Table 1.
Intervention characteristics
| Study | Participants inclusion criteria | Interventions | Disability outcomes* |
|---|---|---|---|
| CGA: Transmural care | |||
| Burns et al. (1995) USA RCT (N = 128) |
Aged ≥ 65; at least two of following criteria: ADL deficits, two or more chronic diseases, polypharmacy, two or more hospitalizations in the previous year | Initial assessment of functional limitations, gait, incontinence, polypharmacy, depression and cognitive impairment in outpatient geriatric clinic by interdisciplinary primary care team (physician, nurse practitioner, social worker, psychologist and pharmacist), followed by long-term management (2 years) with individualized goals, interventions, treatment and follow-up | Katz Activities of Daily Living Scale: Small differences (NS) in favor of IG at 12, 24 months. Lawton & Brody Instrumental Activities of Daily Living Scale: Small differences (NS) in favor of IG at 12 months. No differences between groups at 24 months |
| Hughes et al. (1990) USA RCT (N = 233) |
Two or more impairments based on the Katz Activities of Daily Living Scale | Hospital-based home care program directed by a physician. Approximately 6 home visits by primary care team (physician, nurse, social worker, physical therapist, occupational therapist, dietician, health technician). Medications and supplies from the hospital pharmacy | Barthel ADL Index: No significant differences between groups at 1, 6 months (after discharge) |
| McCusker et al. (2001) RCT Canada (N = 388) |
Aged ≥ 65; score of 2 or more on the Identification of Seniors at Risk Screening Tool | Evaluation by nurse (physical and mental function, medical status and social factors) followed by an interdisciplinary team meeting. After discharge referrals to primary physician, local community health centre, outpatient clinic and other community services. Follow-up visits by nurse to ensure execution of appointments and services | Older American Resources and Services Multidimensional Functional Assessment Questionnaire (ADL and IADL scale): Differences (SS) in favor of IG at 4 months |
| Naylor et al. (1999) USA RCT (N = 363) |
Aged ≥ 65; medical diagnose AND at least 1 of several criteria, e.g., inadequate support system, depression, impairments, hospitalization, poor self-rating of health | Comprehensive discharge planning and home follow-up (till 4 weeks after discharge). Advanced nurse practitioner did a physical and environmental assessment and targeted efforts at patient’s and caregivers’ management of health problems. Interventions (home visits and telephone follow-up) focused on medications, symptom management, diet, activity, sleep, medical follow-up and emotional status | Enforced Social Dependency Scale: No significant differences between groups at 2, 6, 12, 24 weeks (after discharge) |
| Oktay and Volland (1990) USA CCT (N = 191) |
Aged ≥ 65; chronic post-hospital care needs | Assessment by nurse and social worker. After discharge followed home visits (on average 4 home visits per month during 1 year). Nurse and social worker (supported by weekly staff meetings) provided a coordinated program including case management, counseling, referrals, respite, education, support group sessions, medical back-up and on-call help. Strong focus on caregiver/patient configuration | Katz Activities of Daily Living Scale/3 items of Lawton & Brody Instrumental Activities of Daily Living Scale: No significant differences between groups at 1, 3, 6, 9, 12 months (after discharge) |
| Rubin et al. (1993) RCT USA (N = 194) |
Aged ≥ 70; at high risk of hospital readmission for inpatient treatment to stabilize acute episodes of chronic illness | Geriatric Assessment Team (internist, psychiatrist, nurse, social worker) did assessment, developed plan for long-term care and directed discharge planning (including referrals for home health services). In the outpatient period comprehensive interdisciplinary care was provided on an ongoing base in the clinic | Katz Activities of Daily Living Scale: No significant differences between groups at 12 months (after discharge). Older American Resources and Services Multidimensional Functional Assessment Questionnaire (ADL and IADL scale): Differences (SS) in favor of IG at 12 months (after discharge) |
| Siu et al. (1996) USA RCT (N = 354) |
Aged ≥ 65; unstable medical problems OR recent functional limitations OR potentially reversible geriatric clinical problems | At hospital nurse practitioner (NP) carried out a physical examination focused on geriatric problems. Multidisciplinary team meeting was followed by recommendations to the primary care physician (strong focus on physician’s adherence with these recommendations). A home visit was made by NP within 1–3 days after discharge. Three home visits followed by the NP and other team members | Medical Outcome Study Short Form: No significant differences between groups at 1, 2 months (after discharge) |
| CGA: Assessment followed by referrals and recommendations | |||
| Hebert et al. (2001) Canada RCT (N = 503) |
Aged ≥ 75; identified at risk by Sherbrooke postal questionnaire | Home visit by nurse to assess problems with medication, mood, cognition, vision, hearing, blood pressure, gait and balance, orthostatic hypotension, environmental risk of fall, malnutrition, incontinence and social support. Recommendations were sent to general practitioner and referrals were made to specialized resources. Nurse contacted monthly clients to check the implementation | Functional Autonomy Measurement System: No significant differences between groups at 12 months |
| Reuben et al. (1999) USA RCT (N = 363) |
Aged ≥ 65: failed a screen for at least one condition: falls, incontinence, depressive symptoms, functional impairment | Assessment done by social worker, geriatric nurse practitioner/geriatrician team at community-based clinic, followed by team meeting resulting in written recommendations for the patient and the primary physician. Telephone contact with the primary physician. A booklet (how to talk to your doctor) was given to patient. Telephone contacts with a health educator were applied to enhance adherence | Medical Outcome Study Short Form (physical functioning scale): Differences (SS) in favor of IG at 15 months |
| Robichaud et al. (2000) Canada RCT (N = 99) |
Aged ≥ 75; identified at risk by Sherbrooke postal questionnaire | Home visit by nurse to assess problems with medication, mood, cognition, vision, hearing, blood pressure, gait and balance, orthostatic hypotension, environmental risk of fall, malnutrition, incontinence and social support. Results and information sheet (summarizing suggested interventions) were send to general practitioner. Nurse conducted bimonthly telephone interviews for follow-up | Functional Autonomy Measurement System: Small differences (NS) in favor of IG at 10 months |
| Silverman et al. (1995) USA RCT (N = 442) |
Aged ≥ 65; instability in health status in previous 6 months (one or more specific risk indicators, e.g., difficulty walking, falls, incontinence, loss of vision or hearing) | Hospital geriatric team (internist, nurse, social worker) provided a comprehensive outpatient evaluation (medical, psychological and social health problems) and treatment plan. Findings and treatment plan were discussed with the patient and the family. Recommendations were communicated to referring physicians | Older American Resources and Services Multidimensional Functional Assessment Questionnaire (ADL and IADL scale)/Barthel ADL Index: No significant differences between groups at 12 months |
| CGA: Assessment followed by treatment and care | |||
| Bernabei et al. (1998) Italy RCT (N = 200) |
Aged ≥ 65; already receiving community care services or home assistant programs, mostly because of multiple geriatric conditions | Case-manager performed initial assessment and reported findings to geriatric evaluation unit that designed and implemented individualized care plan in agreement with general practitioner. Weekly team meetings to discuss problems emerging from home visits. Re-assessment every 2 months. Team is constantly available to deal with problems, to monitor the provision of services and to guarantee extra help as requested | 6-item scale of daily living/7-item scale of instrumental activities of daily living (name not specified): Differences (SS) in favor of the IG at 12 months |
| Boult et al. (2001) USA RCT (N = 568) |
Aged ≥ 70; at risk for hospitalization and functional decline: ore likely to use hospitals, nursing homes, home care, emergency rooms and medication | 4-steps assessment: General practitioner, home visit by social worker, 2 visits at GEM clinic (general nurse practitioner, geriatrician, nurse). Team meeting led to care plan, delivered by team (medication, regimes, counseling, health education, advance directives, referrals). Hospital care and 24-hours on-call service. Monthly meeting and phone calls (on average for 6 months) to monitor and coordinate care plan. Recommendation for period after discharge was given to general practitioner | Sickness Impact Profile (physical functioning dimension): Differences (SS) in favor of the IG at 6, 12, and 18 months |
| Cohen et al. (2002) USA RCT (N = 1,388) |
Aged ≥ 65; hospitalization; ≥2 frailty criteria: e.g., falls, limitations in BADL or walking, dementia, depression, stroke, bed rest, incontinence, malnutrition | Inpatient and outpatient intervention teams (geriatrician, social worker, nurse) assessed functional, cognitive, affective and nutritional status, caregiver’s capabilities and social situation; team meetings (twice a week) to evaluate and discuss treatment plan with regard to preventive and management services (dietetics, physical and occupational therapy, clinical pharmacy) | Physical Performance Test/Katz Activities of Daily Living Scale: Differences (SS) in favor of inpatient IG in comparison with CG at discharge. No significant differences between groups at 12 months. No significant differences at discharge and at 12 months for the outpatient IG in comparison with CG |
| Gagnon et al. (1999) Canada RCT (N = 427) |
Aged ≥ 70; discharge from hospital previous 12 months at risk for repeated admission (≥40%), assistance with ≥1 ADL OR ≥2 IADL | Nurse assessed health, physical, functional, social, environmental aspects, community services, needs and concerns of older people and caregivers, created and implemented care plan and coordinated professionals. Weekly interdisciplinary case conference. Collaboration with emergency department and community health centre (24-h available). Monthly call, home visits every 6 weeks (10-month period) follow-up by telephone | Older American Resources and Services Multidimensional Functional Assessment Questionnaire/Medical Outcome Study Short Form: No significant differences between groups at 10 months |
| Gitlin et al. (2006) USA RCT (N = 319) |
Aged ≥ 70; functional vulnerable defined as needing help with ≥2 IADL OR ≥ 1 ADL OR ≥ 1 falls (last 1 year) | Interviews and observations to assess problem areas. During 6 months physiotherapist provided 1 visit (90 min) consisting of balance, muscle strength, safe fall, recovery training. Occupational therapist provided 4 visits (90 min) for problem solving, use of control-oriented strategies (environmental modifications, behavioral/cognitive strategies). Installation of home modifications. 3 phone contacts (20 min) to reinforce strategy use and to generalize strategies to new problems | ADL index, IADL index (name not specified): Differences (SS) in favor of IG at 6 months. Mobility/transfer index: Small differences (NS) in favor of IG at 6 months. ADL index, IADL index, mobility/transfer index: No significant differences between groups at 12 months |
| Landi et al. (2001) Italy RCT (N = 187) |
Eligible for home care services: older disabled persons | Case-manager assessed function, health, social support, and service use every 3 months (1 year period) by using Minimum Data Set for Home Care that provided guidelines for further assessment and care (client-oriented assessment protocols). Collaboration with community geriatric evaluation unit and general practitioner led to individualized care plan. Case-manager coordinated and integrated care that is delivered by multidisciplinary tem | Bartel ADL Index/Lawton & Brody Instrumental Activities of Daily Living Scale: Differences (SS) in favor of IG at 12 months |
| Markle-Reid et al. (2006) Canada RCT (N = 288) |
Aged ≥ 75; referral to personal support services; a model of vulnerability is used to define frailty | Nurse regularly assessed risk factors for functional decline and provided health education regarding lifestyle and management of chronic diseases (telephone calls and home visits during 6 months). A participatory approach, involving empowerment, was used to promote positive attitudes, knowledge and skills. Focus on environmental support, referral and coordination of community services (goals-led health plan) | Medical Outcome Study Short Form: Small differences (NS) in favor of IG at 6 months |
| Melin and Bygren (1992) Sweden RCT (N = 249) |
Discharge from hospital (internal medicine, orthopedics); chronically ill and dependent in 1–5 functions of personal ADL according to Katz activities of Daily Living Scale | Assessment of medical and functional status by nurse/home service (phone calls) and physician (home visit) to develop treatment plan. Weekly interdisciplinary team meetings (nurse, home service assistant, geriatrician, psychiatrist). 24 h telephone service. Emergency and routine home visits whenever needed (by nurse, assistant nurse, home aids), also in the weekend (by physician, is always accessible for primary care staff by phone) | Katz Activities of Daily Living Scale: No significant differences between groups at 6 months. IADL modified Katz index: Differences (SS) in favor of IG at 6 months |
| Melis et al. (2008) The Netherlands RCT (N = 151) |
Aged ≥ 70; living at home or in retirement home; limitations in cognition (Mini Mental State Examination) (I)ADL (Groningen Activity Restriction Scale), or mental health (Medical Outcome Study Short Form) | Home visits by nurse for evaluation and management (max. 6 visits during 3-month period). Multidimensional assessment (cognition, nutrition, behavior, mood, mobility), coordination of care, therapeutic monitoring, case management (individualized and integrated treatment plan, including advices and psycho education). Collaboration with primary care physician, other health professionals and caregivers | Groningen Activity Restriction Scale-3: Differences (SS) in favor of IG at 3 months. Slightly smaller differences (NS) in favor of IG at 6 months |
| Phelan et al. (2004) USA RCT (N = 201) |
Aged ≥ 70 AND one more chronic condition; difficulties with ADL but no human help is needed, ability to walk, non-participation in senior centre | General nurse practitioner assessed health and risk factors (self-management of chronic diseases, psychoactive medication, physical activity, depression, social isolation) and developed in collaboration with general practitioner tailor-made health action plan. Senior centre-based, self-management class, peer support, and exercise class (or exercise program at home). Follow-up until 12 months (on average 3 visits and 9 telephone calls) | Health Assessment Questionnaire Disability Index: Incident disability: No significant differences between groups at 6 months. Small differences (NS) in favor of IG at 12 months; Disability improvement: Differences (SS) in favor of IG at 6, 12 months; Disability worsening: Small differences (NS) at 6 months, modest differences (NS) at 12 months in favor of IG |
| Rockwood et al. (2000) Canada RCT (N = 182) |
At least one criteria, e.g., concern about community living, acute illness, frequent physician contact, multiple medical problems, functional decline | Geriatrician nurse assessed mental and emotional status, communication, mobility, balance, bowels, bladders, nutrition, daily activities, and social situation. Geriatrician used Goal Attainment Scaling to set goals, finalizing in multidisciplinary conference. Mobile Geriatric Assessment Team (nurse, geriatrician, physiotherapist, occupational therapist, social worker, dietician, audiologist, speech-language pathologist) implemented recommendations. 3 interdisciplinary consults during 3 months period | Barthel ADL Index/Instrumental activities of daily living scale (name not specified): No significant differences between groups at 12 months |
| Rubenstein et al. (2007) USA RCT (N = 792) |
Aged ≥ 65; clinical visit previous 18 months; ≥4 positive responses on Geriatric Postal Screening Survey | Case-manager (physician assistant) assessed geriatric target conditions and other health problems. Additional assessment in geriatric clinic (in general 1 visit). Team meeting led to care plan given to primary care provider. Case-manager referred and gave recommendations (health promotion). Telephone follow-up by case-manager every 3 months during 3 years | Functional Status Questionnaire (ADL and IADL scale): No significant differences between groups at 1, 2, 3 years. Differences (NS) between subgroups at 12 months |
| Toseland et al./Engelhardt et al. (1997/1996) USA RCT (N = 160) |
Aged between 55–75 AND ≥ 1 ADL or ≥ 2 IADL impairments; >75 AND any combination of 2 ADL or IADL impairments | Team (nurse practitioner, geriatrician, social worker) participated in assessment, development and implementation of care plan, follow-up and re-assessment, monitoring and revision of care plan, referral to and coordination with health and social services. Advices for hospitalization, discharge planning. Weekly team meetings. Routine follow-up and walk-in care | Functional Independence Measure: No significant differences between groups at 8 and 16 months |
| Williams et al. (1987) USA RCT (N = 117) |
Aged ≥ 65; medical evaluation (last year), decline in functional ability and unmet needs, unstable medical problems; polypharmacy; dissatisfaction with care | Multidisciplinary team (internist, physician, psychiatrist, nurse, social worker, nutritionist) assessed physical, mental, social functioning and resulted in a problem list and team goals. Team provided counseling and family support. Follow-up visits were scheduled, among which home visits if requested | Interviews (name not specified)/Patient Assessment Forms: small non-significant differences in favor of the IG at 8 months. No information provided at 12 months |
| Physical exercise | |||
| Binder et al. (2002) USA RCT (N = 119) |
Aged ≥ 78; 2 out of 3 criteria: score between 18–32 on Modified Physical Performance Test, peak oxygen uptake between 10 and 18 mL/kg/min, self-reported difficulty in max. 2 ADLs or 1 IADL | 9 month program provided by physiology exercise technicians consisting of three phases of each 36 sessions. Phase 1: Group format: 22 exercises on flexibility, balance, coordination, speed of reaction and strength. Phase 2: Progressive resistance training and shortened version of phase 1 exercises. Phase 3: Endurance training and shortened version of phase 1 and phase 2 exercises | Older American Resources and Services Multidimensional Functional Assessment Questionnaire (ADL and IADL scale): No differences between group at 3, 6 and 9 months. Functional Status Questionnaire (physical function subscale): Difference (SS) in favor of IG at 6 and 9 months |
| Boshuizen et al. (2005) The Netherlands RCT (N = 72) |
Experiencing difficulty in rising from chair AND maximum knee-extensor torque < 87.5 N-m | 10 week exercise program, each week two group sessions (60 min) by physiotherapist and one unsupervised home session. Focus on exercises with a variation in concentric, isometric and eccentric knee-extensor activity | Groningen Activity Restriction Scale: No differences between groups at 10–12 weeks |
| Chandler et al. (1998) USA RCT (N = 100) |
Aged ≥ 65; Inability to descend stairs step over step without holding the railing | 10 week exercise program, each week three individual in-home sessions by physiotherapist. Focus: progressive resistive lower extremity exercises with theraband | Medical Outcome Study Short Form (physical functioning subscale): No significant differences between groups at 10 weeks |
| Chin A Paw et al. (2001) Netherlands RCT (N = 157) |
Aged ≥ 70; Physical inactivity and involuntary weight loss OR body mass index below 25 kg/m² | 17 week exercise program, each week 2 group sessions (45 min) by experienced instructors. Focus: skills training focused on learning physiologic parameters to perform and sustain motor action | Self-rated disabilities (name not specified): No differences between groups at 17 weeks |
| Gill et al. (2002) USA RCT (N = 188) |
Aged ≥ 75; performance on rapid gait test >10 s OR inability to stand up from seated position | 12 month program with average of 16 visits (45–60 min) by physiotherapist and home exercising in the first 6 months, followed by 6 phone calls in the next 6 months to encourage further (daily) home exercising. Focus: instruction in safe techniques, proper use of devices, removal of environmental hazards and exercises for range of motion, balance, muscle conditioning and strengthening | Self-reported performance in activities of daily living (name not specified): Differences (SS) in favor of IG 7 and 12 months |
| Jette et al. (1999) USA RCT (N = 215) |
Aged ≥ 60; limitations in at least 1 of 9 items of Medical Outcome Study Short Form (physical functioning subscale) | 6 month program with 3-times a week a (videotaped) exercise program for 35 min with elastic bands varying in thickness to individualize resistance. Physiotherapist did two home visits and provided telephone follow-up and support. Several cognitive and behavioral techniques were used to increase adherence | Sickness Impact Profile 68: Differences (SS) in favor of IG at 3 and 6 months |
| King et al. (2002) USA RCT (N = 155) |
Aged ≥ 70; Short Physical Performance Battery score ≤ 9 AND independence in at least 5 ADL’s | 18 month exercise program with 6 months of 3 group sessions (75 min) each week (by physiotherapist and/or exercise leader), followed by 6 months of 1 group session a week and two home-exercise sessions, and 6 months of 3 home exercises a week with monthly call from exercise leader. Focus on endurance, strength, balance and flexibility | Medical Outcome Study Short Form (physical functioning subscale): Slight difference (NS) in favor of CG at 6 and 12 months. Slight difference (NS) in favor of IG 18 months |
| Latham et al. (2003) New Zealand/Australia RCT (N = 243) |
Aged ≥ 65; one or more health problems or functional limitations | 10 weeks three times a week quadriceps exercise program by physiotherapist. Patients performed their first two session in the hospital and continued the rest of their sessions at home. Physiotherapist monitored progress weekly, alternating home visits with telephone calls | Medical Outcome Study Short Form (physical functioning subscale)/Barthell Self-care index: No significant differences between groups at 3 and 6 months |
| Luukinen et al. (2006) Finland RCT (N = 555) |
Aged ≥ 85; at least one risk factor for disability or mobility, e.g., falls, loneliness, depression, low cognitive status, impaired vision or hearing, impaired balance | Risk inventarisation and suggestions for interventions done by physiotherapist and occupational therapist were discussed by patient and family physician. Home exercises (recommended three times daily with 5–15 repetitions) focused on a number of physical exercises (standing, lying or sitting position) in combination with self-care exercises, walking exercises or/and physical exercises in groups | Postal questionnaire for physical disability (name not specified): No significant differences between groups at 5 months |
| Ota et al. (2007) Japan RCT (N = 46) |
Aged ≥ 65; eligible for long-term care needs | 12 week program with 24 sessions (twice a week) with training machines focused on leg press, leg extension/flexion, torso extension/flexion, rowing, chest press and hip adduction/abduction | TMIG-IC instrumental self-maintenance: No significant differences between groups at 12 weeks |
| Timonen et al. (2006) Finland RCT (N = 68) |
Aged ≥ 75; difficulty with balance AND mobility AND symptoms such as dizziness or reported falls or difficulty in walking independently | 10 week exercise program, each week two group sessions (90 min) supervised by two physiotherapists. Core of program; progressive resistance training (lower extremity) and functional exercises. One home visit to instruct stretching program to be performed 2–3 times a week at home | Joensuu Classification Model: No significant differences between groups at 1 week, 3 and 9 months |
| Worm et al. (2001) Denmark RCT (N = 46) |
Aged ≥ 74; inability to leave home unaided OR unattended OR without mobility aids | 12 weeks exercise program with 2 group sessions per week (60 min); flexibility training, aerobics and rhythm, balance and reaction exercises, muscle training. Participants were also asked to perform a home-based exercise program (8–10 min) every morning | Medical Outcome Study Short Form (physical functioning subscale): Differences (SS) in favor of IG at 12 weeks |
| Nutritional interventions | |||
| Chin A Paw et al. (2001) Netherlands RCT (N = 157) |
Aged ≥ 70; physical inactivity and involuntary weight loss OR body mass index below 25 kg/m² | 17 weeks nutrition program; several fruit and dairy products enriched with vitamins and minerals. One fruit and a diary product in addition to daily diet or as a replacement | Self-rated disabilities (name not specified): No significant differences between groups at 17 weeks |
| Kretser et al. (2003) USA RCT (N = 203) |
Aged ≥ 60; score < 22.5 on Mini Nutritional Assessment | 6 month nutrition program consisting of weekly 21 meals and 14 snacks meeting 100% of the Daily Reference Intake (DRI) needed for people over 50 and with a daily caloric level of 1,800 kcal | (Self-?) Reported performance of activities of daily living (name not specified): No significant differences between groups at 6 months |
| Payette et al. (2002) Canada RCT (N = 83) |
Aged > 65; involuntary weight loss and Body Mass Index < 27 OR Body Mass Index < 24 | 16 weeks nutrition program; provision of 235-ml cans of nutrient-dense protein-energy liquid. Two cans a day in addition to usual diet. Each month 1 home visit and each two weeks a phone call was conducted by a dietician | Medical Outcome Study Short Form (physical role functioning scale and emotional role functioning scale): No significant differences between groups at 16 weeks |
| Assistive technology | |||
| Mann et al. (1999) USA RCT (N = 104) |
Receiving services or initial referral for in-home services or in-patient rehabilitation services in previous year | Assessment done by occupational therapists, followed by recommendations for assistive devices and/or home modifications. Participants were trained in the use of the devices and follow-up continued with assessment and provision of assistive technology as needs changed | Functional Independence Measure/Older American Resources and Services Multidimensional Functional Assessment Questionnaire (IADL scale). Differences (SS) in favor of IG at 18 months |
| Tomita et al. (2007) USA RCT (N = 113) |
Aged ≥ 60; difficulties in ADL or IADL | About 18 months computer and internet facilities were provided. Level of automatization fitted participants’ desire and the capacity of the house. Computer engineer ensured a good fit between computer and users. Smart technology (door and window sensors, motion sensors and remote control for lamps and radio) was installed. Participants received instruction from a geriatric nurse | Older American Resources and Services Multidimensional Functional Assessment Questionnaire (IADL score)/CHART mobility: Differences (SS) in favor of IG at 24 months |
| Others | |||
| Beck et al. (1997) USA RCT (N = 321) |
Aged ≥ 65; high care utilization AND one of the following diseases: lung disease, heart disease, joint disease, diabetes | Monthly group meetings (12 × 2 h) with primary care physician and nurse (contributions of other professionals). Each session had a warming up period and specific health related topic (e.g., disease processes, medication, exercise, alternate care home safety) were presented. Medical assessment (e.g., blood pressure) took place by the nurse and a meeting with the physician was possible | Katz Activities of Daily Living Scale/Older American Resources and Services Multidimensional Functional Assessment Questionnaire (IADL score): No significant differences between groups at 12 months |
| Giannini et al. (2006) Italy CCT (N = 121) |
Aged (not clear): necessity of help in two ADL or severely chronically ill with mental impairment (Mini Mental State Examination score < 24/30) | Additional home care attendance (HCA) 24 months varying from 4 to 24 h daily. The primary caregiver got vouchers to buy the amount of hours of HCA from health providers who demonstrated to have professional training in the care of frail elderly | Katz Activities of Daily Living Scale/Lawton & Brody Instrumental Activities of Daily Living Scale: Differences (SS) in favor of IG at 24 months |
| Latham et al. (2003) New Zealand/Australia RCT (N = 243) |
Aged ≥ 65; one or more health problems or functional limitations | Vitamin D in a single oral dose. Patients received six 1.25-mg calciferol | Medical Outcome Study Short Form (physical functioning subscale)/Barthell Self-care index: No significant differences between groups at 3 and 6 months |
| Liang et al. (1986) USA RCT (N = 57) |
Inability to perform self-care tasks OR ADL dysfunction AND potential for rehabilitation, judged by physician, home care and physiotherapist for ≥3 months | Two months treatment program provided by physician and physiotherapist with occasional consultation with hospital-based rehabilitation specialists. Interventions included equipment and assistive devices, supervised exercises to improve function and home modifications for safety and improved function | Functional Status Index: No significant differences between groups at 2, 4 and 6 months |
| Ollonqvist et al. (2008) Finland RCT (N = 708) |
Aged ≥ 65; eligibility criteria for SII allowance for pensioners with a medical disability as verified by a physician to be in need of assistance | 3 separate inpatient treatment periods at a rehabilitation centre within 8 months provided by a team (e.g., physician, physiotherapist, social worker, occupational therapist) with focus on physical activation (group). Home visit for advice on personal hygiene and assistive devices. Activation days between rehabilitation periods with focus on discussing topics, e.g., as safety at home, health promotion and cognition | ADL and IADL items (name not specified): No significant differences between groups at 12 months |
| Scott et al. (2004) USA RCT (N = 294) |
Aged ≥ 60; one or more chronic conditions AND at least 11 outpatient clinic visits in the past 18 months | Monthly group meetings (12 × 2 h) with primary care physician and nurse (contributions of other professionals). Each session had a warming up period and specific health related topic (e.g., disease processes, medication, exercise, alternate care home safety) were presented. Medical assessment (e.g., blood pressure) took place by the nurse and a meeting with the physician was possible | ADL and IADL items (name not specified). No significant differences between groups at 24 months |
*Instruments used to measure disability and reported differences (SS = statistically significant difference if p < 0.05; NS = not statistically significant difference) between intervention group (IG) and control group (CG) at follow-up. Follow-up measurements are in weeks or months after randomization, unless stated otherwise