Evidence map›Paper›PMID 37505991›Full record

SynthesisAge and ageing2023

Complex interventions for improving independent living and quality of life amongst community-dwelling older adults: a systematic review and meta-analysis.

Leonard Ho, Stephen Malden, Kris McGill, Michal Shimonovich, Helen Frost, Navneet Aujla, Iris S-S Ho, Susan D Shenkin, Barbara Hanratty, Stewart W Mercer and 1 more

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Age and ageing, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed, 9 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

29 citing papers in PubMed, 9 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

Leonard HoAdvanced Care Research Centre, Usher Institute, University of Edinburgh, Edinburgh, UK.ORCID 0000-0001-8353-9631
Stephen MaldenAdvanced Care Research Centre, Usher Institute, University of Edinburgh, Edinburgh, UK.
Kris McGillAdvanced Care Research Centre, Usher Institute, University of Edinburgh, Edinburgh, UK.
Michal ShimonovichMRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK.
Helen FrostAdvanced Care Research Centre, Usher Institute, University of Edinburgh, Edinburgh, UK.
Navneet AujlaPopulation Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
Iris S-S HoAdvanced Care Research Centre, Usher Institute, University of Edinburgh, Edinburgh, UK.
Susan D ShenkinAdvanced Care Research Centre, Usher Institute, University of Edinburgh, Edinburgh, UK.ORCID 0000-0001-7375-4776
Barbara HanrattyPopulation Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
Stewart W MercerAdvanced Care Research Centre, Usher Institute, University of Edinburgh, Edinburgh, UK.
Bruce GuthrieAdvanced Care Research Centre, Usher Institute, University of Edinburgh, Edinburgh, UK.ORCID 0000-0003-4191-4880

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundcommunity-based complex interventions for older adults have a variety of names, including Comprehensive Geriatric Assessment, but often share core components such as holistic needs assessment and care planning.

objectiveto summarise evidence for the components and effectiveness of community-based complex interventions for improving older adults' independent living and quality of life (QoL).

methodswe searched nine databases and trial registries to February 2022 for randomised controlled trials comparing complex interventions to usual care. Primary outcomes included living at home and QoL. Secondary outcomes included mortality, hospitalisation, institutionalisation, cognitive function and functional status. We pooled data using risk ratios (RRs) or standardised mean differences (SMDs) with 95% confidence intervals (CIs).

resultswe included 50 trials of mostly moderate quality. Most reported using holistic assessment (94%) and care planning (90%). Twenty-seven (54%) involved multidisciplinary care, with 29.6% delivered mainly by primary care teams without geriatricians. Nurses were the most frequent care coordinators. Complex interventions increased the likelihood of living at home (RR 1.05; 95% CI 1.00-1.10; moderate-quality evidence) but did not affect QoL. Supported by high-quality evidence, they reduced mortality (RR 0.86; 95% CI 0.77-0.96), enhanced cognitive function (SMD 0.12; 95% CI 0.02-0.22) and improved instrumental activities of daily living (ADLs) (SMD 0.11; 95% CI 0.01-0.21) and combined basic/instrumental ADLs (SMD 0.08; 95% CI 0.03-0.13).

conclusionscomplex interventions involving holistic assessment and care planning increased the chance of living at home, reduced mortality and improved cognitive function and some ADLs.

Indexed as

Independent LivingQuality of LifeActivities of Daily LivingAgedGeriatric AssessmentHospitalizationHumansagedCommunity Health ServicesGeriatric Assessmentindependent livingolder peoplequality of lifesystematic review

Identifiers

PMID37505991
PMCPMC10378722

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.