A Pilot Study of a Multicomponent Interventions in Acute Geriatric Care: Effects on Functional Outcomes and Mobility

Introduction: Hospital-induced immobility contributes to functional decline and delirium in older adults. This pilot study evaluated the preliminary efficacy of a multicomponent intervention – Help, Optimise and Mobilise Elders (H.O.M.E) in improving functional mobility among older adults in acute care.

Methods: A quasi-experimental study evaluated the H.O.M.E intervention in older inpatients. The intervention group (n = 42) received pre-mobilisation assessments, regular mobilisation, and weekly group physiotherapy and art activities, while the control group (n = 39) received usual care. Functional mobility and independence were assessed at baseline and discharge (maximum walking distance, gait speed, and the Modified Barthel Index). Secondary outcomes included delirium incidence and hospital length of stay.

Results: Linear regression showed the intervention group had significantly greater improvement in Modified Barthel Index scores than controls (B = 4.19, 95% CI: 0.60–7.79, p = 0.02), with no significant differences in gait speed, maximum walking distance, hospital stay or costs. Unadjusted logistic regression indicated that the intervention group had 65% lower odds of self-reported functional decline at 30 days post-discharge (odds ratio = 0.35, 95% CI: 0.12–0.99, p = 0.047).

Conclusion: The H.O.M.E intervention improved functional independence during hospitalisation and may reduce medium-term functional decline, although limited post-discharge benefits highlight the need for continued care beyond hospitalisation.

SOURCE: Gerontology

DOI: https://doi.org/10.1159/000553113 (opens in new tab)

AUTHORS: Lau LK, Chang TY, Pereira MJ, Yoong RKL, Lim SM, Chua SM, Chia HWA, Ho KYJ, Ee YHD, Lai WK, Lee RPM, Chan BK, Chan PC, Au SYL, Ding YY, Tan MYM.