The Effectiveness of Multicomponent Functional Maintenance Initiatives for Acutely Hospitalized Older Adults: A...

Area of Science:

• Gerontology
• Geriatric Medicine
• Rehabilitation Medicine

Background:

• Functional decline is a significant concern for acutely hospitalized older adults.
• Multicomponent functional maintenance initiatives (MFMIs) aim to mitigate functional decline.
• Evidence on the effectiveness of MFMIs in this population requires synthesis.

Purpose of the Study:

• To evaluate the effectiveness of MFMIs on functional outcomes in hospitalized older adults.
• To assess the impact of MFMIs on adverse events, including mortality and discharge destinations.
• To synthesize current evidence on MFMI efficacy in geriatric care.

Main Methods:

• Systematic review and meta-analysis of randomized controlled trials.
• Searched multiple databases (Ovid Medline, PubMed, Embase, CINAHL, Cochrane, PEDro) up to April 2020.
• Included trials of MFMIs targeting physical function and geriatric syndromes in patients aged 65+.

Main Results:

• Eight studies with 5534 patients were included.
• MFMIs showed no significant effect on functional status, length of stay, or 30-day readmissions.
• Patients not receiving MFMIs had a higher likelihood of nursing home discharge (OR=1.53).
• No effect on all-cause mortality; adverse events were rare.

Conclusions:

• MFMIs may reduce nursing home discharges in hospitalized older adults, but not necessarily through improved physical function.
• Clinical heterogeneity limits definitive conclusions on specific functional outcomes.
• Standardized evaluation of MFMIs is needed for clinical practice decisions.