Feasibility of a Multidisciplinary Student-Led Program to Improve Frailty in Nursing Home Residents

Summary

BACKGROUND Frailty, regarded as a potentially reversible process and defined as a progressive deterioration of physiological systems and intrinsic capacity, constitutes a key risk factor for disability, dependency and institutionalisation.

Currently, it is estimated that between 50% and 75% of older adults living in residential care facilities present with frailty. This clinical profile is often directly associated with multiple comorbidities (around 65-85% of this population suffer from several chronic conditions), emotional decline, polypharmacy, malnutrition and a high prevalence of functional and cognitive impairment. Consequently, two out of every three older adults will require long-term care in specialised centres during their lifetime. In this context, nursing homes represent a key setting not only for providing care, but also for the prevention, detection and management of conditions such as frailty. However, care in residential facilities continues to focus on addressing established problems, with low participation in activities with potential benefits and a high perception of loneliness. Therefore, interventions in these contexts aimed at improving frailty are both necessary and urgent, particularly those that integrate a biopsychosocial approach, promote autonomy and foster active ageing.

Several studies have demonstrated that multidisciplinary intervention programmes and multicomponent physical training are effective in preventing frailty and its consequences. Nevertheless, their widespread implementation is limited by several factors. On the one hand, there is a lack of scientific evidence on the cost-effectiveness of such interventions, and on the other, healthcare systems face budgetary constraints in a context of increasing demand for geriatric care. In the search for more effective interventions to improve frailty and other related variables in older adults residing in nursing homes, supervised multidisciplinary programmes, delivered by health sciences students and implemented by nursing students, may represent a viable alternative. In this regard, students of Physical Activity and Sport Sciences (CAFYD) possess the knowledge required to design physical activity plans adapted to the capacities and needs of older adults. However, given the nature of their care role, nurses provide added value: their continuous presence in the clinical setting enables them to establish a closer therapeutic bond with the patient, ensure thorough monitoring of their progress, and facilitate coordination between physicians and other healthcare team members. These features make nurses key agents in the implementation of comprehensive, person-centred interventions.

Despite the potential of implementing a multidisciplinary intervention programme through health sciences students to improve frailty in older adults living in residential facilities, to the best of our knowledge, no similar interventions exist. Therefore, it is necessary to assess the feasibility of implementing such a proposal prior to conducting a randomised controlled trial to confirm its clinical effectiveness, as this approach plays an important role in determining the most appropriate trial design. To this end, different feasibility study guidelines recommend including variables such as acceptance, adherence and dropout rates as key markers for successful implementation.

STUDY'S HYPOTHESIS The main hypothesis of the CUIDAFRAIL project is that a supervised multidisciplinary intervention programme carried out by nursing and Physical Activity and Sport Sciences students is feasible for improving frailty and other related variables in older adults living in residential care facilities.

AIM AND OBJECTIVES The aim of the CUIDAFRAIL project is to examine the short- term and medium-term effects of a nursing students' multidisciplinary intervention programme on frailty among older adults living in nursing homes.

The secondary objectives of this project are the following:

1. To examine the effects of the intervention on frailty, as well as other frailty-related variables, including physical fitness, functionality, fear of falling, emotional status, loneliness, social support and quality of life in older adults living in residential care facilities.
2. To examine the effects on physiological and clinical parameters associated with frailty.
3. To explore the perceptions and experiences of older adults participating in the programme upon completion.
4. To explore the perceptions and experiences of nursing and Physical Activity and Sport Sciences students upon completion of the programme.

STUDY DESIGN A feasibility study will be carried out. Participants will be randomly assigned to either an intervention group (IG) or a control group (CG).

Conditions

• Frailty

Interventions

BEHAVIORAL

Nursing students' intervention programme

12-week intervention programme conducted by nursing students and students trained in Sciences of Physical Activity and Sport (CAFYD). Participants will receive weekly three sessions of 45-60 minutes. It will include physical exercise and occupational therapy sessions aimed at improving frailty and other related outcomes in the participating older adults through interdisciplinary collaboration and ongoing monitoring. Nursing students will implement personalised intervention programmes designed by a multidisciplinary team comprising CAFYD students, an occupational therapist, and nurses experienced in the care of older adults.

BEHAVIORAL

Standard care from Public Andalusian Health Service

They will receive the standard care provided by the Andalusian Health Service as part of its portfolio of services offered to older adults residing in institutions, as well as the standard care provided by the institutions in which they live. As part of these services, older adults receive support such as accommodation, laundry, health promotion activities, health monitoring, assistance with activities of daily living, individual, group, and community social care, as well as means of communication with the outside world. The action plans or protocols established in care processes for older adults living in nursing homes do not include externally delivered multidisciplinary intervention programmes.

Sponsors & Collaborators

• Universidad de Almeria

  lead OTHER

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Model

PARALLEL

Eligibility

Min Age

65 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2025-10-01

Primary Completion

2026-07-31

Completion

2026-08-30

Countries

• Spain

Study Locations