Sustained improvement of intrinsic capacity in community-dwelling older adults: The +AGIL Barcelona multidomain program.

Abstract

Different programs promote healthy ageing through the optimisation of intrinsic capacity. However, a major challenge is to assess their sustained effects over time. +AGIL Barcelona, a consolidated multidomain program, aims to optimise older adults' intrinsic capacity through a coordinated approach among primary care, geriatrics and community resources, in agreement with the Integrated Care for Older People (ICOPE) guidelines. We aimed to evaluate the +AGIL Barcelona longitudinal effect on older adults' physical performance. All +AGIL Barcelona consecutive participants since 2016 were enrolled. After a Comprehensive Geriatric Assessment (CGA), a tailored, multidisciplinary intervention aligned with the ICOPE guidelines is offered. It includes a 10-week boost multicomponent exercise program, nutritional and sleep-hygiene counselling, revision and optimisation of pharmacological treatments, and screening for cognitive impairment, depression and loneliness. Changes in physical performance after three and six months were assessed using mixed models including baseline frailty degree, time, and all potential significant confounders. We included 194 participants in the analysis (mean age = 81.6 [SD = 5.8], 68% women). An independent, clinically and statistically significant improvement in physical performance (Short Performance Physical Battery test, combining gait speed, strength and balance) was found at three months (SPPB mean change: 1.4; 95%CI: 1.1-1.6) and six months (SPPB mean change: 1.1; 95%CI 0.8-1.5). Equivalent results were observed for all the SPPB sub-tests. A coordinated, multidisciplinary, integrated program can benefit older adults' intrinsic capacity. The participants' empowerment and the connection with the available community resources are critical points for a successful intervention. This article is protected by copyright. All rights reserved.