Translational Medicine @ UniSa. Volume 19 (jan.-jun. 2019)

Editorial: Multi-actor collaboration in healthcare to address the emerging health needs of an aging population

2019-01-01T00:00:00Z

Editorial: Multi-actor collaboration in healthcare to address the emerging health needs of an aging population Illario, Maddalena; Coscioni, Enrico; De Luca, Vincenzo; Cataldi, Mauro; Postiglione, Alfredo; Iaccarino, Guido

Integrated care models for managing and preventing frailty: A systematic review for the European Joint Action on Frailty Prevention (ADVANTAGE JA)

Integrated care models for managing and preventing frailty: A systematic review for the European Joint Action on Frailty Prevention (ADVANTAGE JA) Hendry, Anne; Vanhecke, Eliane; Carriaz, Ana Maria; López-Samaniego, Luz; Espinosa, Juan Manuel; Sezgin, Duygu; O’Donovan, Mark; Hammar, Teija; Ferry, Peter; Vella, Antoine; Bacaicoa, Olatz Albaina; Braga, Mario; Ciutan, Marius; Velivasi, Alexandra; Lamprini, Koula Maria; Van der Heyden, Johan; Liew, Aaron; O'Caoimh, Rónán Frailty requires concerted integrated approaches to prevent functional decline. Although there is evidence that integrating care is effective for older people, there is insufficient data on outcomes from studies implementing integrated care to prevent and manage frailty. We systematically searched PubMed and Cochrane Library database for peerreviewed medical literature on models of care for frailty, published from 2002 to 2017. We considered the effective and transferable components of the models of care and evidence of economic impact, where available. Information on European Unionfunded projects or those registered with the European Innovation Partnership on Active and Healthy Ageing, and grey literature (including good practices) were also considered. We found 1,065 potential citations and 170 relevant abstracts. After excluding reports on specific diseases, processes or interventions and service models that did not report data, 42 full papers met the inclusion criteria. The evidence showed that few models of integrated care were specifically designed to prevent and tackle frailty in the community and at the interface between primary and secondary (hospital) care. Current evidence supports the case for a more holistic and salutogenic response to frailty, blending a chronic care approach with education, enablement and rehabilitation to optimise function, particularly at times of a sudden deterioration in health, or when transitioning between home, hospital or care home. In all care settings, these approaches should be supported by comprehensive assessment and multidimensional interventions tailored to modifiable physical, psychological, cognitive and social factors.

An interregional, transdisciplinary and good practice-based approach for frailty: the mind&gait project

2019-01-01T00:00:00Z

An interregional, transdisciplinary and good practice-based approach for frailty: the mind&gait project Apóstolo, Joao; Couto, Filipa; Bobrowicz-Campos, Elzbieta; Dixe, Maria A.; Ribeiro, Jaime; Braúna, Monica; Camacho, Timoteo; Santos-Rocha, Rita; Parreira, Pedro; Cruz, Armenio; Malça, Cândida; Dantas, Carina; Jegundo, Ana Luisa; Marcelino, Luis; Simões, Mara; Almeida, Maria Social facilities such residential structures and day-centres increasingly seek integrated, structured, adapted, creative, dynamic and economic strategies to prevent frailty. The arising need of an aged and frail population requires innovative interventions and products to prevent cognitive and physical decline. The interregional MIND&GAIT project aims to promote independent living in frail older adults by improving cognition and gait ability by using assistive products. This transdisciplinary strategy within a 24-months period expects as project’ deliverables: i) a structured and good practice-based combined intervention (CI) consisting of a cognitive stimulation programme and a physical exercise programme; ii) an auto-blocking mechanism for rolling walkers with biofeedback acquisition (ABMRW); iii) a randomized clinical trial to assess CI’ effectiveness; and iv) a web-platform to be used as a repository that will support and disseminate the intervention materials, covering the action-line of translational research. Positive benefits are expected in prevention and maintenance of frail older adults’ capacities. Preliminary results showed positive effects on the improvement of cognitive and physical functions, functionality and depressive symptomatology. The interregional geographical coverage induced by MIND&GAIT underlines the potential replicability of the project extension to the community in the Centro and Alentejo regions of Portugal. MIND&GAIT network supports actions and provides learning opportunities and emergence of locally-embedded support systems towards social innovation for older adults.

The role of physical frailty independent components on increased disabilities in institutionalized older women

2019-01-01T00:00:00Z

The role of physical frailty independent components on increased disabilities in institutionalized older women Furtado, Guilherme; Letieri, Rubens; Caldo, Adriana; Patricio, Miguel; Loureiro, Marisa; Hogervorst, Eaf; Ferreira, Jose P.; Teixeira, Ana M. The purpose of this study was to identify the independent components of physical frailty that most influence disability indicators in institutionalized older women. A cross-sectional study with 319 participants (81.96+/-7.89 years old) was performed. Disability was assessed through dynamic and static balance tests, activities of daily life and falls risk screen. Fried physical frailty protocol was used to access physical frailty. The frail subgroup displayed the weakest results for all disability indicators (p < 0.05). Regression analysis showed that in the two models tested, low physical activity levels and slowness were the physical frailty independent components that better associated with the disability indicators. More studies with larger samples will help to better understand the independent relationship of each physical frailty component with disability outcomes and assist to design a co-adjuvant treatment to reverse physical frailty.