What is the purpose of this study? The main goal of this study is to design and test a new "telecare" model to help adults aged 80 and older in Bogotá live healthier and more independent lives. The investigators want to see if providing personalized support through technology can improve physical health, prevent falls, and reduce the need for hospital visits or nursing home care.

Why is this study important? As people get older, they may face more health challenges or feel lonely, especially if they live alone. Traditional healthcare often focuses only on treating illnesses. This study focuses on "healthy aging" by looking at the whole person-including physical health, social support, and daily needs-to help participants stay active and safe in their own homes.

Who can participate?

Participants in this study are adults who:

Are 80 years of age or older.

Live in the urban area of Bogotá.

Are affiliated with Compensar EPS.

Are generally independent (able to perform most daily activities).

Can be reached by telephone.

What will happen during the study? Participants will be randomly assigned to one of two groups: a group receiving the new telecare support or a "usual care" group.

Assessment: At the start, the research team will visit participants' homes to understand participants' health, home environment, and needs.

The Telecare Model: Those in the intervention group will use a simple, easy-to-use device designed specifically for older adults. Through this device, participants will receive:

Health tips and training on self-care.

Support from "case managers" who help coordinate social and health services.

Connections to a support network of family, neighbors, and community resources.

Follow-up: Every six months, the team will check in to see how participants are doing and measure changes in physical and mental well-being.

What are the expected benefits? The investigators hope this model will help participants maintain physical strength and memory, feel more connected to the community, and enjoy a better quality of life. The results will help improve how Bogotá cares for its older citizens in the future.

Study Design and Framework This study is a mixed-methods research project (quantitative and qualitative) centered on a randomized clinical trial to evaluate a person-centered sociosanitary telecare model. The model is based on the World Health Organization Integrated Care for Older People (ICOPE) strategy and the Comprehensive Geriatric Assessment (CGA). It focuses on maintaining functional capacity and intrinsic capacity through five domains: locomotion, vitality (nutrition), sensory capacity, cognition, and psychological well-being.

Intervention Plan

The intervention group will receive a multifaceted telecare program integrated through a simplified technological device specifically designed for older adults. The intervention consists of three core components:

Healthy Aging Interventions: Tailored health activities based on the ICOPE guidelines.

Training: Education for participants on self-care and for participants' social support network (family, caregivers, and community "case managers") on supporting functional maintenance.

Case Management and Resource Linkage: Identification and mobilization of social and health resources within participants' homes, neighborhoods, and city to create a robust support portfolio.

Implementation Phases

Phase 1 (Months 1-4): Characterization of participants through a baseline home visit (Visit 0) using CGA and ICOPE screening. Participatory design and production of the telecare device prototype.

Phase 2 (Implementation): Deployment of the telecare model, including training for "gestores" (care managers) and participants.

Phase 3 (Follow-up): Continuous monitoring with formal evaluations every 6 months over a 24-month period.

Assessment and Outcomes

The study evaluates the model's impact on:

Primary Outcome: Change in physical capacity measured by the Short Physical Performance Battery (SPPB).

Secondary Outcomes: Mortality, frequency of emergency room visits, hospitalizations, institutionalization rates, and changes in quality of life (Euro-QoL), cognitive function (MMSE/MOCA), and depressive symptoms (Yesavage).

Statistical Considerations The trial aims for a total sample of 152 participants (76 per arm), accounting for a 20% estimated loss to follow-up, to achieve 90% statistical power. Participants are randomly assigned to either the intervention group or the "usual care" control group using a computerized system.

Eligibility Criteria

Inclusion Criteria:

• Adults aged 80 years or older.
• Residents of the urban area of Bogotá, Colombia.
• Affiliated with the health insurance provider (EPS) Compensar.
• Functionally independent or with mild dependence (defined by the ability to perform basic activities of daily living).
• Ability to communicate via telephone (landline or mobile).
• Signed informed consent to participate in the study.

Exclusion Criteria:

• Severe cognitive impairment that prevents following instructions or using the telecare device (e.g., advanced dementia).
• Severe sensory impairments (total blindness or profound deafness) that preclude the use of the technology provided.
• Participants currently enrolled in another clinical trial or intensive home-care program that overlaps with the study intervention.
• End-of-life condition or terminal illness with a life expectancy of less than 6 months.
• Total functional dependence (bedbound or requiring permanent assistance for all daily activities).

Individual participant data that underlie the results reported in articles published from this study, after de-identification (text, tables, figures, and appendices), will be shared with researchers who provide a methodologically sound proposal

Due to the nature of the intervention (telecare and case management), it is not possible to mask the participants or the personnel delivering the intervention. However, to minimize bias, the following parties will be masked:

Outcomes Assessors: The individuals responsible for performing the follow-up geriatric assessments and measuring primary/secondary outcomes (such as the SPPB and cognitive tests) will be blinded to the participants' group assignment.

Data Analysts/Statisticians: The research team performing the statistical analysis will work with de-identified data and will be blinded to the group allocation until the primary analysis is completed.

Principal Investigators: While involved in oversight, the PIs will remain blinded to individual participant allocations during the data collection phase to the extent possible