Age and ageing最新文献

{"title":"3118 NOGG guidelines and application in practice: analysis of 3 years of NHFD data and bone health service provision at Royal Albert","authors":"Ð Alićehajić-Bečić","doi":"10.1093/ageing/afaf133.026","DOIUrl":"https://doi.org/10.1093/ageing/afaf133.026","url":null,"abstract":"Introduction National Osteoporosis Guideline Group (NOGG) guidelines published in 2022 significantly changed practice in orthogeriatric setting with recommendation for early treatment to address ‘imminent fracture risk’ and recommendation for greater use of injectable therapies for those at ‘very high fracture risk’. Intravenous zolendronate is now considered first line treatment, particularly post hip fracture but additional services for provision of injectable therapies have not been created to address this. The aim of this work was to analyse treatment choices for patients entered on National Hip Fracture Database (NHFD) for bone protection and assess current service provision against ongoing need. Method Data was collected retrospectively, using NHFD dataset for Royal Albert Edward Infirmary over 3 year period (2022–2024). Details of treatment choice were analysed across the 3 years and service provision for continuation of injectable therapies assessed against patient need. Results There were a total of 420 in 2022, 432 in 2023 and 381 in 2024 patients who were entered on the NHFD locally. In 2022, 192 patients (45%) of patients were discharged on oral bisphosphonate, whereas this number went down to 174 (40%) in 2023 and only 22 in 2024 (6%). Meanwhile, use of zolendronate nearly tripled from 56 (13%) in 2022 to 149 (39%) in 2024. Denosumab use also increased from 75 (18%) in 2022 to 107 (28%) in 2024. Overall, more than two thirds of patients were discharged home on injectable antiresorptive therapy in 2024 following a hip fracture. Conclusions Updated guidelines on optimal bone protection after hip fracture advise greater use of injectable antiresorptive drugs. National initiatives should focus on ensuring equitable access to these treatments both via hospital day case unit provision but also via delivery of injectable therapies for osteoporosis in community, as we aim to deliver more healthcare outside of hospital environments.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"14 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565868","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}

{"title":"3055 Is appetite related to the occurrence of future falls in older adults with upper limb fracture?","authors":"H Saravanan, K Ibrahim, N J Cox","doi":"10.1093/ageing/afaf133.077","DOIUrl":"https://doi.org/10.1093/ageing/afaf133.077","url":null,"abstract":"Introduction Older people can commonly experience reduced appetite and it can be assessed very simply by questionnaires such as the Simplified Nutritional Appetite Questionnaire (SNAQ). Decreased appetite is associated with sarcopenia and frailty, which in turn are related to falls. The aim is to assess if screening for poor appetite might aid in predicting risk of future falls by exploring association between appetite score and falls at three and six months in older people with upper limb fracture. Methods A secondary data analysis. Baseline appetite was assessed using the SNAQ, with score < 14/20 defining poor appetite. Descriptive statistics summarised characteristics associated with poor appetite. Association between baseline characteristics and the presence of falls at 3 and 6 months were measured using logistic regression. Results 100 participants (80% females and 20% males, median age 73 years (IQR 9.75)). 9% had poor appetite. Sarcopenia (SARC-F score ≥ 4), frailty (FRIED phenotype) and a higher number of comorbidities and medications were more prevalent in individuals with poor appetite. Appetite at baseline was not related to occurrence of falls at 3 and 6 months (P = 0.627, P = 0.698 respectively). Sarcopenia, number of comorbidities, EQ5D5L mobility, EQ5D5L self-care and EQ5D5L activities were associated with occurrence of falls at 3 months. There was no relationship between baseline variables and falls at 6 months. In multivariate analysis, the association between EQ5D5L activities and the presence of falls at 3-months remained (OR 3.485 (95% CI 1.463, 8.302), P = 0.005). Conclusion In this study population, poor appetite was related to higher prevalence of sarcopenia and frailty but was not predictive of future falls. Sarcopenia, comorbidities, EQ5D5L mobility and self-care were associated with falls at 3 months. Identifying individuals with sarcopenia and difficulty in performing routine activities continues to be imperative to minimise the risk of future falls.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"36 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565875","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}

{"title":"3010 Improving the assessment and management of bone health on an acute frailty unit","authors":"P Reid, N Htet, K Lee, E Karim, M Atkinson","doi":"10.1093/ageing/afaf133.001","DOIUrl":"https://doi.org/10.1093/ageing/afaf133.001","url":null,"abstract":"Introduction Fragility fractures are a significant cause of morbidity and mortality in the UK. An estimated 549,000 fragility fractures occur each year, with a significant financial and social cost. By identifying and treating those at risk we can reduce the incidence of fragility fractures. We wished to assess how we could optimise management of bone health in those presenting to our acute frailty unit (AFU). Method We conducted a retrospective review of patients admitted to AFU with falls on a background of frailty. 2 PDSA (plan, do, study and act) cycles were undertaken in 2023 and 2024 respectively. We audited if patients had a full assessment of bone health (calcium, Vitamin D levels and FRAX score) and if they had been started on appropriate treatment. Interventions included multiple educational sessions for members of the elderly medicine team, updated guidelines for primary and secondary prevention and concise poster guidelines visible on all elderly care wards. Results Over two cycles, we noted an improvement in bone health assessments among those admitted. By the end of our cycles, 48% had appropriate bone health bloods compared to 13% prior and 30% had a FRAX score calculated compared to 7% before. 33% of the patients had a clearly defined treatment plan for bone health compared to 0% at the start of the cycle. Conclusions 1. Education proved a moderately successful tool for increasing the awareness of bone health in frail patients admitted to AFU and also in increasing appropriate assessment and management of these patients. 2. Despite this, the majority of patient’s did not receive an assessment. Possible factors limiting this included time, clinical acuity and uncertainty about best management option. 3. This QIP has demonstrated the need for the development of a fracture liaison service to provide robust assessment and management in the frail population.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"27 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565638","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}

{"title":"3134 Effectiveness of the SmartJournal digital intervention on oral hygiene in nursing home residents: a cluster randomised trial","authors":"E Karamehmedovic, L E Myhren, E J Rodakowska, A-KN Astrom, E L Melbye","doi":"10.1093/ageing/afaf133.091","DOIUrl":"https://doi.org/10.1093/ageing/afaf133.091","url":null,"abstract":"Introduction The global trend of population ageing has led to a significant demographic transformation, with an increasing proportion of elderly individuals. This shift brings a heightened burden of disease, including oral cavity infections. Declining rates of edentulism and the rise of complex dental prostheses have emphasised the importance of maintaining oral health in older adults. Care-dependent individuals, particularly in institutional settings, rely on nursing staff for oral care; however, different barriers hinder the provision of adequate oral care. Poor oral health is linked to systemic diseases, and reduced quality of life, yet remains an overlooked concern in many institutions. In Norway, studies reveal widespread oral health neglect in nursing homes, highlighting the need for effective interventions to address this critical issue. SmartJournal presents an interactive easy-to-use digital tool to assist nursing staff in preserving the oral health of nursing home residents. The app contains three components: Component 1, ‘registration of daily oral hygiene routines’, component 2, ‘monthly oral health assessment’, and component 3, ‘e-learning (knowledge base)’. Methods The study was designed as a pragmatic, 12-week, parallel-group, three-arm blinded cluster-randomised trial (CRT) aiming to compare the effectiveness of SmartJournal use versus augmented care in improving oral hygiene among nursing home residents. It involved 12 nursing homes and 309 participants. The primary outcome measure was the mucosal-plaque score (MPS), which measures oral hygiene. The secondary outcome measure was the number of teeth. Results Preliminary results show a 10% improvement in oral hygiene scores in the intervention group. Further statistical analysis is ongoing. Conclusion Few clinical trials evaluate the effectiveness of preventive oral health care interventions for care-dependent older adults, making this study’s findings valuable for guiding future research and implementation of similar interventions.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"104 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565732","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}

{"title":"3082 Get it on time: in-patient administration of Parkinson's disease medications in South Tyneside and Sunderland NHS Foundation Trust","authors":"J L Yong, F Johnston","doi":"10.1093/ageing/afaf133.007","DOIUrl":"https://doi.org/10.1093/ageing/afaf133.007","url":null,"abstract":"Introduction The timely administration of Parkinson’s Disease (PD) medications is essential for better motor symptom control, leading to improved patient outcomes. The NICE Guidelines and Parkinson’s UK recommend all hospital in-patients with PD should get their PD medications on time—within 30 minutes of their prescribed administration time. This audit aimed to assess the adherence of timely administration of PD medications among in-patients at South Tyneside and Sunderland NHS Foundation Trust, and to compare this pre- and post-interventions. Methods A two-cycle retrospective audit was conducted in November 2023 (pre-intervention) and July 2024 data (post-intervention). Data on all doses of PD medications administered in the trust, and whether they were given on time, was collected via our trust’s data warehouse application. On analysis, the percentage of PD medication doses given on time was calculated according to location. From this, six lower-performing wards were identified, and interventions for them (surveys, education and training) were carried out in April–May 2024. Results In November 2023, the trust-wide percentage of PD medications given on time was 83.46% (n = 2920), increasing to 88.32% (n = 4024) in July 2024. Pre-intervention, the percentage of PD medications given on time across in-patient locations within the trust was varied, ranging from 0–100%. Post-intervention, there was more consistency—ranging from 50–100%, this evidenced improved performance achieved trust-wide. All wards where interventions took place showed improved results, seeing 7.5–95.4% increases from their previous rates. New lower-performing wards which would benefit from interventions in future cycles of this audit were also identified. Conclusions Over the two cycles, South Tyneside and Sunderland NHS Foundation Trust showed improvement in the percentage of in-patients receiving their PD medications on time. The post-intervention data also illustrates the positive impact of our interventions. Our work has been recognised as a best practice case study by Parkinson’s UK.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"4 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565847","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}

{"title":"2999 An audit of the impact of bone health assessment in residential home patients","authors":"S Evans","doi":"10.1093/ageing/afaf133.021","DOIUrl":"https://doi.org/10.1093/ageing/afaf133.021","url":null,"abstract":"Introduction There are approximately 549,000 new fragility fractures each year in the UK and the prevalence of both osteoporosis and risk of falling increases with age. Care home residents are three times more likely to fall and have a 3- to 4-fold higher incidence of fractures than people of the same age living in the community. These older, frailer and multimorbid patients often have the highest fracture risk and therefore the most to gain from anti-osteoporosis treatments to reduce this risk. Method Retrospective audit of residents who were reviewed by the newly started Enhanced Health in Care Homes (EHCH) team within the 5 residential homes for an initial comprehensive geriatric assessment (CGA) between March 2022–June 2024. These initial CGAs were reviewed to determine if a FRAX assessment had been completed and subsequent sub-analysis of those with high/very high FRAX scores to determine whether they were on appropriate bone protection. Results 100% of residents (183) had a bone health assessment including a FRAX score (age-adjusted if appropriate). Prior to CGA, 37% patients with a high/very high FRAX score were on appropriate bone protection, having excluded patients who were not suitable for any treatment for reasons including poor renal function or not clinically appropriate. Following EHCH initial CGA and management plan, this average improved to 85% across the residential homes. The most significant improvement in one residential home was from 0% to 83% post bone health assessment. Conclusion There has been a considerable improvement from 37% to 85% in the number of residents at high and very high risk of fractures who are on appropriate bone health protection following an initial bone health assessment and subsequent management plan initiated by the Enhanced Health in Care Home team.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"274 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565872","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}

{"title":"3191 Evaluating a frailty same day emergency care service: patient and family perspectives","authors":"J Iqbal, R Morton, E Swinnerton, M Saint, L O'Callaghan, J Fox, L Butler, L Tomkow","doi":"10.1093/ageing/afaf133.049","DOIUrl":"https://doi.org/10.1093/ageing/afaf133.049","url":null,"abstract":"Introduction Frailty is a growing concern, particularly for older adults attending Emergency Departments (EDs). Frailty accounts for 5–10% of all ED visits and up to 30% of acute admissions. The NHS mandates that hospitals with Type 1 EDs provide a minimum of 70 hours of Acute Frailty Services per week to address this challenge. At Salford Royal Foundation Trust (SRFT), a Frailty Same Day Emergency Care (SDEC) service was introduced to deliver rapid assessment and care for frail older adults, aiming to reduce hospital admissions and improve patient outcomes. This service operates five days per week and is staffed by a multidisciplinary team. Methods A mixed-methods approach was used to evaluate the Frailty SDEC service. Data was collected through paper surveys distributed to patients aged 65 years or older with a Clinical Frailty Score (CFS) >5 and their relatives or carers during their admission to the SDEC service. The survey included both closed-ended and open-ended questions. Quantitative data was analysed using descriptive statistics and qualitative data was analysed using thematic analysis. Results A total of 32 responses were collected over a two-month period in 2024. The results showed high levels of patient and family satisfaction (97%) with the Frailty SDEC service. Participants particularly valued the compassionate and personalised care, clear and professional communication, and the efficient and timely service delivery. Areas for improvement included upgrading the physical environment and providing clearer communication about waiting times and procedures. Conclusion The Frailty SDEC service at SRFT demonstrates high levels of patient satisfaction and effectiveness in delivering care for frail older adults. This evaluation provides valuable insights for enhancing patient-centred care and highlights the importance of further research to explore long-term outcomes and compare different models of SDEC services for older adults.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"53 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144566604","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}

{"title":"3209 Route to a streamline transient ischemic attack pathway: a quality improvement initiative","authors":"N Z Hamdani, A L Zainai, C McDermott, D Murphy, A Cashen, T Galvin, M Gilbert, T Walsh","doi":"10.1093/ageing/afaf133.037","DOIUrl":"https://doi.org/10.1093/ageing/afaf133.037","url":null,"abstract":"Background Specialist, hyperacute management of a transient ischemic attack (TIA) is necessary to decrease subsequent stroke. As part of a local Quality Improvement (QI) initiative, we implemented a new TIA pathway in our hospital to maximise efficiency, encourage an ambulatory approach, and improve global TIA management in line with the 2023 UK and Ireland Clinical Guidelines for Stroke. Method We completed a retrospective cohort study of patients who attended our hospital between April 1, 2024, and June 30, 2024. Patients with a primary diagnosis of TIA were identified through the Hospital In-Patient Enquiry (HIPE). Each diagnosis was verified with electronic records review, with exploration of key investigations and management parameters. Result 28 patients were coded as TIA. 28.5% were seen directly via Acute Medical Unit (AMU), increased from 10.1% pre-TIA pathway, with the rest attending ED initially. The median length of Stay (LoS) in hospital was 0.65 days, down from 1.08 days pre-TIA pathway for those managed directly in AMU. 35.7% were managed within 24 hours, vs 28.2% prior to new pathway initiation. Most patients were admitted under the AMU (35% vs 33% pre-pathway) or Stroke service (42.9% vs 26% pre-pathway), with a shorter LoS if the patient was admitted under these services. 27 (96.4%) patients underwent neuroimaging; 89.3% underwent CT Brain vs 94.8% pre-pathway, 75% underwent MRI Brain without preceding CT in keeping with National Clinical Guideline for Stroke for the UK and Ireland recommendations. 96.4% were reviewed by a stroke specialist vs 82.1% pre-pathway. Utilisation of inpatient echocardiograms and 24-hour holter monitors were reduced to 35.7% and 21.4% respectively, down from 42.9% pre-pathway. Conclusion This re-audit has shown improved neuroimaging utilisation, increased numbers of patients being reviewed by stroke specialist clinicians, increased use of ambulatory services, and reduced length of stay.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"1 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565794","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}

{"title":"3172 Rising student numbers—using a comprehensive geriatric assessment exercise to educate surplus students?","authors":"M B Patterson, N Kelly, K Dash, C Mamereli, C S Anike-Nweze, K Colquhoun","doi":"10.1093/ageing/afaf133.064","DOIUrl":"https://doi.org/10.1093/ageing/afaf133.064","url":null,"abstract":"Introduction As medical student numbers rise, clinicians are under increasing pressure to provide high quality teaching. To increase Geriatric medicine representation within the undergraduate curriculum, fourth-year students from the University of Glasgow attending Glasgow Royal Infirmary (GRI) are given the opportunity to participate in an ‘Older People’s Services Float (OPS) week’. Clinical Teaching Fellows (CTFs) and Clinical Development Fellows (CDFs) support students to undertake a condensed version of Comprehensive Geriatric Assessment (CGA). Students assess patients from the perspective of various Multidisciplinary Team (MDT) members. The ‘CGA’ is then presented in a simulated ‘MDT meeting’. This promotes self-directed learning and teamwork while alleviating pressure on clinical teams to deliver teaching. Methods The ‘OPS Float week’ was integrated into the medical student timetable over 15 weeks, with 3 students rotating each week. Anonymised quantitative and qualitative feedback was collected using a questionnaire. This included a combination of Likert scales and free text boxes. Results Data was collected from twenty-eight students. Overall, the feedback was positive. Seventy-five percent (75%) of students reported that they ‘strongly agree’ the exercise improved their knowledge of how to undertake a CGA. Eighty-two percent (82%) reported that they strongly agree the exercise has improved their understanding of the different roles within the MDT. An example of the qualitative data collected includes: ‘Really good. . .Definitely made me think more holistically about the patient and identify areas in a patient’s life that could make a real difference to their care’. Conclusion The introduction of the ‘OPS Float week’ has successfully enhanced the learning experience of medical students by offering valuable insights into Older People’s Services, the CGA process and working within an MDT. The model also presents a practical approach to addressing the challenges of increasing student numbers while continuing to provide high quality medical education.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"20 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565869","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}

{"title":"3029 Healthy ageing in place: perspectives on ‘local’ and age-friendliness in the built environment","authors":"R Tadrous, V Palmer, J R Olsen, M Anderson, R Lewis, K Mitchell, M Thomson, B Rigby, L A R Moore, S A Simpson","doi":"10.1093/ageing/afaf133.093","DOIUrl":"https://doi.org/10.1093/ageing/afaf133.093","url":null,"abstract":"Introduction Age friendly communities aim to create inclusive social and physical environments that facilitate older people to age actively, enjoy good health and continue participating fully in society. The built environment can profoundly influence older adults’ health and wellbeing. This study aimed to explore mid-to-older adults’ perceptions of the age-friendliness of their communities and how they defined localness. Methods Semi-structured interviews were conducted remotely and in-person between September 2023 and March 2024 with community-dwelling mid-to-older aged adults (n = 22; 65.0 ± 5.5 years) from two communities with high levels of deprivation in Scotland, Renfrewshire and South Lanarkshire. Taking a systems-based approach, identified barriers and supports to the age-friendliness of communities were charted against the World Health Organisation Age-Friendly Cities and the Place Standard frameworks, and perceptions of localness were explored. Results Physical influences on age-friendliness included the accessibility of transport modalities, the maintenance of public spaces and paths, the suitability of homes, and seasonal influences and environmental hazards. Social influences included access to places that facilitate social interactions such as churches or community centres, community cohesion, and employment and volunteering-related factors. Service influences included digital inclusion, ageist sentiments, and healthcare accessibility. Localness was defined by i) accessible and preferred modes of transport, with local areas shrinking as mobility declines; ii) the distance people needed to travel to access essential services like supermarkets and pharmacies; and iii) where they knew people, socialised with others, or visited family. Conclusions The gradual deterioration of communities has contributed to a decline in the age-friendliness of mid-to-older aged adults’ local areas. The impact of declining mobility, individual- and area-level deprivation, and closure of essential facilities and social spaces on place attachment must be considered by policy makers to support older adults to age well in place.","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":"144566657","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}