Retirees leaving sociable workplaces may experience accelerated cognitive decline

A study published recently in Age and Ageing, the scientific journal of the British Geriatrics Society, provides new evidence that workers retiring from occupations which involve high levels of social stimulation may be at greater risk of accelerated cognitive decline in later life.

The study, which was conducted by researchers at University of Liège, in collaboration with the Universities of Bordeaux and South Florida, surveyed 1,048 individuals over the age of 65 from Bordeaux. Participants were evaluated at 2 year intervals for a period of 12 years. Psychologists’ evaluations included detailed assessments of subjects’ mental cognition, general health and information about their former occupation. Three independents raters were asked to evaluate the level of social and intellectual stimulation for each occupation. Continue reading

If frailty is viewed by some as a “commissioning Trojan Horse” this should be admitted

Dr Shibley Rahman is currently an academic physician in dementia and frailty. His contribution on the diagnosis of behavioural frontal frontotemporal dementia, published while he was a M.B./Ph.D. student at Cambridge in 1999, is considered widely to be an important contribution to the field, even cited in the Oxford Textbook of Medicine. Here he responds to Steve Parry’s recent BGS blog, The Frailty Industry: Too Much Too Soon?  He tweets at @dr_shibley.

In response to Steve Parry’s recent BGS blog, The Frailty Industry: Too Much Too Soon?, I would simply in this article like to set out some of the strengths and weaknesses in the conceptualisation of frailty, with some pointers about “where now?

There is, actually, no international consensus definition of frailty (although there is one of a related term “cognitive frailty”).

In a world of fierce competition for commissioning, and equally intense political lobbying in health and social care, the danger is that a poorly formulated notion becomes merely a “Trojan Horse” for commissioning.

I must humbly depart from the views of some colleagues – for me, frailty is not just a word. I could likewise point to other single words which cause gross offence, which are unrepeatable in my blogpost here. Continue reading

Systematic reviews for studies of older people

Susan Shenkin is Associate Editor for Systematic Reviews at Age and Ageing journal. She has recently published Systematic reviews: guidance relevant for studies of older people. She tweets at @SusanShenkin

Systematic reviews and meta-analyses are increasingly common. Our recent article in Age and Ageing journal aims to provide guidance for people conducting systematic reviews relevant to the healthcare of older people. It’s essential that systematic reviews are performed by a team which includes the required technical and clinical expertise: if you’re planning to do a review, ask for advice and support early. We hope that highlighting these issues will also help people reading systematic reviews to determine whether the results will influence their clinical practice. Here is a summary of ‘good practice points’. Continue reading

July 2017 issue of Age and Ageing journal is out now

The July 2017 issue of Age and Ageing, the journal of the British Geriatrics Society is out now.  A full table of contents is available here, with editorials, research papers, reviews, short reports, case reports book reviews and more.AA_46-03

Hot topics in this issue include:

  • Care home leadership
  • Physical restraint
  • Diet and muscle function
  • Prescribing for frail older
    adults
  • Treatment of overactive
    bladder

    The Editor’s View article gives an overview of the issue with a summary of highlights. This article is free to read and can be viewed here. Continue reading

    Attitudes and opportunities: Medical students’ and doctors’ attitudes towards older patients

    Dr Rajvinder Samra is a Chartered Psychologist working as a Lecturer in Health and Social Care at The Open University. She enjoys researching the influence of attitudes and personality in medical settings and tweets at @RajvinderSamra Read her Age and Ageing Paper.

    Social psychologists have been interested in attitudes for about 90 years now. Debate rages on about how much of what we do can be predicted from our attitudes. No doubt, over the past year, you will have read newspaper articles about how much someone’s attitude to a prominent issue covered in the media predicted their likelihood to vote for Brexit or Trump. This is an example of the attitude-behaviour link and the media trying to establish patterns so we can understand society better. The influence of attitudes on healthcare are frequently overlooked, but doctors’ or patients’ cognitive reasoning, preferences, values and emotions (i.e. all the things that come together to make up attitudes) can have a significant and meaningful impact on how services can, or should be, delivered. Continue reading

    Walking now prevents dementia later, study finds

    A new study published in Age and Ageing, the scientific journal of the British Geriatrics Society, suggests maintaining a higher level of physical activity during middle age may be a key strategy for the prevention of dementia in older age.

    Past studies have suggested that physical activity such as walking can be a protective factor against dementia but this study suggests that maintaining a higher level of physical activity before older age is more important for the prevention of dementia than physical activity only in older age. Continue reading

    Patients with vertebral fragility fractures treated in hospital – could we do better?

    Terence Ong is a Research Fellow funded by the Dunhill Medical Trust at the Department for Healthcare of Older People, Nottingham University Hospitals NHS Trust. He discusses his Age and Ageing Paper Characteristics and outcomes of hospitalised patients with vertebral fragility fractures: a systematic review. He tweets @terenceongkk

    Vertebral fragility fractures have received much attention lately due to growing research interest and increased awareness driven by high-profile osteoporosis groups such as the International Osteoporosis Foundation (through its vertebral fracture initiative) and the National Osteoporosis Society.

    There is growing literature to support how well vertebral fragility fractures predicts future fractures, morbidity and risk of mortality. However, what has been lacking is research exploring the specific cohort of people with vertebral fractures who are admitted to hospital. Continue reading

    Who’s our jolly good Fellow?

    The Editorial Board of Age and Ageing is delighted to announce the launch of a Fellowship attached to the Age and Ageing Journal.

    This opportunity is intended for trainees who plan a career in geriatric medicine who are interested in medical publishing. The 2-year appointment will run concurrently with the Fellow’s usual clinical post (or during period out of programme for research).

    The Fellow will learn about manuscript preparation, peer review, manuscript editing, and journal production.

    Roles will include involvement in general Journal business including handling submissions (under the supervision of the Editor or Associate Editor). Continue reading

    Designing safer systems of care delivery for older patients

    A new study published in Age & Ageing, the scientific journal of the British Geriatrics Society, identified incidents when poor communication between secondary and primary care and failures within primary care led to patient harm and highlights how improved communications systems could help protect older patients from harm. Timely electronic transfer of information with standardised formats could reduce medication and clinical decision-making incidents. Electronic alerts and expanded use of bar-coding are examples of systems which could tackle drug administration incidents.

    Older adults are frequent users of primary healthcare services and account for half of all 340 million general practice consultations in the United Kingdom each year.  The study was conducted by researchers at Cardiff University School of Medicine and examined 1,591 patient safety reports relating to patients aged over 65 in England and Wales over an eight year period. Continue reading

    Cognitive impairment, mortality and discharge from an acute hospital

    Carole Fogg is a Senior Lecturer at the University of Portsmouth/Portsmouth Hospitals Trust, (UK). She is a PhD Fellow under the Wessex Collaboration for Leadership in Applied Healthcare and Research, exploring hospital care and outcomes for patients with cognitive impairment and dementia. Her paper “The relationship between cognitive impairment, mortality and discharge characteristics in a large cohort of older adults with unscheduled admissions to an acute hospital: a retrospective observational study has recently been published in Age and Ageing. She tweets at @Carole_Fogg 

    When older people with dementia are admitted to hospital, they are more likely to die or to stay in hospital longer than people without dementia. Many older people have cognitive impairment (CI) (problems with memory and thinking) which is a main feature of dementia, but have not yet been given a diagnosis, or may have CI due to other medical conditions. We investigated how common cognitive impairment is in older patients in hospital, and what the risks are for these patients of staying longer or dying in hospital. Continue reading