The purpose of this project is: 1. Provide the epidemiological data of the prevalence, incidence, and risk factors of osteoporosis and sarcopenia among the elderly in rural areas. 2. Screen osteoporosis and sarcopenia among the elderly and provide with assistance for following care in order to improve the diagnosis and treatment rates of osteoporosis and sarcopenia 3. Construct a pragmatic and integrated care service model for osteoporosis and sarcopenia in the elderly people from rural areas
Detailed Description: Investigators plan to use a stepped-wedge cluster randomized trial that allocates participants into the following three groups: 1. Screening group: Inform the elderly about the results of the screening and recommend those with moderate to high risk of fracture to receive active examination and treatment. 2. Multi-disciplinary team intervention group: Introduce integrated services of health education, nutrition, rehabilitation, medication evaluation and other multi-specialties to assist study participants with health promotion. 3. Control group (Delayed intervention): receive general care after collecting basic information, and provide health education related information such as osteoporosis sarcopenia. After two year's follow-up, multi-disciplinary team intervention service will be implemented.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
600
All residents underwent screening using the Fracture Risk Assessment Tool (FRAX) and Mobile dual-energy X-ray absorptiometry (DXA) (Horizon Wi, Hologic Inc., Bedford, MA). Our study nurses actively assisted osteoporosis treatment if indicated.
Sarcopenia assessment adhered to the 2019 Consensus Update on Sarcopenia Diagnosis and Treatment by the Asian Working Group for Sarcopenia guideline. Following screening, individuals identified with sarcopenia underwent tailored interventions involving exercise and nutrition as deemed necessary.
TheraBand (resistance band) was utilized as the exercise tool within the community. T
Nutrition Nutritional education programs aim to increase protein food serving and the choice of those with insufficient dietary intake. Protein supplement was added if indicated.
We collected drug information of the elderly. Detailed and real-time prescription drug information was retrieved from the National Health Insurance PharmaCloud System. A pharmaceutical care team performed patient-centered drug review and discussion every three to six months.
National Taiwan University Hospital, Yunlin branch
Douliu, Yunlin County, Taiwan
RECRUITINGThe changes of Quality of life and quality adjusted life year
Using EQ5D / WHOQOL Brief questionnaires to measure quality of life and evaluate the changes after intervention. In addition, to calculate quality adjusted life year by using utility index derived from qualify of life measurement.
Time frame: one year, two year, 3 year, four year
Intrinsic capacity
To define if the Intrinsic capacity would be changed after intervention
Time frame: one year, two year, 3 year, four year
Institutionalilzation rate
To define if the Institutionalilzation rate would be changed after intervention
Time frame: one year, two year, 3 year, four year
Incidence of fall
To define if the fall frequency would be changed after intervention
Time frame: one year, two year, 3 year, four year
Incidence of fracture
To define if the incidence of fracture would be changed after intervention
Time frame: one year, two year, 3 year, four year
Incidence of unexpected hospitalization
To define if the unexpected hospitalization would be changed after intervention
Time frame: one year, two year, 3 year, four year
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