Age and ageing最新文献

{"title":"2917 Anticholinergic burden, falls and mortality in a diverse elderly population in Kuala Lumpur","authors":"I Sayers, R Walker, W K Gray, M P Tan","doi":"10.1093/ageing/afaf133.074","DOIUrl":"https://doi.org/10.1093/ageing/afaf133.074","url":null,"abstract":"Introduction Falls are a significant cause of morbidity and mortality throughout the world. This burden is greatest in elderly populations. Malaysia is experiencing a rapid demographic shift toward an ageing population, it has a low incidence of falling, but a high mortality to fall ratio. Identifying risk factors may guide future practice and prevent harm. Anticholinergic medication is associated with cognitive decline, mortality and falling. Methods Data were used from the Malaysian Elders Longitudinal Research study (MELoR), an ongoing study to assess geriatric health in Malaysia, to assess anticholinergic burden, falls, and mortality, from which 1472 participants were identified. The Anticholinergic Cognitive Burden (ACB) scale was used and participants were assigned positive (ACB ≥ 1) or negative (ACB = 0) ACB scores. Data analysis used bivariate and regression analysis to adjust for multicollinearity. Results A positive ACB score was identified in 300 (20.4%) participants. Cardiovascular medication accounted for around half the anticholinergic burden. A positive ACB score was a significant predictor for falling and mortality at five years after adjusting for age, sex and ethnicity. Incontinence and hearing loss remained the only significant predictors for both outcomes after regression analysis. Conclusion The impact of anticholinergic burden cannot be fully accounted for by comorbidities. Incontinence and hearing problems are both modifiable risk factors for falls and mortality. Further research into the diagnosis and management of these comorbidities in this population is recommended.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"56 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144566600","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":"3068 Promoting the reduction of sedative use in older adults with delirium—a QI project","authors":"I Kounoupias, D F Barry, M Rawle","doi":"10.1093/ageing/afaf133.006","DOIUrl":"https://doi.org/10.1093/ageing/afaf133.006","url":null,"abstract":"Introduction Non-pharmacological de-escalation techniques are effective in managing agitated patients with delirium yet are often overlooked in favour of pharmacological management. Sedatives are prescribed despite increased falls and extrapyramidal side effects. We used quality improvement methodology with the aim of reducing sedative use in older adults with delirium in an acute UK hospital. Methods Utilising inpatient electronic prescribing records, we collected data on all patients aged ≥65 prescribed a sedative acutely during May 2022 in a 575-bedded acute district general hospital. Based on best-practice guidelines, formulated standards were: <10 cases of sedatives prescribed monthly, and in individuals with sedatives prescribed 100% screened for delirium, 90% have non-pharmacological delirium management methods trialled first, 100% have rationale for sedative prescription documented, and 100% of sedative prescriptions reviewed within 24 hours. Of cases prescribed a benzodiazepine, 100% should have contraindication to haloperidol documented. We conducted one Plan-Do-Study-Act (PDSA) cycle, focussing on hospital-wide education and the implementation of aide-memoires, and repeated our audit in May 2024. Results Total sedatives prescribed declined significantly at re-audit (42 vs 72), with 28 individuals meeting inclusion criteria (vs 36 at baseline). Rates of delirium screening remained static (93%) while documentation of non-pharmacological methods improved by 16%. Where sedatives were used, 21% of prescriptions lacked documentation of rationale (vs 14% at baseline), no instances of contraindication to haloperidol were recorded (vs 6%), and only 68% of prescriptions were reviewed within 24 hours (vs 75%). Sedation for a scan reduced by the largest margin (18% of prescriptions vs 34%). Conclusions The total number of sedatives prescribed decreased through education initiatives. Where prescribed, fewer standards were met, including fewer documentations of rationale and medication reviews. Future work will be to implement an electronic prescribing sedative care plan to encourage non-pharmacological de-escalation techniques prior to consideration of appropriate, time-limited sedative prescriptions.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"89 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144566603","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":"3173 Standardised admissions proforma improves patient-focused care and reduces length of stay","authors":"S R Coutts, J Baniadam, T M Caparrotta, J Dsouza, A Toner, J Warwick, S Parveen, M Kelly, C Patton, J Rimer, L Munang","doi":"10.1093/ageing/afaf133.048","DOIUrl":"https://doi.org/10.1093/ageing/afaf133.048","url":null,"abstract":"Introduction Our district general hospital utilises an unselected medical receiving model where generic admission clerk-ins often miss salient information vital for comprehensive geriatric assessment (CGA). Recent Healthcare Improvement Scotland guidelines outlined people living with frailty that are admitted to an acute hospital are at risk of adverse outcomes. A standardised proforma for admissions to our medicine of the elderly (MOE) ward (clinical frailty score over five required for admission) would ensure critical information was collated for more effective CGA, decision making and discharge planning. The aim was by November 2024, 90% of inpatients within our acute MOE ward would have had complete admission proformas documented. Method We analysed information from generic medical admission notes and identified key items often omitted such as escalation status, medication review and discharge planning goals. We created a standardised MOE admission proforma which was piloted (cycle 1) and then incorporated into the electronic patient record (cycle 2). The outcome measure was the percentage of MOE patients with complete admission proformas. We also reviewed average length of stay data and sought feedback from ward staff. Results Baseline data revealed 57.2% of MOE patients had key CGA information documented on admission. Cycle one (July 2024) illustrated an increase to 74.1% meanwhile cycle two (November 2024) increased to 90.8%. There was a 25% reduction in average length of stay from 12.8 days to 9.6 days. Feedback from users of the standardised proforma was universally positive. Conclusion This proforma established a standardised patient-centred methodology for initial MOE patient assessment by ensuring medication reconciliation, improved comprehensiveness of clinical documentation and streamlining multidisciplinary team assessment to provide effective continuity of care and discharge planning. This was well received by users and resulted in patients returning home sooner. This proforma will be re-audited in 4 months and applied to other MOE wards.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"29 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565639","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":"3126 Antidepressant and anxiolytic use and mortality risk in people with dementia in Northern Ireland: a nested case-control study","authors":"C Sinnamon, C M Hughes, C R Cardwell, H E Barry","doi":"10.1093/ageing/afaf133.068","DOIUrl":"https://doi.org/10.1093/ageing/afaf133.068","url":null,"abstract":"Introduction Limited evidence exists to support the use of antidepressant and anxiolytic medications in people with dementia; these medications may contribute to potentially inappropriate prescribing and be associated with mortality. This study aimed to investigate trends in prescribing of these medications and the association between exposure to antidepressants and anxiolytics and mortality risk among people with dementia. Method A nested case–control study was conducted using record linkage of five administrative population-based data sources in Northern Ireland between 2010 and 2020. Dementia cases (identified if a medication indicated for dementia management was prescribed from 2012) were matched to one control (based on age and sex). Exposure to antidepressants and anxiolytics was assessed from prescribing records two years prior to dementia diagnosis until six months prior to death or end of study. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using conditional logistic regression after adjusting for demographic factors and comorbidities. Sensitivity analyses were undertaken assessing exposure period and number of prescriptions. Results In total, 14,420 dementia cases and 14,361 controls were included. A greater proportion of study participants were prescribed antidepressants (59.2% of cases, 54.7% of controls) than anxiolytics (44.8% of cases, 36.0% of controls). There was evidence of an increased risk of mortality in people with dementia who were prescribed antidepressants (fully adjusted OR = 1.08; 95% CI 1.02–1.14) and in those prescribed anxiolytics (fully adjusted OR = 1.26; 95% CI 1.19–1.33) compared to nonusers. Sensitivity analyses demonstrated neither exposure period nor number of prescriptions had a significant impact on mortality risk. Conclusion In this large population-based study, the use of antidepressants and anxiolytics in people with dementia was high. The use of antidepressants was associated with a slightly increased risk of mortality whilst the use of anxiolytics was more strongly associated with mortality. Further studies are warranted to support these findings.","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":"144565731","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":"3215 Reducing anticholinergic burden (ACB) within the healthcare for older people's (HCOP) wards","authors":"K Ng, N Tan","doi":"10.1093/ageing/afaf133.052","DOIUrl":"https://doi.org/10.1093/ageing/afaf133.052","url":null,"abstract":"Introduction Medications with anticholinergic properties can have significant adverse effects, particularly in older adults. An Anticholinergic Burden (ACB) score of ≥3 is associated with increased risks of falls, cognitive impairment, and mortality. Additionally, side effects such as urinary retention, visual disturbances, and constipation are frequent contributors to delirium. Aim To assess whether raising awareness of ACB within the Healthcare of Older People (HCOP) department can lead to a reduction in ACB scores. Methods Over four months, a teaching session and a poster was disseminated on ACB. Retrospective data were collected from three separate weeks, one before any intervention, one after the teaching session and one after the poster for patients discharged from the HCOP department. Admission and discharge ACB scores were calculated using the ACB Calculator (www.acbcalc.com). Patients on end-of-life medications were excluded. Results Cycle 1: Of 40 patients, 13 had an ACB score ≥ 3 on discharge. Seven patients retained their admission ACB scores ≥3 at discharge, while eight patients showed a reduction. A lack of awareness of ACB was identified, prompting a teaching session. Cycle 2: Of 33 patients, eight had an ACB score ≥ 3 on discharge, and 11 showed a reduction in scores. A poster campaign was launched across HCOP doctors’ offices. Cycle 3: Among 39 patients, 17 had an ACB score ≥ 3 on discharge. However, this cycle achieved the highest number of score reductions, with 12 patients showing improvement. A side analysis revealed that lansoprazole was the most commonly prescribed medication with anticholinergic properties, affecting 33 patients across the three cycles. Conclusion Raising awareness of ACB scores has successfully reduced ACB scores. Sustained efforts, including regular reminders and medication reviews, are essential to mitigate risks for older patients. Ongoing discussions with the pharmacy team aim to implement an automated ACB score calculation in the online noting system.","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":"144565788","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":"3132 Quality improvement project: clinical frailty assessment during clerking for the older patient","authors":"H Purle, A Barrowman, S Joseph, A Eapen","doi":"10.1093/ageing/afaf133.028","DOIUrl":"https://doi.org/10.1093/ageing/afaf133.028","url":null,"abstract":"Introduction The Commissioning for Quality and Innovation (CQUIN) framework sets a 10% minimum and an ideal goal of 30% of acutely presenting patients over the age of 65 to receive frailty assessment scores. Early recognition of frailty helps mitigate risks such as deconditioning. This project aims to assess and improve the adoption of this standard in medical emergency admissions of a Birmingham district general hospital by working with medical admissions teams and frailty services and observing for associated outcome measures. Method PDSA methodology was used. Data was retrospectively collected for patients aged 65 and above from the electronic patient records (EPR) over a week’s interval from the acute medical take. Collected data included prevalence of CFS scoring and social history, escalation discussions and mortality. Interventions were delivered via an educational presentation to resident doctors and displayed posters in key areas. The data was examined for improvements in CFS prevalence and its relationship with onwards referral, escalation discussions or mortality. Results Pre-intervention only 3.31% (8/242 patients) had a recorded CFS score. Post-intervention, 19.10% (34/178) patients had a CFS score documented. Post-intervention, 82.35% of those with CFS scores were referred to the frailty therapy service, as opposed to 17.36% of those without CFS scoring. Escalation discussions were had with 41.17% of those with CFS scoring and 29.17% of patients without. Mortality was 5.88% in the CFS scored patients and 9.72% in the patients with no CFS score. Conclusion After focused interventions, the CFS prevalence was above the 10% minimum requirement and closer to the 30% goal set by the CQUIN 05. Patients with a CFS score saw higher rates of onwards referrals to older person services, and higher rates of escalation discussions. In forwards application, CFS could be discussed in induction, incorporated into IT clerking systems.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"273 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565789","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":"3221 Collaborative care: enhancing frailty management and patient safety through nurse-pharmacist partnerships","authors":"J Sharma","doi":"10.1093/ageing/afaf133.057","DOIUrl":"https://doi.org/10.1093/ageing/afaf133.057","url":null,"abstract":"Introduction Frailty presents significant challenges to healthcare systems, particularly in Thurrock, Essex, where 14% of residents are aged 65 or older. This demographic shift, combined with socioeconomic factors, underscores the need for patient-centred, clinically effective, and tailored healthcare services that prioritise patient safety. Aim To improve frailty management for elderly patients in Thurrock by integrating pharmacist support within a nurse-led service, focusing on medication management, reducing workload pressures, providing holistic, patient-centred care, and ensuring patient safety to enhance outcomes and reduce hospital admissions. Method A 12-week pilot involved patients aged 65+ undergoing joint reviews with a frailty nurse and pharmacist. Participants had a Rockwood Frailty Score of 5–7 and at least one long-term condition. Reviews included evaluations of medication, functional and falls risks, nutritional status, fracture risk, and blood tests. The management phase focused on deprescribing, dose adjustments, and addressing health metrics such as postural hypotension, bone protection, and falls risk. Regular follow-ups ensured coordinated care with a focus on patient-centred outcomes and patient safety. Results From April 4 to June 28, 2024, 37 patients (mean age: 84) participated. Comprehensive assessments led to 155 interventions (averaging 4.07 per patient). Medication management improved significantly, with 88 drugs deprescribed, including 55 Falls Risk Increasing Drgs (FRIDs), resulting in a 14.39% reduction in FRIDs and a 23.03% reduction in polypharmacy. These interventions led to £6252.18 in annual drug savings and a 974.09 kg reduction in CO2 emissions. Key outcomes included 57 health and social interventions. Financial analysis suggested savings of £63,450 from preventable hospital admissions, with a return on investment (ROI) of 1655.4%. Conclusion The pilot demonstrated the clinical effectiveness of pharmacist-nurse collaboration in improving medication management, chronic condition control, reducing falls risk, and preventing hospital admissions. It emphasises the importance of patient-centred care, safety, and skill mixing to enhance clinical outcomes.","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":"144565640","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":"3093 Barriers and facilitators to engagement in fall interventions among older adults from ethnic backgrounds: a systematic review","authors":"S Ravithas, S J Meredith, M Jawad, A Lawal, S Lim","doi":"10.1093/ageing/afaf133.071","DOIUrl":"https://doi.org/10.1093/ageing/afaf133.071","url":null,"abstract":"Background The incidence of falls is a major public health issue with one- third of older people falling annually. Consequently, there are many interventions available to prevent falls such as education and exercise training. However, their effectiveness at reducing fall prevalence is minimal due to low adherence, especially among ethnic minority groups. There is currently a paucity of research in this area particularly among older adults from ethnic minority groups. Aims This systematic review aims to identify the main facilitators and barriers to the uptake of fall prevention programs in older adults from ethnic minority groups. Methods The review was registered onto PROSPERO (CRD42024586433) before conducting a literature search on Medline, Embase and CINAHL databases using the PICO framework to extract relevant English language studies. Inclusion criteria included studies focusing on older adults aged 65 years and above and from ethnic minority groups. After removal of duplicates and full text screening, articles underwent quality assessment using the JBI tool. Data extraction took place, and key themes were categorised using the COM-B model. Results 12 studies were included in the final review: 9 qualitative and 3 mixed method studies. The review included 1176 participants including Hispanics, South Asians, Chinese and African American ethnic groups. Main themes included language barriers, cultural beliefs and inadequate support from healthcare professionals. Quantitative findings showed a statistically significant correlation between adherence and the following factors: living alone, low mood, level of education and culture. Conclusion This review has identified key barriers and facilitators to engage older adults from ethnic minority groups. Future interventions should consider these facilitators and barriers to enhance inclusivity and engagement.","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":"144566605","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":"3149 Measuring vitamin D post hip fracture—should we test or just treat? Lessons learnt from an ortho-geriatric rehab unit","authors":"S Ludlam, J Chillala","doi":"10.1093/ageing/afaf133.018","DOIUrl":"https://doi.org/10.1093/ageing/afaf133.018","url":null,"abstract":"Introduction Plasma 25(OH)D is commonly tested following hip fracture. The National Osteoporosis Society recommends against routine testing in these patients as vitamin D is often co-prescribed with anti-resorptive agents, making vitamin D testing unnecessary. Our median reporting time for plasma 25(OH)D is 11.5 days, costing around £7/unit. High dose, rapid vitamin D loading costs £1.34. So, is vitamin D testing in these patients cost-effective and does it add to our clinical decision-making? Method Records of 72 discharges from our ortho-geriatric unit over 3 months were reviewed for admission serum calcium, creatinine clearance, PTH and vitamin D. Vitamin D prescription regimes were reviewed. Results 100% of patients had plasma 25(OH)D checked. Mean plasma 25(OH)D was 44.8 (range < 5–106.6). 23 patients were vitamin D deficient (32%), 23 insufficient (32%) and 26 replete (36%). 100% of patients with vitamin D deficiency and 91.3% with insufficiency received rapid high dose vitamin D loading regime (150,000–200,000 units over 1–7 days). 53.8% of vitamin D replete patients were prescribed a high dose vitamin D regime (n = 14) but 3 were switched to low dose when levels returned as normal. 12 patients with an early normal plasma 25(OH)D were prescribed Adcal D3 or low dose colecalciferol. Conclusions 58 patients (80.5%) were prescribed rapid high dose vitamin D regimes, the majority of whom were vitamin D deficient or insufficient. Only 3 patients were switched and a further 12 started on low dose vitamin D based on a normal plasma 25(OH)D result. Plasma 25(OH)D resulted in a change in vitamin D regime in only 20.8% of patients. When comparing the cost of the test to that of the treatment regime, we would argue that serum calcium/PTH are more cost-effective and stronger predictors of who requires a lower dose vitamin D dose regime (e.g. in hyperparathyroidism) than plasma 25(OH)D.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"29 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565688","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":"3190 End-of-life dementia care: a qualitative study of the experiences and perceptions of minority ethnic and economically disadvantaged communities","authors":"L Tomkow, M Poole, E Damisa, B Hanratty, F Tissa, M Ngouala, J Dixon, M Karagiannidou, M Ogden, F Dewhurst","doi":"10.1093/ageing/afaf133.082","DOIUrl":"https://doi.org/10.1093/ageing/afaf133.082","url":null,"abstract":"Background Dementia is a leading cause of death globally. However, people living with dementia are often underrepresented in specialist palliative care services. Existing research on palliative care for people with dementia frequently fails to include people from minority ethnic groups and those living in poverty. Aims This study explored the experiences and perceptions of end-of-life dementia care among underserved groups in England. The study also investigated how ethnicity, religion, and socioeconomic status influence these experiences. Methods Ten workshops were conducted, involving 29 Experts-by-Experience (EbE) with professional or personal experience of caring for people living with dementia from disadvantaged communities. Qualitative data from these workshops were analysed thematically. Results The findings highlight cultural, socioeconomic, and systemic barriers to accessing quality end-of-life care. Participants noted pervasive fear, stigma, and mistrust surrounding dementia and end-of-life care. Financial concerns were frequently described as major drivers of inequities in care. Conclusions This study reveals that individuals from minority ethnic and disadvantaged communities face significant challenges in accessing equitable, high-quality end-of-life dementia care. Future research should co-create culturally sensitive interventions with these communities to address disparities in care.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"655 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565729","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}