Introduction Both frailty and HF are common in the elderly population. Elderly HF patients have an increased risk of frailty, and frail elderly patients are at a higher risk of developing HF. Frailty is an independent predictor of mortality in cardiovascular disease. Sarcopenia(defined as decreased muscle mass and muscle strength and/or performance)is also prevalent in HF patients and may progress to cardiac cachexia. HF may induce sarcopenia, and sarcopenia may contribute to the poor prognosis of HF. Aims: To assess the prevalence of frailty in older HF inpatients • To determine the risk of
Introduction: It has been considered that widowed persons have a higher risk of death. This study intends to explore whether social participation can improve this trend. Methods: A longitudinal study database was conducted to explore the trend of survival and its change with social participation in the widowed persons. The Taiwan Longitudinal Study on Aging (TLSA), based on four consecutive waves of longitudinal follow-up data in 1999, 2003, 2007 and 2011 was linked with the National Death Registry from 1999 through 2012. Results: Totally, there were 1,417 widowed persons and 4,500 non-widowed
Aim Dysphagia affects up to 70% of nursing home residents and incorrect management can result in choking and aspiration pneumonia. (SLT). This study aimed to understand the mealtime experience of residents with dysphagia, how this compared with best practice for preventing aspiration pneumonia and what factors influenced their care. Methods: Mealtime care of residents with dysphagia from 2 care homes was observed using structured tool to capture 12 elements of expected practice related to safe nutrition/hydration care and compare observed practice with recommendations in Speech and language
Introduction: With the unprecedented population growth of older adults worldwide, higher life-expectancies are creating increasingly more multigenerational interaction. Funded by the General Research Fund of the Research Grant Council in Hong Kong, the study examined the effects of telephone-administered perspective-taking intervention in the context of intergenerational caregiving. The data was collected from 2019 to 2021 in Hong Kong. Method: Through a cluster-randomized trial, one-hundred seventy-six adult child caregivers of persons living with Alzheimer’s disease (AD) were randomized into
Introduction: Post-diagnostic support is key to ensuring the well-being of people with dementia and unpaid carers. The COVID-19 pandemic has caused a shift from in-person to remote service delivery, often with the use of information communication technologies (ICT) formats. This systematic review examined how ICT has been used to access remote post-diagnostic support services that address the needs people with dementia, or those of dyad, and explored care recipients’ views on accessing dementia-related support remotely. Method: Concepts relating to dementia and ICT were searched across six
Introduction: Poor muscle health is associated with a series of chronic and metabolic conditions that are prevalent in individuals who chronically experience poor-quality sleep. But there is no study deciphering the role of sleep deprivation on muscle ageing. Therefore, in the present study we have measured the ultrastructure, histopathology, and oxidative stressors in soleus muscle of wistar rat after sleep deprivation and recovery sleep. Material and Methods: The experiments were conducted in18 rats of three groups. Group I rats had normal sleep wake cycle, Group II rats were subjected to 24
Introduction: Acute healthcare use varies by age, with older adults the highest users of most acute healthcare services. International reports have highlighted increased use of Emergency Department (ED) services by older adults . Older adults who visit the ED may be admitted to hospital or discharged home and are vulnerable to adverse outcomes including cognitive decline, falls, readmission, mortality and hospital acquired limitations in activities of daily living. Using data from The Irish Longitudinal Study on Ageing (TILDA), the aim of this study was to investigate the impact of acute
Introduction There is an association between frailty and arterial stiffness. However, arterial stiffness does not uniformly correlate with the spectrum of frailty states. Both oxidative stress and inflammaging contribute to vascular aging. There are no human studies exploring links between arterial stiffness, oxidative stress, inflammaging and frailty. Our objective is to investigate arterial stiffness and inflammaging as predictors of frailty states. Methods An observational longitudinal cohort study will be used to examine the association between arterial stiffness, oxidative stress, and
Introduction: Dehydration is a major contributing factor to morbidity and mortality in elderly patients, as they are at greater risk and more vulnerable to the consequences of inadequate fluid intake. Care of the Elderly (COE) wards are set up to meet the specific care needs of elderly patients, however, these care needs are not consistently met on medical outlier wards at NUH. This project aimed to improve hydration-related patient care on outlier wards using a sustainable intervention by increasing average daily fluid intake (ADFI) by 50% and patients with drinks within an arm's reach by 50%
Introduction: The Trauma Audit and Research Network report “Major Trauma in Older People” highlighted the need to recognise falls in older patients as a mechanism leading to potentially life-threatening injuries. Reasons behind falls can be equally serious and must be addressed concurrently. A Frail Trauma Pathway was introduced in the Emergency Department (ED) of a Major Trauma Centre (MTC) and subsequent audit revealed it was underutilised. We relaunched the Frail Trauma Pathway incorporating a checklist with the aim of improving patient care. Method: Retrospective data was collected over
INTRODUCTION The aim of this quality improvement project was to assess the medical discharge letters written by medical colleagues at this trust against the guidelines set by the Royal College of Physicians. The target was to achieve at least 90% compliance across the components evaluated at the end of this project. METHOD This quality improvement project evaluated medical discharge letters from three medical wards. Following the application of filtering criteria, a sample size of approximately 20 patients was randomly selected for data collection. Sections that were evaluated in the discharge
Introduction: NICE guidance recommends that doctors need to identify patients who are approaching their final year of life, through the utilisation of tools such as the Clinical Frailty Score (CFS). The 'Getting it right first time' (GIRFT) document recommended that all local health systems identify older people in the last phase of life and offer them Advanced Care Planning (ACP). Wigan has a large population of frail patients who would benefit from ACP discussions. Aim: Initiate a strategy for identifying patients with severe frailty and establish a process for implementing ACP. Method
Introduction In 2017 NHS England introduced proactive identification of frailty into the General Practitioners (GPs) Contract. There is currently little information as to how this policy has been operationalised by front-line clinicians, their working understanding of frailty, or perceptions of impact on patient care. Evidence from international settings suggests primary care clinicians may have mixed interpretations of frailty, with important implications for their willingness to support different frailty interventions. We aimed to explore the conceptualisation of frailty, and how community
Introduction The Norman Power Centre (NPC) is an Intermediate Care Unit, in Birmingham, UK, providing enhanced assessment beds (EAB) where patients undergo functional assessment after an acute admission. There is little published data regarding the outcomes for patients admitted to EAB, so we set out to analyse outcomes in our unit. Method Data was collected from 50 patients who were discharged from EAB between September 2021 and March 2022. Results The mean length of stay was 36 days, median was 29 days. Of the 50 patients: 4 went home with no services, 9 went home with Early Intervention
Introduction The Norman Power Centre (NPC) is a 32 bedded Intermediate Care Unit, run by an acute hospital trust in Birmingham, UK, for patients who require ongoing 24 hour care, rehabilitation or further assessment, but do not need to be in an acute hospital setting. These frail patients attend numerous outpatient hospital appointments, but rarely do staff receive communication back from these outpatient reviews. This can lead to delays in implementing specialist management plans, with potential for adverse outcomes for patients and increased staff workload in seeking out the required
Introduction: Procollagen-N-terminal-peptide(P1NP) is a bone formation marker. Bisphosphonates lead to a reduction in P1NP levels and levels are significantly elevated shortly after fracture. In older patients taking bisphosphonates who have had a further osteoporotic fracture there is a lack of evidence to guide ongoing osteoporotic management. Objectives: To assess if measuring P1NP in patients receiving Bisphosphonates treatment who develop neck of femur fractures helps guide further management in regards to long term bone protection treatment. Methodology: Retrospective descriptive cohort
Introduction Treatment burden is the workload of healthcare and its impact on patient well-being and functioning. High treatment burden in other long-term conditions is associated with poor health outcomes. This study aimed to determine the extent and levels of treatment burden among people with Parkinson’s (PwP) and their caregivers, and explore modifiable factors. Methods A cross-sectional survey using the Multimorbidity Treatment Burden Questionnaire (MTBQ) to measure treatment burden was conducted among adults (age >18 years) diagnosed with Parkinson’s or self-identified caregivers of
Introduction Patients with frailty who have emergency admissions are at risk of mortality and may benefit from Anticipatory Care Planning (ACP). Appropriate identification, to target limited resource in an in-patient environment can be challenging. We conducted a prospective study on a cohort of frail in-patients with a hospital admission of ≥ 72 hours duration. We aimed to evaluate the effectiveness of the SPICT tool alongside Clinical Frailty Score (CFS) as a predictor of mortality to improve our targeting of patients for ACP. Method. On a single day a SPICT form was completed prospectively
Introduction Important parts of the comprehensive geriatric assessment (CGA) include medication review and assessment of bone health. Such aspects of CGA can be missed in clinical practice in the busy acute hospital setting. We aimed to improve performance of medication review, and assessment of bone health in patients with falls in the form of vitamin D levels and Fracture Risk Assessment Tool (FRAX) scoring, in admissions to the acute Care of the Elderly (COTE) team in a district general hospital in South Wales. Methodology Data were collected from documentation of the initial review of
Background: In response to the COVID pandemic when new robust discharge criteria were introduced to facilitate early discharge to optimise hospital capacity, Post Discharge Frailty Support (PDFS) was established. PDFS provides nurse-led telephone follow-up for patients discharged primarily from the Emergency Department (ED) and the Acute Frailty Assessment Unit (AFAU). Objectives: We aim to provide continuity of care by following up frail elderly patients at home, reviewing their medical, functional and social progress post discharge and ensuring they received adequate support to avoid