Age and ageing最新文献

{"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}

{"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}

{"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}

{"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}

{"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}

{"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}

{"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}

{"title":"3175 Symptom burden and impact on quality of life for those with advanced Parkinson's in a rural area","authors":"R Varden, R Walker, A O'Callaghan","doi":"10.1093/ageing/afaf133.102","DOIUrl":"https://doi.org/10.1093/ageing/afaf133.102","url":null,"abstract":"Introduction We recruited older adults with advanced Idiopathic Parkinson’s disease (IPD) to better understand their symptom burden and its impact on quality of life (QoL) in the predominately rural area of North Cumbria. Methods Records were taken from an IPD prevalence study. Those identified with advanced IPD, defined by Hoehn and Yahr stage 4 or 5, were invited to participate, consultee was contacted for those unable to consent. Quantitative data were collected using validated questionnaires. These included the Movement Disorder Society Non-Motor Symptoms (NMS) Questionnaire and the Parkinson’s Disease Questionnaire. Data were collected electronically with the participant, with assistance from a relative or carer if asked, or consultee as appropriate. Rural areas were defined as living in a settlement of less than 10,000 people. Results All 62 recruited participants experienced NMS, the number ranging between six and 17. Most frequently reported symptoms were sleep disturbance and physical fatigue. Physical fatigue was the most severely reported symptom. Mean NMS score for those living in a rural area (207.8 ± 87.9) was higher than that for those living in an urban area (180.0 ± 62.1), although this did not reach statistical significance (p = 0.17). In rural areas, mental fatigue was the most frequently reported symptom, while those living in urban areas reported sleep disturbance most frequently. Mean NMS score was higher in males (198 ± 85.5) than females (189 ± 67.4), although this did not reach statistical significance (p = 0.67). Mean PDQ-39 scores, an indicator of QoL, were similar in rural (40.6 ± 10.9) and urban (39.4 ± 10.4) areas and similar in males (39.6 ± 10.1) and females (40.5 ± 11.2). Conclusion Sleep disturbance and physical fatigue were frequently and severely reported NMS. Despite a higher NMS burden described in rural areas, QoL was similar between rural and urban areas. This could suggest possible protective factors improving QoL in rural areas.","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":"144565843","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":"3205 Polypharmacy and quality of life in older people: where do we stand? A narrative review","authors":"A Healy, H Barry, B McGuinness","doi":"10.1093/ageing/afaf133.106","DOIUrl":"https://doi.org/10.1093/ageing/afaf133.106","url":null,"abstract":"Introduction Health affects older people’s quality of life (QoL). Those experiencing health decline often require multiple medications (polypharmacy). This narrative review aims to explore the effect polypharmacy has on QoL and health-related QoL (HRQoL). We also wished to determine the QoL/HRQoL measurement tools employed and polypharmacy definitions used in included studies. Method Searches were carried out primarily in MEDLINE and EMBASE. Publication databases for The Irish Longitudinal Study on Ageing (TILDA) and the English Longitudinal Study of Ageing (ELSA) were also searched. Search terms such as ‘polypharmacy’, ‘older person’, ‘health-related quality of life’ and ‘quality of life’ were used. Primary or secondary research articles investigating the association between polypharmacy and QoL/HRQoL, including qualitative studies, QoL/HRQOL tool development studies, and randomised controlled trials investigating the number of medications and QoL/HRQoL as outcomes were included. Screening and data extraction were undertaken by one reviewer and a narrative synthesis conducted. Results In total, 55 articles were included. The key finding of this review was the heterogeneity of the effect of polypharmacy on QoL/HRQoL, ranging from no association to a significant negative clinical association. Considerable variation was seen in the number of QoL/HRQoL measurement tools and polypharmacy definitions used. Qualitative studies highlighted factors which were perceived to impact QoL/HRQoL, including the relationship between patients and healthcare providers, clear benefit of medication and commitment to everyday medication management. These findings highlight the difficulty in interpreting the true impact of polypharmacy on QoL/HRQoL. Conclusion(s) In qualitative research, patients highlight the negative impact of polypharmacy on QoL; however, this isn’t always reflected in quantitative research. The range of differing associations could be due to the responsiveness of the tools used, populations studied, or the nature of the relationship between polypharmacy and QoL, which is likely intertwined bidirectionally with many contributing and confounding factors.","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":"144565790","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":"3062 Support and cognitive rehabilitation care at home in the management of early neurocognitive disorders","authors":"A Poignonec, C Daridon, T Rameau, E Chui, A Aiordachioaie","doi":"10.1093/ageing/afaf133.043","DOIUrl":"https://doi.org/10.1093/ageing/afaf133.043","url":null,"abstract":"Introduction The implementation of cognitive rehabilitation sessions (CRS) in the management of individuals with neurodegenerative diseases has increased. To identify the barriers to the implementation of CRS at home from the perspective of the primary caregiver. Method This is a multicentric, quantitative, descriptive, observational, cross-sectional study. We distributed questionnaires from May to November 2023 to the primary caregivers of patients being followed for mild to moderate cognitive disorders and who had received a prescription for CRS. Comparisons of variables were made using the Kruskal-Wallis test. We collected 150 questionnaires. Our population had an average age of 81 years, predominantly female (55%), and mainly followed in memory clinics (61%) for Alzheimer’s disease (58%). The primary caregiver was mainly a spouse (74%), with 40% being female. The patients mostly received home nursing care (SSIAD) (47%) and physiotherapy (34%), with 54% of the patients receiving the personalised autonomy allowance (APA). 69% of CRS prescriptions were made by a geriatrician, and 19% by a general practitioner. Results The time to prescription of CRS differed according to the place of follow-up (15 months day hospital vs. 26 months general practitioner vs. 20 months memory clinic (p = 0.03)). The average time between prescription and implementation of CRS was 3 months. Regarding the opinions of the primary caregivers: 98% of the primary caregivers considered them beneficial but insufficient in quantity (67%); 22% did not accept the presence of a team at home, and 21% found the home unsuitable for sessions. Conclusion The sessions should be started as early as possible in the management of cognitive disorders to prevent the progression of the pathology. Our study showed that patients managed in a day hospital had a quicker prescription of sessions compared to patients followed by a general practitioner or in a memory clinic.","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":"144565846","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}