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A Profile of Patients Undergoing Comprehensive Geriatric Assessment Though Irish; An Bhfuil Gaeilge Níos Fearr? 接受老年病综合评估的患者概况(爱尔兰语);An Bhfuil Gaeilge Níos Fearr?
IF 6.7 2区 医学
Age and ageing Pub Date : 2024-09-30 DOI: 10.1093/ageing/afae178.148
Máire Ní Neachtain, Cliodhna Fitzmaurice, Aishling Abed, Alma Brehony, Fiona McCleane, Michelle Canavan, Maria Costello
{"title":"A Profile of Patients Undergoing Comprehensive Geriatric Assessment Though Irish; An Bhfuil Gaeilge Níos Fearr?","authors":"Máire Ní Neachtain, Cliodhna Fitzmaurice, Aishling Abed, Alma Brehony, Fiona McCleane, Michelle Canavan, Maria Costello","doi":"10.1093/ageing/afae178.148","DOIUrl":"https://doi.org/10.1093/ageing/afae178.148","url":null,"abstract":"Background The CSO 2022 reported that there were 1,873,997 Irish speakers in Ireland >3yrs of age. Of those, 71,968 speak the language daily. The highest proportion of those who speak Irish in Ireland live in the West of the country. Within our catchment area, we are able to provide an ANP led comprehensive geriatric assessment (CGA) in the Irish language. Methods The aim of this study was to characterise participants referred to an integrated care for older persons (ICPOP) service who had CGAs conducted in Irish from the period of September 2023 to April 2024 and to determine if the patients felt better represented if their CGA was conducted through Irish. Two questions were asked, 1. Do you prefer to have healthcare interaction through Irish? 2. Do you feel better represented by having had your CGA conducted in Irish? Results Over a six-month period 34 patients referred to ICPOP underwent CGA or review through the Irish language. 35.2% (n=12) had their CGA conducted at home. 23.5% (n=8) of those were referred for frailty, 23.5% falls (n=8) and 53% (n=18) for assessment of cognition. Of this cohort 32.3% (n=11) were female, had a median age of 81.5 years and a median clinical frailty score of 5 (range 3-7). The average age of education completion was 14.8yrs. 3% (n=1) had no literacy skills, 23.5% (n=8) had limited and 73.5% (n=25) had good literacy skills. 56% (n=19) gave feedback on their experience. For 23.5% (n=8) it strongly mattered that they had this option. For the remainder, they were indifferent, as they were fluent in both languages. Conclusion We identified that for a proportion of our patient cohort having CGA conducted through Irish was of importance. Ancillary benefits included better understanding of interventions such as deprescribing and brain health techniques when communicated through their primary language.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"220 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142360280","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}
引用次数: 0
Estimating Patient Eligibility And Benefit Of Intravenous Zolendronic Acid In Hip Fracture Patients: A Service Evaluation 估算髋部骨折患者静脉注射唑伦膦酸的资格和获益情况:服务评估
IF 6.7 2区 医学
Age and ageing Pub Date : 2024-09-30 DOI: 10.1093/ageing/afae178.199
Tomás Ó Flatharta, Erica Walsh, Joshua Parris, Mubashra Ashraf, Suzanne Laffan, Niamh O'Regan
{"title":"Estimating Patient Eligibility And Benefit Of Intravenous Zolendronic Acid In Hip Fracture Patients: A Service Evaluation","authors":"Tomás Ó Flatharta, Erica Walsh, Joshua Parris, Mubashra Ashraf, Suzanne Laffan, Niamh O'Regan","doi":"10.1093/ageing/afae178.199","DOIUrl":"https://doi.org/10.1093/ageing/afae178.199","url":null,"abstract":"Background Low trauma hip fractures are serious and carry an estimated re-fracture rate of 10.6%, leading increased morbidity, mortality and healthcare cost. Intravenous Zolendronic Acid (IVZ) administration following hip fracture reduces re-fracture risk by approximately 23% and is recommended yearly for three years by National Osteoporosis Guidelines Group (NOGG) 2021. However, a significant treatment gap remains with only one-fifth of patients receiving IVZ pre-discharge, due to implementation challenges, such as suboptimal Vitamin D levels and lack of resources for yearly infusions. Recently published consensus guidelines offer practical advice as to how to overcome these barriers. This service evaluation estimates the proportion of hip fracture patients eligible for IVZ; as well as the re-fracture rate, prior to the introduction of a local IVZ pathway. Methods Approval from local Quality and Patient Safety Department was received. Low trauma hip fracture patients were identified from the local Orthogeriatric database (October 2019 to January 2021). Hospital electronic laboratory and radiology software were used to identify renal function on discharge and evidence of further fractures (at six months, 1 year and 3 years). Subjects were deemed potentially eligible for IVZ if they had an estimated glomerular filtration rate (eGFR) of ≥50 mls/min (a proxy for calculated creatinine clearance ≥30mls/min in this patient cohort). Results Of 463 subjects, 384 (82.9%) had an eGFR ≥50. Re-fracture data was collected for 263 eligible subjects. Seventeen (6.5%) re-fractured within six months, 21 (8%) re-fractured within a year and 45 (17.1%) re-fractured at any stage post discharge. Conclusion IVZ treatment is the most efficacious secondary fracture prevention post-hip fracture, and most patients are eligible for this treatment. Implementing IVZ pathways for hip fracture patients may significantly reduce re-fracture rate, however expansion of resources allocated to Orthogeriatrics and Fracture Liaison teams is required to successfully implement inpatient pathways and ongoing care.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"36 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142329990","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}
引用次数: 0
DNAR: All or Nothing: Impact of Education Sessions Re-Audit in a Model 3 Hospital DNAR:全有或全无:教育会议对一家 3 型医院重新审核的影响
IF 6.7 2区 医学
Age and ageing Pub Date : 2024-09-30 DOI: 10.1093/ageing/afae178.323
Joshua Ramjohn, Joseph Kelly, Amal Abdalla, Ahmed Hamad, Juliana Carvalho, Ciara Gibbons, Lynn Quigley, Katherine Finan
{"title":"DNAR: All or Nothing: Impact of Education Sessions Re-Audit in a Model 3 Hospital","authors":"Joshua Ramjohn, Joseph Kelly, Amal Abdalla, Ahmed Hamad, Juliana Carvalho, Ciara Gibbons, Lynn Quigley, Katherine Finan","doi":"10.1093/ageing/afae178.323","DOIUrl":"https://doi.org/10.1093/ageing/afae178.323","url":null,"abstract":"Background Do Not Attempt Resuscitation (DNAR) orders are implemented to obviate inappropriate Cardio-Pulmonary Resuscitation (CPR) in patients with low chances of survival post-CPR. However, ambiguity regarding ceilings of care for patients with a DNAR order can arise. This re-audit aimed to review DNAR and ceilings of care documentation according to national HSE guidelines after education sessions, comparing results with the pre-education audit in a Model 3 Hospital. Methods A point-prevalence chart review of thirty-one adult medical inpatients with a DNAR order was conducted after two education sessions were held for Non-Consultant Hospital Doctors (NCHDs) and Consultants. Results Of all thirty-one charts, 35% documented DNAR status in the medical notes, with 32% documenting the reasoning for DNAR status, both of which were unchanged from the first audit cycle. There was an increase in documentation of patient discussion (61% versus 45%) and reasons if this was excluded (66% versus 41%). There was no change in documentation of patient relatives’ discussion (48%) but there was an increase in the reasons if this was excluded (25% versus 18%). There was an overall increase in ceilings of care documentation for ICU admission (three-fold increase), intubation (two-fold increase), inotropic support, and comfort measures, but rates of documentation were still less than 15%. This elucidates the efficacy of education sessions in improving DNAR documentation adherence. Recent studies have highlighted uncertainty among NCHDs regarding treatment escalation in acutely unwell patients in the absence of adequately filled DNAR orders and clear documentation of ceilings of care. Therefore, we posit the introduction of a Ceilings of Care document, akin to the United Kingdom’s Medical Advance Plan. Conclusion Accurate recording of DNAR status and ceilings of care is essential for quality care and treatment escalation. While simple education strategies have proven beneficial in enhancing compliance, additional efforts are needed to enhance ceilings of care documentation.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"74 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142360130","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}
引用次数: 0
Plasma P-tau217 Demonstrates Excellent Diagnostic and Prognostic Performance as a Blood-Based Biomarker for Alzheimer Disease in Older Adults 血浆 P-tau217 作为一种基于血液的老年痴呆症生物标记物,显示出卓越的诊断和预后性能
IF 6.7 2区 医学
Age and ageing Pub Date : 2024-09-30 DOI: 10.1093/ageing/afae178.001
Adam Dyer, Helena Dolphin, Laura Morrison, Antoinette O'Connor, Gavin Sedgwick, Conor Young, Emily Killeen, Conal Gallagher, Aoife McFeely, Eimear Connolly, Naomi Davey, Paddy Doyle, Paul Claffey, Shane Lyons, Christine Gaffney, Ruth Ennis, Cathy McHale, Jasmine Joseph, Graham Knight, Emmet Kelly, Cliona O'Farrelly, Aoife Fallon, Sean O'Dowd, Brian Lawlor, Nollaig Bourke, Sean Kennelly
{"title":"Plasma P-tau217 Demonstrates Excellent Diagnostic and Prognostic Performance as a Blood-Based Biomarker for Alzheimer Disease in Older Adults","authors":"Adam Dyer, Helena Dolphin, Laura Morrison, Antoinette O'Connor, Gavin Sedgwick, Conor Young, Emily Killeen, Conal Gallagher, Aoife McFeely, Eimear Connolly, Naomi Davey, Paddy Doyle, Paul Claffey, Shane Lyons, Christine Gaffney, Ruth Ennis, Cathy McHale, Jasmine Joseph, Graham Knight, Emmet Kelly, Cliona O'Farrelly, Aoife Fallon, Sean O'Dowd, Brian Lawlor, Nollaig Bourke, Sean Kennelly","doi":"10.1093/ageing/afae178.001","DOIUrl":"https://doi.org/10.1093/ageing/afae178.001","url":null,"abstract":"Background There has been unprecedented progress in the development of blood-based biomarkers (BBMs such as p-tau217 to detect Alzheimer Disease (AD) pathology – characterised by the accumulation of Amyloid-Beta (Aβ) and hyper-phosphorylated tau (T). However, BBM performance in “real-world” memory clinic contexts remains unclear. Methods Using high-sensitivity immunoassays, plasma p-tau217 was assessed in 554 participants. Two cohorts were studied: (i) a memory clinic validation cohort of 108 older adults (69 ± 6.5 years; 54.6% female) with early cognitive symptoms and paired plasma/cerebrospinal fluid (CSF) at time of diagnostic Lumbar Puncture (LP) and (ii) a broader replication cohort of 446 individuals ranging from cognitively-unimpaired middle-aged adults to older adults with established AD with 18-month follow-up. Plasma P-tau217 performance was examined against clinically established CSF Aβ+/T+ cut-offs using Area-Under the Curve (AUC) analysis. Plasma cut-offs were optimised vs CSF based on maximal Youden index. Results In the memory clinic cohort, plasma p-tau217 exhibited excellent performance for the detection of Aβ pathology (AUC: 0.91, 0.86-0.97). Plasma p-tau217 was nearly 4-fold higher in Aβ+ (13.89; 7.36-19.0pg/mL) vs Aβ- (3.72; 2.80-4.09pg/mL, U = 230, p<0.001) participants. Plasma p-tau217 was superior in the identification of Aβ vs T pathology (p<0.05, DeLong Test) and outperformed p-tau181 and other BBMs(all p<0.05, DeLong Test). In the replication cohort, plasma p-tau217 maintained >90% accuracy for clinical AD and was significantly associated with clinically meaningful cognitive decline over 18 months (Odds Ratio 1.40; 1.06-1.85, p=0.02). In the initial memory clinic cohort, application of plasma p-tau217 as a diagnostic test would have reduced the need for LPs by over half (56.5%). Conclusion Plasma p-217 demonstrates excellent diagnostic and prognostic performance in older adults with AD, representing an amyloid-responsive measure which also predicts meaningful cognitive decline in established AD. Incorporation of plasma p-tau217 in memory clinic settings may substantially reduce the need for over half of diagnostic LPs.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"219 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142360132","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}
引用次数: 0
Evaluation Of Medical Registrar Confidence In Approach To Acute Stroke And Experience Of Stroke Teaching 评估注册医师对急性卒中治疗方法的信心和卒中教学经验
IF 6.7 2区 医学
Age and ageing Pub Date : 2024-09-30 DOI: 10.1093/ageing/afae178.307
Maeve Ryan, John Paul Yun, Niju Thomas, Una Moffatt, Paula Hickey, Grainne O'Malley
{"title":"Evaluation Of Medical Registrar Confidence In Approach To Acute Stroke And Experience Of Stroke Teaching","authors":"Maeve Ryan, John Paul Yun, Niju Thomas, Una Moffatt, Paula Hickey, Grainne O'Malley","doi":"10.1093/ageing/afae178.307","DOIUrl":"https://doi.org/10.1093/ageing/afae178.307","url":null,"abstract":"Background The American Heart Association scientific statement (2022) addressing inpatient stroke recommends the delivery of stroke-response training to all hospital staff. While performing a service evaluation on in-patient stroke metrics, we explored the self-perceived confidence levels of medical registrars at this hospital, and whether formal on-site teaching was received. We explored various components including awareness of local stroke protocol and teaching pedagogy. Methods Using Google Forms, a survey was sent to all medical registrars in our hospital. A 5-point Likert scale was used to assess the confidence levels of various topics. Results The response-rate was 63% (N=12). Fifty percent (N=6) of participants were on Higher Training Schemes while the remaining 50% (N=6) occupied standalone appointments. Most respondents (83%, N=10) reported experience managing an acute stroke as a registrar. Forty-two percent (N=5) of registrars ‘strongly agreed’ they were confident in assessment of acute stroke, with 50% (N=6) ‘agreeing’, and one respondent remaining ‘neutral’ (N=1). Some registrars were unfamiliar with local stroke protocol (23%, N=3). Half of respondents (50%, N=6) reported no formal teaching on acute stroke. Fifty percent (N=6) of registrars reported that most teaching occurred primarily on ward rounds, with 42% (N=5) reported teaching through lectures. The vast majority (83%, N=10) selected simulation as their preferred teaching method. Conclusion While our medical registrars were confident in their ability to assess and manage acute stroke, significant improvements can be made to ensure formal teaching is prioritized. As stroke protocol can change from site-to-site, it is crucial to define expectations and standards for registrars to ensure timely care for patients. There is a clear preference for simulation as a teaching pedagogy, hence we plan on introducing a formal stroke simulation curriculum. Stroke response is a multidisciplinary effort, hence future research directions include exploring stroke training in nurses, junior doctors, and other healthcare professionals.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"26 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142360137","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}
引用次数: 0
Early Mobilisation Post-Thrombolysis is Safe and Improves Outcomes in Mild-Moderate Acute-Stroke Patients 溶栓后早期活动既安全又能改善轻中度急性中风患者的预后
IF 6.7 2区 医学
Age and ageing Pub Date : 2024-09-30 DOI: 10.1093/ageing/afae178.098
Mary Harte, Evelyn Newell, Trish Galvin, Thomas Walsh, Maeve Scanlon
{"title":"Early Mobilisation Post-Thrombolysis is Safe and Improves Outcomes in Mild-Moderate Acute-Stroke Patients","authors":"Mary Harte, Evelyn Newell, Trish Galvin, Thomas Walsh, Maeve Scanlon","doi":"10.1093/ageing/afae178.098","DOIUrl":"https://doi.org/10.1093/ageing/afae178.098","url":null,"abstract":"Background Thrombolysis (tPA) is the delivery of a clot-lysing agent used in acute ischemic stroke, typically followed by ≥24-hour bed rest. This study aimed to compare the safety and effectiveness of early mobilisation (≤24 hours post-tPA) versus ≥24-hour bed rest in patients with mild-moderate stroke. Methods A literature review was conducted leading to the development of an early mobilisation protocol post-tPA. Retrospective (January-July 2023: pre-early mobilisation protocol) and prospective (July 2023-April 2024: post-early mobilisation protocol) data were analysed. Baseline demographics and outcomes were compared between the two groups. Primary outcome was physical function (Modified Rankin Scale (mRS) at hospital discharge. Secondary outcomes included adverse effects, length of stay (LOS) and discharge destination. Results 11 patients met the criteria for early mobilisation in both groups. There were no significant differences in age, the National Institutes of Health Stroke Scale (NIHSS) pre-tPA and mRS at baseline between the two groups (p>0.05). 8 patients in the early mobilisation protocol were male (72.73%), the median (IQR) age was 61 (54-78) years, and NIHSS was 6 (3-8) pre-tPA and 1 (0-2) post-tPA. Patients had a median (IQR) mRS score of 0 (0-0) pre-stroke and time to early mobilisation was 12 (12-17) hours. Patients in the early mobilisation group had significantly lower mRS on discharge (p=0.007), shorter LOS (Median (IQR) 5 (4-7) days, P=0.13) and higher rates of discharge directly home compared to those mobilised post ≥24-hour bed rest. No adverse effects of early mobilisation occurred. Conclusion Compared with 24-hour bed rest, early mobilisation for mild-moderate stroke patients was safe and associated with significantly better physical function.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"22 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142360213","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}
引用次数: 0
“Addressing the Silent Need” "满足无声的需求"
IF 6.7 2区 医学
Age and ageing Pub Date : 2024-09-30 DOI: 10.1093/ageing/afae178.154
Claire Gallagher, Ruth Staunton, Nichola Boyle
{"title":"“Addressing the Silent Need”","authors":"Claire Gallagher, Ruth Staunton, Nichola Boyle","doi":"10.1093/ageing/afae178.154","DOIUrl":"https://doi.org/10.1093/ageing/afae178.154","url":null,"abstract":"Background Clinical Specialist Teams (CST) are a foundational component of the Integrated Care Programme for Older Persons (ICPOP) providing care for older adults with complex needs, completing Comprehensive Geriatric Assessments (CGA) and supporting goals until outcomes are optimised (HSE, 2021). WHO (2014) estimates 400 million individuals worldwide are affected by hearing loss, with prevalence increasing with age. The WHO in 2024 recommended targeted hearing screening and interventions in older age. NICE guidelines (2023) issued specific recommendations for adults with suspected or diagnosed dementia or mild cognitive impairment (MCI). The aim of this study was to review current practice of sensory assessment with respect to these recommendations. Methods This is a retrospective audit to evaluate current practice against established standards and to identify areas for improvement to achieve best practice. This will form part of an ongoing quality improvement initiative. Data was collected using a team designed tool gathering information on sensory assessment, interventions and onward referrals. A sample of 65 ICPOP clients was chosen from the last quarter of 2023. Results Preliminary results: Conclusion Screening rates for sensory impairment in the CST is high but needs improvement to reach the target of 100%. Referral onto appropriate services for specialised sensory intervention is actioned adequately, but there is need for the CST to advise timely hearing and vision testing to clients in order to adhere to international guidelines, especially those clients with dementia/MCI.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"18 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142360275","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}
引用次数: 0
Identification and Modification of Fall-Risk-Increasing-Drugs Following Fall-Related Hospitalization in Older Adults 老年人因跌倒住院后跌倒风险增加药物的识别与调整
IF 6.7 2区 医学
Age and ageing Pub Date : 2024-09-30 DOI: 10.1093/ageing/afae178.232
Mubashra Ashraf, Yvonne Boland, Sarah Mello
{"title":"Identification and Modification of Fall-Risk-Increasing-Drugs Following Fall-Related Hospitalization in Older Adults","authors":"Mubashra Ashraf, Yvonne Boland, Sarah Mello","doi":"10.1093/ageing/afae178.232","DOIUrl":"https://doi.org/10.1093/ageing/afae178.232","url":null,"abstract":"Background Falls are a common cause of hospitalization in older adults and carry a significant risk of morbidity and mortality. Polypharmacy and certain medications are strongly associated with increased falls risk. Guidelines recommend that falls requiring hospitalization should trigger a multi-factorial risk assessment, including medication review. This study aims to describe the prevalence of fall-risk-increasing-drugs (FRIDs) in older adults admitted with a fall, and to determine whether or not these medications are appropriately identified, reviewed and modified as per the hospital’s recently developed ‘Guideline on Medication and the Risk of Falls’. Methods Hospital admissions were screened daily to identify fallers. Medical chart and drug kardex review was performed to collect demographic data and FRIDs prescription. Anticholinergic burden was calculated using the ACB score. Documentation of medicine reconciliation, indication for FRIDs, and modification of FRIDs by the admitting team was recorded. Results Data was prospectively collected on 25 consecutive patients, 18 (72%) were female and the average age was 82. Overall, 23 (92%) of were prescribed FRIDs and 21 (84%) had polypharmacy. Average ACB score was 1.76 (range 0-6). The most commonly prescribed FRIDs were anti-hypertensives (72%), diuretics (48%) and anti-depressants (44%). FRIDs were identified as a potential cause of falls in six (24%) cases, and their indication was documented in four (16%) cases. FRIDS were reduced, stopped or changed to a safer alternative in eight (32%) of cases. Conclusion FRIDs are commonly prescribed for older adults, with an average of three FRIDS prescribed per patient in this study. The need for improvement in recognition and documentation of FRIDs as potential contributors to falls has also been highlighted. Further education and dissemination of the ‘Guideline on Medication and the Risk of Falls’ is prudent to ensure proper prescribing and de-prescribing practices.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"1 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142360168","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}
引用次数: 0
“What Matters To Me?” Responses from Older People in the Acute Setting "什么对我重要?急诊室老年人的回答
IF 6.7 2区 医学
Age and ageing Pub Date : 2024-09-30 DOI: 10.1093/ageing/afae178.052
Diane O Toole, Mary Berry, Marian Bracken, Alice Farrelly
{"title":"“What Matters To Me?” Responses from Older People in the Acute Setting","authors":"Diane O Toole, Mary Berry, Marian Bracken, Alice Farrelly","doi":"10.1093/ageing/afae178.052","DOIUrl":"https://doi.org/10.1093/ageing/afae178.052","url":null,"abstract":"Background The ‘What Matters to Me’ question has been used in many areas of the healthcare. In the context of older persons, the focus is typically on improving patient-centred care in long stay settings or in people living with dementia. It is also synonymous with end-of-life decisions. The question is contextual in itself and can elicit a wide range of responses. In this abstract, it was included in the Comprehensive Geriatric Assessment (CGA) in a section about future care and responses were anticipated to be relevant to that subject. Methods The Older Person Specialist Nursing Team developed a CGA document for use in acute care. The “What Matters To Me?” question was included with the intention of discovering and recording older persons’ end of life plans and wishes. The responses to this question were extracted from a random 30 completed CGAs. Results A total of 24 responses were gathered, some participants provided multiple answers. Not documented n=6, 3 themes were identified from the responses; Home; Free time and Worries/Concerns. Return home was the most frequently expressed response; n=13. Other responses identified were enjoyment, pass times and pets; n=9. Worries/Concerns were identified in broad terms; “I’m worried out the future” n=7. Conclusion “What matters” in this context was a broad query and responses may have been influenced by participants current health status, location and fear of the future and the subjectivity of the question and the practitioner. Participants did not mention dying a concern but did allude to the future in a broad context. The “What Matters To Me” question will now be in the social information section and the Older Person Specialist Nursing Team are considering a targeted question related to end-of-life plans and wishes.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"22 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142360170","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}
引用次数: 0
Advancing Loneliness as a National Health Priority: Results of a Multisectoral Roundtable 将 "孤独 "作为国家健康优先事项加以推进:多部门圆桌会议的成果
IF 6.7 2区 医学
Age and ageing Pub Date : 2024-09-30 DOI: 10.1093/ageing/afae178.044
Joanna McHugh Power, Aileen O'Reilly, Robyn Homeniuk
{"title":"Advancing Loneliness as a National Health Priority: Results of a Multisectoral Roundtable","authors":"Joanna McHugh Power, Aileen O'Reilly, Robyn Homeniuk","doi":"10.1093/ageing/afae178.044","DOIUrl":"https://doi.org/10.1093/ageing/afae178.044","url":null,"abstract":"Background Ireland has the highest rates of loneliness of all EU countries. Those in the older old category (aged 80+) are at increased risk of developing loneliness, which is in turn a risk factor for many adverse health outcomes. Ireland has a strong tradition of Irish gerontological loneliness research, and it is critical to now know how best to focus research efforts to mitigate the impact of loneliness on older adults. Methods We held a roundtable discussion on priorities in Irish loneliness research at the Loneliness Taskforce Research Network inaugural event on 16th April 2024. 75 attendees were present, including those from non-governmental organisations, health and social care professionals, experts by lived experience, academic experts, researchers, and representatives from the private sector and governmental agencies. Of seven tables discussing loneliness research priorities, two tables were devoted to the discussion of priorities in research on loneliness in older people (with 18 participants in total). The priorities were noted, then amalgamated and organised. Results There was considerable heterogeneity in priorities raised, with little overlap across the two roundtable outputs. Of particular note was the need to evaluate the many services being delivered across Ireland to reduce loneliness, which operate without an evidence base. Other priorities included: Conclusion Results are informative for those planning future research on loneliness among older adults in Ireland and will form the basis for a report from the Loneliness Taskforce to the Irish Government, who have pledged funding for alleviation of loneliness.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"43 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142360172","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}
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