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Editor’s view
Emma Vardy
doi : 10.1093/ageing/afac193
Age and Ageing, Volume 51, Issue 8, August 2022, afac193
Frailty: understanding the difference between age and ageing
Emily H Gordon, Ruth E Hubbard
doi : 10.1093/ageing/afac185
Age and Ageing, Volume 51, Issue 8, August 2022, afac185
In the past, illness and dependence were viewed as inevitable consequences of old age. Now, we understand that there is a difference between age (the passing of chronological time) and ageing (the increased risk of adverse outcomes over time). Over the last 50 years, ‘frailty’ research has established that ageing is heterogeneous, variable and malleable. Significant advances have been made in frailty measurement (description of clinical features and development of clinical models), mechanisms (insights into pathogenesis) and management (development of interventions to reduce and/or prevent progression). Subsequently, the concept of frailty has informed health policy and clinical practice and started to change perceptions of older age held by the general public and the health sector. Here, we overview key achievements in frailty research and clinical practice and highlight the considerable number of known unknowns that may be addressed in the future.
Perioperative care for older people
Judith S L Partridge, S Ramani Moonesinghe, Nicholas Lees, Jugdeep K Dhesi
doi : 10.1093/ageing/afac194
Age and Ageing, Volume 51, Issue 8, August 2022, afac194
Increasing numbers of older people are undergoing surgery with benefits including symptom relief and extended longevity. Despite these benefits, older people are more likely than younger patients to experience postoperative complications, which are predominantly medical as opposed to surgical.
Age and ageing cardiovascular collection: blood pressure, coronary heart disease and heart failure
Jane A H Masoli, Ekow Mensah, Chakravarthi Rajkumar
doi : 10.1093/ageing/afac179
Age and Ageing, Volume 51, Issue 8, August 2022, afac179
As people age they are at increased risk of cardiovascular disease, the leading cause of mortality and morbidity worldwide. Understanding cardiovascular ageing is essential to preserving healthy ageing and preventing serious health outcomes. This collection of papers published in Age and Ageing since 2011 cover key themes in cardiovascular ageing, with a separate collection on stroke and atrial fibrillation planned.
Ageing meets kidney disease
Alberto Ortiz, Francesco Mattace-Raso, MarÃa José Soler, Denis Fouque
doi : 10.1093/ageing/afac157
Age and Ageing, Volume 51, Issue 8, August 2022, afac157
Chronic kidney disease (CKD) is defined as abnormalities of kidney structure or function, present for >3 months, with implications for health. The most used diagnostic criteria are a urinary albumin: creatinine ratio ≥30 mg/g or an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2.
New horizons in the ageing autonomic nervous system: orthostatic hypotension and supine hypertension
Melanie Dani, Patricia Taraborrelli, Dimitrios Panagopoulos, Andreas Dirksen, Miriam Torocastro, Richard Sutton, Phang Boon Lim
doi : 10.1093/ageing/afac150
Age and Ageing, Volume 51, Issue 8, August 2022, afac150
Blood pressure regulation is an automatic, moment-by-moment buffering of the blood pressure in response to physiological changes such as orthostasis, exercise and haemorrhage. This finely orchestrated reflex is called the baroreflex. It is a regulated arc of afferent, central and efferent arms. Multiple physiological changes occur with ageing that can disrupt this reflex, making blood pressure regulation less effective.
New horizons in life extension, healthspan extension and exceptional longevity
David G Le Couteur, Nir Barzilai
doi : 10.1093/ageing/afac156
Age and Ageing, Volume 51, Issue 8, August 2022, afac156
Many common chronic diseases and syndromes are ageing-related. This raises the prospect that therapeutic agents that target the biological changes of ageing will prevent or delay multiple diseases with a single therapy. Gerotherapeutic drugs are those that target pathways involved in ageing, with the aims of reducing the burden of ageing-related diseases and increasing lifespan and healthspan.
Effectiveness of exergaming-based interventions for mobility and balance performance in older adults with Parkinson’s disease: systematic review and meta-analysis of randomised controlled trials
Jiaxin Zhang, Yan Luximon, Marco Y C Pang, Hailiang Wang
doi : 10.1093/ageing/afac175
Age and Ageing, Volume 51, Issue 8, August 2022, afac175
exergaming-based interventions (EbIs) have been proposed to improve older adults’ mobility and balance performance. However, the effectiveness of such interventions for older adults with Parkinson’s disease (OAPD) remains unclear.
Worldwide prevalence of mild cognitive impairment among community dwellers aged 50Â years and older: a meta-analysis and systematic review of epidemiology studies
Wei Bai, Pan Chen, Hong Cai, Qinge Zhang, Zhaohui Su, Teris Cheung, Todd Jackson, Sha Sha, Yu-Tao Xiang
doi : 10.1093/ageing/afac173
Age and Ageing, Volume 51, Issue 8, August 2022, afac173
Mild cognitive impairment (MCI) is the preclinical and transitional stage between healthy ageing and dementia that may be a potential ‘target’ for interventions designed to delay progression to dementia. In this systematic review and meta-analysis, we assessed the prevalence of MCI worldwide in community-dwelling adults aged 50 years and older.
Predictors of returning home after hip fracture: a prospective cohort study using the UK National Hip Fracture Database (NHFD)
Samuel Hawley, Dominic Inman, Celia L Gregson, Michael Whitehouse, Antony Johansen, Andrew Judge
doi : 10.1093/ageing/afac131
Age and Ageing, Volume 51, Issue 8, August 2022, afac131
our objective was to describe trends in returning home after hospitalisation for hip fracture and identify predictive factors of this important patient-focussed outcome.
Examining the prevalence and correlates of multimorbidity among community-dwelling older adults: cross-sectional evidence from the Canadian Longitudinal Study on Aging (CLSA) first-follow-up data
James H B Im, Rebecca Rodrigues, Kelly K Anderson, Piotr Wilk, Saverio Stranges, Kathryn Nicholson
doi : 10.1093/ageing/afac165
Age and Ageing, Volume 51, Issue 8, August 2022, afac165
multimorbidity has become an increasingly important issue for many populations around the world, including Canada. The objectives of this study were to estimate the prevalence of multimorbidity at first follow-up and to identify factors associated with multimorbidity using data from the Canadian Longitudinal Study on Aging (CLSA).
Shared decision-making for the treatment of proximal femoral fractures in frail institutionalised older patients: healthcare providers’ perceived barriers and facilitators
Inge Spronk, Sverre A I Loggers, Pieter Joosse, Hanna C Willems, Romke Van Balen, Taco Gosens, Kornelis J Ponsen, Jeroen Steens, L C P (Marc) Van de Ree, Rutger G Zuurmond, Michael H J Verhofstad, Esther M M Van Lieshout, Suzanne Polinder
doi : 10.1093/ageing/afac174
Age and Ageing, Volume 51, Issue 8, August 2022, afac174
Proximal femoral fractures are common in frail institutionalised older patients. No convincing evidence exists regarding the optimal treatment strategy for those with a limited pre-fracture life expectancy, underpinning the importance of shared decision-making (SDM). This study investigated healthcare providers’ barriers to and facilitators of the implementation of SDM.
Annual risk of falls resulting in emergency department and hospital attendances for older people: an observational study of 781,081 individuals living in Wales (United Kingdom) including deprivation, frailty and dementia diagnoses between 2010 and 2020
Robyn Hollinghurst, Neil Williams, Rebecca Pedrick-Case, Laura North, Sara Long, Richard Fry, Joe Hollinghurst
doi : 10.1093/ageing/afac176
Age and Ageing, Volume 51, Issue 8, August 2022, afac176
falls are common in older people, but associations between falls, dementia and frailty are relatively unknown. The impact of the COVID-19 pandemic on falls admissions has not been studied.
Association of multimorbidity patterns with incident disability and recovery of independence among middle-aged and older adults
Jiayi Zhou, Melissa Y Wei, Jingyi Zhang, Hua Liu, Chenkai Wu
doi : 10.1093/ageing/afac177
Age and Ageing, Volume 51, Issue 8, August 2022, afac177
to identify multimorbidity patterns among middle-aged and older adults in China and examine how these patterns are associated with incident disability and recovery of independence.
Development and validation of a frailty index compatible with three interRAI assessment instruments
Rebecca Abey-Nesbit, Ulrich Bergler, John W Pickering, Prasad S Nishtala, Hamish Jamieson
doi : 10.1093/ageing/afac178
Age and Ageing, Volume 51, Issue 8, August 2022, afac178
a Frailty Index (FI) calculated by the accumulation of deficits is often used to quantify the extent of frailty in individuals in specific settings. This study aimed to derive a FI that can be applied across three standardised international Residential Assessment Instrument assessments (interRAI), used at different stages of ageing and the corresponding increase in support needs.
Dimensions of end-of-life preferences in the Swiss general population aged 55+
Carmen Borrat-Besson, Sarah Vilpert, Ralf J Jox, Gian Domenico Borasio, Jürgen Maurer
doi : 10.1093/ageing/afac162
Age and Ageing, Volume 51, Issue 8, August 2022, afac162
understanding end-of-life preferences in the general population and how they are structured in people’s minds is essential to inform how to better shape healthcare services in accordance with population expectations for their end of life and optimise communication on end-of-life care issues.
The association of hearing problems with social network strength and depressive symptoms: the cardiovascular health study
Sylvie D Dobrota, Mary L Biggs, Sheila Pratt, Rita Popat, Michelle C Odden
doi : 10.1093/ageing/afac181
Age and Ageing, Volume 51, Issue 8, August 2022, afac181
research on the association between hearing impairment and psychosocial outcomes is not only limited but also yielded mixed results.
Trajectories of sleep duration and timing before dementia: a 14-year follow-up study
Clémence Cavaillès, Isabelle Carrière, Maude Wagner, Jean-François Dartigues, Claudine Berr, Yves Dauvilliers, Isabelle Jaussent
doi : 10.1093/ageing/afac186
Age and Ageing, Volume 51, Issue 8, August 2022, afac186
given the complex relationship between sleep and neurodegenerative processes, it is important to examine whether changes in sleep patterns occur prior or close to dementia onset.
Epidemiology and impact of frailty in patients with atrial fibrillation in Europe
Marco Proietti, Giulio Francesco Romiti, Marco Vitolo, Stephanie L Harrison, Deirdre A Lane, Laurent Fauchier, Francisco Marin, Michael Näbauer, Tatjana S Potpara, Gheorghe-Andrei Dan, Aldo P Maggioni, Matteo Cesari, Giuseppe Boriani, Gregory Y H Lip, ESC-EHRA EORP-AF General Long-Term Registry Investigators
doi : 10.1093/ageing/afac192
Age and Ageing, Volume 51, Issue 8, August 2022, afac192
Frailty is a medical syndrome characterised by reduced physiological reserve and increased vulnerability to stressors. Data regarding the relationship between frailty and atrial fibrillation (AF) are still inconsistent.
Multiple hospital organisational factors are associated with adverse patient outcomes post-hip fracture in England and Wales: the REDUCE record-linkage cohort study
Rita Patel, Andrew Judge, Antony Johansen, Elsa M R Marques, Jill Griffin, Marianne Bradshaw, Sarah Drew, Katie Whale, Tim Chesser, Xavier L Griffin, Muhammad K Javaid, Yoav Ben-Shlomo, Celia L Gregson
doi : 10.1093/ageing/afac183
Age and Ageing, Volume 51, Issue 8, August 2022, afac183
Despite established standards and guidelines, substantial variation remains in the delivery of hip fracture care across the United Kingdom. We aimed to determine which hospital-level organisational factors predict adverse patient outcomes in the months following hip fracture.
Healthcare professionals’ experience with emergency department-based acute care performed within nursing homes
Stine Emilie Junker Udesen, Dorthe Susanne Nielsen, Nina Andersen, Claus-Henrik Rasmussen, Søren Mikkelsen, Mikkel Braband, Annmarie Lassen
doi : 10.1093/ageing/afac170
Age and Ageing, Volume 51, Issue 8, August 2022, afac170
hospital admissions of residents from nursing homes often lead to delirium, infections, mortality and reduced functional capacity. We initiated a new service, ‘emergency department-based acute care service’, maintained by consultants from an emergency department (ED) moving emergency care from the hospitals into nursing homes.
Total uncertainty: a systematic review and thematic synthesis of experiences of uncertainty in older people with advanced multimorbidity, their informal carers and health professionals
Simon Noah Etkind, Jiaqi Li, John Louca, Sarah A Hopkins, Isla Kuhn, Anna Spathis, Stephen I G Barclay
doi : /10.1093/ageing/afac188
Age and Ageing, Volume 51, Issue 8, August 2022, afac188
uncertainty pervades the complex illness trajectories experienced by older adults with multimorbidity. Uncertainty is experienced by older people, their informal carers and professionals providing care, yet is incompletely understood. We aimed to identify and synthesise systematically the experience of uncertainty in advanced multimorbidity from patient, carer and professional perspectives.
Trauma care in older people: charting a path from outlier to excellence
Gulraj S Matharu, Michael R Whitehouse, Karen Harding, Michael Kelly, Katherine Walsh
doi : 10.1093/ageing/afac163
Age and Ageing, Volume 51, Issue 8, August 2022, afac163
Trauma in older people leads to substantial morbidity and mortality. The National Hip Fracture Database (NHFD) has driven improved practice with units compared to identify outliers. In 2013, our unit was an outlier for mortality post hip fracture (30-day mortality 12.2% vs. 8.3% nationally).
A novel Artificial Intelligence-based tool to assess anticholinergic burden: a survey
Agostina Secchi, Hulkar Mamayusupova, Saber Sami, Ian Maidment, Simon Coulton, Phyo Kyaw Myint, Chris Fox
doi : 10.1093/ageing/afac196
Age and Ageing, Volume 51, Issue 8, August 2022, afac196
many medications possess anticholinergic activity. Their use is associated with a number of serious adverse effects including cognitive effects. The cumulative anticholinergic effect of medications as assessed by tools such as the anticholinergic burden scale (AchB) can identify people particularly at risk of anticholinergic side-effects. Currently, >20 tools are available for clinicians to use, but there is no consensus on the most appropriate tool.
Bacteraemia with native mitral valve endocarditis in an older patient from an unusual pathogen: Actinotignum schaalii
Arthi Premkumar, Roxanne Su Jen Lim, Chin Kwok Tan, Keng Bee Yap
doi : 10.1093/ageing/afac187
Age and Ageing, Volume 51, Issue 8, August 2022, afac187
Correction to: Family caregivers emphasise patience and personal growth: a qualitative analysis from the Caregiving Transitions Study
doi : 10.1093/ageing/afac180
Age and Ageing, Volume 51, Issue 8, August 2022, afac180
Correction to: Longitudinal associations between falls and future risk of cognitive decline, the Motoric Cognitive Risk syndrome and dementia: the Einstein Ageing Study
doi : 10.1093/ageing/afac128
Age and Ageing, Volume 51, Issue 8, August 2022, afac128
