ACTIVE-AGE@home: a home-based functional exercise program for community-dwelling frail older adults
A lot of people experience acute or chronic conditions that reduce quality of life and self-reliance in later life. Physical activity can slow down or even reverse this vulnerability. In addition, it also promotes mental health and increases the chances of socialising. Unfortunately, due to many personal and environmental barriers, vulnerable people get little exercise. In this four-year project, we want to investigate the effectiveness and cost-effectiveness of a functional exercise programme for frail 70-plussers living at home.
In short
Frail older adults face a combination of physical, mental, and social challenges, leading to reduced independence and quality of life. The ACTIVE-AGE@home program provides an innovative intervention with functional exercises and personalized goals aimed at enhancing quality of life and supporting sustainable elderly care.
Need and relevance
The growing population of older adults highlights the need for innovative and sustainable care solutions. Frailty, characterized by a decline in resilience, increases the risk of functional decline, isolation, and lower quality of life. While physical activity is a proven effective intervention, many older adults remain inactive due to personal and environmental barriers. Accessible and meaningful interventions are urgently needed to promote healthy aging and improve elderly care.
From approach to impact
The ACTIVE-AGE@home program incorporates simple, functional exercises linked to daily activities such as climbing stairs and standing up from a chair. Additionally, it integrates personal goals and meaningful activities to address the physical, mental, and social aspects of frailty. This innovative and scientifically validated intervention not only strengthens the resilience of older adults but also contributes to sustainable and forward-looking elderly care. By improving independence and quality of life, the program has a positive impact on individuals and the broader care sector.
What is the program’s effectiveness?
The four-year study aims to assess the effectiveness and cost-effectiveness of the ACTIVE-AGE@home program through two models:
- Professional-led training: A 24-week program led by professionals experienced in working with older adults.
- Volunteer-led training: A 24-week program led by volunteers, either proposed by the older adult or recruited by the research team.
These two approaches will be compared with standard care for frail older adults in a pragmatic, randomized controlled trial involving 192 participants. Each participant will undergo pre-, post-, and follow-up measurements of physical, mental, and social parameters.
Improving quality of life
The ultimate goal of the project is to enhance the quality of life for frail older adults by increasing their reserve capacity and combating frailty. Researchers anticipate significant societal cost savings if the program is structurally implemented.
Regional and European health policies
This study aligns with regional and European health policies emphasizing community-based support for frail older adults. Engaging family, volunteers, and local communities is key to achieving this. Despite strong evidence supporting physical activity as a primary intervention against frailty, no structured solution currently exists—ACTIVE-AGE@home aims to fill this gap.
Research outputs and publications
Article BMC Medical Research Methodology
BRIDGe recruitment strategies for frail older adults in intervention trials: lessons learned from the ACTIVE-AGE@home trial.
Article ScienceDirect
Unravelling the miscellaneous effects of exercise interventions on activities of daily living in frail older adults: A systematic review and meta-analysis.
Checklist BRIDGe Recruitment Model
A checklist developed for a Dutch audience of researchers who are setting up studies involving vulnerable older adults.
Factsheet: Effects of physical activity interventions on the performance of daily activities in frail older adults.
Partners
The training programme came about thanks to intensive cooperation between the Care and Health expert network and the Education expert network (Department of Physical Education and Movement Recreation) of Artevelde University of Applied Sciences. An extensive network of research institutions and work field partners ensured a widely supported and thoroughly thought-out intervention.
In the current phase, Artevelde University of Applied Sciences, VUB, UGent, UAntwerp, Odisee and UZ Brussel are collaborating in a four-year Applied Biomedical Research project (2022-2026), subsidised by the Fonds Wetenschappelijk Onderzoek - Vlaanderen.
Meet the team
Bio of the researchers
The consortium is composed by Prof. dr. Patricia De Vriendt (Artevelde University of Applied Sciences and Vrije Universiteit Brussel) as principal investigator, together with Prof dr Siddartha Lieten (University Hospital Brussels) in close collaboration with Prof. dr. David Beckwée (University Antwerp), Dhr. Dimitri Vrancken, Dr. Ine De Clerck, (University of Applied Science Artevelde), Prof. Dr. Dominique Van de Velde and Prof. dr. Lieven Annemans (Ghent University), and Dr. Wim Peersman (University of Applied Sciences Odisee).
Patricia De Vriendt
Patricia De Vriendt (H index 15) is occupational therapist, Gerontologist (MSc, PhD)) senior researcher at the Artevelde University of Applied Sciences and professor at the Vrije Universiteit Brussel (2012).
Her research focuses on early detection of dementia and the usefulness of the evaluation of the Activities of Daily Living, for which she received the Lundbeck Geriatric Medicine Grant (2010, 20K€) and was awarded by 3 scientific prizes: Best Poster Communication at the Congress of the Belgian Association of Gerontology and Geriatrics (2012), Best Poster Presentation of Psychogeriatrics (2012), Prize of the Psychogeriatric Foundation (2014, 20K€).
She was project lead of – among others - the Knowledge Innovation Center for Elderly Care’, financed by the Flemish agency for Innovation by Science and Technology, ‘Community based Occupational Therapy’, financed by the Government of East-Flanders, ‘Active Ageing in the nursing homes: promoting meaningful activities’, ‘Shared decision Making in dementia’, ‘Goal oriented Care’ and – which is in particular interesting for this project – the POC study ‘ACTIVE-AGE@home’. She is founding member of the Primary Care Academy. She has several publications in international peer-reviewed journals included in Web of Science (mostly as first and last author; highest IF Plos Medicine 11.862), one of the papers received the award ‘Paper of the Month’ and another the ‘Award of Excellence paper 2019’.
She is actively reaching out to society to disseminate the results of her research at governments and by publishing layman’s texts, papers, books etc. Therefor she published several national publications and (chapters in) books: she had >60 presentations in peer-reviewed, internationally established conferences (also as invited speaker). PDV can look back to a very broad clinical carrier in which she worked with older persons in a variety of settings in different positions, offering a broad network based on a long-standing collaboration with almost all the stakeholders involved in this project. She is also board member of the Belgian Association of Gerontology and Geriatrics. As from 2022 she was selected as a member of the Flemish society of Quality of Care (Vlaams Instituut Kwaliteit van Zorg).
Emma De Keyser
I aim to unravel the black box of exercise induced ADL improvements in frail older adults through a realist evaluation. I will investigate if and in which context (volunteer-led programs vs professional-led programs) cognition and loneliness serve as possible key mechanisms of exercise-induced ADL-improvements.
Understanding in which context and how physical exercise impacts ADL, cognition and loneliness may lay foundations for future targeted physical activity interventions to increase community-dwelling frail older adults’ ADL and QOL, which lowers health-care expenditure and use.
Jade Tambeur
Goal-oriented physical activity (PA) interventions, such as ACTIVE-AGE@home, emerge as a primary strategy to tackle frailty. Yet, the reluctance of frail older adults to engage in such interventions, influenced by numerous barriers, perpetuates their inactivity and leads to negative health outcomes. Therefore I aim to uncover strategies for motivating frail older adults to commit to PA programs and maintain their PA behavior after the intervention ends. The aim is to identify the principles that lead to effective physical activity interventions in frail older adults. Thereby, unravelling what works, for whom and in which circumstances. The exploration whether meaningful activities or self-management abilities could serve as one of the driving mechanisms in effective goal-oriented physical activity adds depth to this investigation.
Dimitri Vrancken
To respond to the intrapersonal and environmental barriers of frail older adults regarding physical activity and to reduce the cost of healthcare expenditures, local volunteers will be incorporated in the ACTIVE-AGE@home exercise program. In the ACTIVE-AGE@home study, the older adults are either trained by a professional trainer or a trained volunteer.
My first aim is to investigate the effects of the ACTIVE-AGE@home functional exercise program on functional capacity and Quality of Life of community dwelling frail older adults, when administered by trained volunteers. Second, I will explore the sustainability and cost-effectiveness of this intervention in regard to healthcare expenditures of the frail older adults, the healthcare system (government) and the adopting organizations or professionals.
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