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Citation
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Liu M, Xue QL, Gitlin LN, Wolff JL, Guralnik J, Leff B, Szanton SL. J. Am. Geriatr. Soc. 2020; ePub(ePub): ePub. |
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Abstract
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OBJECTIVES: To evaluate the effects of a home-based disability prevention program on life-space and falls efficacy among low-income older adults.
DESIGN: Single-blind two-arm randomized controlled trial.
SETTING: Participants' homes.
PARTICIPANTS: Participants were low-income cognitively intact older adults (≥65 years old) with restricted daily activities. Our analytic sample for life-space (n = 194) and falls efficacy (n = 233) varied as the life-space measure was introduced 4 months after the trial began.
INTERVENTION: Up to six 1-hour home visits with an occupational therapist; up to four 1-hour home visits with a registered nurse; and up to $1,300 worth of home repairs, modifications, and assistive devices with a handyman, during a course of 4 months.
MEASUREMENTS: Life-space was measured by the Homebound Mobility Assessment; falls efficacy was measured using the 10-item Tinetti Falls Efficacy Scale at baseline and 5 months.
RESULTS: Participants were on average 75 years old, predominantly Black (86%) and female (85%-86%). Compared with participants in the control group, participants receiving the intervention were more likely to have improved versus decreased life-space in areas of bathroom (adjusted odds ratio (OR) = 3.95; 95% confidence interval (CI) = 1.20-12.97), front or back porch, patio, or deck (adjusted OR = 2.67; 95% CI = 1.05-6.79), stairs (adjusted OR = 4.09; 95% CI = 1.34-12.48), leaving the house for any reason other than for health care (adjusted OR = 2.40; 95% CI = 1.01-5.73), and overall life-space (adjusted OR = 2.15; 95% CI = 1.10-4.19). Participants who received the intervention also had an 11% improvement in falls efficacy in performing daily activities (exponentiated coefficient = 1.12; 95% CI = 1.04-1.21).
CONCLUSION: Life-space and falls efficacy were improved through a multicomponent, person-directed, home-based disability prevention intervention.
FINDINGS suggest that this intervention should be translated into different settings to promote independent aging.
Language: en |