Guideline

Integrated care for older people: guidelines on community-level interventions to manage declines in intrinsic capacity

Year of Publication

2017

Issuing Institution

World Health Organization

Links

Virtual Health Library

Recommendations

13 included recommendations

Multimodal exercise, including progressive strength resistance training and other exercise components (balance, flexibility and aerobic training), should be recommended for older people with declining physical capacity, measured by gait speed, grip strength and other physical performance measures.

Status

New

Recommended in favor

Strong

Certainty of evidence

Moderate

Oral supplemental nutrition with dietary advice should be recommended for older people affected by undernutrition.

Status

New

Recommended in favor

Strong

Certainty of evidence

Moderate

Older people should receive routine screening for visual impairment in the primary care setting, and timely provision of comprehensive eye care.

Status

New

Recommended in favor

Strong

Certainty of evidence

Low

Screening followed by provision of hearing aids should be offered to older people for timely identification and management of hearing loss.

Status

Retired

Recommended in favor

Strong

Certainty of evidence

Low

Cognitive stimulation can be offered to older people with cognitive impairment, with or without a formal diagnosis of dementia.

Status

New

Recommended in favor

Conditional

Certainty of evidence

Low

Older adults who are experiencing depressive symptoms can be offered brief, structured psychological interventions, in accordance with WHO mhGAP intervention guidelines, delivered by health care professionals with a good understanding of mental health care for older adults.

Status

New

Recommended in favor

Conditional

Certainty of evidence

Very low

Prompted voiding for the management of urinary incontinence can be offered for older people with cognitive impairment.

Status

New

Recommended in favor

Conditional

Certainty of evidence

Very low

Pelvic floor muscle training (PFMT), alone or combined with bladder control strategies and self-monitoring, should be recommended for older women with urinary incontinence (urge, stress or mixed).

Status

New

Recommended in favor

Strong

Certainty of evidence

Moderate

Medication review and withdrawal (of unnecessary or harmful medication) can be recommended for older people at risk of falls.

Status

New

Recommended in favor

Conditional

Certainty of evidence

Low

Multimodal exercise (balance, strength, flexibility and functional training) should be recommended for older people at risk of falls.

Status

New

Recommended in favor

Strong

Certainty of evidence

Moderate

Following a specialist’s assessment, home modifications to remove environmental hazards that could cause falls should be recommended for older people at risk of falls

Status

New

Recommended in favor

Strong

Certainty of evidence

Moderate

Multifactorial interventions integrating assessment with individually tailored interventions can be recommended to reduce the risk and incidence of falls among older people.

Status

New

Recommended in favor

Conditional

Certainty of evidence

Low

Psychological intervention, training and support should be offered to family members and other informal caregivers of care-dependent older people, particularly but not exclusively when the need for care is complex and extensive and/or there is significant caregiver strain.

Status

New

Recommended in favor

Strong

Certainty of evidence

Moderate