CAPABLE program improves disability in multiple randomized trials

Area of Science:

• Gerontology and Public Health
• Interprofessional Healthcare Models
• Disability Studies

Background:

• Effective programs are crucial for improving the quality of life for older adults with disabilities.
• Reducing disability can prevent costly hospitalizations and institutionalization.
• Few disability-reducing programs are successfully replicated and scaled.

Purpose of the Study:

• To examine the evidence for the CAPABLE program's effectiveness in improving outcomes for older adults with disabilities.
• To assess the program's impact on functional abilities and home environment supports.
• To evaluate the cost-effectiveness of the CAPABLE program.

Main Methods:

• A systematic review of six trials involving 1144 low-income, community-dwelling older adults with disabilities.
• Analysis of outcomes including activities of daily living (ADLs), instrumental activities of daily living (IADLs), fall efficacy, depression, and pain.
• Comparison of results from studies implementing the full-tested dose versus a decreased dose of the CAPABLE program.

Main Results:

• All six trials showed significant improvements in ADLs and IADLs, with effect sizes ranging from 0.41 to 1.47.
• Studies using the full CAPABLE program dose demonstrated greater improvements in ADLs and cost savings.
• Other outcomes, such as fall efficacy, depression, and pain, showed mixed results across studies.

Conclusions:

• The CAPABLE program consistently improves ADLs and IADLs in older adults with disabilities across multiple trials.
• Adherence to the full program protocol is associated with greater benefits.
• The CAPABLE program is a cost-effective intervention, saving more than it costs to implement.