Preventing decline in function. Evidence from randomized trials around the world

Over the past decade, increasing epidemiologic evidence points to a few important risk factors for loss of mobility and functional decline, such as inactivity, cigarette smoking, obesity, depression, and alcohol and drug misuse. Global interventions addressing these risk factors along with other medical problems have been evaluated in randomized controlled clinical trials. With few exceptions, these trials have shown that intervention has a positive effect on health and functional status, as well as reducing length of stay in a hospital or nursing home. The extent to which the success of these programs is attributable to risk-factor reduction or to geriatric assessment and management is uncertain.