Principal Investigator: Marcel Émond, MD, MSc, Centre de Recherche du CHU de Québec- Université Laval

Co-investigators : Aubertin Leheudre, M; Berg, M; Bissonnette, K; Brousseau, AA; Carpenter, C; Costa, A; Daoust, R; De Wit, K; Eagles, D; Elazhary, N; Giguere, A; Griffith, L; Juneau, L; Lamontagne, ME; Lang, E; Lee, J; Le Sage, N; Melady, D; Molnar, F; Morin, M; Ouellet, MC; Perry, J; Provencher, V; Salbach, N; Sirois, MJ; Veillette, N; Wilding, L

Local research coordinator: Sandrine Hegg

Granting agency: Canadian Institutes of Health Research – CIHR

Approximately 400,000 people aged 65 years and over living in Canadian communities experience life-threatening injuries that limit their functional abilities, mobility and normal activities. Up to 65% of these seniors seek care in Emergency Departments and only 21% to 35% are hospitalized. Of the hospitalized seniors, about 75% were released from the emergency department with a variety of minor injuries, which usually included wounds (44%: blues, abrasions, lacerations), small fractures (31%), and fall sprains 75%) or motor vehicle accidents (10%).

From 2010 to 2016, the CETIe team conducted a large multi-center Canadian cohort study (n = 3000), as well as several related sub-studies that confirmed that minor injuries trigger a negative spiral, including loss of Mobility in 16% of independent seniors before the event. The earlier the detection of the signs of degradation and prefragile / fragile status, the lower the risk of loss of mobility. However, by leaving the emergency room and without additional support, many of the elderly remain in a state of functional disability and mobility within 6 months of their consultation with the emergency department for minor injuries. Unfortunately, there are no guidelines in the emergency room designed to allow these elderly people to take care of them at the exit of the emergency in order to avoid the loss of mobility. The CETI study validated a simple CETI-CDR clinical decision rule and demonstrated its feasibility and effectiveness in the detection and orientation of seniors with high, moderate and low risk of functional decline to appropriate post-ED follow-up .

In addition, there is a large body of scientific evidence (systematic reviews / meta-analyzes) on the effectiveness of exercise interventions to limit the loss of frailty and mobility in older adults (CEDeComS). The CEDeComS intervention, which combines CETI-CDR with exercise-oriented interventions directly from the emergency. This test for the implementation of knowledge is the extension of our previous CETI studies. ‘Based on the development of new partnerships between EDs and community services in Canada. Our main objective is to compare the effectiveness of the CEDeComS intervention against the use of CETI-CDR alone to reduce functional decline.