Effects of a cognitive stimulation program on physical and cognitive dimensions in community-dwelling faller older adults with cognitive impairment: study protocol.

BACKGROUND: Cognitive functioning is an important dimension among the elderly. Cognitive maintenance is vital for aging due to its association with autonomy and independence. Considering the importance of preventive programs in older adults' health, this study aims to share an intervention protocol of a falls prevention program for community-dwelling faller older adults with cognitive impairment. METHODS: This is the protocol of an experimental and longitudinal study, consisting of cognitive stimulation associated with physical exercise in a 16-week fall prevention program. For cognitive intervention, the APG Cognitive Training Protocol will be used. Participants will be assessed pre-and post-intervention and will be randomly allocated to experimental or control groups. The screening protocol is composed of the TUG, FES-I, LAWTON & BRODY, ACE-R, GAI and fall survey instruments, focusing on the assessment of balance and mobility, fear of falling, performance on IADL, cognitive and anxiety tracking, respectively. DISCUSSION: This study can determine the long-term effects of multimodal cognitive training, providing evidence for its replication in the provision of care for the elderly. The objective is to promote improvements in the cognitive performance, mobility and balance of the elderly, with a focus on reducing the number of falls, fractures, hospitalizations and institutionalization, serving as an alternative to interrupt the cycle of falls. TRIAL REGISTRATION: The research was approved by the Research Ethics Committee with Human Beings at the Federal University of São Carlos, CAAE: 3654240.9.0000.5504 and Brazilian Registry of Clinical Trials (REBEC) RBR-3t85fd, registered on the 25th of September, 2020.

Treatment fidelity and satisfaction with an intervention based on case management for older people with falls history: Randomized clinical trial.

PURPOSE: To verify the treatment fidelity and satisfaction with a multifactorial intervention based on case management in community-dwelling older people with falls history and related sociodemographic and clinical factors. METHODS: This is a single-center, randomized, parallel-group controlled clinical trial. 62 community-dwelling older people with falls history were distributed into two groups. The Intervention Group (IG) underwent a case management involving multidimensional evaluation, explanation of the risk factors for falls identified, implementation of an intervention proposal based on the identified risks, elaboration of an individualized falls intervention plan, implementation, monitoring and review of the intervention plan. The Control Group (CG) was accompanied by a monthly phone call. After 16 weeks, the volunteers answered two closed questionnaires about treatment fidelity or non-fidelity to intervention (IG) and satisfaction with intervention (both groups). In addition, the frequency of intervention, adherence to each recommendation of the case management and satisfaction with general care were evaluated. RESULTS: There was good treatment fidelity based on case management, as well as good adherence to recommendations. In addition, the satisfaction of both groups was positive, although the IG had a better score (p<0.05). There was a significant influence of monthly income and general health on treatment fidelity (IG). Also, age, years of schooling, general health and physical mobility significantly influenced satisfaction with the IG. There was a significant influence of number of falls on satisfaction with monitoring conducted in the CG. CONCLUSIONS: Clinical and sociodemographic factors can influence treatment fidelity and satisfaction of older people with falls history to a falls prevention program.