Asking the Big Questions in Dublin’s Fair City – Part 1

Mary Ni Lochlainn is an Academic Clinical Fellow in Geriatric Medicine. She works at King’s College Hospital NHS Foundation Trust.

This February marked the first, hopefully of many, Biogerontology for Clinicians International Conference, held at the state-of-the-art Mercer Institute of Successful Ageing (MISA) at St. James’ Hospital, Dublin. Hosted by the inimitable Professor Rose Anne Kenny, of Trinity College Dublin, and staff of The Irish Longitudinal Study of Ageing (TILDA), the programme boasted twelve expert speakers across a day and a half, with the aim of putting recent advances in biology in context with the pathology of ageing. The idea was to bring together leaders in ageing from various backgrounds, to ‘generate meaningful collaborative, translational approaches with significant potential strategic value to service users.’ And it certainly achieved those aims.

“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.

Can a National Frailty Education Programme be a driver of culture change in healthcare?

Dr Diarmuid O’Shea is a Consultant Geriatrician at St Vincent’s University Hospital in Dublin, Ireland, and Deirdre Lang is the Director of Nursing, National Clinical Programme for Older People, Royal College of Physicians of Ireland and Health Services Executive

We all know that population ageing is occurring rapidly. Between 2015 and 2030 the number of people in the world aged 60 years or over is projected to grow by an extraordinary 56%. By 2050, the global population of older people is projected to more than double its size (United Nations, 2015). In Ireland, the population 65 years and over is projected to increase by between 58 and 63 per cent from 2015 to 2030. The older old population (i.e. those aged 80 years of age and over) is set to rise even more dramatically, by between 85 per cent and 94 per cent in this time period (ESRI 2017).

World first study reveals admitting an older relative in temporary respite care can be a deadly mistake

A world first study into deaths of Australians admitted into aged respite care – usually to provide a planned or emergency break for their carer – reveals that older people in respite care are significantly more likely to die from preventable injury causes such as falls than those who are permanent nursing home residents.

The study found that preventable deaths from choking are twice as high as for long term residential care. Other preventable deaths such as from suicide are also higher in these temporary residents.

The research – published in Age and Ageing journal, by Monash University researchers – has serious implications for the 80% of older Australians who are cared for in the community by spouses, family members and friends. Of these more than 50,000 go into temporary respite care each year.

Older people are living longer than before, but are they living healthier?

Ruby Yu is a research assistant professor at the Chinese University of Hong Kong (CUHK), specialising in gerontology and geriatrics. She is also a research fellow at the CUHK Jockey Club Institute of Ageing. Her recent paper Trajectories of frailty among Chinese older people in Hong Kong between 2001 and 2012: An Age-period-cohort Analysis was published today in Age and Ageing journal.

There is no doubt that people from countries all over of the world are living longer, but there is little evidence to suggest that older people today are living healthier than their predecessors did at the same age. This is a major cause of concern for many governments around the world because if the added years of people today are dominated by chronic diseases and functional disabilities, there will be negative implications (e.g., extended treatment for older people which increases the health and social care cost to society).

The GERIATRIC 5Ms – the 5 simple words every geriatrician needs to know (the new mantra)

Frank Molnar is a Canadian Royal College specialist in Geriatric Medicine who serves as the President of the Canadian Geriatrics Society and as the editor of that society’s Continuing Medical Education Journal. He tweets @FrankMolnarCGS

Those outside Specialized Geriatric Services have long had great difficulty understanding what specialists in Geriatrics do. We have contributed to this lack of clarity. As experts in complexity we often have difficulty communicating simply. In well-intentioned efforts to be inclusive and comprehensive we have employed long complex definitions that few outside our field can understand much less recall.

How often have you heard “what do you geriatricians really do?” Are you tired of explaining and re-explaining yourself? Are you looking for a better way to explain and sell our specialty?

Comprehensive Geriatric Assessment and the role it plays in improving care delivered to the older person

Dr Diarmuid O’Shea is a Consultant Geriatrician at St Vincent’s University Hospital Dublin, and Clinical Lead for the National Clinical Programme of Older People in Ireland.  

Ms. Carmel Hoey is a Nursing & Midwifery Planning and Development Officer at the NMPD Unit, Galway, and HSE Service Planner for the National Clinical Programme of Older People in Ireland. 

Countries around the world are seeing significant growth in the numbers of people living longer and healthier lives. We all need to reflect proactively on how we can best maximise the intergenerational benefits this will undoubtedly bring and we must also address the challenges it will generate.

Ireland is no different, with a substantial growth evident in our older population. The number of people aged over 65 years increased by 14% between 2006 and 2011. An increase of 17% is predicted between 2011 and 2016, and a further 17% is expected by 2021 (Central Statistics Office, 2013).

Is it time to redefine old age?

Vedamurthy Adhiyaman is a geriatrician working is North Wales. Here he discusses why we should redefine old age. He tweets @adhiyamanv 

Western literature arbitrarily defines old age as people above the age of 65 (Oxford textbook of geriatric medicine, Wikipedia etc). Few authors subdivide old age further as young old (65-74), old (75-84) and old-old (85+). This would make our reigning monarch ‘old-old’ and the next in line to the throne and our patron, old (not sure whether he would like to be called old…). And definitions of old age vary according to different parts of the world. For African countries, the United Nations set the age 60+ and the WHO defines 50+ as old. Dictionaries define old age as a later part of normal life without defining any numbers.

Autumn Speakers Series: Ageing and economic growth – not all doom and gloom?

Baroness Sally Greengross is Chief Executive of the International Longevity Centre – UK and has been a crossbench (independent) member of the House of Lords since 2000. She Co-Chairs four All-Party Parliamentary Groups: Dementia, Corporate Social Responsibility, Continence Care and Ageing and Older People. She was awarded a Special Lifetime Achievement Award at the BGS 70^th Anniversary Reception on 6 March 2017.  She will be speaking at the upcoming BGS Autumn Meeting in London.

What are the economic and societal effects of a global ageing society and the increasing need for a healthy older population who will be employed into their 70s? 

Firstly it is worth saying that ageing and economic growth – is not all doom and gloom? Population ageing is a global phenomenon. The rate of growth in older people (people aged over 65) is expected to far outpace the rise of the working age population (people age 15-64). The old age population will grow by more than 300% over the course of this century by comparison with the working age population which will grow by less than 50%.

Geriatric co-management: where is the evidence?

Bastiaan Van Grootven is a PhD researcher at the KU Leuven – University of Leuven in Belgium. His paper Effectiveness of in-hospital geriatric co-management: a systematic review and meta-analysis has recently been published in Age and Ageing. He tweets at @accentvv

Hospitals have long been recognized as a hazardous environment for frail patients. To date, care is still sub-optimal: cognitive and functional problems are not recognised or treated properly and patients are at high risk for delirium and functional decline. In our study, we reviewed 12 experimental studies to evaluate if geriatric co-management can improve outcomes for older in-patients. Co-management was defined as a shared responsibility and decision making between a medical doctor (e.g. surgeon) and geriatrician (or geriatric team) aiming to prevent and treat geriatric complications.