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Complex interventions for improving independent living and quality of life amongst community-dwelling older adults: a systematic review and meta-analysis.
- Source :
- Age & Ageing; Jul2023, Vol. 52 Issue 7, p1-21, 21p, 1 Diagram, 4 Charts
- Publication Year :
- 2023
-
Abstract
- Background community-based complex interventions for older adults have a variety of names, including Comprehensive Geriatric Assessment, but often share core components such as holistic needs assessment and care planning. Objective to summarise evidence for the components and effectiveness of community-based complex interventions for improving older adults' independent living and quality of life (QoL). Methods we searched nine databases and trial registries to February 2022 for randomised controlled trials comparing complex interventions to usual care. Primary outcomes included living at home and QoL. Secondary outcomes included mortality, hospitalisation, institutionalisation, cognitive function and functional status. We pooled data using risk ratios (RRs) or standardised mean differences (SMDs) with 95% confidence intervals (CIs). Results we included 50 trials of mostly moderate quality. Most reported using holistic assessment (94%) and care planning (90%). Twenty-seven (54%) involved multidisciplinary care, with 29.6% delivered mainly by primary care teams without geriatricians. Nurses were the most frequent care coordinators. Complex interventions increased the likelihood of living at home (RR 1.05; 95% CI 1.00–1.10; moderate-quality evidence) but did not affect QoL. Supported by high-quality evidence, they reduced mortality (RR 0.86; 95% CI 0.77–0.96), enhanced cognitive function (SMD 0.12; 95% CI 0.02–0.22) and improved instrumental activities of daily living (ADLs) (SMD 0.11; 95% CI 0.01–0.21) and combined basic/instrumental ADLs (SMD 0.08; 95% CI 0.03–0.13). Conclusions complex interventions involving holistic assessment and care planning increased the chance of living at home, reduced mortality and improved cognitive function and some ADLs. [ABSTRACT FROM AUTHOR]
- Subjects :
- MORTALITY prevention
CINAHL database
PSYCHOLOGY information storage & retrieval systems
MEDICAL databases
META-analysis
CONFIDENCE intervals
MEDICAL information storage & retrieval systems
SYSTEMATIC reviews
FUNCTIONAL status
HOME care services
GERIATRIC assessment
COMMUNITY health services
ACTIVITIES of daily living
COGNITION
HOLISTIC medicine
INDEPENDENT living
QUALITY of life
DESCRIPTIVE statistics
HEALTH care teams
MEDLINE
Subjects
Details
- Language :
- English
- ISSN :
- 00020729
- Volume :
- 52
- Issue :
- 7
- Database :
- Complementary Index
- Journal :
- Age & Ageing
- Publication Type :
- Academic Journal
- Accession number :
- 169328721
- Full Text :
- https://doi.org/10.1093/ageing/afad132