Imagine you’re seeing a consult or you’re on a post-take ward round. How often do we examine a patient and identify cognitive deficits, see that the CT brain scan report and the MMSE score are readily on hand, but then ask staff about the patient’s premorbid cognition and function and are met with blank expressions?
An important factor which complicates the presentation of older people to acute hospitals is the presence of impaired cognitive status (either in the form of dementia, delirium or both). Continue reading →
Healthcare professionals across the Atlantic and around the world need to think beyond single-disease guidelines as they look to provide high-quality, person-centered care for more and more older adults living with multiple chronic conditions, so say editors from the Journal of the American Geriatrics Society and the British Geriatrics Society’s (BGS’s) Age and Ageing in the first from a series of joint editorials launched today. The series will look for common ground in geriatrics “across the pond,” beginning here with the U.K.’s National Institute for Health and Care Excellence (NICE) guideline on multimorbidity, the medical term for those living with several chronic health concerns. Continue reading →
Professor Joseph Ibrahim is Head, Health Law and Ageing Research Unit at Monash University’s Department of Forensic Medicine and the Clinical Director of Geriatric, Rehabilitation and Palliative Care Medicine, at a large regional health service in Australia. Joseph has a keen interest in promoting better care for older people and edits the Communiqués printed educational material designed for health professionals to learn from cases investigated by the Coroners Court. Learn more about Joseph on his personal website.
Joseph and the team recently completed a landmark Australian study published in Age and Ageing, examining deaths due to physical restraint of people living in nursing homes. The study found that five deaths were recorded in nursing home residents due to physical restraint over the 13-year period. The median age of the residents who died was 83 years; all residents had impaired mobility and had restraints applied for falls prevention; four had diagnosed dementia. The mechanism of harm and cause of death were ascertained by a forensic pathologist following autopsy and in all cases, were formulated as ‘neck compression and entrapment by the restraints’. Continue reading →
Having at least 3 servings of vegetables and 2 servings of fruit daily might help prevent dementia in older adults according to a study published today in Age & Ageing, the scientific journal of the British Geriatrics Society.
The study, which was conducted by researchers at the Chinese University of Hong Kong, followed the cognitive status of 17,700 dementia-free older adults for 6 years. The objective was to investigate whether those consuming at least 3 servings of vegetables and 2 servings of fruits daily, in line with the World Health Organisation recommendation, were at a lower risk of developing dementia. Continue reading →
Fátima Brañas is a consultant geriatrician and the clinical lead for orthogeriatrics at the Infanta Leonor University Hospital in Madrid (Spain). She holds a PhD, specializing in HIV infection in older adults, and is working hard in this field—from both a clinical and a research point of view—to provide all the benefits of a geriatric assessment for older HIV-infected adults. She recently co-authored ‘Frailty and physical function in older HIV-infected adults‘ @FatimaBranas
The HIV-infected population is aging due to the success of combination antiretroviral therapy, which prolongs survival, and also because of the growing number of newly diagnosed cases in older adults. Nowadays, over half of people infected with HIV are older than fifty years, which is the age cutoff accepted by the scientific community to consider someone an HIV-infected older adult. Fifty is only their chronological age, but biologically they are older, as accelerated aging in this population has been demonstrated. So, it seems that in the coming years, HIV care is going to be focused on a growing group of older adults and their specific problems. This means more than only survival, infection control, or avoiding the adverse events caused by antiretroviral drugs; it also includes consideration of comorbidities, polypharmacy, functional decline, and geriatric syndromes. Continue reading →
Frequent sauna bathing can reduce the risk of dementia, according to a 20-year follow-up study. Men taking a sauna 4–7 times a week were 66% less likely to be diagnosed with dementia than those taking a sauna once a week. The association between sauna bathing and dementia risk has not been previously investigated.
The effects of sauna bathing on the risk of Alzheimer’s disease and other forms of dementia were studied in the Kuopio Ischemic Heart Disease Risk Factor Study (KIHD), involving more than 2,000 middle-aged men living in the eastern part of Finland. Continue reading →
Jenny Neuburger is a Senior Research Analyst at the Nuffield Trust (@NuffieldTrust) and a Visiting Research Fellow at the London School of Hygiene & Tropical Medicine. She and her co-authors have recently published research in Age and Ageing journal.
We have just published a paper showing that geriatrician involvement in hip fracture care can improve patient outcomes. Patients treated on wards with higher numbers of geriatrician hours tended to have lower mortality within the 30 days after presentation.
We measured geriatrician hours worked in orthopaedic departments using data collected via the National Hip Fracture Database annual survey each year from 2010 to 2013 for English hospitals. Over this period, geriatrician hours increased from 1.5 to 4.0 hours per patient, reflecting investments made in response the financial incentives introduced under the Best Practice Tariff scheme. Continue reading →
Nan Ma is specialist registrar in clinical Gerontology and Aza Abdulla is a consultant geriatrician and general physician at the Princess Royal University Hospital, Kings College NHS Foundation Trust. He is co-founder of the Special Interest Group on Pain in Older People in the British Geriatrics Society (BGS) and participated in producing the first National Guidelines on Management of Pain in Older People. He is also the immediate past president of the Geriatrics & Gerontology Section at the Royal Society of Medicine.
Pain in older people is under-reported and often poorly appreciated. For many, it is seen as part of normal ageing and has to be accepted. It is also a subjective feeling (different people have different pain thresholds) making it difficult for the clinician to quantify its impact in an individual patient. Consequently, it may be overlooked as an important factor that can affect older people’s wellbeing. In fact, chronic pain has a huge influence on quality of life (QoL) through its effects on the physical and mental state, which in turn adversely impacts on the older individual’s economic and social status (effects on carers, friends and family). Inadequately controlled pain perpetuates disability, anxiety, and depression all interfering with the overall QoL. It follows that effective management of pain is crucial in optimising welfare in the older person. Continue reading →
Dr Lucy Selman is Cicely Saunders International Faculty Scholar in the Department of Palliative Care, Policy, and Rehabilitation at King’s College London, and a Research Fellow at the University of Bristol. In this blog Lucy discusses her recent Age and Ageing paper on an international study of patient empowerment in hospitals in London, Dublin and San Francisco (part of BuildCARE, a project led by Prof. Irene J. Higginson at King’s College London).
Empowered patients adopt healthier behaviours, use health services more cost-effectively, and experience better quality of life than patients who feel they are passive recipients of healthcare. Across the developed world, policy-makers are waking up to the benefits for patients and health services when people are encouraged to engage with clinicians, make decisions and manage their illness in a way that reflects their own values. Continue reading →
People with dementia experience more mental and physical health problems than people without dementia, and more frequently take medication for mental health problems, so ensuring the get fair access to mental and physical healthcare is important.
Our study looked at primary care records of 68, 061 people with dementia and 259,337 people without dementia between 2002 and 2013. We looked at how rates of mental health medication prescribing (antipsychotic, antidepressant and sedative drugs); contact with General Practice surgeries and physical health checks (blood pressure, weight monitoring and an annual review) varied between people living in more and less deprived areas, and between men and women. Continue reading →