Impact on physical function of the +AGIL Barcelona program in community-dwelling older adults with cognitive impairment: an interventional cohort study

Abstract Background Older adults with cognitive impairment (CI) have higher multimorbidity and frailty prevalence, lower functional status and an increased likelihood to develop dementia, non-cognitive deficits, and adverse health-related events. +AGIL, a real-world program for frail older adults in...

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Main Authors: Cristina Arnal, L Monica Pérez, Luís Soto, Álvaro Casas Herrero, Joan Ars, Sonia Baró, Francisco Díaz, Araceli Abilla, M Belén Enfedaque, Matteo Cesari, Marco Inzitari
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Language:English
Published: BMC 2023-11-01
Series:BMC Geriatrics
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Online Access:https://doi.org/10.1186/s12877-023-04292-4
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author Cristina Arnal
L Monica Pérez
Luís Soto
Álvaro Casas Herrero
Joan Ars
Sonia Baró
Francisco Díaz
Araceli Abilla
M Belén Enfedaque
Matteo Cesari
Marco Inzitari
author_facet Cristina Arnal
L Monica Pérez
Luís Soto
Álvaro Casas Herrero
Joan Ars
Sonia Baró
Francisco Díaz
Araceli Abilla
M Belén Enfedaque
Matteo Cesari
Marco Inzitari
author_sort Cristina Arnal
collection DOAJ
description Abstract Background Older adults with cognitive impairment (CI) have higher multimorbidity and frailty prevalence, lower functional status and an increased likelihood to develop dementia, non-cognitive deficits, and adverse health-related events. +AGIL, a real-world program for frail older adults in a primary care area of Barcelona, is a pragmatic, multi-component and integrated intervention implemented since 2016. It includes physical activity, nutrition, sleep hygiene, revision and adequacy of pharmacological treatment, detection of undesired loneliness and screening for CI; to improve physical function in community-dwelling older adults. We aimed to assess the + AGIL longitudinal impact on physical function among community-dwelling frail older persons with CI. Methods An interventional cohort study included data from all the + AGIL consecutive participants from July 2016 until March 2020. Based on the comprehensive geriatric assessment, participants were offered a tailored multi-component community intervention, including a 10-week physical activity program led by an expert physical therapist. Physical performance was measured at baseline, three and six months follow-up. The pre-post impact on physical function was assessed by paired sample t-test for repeated samples. Linear mixed models were applied to analyze the + AGIL longitudinal impact. P-values < 0.05 were considered statistically significant. Results 194 participants were included (82 with CI, based on previous diagnosis or the Mini-COG screening tool), 68% women, mean age 81.6 (SD = 5.8) yo. Participants were mostly independent in Activities of Daily Living (mean Barthel = 92.4, SD = 11.1). The physical activity program showed high adherence (87.6% attended ≥ 75% sessions). At three months, there was a clinically and statistically significant improvement in the Short Physical Performance Battery (SPPB) and its subcomponents in the whole sample and after stratification for CI [CI group improvements: SPPB = 1.1 (SD = 1.8) points, gait speed (GS) = 0.05 (SD = 0.13) m/s, Chair stand test (CST)=-2.6 (SD = 11.4) s. Non-CI group improvements: SPPB = 1.6 (SD = 1.8) points, GS = 0.08 (SD = 0.13) m/s, CST=-6.4 (SD = 12.1) seg]. SPPB and gait speed remained stable at six months in the study sample and subgroups. CI had no significant impact on SPPB or GS improvements. Conclusion Our results suggest that older adults with CI can benefit from a multidisciplinary integrated and comprehensive geriatric intervention to improve physical function, a component of frailty.
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spelling doaj-art-77a2bcb93f4b4cb9bb3d7e38048d10d62025-08-20T03:53:32ZengBMCBMC Geriatrics1471-23182023-11-0123111010.1186/s12877-023-04292-4Impact on physical function of the +AGIL Barcelona program in community-dwelling older adults with cognitive impairment: an interventional cohort studyCristina Arnal0L Monica Pérez1Luís Soto2Álvaro Casas Herrero3Joan Ars4Sonia Baró5Francisco Díaz6Araceli Abilla7M Belén Enfedaque8Matteo Cesari9Marco Inzitari10RE-FiT Barcelona Research group. Vall d’Hebron Institute of Research (VHIR) and Parc Sanitari Pere VirgiliRE-FiT Barcelona Research group. Vall d’Hebron Institute of Research (VHIR) and Parc Sanitari Pere VirgiliRE-FiT Barcelona Research group. Vall d’Hebron Institute of Research (VHIR) and Parc Sanitari Pere VirgiliGeriatric Department, Hospital Universitario de Navarra (HUN)RE-FiT Barcelona Research group. Vall d’Hebron Institute of Research (VHIR) and Parc Sanitari Pere VirgiliRE-FiT Barcelona Research group. Vall d’Hebron Institute of Research (VHIR) and Parc Sanitari Pere VirgiliPrimary Healthcare Center Bordeta-Magòria, Catalan Health InstitutePrimary Healthcare Center Bordeta-Magòria, Catalan Health InstituteCatalan Health InstituteGeriatric Unit, IRCCS Insittuti Clinici Scientifici Maugeri, University of MilanRE-FiT Barcelona Research group. Vall d’Hebron Institute of Research (VHIR) and Parc Sanitari Pere VirgiliAbstract Background Older adults with cognitive impairment (CI) have higher multimorbidity and frailty prevalence, lower functional status and an increased likelihood to develop dementia, non-cognitive deficits, and adverse health-related events. +AGIL, a real-world program for frail older adults in a primary care area of Barcelona, is a pragmatic, multi-component and integrated intervention implemented since 2016. It includes physical activity, nutrition, sleep hygiene, revision and adequacy of pharmacological treatment, detection of undesired loneliness and screening for CI; to improve physical function in community-dwelling older adults. We aimed to assess the + AGIL longitudinal impact on physical function among community-dwelling frail older persons with CI. Methods An interventional cohort study included data from all the + AGIL consecutive participants from July 2016 until March 2020. Based on the comprehensive geriatric assessment, participants were offered a tailored multi-component community intervention, including a 10-week physical activity program led by an expert physical therapist. Physical performance was measured at baseline, three and six months follow-up. The pre-post impact on physical function was assessed by paired sample t-test for repeated samples. Linear mixed models were applied to analyze the + AGIL longitudinal impact. P-values < 0.05 were considered statistically significant. Results 194 participants were included (82 with CI, based on previous diagnosis or the Mini-COG screening tool), 68% women, mean age 81.6 (SD = 5.8) yo. Participants were mostly independent in Activities of Daily Living (mean Barthel = 92.4, SD = 11.1). The physical activity program showed high adherence (87.6% attended ≥ 75% sessions). At three months, there was a clinically and statistically significant improvement in the Short Physical Performance Battery (SPPB) and its subcomponents in the whole sample and after stratification for CI [CI group improvements: SPPB = 1.1 (SD = 1.8) points, gait speed (GS) = 0.05 (SD = 0.13) m/s, Chair stand test (CST)=-2.6 (SD = 11.4) s. Non-CI group improvements: SPPB = 1.6 (SD = 1.8) points, GS = 0.08 (SD = 0.13) m/s, CST=-6.4 (SD = 12.1) seg]. SPPB and gait speed remained stable at six months in the study sample and subgroups. CI had no significant impact on SPPB or GS improvements. Conclusion Our results suggest that older adults with CI can benefit from a multidisciplinary integrated and comprehensive geriatric intervention to improve physical function, a component of frailty.https://doi.org/10.1186/s12877-023-04292-4Community-dwellingAgedCognition disordersPhysical functional performanceMulticomponent exercise program.
spellingShingle Cristina Arnal
L Monica Pérez
Luís Soto
Álvaro Casas Herrero
Joan Ars
Sonia Baró
Francisco Díaz
Araceli Abilla
M Belén Enfedaque
Matteo Cesari
Marco Inzitari
Impact on physical function of the +AGIL Barcelona program in community-dwelling older adults with cognitive impairment: an interventional cohort study
BMC Geriatrics
Community-dwelling
Aged
Cognition disorders
Physical functional performance
Multicomponent exercise program.
title Impact on physical function of the +AGIL Barcelona program in community-dwelling older adults with cognitive impairment: an interventional cohort study
title_full Impact on physical function of the +AGIL Barcelona program in community-dwelling older adults with cognitive impairment: an interventional cohort study
title_fullStr Impact on physical function of the +AGIL Barcelona program in community-dwelling older adults with cognitive impairment: an interventional cohort study
title_full_unstemmed Impact on physical function of the +AGIL Barcelona program in community-dwelling older adults with cognitive impairment: an interventional cohort study
title_short Impact on physical function of the +AGIL Barcelona program in community-dwelling older adults with cognitive impairment: an interventional cohort study
title_sort impact on physical function of the agil barcelona program in community dwelling older adults with cognitive impairment an interventional cohort study
topic Community-dwelling
Aged
Cognition disorders
Physical functional performance
Multicomponent exercise program.
url https://doi.org/10.1186/s12877-023-04292-4
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