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The Effectiveness of Frailty Intervention for Older Patients with Frailty during Hospitalization

  • Original Research
  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

This study aims to assess the effectiveness of a multidomain intervention program on the change in functional status of hospitalized older adults.

Design

This single-arm, prospective, non-randomized interventional study investigates the efficacy of a multidomain interventional program including cognitive stimulation activity, simple exercises, frailty education, and nutrition counseling.

Setting and Participants

At a tertiary hospital in southern Taiwan, 352 eligible patients were sequentially enrolled. Included patients were aged ≥65 years (mean age, 79.6 ± 9.0 years; 62% male), scored 3–7 on the Clinical Frailty Scale (CFS), and were hospitalized in the geriatric acute ward.

Intervention

Those receiving standard care (physical rehabilitation and nutrition counseling) during January–July 2019 composed the historical control group. Those receiving the multidomain intervention during August–December 2019 composed the intervention group.

Measurements

The primary outcome was the change in activities of daily life (ADL) and frailty status, as assessed by Katz Index and Clinical Frailty Scale, with using the generalized estimating equation model. The length of hospital stay, medical costs, and re-admission rates were secondary outcomes.

Results

Participants undergoing intervention (n = 101; 27.9%) showed greater improvements in the ADL and CFS during hospitalization (ADL adjusted estimate, 0.61; 95% CI, 0.11–1.11; p = 0.02; CFS adjusted estimate, −1.11; 95% CI, −1.42–−0.80; p < 0.01), shorter length of hospital stay (adjusted estimate, -5.00; 95% CI, −7.99–−2.47; p < 0.01), lower medical costs (adjusted estimate, 0.58; 95% CI, 0.49–0.69; p < 0.01), and lower 30- and 90-day readmission rates (30-day adjusted OR [aOR], 0.12; 95% CI, 0.27–0.50; p < 0.01; 60-day aOR, 0.04; 95% CI, 0.01–0.33; p < 0.01) than did controls.

Conclusions

Participation in the multidomain intervention program during hospitalization improved the functional status and decreased the hospital stay length, medical costs, and readmission rates of frail older people.

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Acknowledgements

The authors would like to thank all colleagues who contributed to this study and the personnel at the Cancer Center, Department of Medical Education and Research, and Research Center of Medical Informatics of Kaohsiung Veterans General Hospital for providing information in response to inquiries and assistance in data processing; Shih-Tsung Huang from Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, and Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan for full assistance in statistical analysis.

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Authors and Affiliations

  1. Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, 386, Ta-Chung 1st RD. Zuoying District, 813, Kaohsiung, Taiwan

    Y.-C. Wang, C.-K. Liang, H.-C. Lin, Y.-H. Hsu, M.-C. Liao,  Ming-Yueh Chou & Y.-T. Lin

  2. Department of Geriatric Medicine, National Yang Ming University School of Medicine, Taipei, Taiwan

    C.-K. Liang &  Ming-Yueh Chou

  3. Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan

    C.-K. Liang &  Ming-Yueh Chou

  4. Division of Neurology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan

    C.-K. Liang & Y.-T. Lin

  5. Department of Nursing, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan

    M.-H. Chou & C.-F. Chiu

  6. Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan

    C.-H. Yin

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Correspondence to Ming-Yueh Chou.

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Conflict of interest: To the best of our knowledge, the named authors have no potential conflict of interest including financial, intellectual property and personal conflicts.

Ethical standards: The authors declare that the study procedures comply with current ethical standards for research involving human participants in Taiwan and follows the principles outlined in the Declaration of Helsinki. The study was approved by the Clinical Research Ethics Committee of the Kaohsiung Veterans General Hospital(KSVGH20-CT9-07). Because this protocol met the waivers of informed consent guidelines, the Institutional Review Board agreed the request to waive the documentation of informed consent.

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Wang, YC., Liang, CK., Chou, MH. et al. The Effectiveness of Frailty Intervention for Older Patients with Frailty during Hospitalization. J Nutr Health Aging 27, 413–420 (2023). https://doi.org/10.1007/s12603-023-1924-y

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