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Effects of preventive home visits on health-related quality-of-life and mortality in home-dwelling older adults.

https://arctichealth.org/en/permalink/ahliterature300278
Source
Scand J Prim Health Care. 2019 Mar; 37(1):90-97
Publication Type
Journal Article
Randomized Controlled Trial
Date
Mar-2019
Author
Heini Liimatta
Pekka Lampela
Pirjo Laitinen-Parkkonen
Kaisu H Pitkala
Author Affiliation
a Hyvinkää City Health Centre , Hyvinkää , Finland.
Source
Scand J Prim Health Care. 2019 Mar; 37(1):90-97
Date
Mar-2019
Language
English
Publication Type
Journal Article
Randomized Controlled Trial
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Female
Finland - epidemiology
Geriatric Assessment
Home Care Services
House Calls
Humans
Independent living
Male
Mortality
Preventive Health Services
Quality of Life
Abstract
We explored the effectiveness of preventive home visits on the health-related quality-of-life (HRQoL) and mortality among independently community-dwelling older adults.
A randomised controlled trial.
Independently home-dwelling older adults 75 years and older, consisting of 211 in the intervention and 211 in the control group.
Hyvinkää town municipality, Finland.
We used the change in HRQoL measured by the 15D scale as our primary outcome. Mortality at two years was retrieved from central registers.
At the one-year time point, the HRQoL according to the 15D scores deteriorated in the control group, whereas we found no change in the intervention group. The difference between the 15D score changes between the groups was -0.015 (95% CI -0.029 to -0.0016; p?=?0.028, adjusted for age, sex, and baseline value). At the two-year time point as the visits ended, that difference diminished. There was no difference in mortality between the groups during the 24-month follow-up.
Preventive home visits implemented by a multidisciplinary team with CGA appear to help slow down the decline in HRQoL among older adults, although the effect diminishes when the visits end. Key points We are exploring preventive home visits as means to support the health-related quality-of-life (HRQoL) of home-dwelling older adults Multiprofessional preventive home visits in this intervention study helped to maintain the HRQoL when measured using 15D The effects on HRQoL diminished when the intervention ended, so could further benefits be attained with a longer intervention?The clinical trial registration number: ACTRN12616001411437.
PubMed ID
30810457 View in PubMed
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Exercise rehabilitation on home-dwelling patients with Alzheimer's disease--a randomized, controlled trial. Study protocol.

https://arctichealth.org/en/permalink/ahliterature140239
Source
Trials. 2010;11:92
Publication Type
Article
Date
2010
Author
Kaisu H Pitkala
Minna M Raivio
Marja-Liisa Laakkonen
Reijo S Tilvis
Hannu Kautiainen
Timo E Strandberg
Author Affiliation
Unit of General Practice, Helsinki University Central Hospital, University of Helsinki, PO Box 20, 00014 University of Helsinki, Finland. kaisu.pitkala@kolumbus.fi
Source
Trials. 2010;11:92
Date
2010
Language
English
Publication Type
Article
Keywords
Aged
Alzheimer Disease - economics - physiopathology - psychology - rehabilitation
Caregivers
Clinical Protocols
Cognition
Cost of Illness
Cost-Benefit Analysis
Day Care - economics
Depression - etiology
Disability Evaluation
Exercise Therapy - economics
Finland
Frail Elderly
Health Care Costs
Humans
Independent living
Mobility Limitation
Neuropsychological Tests
Postural Balance
Quality of Life
Research Design
Time Factors
Treatment Outcome
Walking
Abstract
Besides cognitive decline, Alzheimer's disease (AD) leads to physical disability, need for help and permanent institutional care. The trials investigating effects of exercise rehabilitation on physical functioning of home-dwelling older dementia patients are still scarce. The aim of this study is to investigate the effectiveness of intensive exercise rehabilitation lasting for one year on mobility and physical functioning of home-dwelling patients with AD.
During years 2008-2010, patients with AD (n = 210) living with their spousal caregiver in community are recruited using central AD registers in Finland, and they are offered exercise rehabilitation lasting for one year. The patients are randomized into three arms: 1) tailored home-based exercise twice weekly 2) group-based exercise twice weekly in rehabilitation center 3) control group with usual care and information of exercise and nutrition. Main outcome measures will be Guralnik's mobility and balance tests and FIM-test to assess physical functioning. Secondary measures will be cognition, neuropsychiatric symptoms according to the Neuropsychiatric Inventory, caregivers' burden, depression and health-related quality of life (RAND-36). Data concerning admissions to institutional care and the use and costs of health and social services will be collected during a two year follow-up.
To our knowledge this is the first large scale trial exploring whether home-dwelling patients with AD will benefit from intense and long-lasting exercise rehabilitation in respect to their mobility and physical functioning. It will also provide data on cost-effectiveness of the intervention.
ACTRN12608000037303.
Notes
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PubMed ID
20925948 View in PubMed
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Nutritional treatment of aged individuals with Alzheimer disease living at home with their spouses: study protocol for a randomized controlled trial.

https://arctichealth.org/en/permalink/ahliterature124098
Source
Trials. 2012;13:66
Publication Type
Article
Date
2012
Author
Satu K Jyvakorpi
Taija Puranen
Kaisu H Pitkala
Merja H Suominen
Author Affiliation
Society for Memory Disorders Expertise in Finland, Fredriksberginkatu 2, 00240 Helsinki, Finland.
Source
Trials. 2012;13:66
Date
2012
Language
English
Publication Type
Article
Keywords
Aged
Alzheimer Disease - complications - diagnosis - physiopathology - psychology - therapy
Body Weight
Caregivers - psychology
Cognition
Counseling
Depression - etiology
Dietary Supplements
Finland
Geriatric Assessment
Hand Strength
Humans
Independent living
Malnutrition - diagnosis - etiology - physiopathology - prevention & control - psychology
Nutrition Assessment
Nutrition Therapy
Nutritional Status
Quality of Life
Research Design
Spouses - psychology
Time Factors
Treatment Outcome
Vitamin D - therapeutic use
Vitamins - therapeutic use
Abstract
Nutritional status often deteriorates in Alzheimer's disease (AD). Less is known about whether nutritional care reverses malnutrition and its harmful consequences in AD. The aim of this study is to examine whether individualized nutritional care has an effect on weight, nutrition, health, physical functioning, and quality of life in older individuals with AD and their spouses living at home.
AD patients and their spouses (aged > 65?years) living at home (n?=?202, 102?AD patients) were recruited using central AD registers in Finland. The couples were randomized into intervention and control groups. A trained nutritionist visited intervention couples 4-8 times at their homes and the couples received tailored nutritional care. When necessary, the couples were given protein and nutrient-enriched complementary drinks. All intervention couples were advised to take vitamin D 20?µg/day. The intervention lasted for one year. The couples of the control group received a written guide on nutrition of older people. Participants in the intervention group were assessed every three months. The primary outcome measure is weight change. Secondary measures are the intake of energy, protein, and other nutrients, nutritional status, cognition, caregiver's burden, depression, health related quality of life and grip strength.
This study provides data on whether tailored nutritional care is beneficial to home-dwelling AD patients and their spouses.
ACTRN 12611000018910.
Notes
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PubMed ID
22624652 View in PubMed
Less detail