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Editor’s viewÂ
Rowan H Harwood
doi : 10.1093/ageing/afac042
Age and Ageing, Volume 51, Issue 2, February 2022, afac042
Inappropriate prescribing: hazards and solutions
Mirko Petrovic, Denis O’Mahony, Antonio Cherubini
doi : 10.1093/ageing/afab269
Age and Ageing, Volume 51, Issue 2, February 2022, afab269
With population ageing, the number of older people is growing, which results in increasing number of people with multimorbidity and related polypharmacy. Polypharmacy in its turn leads to drug-related problems (DRPs) and potentially inappropriate prescribing (IP) in older people. In this commentary, susceptibility of older people to DRPs due to changes in pharmacokinetics and pharmacodynamics, plurality of prescribing physicians, inadequate consideration of patients’ characteristics, polypharmacy and its consequences such as prescribing cascades, drug interactions and potentially IP have been discussed respectively. Consecutively, identifying DRPs and optimizing of IP, including drug reconciliation, application of criteria for identifying and preventing IP, implementation of computer-based prescribing systems, and comprehensive geriatric assessment and management have been elaborated as well. One of the main challenges regarding appropriate and tailored prescribing in older people is to evaluate whether the expected benefits of pharmacotherapy are bigger than the risks in a population with multimorbidity, decreased tolerance to vulnerability and limited life expectancy. Comprehensive geriatric assessment enables informed prescribing decisions in the context of such variables. A challenge for future research is how to integrate important clinical information obtained by existing methods into a comprehensive and wide-reaching approach targeting all potential factors involved in causing DRPs. Good prescribing in late life accommodates the needs of older patients with multimorbidity. Individualized, interactive, multidisciplinary, and multifaceted approach to geriatric pharmacotherapy should be promoted and encouraged. How to optimize pharmacological prescription in complex older patients is a major legacy of geriatrics to contemporary medicine/medical practice.
The giants of education in geriatric medicine and gerontology
Roman Romero-Ortuno, Andreas E Stuck, Tahir Masud
doi : 10.1093/ageing/afac004
Age and Ageing, Volume 51, Issue 2, February 2022, afac004
In 2014, the European undergraduate curriculum in Geriatric Medicine was published to cover the minimum requirements that a medical student should achieve by the end of medical school. In 2019, the European postgraduate curriculum in Geriatric Medicine outlined the minimum recommended training requirements to become a geriatrician at specialist level in the EU. The postgraduate dimension of Geriatric Medicine education is a highly relevant topic for all, since most physicians—independently of their specialty—are inevitably involved in the care of older patients, but for most physicians, geriatrics is not part of their postgraduate generalist or specialty training. A key area for postgraduate education remains the provision of Geriatric Medicine competencies to all specialties outside geriatrics. There is also need for wider educational initiatives to improve the gerontological education of patients and the public. Bernard Isaacs famously coined the expression ‘geriatric giants’ or the four clinical I’s: Intellectual impairment, Incontinence, Immobility, and Instability. However, non-clinical giants exist. In education, we face challenges of Investment, Inspiration, Integration, and Interprofessionality; and in research, we need to attract Interest and Income, and generate Innovation and Impact. Without strengthening the links between all giants, we will not be able to achieve the ambition of age-attuned societies. A key goal for gerontological education is to enhance everyone’s understanding of the wide diversity underlying the ‘older people’ demographic label, which will ultimately promote services and societies that are more responsive and inclusive to the needs of all older adults, irrespective of their health status.
Time to move again: from deconditioning to reconditioning
Amit Arora
doi : 10.1093/ageing/afab227
Age and Ageing, Volume 51, Issue 2, February 2022, afab227
Warfarin and increased fracture risk? Answering the big question
Ameenathul M Fawzy, Gregory Y H Lip
doi : 10.1093/ageing/afab263
Age and Ageing, Volume 51, Issue 2, February 2022, afab263
Considerations for integrated cognitive behavioural treatment for older adults with coexisting nocturia and insomnia
Camille P Vaughan, Alayne D Markland, Alison J Huang, Cathy A Alessi, Andrew Guzman, Jennifer L Martin, Donald L Bliwise, Theodore M Johnson II, Kathryn L Burgio, Constance H Fung
doi : 10.1093/ageing/afac024
Age and Ageing, Volume 51, Issue 2, February 2022, afac024
Nocturia and chronic insomnia disorder are common conditions that frequently coexist in older adults. Existing medication treatments for each condition have risks, particularly in older adults. While treatment guidelines recommend starting with behavioural therapy for each condition, no existing program simultaneously addresses nocturia and insomnia. Existing behavioural interventions for nocturia or insomnia contain concordant and discordant components. An expert panel (including geriatricians with sleep or nocturia research expertise, sleep psychologists and a behavioural psychologist) was convened to combine and reconcile elements of behavioural treatment for each condition. Concordant treatment recommendations involve using situational self-management strategies such as urge suppression or techniques to influence homeostatic drive for sleep. Fluid modification such as avoiding alcohol and evening caffeine and regular self-monitoring through a daily diary is also appropriate for both conditions. The expert panel resolved discordant recommendations by eliminating overnight completion of voiding diaries (which can interfere with sleep) and discouraging routine overnight voiding (a stimulus control strategy). The final product is an integrated cognitive behavioural treatment that is delivered by advanced practice providers weekly over 5 weeks. This integrated program addresses the common scenario of coexisting nocturia and chronic insomnia disorder.
New horizons in the perioperative care of older adults
Janani Thillainadesan, Sarah N Hilmer, Aisling M Fleury, Vasi Naganathan
doi : 10.1093/ageing/afab245
Age and Ageing, Volume 51, Issue 2, February 2022, afab245
Older adults undergoing surgery have high perioperative morbidity and mortality. Age-related physiological changes and prevalence of geriatric syndromes such as frailty increase the risk of adverse postoperative outcomes. Geriatricians utilise comprehensive geriatric assessment (CGA) and management to identify and manage geriatric syndromes, and deliver patient-centred perioperative care. Perioperative models of CGA are established for older patients undergoing hip fracture surgery. Recent trials support the benefits of perioperative models of CGA for non-orthopaedic surgery, and have influenced current care recommendations for older surgical patients. Areas for further action include addressing the implementation gap between recommended evidence-based perioperative care and routine perioperative care, evaluating the clinical and cost-effectiveness of perioperative models of CGA for patients living with frailty, and embedding routine use of patient-reported outcome measures to inform quality improvement.
Resistance exercise as a treatment for sarcopenia: prescription and delivery
Christopher Hurst, Sian M Robinson, Miles D Witham, Richard M Dodds, Antoneta Granic, Charlotte Buckland, Sarah De Biase, Susanne Finnegan, Lynn Rochester, Dawn A Skelton ... Show more
doi : 10.1093/ageing/afac003
Age and Ageing, Volume 51, Issue 2, February 2022, afac003
Sarcopenia is a generalised skeletal muscle disorder characterised by reduced muscle strength and mass and associated with a range of negative health outcomes. Currently, resistance exercise (RE) is recommended as the first-line treatment for counteracting the deleterious consequences of sarcopenia in older adults. However, whilst there is considerable evidence demonstrating that RE is an effective intervention for improving muscle strength and function in healthy older adults, much less is known about its benefits in older people living with sarcopenia. Furthermore, evidence for its optimal prescription and delivery is very limited and any potential benefits of RE are unlikely to be realised in the absence of an appropriate exercise dose. We provide a summary of the underlying principles of effective RE prescription (specificity, overload and progression) and discuss the main variables (training frequency, exercise selection, exercise intensity, exercise volume and rest periods) that can be manipulated when designing RE programmes. Following this, we propose that an RE programme that consists of two exercise sessions per week and involves a combination of upper- and lower-body exercises performed with a relatively high degree of effort for 1–3 sets of 6–12 repetitions is appropriate as a treatment for sarcopenia. The principles of RE prescription outlined here and the proposed RE programme presented in this paper provide a useful resource for clinicians and exercise practitioners treating older adults with sarcopenia and will also be of value to researchers for standardising approaches to RE interventions in future sarcopenia studies.
Referral to geriatric rehabilitation: a scoping review of triage factors in acutely hospitalised older patients
Aafke J de Groot, Elizabeth M Wattel, Carmen S van Dam, Romke van Balen, Johannes C van der Wouden, Cees M P M Hertogh
doi : 10.1093/ageing/afac015
Age and Ageing, Volume 51, Issue 2, February 2022, afac015
Old or frail acutely hospitalised patients can benefit from geriatric rehabilitation but criteria concerning referral decisions are unclear. This review presents an overview of clinical factors associated with referral to geriatric rehabilitation that may further consensus between hospital and rehabilitation professionals on triage.
Scoping study of definitions of social participation: update and co-construction of an interdisciplinary consensual definition
Mélanie Levasseur, Marika Lussier-Therrien, Marie Lee Biron, Émilie Raymond, Julie Castonguay, Daniel Naud, Mireille Fortier, Andrée Sévigny, Sandra Houde, Louise Tremblay
doi : 10.1093/ageing/afab215
Age and Ageing, Volume 51, Issue 2, February 2022, afab215
considering the importance of social participation for quality of life and active ageing in older adults, it is an important target of social and health professionals’ interventions. A previous review of definitions of social participation in older adults included articles up to 2009; new publications and changes in the social context (e.g. social media and the COVID-19 pandemic) justify continuing this work.
Patient-related risk factors for in-hospital functional decline in older adults: A systematic review and meta-analysis
Lisa Geyskens, Anthony Jeuris, Mieke Deschodt, Bastiaan Van Grootven, Evelien Gielen, Johan Flamaing
doi : 10.1093/ageing/afac007
Age and Ageing, Volume 51, Issue 2, February 2022, afac007
Functional decline (FD) is a common and serious problem among hospitalised older adults.
Risk of progression to diabetes and mortality in older people with prediabetes: The English longitudinal study on ageing
Nicola Veronese, Marianna Noale, Alan Sinclair, Mario Barbagallo, Ligia J Dominguez, Lee Smith, Damiano Pizzol, Stefania Maggi
doi : 10.1093/ageing/afab222
Age and Ageing, Volume 51, Issue 2, February 2022, afab222
Prediabetes is used to identify people at increased risk for diabetes. However, the importance of prediabetes in older populations is still poorly explored. Therefore, we aimed to investigate the prevalence of prediabetes, based on either glycated haemoglobin (HbA1c) levels or fasting glucose (FG) levels, or both and the progression of prediabetes to diabetes or to mortality in older participants of the English Longitudinal Study on Ageing.
Education as a moderator of middle-age cardiovascular risk factor—old-age cognition relationships: testing cognitive reserve hypothesis in epidemiological study
Paula Iso-Markku, Jaakko Kaprio, Noora Lindgrén, Juha O Rinne, Eero Vuoksimaa
doi : 10.1093/ageing/afab228
Age and Ageing, Volume 51, Issue 2, February 2022, afab228
higher educational attainment and less midlife cardiovascular risk factors are related to better old-age cognition. Whether education moderates the association between cardiovascular risk factors and late-life cognition is not known. We studied if higher education provides resilience against the deteriorative effects of higher middle-age body mass index (BMI) and a combination of midlife cardiovascular risk factors on old-age cognition.
Calf circumference refines sarcopenia in correlating with mortality risk
Shou-En Wu, Wei-Liang Chen
doi : 10.1093/ageing/afab239
Age and Ageing, Volume 51, Issue 2, February 2022, afab239
Recommendations in current guidelines on the use of calf circumference (CC) as a diagnostic measure in sarcopenia is conflicting. In this study, we incorporated CC into conventional models of sarcopenia and compared their predictive scores on mortality.
Emergency department interventions for frailty (EDIFY): improving functional outcomes in older persons at the emergency department through a multicomponent frailty intervention
Edward Chong, Birong Zhu, Sheryl Hui Xian Ng, Hongyun Tan, Eileen Fabia Goh, Joseph De Castro Molina, Michelle Jessica Pereira, Palvinder Kaur, Jewel Baldevarona-Llego, Jia Qian Chia, Amanda Chong, Selina Cheong, Chik Loon Foo, Mark Chan, Wee Shiong Lim
doi : 10.1093/ageing/afab251
Age and Ageing, Volume 51, Issue 2, February 2022, afab251
emergency department interventions for frailty (EDIFY) delivers frailty-centric interventions at the emergency department (ED). We evaluated the effectiveness of a multicomponent frailty intervention (MFI) in improving functional outcomes among older persons.
Processed meat consumption and the risk of incident late-onset depression: a 12-year follow-up of the Salus in Apulia Study
Luisa Lampignano, Rodolfo Sardone, Francesca D’Urso, Mario Altamura, Carla Piccininni, Chiara Griseta, Ilaria Bortone, Fabio Castellana, Roberta Zupo, Rossella Donghia, Vito Guerra, Emanuela Resta, Annamaria Cisternino, Maria Gabriella Caruso, Antonio Daniele, Giovanni De Pergola, Antonello Bellomo, Heiner Boeing, Gianluigi Giannelli, Francesco Panza, Madia Lozupone
doi : 10.1093/ageing/afab257
Age and Ageing, Volume 51, Issue 2, February 2022, afab257
the possible relationship between dietary habits and the incidence of late-onset depression (LOD), defined as first depression onset at later age, is unclear.
Atrial fibrillation and acceleration of frailty: findings from the Irish Longitudinal Study on Ageing
Georgia Richard, Aisling M O’Halloran, Paul Doody, Joseph Harbison, Rose Anne Kenny, Roman Romero-Ortuno
doi : 10.1093/ageing/afab273
Age and Ageing, Volume 51, Issue 2, February 2022, afab273
both atrial fibrillation (AF) and frailty are increasingly prevalent with age. Cross-sectional studies have suggested a relationship between AF and frailty, but longitudinal data are lacking. We explored if the presence of AF was associated with accelerated progression of frailty over 8Â years in community-dwelling older adults.
Incidence of neurological and psychiatric comorbidity over time: a population-based cohort study in Ontario, Canada
Colleen J Maxwell, Laura C Maclagan, Daniel A Harris, Xuesong Wang, Jun Guan, Ruth Ann Marrie, David B Hogan, Peter C Austin, Simone N Vigod, Richard H Swartz,Susan E Bronskill
doi : 10.1093/ageing/afab277
Age and Ageing, Volume 51, Issue 2, February 2022, afab277
Comprehensive, population-based investigations of the extent and temporality of associations between common neurological and psychiatric disorders are scarce.
Development and evaluation of an evidence-based, theory-grounded online Clinical Frailty Scale tutorial
Taleen Haddad, Sunita Mulpuru, Ivy Salter, Emily Hladkowicz, Kathryne Des Autels, Sylvain Gagne, Gregory L Bryson, Colin J L McCartney, Allen Huang, Shirley Huang, Alan Forster, Carl van Walraven, Kwadwo Kyeremanteng, Shannon M Fernando, Sudhir Nagpal, Husein Moloo, Sylvain Boet, Vicki Le Blanc, Manoj M Lalu, Daniel I McIsaac
doi : 10.1093/ageing/afab258
Age and Ageing, Volume 51, Issue 2, February 2022, afab258
Frailty is a robust predictor of adverse outcomes in older people. Practice guidelines recommend routine screening for frailty; however, this does not occur regularly. The Clinical Frailty Scale (CFS) is a validated, feasible instrument that can be used in a variety of clinical settings and is associated with many adverse outcomes. Our objective was to develop and evaluate an online training module to guide frailty assessment using the CFS.
Association between a lifestyle-based healthy heart score and risk of frailty in older women: a cohort study
Mercedes Sotos-Prieto, Ellen A Struijk, Teresa T Fung, Eric B Rimm, Fernando Rodriguez-Artalejo, Walter C Willett, Frank B Hu, Esther Lopez-Garcia
doi : 10.1093/ageing/afab268
Age and Ageing, Volume 51, Issue 2, February 2022, afab268
Evidence on the comprehensive role of lifestyle in frailty risk is scarce. To assess the association between a lifestyle-based Healthy Heart Score (HHS), which estimates the 20-year risk of cardiovascular disease (CVD), and risk of frailty among older women.
Health-related quality of life in older patients surviving ICU treatment for COVID-19: results from an international observational study of patients older than 70Â years
Ivo W Soliman, Susannah Leaver, Hans Flaatten, Jesper Fjølner, Bernhard Wernly, Raphael R Bruno, Antonio Artigas, Bernardo Bollen Pinto, Joerg C Schefold, Michael Beil, Sigal Sviri, Peter Vernon van Heerden, Wojciech Szczeklik, Muhammed Elhadi, Michael Joannidis, Sandra Oeyen, Tilemachos Zafeiridis, Jakob Wollborn, Maria Jose Arche Banzo, Kristina Fuest, Brian Marsh, Finn H Andersen, Rui Moreno, Ariane Boumendil, Bertrand Guidet, Christian Jung, Dylan W De Lange, The COVIP-study group
doi : 10.1093/ageing/afab278
Age and Ageing, Volume 51, Issue 2, February 2022, afab278
health-related quality of life (HRQoL) is an important patient-centred outcome in patients surviving ICU admission for COVID-19. It is currently not clear which domains of the HRQoL are most affected.
Prevalence, management and outcomes of unrecognized delirium in a National Sample of 1,493 older emergency department patients: how many were sent home and what happened to them?
Jacques S Lee, Tiffany Tong, Mark Chignell, Mary C Tierney, Judah Goldstein, Debra Eagles, Jeffrey J Perry, Andrew McRae, Eddy Lang, Darren Hefferon, Louise Rose, Alex Kiss, Bjug Borgundvaag, Shelley McLeod, Don Melady, Valérie Boucher, Marie-Josée Sirois, Marcel Émond
doi : 10.1093/ageing/afab214
Age and Ageing, Volume 51, Issue 2, February 2022, afab214
Retrospective studies estimate Emergency Department (ED) delirium recognition at <20%; few prospective studies have assessed delirium recognition and outcomes for patients with unrecognized delirium.
Home and ambulatory blood pressure levels below target range and clinical effort to detect this condition: a population-based study in older treated hypertensives
Mercedes Sánchez-MartÃnez, Esther López-GarcÃa, Pilar Guallar-Castillón, Rosario Ortolá, Esther GarcÃa-Esquinas, Juan Cruz, Teresa Gijón-Conde, Fernando RodrÃguez-Artalejo, Raymond R Townsend, José R Banegas
doi : 10.1093/ageing/afab236
Age and Ageing, Volume 51, Issue 2, February 2022, afab236
With implementation of stricter blood pressure (BP) treatment targets, potential for excessive BP lowering becomes an important issue, especially in older patients.
Frailty and stroke thrombectomy outcomes—an observational cohort study
Nevan Joyce, Timothy Atkinson, Karen Mc Guire, M Ivan Wiggam, Patricia L Gordon, Enda L Kerr, Cathy E Patterson, Jim McILmoyle, Gerallt E Roberts, Peter A Flynn, Paul Burns, Ian R Rennie, Martin Taylor Rowan, Terence J Quinn, Patricia Fearon
doi : 10.1093/ageing/afab260
Age and Ageing, Volume 51, Issue 2, February 2022, afab260
Mechanical thrombectomy (MT) can improve outcomes following ischaemic stroke. Patient selection for MT is predominantly based on physiological and imaging parameters. We assessed whether people living with pre-stroke frailty had differing outcomes following MT.
Serum markers of biological ageing provide long-term prediction of life expectancy—a longitudinal analysis in middle-aged and older German adults
Bernard Srour, Lucas Cory Hynes, Theron Johnson, Tilman Kühn, Verena A Katzke, Rudolf Kaaks
doi : 10.1093/ageing/afab271
Age and Ageing, Volume 51, Issue 2, February 2022, afab271
lifestyle behaviours and chronic co-morbidities are leading risk factors for premature mortality and collectively predict wide variability in individual life expectancy (LE). We investigated whether a pre-selected panel of five serum markers of biological ageing could improve predicting the long-term mortality risk and LE in middle-aged and older women and men.
Evaluation of an alternative skeletal muscle index for skeletal muscle mass assessment in a group of Australian women
Ming Li Yee, Sophie Einoder, Boyd J G Strauss, Christopher Gilfillan
doi : 10.1093/ageing/afac002
Age and Ageing, Volume 51, Issue 2, February 2022, afac002
Sarcopenia is assessed by several methods, including dual energy X-ray absorptiometry (DEXA), which provide a height-adjusted skeletal muscle index (H-SMI). A SMI 2 standard deviation below the young adult reference [1] combined with low muscle strength or performance is used to identify sarcopenia. As height declines with age, H-SMI may underestimate low skeletal muscle mass in the older population. Our study aims to evaluate an alternative SMI and to examine its relationship to grip strength in a group of Australian women.
The association between the inflammatory response following surgery and post-operative delirium in older oncological patients: a prospective cohort study
Baukje Brattinga, Matthijs Plas, Jacoba M Spikman, Abraham Rutgers, Jacco J de Haan, Anthony R Absalom, Hanneke van der Wal-Huisman, Geertruida H de Bock, Barbara L van Leeuwen
doi : 10.1093/ageing/afab237
Age and Ageing, Volume 51, Issue 2, February 2022, afab237
Post-operative delirium (POD) is associated with increased morbidity and mortality rates in older patients. Neuroinflammation, the activation of the intrinsic immune system of the brain, seems to be one of the mechanisms behind the development of POD. The aim of this study was to explore the association between the perioperative inflammatory response and the development of POD in a cohort of older oncological patients in need for surgery.
Interviewer effects in a survey examining pain intensity and pain interference in nursing home residents
Patrick Kutschar, Juergen Osterbrink, Martin Weichbold
doi : 10.1093/ageing/afac008
Age and Ageing, Volume 51, Issue 2, February 2022, afac008
Face-to-face surveys are applied frequently when conducting research in older populations. Interviewers play a decisive role in data quality, may affect measurement and influence results. This study uses survey data about pain in nursing home residents and analyses, whether affiliation-of-interviewer (internal vs. external to nursing home) and gender-of-interviewer affect residents’ responses in terms of interviewer variance and systematically varying pain reports.
Effects of a transitional home-based care program for stroke survivors in Harbin, China: a randomized controlled trial
Frances Kam Yuet Wong, Shao Ling Wang, Shamay S M Ng, Paul H Lee, Arkers Kwan Ching Wong, Haiyan Li, Wei Wang, Lijie Wu, Yi Zhang, Yangyang Shi
doi : 10.1093/ageing/afac027
Age and Ageing, Volume 51, Issue 2, February 2022, afac027
China has the biggest stroke burden in the world. Continued measures have been taken to enhance post-stroke rehabilitation management in the last two decades. The weak link is with home-based rehabilitation, with more attention and resources devoted to inpatient rehabilitation.
The impact of an exercise intervention on frailty levels in hospitalised older adults: secondary analysis of a randomised controlled trial
Mario Ulises Pérez-Zepeda, Nicolás MartÃnez-Velilla, Dustin Scott Kehler, Mikel Izquierdo, Kenneth Rockwood, Olga Theou
doi : 10.1093/ageing/afac028
Age and Ageing, Volume 51, Issue 2, February 2022, afac028
physical activity reduces frailty in community-dwelling older adults. How exercise influences frailty in hospitalised older adults requires additional investigation.
Developing and validating a Chinese multimorbidity-weighted index for middle-aged and older community-dwelling individuals
Wei-Hua Hu, Yu-Yang Liu, Cong-Hui Yang, Tong Zhou, Chun Yang, Ying-Si Lai, Jing Liao, Yuan-Tao Hao Author Notes
doi : 10.1093/ageing/afab274
Age and Ageing, Volume 51, Issue 2, February 2022, afab274
To develop and validate an index to quantify the multimorbidity burden in Chinese middle-aged and older community-dwelling individuals.
The paradoxes experienced by informal caregivers of people with dementia during the transition from home to a nursing home
Lindsay Groenvynck, Bram de Boer, Audrey Beaulen, Erica de Vries, Jan P H Hamers, Theo van Achterberg, Erik van Rossum, Chandni Khemai, Judith M M Meijers, Hilde Verbeek
doi : 10.1093/ageing/afab241
Age and Ageing, Volume 51, Issue 2, February 2022, afab241
The transition from home to a nursing home is a common care process experienced by older persons with dementia and their informal caregivers. This transition process is often experienced as fragmented and is paired with negative outcomes for both older persons (e.g. mortality) and informal caregivers (e.g. grief). Due to the central role that informal caregivers play, it is crucial to capture their experiences throughout all phases of the transition.
Using video consultation technology between care homes and health and social care professionals: a scoping review and interview study during COVID-19 pandemic
Krystal Warmoth, Jennifer Lynch, Nicole Darlington, Frances Bunn, Claire Goodman
doi : 10.1093/ageing/afab279
Age and Ageing, Volume 51, Issue 2, February 2022, afab279
the COVID-19 pandemic disproportionately affected care home residents’ and staffs’ access to health care and advice. Health and social care professionals adapted rapidly to using video consultation (videoconferencing) technology without guidance. We sought to identify enablers and barriers to their use in supporting care home residents and staff.
Family caregivers emphasise patience and personal growth: a qualitative analysis from the Caregiving Transitions Study
Marcela D Blinka, Chelsa Liu, Orla C Sheehan, J David Rhodes, David L Roth
doi : 10.1093/ageing/afab266
Age and Ageing, Volume 51, Issue 2, February 2022, afab266
informal caregiving for family and friends is becoming increasingly common due to the rising prevalence of chronic conditions and a shortage of affordable care options. While the impact of caregiving on caregivers’ health is well-documented, nuances in caregivers’ experiences may not be captured in quantitative studies. We aimed to better understand caregivers’ perception of their experiences through qualitative analysis.
Facilitated case conferences on end-of-life care for persons with advanced dementia—a qualitative study of interactions between long-term care clinicians and family members
Mari Claire Francisco, Heather Lane, Tim Luckett, Domenica Disalvo, Dimity Pond, Geoffrey Mitchell, Lynette Chenoweth, Jane Phillips, Elizabeth Beattie, Georgina Luscombe, Stephen Goodall, Meera Agar
doi : 10.1093/ageing/afab270
Age and Ageing, Volume 51, Issue 2, February 2022, afab270
Prognostic uncertainty and the need for proxy decision-making owing to cognitive impairment in advanced dementia, adds complexity to end-of-life care planning within the long-term care setting. Case conferences provide a structure to facilitate difficult conversations and an opportunity for family and clinicians to engage in prospective planning, and reach agreement on goals of end-of-life care.
‘It is designed for everybody to find their own level and to improve themselves’; views of older people and instructors of the Falls Management Exercise (FaME) programme
Leher Gumber, Stephen Timmons, Carol Coupland, Johnrf Gladman, Steve Iliffe, Denise Kendrick, Natasher Lafond, Pip Logan, Tahir Masud, Dawna Skelton, Elizabeth Orton
doi : 10.1093/ageing/afac023
Age and Ageing, Volume 51, Issue 2, February 2022, afac023
Older adults are at increased risk of falls due to ageing, decreased muscle strength and impaired balance. Clinical trials have demonstrated the efficacy and effectiveness of the Falls Management Exercise (FaME) programme in improving functioning and preventing falls. However, programme completion is often low, impacting the potential benefits of FaME.
The experiences of dietitian’s working in care homes in England: a qualitative study
Vittoria Romano, Catherine J Minns Lowe
doi : 10.1093/ageing/afac006
Age and Ageing, Volume 51, Issue 2, February 2022, afac006
The provision of appropriate nutritional care in care homes is a priority for health services in England. There is limited evidence demonstrating the role of dietitians within older people care homes. This study explores the experiences of dietitians working with care homes for older people in England.
‘The worse my hearing got, the less sociable I got’: a qualitative study of patient and professional views of the management of social isolation and hearing loss
Eithne Heffernan, Christine M Withanachchi, Melanie A Ferguson
doi : 10.1093/ageing/afac019
Age and Ageing, Volume 51, Issue 2, February 2022, afac019
Social isolation is a major consequence of hearing loss. It includes an objective component (e.g. small social network) and a subjective component (e.g. loneliness).
Calculating the carbon footprint of a Geriatric Medicine clinic before and after COVID-19
Sarah Bartlett, Sarah Keir
doi : 10.1093/ageing/afab275
Age and Ageing, Volume 51, Issue 2, February 2022, afab275
climate change is a health emergency. Central to addressing this is understanding the carbon footprint of our daily life and work, in order to reduce it effectively. The coronavirus disease of 2019 (COVID-19) pandemic has brought about rapid change to clinical practice, most notably in use of virtual clinics and personal protective equipment (PPE).
Medication modification in a population of community-dwelling individuals aged 65Â years or older
Lidvine Godaert, Cécilia Cofais, Emeline Proye, Laury Allard Saint Albin, Moustapha Dramé
doi : 10.1093/ageing/afab240
Age and Ageing, Volume 51, Issue 2, February 2022, afab240
medication safety is a major public health challenge, particularly among older populations. Changing the medication’s form may be inappropriate and may incur a risk of adverse effects.
Frailty in the oldest old: is the current level or the rate of change more predictive of mortality?
Erwin Stolz, Hannes Mayerl, Emiel O Hoogendijk
doi : 10.1093/ageing/afac020
Age and Ageing, Volume 51, Issue 2, February 2022, afac020
It is unclear whether frailty index (FI) change captures mortality risk better than and independently of the current FI level, i.e. whether a regular FI assessment among older adults provides additional insights for mortality risk stratification or not.
Vitamin K dietary intake is associated with cognitive function in an older adult Mediterranean population
LucÃa Camacho-Barcia, Jesús GarcÃa-Gavilán, Miguel Ã�ngel MartÃnez-González, Fernando Fernández-Aranda, Serena Galié, Dolores Corella, Aida Cuenca-Royo, Dora Romaguera, Jesús Vioque, Ã�ngel M Alonso-Gómez, Julia Wärnberg, J Alfredo MartÃnez, LuÃs Serra-Majem, Ramón Estruch, M Rosa Bernal-López, José Lapetra, Xavier Pintó, Josep A Tur, Antonio Garcia-Rios, Aurora Bueno-Cavanillas, Miguel Delgado-RodrÃguez, Pilar MatÃa-MartÃn, Lidia Daimiel, Vicente MartÃn-Sánchez, Josep Vidal, Clotilde Vázquez, Emilio Ros, Miguel Ruiz Canela, Jose V SorlÃ, Rafael de la Torre, Jadwiga Konieczna, Alejandro Oncina-Cánovas, Lucas Tojal-Sierra, Jessica Pérez-López, Itziar Abete, Almudena Sánchez-Villegas, Rosa Casas, Araceli Muñoz-Garach, José Manuel Santos-Lozano, Cristina Bouzas, Cristina Razquin, Raúl MartÃnez-Lacruz, Olga Castañer, Aina M Yañez, Rafael Valls-Enguix, Maria Concepción Belló-Mora, Javier Basterra-Gortari, Josep Basora, Jordi Salas-Salvadó, Mònica Bulló
doi : 10.1093/ageing/afab246
Age and Ageing, Volume 51, Issue 2, February 2022, afab246
In the last years, evidence that dietary vitamin K could have a role in the cognitive domain has increased. However, data from large trials are limited. The objective of this study was to assess the association of 2 year changes in the dietary intake of vitamin K with cognitive function measured through neuropsychological performance tests.
Prognosis in dysphagic patients who are eating and drinking with acknowledged risk: results from the evaluation of the FORWARD project
Peter Sommerville, Jonathan Hayton, Naomi Soar, Sally Archer, Adam Fitzgerald, Alex Lang, Jonathan Birns
doi : 10.1093/ageing/afac005
Age and Ageing, Volume 51, Issue 2, February 2022, afac005
patients with a permanently unsafe swallow may choose to eat and drink with acknowledged risk (EDAR). Informed decision-making and advance care planning depend on prognosis, but no data have yet been published on outcomes after EDAR decisions.
The DEMS-DOSS study: validating a delirium monitoring tool in hospitalised older adults
Amy Montgomery, Jo-Anne Todd, Cindy Jones, June Koroitamana, Laurie Grealish, Anne Wand, Stephen Billett, Andrew Teodorczuk
doi : 10.1093/ageing/afac012
Age and Ageing, Volume 51, Issue 2, February 2022, afac012
to evaluate the sensitivity, specificity and test–retest reliability of the Delirium Early Monitoring System-Delirium Observation Screening Scale (DEMS-DOSS).
Improving delirium screening and recognition in UK hospitals: results of a multi-centre quality improvement project
Geriatric Medicine Research Collaborative
doi : 10.1093/ageing/afab243
Age and Ageing, Volume 51, Issue 2, February 2022, afab243
delirium is an acute severe neuropsychiatric condition associated with adverse outcomes, particularly in older adults. However, it is frequently under-recognised.
