Leader: Antonella Zambon (UNIMIB); Other collaborator(s): CNR, UNIBA, UNIMIB
Identification of : i) modifiable and not modifiable risk factors for functional and cognitive decline due to institutionalisation; ii) interventions aiming to improve/maintain functional independence of residents; iii) overall evaluation of interventions' cost-benefits. This task will be carried out with different approaches: systematic review and meta-analysis of scientific literature and analysis of pre-existing databases (when possible with an individual data meta-analysis). When possible, the activities will be automated through appropriate algorithms (e.g. text mining) to optimize the update.
Brief description of the activities and of the intermediate results
Three systematic reviews with meta-analysis (MA) were conducted to evaluate: i) the effectiveness of multicomponent interventions in improving the cognitive and functional status of elderly patients living in the community, or hospitalized, or living in a nursing home, ii) the role of multi-component treatment on change of biomarker, iii) the association between the biomarker and functional and cognitive conditions. After meetings with experts from various disciplines (neurologists, geriatricians, etc.) a consensus was reached about the various search strings. For first MA 36 articles were eligible for inclusion in the analysis. Thirtytwo studies were in community-dwelling setting, 3 in hospital setting and only 1 in nursing home setting.
Only the most frequently reported functional and cognitive outcomes were meta-analyzed: the short physical performance battery [SPPB], the timed up and go test [TUG], the Montreal Cognitive Assessment [MoCA] scale, and the mini-mental state examination test [MMSE]. Improvements in functional and cognitive status in favor of the multi-component intervention compared to the control group were reported for all the outcomes analyzed. However, the only outcome who reached a statistically significant result was the TUG test.
Main policy, industrial and scientific implications
To address the expected impact of biomarkers on efficacy of multi-intervention approach . These results will be useful in eventual ongoing modfification of clinical trials
Activity completed.
Manuscript in preparation.