Despite decreasing disability rates, more than 7 million Americans 65 or older suffer from chronic disabilities that make it difficult to live independently. A new study shows that a 6 month at-home "prehabilitation" intervention to improve physical abilities was more effective in preventing declines and preserving functional abilities such as walking, dressing, and bathing than was a 6 month health education program. At the end of 12 months, the "prehabilitation" group showed a 37 percent reduction in risk for new disabilities.

The results of the study, titled A Program to Prevent Functional Decline in Physically Frail, Elderly Persons Who Live at Home are published in the October 3 issue of The New England Journal of Medicine. The study, authored by Thomas M. Gill, M.D., at the Yale University School of Medicine Department of Internal Medicine and his colleagues,* was funded through the Claude D. Pepper Older Americans Independence Center, the National Institute on Aging, and the Gaylord Rehabilitation Institute.

"This is an intervention that could make a big difference for many frail older persons wishing to remain independent while living at home," said Evan Hadley, M.D., NIA's Associate Director for Geriatrics and Clinical Gerontology.

A physical therapist assessed each of the 188 participants' levels of impairment and home environment to determine eligibility for the study. People were considered physically frail if they required more than 10 seconds to walk back and forth over a 10-ft. course or if they could not stand up from a hardback chair with their arms folded.

Participants in the "prehabilitation" intervention met with a physical therapist an average of 16 times over 6 months. They exercised their arms and legs with resistant elastic bands to improve their balance, muscle strength, transfer skills, and mobility.

Participants were instructed to perform balance exercises once a day and conditioning exercises 3 times a
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Contact: Jeannine Mjoseth
Mjosethj@nia.nih.gov
301-496-1752
NIH/National Institute on Aging
2-Oct-2002

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