Improving health related quality of life and independence in community dwelling frail older adults through a client-centred and activity-oriented program. A pragmatic randomized controlled trial

INTRODUCTION AND AIM: In the ageing society, a considerable part of the older adults are frail. Frailty has a major impact on the individual’s quality of life, independence and also on his environment. This study aimed to investigate–as a secondary prevention of disability - the effectiveness of a client-centred and activity-oriented intervention program for frail community living older adults. It was hypothesized that this program could be effective in improving basic Activities of Daily Living (b-ADL) and increasing Health Related Quality of Life (HRQoL). METHOD: This study was a single blind randomized controlled trial with an intervention and a control group (pre-test-post-test control group design). Analysis of covariance (ANCOVA) was used to compare the outcome across groups with post-test as outcome and baseline values as a covariate. Data were analysed using the intention-to-treat principle. RESULTS: The intervention group (n = 86) experienced more improvement on b-ADL and HRQoL compared with the control group (n = 82). These effects were statistically significant for the b-ADL index (p = 0.013) and the ‘physical subscale pain’ (p = 0.049). DISCUSSION AND CONCLUSION: These positive results can be seen as promising for further development of intervention strategies, although follow-up study should be conducted to determine long term effectiveness.