title: Prevention of Functional Decline by Reframing the Role of Nursing Homes?
abstract: Institutionalization is generally a consequence of functional decline driven by physical limitations, cognitive impairments, and/or loss of social supports. At this stage, intervention to reverse functional losses is often too late. To be more effective, geriatric medicine must evolve to intervene at an earlier stage of the disability process. Could nursing homes (NHs) transform from settings in which many residents dwell to settings in which the NH residents and those living in neighboring communities benefit from staff expertise to enhance quality of life and maintain or slow functional decline? A task force of clinical researchers met in Toulouse on December 2, 2015, to address some of these challenges: how to prevent or slow functional decline and disabilities for NH residents and how NHs may promote the prevention of functional decline in community-dwelling frail elderly. The present article reports the main results of the Task Force discussions to generate a new paradigm.
authors.affiliation: Department of Geriatric Medicine, Gérontopôle, Toulouse University Hospital (CHU de Toulouse), Toulouse, France; Inserm UMR 1027, Toulouse, France. Electronic address: laffondemazieres.c@chu-toulouse.fr.
authors.forename: Clarisse
authors.initials: C
authors.lastname: Laffon de Mazières
authors.affiliation: Division of Geriatric Medicine, Saint Louis University School of Medicine, St Louis, MO; Division of Endocrinology, Saint Louis University School of Medicine, St Louis, MO.
authors.forename: John E
authors.initials: JE
authors.lastname: Morley
authors.affiliation: Denver-Seattle Center of Innovation at the Denver VA Medical Center, Denver, CO; Division of Health Care Policy and Research, University of Colorado School of Medicine, Aurora, CO.
authors.forename: Cari
authors.initials: C
authors.lastname: Levy
authors.affiliation: Office for Science and Technology, French Consulate in Los Angeles, Embassy of France in the United States, Los Angeles, CA, USA.
authors.forename: Fabien
authors.initials: F
authors.lastname: Agenes
authors.affiliation: Geriatric Unit, University of Palermo, Palermo, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Barbagallo
authors.affiliation: Department of Geriatric Medicine, Gérontopôle, Toulouse University Hospital (CHU de Toulouse), Toulouse, France; Inserm UMR 1027, Toulouse, France.
authors.forename: Matteo
authors.initials: M
authors.lastname: Cesari
authors.affiliation: Department of Geriatric Medicine, Gérontopôle, Toulouse University Hospital (CHU de Toulouse), Toulouse, France; Inserm UMR 1027, Toulouse, France.
authors.forename: Philipe
authors.initials: P
authors.lastname: De Souto Barreto
authors.affiliation: Sapienza University of Rome, Rome, Italy.
authors.forename: Lorenzo Maria
authors.initials: LM
authors.lastname: Donini
authors.affiliation: Psychiatry and Behavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA; Geriatric Psychiatry, Greater Los Angeles VA, Sepulveda Campus, Los Angeles, CA.
authors.forename: Jaime
authors.initials: J
authors.lastname: Fitten
authors.affiliation: University of Nice-Sophia Antipolis, Nice, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Franco
authors.affiliation: Department of Health Sciences, Public University of Navarre, Navarra, Pamplona, Spain.
authors.forename: Mikel
authors.initials: M
authors.lastname: Izquierdo
authors.affiliation: Center on Aging, Division of Health Policy & Management, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: Rosalie A
authors.initials: RA
authors.lastname: Kane
authors.affiliation: King's College London, London, UK.
authors.forename: Finbarr C
authors.initials: FC
authors.lastname: Martin
authors.affiliation: Department of Geriatrics, Centro Medicina Invecchiamento, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Graziano
authors.initials: G
authors.lastname: Onder
authors.affiliation: Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL; Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL.
authors.forename: Joseph
authors.initials: J
authors.lastname: Ouslander
authors.affiliation: University of Helsinki, Department of General Practice and Primary Health Care, Helsinki University Hospital, Unit of Primary Health Care, Helsinki, Finland.
authors.forename: Kaisu
authors.initials: K
authors.lastname: Pitkälä
authors.affiliation: UCLA/JH Borun Center for Gerontological Research, University of California, Los Angeles, CA; Los Angeles Veterans Administration Geriatrics Research Education and Clinical Center, Los Angeles, CA.
authors.forename: Debra
authors.initials: D
authors.lastname: Saliba
authors.affiliation: Foundation for Diabetes Research in Older People, Diabetes Frail, Medici Medical Practice, Luton, UK.
authors.forename: Alan
authors.initials: A
authors.lastname: Sinclair
authors.affiliation: Department of Geriatrics, Hospital Universitario de Getafe and School of Health Sciences, Universidad Europea de Madrid, Getafe, Spain.
authors.forename: Leocadio Rodriguez
authors.initials: LR
authors.lastname: Manas
authors.affiliation: Department of Geriatric Medicine, Gérontopôle, Toulouse University Hospital (CHU de Toulouse), Toulouse, France; Inserm UMR 1027, Toulouse, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Vellas
authors.affiliation: Department of Geriatric Medicine, Gérontopôle, Toulouse University Hospital (CHU de Toulouse), Toulouse, France; Inserm UMR 1027, Toulouse, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Rolland
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D060825:Cognitive Dysfunction / Q000517:prevention & control*; D016330:Frail Elderly; D006801:Humans; D009735:Nursing Homes; D014481:United States
keywords: Nursing home; frailty; functional decline; prevention