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European Geriatric Medicine
https://doi.org/10.1007/s41999-020-00321-2
RESEARCH PAPER
A cohort study of the efects of multidisciplinary in‑patient primary
care in older adults
Martin Gronbech Jorgensen
1
· Maria Rodrigo‑Domingo
2
· Stig Andersen
1,3
· Johannes Riis
1,3
·
Dorthe Bruun Jakobsen
4
· Mikkel Lerche
4
· Hanne Hostrup
5
· Jane Andreasen
6,7
Received: 28 November 2019 / Accepted: 2 April 2020
© European Geriatric Medicine Society 2020
Key summary points
Aim To evaluate to the efects of a multifactorial, multidisciplinary in-patient municipality intervention on functioning,
need-of-care, and quality of life in functionally declining older adults.
Findings Following the intervention, patients had increased quality of life, which remained at the post-intervention level
even after 6 months. Further, participants had lower need-of-care and increased performance in physical function tests.
Message A well-structured multifactorial and multidisciplinary in-patient intervention may lead to long-term clinically
relevant improvements in functionally declining older adults.
Abstract
Purpose To evaluate short and long-term efects of a multifactorial and multidisciplinary in-patient municipality intervention
including training of activities of daily living, cardiovascular exercise, resistance training and social activities on quality-of-
life, need-of-care, and physical function in older adults at risk of further functional decline.
Method A cohort study including data collected rigorously during 3.5 years at an in-patient municipality rehabilitation center
in Aalborg, Denmark. Patients received a multifactorial and multidisciplinary intervention. Outcomes were quality-of-life
(EQ5D), weekly need-of-care hours, and test of physical functioning (sit-to-stand, 6-min walking test, tandem balance).
Results Data was collected from 532 patients (63.3% women). The median [5; 95 percentiles] age was 79 [55; 92] years
with a length-of-stay of 21 [8; 55] days. The mean (95% CI) EQ5D index score showed a clinically relevant improvement
from admission 0.46 (0.44; 0.48) to discharge 0.69 (0.67; 0.71) and there was no decline 6-month postdischarge 0.67 (0.64;
0.70). The weekly need-of-care decreased signifcantly by 7.2 (6.6, 7.9) h from a mean of 9.8 h before admission to 2.6 h
6-month postdischarge. Sit-to-stand improved from 6.3 (6.0; 6.7) to 9.3 (8.9; 9.6) repetitions, 6-min walking test from 147
(138; 156) to 217 (207; 227) m, and tandem balance from 20.7 (19.8; 21.6) to 25.2 (24.8; 26.2) s.
Conclusion Our results were remarkable and highlight that a well-structured multifactorial and interdisciplinary intervention
with a clear aim and inclusion criteria related to functional decline may lead to long-term clinically relevant improvements in
functionally declining older adults. Future studies should, however, explore similar interventions in comparable populations
preferably in randomized controlled designs.
* Johannes Riis
johannes0408@live.dk
1
Department of Geriatric and Internal Medicine, Aalborg
University Hospital, Hobrovej 18, 9000 Aalborg, Denmark
2
Department of Psychiatry, Aalborg University Hospital,
Aalborg, Denmark
3
Department of Clinical Medicine, Aalborg University,
Aalborg, Denmark
4
Unit of Quality and Innovation, Department of Care
for the Elderly and Disabled, Aalborg Municipality, Aalborg,
Denmark
5
Rehabilitation Center Aalborg (Mou), Aalborg, Denmark
6
Department of Physiotherapy and Occupational Therapy,
Aalborg University Hospital, Aalborg, Denmark
7
Public Health and Epidemiology Group, Department
of Health, Science and Technology, Aalborg University,
Aalborg, Denmark