Age and ageing最新文献

{"title":"3059 Collaborative reviews of anticholinergic burden (ACB) scores in primary care following discharge from secondary care after a fall","authors":"R Loonat, S Mitchell-Gears","doi":"10.1093/ageing/afaf133.005","DOIUrl":"https://doi.org/10.1093/ageing/afaf133.005","url":null,"abstract":"Background Older adults with multimorbidity are prescribed medicines to manage chronic conditions. Some of these cause anticholinergic side effects which can lead to falls. Introduction This work originated from the West Yorkshire ACB Task and Finish Group and involved pharmacists in secondary and primary care working collaboratively. The aims were: To raise awareness of ACB across all sectors. To calculate the ACB scores for patients admitted with falls on acute elderly admission wards in two hospitals and refer to primary care for review on discharge if the score is 3 or more (clinically significant). Method On admission, the pharmacist calculated the ACB score using an online ACB calculator. Medicines contributing to ACB were reviewed throughout the hospital stay reducing doses and stopping medicines where appropriate following discussion with patients and carers. Any ACB score still ≥3 on discharge was documented in the discharge letter with a request to review and deprescribe anticholinergic medicines in primary care. Consent to access SystmOne was obtained so patient records could be checked in secondary care 6 weeks post discharge. Results Over one hundred ACB scores were calculated during the 4-week data collection period. After reduction of ACB scores in secondary care, 15 patients still scored 3 or more on discharge and were referred to primary care for review. 66.67% (10/15) of patients referred received a primary care review. 70% (7/10) of primary care reviews resulted in reduced ACB scores. Conclusion Awareness of ACB in secondary care was raised through routine calculation of ACB scores on admission. A high proportion of referrals were actioned in primary care. By reducing ACB scores patients were subjected to less side effects and a potentially reduced falls risk. This project was identified by NHSE in a national scoping exercise and analysed in a medicine safety scoping review.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"190 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565733","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":"3143 Active and connected: place utilisation to enhance physical and social activity in mid-to-older adults","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/afaf133.098","DOIUrl":"https://doi.org/10.1093/ageing/afaf133.098","url":null,"abstract":"Introduction Physical activity and social connectedness play an important role in healthy ageing. Access to facilities such as libraries, parks, and community centres can facilitate physical activity, social interaction, and community building. Little is known about how older adults use places for physical or social activities. This study aimed to explore the places mid-to-older adults go to, and why they choose to engage or not engage in physical and/or social activities in particular places. Methods Semi-structured interviews were conducted with community-dwelling adults aged 55–75 years (n = 22; 65.0 ± 5.5 years) from two communities with high levels of deprivation in Scotland, Renfrewshire and South Lanarkshire between September 2023 and March 2024. Taking a systems-based approach, we explored place utilisation among mid-to-older adults to support physical and social activity. Maps of participant’s local community populated from Ordnance Survey data, such as depicting parks, were used to guide the interviews. Results Participants varied according to levels of physical activity, frailty, and loneliness. Places for physical and social activities included community centres, green spaces, gyms, clubs, religious buildings, shops and places for eating and drinking. Social enablers to place utilisation included having inclusive, well-advertised activities in multi-purpose spaces like community centres to foster intergenerational connections, community cohesion, and social engagement. Physical enablers included the importance of accessibility and convenience, mobility-friendly design, and diverse transport options. Barriers to place utilisation included activities that perpetuated ageist sentiments, the rising costs of physical and social activities, and seasonal barriers such as poor weather and reduced daylight. Conclusions It is essential to provide affordable and engaging activities, as well as versatile spaces that combine recreation, learning, and social interaction to foster intergenerational and social connections for older adults. Additionally, infrastructure and transportation should prioritise accessibility, while communities should promote respect, inclusion, and active participation in society.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"16 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565766","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":"3036 Evaluation of a new regional pathway for Medicines Optimisation in Older People (MOOP) medicines adherence pharmacist optimising","authors":"P Crawford, S Johnston, P Galbraith, P Tennyson, C Darcy, C McGuigan, K Miller, J Patterson, J Agnew, J McGennity, H McKee, A Cunningham, C Stevenson, K Bloomer","doi":"10.1093/ageing/afaf133.004","DOIUrl":"https://doi.org/10.1093/ageing/afaf133.004","url":null,"abstract":"Introduction The Regional Medicines Optimisation in Older People (MOOP) Medicines Adherence Pharmacy team review medicines for older people at home across Northern Ireland (NI). Northern Ireland Ambulance Service (NIAS) are often first responders to older people at home requiring medical attention, and identify medicines adherence issues, which may lead to Emergency Department presentation and hospitalisation if not addressed. Method In July 2023, Belfast HSC Trust MOOP pharmacy team led a new regional pathway pilot to enable NIAS first responders to refer older people for medicines adherence review. Inclusion Criteria: Pharmacist Interventions were graded using Eadon grading scale (1), & ScHARR cost avoidance estimates (2,3) which defines costs related to Adverse Drg Events (ADEs) were applied. Results n = 12 patients: Reason for referral by NIAS included people with multiple unused medicine compliance aids, suboptimal pain management, or confused about their medicines. Time spent by pharmacist ranged from 60 to 400 minutes (average 170 minutes per patient). Clinical pharmacist interventions (n = 62) included blood pressure measurement, deprescribing of inappropriate medicines, optimising pain management, & supply of adherence aids. 97% of clinical interventions were potentially significant at Eadon grade 4 (n = 60). Total cost avoidance due to pharmacist interventions was £5678 to £12,867, with Invest to Save £6.40 to £14.52 for every pound invested. Conclusion A collaborative pathway between medicines optimisation in older people pharmacy service and the Northern Ireland Ambulance Service, led to cost effective improvements in medicines optimisation for older people. References 1. Eadon, H. 1992 Assessing the quality of ward pharmacists’ interventions. Int J Pharm Pract. 1(3): 145–147. 2. Karnon, J., et al. 2008. Modelling the expected net benefits of interventions to reduce the burden of medication errors. J Health Serv Res Policy 2008; 13: 85–91. 3. Mair, A., et al. 2023 iSimpathy Evaluation Report Edinburgh ISBN978–1–3999-6298-8.","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":"144565879","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":"3139 Do preoperative ECG abnormality at pre-assessment predict cardiac complications in patients undergoing major non-cardiac surgery","authors":"R Jackson-Wade, S Ranasinghe, J Jegard, L Kandakumar","doi":"10.1093/ageing/afaf133.101","DOIUrl":"https://doi.org/10.1093/ageing/afaf133.101","url":null,"abstract":"Background Cardiovascular complications are one of the most common causes of morbidity and mortality perioperatively during non-cardiac surgery. This risk is significantly increased in those ≥65 and those who are frail. NICE and ESC both recommend that all patients ≥65 have a pre-operative ECG to assess each patient’s risk of perioperative cardiovascular complications before any intermediate or high-risk surgery. This study aims to assess the risk of perioperative cardiovascular complications in those ≥65 with abnormal ECGs. Methods We analysed data from patients attending our combined Geriatrician and Anaesthetist run pre-operative assessment clinic for elective colorectal cancer resections between 23/09/2021–11/09/2023. All patients were aged ≥65, those who then underwent surgery had their pre-operative ECGs assessed for abnormalities including; New AF, LBBB, RBBB, LAD, Heart block, ectopics, ST depression, and T wave Inversion. There were no patients with episodes of non-sustained VT or long QT intervals, two categories ordinarily considered higher risk for complications. The discharge letters, operation notes, and any post-operative cardiology letters were then assessed for any perioperative/post-operative cardiac complications including myocardial infarction, cardiac arrest, acute heart failure, and established new arrhythmias. Results 140 patients between 23/09/2021 and 11/09/2023 underwent elective colorectal resection. 56 of these patients had abnormal pre-operative ECGs (40%) with; New AF (2), LBBB (3), RBBB (16), LAD (15), Heart block (6), Ectopics (7), ST depression (3), and T-wave Inversion (4). On assessment, none of these patients had any perioperative or postoperative cardiac complications. Conclusion Our study suggests pre-operative ECGs alone were not predictive of perioperative/post-operative cardiac complications in patients undergoing elective colorectal resection for cancer. All of the patients were managed by perioperative Geriatricians without the need of further onward referrals to Cardiology, suggesting a perioperative cost saving.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"30 19 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565845","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":"3138 Older patients' and caregivers' perceptions of and attitudes to de-prescribing in Saudi Arabia: a cross-sectional study","authors":"T M Alenzy, C Parsons, H E Barry, S A Alkahtani","doi":"10.1093/ageing/afaf133.084","DOIUrl":"https://doi.org/10.1093/ageing/afaf133.084","url":null,"abstract":"Introduction Development of effective deprescribing interventions requires thorough understanding of attitudes of relevant stakeholders involved in the medication decision-making process. This study aimed to examine older patients; and caregivers; perspectives on deprescribing in Saudi Arabian hospitals and explored factors influencing their attitudes. Method A survey study was conducted using the Revised Patients’ Attitudes Toward Deprescribing (rPATD) questionnaire (Arabic version), which was administered to older patients and caregivers recruited from two hospitals in southern Saudi Arabia through convenience sampling. Participants provided written informed consent and ethical approval was obtained. Descriptive analyses (frequencies and proportions) summarised beliefs about medication inappropriateness, burden, discontinuation concerns, involvement and two global questions. Bivariate analyses examined links between participant characteristics and questionnaire responses. Results Questionnaires were completed by 253 participants (126 older patients and 127 caregivers; response rate 87%). Most patients were aged 65–69 years (53.2%), married (65.1%), and taking 5–8 medications (57.2%). Almost two-thirds (65.9%) were satisfied with medications, and 88.1% were willing to have them deprescribed. Patients taking 5–8 medications showed significantly greater willingness for deprescribing compared to those taking ≥9 medications (p < 0.001). Married patients were more involved in medication decision-making than non-married patients (p < 0.05). Most caregivers were aged 25–34 years (38.5%) and married (75%). Their care recipients were primarily ≥80 years, with 67.7% taking 5–8 medications. Most caregivers (60%) were satisfied with care recipients; medications, and 82.6% were willing to have these deprescribed. Caregivers of care recipients taking ≥9 medications reported greater burden associated with managing medications (p < 0.001). Conclusion Characteristics such as the number of prescribed medications influenced patients’ and caregivers’ perceptions of medication burden and willingness to have medications deprescribed, while marital status influenced involvement in medication decision-making among patients. These insights may be used to help guide hospital deprescribing interventions.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"77 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144566599","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":"3176 Disparities in Parkinson's service provision for those living in a rural area of North West England","authors":"R Varden, R Walker, A O'Callaghan","doi":"10.1093/ageing/afaf133.104","DOIUrl":"https://doi.org/10.1093/ageing/afaf133.104","url":null,"abstract":"Introduction As part of an Idiopathic Parkinson’s disease (IPD) prevalence study, electronic records were identified for 721 individuals living in North Cumbria under the care of the local specialist service. This study aimed to understand how individuals access services, with a view to identifying trends and barriers. Methods An electronic record search was performed to identify frequency of contact with a doctor and Parkinson’s nurse specialist (PDNS). Contact within the last three, six or 12 months, and whether this was via telephone or face-to-face was detailed. We recorded contact with tertiary referral services for consideration of advanced therapies. Rural areas were defined as living in a settlement of less than 10,000 people, and most and least deprived areas, defined as the lowest five and highest five deciles of deprivation retrospectively. Results In total 93.1% had contact with a specialist within the last 12 months. The number receiving contact from a PDNS within the last six months was 194 (26.9%), lower than seen nationally. Only 23 (3.2%) of this population were receiving/considered for advanced therapies. There was no difference seen in service contact between rural and urban areas. Numbers in the most deprived areas were statistically significantly more likely to not have had service contact in the last 12 months compared to the least deprived areas, 37 (74.0%) (95% CI 61.8–86.2) compared to 13 (26.0%) (95% CI 13.8–38.2). There were statistically significantly fewer numbers with face-to-face PDNS contact in the most, compared to the least deprived areas, 48 (38.4%) (95% CI 29.9–46.90) compared to 77 (61.6%) (95% CI 53.1–77.1). Conclusion Greater disparities in service contact were seen between the most and least deprived areas, rather than living in the most remote or rural areas. It is hoped results will inform quality improvement work to improve equitable service provision throughout North Cumbria.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"88 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565792","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":"3151 Effectiveness of a brief video-based intervention on the intention to book future vision and hearing assessments","authors":"O McGucken, E Cunningham, K Patterson, B McGuinness","doi":"10.1093/ageing/afaf133.090","DOIUrl":"https://doi.org/10.1093/ageing/afaf133.090","url":null,"abstract":"Introduction Hearing and vision impairment are associated with cognitive impairment and dementia in older adults. There is limited public understanding that modifying these risk factors can reduce the risk of dementia. In previous studies 36% of older adults have not had a vision assessment and hearing aids are thought to be underused. This study aimed to increase the understanding of patients attending a memory service of the link between cognition, vision and hearing impairment and encourage participants to have future eye and hearing assessments. Method A video was developed with patient and public involvement explaining the link between eyesight, hearing and cognitive impairment and the importance of regular vision and hearing assessments (https://vimeo.com/948705659 Password EMSAMS). All patients attending a memory clinic between 16/09/24 and 05/11/24 were asked to watch this short animated video. A questionnaire was performed after the video asking about previous hearing and vision assessments and whether it was more likely for participants to book a hearing or vision assessment after the video. Results 18 patients participated. 72% had a vision assessment in the past 2 years and 94% recalled at least 1 vision assessment. 66% of participants felt that this video made it more likely they would book a vision assessment in future. 33% of participants had a hearing assessment in the last 2 years. 44% felt that this video would make it more likely that they would book a hearing assessment in future. Free text comments about the video stated that the link between hearing, eyesight and memory was interesting and that the video was easy to understand. Conclusions This study shows that a video shown to patients at memory clinic explaining the link between hearing and vision impairment, and cognitive impairment and dementia can motivate patients to book future hearing and vision assessments.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"47 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144566598","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":"3189 Isomyosamine for the treatment of sarcopenia in older adults","authors":"M Glass, D Mazzucco, A Bellezza","doi":"10.1093/ageing/afaf133.059","DOIUrl":"https://doi.org/10.1093/ageing/afaf133.059","url":null,"abstract":"Introduction Sarcopenia, a condition marked by the loss of muscle mass and function, significantly impacts older adults, contributing to frailty and decreased independence. Chronic inflammation is believed to play a key role in its progression. Isomyosamine, a small molecule derived from tobacco alkaloids, has the potential to regulate key inflammatory cytokines, including tumour necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and soluble TNF receptor 1 (sTNFR1), offering a therapeutic strategy for sarcopenia. Method In a Phase II clinical trial, older adults diagnosed with sarcopenia were administered once-daily oral doses of Isomyosamine (ranging from 600 mg to 1050 mg) for 28 days. Blood samples were collected at baseline and on Days 7, 14, 21, and 28 to measure inflammatory biomarkers. The pharmacokinetics (absorption and elimination) of the drug were also assessed. Safety and tolerability were evaluated by monitoring adverse events. Results Significant reductions in TNF-α levels were observed at both Day 7 (p = 0.04) and Day 14 (p = 0.04). IL-6 and sTNFR1 were also reduced after the first dose in most cohorts. No serious adverse events were reported, and the drug was well-tolerated. However, due to the rapid absorption and elimination of Isomyosamine, once-daily dosing may not be sufficient for therapeutic efficacy, suggesting a need for more frequent dosing in future trials. Conclusion(s) Isomyosamine shows promise as a treatment for sarcopenia, significantly reducing inflammatory biomarkers in older adults. A new Phase II clinical trial will evaluate the effects of more frequent dosing on functional recovery in patients with sarcopenia who have suffered hip or femur fractures. This study, expected to begin in Q1 2025, will assess changes in mobility and inflammatory markers to further investigate the drug’s potential in improving clinical outcomes.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"37 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565642","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":"3177 Sex differences in the associations between social vulnerability, frailty, 5-year survival and long-term care home entry","authors":"J Mah, J MacDonald, M Andrew, J Quach, S Stevens, J Keefe, K Rockwood, J Godin","doi":"10.1093/ageing/afaf133.085","DOIUrl":"https://doi.org/10.1093/ageing/afaf133.085","url":null,"abstract":"Introduction Frailty and social vulnerability use deficit accumulation approaches to understand heterogeneity in older adult health outcomes. We examined sex differences in the effect of frailty and social vulnerability on 5-year mortality and long-term care home (LTCH) entry in Nova Scotia, Canada. Methods We followed community-dwelling older adults 65 years and over who were assessed for public home care supports from 2005 to 2018 using data from the Resident Assessment Instrument. We conducted sex-stratified and sex-disaggregated Cox proportional hazards analyses, adjusting for age, Cognitive Performance Scale and cohort year of entry. Results Of 5520 home care clients, mean age was 80.5 (SD 7.5), frailty Index (FI) was 0.23 (SD 0.10) and Social Vulnerability Index (SVI) was 0.22 (SD 0.69). The cohort was 66.6% female who were significantly less frail, more socially vulnerable and more cognitively intact at baseline. At five years, 49.1% females and 63.0% males had died, and 36.3% females and 29.5% males required admission to LTCH. In sex-stratified models, higher SVI was associated with decreased 5-year mortality and increased LTCH entry; while higher FI was associated with increased 5-year mortality and LTCH entry. In sex-disaggregated analyses, higher SVI remained significantly associated with decreased 5-year mortality for females (aHR 0.92; CI: 0.86–0.99, p = 0.02), but not for males (aHR 0.94; 0.86–1.02, p = 0.11). There was a weaker association between FI and 5-year LTCH placement for males. Conclusion Greater frailty was associated with LTCH placement and mortality across sexes, as we hypothesized. However, in sex-disaggregated analyses, the association between frailty and LTCH entry was weaker for males and higher social vulnerability was associated with decreased mortality only in female models. This raises the importance of evaluating these populations separately, as well as the question of how current LTCH placement policies may be inadvertently perpetuating the sex (and gendered) differences of ageing.","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":"144565727","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":"3013 A new community-based approach to the care of acute delirium","authors":"J H Youde, S Ross","doi":"10.1093/ageing/afaf133.022","DOIUrl":"https://doi.org/10.1093/ageing/afaf133.022","url":null,"abstract":"Background Current practice for acute delirium presentation is hospital admission whilst the delirium resolves, often including multiple transfers with poor outcomes. This project challenges this practice and allows people to recover at home with a maximum of 6 calls a day and night with carers trained in delirium. Results From a previous audit of Pathway 2 beds patients with delirium had poor outcomes, high levels of placement in permanent care and long lengths of stay (21 days). There have been 192 episodes of care through the Delirium Pathway. 80% were from hospital wards and 20% stepped up from community settings. In 2023, 42% had no ongoing social care support needs and 21% had only the requirement of ongoing domiciliary care needs at home. 2.6% entered long term care with the re-admission rate remaining within the local rate for this cohort of 20–30%. There has been low demand for night care. The average LoS is 15 days. Delirium symptoms significantly improved at discharge and stayed improved; pre-discharge the median 4AT score was 7, at first pathway assessment (generally within 24 hours of arrival home), the median 4AT score was 2 and at exit of pathway the median 4AT score was 1. Patients and carers reported that the discharge home felt safe and that home was the best place for recovery: 89% of patients and 76% of carers felt it was safe to return home; 94% of patients; and 93% of carers felt that home was the best place for recovery. Conclusion This pathway has demonstrated that discharging patients with an acute delirium with supportive home care is safe, effective, and reduces admissions to long term 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":"144565771","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}