What is the purpose of this study? The main goal of this study is to design and test anew "telecare" model to help adults aged 80 and older in Bogotá live healthier and moreindependent lives. The investigators want to see if providing personalized supportthrough technology can improve physical health, prevent falls, and reduce the need forhospital visits or nursing home care.Why is this study important? As people get older, they may face more health challenges orfeel lonely, especially if they live alone. Traditional healthcare often focuses only ontreating illnesses. This study focuses on "healthy aging" by looking at the wholeperson-including physical health, social support, and daily needs-to help participantsstay active and safe in their own homes.Who can participate?Participants in this study are adults who:Are 80 years of age or older.Live in the urban area of Bogotá.Are affiliated with Compensar EPS.Are generally independent (able to perform most daily activities).Can be reached by telephone.What will happen during the study? Participants will be randomly assigned to one of twogroups: a group receiving the new telecare support or a "usual care" group.Assessment: At the start, the research team will visit participants' homes to understandparticipants' health, home environment, and needs.The Telecare Model: Those in the intervention group will use a simple, easy-to-use devicedesigned specifically for older adults. Through this device, participants will receive:Health tips and training on self-care.Support from "case managers" who help coordinate social and health services.Connections to a support network of family, neighbors, and community resources.Follow-up: Every six months, the team will check in to see how participants are doing andmeasure changes in physical and mental well-being.What are the expected benefits? The investigators hope this model will help participantsmaintain physical strength and memory, feel more connected to the community, and enjoy abetter quality of life. The results will help improve how Bogotá cares for its oldercitizens in the future.
Study Design and Framework This study is a mixed-methods research project (quantitative
and qualitative) centered on a randomized clinical trial to evaluate a person-centered
sociosanitary telecare model. The model is based on the World Health Organization
Integrated Care for Older People (ICOPE) strategy and the Comprehensive Geriatric
Assessment (CGA). It focuses on maintaining functional capacity and intrinsic capacity
through five domains: locomotion, vitality (nutrition), sensory capacity, cognition, and
psychological well-being.
Intervention Plan
The intervention group will receive a multifaceted telecare program integrated through a
simplified technological device specifically designed for older adults. The intervention
consists of three core components:
Healthy Aging Interventions: Tailored health activities based on the ICOPE guidelines.
Training: Education for participants on self-care and for participants' social support
network (family, caregivers, and community "case managers") on supporting functional
maintenance.
Case Management and Resource Linkage: Identification and mobilization of social and
health resources within participants' homes, neighborhoods, and city to create a robust
support portfolio.
Implementation Phases
Phase 1 (Months 1-4): Characterization of participants through a baseline home visit
(Visit 0) using CGA and ICOPE screening. Participatory design and production of the
telecare device prototype.
Phase 2 (Implementation): Deployment of the telecare model, including training for
"gestores" (care managers) and participants.
Phase 3 (Follow-up): Continuous monitoring with formal evaluations every 6 months over a
24-month period.
Assessment and Outcomes
The study evaluates the model's impact on:
Primary Outcome: Change in physical capacity measured by the Short Physical Performance
Battery (SPPB).
Secondary Outcomes: Mortality, frequency of emergency room visits, hospitalizations,
institutionalization rates, and changes in quality of life (Euro-QoL), cognitive function
(MMSE/MOCA), and depressive symptoms (Yesavage).
Statistical Considerations The trial aims for a total sample of 152 participants (76 per
arm), accounting for a 20% estimated loss to follow-up, to achieve 90% statistical power.
Participants are randomly assigned to either the intervention group or the "usual care"
control group using a computerized system.
Behavioral: Telecare and Case Management Program
Multifaceted intervention involving a telecare device for monitoring, personalized health
care paths (ICOPE), and social support network management.
Other: Usual Care
Standard health promotion and prevention programs provided by the EPS.
Eligibility Criteria
Inclusion Criteria:
- Adults aged 80 years or older.
- Residents of the urban area of Bogotá, Colombia.
- Affiliated with the health insurance provider (EPS) Compensar.
- Functionally independent or with mild dependence (defined by the ability to perform
basic activities of daily living).
- Ability to communicate via telephone (landline or mobile).
- Signed informed consent to participate in the study.
Exclusion Criteria:
- Severe cognitive impairment that prevents following instructions or using the
telecare device (e.g., advanced dementia).
- Severe sensory impairments (total blindness or profound deafness) that preclude the
use of the technology provided.
- Participants currently enrolled in another clinical trial or intensive home-care
program that overlaps with the study intervention.
- End-of-life condition or terminal illness with a life expectancy of less than 6
months.
- Total functional dependence (bedbound or requiring permanent assistance for all
daily activities).
Hospital Universitario San ignacio
Bogotá, Colombia
Not Provided