Sustained improvement of intrinsic capacity in community‐dwelling older adults: The +AGIL Barcelona multidomain program

Abstract

AbstractBackgroundDifferent programs promote healthy ageing through the optimization of intrinsic capacity. However, a major challenge is to assess their sustained effects over time. +AGIL Barcelona, a consolidated multidomain program, aims to optimize older adults’ intrinsic capacity through a coordinated approach among primary care, geriatrics and community resources, in agreement with the integrated care for older people (ICOPE) guidelines. We aimed to evaluate the +AGIL Barcelona longitudinal effect on older adults’ physical performance.MethodsAll +AGIL Barcelona consecutive participants since 2016 were enrolled. After a comprehensive geriatric assessment, a tailored, multidisciplinary intervention aligned with the ICOPE guidelines is offered. It includes a 10‐week boost multicomponent exercise program, nutritional and sleep‐hygiene counselling, revision and optimization of pharmacological treatments and screening for cognitive impairment, depression and loneliness. Changes in physical performance after 3 and 6 months were assessed using mixed models including baseline frailty degree, time and all potential significant confounders.ResultsWe included 194 participants in the analysis (mean age = 81.6 [standard deviation = 5.8], 68% women). An independent, clinically and statistically significant improvement in physical performance (Short Physical Performance Battery [SPPB] test, combining gait speed, strength and balance) was found at 3 months (SPPB mean change: 1.4; 95% CI: 1.1–1.6) and 6 months (SPPB mean change: 1.1; 95% CI 0.8–1.5). Equivalent results were observed for all the SPPB sub‐tests.ConclusionsA coordinated, multidisciplinary and integrated program can benefit older adults’ intrinsic capacity. The participants’ empowerment and the connection with the available community resources are critical points for a successful intervention.