A Multi-Domain Group-Based Intervention to Promote Physical Activity, Healthy Nutrition, and Psychological Wellbeing in Older People with Losses in Intrinsic Capacity: AMICOPE Development Study

Abstract

The World Health Organization has developed the Integrated Care of Older People (ICOPE) strategy, a program based on the measurement of intrinsic capacity (IC) as “the composite of all physical and mental attributes on which an individual can draw”. Multicomponent interventions appear to be the most effective approach to enhance IC and to prevent frailty and disability, since adapted physical activity is the preventive intervention that has shown most evidence in the treatment of frailty and risk of falls. Our paper describes the development of a multi-domain group-based intervention addressed to older people living in the community, aimed at improving and/or maintaining intrinsic capacity by means of promoting physical activity, healthy nutrition, and psychological wellbeing in older people. The process of intervention development is described following the Guidance for reporting intervention development studies in health research (GUIDED. The result of this study is the AMICOPE intervention (Aptitude Multi-domain group-based intervention to improve and/or maintain IC in Older PEople) built upon the ICOPE framework and described following the Template for Intervention Description and Replication (TIDieR) guidelines. This study represents the first stage of the UK Medical Research Council framework for developing and evaluating a complex intervention. The next step should be carrying out a feasibility study for the AMICOPE intervention, and in a later stage, assessing the effectiveness in a randomized controlled trial.

Multidomain Integrated Exercises Decreased the Risk of Falls of Community-Dwelling Older Adults

“…Multicomponent exercise programs appear to be the most effective interventions for improving the overall health status of frail elderly individuals 41–46. This statement is supported by the literature, in which positive effects on functional capacity are more often observed when more than one physical-conditioning component (ie, strength, endurance, or balance) comprises the exercise intervention, compared with only one type of exercise 41–48…”

“…In the current study, with the MDHP fall prevention training conducted in the community-based care centers, 91 older people who were originally categorized as having high risk of falls became low risk, which was about 1 in 4 being cleared from the risk of falls. Various studies using multicomponent exercise (usually consisting of functional, strength, balance, and aerobic exercises) also showed significant improvement in fall prevention; the intervention duration ranged from single session49 to 12 weeks or even longer,46–47 provided as home-based,16,48 community-based,40–42,46 long-term care institution-based,44 or hospital-based,45 all demonstrated fewer falls, better strength and balance, gait pattern, and subsequently may prevent disability, admission to hospital, or death 29,32,44,50,51. Our finding supports conductance of the MDHP program with emphasis on fall prevention at community-based care centers, for at least 1 hour per week, was effective in reducing the risk of falls.…”