Cited by 780Frailty in Older AdultsAging, Health, and DisabilityBalance, Gait, and Falls Prevention

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Complex interventions to improve physical function and maintain independent living in elderly people: a systematic review and meta-analysis

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Beswick, Andrew D, Rees, Karen, Dieppe, Paul, Ayis, Salma, Gooberman-Hill, Rachael, Horwood, Jeremy, Ebrahim, Shah·2008·The Lancet

DOI 10.1016/s0140-6736(08)60342-6PMC PMC2262920

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Abstract

Background In old age, reduction in physical function leads to loss of independence, the need for hospital and long-term nursing-home care, and premature death. We did a systematic review to assess the effectiveness of community-based complex interventions in preservation of physical function and independence in elderly people.Methods We searched systematically for randomised controlled trials assessing community-based multifactorial interventions in elderly people (mean age at least 65 years) living at home with at least 6 months of follow-up. Outcomes studied were living at home, death, nursing-home and hospital admissions, falls, and physical function. We did a meta-analysis of the extracted data.Findings We identified 89 trials including 97 984 people. Interventions reduced the risk of not living at home (relative risk [RR] 0.95, 95% CI 0.93-0.97). Interventions reduced nursing-home admissions (0.87, 0.83-0.90), but not death (1.00, 0.97-1.02). Risk of hospital admissions (0.94, 0.91-0.97) and falls (0.90, 0.86-0.95) were reduced, and physical function (standardised mean difference -0.08, -0.11 to -0.06) was better in the intervention groups than in other groups. Benefit for any specific type or intensity of intervention was not noted. In populations with increased death rates, interventions were associated with reduced nursing-home admission. Benefit in trials was particularly evident in studies started before 1993.Interpretation Complex interventions can help elderly people to live safely and independently, and could be tailored to meet individuals' needs and preferences.

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Authors: Beswick, A. D., Rees, K., Dieppe, P., Ayis, S., Gooberman-Hill, R., Horwood, J., & Ebrahim, S.
Affiliations: University of Bristol (GB)
Corresponding author: Beswick, Andrew D
ORCID: Beswick, Andrew D
Rees, Karen
Ayis, Salma
Horwood, Jeremy
Ebrahim, Shah
Venue: The Lancet
Publisher: Elsevier BV
Published: 2008-03
Volume: 371
Issue: 9614
Pages: 725-735
ISSN: 0099-5355 (ISSN-L)
0140-6736
DOI: 10.1016/s0140-6736(08)60342-6
PMC: PMC2262920
OpenAlex: W2123193855
Cited by: 780
References: 118
Citations by year: 2026: 10 · 2025: 25 · 2024: 33 · 2023: 21 · 2022: 22 · 2021: 53 · 2020: 44 · 2019: 60 · 2018: 59 · 2017: 60 · 2016: 65 · 2015: 57 · 2014: 52 · 2013: 57 · 2012: 48
FWCI: 3.16
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
doi.org/10.15223/policy-017 (stm-asf)
doi.org/10.15223/policy-037 (stm-asf)
doi.org/10.15223/policy-012 (stm-asf)
doi.org/10.15223/policy-029 (stm-asf)
doi.org/10.15223/policy-004 (stm-asf)
Locations: The Lancet (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
BIBSYS Brage (BIBSYS (Norway)) (submittedVersion)
Research Portal (King's College London) (submittedVersion)
NORA - Norwegian Open Research Archives (submittedVersion, other-oa)
Bristol Research (University of Bristol) (submittedVersion)
Funders: Medical Research Council
Topics: Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
Keywords: complex interventions, multifactorial intervention, physical function, independent living, older adults, community-based intervention, nursing home admission, hospitalization, falls, mortality
MeSH terms: Activities of Daily Living, Aged, Health Status, Humans, Mortality, Patient Discharge, Risk, Geriatric Assessment, Randomized Controlled Trials as Topic, Frail Elderly, Housing for the Elderly, Community Networks

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Complex interventions to improve physical function and maintain independent living in elderly people: a systematic review and meta-analysis

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