Effects of modified version of the Hospital Elder Life Program on post-discharge cognitive function and activities of daily living among older adults undergoing total knee arthroplasty

doi:10.1016/j.archger.2020.104284

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Please use this identifier to cite or link to this item: https://ir.cnu.edu.tw/handle/310902800/34457

Title:	Effects of modified version of the Hospital Elder Life Program on post-discharge cognitive function and activities of daily living among older adults undergoing total knee arthroplasty
Authors:	Liang, Chih-Kuang Chu, Che-sheng Hsu, Ying-Hsin Chou, Ming-Yueh Wang, Yu-Chun Lin, Yu-Te Renn, Jenn-Huei Liu, Tsung-Yun Yang, Chen-Chang
Contributors:	Kaohsiung Vet Gen Hosp, Ctr Geriatr & Gerontol Natl Yang Ming Univ, Sch Med, Inst Environm & Occupat Hlth Sci Natl Yang Ming Univ, Aging & Hlth Res Ctr Kaohsiung Vet Gen Hosp, Dept Internal Med, Div Neurol Kaohsiung Vet Gen Hosp, Dept Psychiat Chia Nan Univ Pharm & Sci Kaohsiung Vet Gen Hosp, Dept Orthopaed Kaohsiung Vet Gen Hosp, Dept Med Affair Adm Taipei Vet Gen Hosp, Dept Med, Div Clin Toxicol & Occupat Med
Keywords:	Intervention Cognitive decline Functional decline Delirium Total knee arthroplasty
Date:	2021
Issue Date:	2023-11-11 11:53:52 (UTC+8)
Publisher:	ELSEVIER IRELAND LTD
Abstract:	Objectives: This study aimed to investigate the effects of a modified Hospital Elder Life Program (mHELP) on post-discharge cognition and physical function among older adults undergoing total knee arthroplasty (TKA), and to evaluate the incidence of postoperative delirium. Design: Non-randomized intervention trial. Setting and participants: A total of 140 patients aged 60 years and older scheduled for elective orthopedic surgery at our institution between August 2017 and December 2018 were included. Methods: Ward-level stratification was used with one surgical ward receiving mHELP (intervention group), including orientation communication, early mobilization, vision/hearing impairment equipment, and dehydration prevention, and another ward providing usual care (control group). All participants were assigned to two surgical wards. Outcome measures were collected using MMSE telephone version (tMMSE), activities of daily living (ADL) and instrumental activities of daily living (IADL) instruments at 1, 6, and 12 months after discharge. Multiple linear regression analysis was used to measure effects of mHELP intervention on mean differences in tMMSE, ADL and IADL scores from baseline to 1-, 6- and 12-months. Results: Effects of mHELP intervention significantly preserved cognitive function at 1 and 12 months, but not at 6 months, compared with controls, regardless of adjustments for confounders. However, no intervention effects were noted in ADL and IADL scores. Postoperative delirium in the whole cohort was 3.6 % (2.5 % in intervention group, 5.1 % in control group, P = 0.41). Conclusions: mHELP intervention preserves post-discharge cognitive function, but has no notable effect on ADL and IADL function in older adults undergoing elective TKA surgery.
Relation:	ARCH GERONTOL GERIAT, v.93, 104284
Appears in Collections:	[Dept. of Pharmacy] Periodical Articles

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