Abstract
BackgroundFrail community-dwelling older adults, whom might experience problems regarding physical, cognitive, psychological, social and environmental factors, are at risk for adverse outcomes such as disability, institutionalization and mortality. People in need of help do not always find their way to care and support services and are left undetected. The aim of the D-SCOPE project is to detect frail community-dwelling older adults who previously went unnoticed and to improve their access to care and support. Goal is to increase their frailty-balance, quality of life, meaning in life, life satisfaction, mastery, community inclusion and ageing well in place.Methods/designThe study is a prospective, longitudinal randomized four-armed controlled trial with follow-up at 6 months. The study group aims to include 900 community-dwelling older adults aged 60 years and over from 3 municipalities in Flanders (Belgium). While selecting the study group, risk profiles for frailty will be taken into account. Participants will be randomly selected from the census records in each municipality. Data will be collected prospectively at baseline (T0) and at follow-up, 6 months after baseline (T1). At baseline, participants who are at least mild frail on one of the 5 domains of frailty (CFAI-plus) or feel frail based on the subjective assessment of frailty will be randomly assigned to (1) the study group or (2) the control group. A mixed method design with the inclusion of quantitative and qualitative data analyses will be used to evaluate the efficacy and experiences of the detection and prevention program on frailty.DiscussionThe study will contribute to an innovative vision concerning the organization of care and support, and a timely and accurate detection and support of community-dwelling older adults at risk for frailty.Trial registrationThis trial was registered at ClinicalTrials.gov, on May 26, 2017, identifier: NCT03168204.
Highlights
Frail community-dwelling older adults, whom might experience problems regarding physical, cognitive, psychological, social and environmental factors, are at risk for adverse outcomes such as disability, institutionalization and mortality
The study will contribute to an innovative vision concerning the organization of care and support, and a timely and accurate detection and support of community-dwelling older adults at risk for frailty
Older adults will be included in the Randomized Controlled Trial (RCT) if they are at least mild frail on one of the 5 domains of the Comprehensive Frailty Assessment Instrument (CFAI)-plus (i.e., ≥ 25 for physical frailty, ≥ 12.52 for cognitive frailty, ≥ 20 for psychological frailty, ≥ 37.5 for Demographic data (2016) Total number of inhabitants Population growth since 2005 Total number of older inhabitants Older population growth since 2005 % older adults (65 years and over) % older adults (80 years and over)
Summary
Frail community-dwelling older adults, whom might experience problems regarding physical, cognitive, psychological, social and environmental factors, are at risk for adverse outcomes such as disability, institutionalization and mortality. Governments are implementing a proactive care approach in order to prevent or delay (the high costs of ) such institutionalization and other adverse outcomes, and stimulate older adults to stay in their own environment as long as possible with good quality of life [20]. This so-called policy on aging in place is in line with the wish of the majority of older adults [21], even when they need care and support, have economic difficulties or live in inadequate housing or deprived environments [22]
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