Does a functional activity programme improve function, quality of life, and falls for residents in long term care? Cluster randomised controlled trial

Contact Information

Keywords

Ngaire Kerse zn.ca.dnalkcua@esrek.n

N/A

Abstract

Objective: To assess the effectiveness of an activity programme in improving function, quality of life, and falls in older people in residential care. Design: Cluster randomised controlled trial with one year follow-up. Setting: 41 low level dependency residential care homes in New Zealand. Participants: 682 people aged 65 years or over. Interventions: 330 residents were offered a goal setting and individualised activities of daily living activity programme by a gerontology nurse, reinforced by usual healthcare assistants; 352 residents received social visits. Main outcome measures: Function (late life function and disability instruments, elderly mobility scale, FICSIT-4 balance test, timed up and go test), quality of life (life satisfaction index, EuroQol), and falls (time to fall over 12 months). Secondary outcomes were depressive symptoms and hospital admissions. Results: 473 (70%) participants completed the trial. The programme had no impact overall. However, in contrast to residents with impaired cognition (no differences between intervention and control group), those with normal cognition in the intervention group may have maintained overall function (late life function and disability instrument total function, P=0.024) and lower limb function (late life function and disability instrument basic lower extremity, P=0.015). In residents with cognitive impairment, the likelihood of depression increased in the intervention group. No other outcomes differed between groups. Conclusion: A programme of functional rehabilitation had minimal impact for elderly people in residential care with normal cognition but was not beneficial for those with poor cognition. Trial registration Australian Clinical Trials Register ACTRN12605000667617.

Citation

Kerse, N., Peri, K., Robinson, E., Wilkinson, T., von Randow, M., Kiata, L., Parsons, J., Latham, N., Parsons, M., Willingale, J., Brown, P., & Arroll, B. (2008). Does a functional activity programme improve function, quality of life, and falls for residents in long term care? Cluster randomised controlled trial. BMJ (Clinical research ed.), 337, a1445. https://doi.org/10.1136/bmj.a1445

DOI

10.1136/bmj.a1445

EWB Constructs:

(1) goal pursuit; (2) life satisfaction; (3) positive affect; (5) sense of meaning

EWB Measures:

(1) life satisfaction index
(2) EuroQol (quality of life)

data availability:

data availability details:

N/A

brain imaging paradigm:

N/A

brain region/circuit:

Exclusion Criteria:

We excluded residents who were unable to communicate to complete the study measures, had anxiety as their main diagnosis, were acutely unwell, or were in a terminal state.

Inclusion Criteria

Eligible residents were aged 65 years and over, able to engage in a conversation about a goal, remember the goal, and participate in a programme to achieve the goal (a proxy for cognitive state).

Non-EWB Behavioral
Measures:

(1) abbreviated mental test score
(2) geriatric depression scale
(3) late life function and disability instrument
(4) elderly mobility scale
(5) timed up and go test

First author:

Ngaire Kerse

species:

Human

sample size:

682

study design:

(5) RCT

longitudinal data?

Yes

younger controls?

interventions:

promoting independence in residential care (PIRC) intervention

study population:

(1) cognitively healthy adults
(2) patients with (pre)clinical dementia

sex (% female):

74%

ethnicity (%white)

not stated (New Zealand)

Age (mean, sd):

84.3, 7.2

biological/Physiological Measures:

N/A