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Maintaining independence in older people

Published online by Cambridge University Press:  07 April 2010

AD Beswick*
Affiliation:
Department of Clinical Science at North Bristol, University of Bristol, UK
R Gooberman-Hill
Affiliation:
Department of Clinical Science at North Bristol, University of Bristol, UK
A Smith
Affiliation:
Department of Clinical Science at North Bristol, University of Bristol, UK
V Wylde
Affiliation:
Department of Clinical Science at North Bristol, University of Bristol, UK
S Ebrahim
Affiliation:
Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
*
Address for correspondence: Andrew Beswick, Orthopaedic Surgery, Department of Clinical Science at North Bristol, University of Bristol, Bristol BS2 8HW. Email: andy.beswick@bristol.ac.uk

Summary

Appropriate social and medical interventions may help maintain independence in older people. Determinants of functional decline, disability and reduced independence are recognized and specific interventions target the treatment of clinical conditions, multiple health problems and geriatric conditions, prevention of falls and fractures, and maintenance of physical and cognitive function and social engagement.

Preventive strategies to identify and treat diverse unmet needs of older people have been researched extensively. We reviewed systematically recent randomized controlled trials evaluating these ‘complex’ interventions and incorporated the findings of 21 studies into an established meta-analysis that included 108,838 people in 110 trials. There was an overall benefit of complex interventions in helping older people to live at home, explained by reduced nursing home admissions rather than death rates. Hospital admissions and falls were also reduced in intervention groups. Benefits were largely restricted to earlier studies, perhaps reflecting general improvements in health and social care for older people. The wealth of high-quality trial evidence endorses the value of preventive strategies to help maintain independence in older people.

Type
Psychological and social gerontology
Copyright
Copyright © Cambridge University Press 2010

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