Effects of comprehensive geriatric assessment and targeted intervention on mobility in persons aged 75 years and over: a randomized controlled trial.

OBJECTIVE

To assess the effect of a comprehensive geriatric assessment and individually tailored intervention on mobility in older people. In addition, the effectiveness of the geriatric intervention was evaluated among a subgroup of persons with musculoskeletal pain.

DESIGN

Three-year geriatric development project with randomized assignment to intervention and control group.

SETTING

Research centre, community and assisted living facilities.

PARTICIPANTS

Seven hundred and eighty-one Finnish persons aged 75-98 years were assigned to an intervention (n = 404) or control (n = 377) group.

INTERVENTION

A comprehensive geriatric assessment with a multifactorial intervention lasting two years. The intervention included individualized referrals, recommendations, physical activity counselling and supervised resistance training.

MEASUREMENTS

Perceived limitation in walking 400m was gathered annually during the intervention and at the one-year post-intervention follow-up.

RESULTS

The proportion of persons with mobility limitation at the beginning, at the two-year intervention and at the one-year post-intervention follow-up was 16%, 15%, 12% and 14%, respectively, in the intervention group. In the control group, the corresponding proportions were 19%, 18%, 23% and 26%. The treatment effect was significant at the end of the two-year intervention (odds ratio 0.82, 95% confidence interval 0.70-0.96, P = 0.013), and at the one-year post-intervention follow-up (0.84, 0.75-0.94, P = 0.002). The parallel positive effect of the intervention on mobility was even greater among persons with musculoskeletal pain.

CONCLUSION

The comprehensive geriatric assessment and individually tailored multifactorial intervention had a positive effect on mobility, underlining their importance in health promotion and disability prevention in older people.