Boston RISE Study Overview

Mobility problems affect as many as 25% of adults over 70 years and are predictive of disability and mortality. The consequences of mobility limitations lead to such problems as functional dependence, hip fracture and nursing home placement. With the rapidly growing population of older adults, these problems have a huge impact on our society both socially and financially. The overall goal of our work is to position rehabilitative care as a cost effective mode of treatment that will help prevent and ameliorate late-life mobility related disability. Simple tests evaluating mobility status exists and these tests can identify older adults at risk for disability and mortality. It has been advocated that mobility screening should be used in primary care and that vulnerable elders should receive treatment. Though the recommended treatment primarily consists of rehabilitative care, the current model (and compensation) of rehabilitative care is not designed around a preventative model, but rather treatment after injury or disability has already developedThe appropriate design for the content of preventative rehabilitative care for vulnerable older adults has yet to be established.

Towards that end, we have been awarded a 5-year grant from that National Institute on Aging for a research project which we are calling Boston RISE (Rehabilitative Impairment Study of the Elderly). Rehabilitative Impairments represent impairments such as weakness, poor balance and slowed reaction time that can be corrected through rehabilitative care. The purpose of the study is to better understand what patterns of rehabilitative impairments that are most responsible for mobility decline and disability. We will be recruiting 420 primary care patients 65 years and older that are recognized as being at increased risk for mobility decline. They will undergo a a physical exam at the Massachusetts General Hospital Clinical Research Center and a comprehensive outpatient rehabilitative assessment at the Spaulding Cambridge Outpatient Center. The assessment will include a large set of rehabilitative impairments associated with mobility as well as measures of mobility and disability. For all participants, it will be repeated annually over 2 years.

The results of this study will lead to a future primary care based study evaluating the benefits of preventative rehabilitative care as a means of disability prevention. This study includes collaborators from MGH primary care, Boston University’s Health and Disability Research Institute, UMass Boston, and the Institute for Community Health.