Background: As the aging population grows, hospitalized elderly individuals with frailty have become a major concern. Frailty is a complex syndrome linked to aging, marked by dependency and vulnerability. Elderly patients often face chronic diseases, making them more susceptible to frailty. Studies show frailty prevalence in hospitalized elderly patients is 88.7%, and 75.3% among kidney disease patients. Frailty is associated with advanced age, female gender, low body mass index, comorbidities, and poor nutrition, increasing the risks of falls, hospitalization, and mortality. Frail kidney disease patients face worse outcomes. However, frailty is reversible with early intervention. Current treatments, based on comprehensive geriatric assessment (CGA), require significant resources. This study aims to explore frailty prevention and care through research and intervention development.
Purpose: To explore the effectiveness of an intelligent intervention program in improving frailty among hospitalized elderly individuals.
Methods: An experimental research design was adopted. A total of 156 hospitalized elderly patients with kidney disease who met the inclusion criteria were recruited through convenience sampling. Participants were randomly assigned to either the experimental group (n = 78) or the control group (n = 78). The experimental group received a 12-week intelligent intervention program, while the control group received routine care.Subsequently, data on frailty level, daily living function 30 days after discharge, and unexpected readmission rate 30 days after discharge will be collected by researchers and analyzed using SPSS 22.0, including chi-square tests, repeated measures ANOVA, and Generalized Estimating Equations (GEE) for intra-group and inter-group comparisons of each outcome variable.
Expected research results: This study aims to understand the current status and influencing factors of frailty among hospitalized elderly patients with kidney disease and to develop an intelligent intervention program. The goal is to provide clinical nursing staff with a frailty care strategy for hospitalized patients, effectively reducing frailty among elderly inpatients, improving their daily functional ability after discharge, and decreasing hospital readmission rates.
Condition or disease: frailty Intervention/treatment: intelligent intervention program
Hospitalized patients aged 65 years and older. (、
Admitted to the nephrology department or undergoing dialysis.
Conscious, able to express themselves independently, follow instructions, and communicate in Mandarin or Taiwanese.
Expected hospital stay of at least six days.
Severe visual or hearing impairments that hinder communication or assessments.
Significant cognitive impairment, defined as a Montreal Cognitive Assessment (MoCA) score < 24.
Patients who do not consent to participate in the study.
Individuals unable to personally complete the consent form.
Parallel
Intelligent intervention programs
BehavioralThe intervention involves a structured exercise program, with participants in the experimental group engaging in cycling exercises three times per week, each session lasting 30 minutes during hospitalization. After discharge, they will follow a walking program, increasing their daily step count by 1,000 steps above the average recorded during hospitalization, for a total of 12 weeks. Structured questionnaires and medical records will be used for data collection at four time points: the first week of enrollment (T0), hospital discharge (T1), the eighth week post-enrollment (T2), and the twelfth week post-enrollment (T3). Additionally, a tri-axial accelerometer-equipped smart wristband will be used to monitor and record participants' heart rate, respiration, blood pressure, daily step count, and sleep quality.
Fried frailty phenotype
Number of Participants Classified as Frail or Pre-Frail Based on the Fried Frailty Phenotype Criteria: Unintentional Weight Loss, Exhaustion, Weak Grip Strength, Slow Walking Speed, and Low Physical Activity
Fried frailty phenotype
Number of Participants Classified as Frail or Pre-Frail Based on the Fried Frailty Phenotype Criteria: Unintentional Weight Loss, Exhaustion, Weak Grip Strength, Slow Walking Speed, and Low Physical Activity
Fried frailty phenotype
Number of Participants Classified as Frail or Pre-Frail Based on the Fried Frailty Phenotype Criteria: Unintentional Weight Loss, Exhaustion, Weak Grip Strength, Slow Walking Speed, and Low Physical Activity
Fried frailty phenotype
Number of Participants Classified as Frail or Pre-Frail Based on the Fried Frailty Phenotype Criteria: Unintentional Weight Loss, Exhaustion, Weak Grip Strength, Slow Walking Speed, and Low Physical Activity
15-item geriatric depression scale(GDS-15)
This tool measures depressive symptoms through 15 questions, with total scores ranging from 0 to 15. A score above 5 is considered indicative of depressive symptoms, with higher scores reflecting greater severity of depression. The Cronbach's α coefficient of the scale is 0.76, with a sensitivity of 84% and specificity of 95%.
15-item geriatric depression scale(GDS-15)
This tool measures depressive symptoms through 15 questions, with total scores ranging from 0 to 15. A score above 5 is considered indicative of depressive symptoms, with higher scores reflecting greater severity of depression. The Cronbach's α coefficient of the scale is 0.76, with a sensitivity of 84% and specificity of 95%.
15-item geriatric depression scale(GDS-15)
This tool measures depressive symptoms through 15 questions, with total scores ranging from 0 to 15. A score above 5 is considered indicative of depressive symptoms, with higher scores reflecting greater severity of depression. The Cronbach's α coefficient of the scale is 0.76, with a sensitivity of 84% and specificity of 95%.
15-item geriatric depression scale(GDS-15)
This tool measures depressive symptoms through 15 questions, with total scores ranging from 0 to 15. A score above 5 is considered indicative of depressive symptoms, with higher scores reflecting greater severity of depression. The Cronbach's α coefficient of the scale is 0.76, with a sensitivity of 84% and specificity of 95%.
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