Effectiveness of a combined intervention on psychological and physical capacities of frail older adults: a cluster randomized controlled trial

Background: Older adults experience physical and psychological declines affecting independency. Adapted and structured combined interventions composed of cognitive stimulation and physical exercise contribute to comorbidities’ reduction. Methods: Multicenter single-blinded two-arm cluster randomized controlled trial conducted to assess effectiveness of a combined intervention (CI), composed of a cognitive stimulation program (CSP) and a physical exercise program (PEP), on psychological and physical capacities of frail older adults as to on their activities of daily living. Were recruited 50 subjects from two elderly end-user organizations. Of these, 44 (65.9% females, mean age of 80.5 8.47 years) were considered eligible, being randomly allocated in experimental (EG) or control group (CG). Data collected at baseline and post-intervention. EG received CI three times a week during 12 weeks. CG received standard care. Non-parametric measures were considered. Results: At baseline, groups were equivalent for study outcomes. The comparison of pre- and post-intervention data revealed that subjects receiving CI reduced depressive symptomatology and risk of fall based on gait and balance, and improved gait speed. Simultaneously, in the CG a significant decline on activities of daily living was observed. Significant results were found among biomechanical parameters of gait (BPG). EG’ effect size revealed to be small (0.2 r < 0.5). CG’ effect size was also small; but for activities of daily living there was an evident decrease. Conclusion: The CI is effective on managing older adults’ psychological and physical capacities.

Description

Funding: This research was funded by the Portuguese project AAC in 02/SAICT/2016 reference number 023822, is funded by the program COMPETE 2020 under the Scientific and Technological Research Support System, with an incentive of European Regional Development Fund (ERDF). It has the support of the Nursing School of Coimbra and the Health Sciences Research Unit: Nursing. Acknowledgments: The current paper is being presented on behalf of a research group. It is part of the MIND&GAIT project—Promoting independent living in frail older adults by improving cognition and gait ability and using assistive products [74]. This is a Portuguese project with the support of COMPETE 2020 under the Scientific and Technological Research Support System, in the co-promotion phase. We acknowledge The Health Sciences Research Unit: Nursing (UICISA: E) of the Nursing School of Coimbra, the Polytechnic Institute of Leiria, the Polytechnic Institute of Santarém, the Polytechnic Institute of Coimbra, the Caritas Coimbra; the Santa Casa da Misericórdia de Coimbra and also to other members, institutions and students involved in the project.