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This research project is structured in two phases: an initial observational phase and a subsequent randomized controlled trial (RCT) phase. The goal of the observational phase is to compare hospital admission and Hospital at Home (HaH). The objective of the RCT is to assess the effectiveness of a multicomponent intervention following acute hospitalization in older adults. The main questions it aims to answer are:
Researchers will compare a post-discharge multicomponent intervention to usual care to see the effects on physical and cognitive function.
Participants will receive a home-based cognitive and physical exercise intervention or usual care.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Multicomponent intervention | Experimental | Physical exercise and cognitive exercises |
|
| Usual care | No Intervention |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Physical exercise and cognitive exercises | Behavioral | The intervention will be based on the Vivifrail program, which is a multicomponent physical exercise program designed specifically for older adults. |
| Measure | Description | Time Frame |
|---|---|---|
| Physical function | Short Physical Performance Battery (SPPB): scores range from 0 to 12, with higher scores indicating better physicalfunction. | Within the first 24-48 hours of acute care admission (in hospital or home hospitalization), pre-intervention baseline, and immediately after the intervention. |
| Cognitive function | Mini-Mental State Examination (MMSE): scores range from 0 to 30, with higher scores indicating better cognitive function. | Within the first 24-48 hours of acute care admission (in hospital or home hospitalization), pre-intervention baseline, and immediately after the intervention. |
| Physical activity | Physical activity will be assessed with a Firstbeat device (format: hh:mm:ss). | During hospital stay or during home-base hospitalization . |
| Sedentarism | Sedentarism will be assessed with a Firstbeat device (format: hh:mm:ss). | During hospital stay or during home-based hospitalization. |
| Measure | Description | Time Frame |
|---|---|---|
| Health-related quality of life (HRQOL) | EQ-5D-5L provides a health profile that is converted to a utility index, in which 0 is equivalent to death and 1 indicates perfect health. Additionally, the EQ-VAS ranges from 0 to 100, with higher scores indicating better health. | Pre-intervention baseline and immediately after the intervention. |
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Inclusion Criteria:
Exclusion Criteria:
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| ID | Term |
|---|---|
| D009043 | Motor Activity |
| ID | Term |
|---|---|
| D001519 | Behavior |
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| ID | Term |
|---|---|
| D015444 | Exercise |
| ID | Term |
|---|---|
| D009043 | Motor Activity |
| D009068 | Movement |
| D009142 | Musculoskeletal Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |
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This research project is structured in two phases: an initial observational phase comparing hospital admission and hospital at home, and a subsequent randomized controlled trial phase assessing the efficacy of a multicomponent post-hospitalization intervention.
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| Heart rate variability |
Heart rate variability will be assessed usign a Firstbeat device. |
| During hospital stay or during home-based hospitalization. |
| Handgrip strength | Handgrip strength will be measured using a handgrip dynamometer. | Within the first 24-48 hours of acute care admission (in hospital or home hospitalization), pre-intervention baseline, and immediately after the intervention. |
| Sleep quantity | Sleep duration will be recorded (format: hh:mm:ss). | During hospital stay or during home-based hospitalization. |
| Sleep quality | The heart rate variability parameter RMSSD (measured in ms) will be assessed during sleep. | During hospital stay or during home-based hospitalization. |
| Energy expenditure | Energy expenditure (kcal) will be assessed in with a Firstbeat device. | Within the first 24-48 hours of acute care admission (in hospital or home hospitalization), pre-intervention baseline, and immediately after the intervention. |
| Rate of hospital readmissions | Number of readmissions of each patient will be registered using the information from the medical records. | 3 months, 6 months, and 12 months post-discharge. |
| Rate of falls | The number of falls for each patient will be recorded through follow-up phone calls. | 3 months, 6 months, and 12 months post-discharge. |
| Incidence of mortality | Number of deaths will be registered using the information from the medical records. | 3 months, 6 months, and 12 months post-discharge. |
| Rate of emergency visits | Number of emergency visits will be registered using the information from the medical records. | 3 moths, 6 months, and 12 months post-discharge. |
| Prescribed pharmacologic treatment | All medications prescribed to each patient will be recorded using the information from the medical records. | Within the first 24-48 hours of acute care admission (in hospital or home hospitalization), pre-intervention baseline, and immediately after the intervention. |
| Cost-effectiveness | Cost-effectiveness will be assessed by calculating the cost per Quality-Adjusted Life Year (QALY) gained. | At pre-intervention baseline, at 3 months post-discharge, at 6 months post-discharge, and at 12 months post-discharge. |