A nurse-led age-friendly education model to prevent stroke in older adults: Implications for policy and practice.

AIM: Evaluate the effectiveness of a nurse-led, age-friendly educational model based on the 4Ms framework in reducing stroke risk and promoting health-promoting behaviors among older adults.

BACKGROUND

Stroke is a primary cause of disability and death globally, particularly among older adults. The Age-Friendly Health Systems (AFHS) 4Ms framework What Matters, Medication, Mentation, and Mobility offers a practical, person-centered approach to stroke prevention. Given the limited evidence from low- and middle-income countries, assessing this model's impact in resource-constrained contexts is crucial.

DESIGN

A randomized controlled trial design was used.

METHODS

A total of 170 older adults were randomized to the intervention or control group. Per-protocol analysis included 161 participants who completed follow-up (intervention n = 81; control n = 80). The intervention included two nurse-led educational sessions following the 4Ms framework, supported by three months of telephone reinforcement. Outcomes were measured using the Revised Framingham Stroke Risk Profile (R-FSRP) and the Health-Promoting Lifestyle Profile II (HPLP-II). Statistical analyses included independent and paired t-tests, chi-square tests, and calculation of effect sizes (Cohen's d).

RESULTS

Post-intervention, the intervention group showed a significant reduction in R-FSRP scores (p < .001, d = 0.78) and considerable improvements across all HPLP-II domains, most notably nutrition (d = 2.10) and physical activity (d = 1.60). The proportion of participants with "good" stroke-prevention practices increased substantially from 7.1% to 55.3% (p < .001).

CONCLUSIONS

The nurse-led, 4Ms-guided educational model was effective in reducing stroke risk and enhancing health-promoting behaviors in older adults. Integrating such age-friendly, nurse-led interventions into national policies could significantly strengthen preventive care and promote healthy aging.