Discussion 
depressive, CCM
SECONDARY, DEGENERATION, DISEASES, CHRONIC DISEASES
In this RCT, we analyzed the effectiveness of a newly developed local, collaborative, stepped, and personalized care management approach for older people with chronic diseases, LoChro-Care. The results revealed no significant differences between participants receiving the LoChro-Care intervention and participants with usual care on any of the primary or secondary outcome variables. Thus, no improvements in the participants’ physical, psychological, and social health status, as indicated by functional health and depressive symptoms, were observed. In addition, participants who received LoChro-Care did not rate their health care situation, HRQL, or LS better than participants with usual care did. In sum, LoChro-Care yielded no effect over and above usual care, although individualized support by a CCM was provided.In contrast to previous interventions which only focused on single diseases [In addition, another potential explanation for the absence of an intervention effect might be that our study participants may have already started with a considerably high level of health problems, whose progression could no longer be delayed. Hence, LoChro-Care probably could not reveal an effect at all. In this regard, we observed a decline in functional health and increasing depressive symptoms across the study period in all participants. A period of 18 months can be a long time for older people, making degeneration and reduced functional capacity more likely. In that sense, a longitudinal study in older adults revealed that the decline in activities of daily living and gait speed – aspects of functional health – took place most rapidly [In line with the results reported here, previous RCTs that examined the effectiveness of interventions for older adults with multiple health complaints showed no clear superiority of the intervention group participants [