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Editor’s view
Rowan H Harwood
doi : 10.1093/ageing/afab127
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1007–1008
Models will only get us so far: planning for place of care and death
Erica Borgstrom
doi : 10.1093/ageing/afab070
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1009–1010
Changes in psychological distress before and during the COVID-19 pandemic among older adults: the contribution of frailty transitions and multimorbidity
Yi Wang, Peipei Fu, Jie Li, Zhengyue Jing, Qiong Wang, Dan Zhao, Chengchao Zhou
doi : 10.1093/ageing/afab061
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1011–1018
To investigate changes in psychological distress in community-dwelling older adults before and during the coronavirus disease 2019 (COVID-19) pandemic and the contribution of frailty transitions and multimorbidity in predicting the psychological distress.
COVID-19 infection and attributable mortality in UK care homes: cohort study using active surveillance and electronic records (March–June 2020)
Peter F Dutey-Magni, Haydn Williams, Arnoupe Jhass, Greta Rait, Fabiana Lorencatto, Harry Hemingway, Andrew Hayward, Laura Shallcross
doi : 10.1093/ageing/afab060
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1019–1028
epidemiological data on COVID-19 infection in care homes are scarce. We analysed data from a large provider of long-term care for older people to investigate infection and mortality during the first wave of the pandemic.
Impact of COVID-19 on care-home mortality and life expectancy in Scotland
Jennifer K Burton, Martin Reid, Ciara Gribben, David Caldwell, David N Clark, Peter Hanlon, Terence J Quinn, Colin Fischbacher, Peter Knight, Bruce Guthrie, David A McAllister
doi : 10.1093/ageing/afab080
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1029–1037
COVID-19 deaths are commoner among care-home residents, but the mortality burden has not been quantified.
The demography and characteristics of SARS-CoV-2 seropositive residents and staff of nursing homes for older adults in the Community of Madrid: the SeroSOS study
Francisco Javier Candel, Pablo Barreiro, Jes?s San Rom?n, Mar?a del Mar Carretero, Juan Carlos Sanz, Marta Pérez-Abeledo, Belén Ramos, José Manuel Vi?uela-Prieto, Jes?s Canora, Francisco Javier Mart?nez-Peromingo, Raquel Barba, Antonio Zapatero, the investigators of the SeroSOS study
doi : 10.1093/ageing/afab096
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1038–1047
Nursing homes for older adults have concentrated large numbers of severe cases and deaths for coronavirus disease 2019 (COVID-19).
Documentation of Do-Not-Attempt-Cardiopulmonary-Resuscitation orders amid the COVID-19 pandemic
David Connellan, Kara Diffley, John McCabe, Aoife Cotter, Tara McGinty, Gerard Sheehan, Karen Ryan, Walter Cullen, John S Lambert, Elizabeth L Callaly, Lorraine Kyne
doi : 10.1093/ageing/afab075
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1048–1051
the COVID-19 pandemic has brought the decision-making process regarding cardiopulmonary resuscitation (CPR) into focus. The aim of this study is to compare rates of Do-Not-Attempt-CPR (DNACPR) documentation in older hospitalised patients before and during the COVID-19 pandemic.
The COVID-19 pandemic appears to have increased longevity in Japanese centenarians
Yuji Aoki, Sean Collin Mehmet
doi : 10.1093/ageing/afab077
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1052–1053
New Horizons in the impact of frailty on pharmacokinetics: latest developments
Sarah N Hilmer, Carl M J Kirkpatrick
doi : 10.1093/ageing/afab003
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1054–1063
Frail older people have a high prevalence of drug use and are susceptible to adverse drug reactions. The physiological changes of frailty are likely to affect pharmacokinetics and pharmacodynamics. We reviewed the methods and findings of published studies of pharmacokinetics in frailty. Nine studies describing pharmacokinetics and an additional three of pharmacokinetic pathways in frail older people were identified. Most pharmacokinetic studies investigated a single administration of a medication, dose or formulation, in small populations, often with limited representation of males or females, and applied variable definitions of frailty. Pharmacokinetic sampling designs generally utilised saturated sampling followed by analysis based on the trapezoidal rule for area under the curve, with more recent studies using sparser sampling and more sophisticated modelling to obtain individual and population values of all pharmacokinetic parameters. Overall, the pharmacokinetic studies reported only small changes in some parameters for some drugs with frailty, with the most consistent change reduced hepatic clearance in frail older people. Recommendations for future studies of pharmacokinetics in frailty include (i) standard objective definitions of frailty; (ii) larger studies including people with mild, moderate and severe frailty; (iii) population pharmacokinetic modelling to allow sparser sampling and consideration of multiple influences on pharmacokinetics; (iv) physiologically based modelling as the physiology of frailty emerges and (v) longitudinal pharmacokinetic studies of chronic drug therapy from middle to old age and from robust to pre-frail to frail, including pre-clinical studies. These data, accompanied by pharmacodynamics data in frailty, will inform safe, effective prescribing for frail older people.
New horizons in cardiogeriatrics: geriatricians and heart failure care—the custard in the tart, not the icing on the cake
Shuli Levy, Graham Cole, Punam Pabari, Melanie Dani, Carys Barton, Jamil Mayet, Theresa McDonagh, John Baxter, Carla Plymen
doi : 10.1093/ageing/afab057
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1064–1068
Heart failure (HF) can be considered a disease of older people. It is a leading cause of hospitalisation and is associated with high rates of morbidity and mortality in the over-65s. In 2012, an editorial in this journal detailed the latest HF research and guidelines, calling for greater integration of geriatricians in HF care. This current article reflects upon what has been achieved in this field in recent years, highlighting some future challenges and promising areas. It is written from the perspective of one such integrated team and explores the new role of cardiogeriatrician, working in a multidisciplinary team to deliver and improve care to increasingly complex, older, frail patients with multiple comorbidities who present with primary cardiology problems, especially decompensated HF. Geriatric liaison has improved the care of frail patients in orthopaedics, cancer services, stroke, acute medicine and numerous community settings. We propose that this vital role should now be extended to cardiology teams in general and to HF in particular.
Potential biases when observing increased mortality risk in association with smoking cessation among older adults
Michael J Green
doi : 10.1093/ageing/afab041
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1069–1070
Hyponatraemia in older people is usually multifactorial and commonly iatrogenic
Roy L Soiza
doi : 10.1093/ageing/afab064
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1071–1072
Delayed transfers of care for older people: a wider perspective
Sebastian Hinde, Laura Bojke, Gerry Richardson, Yvonne Birks, William Whittaker, Mark Wilberforce, Andrew Clegg
doi : 10.1093/ageing/afab035
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1073–1076
Delayed transfers of care (DTOC), often unhelpfully referred to as ‘bed blocking’, has become a byword for waste and inefficiency in healthcare systems throughout the world. An estimated 2.7 million bed days are occupied each year in England by older people no longer in need of acute treatment, estimated to cost £820 million (2014/15) in inpatient care. Policy and media attention have often been drawn to this narrative of financial waste, resulting in policy setting that directly targets the level of DTOC, but has done little to put patient health first.
Can person-centred care for people living with dementia be delivered in the acute care setting?
Rebecca A Abbott, Debbie Cheeseman, Anthony Hemsley, Jo Thompson Coon
doi : 10.1093/ageing/afab065
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1077–1080
The need to improve care for people living with dementia in the hospital setting has long been recognised. Person-centred care has the potential to improve the experience of care for persons living with dementia and their carers, and has been shown to improve the experiences of hospital staff caring for the persons living with dementia, however it remains challenging to deliver in a time- and task-focussed acute care setting. This commentary suggests that to embed person-centred care across the hospital environment, cultural changes are needed at organisational and ward levels. In particular there needs to be: leadership that supports and advocates for workforce capacity to recognise and meet both psychological and physical needs of people living with dementia, promotion of physical environments that support familiarisation and social interactions, an inclusive approach to carers and the development of a culture of sharing knowledge and information across hierarchies and roles. An evidence-based set of pointers for service change are described which highlight institutional and environmental practices and processes that need to be addressed in order for person-centred care to become part of routine care.
Silver Book II: an international framework for urgent care of older people in the first 72 hours from illness or injury
Carolyn J Hullick, Rosa McNamara, Brittany Ellis
doi : 10.1093/ageing/afab062
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1081–1083
The new edition of the Silver Book, Silver Book II, provides a framework for the urgent care of older people in the first 72 hours from illness or injury. It incorporates principles of geriatric medicine, quality improvement (including patient reported outcome measures) and interdisciplinary care in a balanced, practical and evidence-rich manual on unscheduled and emergent care for older adults. Silver Book II shows how frailty, comprehensive geriatric assessment and shared decision-making can be locally adapted according to national practice and policy across the world. The challenge for all providers is adapting our models of care to meet the changing needs of older patients and their caregivers as well as changes in the delivery of medical care in the 21st century.
Effects of dance on cognitive function in older adults: a systematic review and meta-analysis
Patricia Hewston, Courtney Clare Kennedy, Sayem Borhan, Dafna Merom, Pasqualina Santaguida, George Ioannidis, Sharon Marr, Nancy Santesso, Lehana Thabane, Steven Bray, Alexandra Papaioannou
doi : 10.1093/ageing/afaa270
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1084–1092
dance is a mind–body activity that stimulates neuroplasticity. We explored the effect of dance on cognitive function in older adults.
Diagnostic accuracy of dementia screening tools in the Chinese population: a systematic review and meta-analysis of 167 diagnostic studies
Zhaohua Huo, Jiaer Lin, Baker K K Bat, Joyce Y C Chan, Kelvin K F Tsoi, Benjamin H K Yip
doi : 10.1093/ageing/afab005
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1093–1101
The rate of undetected dementia is high in China. However, the performance of dementia screening tools may differ in the Chinese population due to the lower education level and cultural diversity. This study aimed to evaluate the diagnostic accuracy of dementia screening tools in the Chinese population.
Safety and efficacy of very short dual antiplatelet therapy followed by P2Y12 inhibitor monotherapy in older patients undergoing percutaneous coronary intervention: meta-analysis of randomised controlled trials
Vincent Roule, Adrien Lemaitre, Wilhelm Pommier, Mathieu Bignon, Rémi Sabatier, Katrien Blanchart, Farzin Beygui
doi : 10.1093/ageing/afab047
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1102–1107
older patients undergoing percutaneous coronary intervention (PCI) represent a growing population sharing both a high ischemic and bleeding risk. Dual antiplatelet therapy (DAPT) reduces the incidence of thrombotic events but exposes patients to an increased risk of bleeding and subsequent mortality. Its optimal duration after PCI remains unclear.
Reasons for discontinuing oral anticoagulation therapy for atrial fibrillation: a systematic review
Jackie Buck, Julia Fromings Hill, Alison Martin, Cassandra Springate, Bikramaditya Ghosh, Rachel Ashton, Gerry Lee, Andrzei Orlowski
doi : 10.1093/ageing/afab024
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1108–1117
Atrial fibrillation (AF) is the most common cardiac arrhythmia and can lead to significant comorbidities and mortality. Persistence with oral anticoagulation (OAC) is crucial to prevent stroke but rates of discontinuation are high. This systematic review explored underlying reasons for OAC discontinuation.
Abdominal obesity, body mass index and the risk of frailty in community-dwelling older adults: a systematic review and meta-analysis
Linli Yuan, Meilian Chang, Jing Wang
doi : 10.1093/ageing/afab039
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1118–1128
Obese older people are more likely to be frail than those with a normal body mass index (BMI), but the results of individual studies have been inconsistent. We conducted a systematic review and meta-analysis to clarify the association between obesity and the risk of frailty, and whether there was a relationship between BMI and frailty, in community-dwelling older adults aged ?60 years. Eight databases (PubMed/MEDLINE, EMBASE, EBSCO, CINAHL, Scopus, Cochrane Library and Web of Science) were systematically searched from inception to August 2020. Relative risks for incident frailty were pooled using a random-effects model. We found a positive association between abdominal obesity and frailty [relative risk (RR)?=?1.57, 95% confidence interval (CI) 1.29–1.91, I2?=?48.1%, P?=?0.086, six observational studies, 18,764 subjects]. People in the higher category of waist circumference had a pooled 57% higher risk of frailty than those with a normal waist circumference. In addition, a total of 12 observational studies comprising 37,985 older people were included in the meta-analysis on the relationship between BMI and the risk for frailty. Taking the normal BMI as the reference group, the pooled RR of frailty risk ranged from 1.45 (95% CI 1.10–1.90, I2?=?83.3%; P?<?0.01) for the underweight group, to 0.93 (95% CI 0.85–1.02, I2?=?34.6%; P?=?0.114) for the overweight group and to 1.40 (95% CI 1.17–1.67, I2?=?86.1%; P?<?0.01) for the obese group. We have shown that obesity or underweight is associated with an increased risk of frailty in community-dwelling older adults.
Optimal management of older people with frailty non-weight bearing after lower limb fracture: a scoping review
Saleh Aloraibi, Vicky Booth, Katie Robinson, Eleanor Katharine Lunt, Deborah Godfrey, Alan Caswell, Margaret Kerr, Benjamin Ollivere, Adam Lee Gordon, J R F Gladman
doi : 10.1093/ageing/afab071
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1129–1136
Patients with lower limb fractures who are non-weight bearing are at risk of the complications of the associated immobility and disability, particularly people with frailty, but there is lack of clarity about what constitutes optimal care for such patients. A scoping literature review was conducted to explore what evidence is available for the management of this patient group.
Awareness of the use of hyponatraemia-inducing medications in older adults with hyponatraemia: a study of their prevalent use and association with recurrent symptomatic or severe hyponatraemia
Kwanghee Jun, Yujin Kim, Young-Mi Ah, Ju-Yeun Lee
doi : 10.1093/ageing/afaa195
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1137–1143
Cautious use or avoidance of hyponatraemia-inducing medications (HIMs) is recommended in older patients with hyponatraemia.
Active management of hyponatraemia and mortality in older hospitalised patients compared with younger patients: results of a prospective cohort study
Owen Thorpe, Martin Cuesta, Ciaran Fitzgerald, Owen Feely, William P Tormey, Mark Sherlock, David J Williams, Chris J Thompson, Aoife Garrahy
doi : 10.1093/ageing/afaa248
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1144–1150
Hyponatraemia is associated with increased morbidity and mortality; the aetiology and outcomes of hyponatraemia in older patients have not been defined in prospective studies.
Impaired hydration status in acutely admitted older patients: prevalence and impact on mortality
Gianfranco Sanson, Ilaria Marzinotto, Daniela De Matteis, Giuliano Boscutti, Rocco Barazzoni, Michela Zanetti
doi : 10.1093/ageing/afaa264
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1151–1158
impaired hydration is common in the older people, however studies of its effects on outcome in the acute setting are limited.
The impact of dementia on aged care service transitions in the last five years of life
Heidi J Welberry, Louisa R Jorm, Sebastiano Barbieri, Benjumin Hsu, Henry Brodaty
doi : 10.1093/ageing/afaa254
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1159–1165
To investigate the impact of dementia on aged care service use at end-of-life.
Early Mobilization in Older Adults with Acute Cardiovascular Disease
Michael Goldfarb, Koorosh Semsar-kazerooni, José A Morais, Diana Dima
doi : 10.1093/ageing/afaa253
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1166–1172
Early mobilization (EM) is beneficial in critical care units and in older hospitalized patients, but little is known about EM in older adults with acute cardiovascular disease.
Control of blood pressure in older patients with heart failure and the risk of mortality: a population-based prospective cohort study
Antonios Douros, Alice Schneider, Natalie Ebert, D?rte Huscher, Martin K Kuhlmann, Peter Martus, Nina Mielke, Markus Van Der Giet, Volker Wenning, Elke Schaeffner
doi : 10.1093/ageing/afaa261
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1173–1181
treatment goals for blood pressure (BP) lowering in older patients with heart failure (HF) are unclear.
The mortality rate of Parkinson’s disease and related comorbidities: a nationwide population-based matched cohort study in Korea
Seo Yeon Yoon, Jaeyong Shin, Yong Wook Kim, Jee Suk Chang, Hye Won Kim
doi : 10.1093/ageing/afaa250
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1182–1188
previous studies on mortality of Parkinson’s disease (PD) enrolled a relatively small number of participants and were conducted in western countries. The objective of this study was to evaluate mortality rate of PD using a large nationwide cohort in Korea and to evaluate effects comorbidities have on mortality in PD.
STOPPFall (Screening Tool of Older Persons Prescriptions in older adults with high fall risk): a Delphi study by the EuGMS Task and Finish Group on Fall-Risk-Increasing Drugs
Lotta J Seppala, Mirko Petrovic, Jesper Ryg, Gulistan Bahat, Eva Topinkova, Katarzyna Szczerbi?ska, Tischa J M van der Cammen, Sirpa Hartikainen, Birkan Ilhan, Francesco Landi, Yvonne Morrissey, Alpana Mair, Marta Gutiérrez-Valencia, Marielle H Emmelot-Vonk, Mar?a ?ngeles Caballero Mora, Michael Denkinger, Peter Crome, Stephen H D Jackson, Andrea Correa-Pérez, Wilma Knol, George Soulis, Adalsteinn Gudmundsson, Gijsbertus Ziere, Martin Wehling, Denis O’Mahony, Antonio Cherubini, Nathalie van der Velde
doi : 10.1093/ageing/afaa249
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1189–1199
Healthcare professionals are often reluctant to deprescribe fall-risk-increasing drugs (FRIDs). Lack of knowledge and skills form a significant barrier and furthermore, there is no consensus on which medications are considered as FRIDs despite several systematic reviews. To support clinicians in the management of FRIDs and to facilitate the deprescribing process, STOPPFall (Screening Tool of Older Persons Prescriptions in older adults with high fall risk) and a deprescribing tool were developed by a European expert group.
Activities of daily living at hospital admission and estimated survival time of older patients
Jesper Ryg, Henriette Engberg, Pavithra Laxsen Anru, Solvejg Gram Henneberg Pedersen, Martin Gronbech Jorgensen, Kirsten Laila Vinding, Tahir Masud, Karen Andersen-Ranberg
doi : 10.1093/ageing/afaa251
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1200–1207
Predicting expected survival time in acutely hospitalised older patients is a clinical challenge.
A comparison of two national frailty scoring systems
Joe Hollinghurst, Gemma Housley, Alan Watkins, Andrew Clegg, Thomas Gilbert, Simon P Conroy
doi : 10.1093/ageing/afaa252
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1208–1214
The electronic Frailty Index (eFI) has been developed in primary care settings. The Hospital Frailty Risk Score (HFRS) was derived using secondary care data.
Consumption of dietary nuts in midlife and risk of cognitive impairment in late-life: the Singapore Chinese Health Study
Yi-Wen Jiang, Li-Ting Sheng, Lei Feng, An Pan, Woon-Puay Koh
doi : 10.1093/ageing/afaa267
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1215–1221
evidence from prospective studies investigating the association between consumption of nuts in midlife and risk of cognitive impairment in late life is limited.
Social isolation, loneliness and functional disability in Chinese older women and men: a longitudinal study
Lizhi Guo, Li An, Fengping Luo, Bin Yu
doi : 10.1093/ageing/afaa271
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1222–1228
This study investigated whether loneliness or social isolation is associated with the onset of functional disability over 4 years among Chinese older populations.
The value of ambulatory blood pressure measurement to detect masked diastolic hypotension in older patients treated for hypertension
Emma E F Kleipool, Eva S Rozendaal, Shaya K N Mahadew, Mark H H Kramer, Bert-Jan H van den Born, Erik H Serné, Mike J L Peters, Majon Muller
doi : 10.1093/ageing/afaa287
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1229–1235
assess how many patients with low ambulatory diastolic blood pressure (DBP) are not identified when relying on office DBP alone, and thus have ‘masked diastolic hypotension’.
Vision, vision-specific functioning and mobility, and their relationship with clinically assessed cognitive impairment
Eva K Fenwick, Alfred T L Gan, Ryan E K Man, Preeti Gupta, Charumathi Sabanayagam, Ching-Yu Cheng, Christopher Li-Hsian Chen, Carol Y Cheung, Kah Hie Wong, Narayanaswamy Venketasubramanian, Xin Xu, Saima Hilal, Eddie J Y Chong, Yih-Chung Tham, Tien Y Wong, Ecosse L Lamoureux
doi : 10.1093/ageing/afaa276
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1236–1242
The relationship between self-reported visual disability and cognitive impairment in older individuals is unclear.
General practitioner conduct of clinical services representing comprehensive geriatric assessment is associated with lower risk of mortality in older Australians receiving home care packages
Renuka Visvanathan, Azmeraw T Amare, Steve Wesselingh, Maria C Inacio
doi : 10.1093/ageing/afaa272
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1243–1251
The purpose of this paper is to investigate the utilisation of general practice Medicare Benefit Schedule (MBS) services aligned to Comprehensive Geriatric Assessment (CGA) within 6 months of an aged care eligibility assessment and its effects on mortality and transition to permanent residential aged care (PRAC).
A medical history of arterial thrombosis is a strong predictor of post-operative myocardial infarction and stroke in patients with hip fractures—a nationwide cohort study
Liv Riisager Wahlsten, Bochra Zareini, L?rke Smedegaard, Gunnar H Gislason, Henrik Palm, Stig Brorson
doi : 10.1093/ageing/afaa279
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1252–1260
Hip fractures lead to a substantial burden of disease and mortality among the elderly. Myocardial infarction (MI) and stroke are serious and overlooked complications, and their impact on mortality and morbidity may be underestimated. We investigated; 90-day absolute risk of stroke and MI following hip fracture surgery, and ii) anamnestic risk factors associated with elevated risk of postoperative MI and stroke.
The My Active and Healthy Aging ICT platform prevents quality of life decline in older adults: a randomised controlled study
Innocenzo Rainero, Mathew J Summers, Michaela Monter, Marco Bazzani, Eleftheria Giannouli, Georg Aumayr, Dalila Burin, Paolo Provero, Alessandro E Vercelli, for the My-AHA Consortium
doi : 10.1093/ageing/afaa290
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1261–1267
Prevention of frailty is paramount in older adults. We evaluated the efficacy of a tailored multidomain intervention, monitored with the My Active and Healthy Aging platform, in reducing conversion from a prefrail status to overt frailty and preventing decline in quality of life.
Dual impairments in visual and hearing acuity and age-related cognitive decline in older adults from the Rancho Bernardo Study of Healthy Aging
Humberto Parada, Gail A Laughlin, Mingan Yang, Frances R Nedjat-Haiem, Linda K McEvoy
doi : 10.1093/ageing/afaa285
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1268–1276
We examined the associations between dual impairments in visual and hearing acuity and aging-related cognitive decline.
The association between an early diagnosis of dementia and secondary health service use
Elyse Couch, Christoph Mueller, Gayan Perera, Vanessa Lawrence, Matthew Prina
doi : 10.1093/ageing/afab079
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1277–1282
dementia policy suggests diagnosing dementia early can reduce the risk of potentially harmful hospital admissions or emergency department (ED) attendances; however, there is little evidence to support this. A diagnosis of mild cognitive impairment (MCI) before dementia is a helpful proxy to explore early diagnosis. This study investigated the association between an early diagnosis of dementia and subsequent hospitalisations and ED attendances.
Social gradient of self-rated health in older people—the moderating/mediating role of sense of community
Eric T C Lai, Ruby Yu, Jean Woo
doi : 10.1093/ageing/afaa277
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1283–1289
Social gradients of self-rated health (SRH) of older people are evident in various settings. However, it is not clear whether improving older people’s sense of community (SoC) could mitigate the social gradient.
‘Real world’ effectiveness of the Falls Management Exercise (FaME) programme: an implementation study
Elizabeth Orton, Sarah Audsley, Carol Coupland, John R F Gladman, Steve Iliffe, Natasher Lafond, Philippa Logan, Tahir Masud, Dawn A Skelton, Clare Timblin, Stephen Timmons, Derek Ward, Denise Kendrick
doi : 10.1093/ageing/afaa288
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1290–1297
Falls incidence increases with age alongside declines in strength and balance. Clinical trials show that the Falls Management Exercise (FaME) programme improves strength and balance, which can reduce falls and improve physical functioning.
Smoking cessation in late life is associated with increased risk of all-cause mortality amongst oldest old people: a community-based prospective cohort study
Yuan Wei, Yuebin Lv, Jinhui Zhou, Xiang Gao, Jun Duan, Chao Zhao, Zhaoxue Yin, Qi Kang, Bing Wu, Chen Chen, Chen Mao, Juan Li, Xiaoming Shi
doi : 10.1093/ageing/afaa280
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1298–1305
we aimed to investigate the association of smoking cessation with risk of all-cause mortality amongst oldest old people (aged ? 80 years).
Trends in prevalence and outcomes of frailty in a Swiss university hospital: a retrospective observational study
Thierry Bonjour, Gérard Waeber, Pedro Marques-Vidal
doi : 10.1093/ageing/afaa278
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1306–1313
Frailty complicates management and worsens outcomes. We assessed the prevalence, determinants and consequences of frailty among elderly patients in a hospital setting.
Inter-rater reliability of care home staff’s proxy judgements with residents’ assessments of their own health-related quality of life: an analysis of the PATCH trial EQ-5D data
Charlotte Kelly, Claire Hulme, Liz Graham, Alison Ellwood, Ismail Patel, Bonnie Cundill, Amanda Farrin, Madeline Goodwin, Karen Hull, Jill Fisher ... Show more
doi : 10.1093/ageing/afab053
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1314–1320
to compare care staff proxies with care home residents’ self-assessment of their health-related quality of life (HRQoL).
The ‘Wish to Die’ in later life: prevalence, longitudinal course and mortality. Data from TILDA
Robert Briggs, Mark Ward, Rose Anne Kenny
doi : 10.1093/ageing/afab010
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1321–1328
‘Wish to Die’ (WTD) involves thoughts of or wishes for one’s own death or that one would be better off dead.
Mortality risk associated with combinations of loneliness and social isolation. Findings from The Irish Longitudinal Study on Ageing (TILDA)
Mark Ward, Peter May, Charles Normand, Rose Anne Kenny, Anne Nolan
doi : 10.1093/ageing/afab004
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1329–1335
Social distancing and similar measures in response to the coronavirus disease 2019 pandemic have greatly increased loneliness and social isolation among older adults. Understanding the association between loneliness and mortality is therefore critically important. We examined whether combinations of loneliness and social isolation, using a metric named social asymmetry, was associated with increased mortality risk.
Patterns of multimorbidity trajectories and their correlates among Korean older adults
Sun Ah Lee, Susanna Joo, Hye Won Chai, Hey Jung Jun
doi : 10.1093/ageing/afab002
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1336–1341
This study aims to identify distinct patterns of 10-year multimorbidity trajectory among Korean older adults and examine factors associated with the patterns.
Balance and cognitive decline in older adults in the cardiovascular health study
Claire C Meunier, Ellen Smit, Annette L Fitzpatrick, Michelle C Odden
doi : 10.1093/ageing/afab038
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1342–1348
Previous studies have demonstrated an association between gait speed and cognitive function. However, the relationship between balance and cognition remains less well explored. This study examined the cross-sectional and longitudinal relationship of balance and cognitive decline in older adults.
Patterns of multimorbidity and their association with hospitalisation: a population-based study of older adults in urban Tanzania
Andrew Tomita, Germana H Leyna, Hae-Young Kim, Yoshan Moodley, Emmanuel Mpolya, Polycarp Mogeni, Diego F Cuadros, Armstrong Dzomba, Alain Vandormael, Till B?rnighausen, Frank Tanser
doi : 10.1093/ageing/afab046
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1349–1360
while the HIV epidemic remains a considerable challenge in sub-Saharan Africa, a dramatic reduction in the associated mortality has led to a fundamental shift in the public health priorities aimed at tackling multimorbidity. Against the unprecedented level of urbanisation taking place in Tanzania, the burden of multimorbidity and its consequences among ageing adults, in the form of costly inpatient hospitalisation, remain unquantified.
‘Patients come with two garbage bags full of problems and we have to sort them.’ A qualitative study of the experiences of healthcare professionals on patients admitted to short-term residential care in the Netherlands
Judith H van den Besselaar, Linda Hartel, Joost D Wammes, Janet L MacNeil-Vroomen, Bianca M Buurman
doi : 10.1093/ageing/afab011
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1361–1370
Short-term residential care (STRC) facilities were recently implemented in the Netherlands to provide temporary care to older adults with general health problems. The aim of STRC is to allow the individual to return home. However, 40% of patients are discharged to long-term care facilities. In-depth data about characteristics of patients admitted and challenges in providing STRC are missing.
How quality improvement collaboratives work to improve healthcare in care homes: a realist evaluation
Reena Devi, Neil H Chadborn, Julienne Meyer, Jay Banerjee, Claire Goodman, Tom Dening, John R F Gladman, Kathryn Hinsliff-Smith, Annabelle Long, Adeela Usman, Gemma Housley, Sarah Lewis, Matthew Glover, Heather Gage, Philippa A Logan, Finbarr C Martin, Adam L Gordon
doi : 10.1093/ageing/afab007
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1371–1381
Quality improvement collaboratives (QICs) bring together multidisciplinary teams in a structured process to improve care quality. How QICs can be used to support healthcare improvement in care homes is not fully understood.
Discordance between dementia caregivers’ goal of care and preference for life-extending treatments
Chetna Malhotra, Hazirah, Mohamad, Truls ?stbye, Kathryn I Pollak, Bharathi Balasundaram, Rahul Malhotra, Ka-Mun Tong, Allyn Yin Mei Hum, John Carson Allen, Dennis Seow, Jing Rong Yong, Sungwon Yoon, PISCES Study Group
doi : 10.1093/ageing/afab049
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1382–1390
Many older adults with severe dementia receive potentially life-extending treatments even when caregivers do not wish to prolong their life inappropriately.
Developing a virtual geriatric perioperative medicine clinic: a mixed methods healthcare improvement study
Andrea Joughin, Sarah Ibitoye, Amy Crees, David Shipway, Philip Braude
doi : 10.1093/ageing/afab066
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1391–1396
the Geriatric Perioperative Care clinic at North Bristol NHS Trust was suspended in March 2020 during the COVID-19 pandemic. A virtual clinic was piloted to deliver preoperative health optimisation and shared decision-making for patients undergoing critical elective surgery. No literature existed on virtual preoperative clinics for older people to support the development.
Rotigotine patch prescription in inpatients with Parkinson’s disease: evaluating prescription accuracy, delirium and end-of-life use
Hussein Ibrahim, Zoe Woodward, Jennifer Pooley, Edward William Richfield
doi : 10.1093/ageing/afaa256
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1397–1401
Rotigotine patch, a trans-dermal dopamine agonist, is used acutely to replace oral dopaminergic medications for inpatients with Parkinson’s disease where enteral routes are no longer available, and is also an option in end-of-life care where patients can no longer swallow. Concerns regarding acute use of Rotigotine include difficulty achieving dopaminergic equivalence, promotion of delirium/hallucinations and promotion of terminal agitation.
Development and validation of an aetiology in delirium diagnostic support tool
Eamonn Eeles, Lisa Huang, Lucy Dakin, Carolina Ling, Erin Dunn, Jon Fraser, Nadeeka N Dissanayaka
doi : 10.1093/ageing/afaa269
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1402–1405
recognition of the multifactorial causes of delirium represents a clinical challenge.
A classification tree to assist with routine scoring of the Clinical Frailty Scale
Olga Theou, Mario Ulises Pérez-Zepeda, Alexandra M van der Valk, Samuel D Searle, Susan E Howlett, Kenneth Rockwood
doi : 10.1093/ageing/afab006
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1406–1411
the Clinical Frailty Scale (CFS) was originally developed to summarise a Comprehensive Geriatric Assessment and yield a care plan. Especially since COVID-19, the CFS is being used widely by health care professionals without training in frailty care as a resource allocation tool and for care rationing. CFS scoring by inexperienced raters might not always reflect expert judgement. For these raters, we developed a new classification tree to assist with routine CFS scoring. Here, we test that tree against clinical scoring.
Factors associated with virtual care access in older adults: a cross-sectional study
Laura Liu, Zahra Goodarzi, Aaron Jones, Ron Posno, Sharon E Straus, Jennifer A Watt
doi : 10.1093/ageing/afab021
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1412–1415
virtual care has been critical during the COVID-19 pandemic, but there may be inequities in accessing different virtual modalities (i.e. telephone or videoconference).
Oropharyngeal dysphagia in older patients with hip fracture
Jes?s Mateos-Nozal, Elisabet Sanchez Garcia, Estela Romero Rodr?guez, Alfonso J Cruz-Jentoft
doi : 10.1093/ageing/afab032
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1416–1421
oropharyngeal dysphagia (OD) and hip fracture are common problems in older patients, both associated with important complications.
Cycle more with virtual reality: a proof of concept study in an institutionalised able-bodied geriatric population
Gilles Loggia, Antoine Gauthier, Fabrice Lemiere, Joffrey Drigny, Antoine Desvergee, Pascale Leconte, Alexis Ruet
doi : 10.1093/ageing/afab040
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1422–1425
Physical activity (PA) has significant benefits for older adults. However, the recommended PA is rarely achieved in nursing homes. In this proof of concept study, we assessed whether virtual reality (VR) could help to increase spontaneous PA during a stationary cycling session.
Lessons from recent medical history: an obsolete anti-reflux device in an older patient with variable gastrointestinal symptoms
Charlotte Squires, Ross J Porter, Benjamin M Ward
doi : 10.1093/ageing/afab089
Age and Ageing, Volume 50, Issue 4, July 2021, Pages 1426–1427
A frail 93-year-old lady presented with delirium, on a background of heart failure, cerebrovascular disease, constipation and osteoporosis. A computed tomography (CT) pulmonary angiography, undertaken due to persistent hypoxia, identified no pathology aside from an unusual appearance of the left hypochondrium, necessitating further elucidation with CT abdomen. This unexpectedly reported the presence of a gastric band, leading us to consider possible misidentification. Perusing her General Practitioner (GP) records demonstrated that she underwent surgical insertion of an Angelchik prosthesis in 1984. Angelchik prostheses were anti-reflux devices used for a short period, before falling from favour due to increasing evidence around late developing complications. A collateral history from family revealed that this patient had experienced multiple longstanding symptoms including bloating, reflux and constipation, potentially linked to her prosthesis, a previously unestablished link.
Fall with acute traumatic central cord syndrome in an older patient
Wassim Gana, Ubrich Acko, Dana Simionca, Estelle Acko-Ohui, Camille Debacq, Amal Aidoud, Bertrand Fougère
doi : 10.1093/ageing/afab069
Age and Ageing, Volume 50, Issue 4, July 2021, Page 1428
The delicate balance between over- and underdiagnosis in older people: a simple inguinal hernia?
Renée A G Brüggemann, Steffie H A Brouns, Elwin H H Mommers, Bart Spaetgens
doi : 10.1093/ageing/afab087
Age and Ageing, Volume 50, Issue 4, July 2021, Page 1429
