Disability Prevention Program Research Articles

SUBTYPES OF FRAILTY AND NONFRAIL HEALTH IMPROVEMENT OF DISABILITY PREVENTION PROGRAM: LATENT CLASS ANALYSIS

Abstract Frailty has become a public health priority in many advanced countries. However, the effects of national implemented intervention remained unclear. Taiwan implemented a disability prevention program nationwide targeting on people aged 65 and over in 2019. We aimed to identify the subtypes of function outcomes of the national disability prevention programs and compare the different outcome subtypes between frail and non-frail older adults. The current study analyzed participants’ outcomes before and after the program. Two years of data (2019-2020) from the national disability program were used for analysis. Among the participants, 622 were frail (3.8%), and 13084 are non-frail (81.3%). Outcomes were nine domains of Kihon checklist assessed, including nutrition, depressive mood, oral function, fall risk, cognitive function, socialization, independent function, mobility and health knowledge. Latent Class Analysis is used to identify the subtypes of classes in frailty and non-frail older adults. Four classes of outcomes subtypes for frail and non-frail older adults were identified, and both of them have groups of multi-aspect improvement and no improvement groups. The other two classes for frail people were cognitive and independent function improvement group and social and fall risk improvement group, whereas non-frail group had independent function improvement group, and independent and mobility function improvement group. The similar groups identified indicated both frail and non-frail can benefited and not benefited from the program. The two different subtypes identified benefited from the program. Further study investigating the characteristic of people in different outcome subtypes may shed some light for future tailored-made disability prevention.

Frailty and functional dependence in older population: lessons from the FREEDOM Limousin \u2013 Nouvelle Aquitaine Cohort Study

BackgroundMonitoring frailty indicators in elderly people is recommended to identify those who could benefit from disability prevention programs. To contribute to the understanding of the development of frailty in the elderly, we have created the FREEDOM-LNA cohort constituting an observational study of ageing in general population. Here, we described the characteristics of a cohort of elderly subjects who are followed for determination of frailty and loss of independence trajectories.ResultsThe cohort was composed of 1085 subjects in advanced age (mean: 83.7 ± 6.0 years) and of women in majority (68.3%). Cardiovascular risk factors were present in 88.4% of subjects. Abnormal musculoskeletal signs were reported in 44.0% and neurologic signs in 31.9%. There were 44.8% of subjects at risk of malnutrition (MNA <24) and 73.3% (668/911) at risk of mobility-related disability (SPPB ≤9); 39% (384/973) of subjects had impaired cognitive function (MMSE< 24, adjusted on education) and 49.0% (397/810) had signs of depression (GDS >9); 31.8% (240/753) were frail and 58.3% were pre-frail. Most subjects had at least one disability in ADL (66.9%) and IADL (85.1%). The SMAF indicated a loss of independence in 59.6%. Overall, 59.9% of subjects could not stay at home without at least some help. Consequently, a medical consultation was proposed in 68.2 and 42.1% social supports.ConclusionsA large part of this cohort was frail or pre-frail and presented signs of loss of independence, which may be explained by multiple factors including impaired health status, poor physical performance, cognition, isolation, depression, or nutrition. This cohort will help to determine factors that adversely influence the trajectory of physical frailty over time.

Evaluation of an Innovative Student-Led Work Disability Prevention Program

A university-based, role-emerging fieldwork placement for occupational therapy students has been developed to provide work disability prevention services for university managers and workers. Over five years, 24 students have provided holistic interventions across 18 departments. The purpose of this project was to formally evaluate the perceptions of the program and the impact of services on managers and workers and to examine the experience of participating students. A utilization-focused evaluation approach was used as the guiding framework for this project. Methods included a retrospective review of reports and educational materials, a manager and worker survey, and a review of results from an existing student survey. The retrospective review of reports and educational materials demonstrated that students utilized a comprehensive and holistic lens that considered the interaction between the person, environment, and occupation. Workers and managers reported they were satisfied and found that services were beneficial. The majority reported changing their work setup or work habits after receiving student services to prevent workplace disability. Students reported overwhelmingly positive responses about the placement, with 96% (n=23) of students agreeing that they had an excellent experience and 100% (n=24) of students agreeing they were able to use their acquired knowledge. This paper describes the formal evaluation process and the outcomes of the project. Findings support the benefits of a partnership with human resources and occupational therapy in developing a role-emerging placement that benefits students, workers, and the organization and promotes the value of occupational therapy in workplace disability prevention and health promotion.

Recruitment cost and outcomes for an arthritis work disability prevention randomized clinical trial: The Work It study

BackgroundDespite the recommendations to increase recruitment of participants into clinical trials, investigators face costly challenges in trials investigating work disability interventions for people with arthritis and rheumatological conditions. This study aims to evaluate the recruitment costs and outcomes from a randomized controlled trial of an arthritis work disability prevention program conducted between 2011 and 2015, to inform planning and monitoring recruitment in similar studies. MethodsData were obtained from enrollment and financial records pertaining to recruitment costs for each recruitment approach employed. The cost for each recruitment method was calculated for total cost and cost per number of participants screened, eligible, and enrolled in the trial. Then the yield of each possible recruitment method was also determined based on the ratio of the number of randomized participants divided by the number of people contacted through each recruitment method. Finally, the ResultsRecruitment rate was lower than projected. Community advertising, specifically newspapers, was the most successful method of recruitment in terms of numbers, but social media, specifically Craigslist, was the least costly method used to recruit. Some social media approaches, including Facebook and LinkedIn, yielded few if any participants. Recruitment efforts used successfully in the past are not always effective. ConclusionsCosts to recruit large numbers of people with arthritis into clinical trials are high. Investigators are encouraged to monitor recruitment efforts and evaluate the costs and outcomes of their strategies throughout the study period. Close consideration to recruitment costs should be considered as part of the research fiscal resources prior to and during the study period for long-term outcomes like work disability. Trial registrationClinicalTrials.gov Identifier: NCT01387100, date: 06/01/2011.

The Impact of Social Support on Treatment Participation and Completion in a Disability Prevention Intervention for Older Adults.

Objectives: This study evaluates the role of emotional and instrumental social support on treatment participation and completion using the Positive Minds-Strong Bodies (PMSB) disability prevention program. Methods: Data from a multisite randomized controlled trial of the PMSB program for older adults (≥60years) with physical impairment and mild to severe depression and/or anxiety were used. Participants were randomly assigned to receive 10 sessions of cognitive behavior therapy (CBT) plus 36 sessions of group exercise or usual care. Results: Adjusting for covariates, higher levels of emotional social support at baseline were associated with increased odds of completing the recommended number of CBT sessions (6 or more, OR = 2.58, p = .030), attending 5.56 more exercise sessions (p = .006), and increased odds of completing the recommended exercise sessions (25 or more, OR = 2.37, p = .047). Discussion: Emotional social support appears to increase dosage in a disability prevention program.

Influences of remote exercise training for community-dwelling older adults in Japan during the COVID-19 pandemic.

[Purpose] The coronavirus disease (COVID-19) pandemic has caused sudden lifestyle changes. This study aimed to determine the limitations in activity and the influences of remote exercise training on community-dwelling older adults during a state of emergency in Japan. [Participants and Methods] In May 2020, during the COVID-19 state of emergency, we carried out a mail survey of community-dwelling older adults who had previously participated in a disability prevention program in Ami town, Ibaraki, Japan. The mail included a brochure on exercises and a DVD. The attached exercise program was comprised of 10 different exercises, which could be conducted in approximately 30 minutes. [Results] Of the 191 older adults, 73 responded to this survey (38.2%), of which 42 (58.5%) participants had decreased outdoor exercise activity, and 50 (68.5%) decreased the amount of time spent on physical activities during the COVID-19 state of emergency. There were significant reductions (19.2–22.5%) in the perceived exercise load for each posture after two weeks of remote exercise training with DVD (n=26). [Conclusion] Our results suggested that the remote exercise training with the brochure and DVD may be effective. Since this study involved a small number of participants, future studies should involve larger populations.

The Effects of Organizational-Level Factors on the National Disability Prevention Programs for Older Adults

In 2017, Taiwan implemented nationwide disability preventive programs that aimed to maintain older adults’ function and prevent disability. This study aimed to evaluate the impact of organizational-level factors on older adults’ improvement through participating in the 2019 preventive disability programs. There were 202 disability preventive programs, which included a 2-hour sessions per week for 12 weeks, in Taiwan in 2019. Participants’ physical, mental, and social functions were assessed before and after participating the programs and reported to the government. A total of 7194 older adults’ assessments were received. This study administered survey by the end of 2019 in the 202 programs in Taiwan and 8 organizational-level factors were assessed, including effectiveness, efficiency, professional, support from the upper organization, and cooperation with community, adequacy, responsiveness, and sustainability. Multilevel analysis was conducted to assess the impacts of organizational-level factors on disability prevention programs. A total of 170 programs (84%) has responded to our survey. About 48.2% of the programs were implemented by local public health centers. The domains of responsiveness and sustainability are rated highest among these programs. Programs with the following characteristics were associated with better program outcomes among older adults: better ability to provide outreach services was associated with improved depression; higher level in profession domain was associated with improved f mobility; better program responsiveness was associated with improved in nutritional status and oral function, and depression risk. Our results shed lights on how to improve a national disability prevention programs from programs’ characteristics point of view.

Disability Prevention Program Improves Life-Space and Falls Efficacy: A Randomized Controlled Trial

Life-space and falls efficacy are essential to physical independence and consistently predict disabilities. However, it remains unknown whether the CAPABLE, a disability prevention program, improves life-space and falls efficacy in older adults. We evaluated the effects of a home-based disability prevention program on life-space (N=194) and falls efficacy (N=233) among low-income older adults with restricted daily activities. The CAPABLE intervention consists of up to 6 one-hour home visits with an Occupational Therapist (OT), up to 4 one-hour home visits with a Register Nurse (RN), and up to $1300 worth of home repairs, modifications, and assistive devices with a handyman, during four months. Life-space and falls efficacy were measured by the Telephone Assessment of Mobility for homebound older adults and the Tinetti Falls Efficacy Scale at baseline and five months, respectively. Multinomial logistic regression and generalized linear models were used for data analyses. Participants in both samples were, on average, 75 years, predominantly black (86%) and female (85%-86%). Compared to participants in the control group, participants receiving the intervention were more likely to have improved (Odds Ratio [OR]: 2.10, 95% CI: 1.06-4.20) or unchanged overall life-space (OR: 2.62, 95% CI: 1.10-6.27) vs. decreased overall life-space. Participants who received the intervention also had significantly higher falls efficacy in performing daily activities (exponentiated coefficient: 1.11, 95% CI: 1.04-1.19). Life-space and falls efficacy can be significantly improved by CAPABLE program. These findings provide more evidence for the reasons for the increased physical independence.

Disability Prevention Program Improves Life-Space and Falls Efficacy: A Randomized Controlled Trial.

To evaluate the effects of a home-based disability prevention program on life-space and falls efficacy among low-income older adults. Single-blind two-arm randomized controlled trial. Participants' homes. Participants were low-income cognitively intact older adults (≥65 years old) with restricted daily activities. Our analytic sample for life-space (n = 194) and falls efficacy (n = 233) varied as the life-space measure was introduced 4 months after the trial began. Up to six 1-hour home visits with an occupational therapist; up to four 1-hour home visits with a registered nurse; and up to $1,300 worth of home repairs, modifications, and assistive devices with a handyman, during a course of 4 months. Life-space was measured by the Homebound Mobility Assessment; falls efficacy was measured using the 10-item Tinetti Falls Efficacy Scale at baseline and 5 months. Participants were on average 75 years old, predominantly Black (86%) and female (85%-86%). Compared with participants in the control group, participants receiving the intervention were more likely to have improved versus decreased life-space in areas of bathroom (adjusted odds ratio (OR) = 3.95; 95% confidence interval (CI) = 1.20-12.97), front or back porch, patio, or deck (adjusted OR = 2.67; 95% CI = 1.05-6.79), stairs (adjusted OR = 4.09; 95% CI = 1.34-12.48), leaving the house for any reason other than for health care (adjusted OR = 2.40; 95% CI = 1.01-5.73), and overall life-space (adjusted OR = 2.15; 95% CI = 1.10-4.19). Participants who received the intervention also had an 11% improvement in falls efficacy in performing daily activities (exponentiated coefficient = 1.12; 95% CI = 1.04-1.21). Life-space and falls efficacy were improved through a multicomponent, person-directed, home-based disability prevention intervention. Findings suggest that this intervention should be translated into different settings to promote independent aging.

Long-Term Care System in Japan.

The long-term care insurance (LTCI) system was introduced in Japan in 2000 to address the demands of older persons with disabilities based on the concept of a user-oriented social insurance system with support for independence. Older people with a certification for LTCI service needs can utilize facility services, in-home services, and community-based services depending on their physical and cognitive impairments. After the implementation of the LTCI system, there was a rapid increase in persons certified for LTCI service needs, with a corresponding increase in the financial burden on the government. Therefore, the Japanese government started a disability prevention program in which older people were screened for frailty by the Kihon checklist in addition to a high-risk approach with appropriate prevention programs in each community. After unsatisfactory outcomes of the high-risk approach for disability prevention, the government changed the primary strategy to a community-based population strategy to build a community to seamlessly provide preventive, medical, and long-term care and welfare and housing services to all individuals. Further improvement of the community-based integrated care system is needed for healthy aging in a superaged society.

Frequency, intensity, time, and type principle of physical activity as a medical disability prevention program in ethiopia: a mixed-method study.

Despite the recognized benefits of physical activity (PA), the extent of its recognition and applications as a medical disability (MD) prevention program by practitioners working in Ethiopian health-care settings is unknown. The objective of the study was to explore health-care professionals' knowledge base and characteristics on the utilization of the frequency, intensity, time (duration), and type principle (FITT) of PA as an MD prevention program in the Ethiopian public health-care system. A mixed-method research design was used with data collected from 13 public referral hospitals in Ethiopia. In Phase I, quantitative data were collected from 312 health professionals (99 physicians and 213 nurses) using a survey. In Phase II, qualitative data were collected by interviewing health officers (n = 13 physician-hospital managers) and conducting one focus group discussion (n = 6 national health bureau officers). A quarter (28%) of practitioners working in referral hospitals are using PA as an MD prevention program. Higher specialization (adjusted odds ratio [AOR] = 20.203, P < 0.001), many service years (AOR = 0.041, P = 0.014), young age (AOR = 19.871, P < 0.001), and being male (AOR = 0.269, P < 0.001) were associated with using PA as a MDs prevention program. Applying the FITT principle of PA for the prevention of MD among practitioners was very poor. Training of health-care professionals to use PA as a program for MDs prevention is required at the undergraduate level as well as specialized courses on qualification.

Lymphatic filariasis in the Southeast Asian region; status and control options

Abstract The Global Program to Eliminate Lymphatic Filariasis (GPELF) was launched in year 2000 by the World Health Organization (WHO) with the goal set for elimination by 2020. Over half the global disease burden lies in the Southeast Asian region (SEAR). The preventive chemotherapy (PC) programme has been initiated in all the WHO SEAR member states with varying levels of progress. Maldives, Sri Lanka and Thailand have achieved the goal of elimination as a public health problem (EPHP) within the stipulated period with Bangladesh working towards validation in 2021. Both Sri Lanka and Thailand are continuing with post-validation surveillance combined with selective treatment, striving for zero transmission in-parallel with the morbidity management and disability prevention program (MMDP). Timor-Leste appears close to reaching critical transmission thresholds with 100% coverage and triple therapy in the last round of PC. Data on MMDP activities are insufficient to comment on reaching EPHP status. PC coverage and country reports indicate on-going transmission in Nepal, Myanmar, Indonesia and India requiring further rounds of PC. The PELF has made considerable progress in the SEAR towards elimination but there still remain significant transmission and disease burden in the highly populated countries in SEAR.

Knowledge and self-care practice of leprosy patients at ALERT Hospital, Ethiopia

Introduction: In addition to multi-drug treatment, patient self-care practice is crucial for the successful treatment of the disease. This study assessed the knowledge and self-care practices of leprosy patients at ALERT leprosy referral hospital in Ethiopia. Methods: A total of 424 leprosy patients were interviewed using pre-tested structured questionnaires. The questionnaires included core points such as sociodemographic characteristics, knowledge of leprosy and self-care practices. Bloom’s cut off point was used to describe the knowledge and self-care practices of the respondents and statistical significance was assessed at 95% confidence interval with 5% of level of significance. Results: The knowledge score of the respondents was poor for 276 (65.1%) and good for 148 (34.9%). The level of knowledge varied significantly with respect to age group (p &lt; 0.01), sex (p &lt; 0.01), marital status (p = 0.003), educational status (p &lt; 0.01) and income (p &lt; 0.01). About 77.4% of interviewed patients had poor self-care practices and only 22.6 of patients had a good self-care practice score (p &lt; 0.01). Age (p &lt; 0.002), previous disability due to leprosy (p &lt; 0.01), knowledge of leprosy (p = 0.038) and income (P = 0.028), were significantly associated with poor selfcare practice. Conclusion: Although leprosy treatment, disability prevention and rehabilitation programs have been run in the country for decades, poor leprosy self-care practice and poor leprosy knowledge has been confirmed in this study. Therefore, the leprosy program should re-visit its strategy and mode of delivery to improve the leprosy knowledge and leprosy self-care practices of patients.

Morbidity management and disability prevention for lymphatic filariasis in Sri Lanka: Current status and future prospects.

BackgroundSri Lanka was acknowledged to have eliminated lymphatic filariasis (LF) as a public health problem in 2016, largely due to its success in Mass Drug Administration (MDA) to interrupt disease transmission. Analysis of the Strengths, Weaknesses, Opportunities and Threats (SWOT) of the national Morbidity Management and Disability Prevention (MMDP) program, the other pillar of the LF control program, was carried out with the objective of evaluating it and providing recommendations to optimize the use of available resources.MethodologyA situation analysis of the MMDP activities provided by the state health sector was carried out using published records, in-depth interviews with key informants of the Anti Filariasis Campaign, site-visits to filariasis clinics with informal discussions with clinic workforce and personal communications to identify strengths and weaknesses; and opportunities to overcome weaknesses and perceived threats to the program were explored.The principal strength of the MMDP program was the filariasis clinics operational in most endemic districts of Sri Lanka, providing free health care and health education to clinic attendees. The weaknesses identified were the low accessibility of clinics, incomplete coverage of the endemic region and lack of facilities for rehabilitation. The perceived threats were diversion of staff and resources for control of other vector-borne infections, under-utilization of clinics and non-compliance with recommended treatment. Enhanced high level commitment for MMDP, wider publicity and referral systems, integration of MMDP with other disease management services and collaboration with welfare organizations and research groups were identified as opportunities to overcome weaknesses and challenges.ConclusionsThe recommended basic package of MMDP was functional in most of the LF-endemic region. The highlighted weaknesses and challenges, unless addressed, may threaten program sustainability. The identified opportunities for improvement of the programme could ensure better attainment of the goal of the MMDP program, namely access to basic care for all affected by lymphatic filarial disease.

Psychometric properties of the Functional Disability Inventory for assessing Pain-related disability in children from the community

Purpose: The aim of this study was to evaluate the psychometric properties of the Functional Disability Inventory for assessing pain-related disability in a community sample of children and adolescents.Materials and methods: Five hundred and sixty-one schoolchildren (aged 8–18 years) completed the Functional Disability Inventory. They were also administered measures assessing anxiety sensitivity, internalizing pain coping behaviors, social support seeking, and positive self-statements. A subset of 107 participants completed measures of quality of life.Results: The results confirmed the two-factor structure solution for the Functional Disability Inventory items. The measure’s scales scores demonstrated adequate to good internal consistencies. Convergent validity was supported by significant positive correlations between FDI scores and anxiety sensitivity and internalizing pain coping behaviors, and negative correlations with quality of life. Discriminant validity was supported by weak and non-significant correlations between disability scores and the social support seeking and positive self-statements pain coping strategies scores. Differences in the disability scores between participants who did not experience pain in the last 3 months and those that experienced at least some pain provided additional evidence for construct validity.Conclusions: The findings support the Functional Disability Inventory as a reliable and valid measure for assessing pain-related disability in children and adolescents from the community.Implications for rehabilitationChronic pain is a common health problem in youths and is associated with disability (which implies difficulties in physical, psychological, social or school functioning).The FDI is one of the most used measures to assess disability in youths with chronic pain. However, its psychometric properties have not been studied in a community sample.This study shows new and important findings demonstrating that the FDI provides reliable and valid scores when used to assess pain-related disability in a community sample of schoolchildren.These findings support the use of the FDI as a measure of the benefits of community-based pain treatments or the benefits of disability prevention programs over time.

Efficacy of a Work Disability Prevention Program for People with Rheumatic and Musculoskeletal Conditions: A Single-Blind Parallel-Arm Randomized Controlled Trial.

Work disability rates are high among people with rheumatic and musculoskeletal conditions. Effective disability preventive programs are needed. We examined the efficacy of a modified vocational rehabilitation approach delivered by trained occupational therapists and physical therapists on work limitation and work loss over 2 years among people with rheumatic and musculoskeletal conditions. Eligibility criteria for this single-blind, parallel-arm randomized trial included ages 21-65 years, 15 or more hours/week employment, a self-reported doctor-diagnosed rheumatic or musculoskeletal condition, and concern about staying employed. The intervention consisted of a 1.5-hour meeting, an action plan, written materials on employment supports, and telephone calls at 3 weeks and 3 months. Control group participants received the written materials. The primary outcome was the Work Limitations Questionnaire (WLQ) output job demand subscale. The secondary outcome was work loss. Intent-to-treat analyses were performed. Between October 2011 and January 2014, 652 individuals were assessed for eligibility. A total of 287 participants were randomized: 143 intervention and 144 control participants. In total, 264 participants (92%) completed 2-year data collection. There was no difference in the mean ± SD WLQ change scores from baseline to 2-year followup (-8.6 ± 1.9 intervention versus -8.3 ± 2.2 control; P = 0.93). Of the 36 participants who experienced permanent work loss at 2 years, 11 (8%) were intervention participants and 25 (18%) control participants (P = 0.03). The intervention did not have an effect on work limitations but reduced work loss. The intervention can be delivered by trained rehabilitation therapists.

Cost-utility analysis of a disability prevention program for community-dwelling older adults with mild disability in the urban area of Tokyo, Japan

Cost-utility analysis of a disability prevention program for community-dwelling older adults with mild disability in the urban area of Tokyo, Japan

Effects of a community disability prevention program for frail older adults at 48-month follow up.

The present prospective study was carried out to determine whether participation in community-based intervention studies exerted a positive impact on disability prevention in older adults with physical frailty. A total of 514 community-dwelling older adults (aged ≥65years) with physical frailty who had undergone baseline assessment and participated in community-based intervention studies (participants) or did not (non-participants) were included in the present study. Non-participants were selected through propensity score matching, to balance potential covariates at baseline. Disability incidence was followed up at 48months as a main outcome. Demographic data (age, sex and medical history), global cognitive function, grip strength, walking speed, and blood test results including serum albumin and brain-derived neurotrophic factor at baseline were included as covariates. Disability incidence rates differed significantly between participants (11.3%) and non-participants (19.8%) of community-based intervention studies during the 48-month follow-up period (P=0.007). Participation in community-based intervention studies (hazard ratio 0.55, 95% confidence interval 0.35-0.88) was significantly associated with the incidence of disability in older adults with physical frailty. Participation in community-based intervention studies could reduce the incidence of disability in older adults with physical frailty. Thus, strategies designed to increase the number of participants in community-based intervention programs should be considered in community-based approaches for the prevention of disability in older adults with physical frailty. Geriatr Gerontol Int 2017; 17: 2347-2353.

휠체어 장애인과 함께하는 장애예방교육의 융·복합 효과에 관한 연구 : 초등학생을 중심으로

휠체어 장애인과 함께하는 장애예방교육의 융·복합 효과에 관한 연구 : 초등학생을 중심으로

Disability Prevention Programs for Older People: Factors Associated with Medical and Nursing Care Costs

This study aimed to clarify factors associated with medical and nursing care costs for older people living in community and to suggest an effective disability prevention programs. Total of participants in this study was 83 individuals (29 men and 54 women; mean age 81.2 ± 6.3 years old) on November 1st – December 28th, 2014. This study compared the average medical and nursing care costs per month with national average for those aged ≥ 65 years old. Logistic regression test was conducted to examine itsassociation with medical and nursing care costs. Those who had outing activities ≥ 3 times a week were approximately three times less likely to reduce medical and nursing care costs than those who had outing activities &lt; 3 times a week despite three controlled covariates (OR = 3.23 and 95% CI = 1.03 – 10.42). Disability prevention programs that improve frequency of outing at least three times in a week may become a valid economic approach to older people who do not live in nursing home.AbstrakPenelitian ini bertujuan untuk mengklarifikasi faktor-faktor yang terkait dengan biaya medis dan perawatan lanjut usia (lansia) yang tinggal di panti sosial serta menyarankan program pencegahan disabilitas yang efektif. Total partisipan dalam penelitian ini adalah 83 orang (29 laki-laki dan 54 perempuan; usia rata-rata 81,2 ± 6,3 tahun) pada 1 November – 28 Desember 2014. Penelitian ini membandingkan biaya medis dan perawatan rata-rata per bulan dengan rata-rata nasional bagi yang berusia ≥ 65 tahun. Uji regresi logistik dilakukan untuk memeriksa keterkaitannya dengan biaya medis dan perawatan. Mereka yang pergi ke luar rumah ≥ 3 kali seminggu tiga kali lebih kecil kemungkinannya untuk mengurangi biaya medis dan perawatan dibandingkan mereka yang pergi ke luar rumah &lt; 3 kali seminggu meskipun dengan tiga kovariat yang dikontrol (OR = 3,23 dan 95% CI = 1,03 – 10,42). Program pencegahan disabilitas yang meningkatkan frekuensi ke luar rumah sedikitnya tiga kali seminggu dapat menjadi pendekatan ekonomis yang valid pada lansia yang tidak tinggal di panti wreda.