This research project is structured in two phases: an initial observational phase and a subsequent randomized controlled trial (RCT) phase. The goal of the observational phase is to compare hospital admission and Hospital at Home (HaH). The objective of the RCT is to assess the effectiveness of a multicomponent intervention following acute hospitalization in older adults. The main questions it aims to answer are: * What are the differences between hospital admission and HaH in sedentary and physical activity levels? * What are the effects of a multicomponent intervention following acute hospitalization in older adults? Researchers will compare a post-discharge multicomponent intervention to usual care to see the effects on physical and cognitive function. Participants will receive a home-based cognitive and physical exercise intervention or usual care.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
200
The intervention will be based on the Vivifrail program, which is a multicomponent physical exercise program designed specifically for older adults.
Physical function
Short Physical Performance Battery (SPPB): scores range from 0 to 12, with higher scores indicating better physicalfunction.
Time frame: Within the first 24-48 hours of acute care admission (in hospital or home hospitalization), pre-intervention baseline, and immediately after the intervention.
Cognitive function
Mini-Mental State Examination (MMSE): scores range from 0 to 30, with higher scores indicating better cognitive function.
Time frame: Within the first 24-48 hours of acute care admission (in hospital or home hospitalization), pre-intervention baseline, and immediately after the intervention.
Physical activity
Physical activity will be assessed with a Firstbeat device (format: hh:mm:ss).
Time frame: During hospital stay or during home-base hospitalization .
Sedentarism
Sedentarism will be assessed with a Firstbeat device (format: hh:mm:ss).
Time frame: During hospital stay or during home-based hospitalization.
Health-related quality of life (HRQOL)
EQ-5D-5L provides a health profile that is converted to a utility index, in which 0 is equivalent to death and 1 indicates perfect health. Additionally, the EQ-VAS ranges from 0 to 100, with higher scores indicating better health.
Time frame: Pre-intervention baseline and immediately after the intervention.
Heart rate variability
Heart rate variability will be assessed usign a Firstbeat device.
Time frame: During hospital stay or during home-based hospitalization.
Handgrip strength
Handgrip strength will be measured using a handgrip dynamometer.
Time frame: Within the first 24-48 hours of acute care admission (in hospital or home hospitalization), pre-intervention baseline, and immediately after the intervention.
Sleep quantity
Sleep duration will be recorded (format: hh:mm:ss).
Time frame: During hospital stay or during home-based hospitalization.
Sleep quality
The heart rate variability parameter RMSSD (measured in ms) will be assessed during sleep.
Time frame: During hospital stay or during home-based hospitalization.
Energy expenditure
Energy expenditure (kcal) will be assessed in with a Firstbeat device.
Time frame: Within the first 24-48 hours of acute care admission (in hospital or home hospitalization), pre-intervention baseline, and immediately after the intervention.
Rate of hospital readmissions
Number of readmissions of each patient will be registered using the information from the medical records.
Time frame: 3 months, 6 months, and 12 months post-discharge.
Rate of falls
The number of falls for each patient will be recorded through follow-up phone calls.
Time frame: 3 months, 6 months, and 12 months post-discharge.
Incidence of mortality
Number of deaths will be registered using the information from the medical records.
Time frame: 3 months, 6 months, and 12 months post-discharge.
Rate of emergency visits
Number of emergency visits will be registered using the information from the medical records.
Time frame: 3 moths, 6 months, and 12 months post-discharge.
Prescribed pharmacologic treatment
All medications prescribed to each patient will be recorded using the information from the medical records.
Time frame: Within the first 24-48 hours of acute care admission (in hospital or home hospitalization), pre-intervention baseline, and immediately after the intervention.
Cost-effectiveness
Cost-effectiveness will be assessed by calculating the cost per Quality-Adjusted Life Year (QALY) gained.
Time frame: At pre-intervention baseline, at 3 months post-discharge, at 6 months post-discharge, and at 12 months post-discharge.
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