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Frailty assessed by a wrist-worn device can predict hospitalisation and mortality in middle-aged and older adults: a UK Biobank study 英国生物银行的一项研究表明,通过佩戴在手腕上的设备评估的虚弱程度可以预测中老年人的住院治疗和死亡率
IF 6.7 2区 医学
Age and ageing Pub Date : 2025-08-01 DOI: 10.1093/ageing/afaf210
Yosuke Osuka, Lloyd L Y Chan, Matthew Brodie, Yoshiro Okubo, Stephen R Lord
{"title":"Frailty assessed by a wrist-worn device can predict hospitalisation and mortality in middle-aged and older adults: a UK Biobank study","authors":"Yosuke Osuka, Lloyd L Y Chan, Matthew Brodie, Yoshiro Okubo, Stephen R Lord","doi":"10.1093/ageing/afaf210","DOIUrl":"https://doi.org/10.1093/ageing/afaf210","url":null,"abstract":"Background Digital gait biomarkers (DGBs) from wrist-worn devices may offer a simple, convenient method for assessing frailty; however, their clinical validity has not been sufficiently verified. This study aimed to determine whether frailty assessed using DGBs is not inferior to the Fried frailty phenotype for predicting hospitalisation and mortality. Methods This longitudinal study included 10 156 adults (aged 43–81 years) with complete Fried frailty phenotype and DGB data from the UK Biobank. DGBs were extracted using validated algorithms on raw data from wrist-worn accelerometers over 7 days. DGB frailty was derived from DGBs and the Fried frailty phenotype. Results First hospitalisations and deaths were followed for 4.4 ± 2.7 and 7.2 ± 0.7 years, respectively. In these periods, 6148 (60.5%) were hospitalised (44 277 person-years follow-up) and 270 (2.7%) died (73 312 person-years follow-up). Cox proportional hazards models, adjusting for confounders, showed that both Fried and DGB frailties were predictive of hospitalisation (hazard ratios and 95% confidence intervals [CIs]: 1.29 [1.13–1.47] versus 1.33 [1.17–1.52]) and mortality (1.63 [1.01–2.62] versus 1.77 [1.14–2.74]). The mean differences (DGB frailty–Fried frailty) and 95% CIs in Harrell’s C-index for hospitalisation and mortality were 0.000 [−0.002 to 0.001] and 0.002 [−0.004 to 0.009], respectively, with the lower limit of the 95% CIs exceeding the prespecified noninferiority margin (−0.1). Conclusion DGB-derived frailty predicted hospitalisation and mortality and was not inferior to the Fried frailty phenotype. These findings support the clinical validity and potential utility of wearable devices in the assessment of frailty in clinical practice.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"719 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Six-month outcomes of layperson-delivered, telephone-based behavioural activation and mindfulness interventions on loneliness among older adults during the COVID-19 pandemic: The HEAL-HOA Dual Randomised Controlled Trial 2019冠状病毒病大流行期间,外行人提供的、基于电话的行为激活和正念干预对老年人孤独感的六个月结果:HEAL-HOA双随机对照试验
IF 6.7 2区 医学
Age and ageing Pub Date : 2025-08-01 DOI: 10.1093/ageing/afaf209
Da Jiang, Jojo Yan Yan Kwok, Dannii Yuen-lan Yeung, Vivien Foong Yee Tang, Namkee G Choi, Rainbow Tin Hung Ho, Lisa M Warner, Kee-Lee Chou
{"title":"Six-month outcomes of layperson-delivered, telephone-based behavioural activation and mindfulness interventions on loneliness among older adults during the COVID-19 pandemic: The HEAL-HOA Dual Randomised Controlled Trial","authors":"Da Jiang, Jojo Yan Yan Kwok, Dannii Yuen-lan Yeung, Vivien Foong Yee Tang, Namkee G Choi, Rainbow Tin Hung Ho, Lisa M Warner, Kee-Lee Chou","doi":"10.1093/ageing/afaf209","DOIUrl":"https://doi.org/10.1093/ageing/afaf209","url":null,"abstract":"Background Loneliness among older adults during the COVID-19 pandemic constituted a global public health crisis. This study aimed to determine whether layperson- and telephone-delivered behavioural activation (Tele-BA) and mindfulness (Tele-MF) interventions, compared to telephone befriending/support calls (Tele-BF; attention control), could reduce loneliness among older adults who were living alone, socioeconomically deprived and digitally excluded. Methods As part of the ‘Helping Alleviate Loneliness in Hong Kong Older Adults’ dual randomised controlled trial (RCT), 1151 older adults (Mage = 76.6, SD = 7.8) were randomly assigned to Tele-BA, Tele-MF or Tele-BF. Assessments were conducted at baseline (T0), 4-week (T1), 3-month (T2) and 6-month post-intervention (T3). All interventions (eight 30-minute telephone sessions over four weeks) were delivered by 185 trained lay counsellors who were 50–70 years old and reported feeling lonely. Outcomes The primary outcome was loneliness (assessed with the UCLA Loneliness Scale [UCLA-LS] and De Jong Gierveld Loneliness Scale [DJGL]). Secondary outcomes were perceived social support, social network size, perceived stress, life satisfaction, psychological well-being, sleep quality and depressive and anxiety symptoms. The UCLA-LS scores were significantly reduced in Tele-BA at T2 and T3 and in Tele-MF at T2, compared to Tele-BF. No significant difference was observed between Tele-BA and Tele-BF from T1 through T3 in DJGL. The Tele-MF group showed significantly higher DJGL scores at T1 and T3 than the Tele-BF group. Significant positive effects of Tele-BA, compared to Tele-BF, were found in perceived social support, perceived stress, psychological well-being, depression and anxiety. Tele-MF did not significantly differ from Tele-BF on these secondary outcomes. Interpretation The trial demonstrates the effectiveness of telephone-based psychosocial interventions delivered by laypersons in reducing loneliness. It also underscores the potential for training peer lay counsellors to telephone-deliver scalable psychosocial interventions for older adults experiencing loneliness.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"138 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Diagnosis accuracy of touchscreen-based testings for major neurocognitive disorders: a systematic review and meta-analysis 触摸屏检测对主要神经认知障碍的诊断准确性:一项系统回顾和荟萃分析
IF 6.7 2区 医学
Age and ageing Pub Date : 2025-07-31 DOI: 10.1093/ageing/afaf204
Nathavy Um Din, Florian Maronnat, Victoria Zolnowski-Kolp, Samir Otmane, Joël Belmin
{"title":"Diagnosis accuracy of touchscreen-based testings for major neurocognitive disorders: a systematic review and meta-analysis","authors":"Nathavy Um Din, Florian Maronnat, Victoria Zolnowski-Kolp, Samir Otmane, Joël Belmin","doi":"10.1093/ageing/afaf204","DOIUrl":"https://doi.org/10.1093/ageing/afaf204","url":null,"abstract":"Facing an increasing prevalence, diagnosis and management of dementia has become a global health challenge. While most cognitive assessments are based on paper tests, the current trend is to digitise them, using new technologies. We aimed to achieve a systematic review on touchscreen-based assessments for neurocognitive disorders. A search on four databases (PubMed, Embase, IEEE Xplore and Web of Science) was performed. Two investigators independently selected the articles and assessed their quality using the QUADAS-2 tool. We included articles whose participants were over 65 years, classified according to the presence/absence of major neurocognitive disorder (M-NCD) determined by conventional assessment of cognition, examined with a novel tool using a touchscreen device (tablet or smartphone). We finally retained 35 articles for the systematic review and 24 for the meta-analysis. Of the 35 articles included in the systematic review, participants had Alzheimer’s disease, Parkinson’s disease, vascular dementia, Lewy body disease or any type of dementia. Pooled sensitivity and specificity were 0.89 (95% CI: 0.86–0.91) and 0.88 (95% CI: 0.82–0.92), respectively. Performances of self-administered or brief assessment testings were similar to those of assessor-administered or longer duration testings. The major limitation of this review and meta-analysis is the multiplicity and diversity of methods (tools, cognition assessment and type of M-NCD), which make the comparison difficult. We conclude that brief and self-assessment touchscreen-based cognitive tests are appropriate and simple tools to screen major cognitive disorders that can be used in primary care. The study was registered in Prospero (CRD42022358725).","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"149 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144747238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
`Resigned agency' in older adults: a meta-ethnography of the lived experience of urinary incontinence 老年人的“辞职代理”:尿失禁生活经验的元民族志
IF 6.7 2区 医学
Age and ageing Pub Date : 2025-07-28 DOI: 10.1093/ageing/afaf207
Wayren Loke, Song Hen Soh, Pei Xuan Chua, Chun En Yau, Clyve Yu Leon Yaow, Yu Liang Lim, Qin Xiang Ng
{"title":"`Resigned agency' in older adults: a meta-ethnography of the lived experience of urinary incontinence","authors":"Wayren Loke, Song Hen Soh, Pei Xuan Chua, Chun En Yau, Clyve Yu Leon Yaow, Yu Liang Lim, Qin Xiang Ng","doi":"10.1093/ageing/afaf207","DOIUrl":"https://doi.org/10.1093/ageing/afaf207","url":null,"abstract":"Background Urinary incontinence (UI) is highly prevalent among older adults and often leads to significant physical, social and psychological consequences. Understanding these lived experiences is essential for developing effective, person-centred interventions that address not only the physiological but also the emotional and social dimensions of UI. Methods A qualitative systematic review following the PRISMA guidelines was conducted to identify original studies that explored older adults’ experiences with UI. Databases including PubMed, EMBASE, Scopus and PsycINFO were searched up to 30 November 2024. Eligible studies employed qualitative methods or mixed-methods designs with a clear qualitative component, examined participants aged 60 or older with any type of UI and focused on their perceptions, coping mechanisms or lived experiences. Meta-ethnography guided the synthesis of first-, second- and third-order constructs. Results Thirty-two studies were included. Five interlinked themes emerged: (i) normalisation of UI as a part of ageing, (ii) stigma and concealment, (iii) adaptive self-management strategies, (iv) barriers and critical triggers for help-seeking and (v) identity disruptions and relational strain. A central concept of ‘resigned agency’ was identified, where individuals acknowledged the burden of UI yet deferred help-seeking, navigating the condition through self-regulation and quiet endurance. Conclusions Older adults with UI often enact a form of resigned agency, balancing silent acceptance with personal coping strategies while delaying or avoiding formal care. For future work, interventions (such as destigmatising conversations and support) should be developed to address both individual illness representations and the social contexts that shape them, including stigma, cultural norms and healthcare responsiveness. Registration The study protocol was registered in PROSPERO (registration number CRD42024614673).","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"144 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluating the role of clinical decision support systems in medication safety for older people: a systematic review 评价临床决策支持系统在老年人用药安全中的作用:一项系统综述
IF 6.7 2区 医学
Age and ageing Pub Date : 2025-07-27 DOI: 10.1093/ageing/afaf206
Yaoyi Ng, Jovan Teng Yuan Hsu, Noelle Na En Ng, Joel Zuo Er Ong, Jolene Li Jun Hsu, Farisah Sulaimi, Hiang Khoon Tan, Ansel Shao Pin Tang, Qin Xiang Ng
{"title":"Evaluating the role of clinical decision support systems in medication safety for older people: a systematic review","authors":"Yaoyi Ng, Jovan Teng Yuan Hsu, Noelle Na En Ng, Joel Zuo Er Ong, Jolene Li Jun Hsu, Farisah Sulaimi, Hiang Khoon Tan, Ansel Shao Pin Tang, Qin Xiang Ng","doi":"10.1093/ageing/afaf206","DOIUrl":"https://doi.org/10.1093/ageing/afaf206","url":null,"abstract":"Background Older people are particularly vulnerable to medication errors and adverse drug events (ADEs) due to polypharmacy and age-related physiological changes. Clinical decision support systems (CDSS) presents itself as a potential solution for clinicians, but their effectiveness in care for older people remains uncertain. Objectives To evaluate the impact of CDSS on reducing potentially inappropriate medications (PIMs) and improving medication safety amongst older people. Design and Setting This was a systematic review of randomized controlled trials (RCTs) evaluating CDSS interventions in older populations (aged 65 or older). Methods A comprehensive search was conducted in OVID Medline, Embase, and Cochrane Library from inception to April 2025. Eligible studies were RCTs assessing CDSS in reducing PIM use and ADEs amongst older people. Data on medication safety outcomes (PIM, deprescription and ADEs) were extracted. The findings were narratively synthesized, and the certainty of evidence was evaluated using the GRADE framework. The Cochrane Risk-of-Bias 2 tool was also applied. Results A total of 16 RCTs (comprising 135,108 participants) were included. CDSS significantly reduced PIM initiation by up to 18% (moderate certainty) and improved deprescription rates, with intervention groups achieving 55.4% PIM discontinuation. However, CDSS had inconsistent effects on ADEs (low certainty). Conclusions CDSS improved prescribing practices by reducing inappropriate medication use in older people. However, its impact on ADEs was less evident. Implementation challenges such as clinician adherence, alert fatigue and system usability must be addressed to optimize CDSS effectiveness in care for older people. Further research is needed for long-term evaluation and refinement of CDSS.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"17 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144715318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
3171 Better mealtimes for people living with dementia in care homes: a feasibility study 3171改善老年痴呆症患者的用餐时间:一项可行性研究
IF 6.7 2区 医学
Age and ageing Pub Date : 2025-07-04 DOI: 10.1093/ageing/afaf133.063
J Faraday, P Van der Graaf, A Hand
{"title":"3171 Better mealtimes for people living with dementia in care homes: a feasibility study","authors":"J Faraday, P Van der Graaf, A Hand","doi":"10.1093/ageing/afaf133.063","DOIUrl":"https://doi.org/10.1093/ageing/afaf133.063","url":null,"abstract":"Introduction Some people living with dementia have difficulties at mealtimes, with significant implications for physical and mental health (Abdelhamid et al., 2016). Care home staff provide direct care at mealtimes (Skills for Care, 2015), but there is a shortage of high-quality dementia care training focusing on mealtimes (Fetherstonhaugh et al., 2019). This study tested the feasibility and acceptability of an evidence-based training programme promoting better mealtime care for people living with dementia (Faraday et al., 2022). Method The study comprised a before-and-after design using multiple methods of data collection and analysis. The qualitative arm of the study is reported here. The training programme was delivered in three care homes in the UK, chosen for differences in context, size and ownership. Trainees were recruited from a range of different roles across the homes, including care staff, kitchen staff and management staff. After training, participants attended focus groups to elicit views on their experience of the training and suggestions for improvement. Data from the focus groups were analysed using reflexive thematic analysis (Braun & Clarke, 2022). Results Analysis to date has generated five themes: Need a mix of experience in the room; More dementia-specific content; Make the most of group discussions; Scenarios should be nuanced and complex; One-day delivery is easiest; Facilitator experience and skill outweighs profession. These themes will inform modification of the training programme’s content and format, to increase its acceptability and usefulness to care home staff, prior to wider roll-out and evaluation. At the same time, a short animation has been co-produced with experts by experience to convey key messages from the training as accessibly as possible (https://vimeo.com/1009856313). Conclusion(s) This study has reduced uncertainty about the training programme’s acceptability, so that it is more likely to become embedded in practice and improve mealtime care for people living with dementia.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"6 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
3051 GaitKeeper: revolutionising standardised gait speed measurement with AI-enabled mobile technology 3051 GaitKeeper:革命性的标准化步态速度测量与人工智能支持的移动技术
IF 6.7 2区 医学
Age and ageing Pub Date : 2025-07-04 DOI: 10.1093/ageing/afaf133.076
N Davey, G Harte, A Boran, P McElwaine, S P Kennelly
{"title":"3051 GaitKeeper: revolutionising standardised gait speed measurement with AI-enabled mobile technology","authors":"N Davey, G Harte, A Boran, P McElwaine, S P Kennelly","doi":"10.1093/ageing/afaf133.076","DOIUrl":"https://doi.org/10.1093/ageing/afaf133.076","url":null,"abstract":"Introduction Gait speed, often referred to as the ‘sixth vital sign,’ is an important health indicator in older adults, predicting morbidity and functional status. This study evaluated GaitKeeper, a novel artificial intelligence (AI)-enabled mobile technology that integrates augmented reality (AR). GaitKeeper is designed to standardise the measurement of gait speed and address inconsistencies commonly encountered in traditional clinical settings due to varied assessment techniques. Methods This study was conducted in two phases to validate GaitKeeper against Vicon and GaitRite, two established gait analysis systems. Phase One involved thirty-five healthy volunteers from a university setting, comparing gait speed, stride length and step length between GaitKeeper and Vicon. Phase Two tested GaitKeeper in a clinical environment with thirty participants diagnosed with mild cognitive impairment to assess the comparative accuracy and reliability of GaitKeeper and GaitRite in recording gait dynamics. Results In Phase One, GaitKeeper demonstrated high external consistency with the Vicon system, showing less than 2% variance in measurements of gait speed and stride length. Spearman correlation coefficients were 0.947 for gait speed and 0.989 for stride length, both statistically significant (p < 0.0001). Phase Two established GaitKeeper’s reliability in clinical assessments, exhibiting a strong Pearson correlation coefficient of 0.71 for stride length with GaitRite—also highly significant (p < 0.0001). The Spearman correlation coefficient for gait speed was 0.918 (p = 0.000) indicating a high degree of consistency between the two systems. Conclusion GaitKeeper has been validated as a reliable and precise tool, providing standardised measurements of gait speed in a timely manner. Additionally, GaitKeeper supports longitudinal monitoring, crucial for managing chronic conditions and rehabilitation programmes. Its versatility allows for deployment in a variety of settings, from traditional hospital environments to home-based rehabilitation where routine gait speed assessments can be challenging. This adaptability positions GaitKeeper to revolutionise gait analysis across diverse healthcare contexts.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"6 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
2505 Barriers perceived by medical students when considering a career in geriatric medicine 2505医科学生在考虑从事老年医学职业时遇到的障碍
IF 6.7 2区 医学
Age and ageing Pub Date : 2025-07-04 DOI: 10.1093/ageing/afaf133.061
G Fisher, S True
{"title":"2505 Barriers perceived by medical students when considering a career in geriatric medicine","authors":"G Fisher, S True","doi":"10.1093/ageing/afaf133.061","DOIUrl":"https://doi.org/10.1093/ageing/afaf133.061","url":null,"abstract":"Introduction Despite the UK’s increasing life expectancy, and increase in the elderly population, there is an overwhelming lack of Geriatricians in the UK; as of 2022, there is only 1 consultant Geriatrician per 8031 individuals over the age of 65 (BGS, 2023). To meet the complex care needs of this population, there must be a focus on increasing the interest that doctors have toward Geriatric Medicine, with the overall aim being to recruit more doctors into the speciality. Method The aim of this review was to investigate what factors medical students perceive as barriers to pursuing a career in Geriatric Medicine and then, from identifying these, generate a set of comprehensive suggestions as to how to tackle these barriers at a medical school level to increase the interest and ultimately uptake of Geriatric Medicine. The qualitative review contains literature published between 2003 and 2023 accessed using MedLine. Results Six themes were identified in answering our question: (a) high emotional burden, (b) caring for patients with complex needs, (c) negative preconceptions of non-clinical factors (prestige, salary, career progression), (d) negative influence of clinical educators, (e) lack of intellectual stimulation and (f) lack of exposure to the speciality and the elderly. Conclusion The barriers perceived by medical students when considering Geriatrics as a speciality are complex and multifaceted; these barriers must be tackled promptly in order to secure the next generation of Geriatricians. We suggest that this work can be used as a foundation for further qualitative studies with UK medical students to investigate barriers that are specific to UK students. From this, interventional courses designed to increase Geriatric Medicine uptake could be developed to strengthen the UK Geriatric Medicine workforce.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"6 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
3124 Rehabilitation after an episode of delirium: mixed methods process evaluation of the RecoverED multi-site feasibility study 3124谵妄发作后的康复:多地点康复可行性研究的混合方法过程评估
IF 6.7 2区 医学
Age and ageing Pub Date : 2025-07-04 DOI: 10.1093/ageing/afaf133.081
S Raghuraman, A Mahmoud, A Bingham, A Laverick, K Chandler, L Clare, L Allan, S Morgan-Trimmer
{"title":"3124 Rehabilitation after an episode of delirium: mixed methods process evaluation of the RecoverED multi-site feasibility study","authors":"S Raghuraman, A Mahmoud, A Bingham, A Laverick, K Chandler, L Clare, L Allan, S Morgan-Trimmer","doi":"10.1093/ageing/afaf133.081","DOIUrl":"https://doi.org/10.1093/ageing/afaf133.081","url":null,"abstract":"Introduction A process evaluation was conducted alongside a multi-site feasibility trial of RecoverED, a multicomponent delirium rehabilitation intervention for older people in post-acute settings. Up to 10 sessions of the home-based intervention is delivered by a multidisciplinary healthcare team. A modified Conceptual Model for Implementation Fidelity was used. Findings on implementation and acceptability are presented. Design and Methods A mixed-methods design was employed, and participants included older adults with delirium, their carers, and trained healthcare professionals (HCPs) from six NHS hospitals in the UK. Adherence to content, dose, and coverage, as well as moderating factors such as recruitment, context, participant responsiveness, delivery quality, and intervention complexity, were assessed. Data included in-depth interviews, focus groups, trial documentation, and training, and supervision logs. Mixed-methods findings were triangulated. Results Nineteen participant-carer pairs were recruited. Five older people, 9 carers, and 8 HCPs were interviewed post-intervention. Seven HCPs participated in two focus groups. Evaluating adherence to content was complex since the intervention is person-centred and personalised. Psychosocial support was delivered more frequently than planned for each individual, while physical rehabilitation and functional recovery activities were delivered less than planned. The value of participant-led goals was emphasised, with high satisfaction, engagement, and perceived value. Implementation was according to the theorised delivery approach, and participants expressed positive views on the quality of delivery. While HCPs found the training comprehensive, they preferred a more interactive and practical format. Teams need to be specifically staffed and co-located for effective coordination and supervision of RecoverED. Most withdrawals (N = 10) were due to complex needs or impairments. No minority ethnic participants were recruited. Conclusion The RecoverED intervention was found to be acceptable; however, recruitment challenges suggest that acceptability and fidelity to dose and coverage should be interpreted with caution. Implementation fidelity to the delivery approach was high and well-perceived.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"48 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
3088 Can the length of stay on intermediate care units (ICUs) be reduced for non-weight bearing patients? 3088非负重病人在中间护理病房的住院时间可否缩短?
IF 6.7 2区 医学
Age and ageing Pub Date : 2025-07-04 DOI: 10.1093/ageing/afaf133.016
S Pannell, E Clift
{"title":"3088 Can the length of stay on intermediate care units (ICUs) be reduced for non-weight bearing patients?","authors":"S Pannell, E Clift","doi":"10.1093/ageing/afaf133.016","DOIUrl":"https://doi.org/10.1093/ageing/afaf133.016","url":null,"abstract":"Introduction Fragility Fractures can lead to immediate complications, decline in health status, increase in hospital stay, increased care needs and reduction in the quality of life (Court-Brown C Clement N, Duckworth A, The Bone and Joint Journal, 2014 96-B(3) 366–372). However, the National Osteoporosis Society (2017) reported 80% of non-hip fractures were not offered strength or balance exercises It is estimated that fragility fractures cost the UK £4.4 billion which includes £1.1 billion for social care (Office for Health Improvement & Disparities, 2022). At Sussex Community NHS Foundation Trust, non-weight bearing (NWB) patients have prolonged bed-based stays. Complex patients cannot be discharged home when NWB as there is no commissioned social care pathway. These patients are seen as low priority for rehabilitation. The aim of the project was to reduce the length of stay for NWB orthopaedic patients. Method Baseline data of 10 inpatients from the Sussex Community NHS Foundation Trust ICU, discharged in April 24 was scrutinised. The team articulated the issues for NWB in a fishbone diagram, and a tailored programme of resistance strengthening and balance exercises was introduced for 8 NWB patients in May and June 2024, as a PDSA cycle. This included leg ankle weights and dumbbells to carry out chair and standing exercises (when appropriate), in addition to routine group physiotherapy sessions. All patients were seen 2–3 times a week. Results The average length of stay for NWB patients reduced by 14 days. The number of therapy contact sessions reduced to 2.1 post orthopaedic review and patients were weight bearing again. Conclusion Providing a tailored strengthening exercise programme that focuses on the non-weight bearing phase of the patient’s orthopaedic rehabilitation journey reduced the length of stay on the intermediate care unit, and the physiotherapy interventions once weight bearing.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"7 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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