Abstract: | Objective: Osteoporotic fractures in elderly individuals can lead to disabilities, and considerable financial and societal burdens. Although earlier multicomponent interventions have focused on exercise, nutrition, and cognitive training to promote healthy aging, they have overlooked the importance of preventing osteoporosis. To address this, the Healthy Longevity and Aging in Place (HOPE) project introduces a comprehensive care that integrates osteoporotic fracture prevention into existing multicomponent programs, with the aim of demonstrating its efficacy. Methods: HOPE was a stepped-wedge cluster-randomized controlled trial with four-year follows. Eligible participants were community-dwelling residents aged 50 years or older. Participants were randomized to one of three interventions: osteoporosis treatment combined with exercise training, nutritional support, and medication simplification, without these interventions, or delayed interventions. The six months outcomes of interest included physical performance, quality of life, and the initiation of osteoporosis treatment when needed. Results: 567 older adults from 30 communities between September 2021 and April 2022 were recruited. The participants had a mean age of 74.8 ± 8.7, with 81.1% female. At baseline, the average BMI was 24.7 ± 3.7, the Charlson comorbidity index score was 3.9 ± 1.3, and the average ADL score was 98.6 ± 4.8. Osteoporosis was identified in 63% of women and 22.4% of men, more than 30% of participants had sarcopenia, and 37.7% had potentially inappropriate medications. Following six months of intervention, the multicomponent care group exhibited significant improvements in hand strength (p = 0.041) and happiness score (p \ 0.001). The rate of osteoporosis treatment was notably higher in the multicomponent care group (58.6%) and osteoporosis care group (69.2%) compared to the delayed care group (4.1%). Conclusion: The HOPE project has demonstrated its novel approach, which integrates community resources and hospital-based healthcare teams, has the potential to improve the health and overall wellness of older adults in communities. Prioritizing osteoporotic fracture prevention, the multicomponent approach is a promising model that can be useful for regions with an aging population. |