the health priorities of older adults (≥65 years) living in temporary container housing following the devastating Kahramanmaraş earthquakes in February 2023. Recognizing the unique vulnerabilities of elderly individuals in post-disaster environments - such as frailty, physical inactivity, limited access to care, and psychosocial distress - the study implemented a multidisciplinary, holistic intervention targeting their comprehensive health needs.

Participants were allocated into two groups (intervention and control) based on frailty stratification using the Edmonton Frailty Scale and randomized using a sealed-envelope method. The intervention group received a 12-week individualized health management program, tailored to physical, mental, and nutritional domains. The program was developed and delivered by a multidisciplinary team including physiotherapists, geriatric nurses, nutritionists, and mental health professionals.

The intervention included:

Physical health sessions: individualized exercise plans for posture correction, mobility, strength, and balance.

Nutritional counseling: personalized dietary education based on individual risk factors and nutritional deficiencies.

Mental health support: education on coping mechanisms, peer group interaction, and anxiety-reducing strategies.

Medication education: safe drug use training, including awareness of polypharmacy and drug-food interactions.

All sessions were conducted in person within the container housing area, considering participants' mobility limitations. Adherence was monitored throughout the study. The control group underwent only baseline and 12-week follow-up assessments and received no active intervention during the trial period.

This trial aims to demonstrate the feasibility and effectiveness of a holistic health model in disaster-stricken elderly populations. The approach moves beyond disease management, incorporating lifestyle reorganization and psychosocial support. The findings are intended to contribute to the creation of post-disaster rehabilitation guidelines and policies for geriatric populations in similar emergency settings.

Enrollment: 60 patients

Sex: All

Ages: 65+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Living in a container city,
• Scoring 4 or below on the vulnerability scale,
• Being an earthquake victim,
• Being able to understand verbal commands and being over 65 years of age,
• Being able to speak and understand Turkish,
• Volunteering to participate in the research.

Exclusion criteria

• Not being an earthquake victim,
• Not living in a container,
• Being under 65 years of age,
• Not knowing or understanding Turkish,
• Not wanting to participate in the study,
• Not being able to understand verbal commands,
• Having received any psychological diagnosis,
• Having undergone any surgery within the last 6 months,
• Scoring 5 or above on the frailty scale.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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60 participants in 2 patient groups

Study Group

Experimental group

Description:

Individuals over the age of 65 who experienced the earthquake

Treatment:

Other: Multimodal intervention

Control Group

No Intervention group

Description:

Individuals over the age of 65 who experienced the earthquake