Shane O’Hanlon’s Age & Ageing Christmas Review- Part 2

Shane O’Hanlon is the Digital Media Editor for the BGS. He tweets @drohanlon

The second part of our look back at the most downloaded Age & Ageing articles of 2016…

6. Jeanet Blom and team conducted a cluster randomised controlled trial of effectiveness and cost-effectiveness of a proactive, goal-oriented, integrated care model in general practice for older people in the Netherlands. No beneficial effects were found on QoL, patients’ functioning or healthcare use/costs, but GPs experienced better overview of the care and stability, e.g. less unexpected demands, in the care.

5. Arun Kumar led a Cochrane systematic review and meta-analysis of exercise for reducing fear of falling in older people living in the community. They found that exercise interventions probably reduce fear of falling to a small to moderate degree immediately post-intervention in community-living older people. They noted that a high risk of bias in most included trials suggests findings should be interpreted with caution and that high-quality trials are needed to strengthen the evidence base in this area.

4. It has been suggested that overweight/obesity as a risk factor for incident dementia differs between mid-life and later life. Emilio Pedditizi, Ruth Peters & Nigel Beckett performed a systematic review and meta-analysis of the up-to-date current literature to assess this. Interestingly, their findings suggested a positive association between obesity in mid-life and later dementia but the opposite in late life. They comment that whether weight reduction in mid-life reduces risk is worthy of further study.

3. In a strong year for systematic reviews, Sabrina Youkhana and colleagues examined whether Yoga-based exercise improves balance and mobility in people aged 60 and over. They found 6 high quality trials and overall yoga interventions resulted in small improvements in balance and medium improvements in physical mobility. Whether that translates into prevention of falls is the next question.

2. Miriam Ruth Stanyon and colleagues looked at the facilitators of communication with people with dementia in a care setting in an interview study with healthcare workers. They found four overarching categories of themes were identified from the interviews that impact on communication: the attributes of a care worker, communication strategies used, organisational factors and the physical characteristics of the care environment. As many strategies used by healthcare workers to facilitate communication have not yet been studied, they recommended that participants’ views on training should be incorporated into future dementia training programmes.

1. By quite a margin, the electronic frailty index (eFI) paper by Andy Clegg and his team comes in as our most downloaded paper this year. Their aim was to develop and validate an eFI using routinely available primary care electronic health record data. Using data from almost a million patients, they found that one-year adjusted HR for mortality was 1.92 for mild frailty, 3.10 for moderate frailty and 4.52 for severe frailty. Corresponding estimates for hospitalisation were 1.93, 3.04 and 4.73 and for nursing home admission were 1.89, 3.19 and 4.76. With such useful data the authors posit that routine implementation of the eFI could enable delivery of evidence-based interventions to improve outcomes for this vulnerable group.