Chang Ya-Hui, Hung Chih-Chien, Chiang Yen-Yi, Chen Chiu-Ying, Liao Ling-Chiao, Ma Matthew Huei-Ming, Hwang Juey-Jen, Hsu Chih-Cheng, Li Chung-Yi, Fu Shau-Huai, Wang Chen-Yu
Emergency Department, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan.
Age Ageing. 2025 Feb 2;54(2). doi: 10.1093/ageing/afaf017.
Monitoring and improving intrinsic capacity (IC) and well-being are essential for older adults to maintain functional abilities. However, evidence of effective interventions to improve IC and happiness is scarce. This study examined the effects of multicomponent interventions in the Healthy Longevity and Ageing in Place (HOPE) randomised controlled trial on IC and happiness among rural community-dwelling older adults.
This cluster randomised trial was conducted in rural communities in Taiwan (NCT05104034). Participants aged ≥50 were enrolled from September 2021 to April 2022 and randomly assigned by community level to one of three groups: multicomponent integrated care (MIC), osteoporosis care (OC) and usual care (UC). MIC included osteoporosis, sarcopenia and polypharmacy care, along with exercise and nutritional support. OC was a resource-conservative, focusing on osteoporosis screening and treatment alone. IC and happiness were measured at baseline and 12 months after follow-up. IC was assessed across cognition, locomotion, vitality, sensory and psychological domains per World Health Organization Integrated Care for Older People (ICOPE) guidelines. Happiness was measured using the 10-item Chinese Happiness Inventory. Generalised estimating equations were used to estimate the effect of the intervention.
567 residents were recruited from 30 congregate meal service centres. Mean IC score increased across all the groups, though the happiness score decreased. Compared to UC, the MIC group exhibited a significantly greater improvement in IC scores (adjusted estimate = 0.30, standard error (SE) = 0.11, P = .01), whereas OC did not show significant effects. Smaller reductions in happiness scores were observed in both the MIC (adjusted estimate = 1.46, SE = 0.48, P = .003) and OC groups (adjusted estimate = 0.95, SE = 0.48, P = .05).
MIC, including osteoporosis and pharmaceutical care, along with exercise and nutritional support, is an effective strategy to enhance IC and happiness compared to osteoporosis treatment alone and UC. This underscores the importance of comprehensive strategies for promoting healthy ageing in rural communities.
监测和改善内在能力（IC）以及幸福感对于老年人维持功能能力至关重要。然而，关于改善IC和幸福感的有效干预措施的证据却很少。本研究在“健康长寿与就地养老”（HOPE）随机对照试验中，考察了多组分干预措施对农村社区居住的老年人的IC和幸福感的影响。
这项整群随机试验在台湾的农村社区进行（NCT05104034）。2021年9月至2022年4月招募了年龄≥50岁的参与者，并按社区水平随机分配到三组之一：多组分综合护理（MIC）、骨质疏松症护理（OC）和常规护理（UC）。MIC包括骨质疏松症、肌少症和多重用药护理，以及运动和营养支持。OC是一种资源保守型，仅侧重于骨质疏松症筛查和治疗。在基线和随访12个月后测量IC和幸福感。根据世界卫生组织《老年人综合护理》（ICOPE）指南，在认知、运动、活力、感官和心理领域评估IC。使用10项中文幸福感量表测量幸福感。采用广义估计方程来估计干预效果。
从30个集体用餐服务中心招募了567名居民。所有组的IC平均得分均有所提高，不过幸福感得分有所下降。与UC相比，MIC组的IC得分有显著更大的改善（调整估计值=0.30，标准误（SE）=0.11，P=0.01），而OC组未显示出显著效果。MIC组（调整估计值=1.46，SE=0.48，P=0.003）和OC组（调整估计值=0.95，SE=0.48，P=0.05）的幸福感得分下降幅度较小。
与单独的骨质疏松症治疗和UC相比，包括骨质疏松症和药物护理以及运动和营养支持的MIC是增强IC和幸福感的有效策略。这凸显了农村社区促进健康老龄化综合策略的重要性。
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