Reflections of an Editor

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.

ECFs and ANPs – The Future of Frailty?

Rachel Viggars is an Advanced Nurse Practitioner at Ashley Surgery (North Staffordshire CCG). Brigitte Knowles is a Elderly Care Facilitator at Madeley Surgery (North Staffordshire CCG). Both are undertaking the MSc Frailty and Integrated Care at Keele University.

We’ve always loved working with older people. Our roles in general practice certainly facilitate this!  When we were offered the opportunity to study at Masters Level in Medical Science: Frailty and Integrated Care, we jumped at the chance.  Finally, there was a focus on older people and an opportunity to improve standards and care.  But aside from this, it was a fantastic opportunity for us to complete a MSc in an area that we are passionate about, and the multi-professional learning that took place, really valued us as individual Health Care Professionals.  We were able to share and learn from the other professionals on the course and we really started to believe that we could do this and make a difference to our patient groups. 

Frequent drinkers unravelled

Beth Bareham, NIHR SPCR  doctoral fellow at Newcastle University Institute of Health and Society and Institute for Ageing (@bkateb1) She co-authored the Age and Ageing Paper Drinking in later life: a systematic review and thematic synthesis of qualitative studies exploring older people’s perceptions and experiences with Professor Eileen Kaner @EileenKaner, Liam Spencer @LiamPSpencer and Professor Barbara Hanratty @BarbaraHanratty.

Within the United Kingdom, older people experience more alcohol-related hospitalisations and deaths than any other age group. Risky drinking amongst  older people is not just confined to the United Kingdom. Potentially harmful patterns of drinking are common amongst older age groups across the globe. Older people are not only at risk because they drink more often, but also because quantities of alcohol that may have been safer earlier in life have the potential to damage an older person’s health if, like most, they have medical conditions or take medications. However, moderate drinking in older age has been linked with some health benefits, and drinking may also have a positive impact on their social lives. The impact of alcohol on older people is complex, and many different factors can influence their choices. To modify riskier drinking in later life and support people to live longer, healthier lives, it’s vital that we understand these complexities. 

Drug burden in older people approaching end of life

Dr. Denis Curtin is a specialist registrar in Geriatric Medicine in Cork University Hospital, Ireland. His paper Drug consumption and futile medication prescribing in the last year of life: an observational study was recently published the Age and Ageing journal.

The vast majority of older adults are admitted to hospital in their last year of life. For many of these people, hospitalizations are frequent and prolonged.

We reviewed the medical records of 410 older adults who were admitted to our hospital in the year prior to death. The median number of days spent in hospital was 32. While in hospital, patients consumed an average of 24 different medications. One-in-six patients consumed 35 or more individual medications. When discharged home from hospital, patients were prescribed an average of 2 unnecessary or inappropriate medications.

MY heart leaps up…

John Starr, Professor of Health & Ageing, Director of the Alzheimer Scotland Dementia Research Centre, University of Edinburgh.

I have been a consultant geriatrician in Edinburgh for over twenty years. I studied in Cambridge and London, and worked in Kent, the West Midlands and London before moving to Scotland.

Recently, one of my PhD students had just got a post-doc post. He’s a mathematician by training and we’ve been working on applying graph theory to EEGs to understand changing connections in the brain before the onset of dementia. He’s shortly going on to work with the Dementia Research Institute, including the vast genomic data of UK BioBank. He has no background in biology so I was explaining to him how all our cells have the same DNA, but not all the genes are expressed by all cells.

“Doc, I read on the Internet that probiotics might help me. Is it true?”

Patrick Alexander Wachholz  is a Geriatrician, Research associate at Botucatu Medical School, São Paulo State University (UNESP). His paper Effectiveness of probiotics on the occurrence of infections in older people: systematic review and meta-analysis was recently published in Age and Ageing journal.

In 2001, an international Joint Expert Consultation of sci­entists working on behalf of the Food and Agriculture Organization of the United Nations (FAO) and the World Health Organization (WHO) defined probiotics as “live microorganisms which, when administered in adequate amounts, confer a health benefit on the host”.

Probiotics are intended to have health benefits, and in some countries we can find a huge variety of products sold as probiotics including foods (such as yogurt and fermented milk), dietary supplements, and products that aren’t used orally, such as skin or vaginal creams.

New guidelines for recognising and assessing pain in older adults

New recommendations to help healthcare professionals recognise and assess levels of pain in older people were published today in the scientific journal Age and Ageing. The guidelines were developed by the British Geriatrics Society, the British Pain Society, the Royal College of Nursing, in collaboration with researchers at Teesside University, Anglia Ruskin University, University of Bournemouth, Centre for Ageing Better, and the Centre for Positive Ageing.

There is growing evidence to demonstrate that chronic pain is more prevalent among the older population and pain that interferes with everyday activities increases with age. Alleviating pain in the older population is therefore a priority but presents a number of challenges, especially in relation to communication with patients. These guidelines seek to address specific areas in which improvements can be made. To support this aim all existing publications on acute and chronic pain screening and assessment in adults over 60 years of age were identified, and two reviewers independently read and graded the papers according to the National Health and Medical Research Council criteria (1999b).

200 years of Parkinson’s disease

Gavin Gordon is a medical student from Newcastle University currently intercalating in the History of Medicine MA programme. He is the co-author of “200 Years of Parkinson’s disease: what have we learnt from James Parkinson?” recently published in Age and Ageing.

The 200th anniversary of James Parkinson’s seminal Essay on the Shaking Palsy gives cause for commemoration and reflection. Parkinson’s astute observation and careful description of only six patients led to one of the earliest and most complete clinical descriptions of Parkinson’s disease. With the concept of a syndrome still not fully realised, Parkinson was among the first writers to unify a set of seemingly unrelated symptoms into one diagnosis.

Number of older people with four or more diseases will double by 2035, say researchers

A study published recently in Age and Ageing, the scientific journal of the British Geriatrics Society, reports that the number of older people diagnosed with four or more diseases will double between 2015 and 2035. A third of these people will be diagnosed with dementia, depression or a cognitive impairment.

The study, conducted by researchers at Newcastle University’s Institute for Ageing, found that over the next 20 years there will be a massive expansion in the number of people suffering from multiple diseases, known as multi-morbidity. As a result two-thirds of the life expectancy gains, predicted as 3.6 years for men, 2.9 years for women, will be spent with four or more diseases.

Qualitative Research in Age and Ageing

This themed collection of Age and Ageing articles includes a selection of papers published over the last 10 years which highlights the value of qualitative methodologies in health services research, particularly in understanding patient experience of health and illness and decision making about treatment and preventive care. We hope this issue will raise awareness of the scope for further contributions and encourage authors to submit papers reporting qualitative studies to the journal.

Summary of topics and themes:

In an editorial in Age and Ageing ⁽⁵⁾, we drew attention to the way in which the application of qualitative research methods within the social science disciplines of sociology, anthropology and social psychology can enrich understanding of ageing and illness: for example, through eliciting the meaning and process of ageing, health and illness from the perspective of older people; the practice of service delivery and what shapes it; and the beliefs, values and ‘taken for granted ‘knowledge that professionals may apply in their work with older people.