Journal of the American Medical Directors Association
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Randomized Controlled Trial Multicenter Study
Effect of Sit-to-Stand Exercises Combined With Protein-Rich Oral Supplementation in Older Persons: The Older Person's Exercise and Nutrition Study.
Nursing home (NH) residents are often undernourished and physically inactive, which contributes to sarcopenia and frailty. The Older Person's Exercise and Nutrition Study aimed to investigate the effects of sit-to-stand exercises (STS) integrated into daily care, combined with a protein-rich oral nutritional supplement (ONS), on physical function, nutritional status, body composition, health-related quality of life, and resource use. ⋯ Twelve-week intervention of daily STS combined with ONS in NH residents did not improve physical function, but increased body weight. Subgroup analyses indicated that high adherence to the combined intervention was associated with maintained or improved physical function and a gain of fat free mass.
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From 2013 to 2016, the Centers for Medicare and Medicaid Services Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents ("the Initiative") tested a series of clinical interventions and care models, through organizations called Enhanced Care and Coordination Providers (ECCPs), with the goal of reducing avoidable inpatient hospital admissions among long-stay nursing home residents. We identify the effect of the Initiative on the probability and count of acute care transfers [capturing any transfer to the hospital, including hospitalizations (inpatient stays), emergency department visits, and observation stays]. ⋯ The clinical interventions and care models implemented by the ECCPs show that by using staff education, facility leadership and physician engagement, and/or clinical assessment and treatment of residents who experienced a change in condition, it is possible to reduce acute care transfers of nursing facility residents. This could lead to better outcomes and reduced cost of care for this vulnerable patient population.
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Randomized Controlled Trial Multicenter Study
Effectiveness of a Diet and Resistance Exercise Intervention on Muscle Health in Older Adults: ProMuscle in Practice.
Clinical studies show that resistance exercise and a protein-rich diet can counteract the age-related decline of muscle mass, strength, and physical performance. The aim of the ProMuscle in Practice study was to test effectiveness of a resistance exercise and dietary protein intervention for older adults implemented in a real-life setting. ⋯ ProMuscle in Practice was effective on improving muscle strength and LBM, with small changes in the composite function score in community-dwelling older adults in a real-life setting. Further research should explore feasibility of real-life implementation, as well as improving long-term compliance.
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To study the effects of a nonpharmacologic intervention, Music and Memory (M&M), on residents with dementia and/or behavioral problems living in nursing homes (NHs). ⋯ This is the largest study of M&M to date. We found clinically and statistically significant reductions in psychotropic medications and improved behaviors in residents using M&M. Although the study showed positive results overall, the lack of a control group was a significant limitation that precluded determining how much more improvement participating residents experienced compared with nonparticipants. Future studies should include a control group so that better conclusions can be drawn regarding the effectiveness of the M&M program.