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Age and Ageing

J Hewitt, B Carter, K McCarthy, L Pearce, J Law, F V Wilson, H S Tay, C McCormack, M J Stechman, S J Moug, P K Myint
BACKGROUND: frail patients in any age group are more likely to die than those that are not frail. We aimed to evaluate the impact of frailty on clinical mortality, readmission rate and length of stay for emergency surgical patients of all ages. METHODS: a multi-centre prospective cohort study was conducted on adult admissions to acute surgical units. Every patient presenting as a surgical emergency to secondary care, regardless of whether they ultimately underwent a surgical procedure was included...
February 19, 2019: Age and Ageing
Nazmus Saquib, Robert Brunner, Manisha Desai, Candyce Kroenke, Lisa W Martin, Martha Daviglus, Norrina B Allen, Jennifer Robinson, Hilary Tindle, Marcia L Stefanick
Background: physical and mental health are important risk factors for cardiovascular disease (CVD) incidence and death among postmenopausal women. The objective of this study was to assess whether changes in physical and mental health were associated with CVD incidence and death. Methods: in the Women's Health Initiative Observational Study, 48,906 women (50-79 years) had complete data at baseline on physical and mental health (assessed with Short Form-36) and key covariates...
February 11, 2019: Age and Ageing
Rebecca Cole, Sanja Thompson, Sergios Gargalas
A case report of a 94-year-old, previously well male patient who presented with fever thought to be caused by community acquired pneumonia, new unilateral hearing loss and reduced consciousness. Despite antibiotic treatment he continued to deteriorate. Brain imaging with computer tomography and magnetic resonance imaging revealed a left otomastoiditis with osteomyelitis of the skull base, associated with an adjacent subdural empyema. He was also found to have a venous sinus thrombosis, most likely secondary to otitis media...
February 6, 2019: Age and Ageing
Kirsty Bowman, Madhav Thambisetty, George A Kuchel, Luigi Ferrucci, David Melzer
Background: overweight or obesity at ages <65 years associates with increased dementia incidence, but at ≥65 years estimates are paradoxical. Weight loss before dementia diagnosis, plus smoking and diseases causing weight loss may confound associations. Objective: to estimate weight loss before dementia diagnosis, plus short and longer-term body mass index associations with incident dementia in 65-74 year olds within primary care populations in England. Methods: we studied dementia diagnosis free subjects: 257,523 non-smokers without baseline cancer, heart failure or multi-morbidity (group A) plus 161,927 with these confounders (group B), followed ≤14...
February 6, 2019: Age and Ageing
Andrea C Tricco, Sonia M Thomas, Areti Angeliki Veroniki, Jemila S Hamid, Elise Cogo, Lisa Strifler, Paul A Khan, Kathryn M Sibley, Reid Robson, Heather MacDonald, John J Riva, Kednapa Thavorn, Charlotte Wilson, Jayna Holroyd-Leduc, Gillian D Kerr, Fabio Feldman, Sumit R Majumdar, Susan B Jaglal, Wing Hui, Sharon E Straus
Background: Falls are a common occurrence and the most effective quality improvement (QI) strategies remain unclear. Methods: We conducted a systematic review and network meta-analysis (NMA) to elucidate effective quality improvement (QI) strategies for falls prevention. Multiple databases were searched (inception-April 2017). We included randomised controlled trials (RCTs) of falls prevention QI strategies for participants aged ≥65 years. Two investigators screened titles and abstracts, full-text articles, conducted data abstraction and appraised risk of bias independently...
February 5, 2019: Age and Ageing
Yoshihiro Sato, Haruko Kuno, Takeshi Asoh, Yoshiaki Honda, Kotaro Oizumi
No abstract text is available yet for this article.
February 5, 2019: Age and Ageing
Lona Mody, Manisha Juthani-Mehta
No abstract text is available yet for this article.
February 4, 2019: Age and Ageing
Tessa J Parsons, Efstathios Papachristou, Janice L Atkins, Olia Papacosta, Sarah Ash, Lucy T Lennon, Peter H Whincup, Sheena E Ramsay, S Goya Wannamethee
Background: increasing numbers of older adults are living with frailty and its adverse consequences. We investigated relationships between diet quality or patterns and incident physical frailty in older British men and whether any associations were influenced by inflammation. Methods: prospective study of 945 men from the British Regional Heart Study aged 70-92 years with no prevalent frailty. Incident frailty was assessed by questionnaire after 3 years of follow-up...
January 22, 2019: Age and Ageing
Miles D Witham, Helen C Roberts, John Gladman, David J Stott, Avan Aihie Sayer
Academic geriatric medicine activity lags behind the scale of clinical activity in the specialty. A meeting of UK academic geriatricians was convened in March 2018 to consider causes and solutions to this problem. The meeting highlighted a lack of research-active clinicians, a perception that research is not central to the practice of geriatric medicine and a failure to translate discovery science to clinical studies. Solutions proposed included better support for early-career clinical researchers, schemes to encourage non-University clinicians to be research-active, wider collaboration with organ specialists to broaden the funding envelope, and the need to co-produce research programmes with end-users...
January 22, 2019: Age and Ageing
Patricia Harkins, Helen O'Brien, Deirdre McCartan, Nizrull Nasir, Billy Twomey, Karthika Srikumar, Tara Coughlan, Sean Kennelly, Paul McElwaine, Desmond O'Neill, Dan Ryan, Collins Ronan
No abstract text is available yet for this article.
January 22, 2019: Age and Ageing
Alex Bottle, Dani Kim, Benedict Hayhoe, Azeem Majeed, Paul Aylin, Andrew Clegg, Martin R Cowie
Background: frailty has only recently been recognised as important in patients with heart failure (HF), but little has been done to predict the first hospitalisation after diagnosis in unselected primary care populations. Objectives: to predict the first unplanned HF or all-cause admission after diagnosis, comparing the effects of comorbidity and frailty, the latter measured by the recently validated electronic frailty index (eFI). Design: observational study...
January 9, 2019: Age and Ageing
Andrea L Joughin, Judith S L Partridge, Tessa O'Halloran, Jugdeep K Dhesi
Introduction: national reports highlight deficiencies in the care of older patients undergoing surgery. A 2013 survey showed less than a third of NHS trusts had geriatrician-led perioperative medicine services for older surgical patients. Barriers to establishing services included funding, workforce and limited interspecialty collaboration. Since then, national initiatives have supported the expansion of geriatrician-led services for older surgical patients. This repeat survey describes geriatrician-led perioperative medicine services in comparison with 2013, exploring remaining barriers to developing perioperative medicine services for older patients...
January 9, 2019: Age and Ageing
Alexander N Allen, Robert Clarke, Martin Shipley, David A Leon
Aims and objectives: to examine the hypothesis that obesity is protective for dementia, we compared the associations of death from dementia with body weight and body mass index (BMI) in both middle and old age. Design: height and weight were measured in a prospective study of 19,019 middle-aged men in the Whitehall study in 1967-70 and in 6,158 surviving participants at resurvey in 1997. Cox regression was used to examine the associations of death from dementia over a 40-year period with weight or BMI measured by health professionals in middle and old age adjusting for age, smoking habits, employment grade and marital status...
January 9, 2019: Age and Ageing
Anouk Overbeek, Ida J Korfage, Bernard J Hammes, Agnes van der Heide, Judith A C Rietjens
Background: Advance Care Planning (ACP) may prepare relatives of frail older patients for future decision-making. Objective: to investigate (1) how bereaved relatives of frail older patients experience ACP conversations and (2) whether ACP has an effect on relatives' preparation for decision-making and on their levels of anxiety and depression. Design: cluster randomised controlled trial. Setting: residential care homes in the Netherlands and community setting...
January 7, 2019: Age and Ageing
R Peters, N Beckett, R Antikainen, K Rockwood, C J Bulpitt, K J Anstey
Background: there is a growing body of evidence demonstrating an association between subjective memory complaints (SMC) and an increased risk of incident cognitive decline or dementia. To date this has not been examined in hypertensive older adults, a prevalent and growing population group at high risk of cognitive decline. Methods: using data from participants in the Hypertension in the Very Elderly Trial cohort the association between baseline SMC and incident cognitive decline and dementia was examined using Cox proportional hazard regression...
January 7, 2019: Age and Ageing
Morten Tange Kristensen, Buket Öztürk, Niels Dieter Röck, Annette Ingeman, Henrik Palm, Alma B Pedersen
Background: early mobilization after hip fracture (HF) is an important predictor of outcome, but knowledge of the consequences of not achieving the pre-fracture basic mobility status in acute hospital recovery is sparse. Objective: we examined whether the regain of pre-fracture basic mobility status evaluated with the cumulated ambulation score (CAS) at hospital discharge was associated with 30-day post-discharge mortality and readmission. Design: this is a population-based cohort study...
January 7, 2019: Age and Ageing
Ian P Donald
All medical admissions should receive risk assessment for the value of prophylaxis against venous thromboembolism. Unfortunately, for such patients the risk of thromboembolism is closely balanced with the risk of haemorrhage exaggerated by chemical prophylaxis. The recent NICE guideline continues to recommend comprehensive risk assessment, and to use prophylaxis where the risk of thromboembolism exceeds the risk of bleeding. The widely used Department of Health Risk Assessment Tool does not rank the risks of thromboembolism and bleeding, but NICE was unable to mandate another assessment tool fit for the purpose in the UK...
January 7, 2019: Age and Ageing
Adeela Usman, Sarah Lewis, Kathryn Hinsliff-Smith, Annabelle Long, Gemma Housley, Jake Jordan, Heather Gage, Tom Dening, John R F Gladman, Adam L Gordon
Introduction: care home residents are often unable to complete health-related quality of life questionnaires for themselves because of prevalent cognitive impairment. This study compared care home resident and staff proxy responses for two measures, the EQ-5D-5L and HowRU. Methods: a prospective cohort study recruited residents ≥60 years across 24 care homes who were not receiving short stay, respite or terminal care. Resident and staff proxy EQ-5D-5L and HowRu responses were collected monthly for 3 months...
January 7, 2019: Age and Ageing
Maria Bjerk, Therese Brovold, Dawn A Skelton, Teresa Liu-Ambrose, Astrid Bergland
Background: falls have serious consequences for quality of life (QOL) and contribute substantially to the global burden of disease. Home care is an important arena to address falls prevention and QOL, but this vulnerable group of older adults is underrepresented in health research. This study explores the effects of a falls prevention exercise programme on health-related quality of life (HRQOL), physical function and falls self-efficacy in older fallers receiving home care. Methods: the study design is a parallel-group randomised controlled trial...
January 7, 2019: Age and Ageing
Gavin Wylie, Claire Torrens, Pauline Campbell, Helen Frost, Adam Lee Gordon, Hylton B Menz, Dawn A Skelton, Frank Sullivan, Miles D Witham, Jacqui Morris
Background: foot problems are independent risk factors for falls in older people. Podiatrists diagnose and treat a wide range of problems affecting the feet, ankles and lower limbs. However, the effectiveness of podiatry interventions to prevent falls in older people is unknown. This systematic review examined podiatry interventions for falls prevention delivered in the community and in care homes. Methods: systematic review and meta-analysis. We searched multiple electronic databases with no language restrictions...
January 7, 2019: Age and Ageing
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