[Diagnosis of frailty as starting point for training interventions]

The concept of frailty describes an older at-risk population, which has a higher probability for the occurrence of unfavorable health outcomes. It is in the interest of frail individuals as well as the healthcare system to improve the prognosis of these people by targeted interventions. Several systematic reviews and meta-analyses are now available comparing very different interventions in frail older adults. These studies came to the conclusion that training interventions were found to be the most effective. Compared to exercise interventions delivered at participants homes, exercise in groups was found to be more effective. The case finding for such interventions should be carried out with frailty instruments that focus on strength, endurance and/or physical activity. Particularly suitable for this are the frailty criteria of Fried, gait speed or the short physical performance battery (SPPB). From a geriatrics perspective, a comprehensive offer of group training seems to be urgently necessary; however, the implementation requires a large expansion of existing structures and new ways to reach older people with frailty.

A controlled evaluation of the effect of social prescribing programs on loneliness for adults in Queensland, Australia (protocol)

BACKGROUND

In social prescribing, link workers support individuals whose persistent health problems are exacerbated by loneliness by connecting them to community-based social activities. This approach is well established in the UK and is gaining attention in Australia. However, a major limitation of research to date has been a lack of theoretically informed and rigorous evaluations of social prescribing. We will address these points in this study, applying a social identity framework to examine the effects of group-based social prescribing (SP) activity compared to primary care treatment as usual (TAU).

METHODS

Ninety participants experiencing loneliness recruited from primary care services and community centres across five sites in Southeast Queensland will be assigned to one of two conditions (SP, TAU) and assessed at two timepoints (baseline, + 8 weeks). Individuals will be aged 18 years and over, have sufficient English language skills to provide consent, and at the time of recruitment they will not be experiencing acute symptoms or social issues that require urgent intervention. Primary outcomes are loneliness, mental well-being, and health service use (total number of GP, hospital, and allied health visits in the past 3 months). Secondary outcomes will assess social group processes, including number of important social groups, new group identification, multiple identity compatibility, and group-based support and emotion regulation.

DISCUSSION

This study will provide comprehensive data about the extent to which, and how, social prescribing to community-based group activities may help people to feel less lonely, more socially integrated, and healthy over the first 8 weeks. If effective, this social identity-informed model of social prescribing can be disseminated in communities across Australia.

TRIAL REGISTRATION

ANZCTR, Registered 8 June 2022 - Retrospectively registered, https://www.anzctr.org.au/ACTRN12622000801718.aspx.

[Group-based exercise to prevent falls in community-dwelling older adults : Update of the 2009 recommendations of the German Federal Initiative to Prevent Falls]

Dieser Beitrag stellt eine Aktualisierung des Empfehlungspapiers der Bundesinitiative Sturzprävention für das körperliche Gruppentraining zur Sturzprävention bei älteren, zu Hause lebenden Menschen aus dem Jahre 2009 unter Berücksichtigung aktueller Evidenz dar. Das aktualisierte Empfehlungspapier zielt darauf ab, die Umsetzung ambulanter Sturzpräventionsgruppen zu fördern sowie konkrete Empfehlungen für deren Einrichtung und Durchführung auszusprechen. Die Empfehlungen beziehen sich auf die Identifikation und Ansprache der Zielgruppe für gruppenbasierte Sturzpräventionsprogramme sowie auf die Programmgestaltung und Qualitätssicherung. Hintergründe zu Finanzierung und Trainer*innen-Ausbildung werden samt einer Auflistung der in Deutschland etablierten Programme ebenfalls dargelegt.