Dr Catherine Pennington is a Senior Clinical Research Fellow at the Centre for Dementia Prevention, University of Edinburgh, and honorary Clinical Lecturer at the University of Bristol ReMemBr Group. In the accompanying article she reviews different tools for assessing decision making capacity in people with dementia.
David Stott is Professor of Geriatric Medicine at the Institute of Cardiovascular and Medical Sciences at the University of Glasgow and is Editor in Chief for Age and Ageing journal. He will be retiring as Editor in Chief of Age and Ageing at the end of 2018 and expressions of interest are invited from qualified candidates to succeed him in January 2019 after a period of handover.
I am now coming toward the end of my 5 year tenure as Editor-in-Chief of Age and Ageing, having taken over this role from Roger Francis in February 2014.
Roger left the journal in terrific shape and so I was initially quite anxious about whether I would be able to ‘fill his boots’. However very quickly I realised that I was embedded in a fantastic team who are hugely supportive and great fun to work with. Continue reading
Professor Robert Clarke, Professor of Epidemiology and Public Health Medicine, University of Oxford and Angel Wong, MSc student in Global Health Science, examined the relevance of cardiovascular disease (CVD) risk factors for frailty in a recent report in Age and Ageing.
This report adds to the growing body of evidence linking CVD risk factors with an increased risk of frailty.
A frailty index questionnaire (40-items) was used to screen for frailty. CVD risk factors were combined using three composite risk scores: European Cardiovascular Disease Risk Score (SCORE), American Heart Association Ideal Cardiovascular Health (ICH) and Cardiovascular Health Metrics (CHM). Continue reading
Dr. Marcos Saraiva is a geriatrician from the Division of Geriatrics of University of São Paulo Medical School, Brazil. He and his co-authors recently published the paper Persistent pain is a risk factor for frailty: a systematic review and meta-analysis from prospective longitudinal studies in Age and Ageing journal.
Pain is a very common condition in older people, ranging from 40% in community-dwelling older adults to 80% in institutionalised individuals. It is known that pain, especially persistent pain (defined as a painful experience that continues for a prolonged period of time that may or may not be associated with a recognisable disease process), is associated with depression, social isolation, anxiety, insomnia, falls, higher health costs, weight loss, greater vulnerability to stressors and functional loss in older people. Continue reading
This blog was first published on the National Institute for Health Research (NIHR) Dissemination Centre Discover Portal. Read the corresponding Age and Ageing paper Yoga-based exercise improves health-related quality of life and mental well-being in older people: a systematic review of randomised controlled trials.
Yoga-based exercise offers a safe and accessible way to improve health-related quality of life and mental well-being for people over 60. Evidence for a moderate benefit of yoga in later life now extends beyond improved balance and flexibility.
Yoga includes stretches, poses, breathing routines and meditation. This review focused on the physical exercise/activity components. Most of the 12 included trials took place in Western countries and classes were all run by qualified yoga instructors as in the UK. Class attendance was high for eight weeks or more (50 to 96%). However, women outnumbered men by three to one, implying that yoga classes may need adapting to appeal to older men.
Yoga classes are widely available and could offer an accessible way to improve older people’s activity levels and well-being. The research was moderate to high quality, but it cannot yet show exactly how much yoga or which kind works best for particular groups of people. However, the good news is that these approaches seem effective.
The July 2018 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.
- Blood pressure targets in treatment of hypertension
- Falls prevention
- Probiotics and prevention of infection
- Improving healthcare outcomes in care homes
- Caregiver relationships and Parkinson’s disease
Giola Santoni is a researcher on health status and health trends in older people. She has worked at the Aging Research Center, Karolinska Institutet in Sweden and she is currently a biostatistician at the same institute.
Anna-Karin Welmer is associate professor and senior university lecturer at Karolinska Institutet. She is vice-principal investigator of the Swedish National study on Aging and Care in Kungsholmen (SNAC-K) population-study. Anna-Karin’s primary area of research interest is the epidemiology of physical function, disability and falls in older persons.
Despite the rapid gain in life expectancy in the last century, it is not clear if the added years consist of healthy years or years lived in poor health and disability.
Previous studies have reported stable or even declining levels of disability. However, disability is defined as the inability to perform basic activities of daily living independently in the environment a person lives. Disability trends can therefore be influenced by changes in the environment such as development of technical equipment. To what extent does the encouraging trend towards declines in disability in the older population reflect actual improvements in physical function? Continue reading
Professor Fiona Matthews is Professor of Epidemiology at Newcastle University, Newcastle-upon-Tyne, UK. In this blog, she shares a recent Age and Ageing publication looking at data collected since the 1990s on how much frailty exists in the population and whether it is more or less related to dying now than 30 years ago.
Most doctors involved in the care of older people would claim to know a frail patient when they see one. Being able to detect this frailty is crucial to ensure that treatment is appropriate, proportionate and likely to produce positive outcomes wherever possible. The measurement of frailty has become important recently with the inclusion of frailty within the requirements of an assessment in general practice, and tools to assist doctors in emergency departments evaluate frailty quickly. The most popular method for these investigations has been the frailty index, where diseases and impairments are added all together to give a score. The relationship between this frailty index and mortality has been seen across the world, giving rise to suggestions that it is one measure that is consistent across time and place. Continue reading
Dr Kristy Robson is a Lecturer in Podiatry at Charles Sturt University, a regional university in Australia. In this blog she shares a recent Age and Ageing publication that explores the behavioural decisions older people make when they knowingly and unknowingly undertake activities or tasks that pose a risk of falling. She tweets @KristyRobson2
Fall related injuries in older people constitute a significant public health issue in Australia and internationally. Falling represents the leading cause of unintentional injury in this population with approximately one third of older adults falling each year. Effective management of falls in older populations has proven to be challenging. Despite the substantial focus on falls prevention by the Australian government over the last decade the age standardised hospital admission rates attributed to falls continue to increase. The complexity of managing falls risk in the diverse populations found within Australia, coupled with an ageing population and finite resources, drives the need to better understand factors that can influence falling from the perspective of the older person. Continue reading
Sven Streit is a general practitioner at the Institute of Primary Health Care (BIHAM) in Bern (CH) and PhD Candidate at Leiden University Medical Center (NL). In this blog, he introduces the results of his PhD in a recent Age & Ageing paper on blood pressure, mortality risk and cognitive decline in a population-based cohort of oldest-old (all 85 years) in Leiden. He tweets @Sven_Streit
With increasing age, blood pressure rises as a consequence of arterial stiffness. It has been debated whether or not to it is beneficial to treat hypertension in old age, especially in >75-year-olds when they have multimorbidity, polypharmacy or frailty. Large hypertension trials showed that lowering blood pressure in over 60-year-olds is beneficial and lowers the risk for myocardial infarction, stroke and all-cause mortality, even in >80-year-olds. However, these trials lack generalizability and typically excluded patients with multimorbidity and frailty. At the same time, observational studies raise concerns about lowering blood pressure too much, since there are several cohort studies showing a reverse association between low blood pressure and increased mortality and accelerated cognitive decline starting from age >75-year-olds. Continue reading