Cardiovascular risk factors and frailty in a cross-sectional study of older people: implications for prevention

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

Moderate alcohol consumption associated with improved health in older people

wineA paper published this week in Age & Ageing, the scientific journal of The British Geriatrics Society, expands upon earlier research that moderate alcohol consumption is associated with lower levels of inflammation, and explores the potential for decreased risk for age-related conditions such as cardiovascular disease and frailty.

The editorial, which was written by researchers at The National Institute on Ageing in the United States, highlights the statistical correlation between moderate alcohol consumption and downregulation of C-reactive protein, an important biomarker of inflammation used in clinical practice. Ageing is associated with progressively higher levels inflammation and evidence has shown that individuals with raised levels of C-reactive protein are at higher risk for developing many age-related medical conditions including frailty, poor physical performance and low muscle strength. Inflammation is also a well-documented independent risk factor for cardiovascular disease. Continue reading

Highly irregular – atrial fibrillation treatment may reduce cognitive impairment

Terry Quinn is the joint Stroke Association & Chief Scientist Office Senior Clinical Lecturer based in the Institute of Cardiovascular and Medical Sciences, University of Glasgow. In this blog Terry discusses his recent Age and Ageing paper looking at anticoagulants (blood thinners) and dementia. He tweets @DrTerryQuinn

aaDespite decades of research, an effective treatment to prevent or delay dementia remains elusive. This is in stark contrast to cardiovascular disease, where we have many evidence based treatments in the therapeutic toolbox.  Certain cardiac diseases seem to be associated with cognitive decline and this begs the question, could cardiovascular medications prevent dementia?

We decided to look at a particularly common cardiac condition, atrial fibrillation (AF, an irregular heart beat). People with AF are at risk of stroke, a risk that can be substantially reduced with anticoagulant medication.  Continue reading

Atrial Fibrillation: The real story behind the new NICE guidelines

Richard Bogle is a Consultant Cardiologist based in London and Surrey. He specialises in the assessment and treatment of patients with all types of heart and vascular disease. He tweets at @richardbogleshutterstock_180215222

If you watched the news this week you might have thought that the only recommendation in the NICE Atrial Fibrillation Guideline was that doctors should not prescribe aspirin to prevent strokes. In fact most cardiologists and geriatricians stopped using aspirin for this condition several years ago and the NICE recommendation simply reaffirms those issued previously by other professional societies such as the European Society of Cardiology.

The real story behind the guidelines was, in my opinion, nothing to do with medication or rate versus rhythm but rather the importance of delivering a personalised package of care for patients with atrial fibrillation (AF). Recognising that AF is a long term health condition there is emphasis on the importance of shared decision making processes particularly around anticoagulation. Alongside the guideline NICE published a Patient Decision Aid to assist with this process.  Continue reading

British Geriatrics Society Scientific meeting: Day 2

This week sees the 2013 BGS Autumn Scientific Meeting take place in Harrogate. This international multi-disciplinary conference is for professionals concerned with the the health and care of older people. We will be presenting a packed scientific programme, with updates on a variety of clinical topics covering several special interests.poster exhibition

The second day of our conference opens at 9.00 with the President’s Welcome Address, followed by an update on the BGS response to the Francis Report.

Session G (9.20-10.30) is dedicated to Syncope beginning with Prof Roseanne Kenny (Trinity College Dublin) on the assessment of the older patient with syncope, followed by Dr Michael Norton (South of Tyne and Wear) who will be discussing when a cardiologist should see an older patient with syncope? Continue reading

May issue of Age and Ageing out now

The May 2013 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. Hot topics this issue include:

  • Pathogenesis and management of osteoarthritis
  • Risk factors for abuse in older people
  • The cost of stroke in Ireland
  • Preventing iatrogenic illness
  • Quality of life with advancing age

The Editor’s View article can be read here.

This issue’s free and open access paper are:

Age and Ageing collection: Developments in Stroke Medicine

Dr Victoria Haunton is Clinical Research Fellow and Honorary Specialist Registrar at Leicester Royal Infirmary.

Prof Tom Robinson is Professor of Stroke Medicine at Leicester Royal Infirmary and is an Associate Editor and the Supplements Editor for Age and Ageing journal.MCA-Stroke-Brain-Humn-2A

A collection of 10 Age and Ageing papers is free to view on the journal website.

Despite the dramatic revolution in stroke medicine, levels of stroke knowledge amongst the general public remain surprisingly poor, and there are still significant difficulties in getting patients to access stroke services promptly. Stephanie Jones et al sought to try and understand these problems in their important integrative review. Worryingly, they found that people struggle to name even one stroke risk factor or stroke symptom, particularly when open ended questions are used. Knowledge is especially poor in older members of the population, ethnic minority groups and those with a lower socio-economic status, but there is also a surprising lack of knowledge amongst those who have already suffered a stroke. Furthermore, there appears to be a real paradox between what people say they would do and what they would actually do in the event of a stroke; whilst at least 47% said they would contact emergency medical services if they suspected they or a relative were experiencing a stroke, only 18% of stroke patients had actually done this. There is therefore an urgent need for further public education. In light of their findings, Stephanie Jones and colleagues suggest that the ideal campaign should minimise barriers to health services and provide cues to action. Continue reading