Multimodal Intervention for Older Adults Residing in Temporary Housing After an Earthquake: A Randomized Controlled Study

Daily Living and Instrumental Activities Scale

时间窗: 1.week and 12.week intervention

The instrumental activities of daily living scale consists of eight items measuring an individual's ability to make phone calls, shop, prepare meals, do housework, do laundry, use transportation, take their own medication, and manage their finances. A participant can receive a minimum of 8 and a maximum of 24 points. A score range of 0-8 indicates that the participant is dependent in instrumental activities of daily living, a score range of 9-16 indicates that the participant is semi-dependent, and a score range of 17-24 indicates that the participant is independent. A higher scale score indicates a higher degree of independence.

Physical Activity Scale For The Elderly (PASE)

时间窗: 1.week and 12.week intervention

The PASE examines the intensity, frequency, and duration of physical activities such as walking; light, moderate, and strenuous sports and recreational activities; muscle-strengthening and endurance exercises; work-related activities, including walking and standing; lawn and garden care; caregiving; home repairs; and assesses both strenuous and light household activities performed by participants in the past week. the overall PASE score ranges from 0 to 400 or more, with higher scores indicating better physical activity levels.

Posture Screen mobile app

时间窗: 1.week and 12.week intervention

The Posture Screen mobile app allows you to quickly capture posture images using photography in frontal and lateral stances. This app identifies postural deviations.

The Short Physical Performance Battery

时间窗: 1.week and 12.week intervention

The Short Physical Performance Battery (SPPB) is widely used to assess the physical and functional health of elderly people living in the community (20). The SPPB consists of three objective tests that assess lower body function: a 4-meter walk, a chair rise, and a standing balance test. A 5-level summary score (0-4) is assigned to each test. A score of zero indicates "failure to perform." Participants included in the "failure to perform" category were: 1. Those who attempted but were unable to perform the activity, 2. Those who felt unsafe due to the interviewer or the subject, and 3. Those who were unable to perform the activity due to other health reasons. The scores 1-4 obtained by the subjects indicate the progressive performance required to complete the test according to the times specified below.

Muscle Strength Measurement

时间窗: 1.week and 12.week intervention

It will be evaluated by isometric strength measurement of bilateral serratus anterior, trapezius, deltoid, supraspinatus, teres minor, biceps brachii muscles of the upper extremity and bilateral iliopsoas, gluteus medius, gluteus maximus, hamstring, quadriceps femoris, tibialis anterior muscles of the lower extremity with a digital muscle strength measurement device (KFORCE KINVENT digital muscle strength measurement device).

Grip strength measurement

时间窗: 1.week and 12.week intervention

Jamar hand dynanometer (Baseline®) (Svens B, 2005) and PinchMetre Pinch Meter (Baseline Mechanical Pinch Gauge With Case, Blue, 30 Lb) (Dukelow NJ, 1996) will be used for grip strength measurement.

Timed Up and Go Test (TWAT)

时间窗: 1.week and 12.week intervention

Timed Up and Go Test (TWAT) is a reliable test that measures walking speed, postural control, functional mobility, and balance. TWAT is a clinical measure that is easy to administer to older adults and indicates the risk of falls.

Postural Sway and Balance Assessment

时间窗: 1.week and 12.week intervention

Postural Sway and Balance Assessment with Gyko: This device determines three main measures of body sway: sway length and area, sway progression rate, and sway frequency. Postural analysis is objectively performed through biomechanical movement analysis, with changes in minimal postural adjustments. This device measures postural sway, sway length, sway duration, and frequency. Used to assess and measure individuals' balance in various situations and/or on various surfaces, Gyko measures this by detecting postural sway in forward-backward, medial-lateral directions, and changes and imbalances within the support surface. By determining the main directions and amplitude of trunk movement, this device records the movement.

Nutritional evaluation

时间窗: 1.week and 12.week intervention

Nutritional evaluation; eating habits, body mass index, waist/hip ratio, and fat type will be determined.

Food Consumption Frequency

时间窗: 1.week and 12.week intervention

Food Consumption Frequency Form: This form will be used to determine the frequency and quantity of food groups or foods consumed. Consumption frequency is given by day, month, or week. Food consumption frequency provides information about an individual's dietary pattern. It is a frequently used method for assessing the relationship between nutrition and health. The food consumption frequency form can be prepared differently depending on the purpose of the person preparing it. Foods are listed as a single statement or by classification (full-fat, low-fat, or fat-free). The food consumption frequency form used in the study includes a total of 18 food items. The food groups are milk and dairy products, meat, eggs, legumes, vegetables and fruits, grains, fats and sweets, and beverages. Participants will be asked how often they consume the food (1-2 times a day, 1-3 times a week, 4-6 times a week, once every 15 days, once a month, never) to determine their daily energy and nutrient intake.

Body Mass Index

时间窗: 1.week and 12.week intervention

Body Mass Index: Individuals' body weights will be measured using a scale with a capacity of at least 100 g and 150 kg, and their heights will be measured using a non-flexible tape measure, held in the Frankfurt plane, with shoes and feet together and not fixed to a wall. BMI values will be calculated by dividing individuals' body weight (kg) by the square of their height (kg/m2), and they will be classified according to the WHO BMI classification.

Waist and hip circumference

时间窗: 1.week and 12.week intervention

Waist circumference will be measured with a 0.1 cm precision, non-flexible tape measure, with the individual standing, arms relaxed, feet together, and the midpoint between the lower rib and the groin without applying pressure. Hip circumference will be measured with the individual standing upright, with the researcher holding the tape measure parallel to the floor, at the skin level of the trochanterion points of the femur. The measurement will be taken with the tape measure parallel to the floor and taut. The measurement will be recorded in millimeters.

Waist/Hip Ratio

时间窗: 1.week and 12.week intervention

Waist/Hip Ratio: According to the World Health Organization, when determining obesity, body mass index, waist circumference, and waist-hip ratio methods are used, a ratio of 0.85 or higher in women and 0.90 or higher in men will be considered obese.

Nutritional Assessment

时间窗: 1.week and 12.week intervention

Nutritional Assessment; Mini Nutrition Test (MNA), whose Turkish validity and reliability study was conducted by Sarıkaya (2013), is one of the most frequently used tests to screen for nutritional status and indicate the risk of malnutrition in older adults. The MNA test consists of 18 questions: 6 screening and 12 assessment questions. Fifteen of these questions are verbal questions and three are anthropometric measurements. The nutritional score is evaluated out of 30 points. A score of 12 or higher out of 14 in the six-question preliminary questioning section is considered normal, and the test is terminated. Individuals who score 11 or less in this section continue with the remaining 12 questions. A total score of \<17 indicates definite malnutrition, 17-23 indicates risk of malnutrition, and 23.5-30 indicates normal nutritional status.

Mental State Examination

时间窗: 1.week and 12.week intervention

Mini Mental State Examination: The Mini Mental State Examination (MMSE), which is highly suitable for screening cognitive function in the elderly and assesses cognitive functions in five separate areas (orientation, registration, attention and calculation, recall, and language), is frequently used. A score below 24 on the MMSE indicates dementia, 24-26 indicates mild cognitive impairment, and 26 or above indicates normal cognitive function.

Geriatric Anxiety

时间窗: 1.week and 12.week intervention

Geriatric Anxiety Scale (GAS) aims to measure anxiety symptoms in the elderly dimensionally. The scale's fundamental psychometric property is its ability to distinguish between those with and without anxiety and those with and without generalized anxiety disorder. The cut-off point for generalized anxiety disorder is set at 10/11. Accordingly, the scale is structured as "anxiety symptoms and generalized anxiety disorder \> 10; anxiety symptoms only \< 10." The 20-item scale, scored on two dimensions: "agree" and "disagree," contains no reverse-coded items. Therefore, "agree" is assigned 1 point and "disagree." Therefore, scale scores can range from 0 to 20.

Health Care Assessment

时间窗: 1.week and 12.week intervention

Health Care Assessment; Nottingham Health Profile (NSP), available in Turkish, is a measurement tool that assesses individuals' health problems and how these problems impact their daily activities. It is used to assess the quality of life of older adults. The NSP consists of 38 items across six dimensions. The subdimensions are: energy level (ES), emotional reactions (ER), physical activity (PA), pain (A), sleep (U), and social isolation (SI). It is a general health questionnaire consisting of 38 items and six subparameters. Answers to the questions are given as "yes" or "no" based on the current situation.