FRAILTY PREVENTION IN AT-RISK OLDER ADULTS IN THE PRIMARY CARE AND COMMUNITY SETTING
Bibliographic record
Abstract
Research demonstrates it is possible to prevent and/or delay frailty. Comprehensive geriatric assessment (CGA), patient directed chronic disease management planning and health coaching have been identified as effective frailty prevention interventions for older adults. The CARES (Community Action and Resources Empowering Seniors) Project combines all three interventions in a collaborative inter-disciplinary model that introduces the CGA and FI calculation capacity into primary care physicians’ electronic medical record (EMR) Methods: Seniors aged 65 to 85 with an estimated clinical frailty score between 3 and 5 receive personalized health coaching for up to six months from Self-Management BC at no charge in weekly telephone contacts. Before and post coaching, primary care physicians conduct a CGA, which is embedded in the electronic health record and able to calculate a Frailty Index (FI). The effect of the combined intervention on frailty is evaluated by comparing the baseline and follow-up FI-CGA scores and quality of life assessments. Results: Pilot studies CGA-FI scores of the participants were statistically significantly (0.032) decreased post intervention, which is equivalent to 2 less health problems at follow up. Meanwhile, 59% of participants reported an increase in their health attitude and 67% reported an increase in exercise frequency. Discussion: CARES involves physicians, health coaches and patients in the prevention of frailty. The electronic CGA, FI and free health coaching provide both a measurement and management strategy to address frailty in the primary care and community setting. Conclusion: Preliminary results suggest CARES is effective in delaying frailty. CARES empowers seniors to engage in self-management of their health in partnership with their physician. Together they are able to track and address frailty development through the use of the electronic CGA and FI results. Fraser Health in British Columbia, Canada has adopted CARES as part of a senior care strategy. More research is pending.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".