Neumann L, Dapp U, von Renteln-Kruse W, Minder C E
Lilli Neumann, Albertinen-Haus, Geriatrics Centre, Scientific Department at the University of Hamburg, Sellhopsweg 18-22, D-22459 Hamburg, Germany, Tel.: ++49-40-5581-1692; Fax: ++49-40-5581-1874; E-Mail:
J Nutr Health Aging. 2017;21(9):1016-1023. doi: 10.1007/s12603-017-0932-1.
An RCT of a health promotion and preventive care intervention was done in 2001-2002. Here, long-term analyses based on 12 years of follow-up of survival and of change in functional competence between intervention and control group are presented. Positive 1-year results (significantly higher use of preventive services and better health behaviour) were presented earlier.
Parallel group randomised controlled trial (RCT) with 878 participants in the intervention and 1,702 participants in the control group.
The study took place in Hamburg, Germany and made use of health care structures and professionals of a geriatrics centre.
Study participants were initially community-dwelling, aged 60 years and older and without B-ADL-restrictions, cognitive impairment, or need of nursing care, with sufficient command of the German language.
Health promotion and preventive care interventions relied on an extensive health questionnaire and the subsequent offer to participate in multi-topic personal reinforcement performed in small group sessions or at preventive home visits.
Primary outcome: Survival time; in some analyses, adjustments were made for gender, age and self-perceived health. Secondary outcome: Functional competence (LUCAS Functional Ability Index) based on responses to self-administered questionnaires at 1-year follow-up and 12 years after 1-year follow-up (2013/2014).
Mean time under observation was 10.3 years. 38.3% (987/2,580) of the participants died; intervention group (IG): 35.7% (313/878), control group (CG): 39.6% (674/1,702); HR=0.89; p=0.09. Functional competence at 1-year follow-up: IG: ROBUST 67.4% (391/580), FRAIL 11.9% (69/580) vs. CG: ROBUST 62.9% (861/1,368), FRAIL 14.8% (203/1,368); p=0.12. 12-years after 1-year follow-up: IG: ROBUST 50.0% (160/320), FRAIL 30.9% (99/320) vs. CG: ROBUST 48.9% (307/628), FRAIL 34.1% (214/628); p=0.56.
Insignificant but consistent effects on survival and the dynamics of functional competence suggest effectivity of the complex intervention. We plan to take a closer look at the effect of each reinforcement separately.
2001 - 2002年开展了一项健康促进与预防保健干预的随机对照试验（RCT）。本文呈现了基于12年随访的干预组与对照组生存情况及功能能力变化的长期分析结果。此前已公布了1年的阳性结果（预防服务使用显著增加且健康行为改善）。
平行组随机对照试验（RCT），干预组有878名参与者，对照组有1702名参与者。
研究在德国汉堡进行，利用了一家老年医学中心的医疗保健结构和专业人员。
研究参与者最初为社区居民，年龄在60岁及以上，无基本日常生活活动（B - ADL）限制、认知障碍或护理需求，德语能力良好。
健康促进与预防保健干预基于一份详尽的健康问卷，并随后提供机会参与在小组会议或预防性家访中进行的多主题个人强化干预。
主要结局：生存时间；在一些分析中，对性别、年龄和自我感知健康状况进行了调整。次要结局：基于1年随访及1年随访后12年（2013/2014年）自我填写问卷的回复得出的功能能力（卢卡斯功能能力指数）。
平均观察时间为10.3年。38.3%（987/2580）的参与者死亡；干预组（IG）：35.7%（313/878），对照组（CG）：39.6%（674/1702）；风险比（HR）=0.89；p = 0.09。1年随访时的功能能力：干预组：强健 67.4%（391/580），虚弱 11.9%（69/580），对照组：强健 62.9%（861/1368），虚弱 14.8%（203/1368）；p = 0.12。1年随访后12年：干预组：强健 50.0%（160/320），虚弱 30.9%（99/320），对照组：强健 48.9%（307/628），虚弱 34.1%（214/628）；p = 0.56。
对生存及功能能力动态变化的影响虽不显著但具有一致性，提示该综合干预措施有效。我们计划分别仔细研究每次强化干预的效果。
