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C. Laffon de Mazières1,2, J. E. Morley3, C. Levy4, F. Agenes5, M. Barbagallo6,
M. Cesari1,2, P. De Souto Barreto1,2, L. M. Donini7, J. Fitten8, A. Franco9, M. Izquierdo10, R. A. Kane11, F. C. Martin12, G. Onder13, J. Ouslander14, K. Pitkälä15, D. Saliba16,
A. Sinclair17, L. Rodriguez Manas18, B. Vellas1,2, Y. Rolland1,2
1. Department of Geriatric Medicine, Gérontopôle, Toulouse University Hospital (CHU de Toulouse), Toulouse, France; 2. Inserm UMR 1027, Toulouse, France; 3. Division of Geriatric Medicine, Saint Louis University School of Medicine, St Louis, MO; Division of Endocrinology, Saint Louis University School of Medicine, St Louis, MO; 4. Denver-Seattle Center of Innovation at the Denver VA Medical Center, Denver, CO; Division of Health Care Policy and Research, University of Colorado School of Medicine, Aurora, CO; 5. Office for Science and Technology, French Consulate in Los Angeles, Embassy of France in the United States, Los Angeles, CA, USA; 6. Geriatric Unit, University of Palermo, Palermo, Italy; 7. Sapienza University of Rome, Rome, Italy; 8. Psychiatry and Behavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA; Geriatric Psychiatry, Greater Los Angeles VA, Sepulveda Campus, Los Angeles, CA; 9. University of Nice-Sophia Antipolis, Nice, France; 10. Department of Health Sciences, Public University of Navarre, Navarra, Pamplona, Spain; 11. Center on Aging, Division of Health Policy & Management, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA; 12. King’s College London, London, UK; 13. Department of Geriatrics, Centro Medicina Invecchiamento, Università Cattolica del Sacro Cuore, Rome, Italy; 14. Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL; Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL; 15. University of Helsinki, Department of General Practice and Primary Health Care, Helsinki University Hospital, Unit of Primary Health Care, Helsinki, Finland; 16. UCLA/JH Borun Center for Gerontological Research, University of California, Los Angeles, CA; Los Angeles Veterans Administration Geriatrics Research Education and Clinical Center, Los Angeles, CA; 17. Foundation for Diabetes Research in Older People, Diabetes Frail, Medici Medical Practice, Luton, UK; 18. Department of Geriatrics, Hospital Universitario de Getafe and School of Health Sciences, Universidad Europea de Madrid, Getafe, Spain. Corresponding author:  Clarisse Laffon de Mazières, MD; Department of Geriatric Medicine, Gérontopôle, Toulouse University Hospital, 224 avenue de Casselardit, TSA 40031-31059 Toulouse cedex 9, France, Email: laffondemazieres. c@chu-toulouse. fr
Observers: S. Andrieu, L. Benattar, F. Bertin-Hugault, P. Denormandie, J. de Kerimel, P. -Y. de Kerimel, L. Dominguez, S. Guyonnet, F. Rey, S. Sasat, E. Tangalos, and H. Tissot.

Abstract: Institutionalization is generally a consequence of functional decline driven by physical limitations, cognitive impairments, and/or loss of social supports. At this stage, intervention to reverse functional losses is often too late. To be more effective, geriatric medicine must evolve to intervene at an earlier stage of the disability process. Could nursing homes (NHs) transform from settings in which many residents dwell to settings in which the NH residents and those living in neighboring communities benefit from staff expertise to enhance quality of life and maintain or slow functional decline? A task force of clinical researchers met in Toulouse on December 2, 2015, to address some of these challenges: how to prevent or slow functional decline and disabilities for NH residents and how NHs may promote the prevention of functional decline in community-dwelling frail elderly. The present article reports the main results of the Task Force discussions to generate a new paradigm.

Key words: Nursing home; prevention; functional decline; frailty.