Frailty, Osteoporosis, Sarcopenia
Conditions
Keywords
Osteoporosis, Sarcopenia, Quality of life, Intrinsic capacity, Frailty
Brief summary
The purpose of this project is: 1. Provide the epidemiological data of the prevalence, incidence, and risk factors of osteoporosis and sarcopenia among the elderly in rural areas. 2. Screen osteoporosis and sarcopenia among the elderly and provide with assistance for following care in order to improve the diagnosis and treatment rates of osteoporosis and sarcopenia 3. Construct a pragmatic and integrated care service model for osteoporosis and sarcopenia in the elderly people from rural areas
Detailed description
Detailed Description: Investigators plan to use a stepped-wedge cluster randomized trial that allocates participants into the following three groups: 1. Screening group: Inform the elderly about the results of the screening and recommend those with moderate to high risk of fracture to receive active examination and treatment. 2. Multi-disciplinary team intervention group: Introduce integrated services of health education, nutrition, rehabilitation, medication evaluation and other multi-specialties to assist study participants with health promotion. 3. Control group (Delayed intervention): receive general care after collecting basic information, and provide health education related information such as osteoporosis sarcopenia. After two year's follow-up, multi-disciplinary team intervention service will be implemented.
Interventions
BEHAVIORALOsteoporosis screening and treatment as needed
All residents underwent screening using the Fracture Risk Assessment Tool (FRAX) and Mobile dual-energy X-ray absorptiometry (DXA) (Horizon Wi, Hologic Inc., Bedford, MA). Our study nurses actively assisted osteoporosis treatment if indicated.
BEHAVIORALSarcopenia
Sarcopenia assessment adhered to the 2019 Consensus Update on Sarcopenia Diagnosis and Treatment by the Asian Working Group for Sarcopenia guideline. Following screening, individuals identified with sarcopenia underwent tailored interventions involving exercise and nutrition as deemed necessary.
BEHAVIORALExercise
TheraBand (resistance band) was utilized as the exercise tool within the community. T
DIETARY_SUPPLEMENTNutrition
Nutrition Nutritional education programs aim to increase protein food serving and the choice of those with insufficient dietary intake. Protein supplement was added if indicated.
BEHAVIORALPharmaceutical care
We collected drug information of the elderly. Detailed and real-time prescription drug information was retrieved from the National Health Insurance PharmaCloud System. A pharmaceutical care team performed patient-centered drug review and discussion every three to six months.
Sponsors
National Health Research Institutes, Taiwan
National Taiwan University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
50 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Age≥ 50 old and lived in the community
Exclusion criteria
* Life expectancy less than two years
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Intrinsic capacity | one year, two year, 3 year, four year | To define if the Intrinsic capacity would be changed after intervention |
| Institutionalilzation rate | one year, two year, 3 year, four year | To define if the Institutionalilzation rate would be changed after intervention |
| The changes of Quality of life and quality adjusted life year | one year, two year, 3 year, four year | Using EQ5D / WHOQOL Brief questionnaires to measure quality of life and evaluate the changes after intervention. In addition, to calculate quality adjusted life year by using utility index derived from qualify of life measurement. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of fall | one year, two year, 3 year, four year | To define if the fall frequency would be changed after intervention |
| Incidence of fracture | one year, two year, 3 year, four year | To define if the incidence of fracture would be changed after intervention |
| Incidence of unexpected hospitalization | one year, two year, 3 year, four year | To define if the unexpected hospitalization would be changed after intervention |
Other
| Measure | Time frame | Description |
|---|---|---|
| Nutrition related outcomes | one year, two years | Changes in protein intake, dietary/caloric intake, nutritional status |
| Incidence of mortality | one year, two year, 3 year, four year | To define if the Incidence of mortality would be changed after intervention |
| Cognition | one year, two years | Changes in MMSE |
| Changes of drug related problems | one year, two year, 3 year, four year | Under the assumption of the intervention of pharmaceutical care in the multi-component group can improve the DRPs of the elderly, we also measured the changes of drug number, anticholinergic burden and adherence (using the Adherence to Refills and Medications Scale). |
| Phyiscal performance | one year, two years | Changes of muscle strength, body composition, physical performance, activites of daily living |
| Sarcopenia related outcomes | one year, two years | We follow sarcopenia diagnosis rate, treatment rate, changes of muscle mass, fat, and muscle-fat index |
| Osteoporosis related outcomes | one year, two years | We follow osteoporosis diagnosis rate, treatment rate, adherence to osteoporosis treatment, and changes of bone mineral density |
| Mental health | one year, two years | We use Geriatric Depression Scale and Chinese Happiness Inventory to measure depression and happiness |
Countries
Taiwan
Contacts
Primary ContactShau-Huai Fu, Doctor
Backup ContactChen-Yu Wang, Doctor
Outcome results
None listed