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Open AccessArticle

Effects of Self-Care for Older PErsons (SCOPE) on Functional and Physiological Measures: A Cluster Randomized Controlled Trial

1
Center for Aging, Research and Education, Duke-National University of Singapore Medical School, Singapore 169857, Singapore
2
Program in Health Services and Systems Research, Duke-National University of Singapore Medical School, Singapore 169857, Singapore
3
Department of Medicine (General Internal Medicine), Duke University School of Medicine, Durham, NC 27710, USA
4
Center for Quantitative Medicine, Duke-National University of Singapore Medical School, Singapore 169857, Singapore
5
Department of Sociology, Faculty of Arts and Social Sciences, National University of Singapore, Singapore 117570, Singapore
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(3), 885; https://doi.org/10.3390/jcm9030885
Received: 20 January 2020 / Revised: 21 February 2020 / Accepted: 3 March 2020 / Published: 24 March 2020
(This article belongs to the Special Issue Self-Management and Health Promotion in Chronic Disease)
Background: Population aging poses unprecedented demands on the healthcare system. There is also a scarcity of evidence on self-care intervention to improve objective measures of morbidity and aging-associated functional and physiological measures in a low-income multi-ethnic population setting. Methods: We conducted a cluster randomized controlled trial (ClinicalTrials.gov Identifier: NCT01672177) to examine the effects of the Self-Care for Older PErsons (SCOPE) program. We randomized 14 Senior Activity Centers and randomly selected older adults within these centers. Functional and physiological measurements were performed at baseline, 10-month, and 18-month periods. The primary outcome was a composite of three morbidity-specific measures, which include hemoglobin A1c (HbA1C), peak expiratory flow, and systolic blood pressure. Aging-associated functional and physiological measures were examined as secondary outcomes. Repeated-measure mixed models were employed to examine the effects of SCOPE on these measures. Results: 378 community-dwelling older adults participated in either the treatment (n= 164) or the control arm (n = 214). The primary outcome was not significantly improved. For the secondary outcomes, SCOPE participants demonstrated slower oxygen desaturation at an 18-month period (p = 0.001), improved time to complete the chair-stand test (p < 0.001) at a 10-month period with the effect persisting at the 18-month period (p < 0.001). SCOPE participants also had significantly improved vitamin B12 levels at the 18-month period (p < 0.001), increased hemoglobin concentration (p < 0.001), decreased mean corpuscular volume (p = 0.001), and decreased creatinine (p = 0.002) at the 10-month period. Conclusions: SCOPE did not improve morbidity-specific measures. However, it improved several aging-associated measures implicated in geriatric syndromes. This study highlights the potential of a self-care program in the prevention of geriatric syndromes in community-dwelling older adults, while emphasizing self-management to manage existing morbidities. View Full-Text
Keywords: self-care; randomized control trial; community-based program; physiological measures; functional measures self-care; randomized control trial; community-based program; physiological measures; functional measures
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Ng, T.K.S.; Matchar, D.B.; Sultana, R.; Chan, A. Effects of Self-Care for Older PErsons (SCOPE) on Functional and Physiological Measures: A Cluster Randomized Controlled Trial. J. Clin. Med. 2020, 9, 885.

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