Supplementary Table 1.
Algorithm for targeted risk factors and interventions
| Risk factor | Recommendations | Baseline assessment | 3 months by telephone | 9 months by telephone | 12-month assessment |
|---|---|---|---|---|---|
| Medications | |||||
| Use of ≥5 medications (over more than 6 months) | Discussion with patient about secondary effects, adherence | ||||
| If drugs | (Morinsky test) | ||||
| Anti-inflammatory | |||||
| Cardiovascular | Recommendations to discuss medication with physician; reduce usage of as-needed medication | ||||
| Antibiotics | |||||
| Benzodiazepines | |||||
| Antidepressants | |||||
| Neuroleptics | |||||
| Others (diuretics, vitamins) | Advice for nonpharmacological options for sleep, pain, and constipation | ||||
| Nutrition | |||||
| If MNA test <23.5/30 | Provide nutrition and exercise booklet | ||||
| Problems chewing, swallowing, teething | Exercise 30 minutes before meals | ||||
| If defective mouthpiece, bad oral hygiene or not adjusted | Recommendations to physician to consider etiology | ||||
| Vision | |||||
| Visual acuity: Jaeger tables <5 | Nursing accident prevention advice | ||||
| Diabetes mellitus: mydriatic camera review | Attention to turning movements ocular–cephalic Optometrist or ophthalmologist |
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| Sense of hearing | |||||
| Whispered voice test abnormal | Annual review of headphones Recommendations to physician to consider etiology and review ORL |
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| Locomotor system: balance and mobility | |||||
| Join deformity, callus | Revision of lumbar spine, and upper and lower extremities | ||||
| Tinetti gait test (<9) | Recommendations for safe performance of mobility tasks | ||||
| Hand grip dynamometry | Consider referral to physical therapy | ||||
| Functional status | |||||
| Barthel I ≤60/100 | Patient and caregiver education regarding safe performance task, increased supervision, or other social assistance Recommendations to environmental hazards |
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| Cognition | |||||
| MEC <24/35 | Patient and caregiver education avoiding multitasking, review of diary repercussion, consider depression Recommendations occupational therapy Recommendations to physician for further testing or consider neurology advice |
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| Home hazards | |||||
| Carpets, baths, stairs | Removal of throw rugs Recommendations for bathroom safety Social assistance if necessary to completed assessment |
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| Home help | |||||
| Lives alone, social risk revision | Attention to cleaning, meals, personal care, dependency | ||||
Abbreviations: MNA, Mini-Nutritional Assessment; MEC, Spanish version of Mini-Mental State Examination; ORL, otorhinolaryngologist.