Socio-Geriatric Support for Aging Individuals

(ESOGER Trial)

Overseen By Olivier Beauchet, MD

Age: 65+

Sex: Any

Trial Phase: Academic

Sponsor: Centre integre universitaire de sante et de services sociaux du Centre-Sud-de-l'Île-de-Montréal

Disqualifiers: Outside territory, Other trial, Language barrier

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 2

260 Participants Needed

Trial Summary

What is the purpose of this trial?

With the COVID-19 pandemic, elderly people (EP) living at home have seen their health deteriorated, thus increasing their needs in support and care. Indeed, while it was estimated that before the pandemic120 000 unattended living at home EP required care and services (taking bath, access to medication and food, etc.), the number doubled after COVID-19. Therefore, the waiting list for socio-medical services for unattended vulnerable clientele without a family doctor grew from 1300 à 1715 EP in a couple of months during the pandemic. With these numbers, it becomes clear that an intervention is needed. Truly, the Institut National d'Excellence en Santé et Services Sociaux (INESSS) conclude that it was pivotal to first identify the most vulnerable EP and second re-orient them according to their needs. Thus the investigator developed the Évaluation et orientation SOcio-GÉRiatrique (ESOGER) questionnaire available on a secure digital plateform enabling both a rapid evaluation and intervention to asses EP needs and provide the adequate ressources. Investigator's previous research has demonstrated that ESOGER is one of the rare clinical tools of first contact in telehealth while being global, multidimensional, and equitable. For this study, the investigator aims to evaluate the effect of ESOGER on EP physical and mental health, loss of autonomy, social isolation, quality of life and ressources consumption.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment ESOGER?

The use of goal attainment scaling (GAS) in frail elderly patients showed that it is a sensitive and efficient way to measure improvements in health status, suggesting that individualized approaches like ESOGER could be effective in supporting aging individuals. ^{1 2 3 4 5}

How is the treatment ESOGER different from other treatments for aging individuals?

ESOGER is unique because it focuses on evaluating and improving the social aspects of elderly individuals' lives, such as their social contacts, activities, and living conditions, which are crucial for their overall life satisfaction and well-being. Unlike traditional treatments that may focus solely on medical or physical health, ESOGER addresses the social environment and interactions, aiming to enhance the quality of life through a comprehensive socio-geriatric assessment. ^{6 7 8 9 10}

Eligibility Criteria

This trial is for elderly people aged 65 or older living at home in the CCSMTL's Jeanne-Mance territory, who are experiencing varying degrees of frail health as indicated by a BGA score of 1/14 or more. It excludes those already in another trial, living outside the specified area, or unable to understand French or English.

Inclusion Criteria

I am 65 years old or older.

Living at home on the territory CIUSSS-Centre-Sud de l'île-de-Montréal (CCSMTL) of Jeanne-Mance

Brief Geriatric Assessment (BGA) score of 1/14 or more defining a severely to mildly frail health.

Exclusion Criteria

Principal address outside of the CCSMTL's Jeanne-Mance territory

I cannot understand French or English.

Participate in another clinical trial to avoid interferences

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants take the ESOGER questionnaire at month 0 and month 3, with the intervention group receiving recommendations based on their needs

3 months

2 visits (virtual)

Follow-up

Participants are monitored for changes in autonomy, socio-economic characteristics, quality of life, caregiver burden, COVID-19 symptoms, psychological frailty, and social health

3 months

Treatment Details

Interventions

• ESOGER

Trial Overview The study tests the ESOGER questionnaire delivered via a secure digital platform. This tool aims to rapidly assess and address the needs of elderly individuals by identifying their vulnerabilities and directing them to appropriate resources.

Participant Groups

Group I: Group Intervention Experimental Treatment 1 Intervention

Experimental: Group 1 The intervention group will take the ESOGER questionnaire at month 0 and month 3 ( beginning and end) and receive recommendations following their needs.

Group II: Group control Active Control 1 Intervention

The participants will only take the ESOGER questionnaire at month 0 and month 3 without recommendations

Who Is Running the Clinical Trial?

Centre integre universitaire de sante et de services sociaux du Centre-Sud-de-l'Île-de-Montréal

Lead Sponsor

Trials

15

Recruited

24,400+

Findings from Research

In a study of 210 patients aged 65 and older undergoing geriatric rehabilitation, better mobility at discharge was identified as the strongest predictor of whether patients could live at home after rehabilitation.

Other important factors included lower multimorbidity, better cognitive function, and not living alone, highlighting the need for targeted mobility assessments and training in rehabilitation programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Predictors for living at home after geriatric inpatient rehabilitation: A prospective cohort study. Kool, J., Oesch, P., Bachmann, S.[2022]

Goal Attainment Scaling (GAS) was found to be a more sensitive and efficient outcome measure for assessing health status changes in frail elderly patients compared to traditional measures, based on a study of 45 patients with a mean age of 81 years.

The study demonstrated that GAS not only allowed for individualized goal tracking but also showed a high inter-rater reliability of 0.91, indicating consistent scoring among evaluators.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Use of goal attainment scaling in measuring clinically important change in the frail elderly. Rockwood, K., Stolee, P., Fox, RA.[2022]

In a study of 209 older patients in geriatric rehabilitation, common goals included 'walking', 'getting rid of pain', 'autonomy', and 'returning home', which were linked to the International Classification of Functioning, Disability and Health (ICF).

Achieving these patient-defined goals, along with a shorter length of hospital stay, significantly predicted improvements in overall functioning, highlighting the importance of incorporating patients' perspectives in rehabilitation planning.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Patient goals in post-acute geriatric rehabilitation--goal attainment is an indicator for improved functioning. Kus, S., Müller, M., Strobl, R., et al.[2022]

The Vitor Quality of Life Scale for the Elderly (VITOR QLSE) was validated and found to be reliable, with a final version consisting of 48 items across six domains, demonstrating a high overall reliability score of 0.93.

This scale effectively measures quality of life in elderly individuals, addressing a gap in available tools in Latin America, particularly Brazil, where there is a need for such assessments as the population ages.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Vitor Quality of Life Scale for the Elderly: evidence of validity and reliability. da Silva, JV., Baptista, MN.[2020]

In a study of 185 older adults attending a psychogeriatric day hospital, significant reductions in anxiety and depression symptoms were observed, along with improvements in quality of life and life satisfaction, all with moderate effect sizes.

The findings suggest that personalized, time-limited care in psychogeriatric day hospitals can lead to meaningful mental health benefits for older adults, highlighting the need for more such facilities as alternatives to costly inpatient care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Psychogeriatric day hospital reduces depression and anxiety symptoms and improves quality of life. Hoggarth, PA.[2019]

A new rating instrument was developed to evaluate the social situation of elderly individuals, focusing on areas like activities, contacts, living conditions, and finances, and was tested on a group of 60 elderly participants.

The study found positive correlations between the evaluated social dimensions and life satisfaction, suggesting that the instrument can help identify elderly individuals at risk for low life satisfaction based on their social circumstances.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Social status and life satisfaction of the elderly]. Adler, G., Tremmel, S., Brassen, S., et al.[2019]

A validated questionnaire for assessing social aspects of elderly patients showed high interrater reliability (0.92-0.97) and significant test-retest reliability (0.75), indicating it is a reliable tool for geriatric assessment.

The questionnaire effectively correlates with therapeutic assessments, demonstrating a significant relationship (r = 0.51, p < 0.01) and achieving high sensitivity and specificity, making it useful for identifying patients who may benefit from additional support or home visits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Social aspects in diagnosis and therapy of very elderly patients. Initial experiences with a newly developed questionnaire within the scope of geriatric assessment]. Nikolaus, T., Specht-Leible, N., Bach, M., et al.[2022]

The social evaluation scale for the elderly demonstrated excellent inter-observer reliability with an intraclass correlation coefficient of 0.957, indicating that different observers can consistently use the scale to assess social situations.

While the scale showed moderate to low internal consistency (Cronbach alpha of 0.4467), it effectively identifies social risks and problems, suggesting it is a useful tool for professionals in social and health care settings for the elderly.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[An evaluation of the feasibility and validity of a scale of social assessment of the elderly]. García González, JV., Díaz Palacios, E., Salamea García, A., et al.[2022]

The social-geriatric examination is conducted by an ambulatory team at the patient's home, focusing on the interactions between individuals and their environment to assess care needs.

This examination helps identify and analyze unfavorable social, mental, and physical conditions that disrupt the balance of the patient's health system, allowing for timely intervention through the primary health care system.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Social geriatric examination]. Sipsma, DH.[2007]

The SOCG-4, a 4-item scale derived from the original Sociotype Questionnaire, effectively assesses social relationships in the elderly, demonstrating strong validity and reliability with a correlation of 0.82 with the full SOCQ.

In a pilot study involving 150 elderly participants, the SOCG-4 proved useful for identifying individuals in need of social care or psychosocial intervention, highlighting its potential application in primary care and geriatric clinics.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Cost of Loneliness: Assessing the Social Relationships of the Elderly via an Abbreviated Sociotype Questionnaire for inside and outside the Clinic. Navarro, J., Cañete, M., Olivera, FJ., et al.[2022]

References

1. Sweden pubmed.ncbi.nlm.nih.gov

Predictors for living at home after geriatric inpatient rehabilitation: A prospective cohort study. [2022]

2. United States pubmed.ncbi.nlm.nih.gov

Use of goal attainment scaling in measuring clinically important change in the frail elderly. [2022]

3. Sweden pubmed.ncbi.nlm.nih.gov

Patient goals in post-acute geriatric rehabilitation--goal attainment is an indicator for improved functioning. [2022]

4. Switzerland pubmed.ncbi.nlm.nih.gov

Vitor Quality of Life Scale for the Elderly: evidence of validity and reliability. [2020]

5. New Zealand pubmed.ncbi.nlm.nih.gov

Psychogeriatric day hospital reduces depression and anxiety symptoms and improves quality of life. [2019]

6. Germany pubmed.ncbi.nlm.nih.gov

[Social status and life satisfaction of the elderly]. [2019]

7. Germany pubmed.ncbi.nlm.nih.gov

[Social aspects in diagnosis and therapy of very elderly patients. Initial experiences with a newly developed questionnaire within the scope of geriatric assessment]. [2022]

8. Spain pubmed.ncbi.nlm.nih.gov

[An evaluation of the feasibility and validity of a scale of social assessment of the elderly]. [2022]

9. Netherlands pubmed.ncbi.nlm.nih.gov

[Social geriatric examination]. [2007]

10. Switzerland pubmed.ncbi.nlm.nih.gov

The Cost of Loneliness: Assessing the Social Relationships of the Elderly via an Abbreviated Sociotype Questionnaire for inside and outside the Clinic. [2022]