Age and ageing最新文献

{"title":"Population-based incidence rate of in-hospital delirium in older adults in Norway-a HUNT study.","authors":"Wilhelm Frich, Kristine Ringnes Verlo, Miguel Germán Borda, Thomas Andrew Jackson, Gill Livingston, Christian Myrstad, Kenneth Rockwood, Geir Selbæk, Håvard Kjesbu Skjellegrind, Bjørn Heine Strand, Gro Gujord Tangen, Leiv Otto Watne, Yehani Wedatilake, Dag Årsland, Bjørn Erik Neerland","doi":"10.1093/ageing/afag297","DOIUrl":"10.1093/ageing/afag297","url":null,"abstract":"<p><strong>Background: </strong>Most studies of delirium occurrence are based on selected hospitalised populations or administrative data. We aimed to estimate the incidence rate of in-hospital delirium in older adults and to assess use of the International Classification of Diseases, 10th Revision (ICD-10) delirium code (F05) in electronic health records.</p><p><strong>Methods: </strong>This population-based cohort study included 9956 participants aged ≥70 years from HUNT4 70+. Participants were followed from the date of study participation (2017-19) until 31 December 2023. In-hospital delirium was identified by retrospective chart review of all admissions during follow-up, using Diagnostic and Statistical Manual of Mental Disorders, fifth edition criteria. Incidence rates were estimated using the first delirium episode per participant, weighted for non-participation.</p><p><strong>Results: </strong>During follow-up, 1507 participants (15.1%) experienced ≥1 in-hospital delirium episode. The weighted incidence rate was 33.1 (95% CI 31.5-34.9) per 1000 person-years and increased with age from 11.4 (age 70-74) to 109.0 (age ≥90) per 1000 person-years. Men had higher incidence rates than women across age groups. Among admissions with delirium, 11.9% had an ICD-10 discharge delirium diagnosis code (F05).</p><p><strong>Conclusion: </strong>In-hospital delirium was common, increased markedly with age and was rarely captured by diagnostic coding. Low coding rates suggest that routine health-care data substantially underestimate delirium burden. Under-recognition of delirium may limit opportunities for follow-up in a group at high risk of adverse outcomes. With an ageing population, the burden of delirium is likely to increase for individuals and health-care systems. Our findings support systematic approaches to improve identification and management.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"55 10","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Mapping the landscape of geriatric medicine education, training and practice in Europe.","authors":"","doi":"10.1093/ageing/afag295","DOIUrl":"10.1093/ageing/afag295","url":null,"abstract":"","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"55 10","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improvement of frailty and prefrailty in older cancer survivors: a 6-month home-based pilot study.","authors":"Sabine Drevet, Mahugnon-Antonin Agbogbo, Abdallah Ghaith, Matthias Chardon, Michel Guinot, Marie Coudurier, Stephane Doutreleau, Sophie Lumale, Noé Musso, Pascal Petit, Clara Lopez, Galina Penkov, Emma El Mouzdahir, Stéphane Mouret, Evelyne Liuu, Nicolas Vuillerme, Patrice Flore, Gaëtan Gavazzi","doi":"10.1093/ageing/afag245","DOIUrl":"10.1093/ageing/afag245","url":null,"abstract":"<p><strong>Background: </strong>Frailty affects 42% of older patients with cancer and is a predictor of cancer recurrence and mortality. Its impact on older cancer survivors has not yet been extensively studied.</p><p><strong>Objective: </strong>Assess the impact of a multicomponent home-based intervention on frailty prevalence in older adults in remission from cancer.</p><p><strong>Design: </strong>Bicentric before-and-after non-randomised intervention study (NCT04746768).</p><p><strong>Setting: </strong>Community-dwelling.</p><p><strong>Subjects: </strong>Patients ≥70 years old in remission from cancer who met at least one criterion for the Fried phenotype.</p><p><strong>Methods: </strong>A 6-month multicomponent home-based intervention was performed combining supervised exercise training and personalised nutritional support. The primary endpoint was the proportion of patients who achieved frailty or prefrailty improvement from the initial assessment (M0) to M6.</p><p><strong>Results: </strong>The mean age of the 110 participants was 77 (SD = 5) years. At baseline, 45% were frail and none were robust. Eighty-one completed the intervention (Completion Group: CG). In CG, functional, physical performance measures and the T-stage of cancer were associated with baseline frailty, while none of the other cancer-related characteristics were. Among the CG, 62% improved their frailty status at M6: 78% of frails improved, 51% of pre-frail became robust. Frailty severity decreased at M6 in 74% of participants. Vitamin D showed a group × time interaction, suggesting that frailty trajectories differed according to vitamin D status.</p><p><strong>Conclusions: </strong>These preliminary findings suggest a potential beneficial effect of a home-based multicomponent intervention to improve frailty in community-dwelling older cancer survivors. Further controlled and adequately powered trials are required to confirm these findings.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"55 8","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787118","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":"Comparing frailty index distribution, mortality and frailty dynamics across multiple countries: applying the 'zero-state' principle to harmonised ageing data.","authors":"Saskia Drijver-Headley, Judith Godin, Kenneth Rockwood, Peter Hanlon","doi":"10.1093/ageing/afag242","DOIUrl":"10.1093/ageing/afag242","url":null,"abstract":"<p><strong>Introduction: </strong>Frailty is a dynamic state linked to disability, hospitalisation and mortality. Cross-country comparisons of frailty progression remain limited. We compared frailty distribution, mortality risk and deficit accumulation across 17 middle-/high-income countries. We then examined whether outcomes among individuals with minimal baseline deficits ('zero-state') reflect broader population health patterns to explore utility of the 'zero-state' as a marker of population health.</p><p><strong>Methods: </strong>Data were from five harmonised longitudinal ageing surveys (Health and Retirement Survey, Survey of Health, Ageing and Retirement in Europe, English Longitudinal Study of Ageing, Chinese Health and Retirement Longitudinal Survey, Mexican Health and Ageing Study). A 31-item frailty index (FI) was constructed using identical variables at baseline, 2- and 4-year follow-up. Participants with <2 deficits were classified as in 'zero-state'. Outcomes: all-cause mortality and FI change among survivors. Logistic regression (mortality) and negative binomial models (deficit accumulation) were adjusted for age, sex and baseline FI. Analyses were stratified by zero-state and non-zero-state.</p><p><strong>Results: </strong>Baseline frailty varied between countries: highest in the USA, Mexico and Southern/Eastern European nations, and lowest in Northern/Central Europe. Mortality and deficit accumulation differed substantially. Mexico showed highest mortality and fastest accumulation, while Switzerland and Scandinavian countries showed the lowest. Zero-state analyses revealed larger between-country differences, but lower statistical power, than analyses of those with higher FI. Some countries (e.g. USA, UK) showed favourable zero-state outcomes but more rapid progression among individuals with higher baseline FI.</p><p><strong>Conclusion: </strong>Frailty distribution, mortality and frailty progression vary widely across settings, with poorer outcomes in lower-income countries. Zero-state trajectories capture important population differences but do not fully reflect patterns among those with existing frailty, potentially reflecting within-country inequalities.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"55 8","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13480471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148786992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency department-initiated interventions to reduce risk of recurrent falls in older adults: a systematic review and meta-analysis.","authors":"Wilmar Charmant, Sofie Jansen, Natasja M van Schoor, Ralph de Vries, Prabath Nanayakkara, Hanna C Willems, Nathalie van der Velde","doi":"10.1093/ageing/afag227","DOIUrl":"10.1093/ageing/afag227","url":null,"abstract":"<p><strong>Background: </strong>Older adults presenting to the emergency department (ED) following a fall are at high risk for recurrent falls, injuries and increased healthcare utilisation. This systematic review and meta-analysis evaluated the effectiveness of interventions initiated upon ED presentation in reducing falls (primary outcome) and fall-related outcomes (secondary outcomes) among older adults.</p><p><strong>Methods: </strong>A comprehensive search was performed in Ovid Medline, Embase, CINAHL, PEDro, Web of Science, and Scopus up to June 2025, following PRISMA guidelines. This yielded 9624 references, of which 4811 records remained after deduplication and were screened for eligibility. Meta-analyses and descriptive methods, including vote counting, were applied where appropriate. Sensitivity and subgroup analyses were conducted.</p><p><strong>Results: </strong>Thirty articles were included. Interventions were associated with a significant reduction in fall incidence (rate ratio 0.69; 95% CI 0.54-0.88; I2 = 95%), supported by vote counting. While reductions were also observed in the proportion of fallers (odds ratio 0.87; 95% CI 0.71-1.07; I2 = 61%), fall-related and all-cause ED revisits, hospital admissions, recurrent falls and mortality, these trends did not reach statistical significance. Sensitivity analysis excluding studies with modified usual care showed a significant reduction in fall-related ED revisits and people sustaining an injurious fall. Secondary outcomes including quality of life, fear of falling and physical functioning generally showed trends favouring the intervention group. Considerable heterogeneity and variation in intervention characteristics were noted across studies.</p><p><strong>Conclusion: </strong>Interventions for older adults presenting to the ED after a fall suggest a favourable effect on fall rate. Non-significant trends favouring the intervention group were observed for several other outcomes, but heterogeneity and methodological limitations preclude definitive conclusions.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"55 8","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13430035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unmet educational needs in geriatric care among interdisciplinary professionals working in ambulatory and home care settings: a pan-European survey by the PROGRAMMING COST Action 21122.","authors":"Evrydiki Kravvariti, Stefan Arsov, Luca Soraci, Karolina Piotrowicz, Sofia Duque, Anne W Ekdahl, Regina Roller-Wirnsberger, Mirko Petrovic, Tahir Masud, Nenad Bogdanovic, Marina Kotsani","doi":"10.1093/ageing/afag306","DOIUrl":"10.1093/ageing/afag306","url":null,"abstract":"<p><strong>Background: </strong>Healthcare professionals (HCPs) with variable undergraduate geriatric education increasingly manage older adults with geriatric syndromes in ambulatory and home care settings. We aimed to identify specific unmet geriatric educational needs of the different professional groups involved in older people's outpatient care.</p><p><strong>Methods: </strong>A cross-sectional structured questionnaire assessing self-perceived knowledge, interest and relevance to practice regarding 33 geriatric domains was disseminated online to interdisciplinary HCPs working in ambulatory and home care settings in the World Health Organization European Region, in the context of the PROGRAMMING COST Action 21122. A global topic score, derived from the formula (relevance + interest-knowledge) served as a surrogate of unmet educational needs, and was standardised using z-scores to enable comparisons across topics and professionals.</p><p><strong>Results: </strong>In the overall sample of 2380 responders from 41 countries, perceived relevance and interest consistently exceeded self-reported knowledge across all topics. Global topic scores ranking in the top Z-score quintile, indicative of perceived unmet educational needs for most HCP groups, included comprehensive geriatric assessment, resilience and diversity, chronic pain, management of behavioral and psychiatric symptoms in dementia, depression, frailty and cognitive impairment screening. Profession-specific priorities included communication, advance healthcare directives and assessment of capacity to consent for nurses and speech-language therapists, polypharmacy and deprescribing for medical doctors and pharmacists, sarcopenia, dysphagia and nutritional assessment for dieticians and mental health problems for psychologists and social workers.</p><p><strong>Conclusions: </strong>Substantial and profession-specific gaps in geriatric education exist in ambulatory and home healthcare settings, which warrant targeted interdisciplinary geriatric courses.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"55 10","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149214819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of sarcopenia and individual- and country-level risk factors in 36 countries: pooled analysis of nationally representative individual data","authors":"Simu Huang, Wenyu Lai, David Flood, Yuding Wei, Yu Zheng, Qitong Liu, Haoying Ren, Suyue Xiong, Norma Mansor, Huijing He, Meihong Xu, Lianggong Ding, Mingxuan Liu, Hao Hu, Peiyi Lu, Yuanjia Hu, Chihua Li","doi":"10.1093/ageing/afag210","DOIUrl":"https://doi.org/10.1093/ageing/afag210","url":null,"abstract":"Background Sarcopenia is an age-related condition that contributes to disability and healthcare burden worldwide. Yet cross-national evidence on prevalence and multi-level risk factors is limited. Methods We pooled data from 10 nationally representative or population-based ageing studies, including 144 226 adults aged ≥50 years from 36 high- and middle-income countries. Sarcopenia and severe sarcopenia were defined using 2019 revised European Working Group on Sarcopenia in Older People criteria. Prevalence was standardised by age and gender within each country. We examined associations between sarcopenia and individual-level sociodemographic and health characteristics, and country-level socioeconomic indicators. Results Sarcopenia prevalence ranged from 2.1% to 17.4% across 36 countries, with 16 countries above 5.0% and three above 10.0%. Approximately 92.7 million of 1.07 billion adults ≥50 in these countries were projected to have sarcopenia. At the individual-level, higher risk was associated with older age, gender (men), lower education, being unmarried or not partnered, non-full-time employment, lower household wealth, current smoking, non-recent drinking, physical inactivity and ≥2 chronic diseases (e.g. men: RR = 1.47; 95% CI: 1.32, 1.64). At the country-level, higher gross domestic product (GDP) per capita, higher Gender Development Index and lower Labor Force Participation Rate were associated with lower sarcopenia risk (e.g. GDP per capita: RR = 0.42; 95% CI: 0.30, 0.60). Conclusion Sarcopenia varies widely across countries and is more common in middle-income than high-income settings, pointing to a pattern shaped by both personal and contextual conditions. Addressing the emerging burden of sarcopenia will require integrated strategies targeting modifiable risk factors while tackling contextual and structural inequalities.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"33 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564679","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":"Perioperative Decision-Making in a Multidisciplinary Preoperative Clinic: Associations of Frailty Assessment with Treatment Recommendations and Mortality in a Non-Oncological Cohort","authors":"Vanessa Del Carmen Oropeza Alvarez, Susana Aguila, Maria Sospedra, Agnes Marti, Ramon Miralles, Pere Altes, Miquel Angel Mas","doi":"10.1093/ageing/afag197.017","DOIUrl":"https://doi.org/10.1093/ageing/afag197.017","url":null,"abstract":"Introduction Frailty is increasingly recognised as a dynamic condition; however, in patients referred for surgery, particularly those with advanced comorbidity, baseline frailty remains a strong marker of short-term prognosis. The role of Comprehensive Geriatric Assessment (CGA) in perioperative medicine, continues to evolve, particularly in aligning treatment plans with patient priorities and anticipated benefit. Methods We conducted a retrospective observational study of a cohort of consecutive non-oncological patients referred to a multidisciplinary geriatric perioperative assessment clinic. Baseline frailty was categorised after CGA and by using the Clinical Frailty Scale (CFS). The primary outcome was recommendation of a non-operative /conservative /palliative treatment pathway following CGA and shared decision-making. Secondary outcomes included mortality at 3 months and 1 year. Associations were explored using logistic regression and categorical analyses. Results Eighty-nine patients were included. Increasing frailty was strongly associated with a non-operative or palliative pathway (OR 3.70 per one-point increase in CFS, 95% CI 1.90–7.20; p&amp;lt; 0.001). 0% patients with CFS 1–4 were recommended a palliative pathway, compared with 34% of those with CFS 5–6 and 80% of those with CFS 7–9. Frailty was also associated with increased short- and mid-term mortality among patients with higher CFS. The associations were consistent across surgical subgroups. Conclusion In a non-oncological perioperative cohort, baseline frailty was strongly associated with both treatment recommendations and mortality. Frailty assessment provided essential prognostic context to support shared decision-making and appropriate perioperative planning. These findings highlight the value of CGA in perioperative medicine.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"243 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148522433","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":"FIT for Home Post Trauma","authors":"Sarah Allen, Aine O’Sullivan, Ellen Coakley, Fiona Condon, Maeve Scannell, Marian Lyons, Niamh O’Driscoll, Niamh Spillane, Therese Corry, Denis Curtin","doi":"10.1093/ageing/afag197.044","DOIUrl":"https://doi.org/10.1093/ageing/afag197.044","url":null,"abstract":"Introduction Frailty Intervention teams (FIT) successfully working within emergency departments (ED) improve outcomes for frail older adults through facilitating reduced patient experience time, identifying frailty symptoms, and supporting early discharge. A comprehensive geriatric assessment (CGA) is completed by the members of the team ensuring all the patients’ needs are considered when creating a tailored care plan. To improve discharge efficiency, a model-four hospital’s FIT analysed the barriers to discharging frail older patients presenting after a fall. FIT reviews approximately 200 frail older adults a month with 50% of these presenting after a fall. Methods Over a four-week period 48 patients referred to FIT for assessment were reviewed. Patient outcomes and barriers to discharge were logged in Excel then analysed to identify recurring themes and opportunities for service improvement. Results Of the 48 patients reviewed 33 (69%) were discharged after assessment of the FIT. Three patients had acute medical needs and were not suitable for discharge (New Afib, delirium 4AT: 12, laceration requiring plastics review). Three common themes emerged from the remaining 12 patients who were not discharged. Four patients experienced pain that was not well controlled, five had a change functional mobility that could not be supported on discharge e.g. assistance of two. Three patients did not have support to assist with personal activities of daily living (PDL) e.g. toileting Conclusion Uncontrolled pain, change in mobility status and insufficient social support to facilitate PDL’s were the common barriers to facilitating discharge. There is potential to improve patients experience through educating emergency doctors about the teams’ findings. Future collaboration between FIT and emergency medicine is required to devise a common pain ladder for frail older adults.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"60 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148522476","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":"Collaborative Development of Perioperative Care for Older People in Wales: From Regional Partnership to National Planned Care Funding","authors":"Nia Angharad Humphry, Karina James, Margaret Coakley","doi":"10.1093/ageing/afag197.005","DOIUrl":"https://doi.org/10.1093/ageing/afag197.005","url":null,"abstract":"Introduction Older patients undergoing planned surgery benefit from Comprehensive Geriatric Assessment (CGA) via a Perioperative care for Older People undergoing Surgery (POPS) service. This cost-saving intervention that improves perioperative outcomes is only available in two of six Welsh health boards who provide surgical services. We describe how collaboration between local clinicians and national groups facilitates standardisation of perioperative care for older people in Wales. Methods A cross-health-board collaboration was established between two POPS services, supported by the Bevan Commission – a Welsh health and social care think tank. Through an ‘Adopt and Spread’ programme we developed an implementation toolkit to share learning and guide service models, workforce planning and outcome frameworks. This conformed to ethical standards. It was complemented by collaboration with NHS Wales Performance and Improvement funding to provide staff secondments and start-up costs in each health board for up to twelve months. Results All 6 health boards expressed an interest in developing or expanding a POPS service. Four health boards (67%) have utilised the support and funding thus far - 2 to start new services and 2 to accommodate a new surgical specialty. Limitations to uptake included capacity of geriatricians to support the service and hesitation due to a non-substantive funding model. Conclusion Regional collaboration can gain national traction and act as a catalyst for service development. This model provided implementation support and resources to accelerate POPS service mobilisation in new sites and an existing service expansion - an important step towards reducing unwarranted variation in perioperative pathways for older surgical patients in Wales.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"119 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148522480","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}