New National Osteoporosis Guideline launched today – an opportunity for those aged 70 years or older?

Dr Celia Gregson is a Consultant Geriatrician in Bath and Consultant Senior Lecturer in Bristol. She is also a member of the National Osteoporosis Guideline Development Group. She tweets @celiagregson

The National Osteoporosis Guideline Group (NOGG) is pleased to announce that the UK NOGG 2017 Update was released via their website today.  This new Guideline, accredited by the National Institute for Health and Care Excellence (NICE) in March 2017, includes a number of updates relating to fracture risk assessment, management of osteoporosis and treatment recommendations, all highly relevant for older people.

It is currently recommended that fracture risk should be assessed using the freely available online FRAX tool in all postmenopausal women, and men age 50 years or more, who have risk factors for sustaining a fracture.  Continue reading

“Frailty is the most problematic expression of population ageing”

Dr Diarmuid O’Shea is a Consultant Geriatrician at St Vincent’s University Hospital in Dublin, Ireland.  The aim of this article is to provide an overview of the clinical syndrome of frailty, how it can be considered and effectively managed as a long-term condition.

One of the greatest challenges posed by an ageing population is the ability of healthcare professionals to understand, recognise and manage vulnerable older adults at increased risk of adverse healthcare outcomes. This frailty syndrome is age associated and is most marked in among those over 75 years of age. The older person showing signs of frailty is at increased risk of long term institutional care, hospitalisation, prolonged length of hospital stay and mortality, and will require specific interventions that span several health and social care services to enable them to live well for their remaining years. Continue reading

Take time to talk! The importance of an informant history

Adam Dyer is a Final Year Medical Student in Trinity College Dublin. Dr. Sean Kennelly (MB PhD FRCPI) is a Consultant Physician in Geriatric and Stroke Medicine in Tallaght Hospital (Dublin, Ireland) and a Clinical Senior Lecturer in Medical Gerontology at Trinity College Dublin (TCD). The following work was presented as a platform presentation at the 64th Irish Gerontological Society Meeting in Killarney, Ireland (October, 2016).

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

Feedback required from BGS members in England on the STP process so far…

Professor Tahir Masud is President-Elect of the BGS and heads the Clinical Gerontology Research Unit at Nottingham University Hospitals NHS Trust. 

Sustainability and Transformation Plans (STPs) were announced as part of NHS England’s NHS planning guidance 2016/17 – 2020/21. These documents created a new funding environment for NHS providers that aims to achieve collaboration by bringing together commissioners and providers of health and care services to support delivery of the NHS Five Year Forward View. To receive funding providers have to demonstrate that they have worked with each other, commissioners, the public and local authorities to create plans that will address the three gaps identified in the Forward View: 1) health and wellbeing, 2) care and quality and 3) finance and efficiency.  Continue reading

Unchain me: how our approach to safety leads to harm

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

Sarcopenia; a key driver of physical frailty

Miles Witham is a Clinical Reader in Ageing and Health, University of Dundee, and is Deputy Editor for Age and Ageing.

The BGS Autumn Meeting 2016 saw the launch of the newest BGS Special Interest Group – the Frailty and Sarcopenia Research SIG. The inaugural session, held in the main auditorium in Glasgow’s SECC was attended by several hundred delegates, and so far, over 100 members have signed up on-line to be part of the new SIG. So why do we need this SIG, and what do we hope it will achieve? Continue reading

Arise, Geriatricians of tomorrow! – A specialty rising to meet the challenges of the modern NHS

Dr Vicky Gibson is an ST5 Geriatric medicine/ General Internal Medicine trainee in North-East England. She is secretary of the Association for Elderly Medicine Education (AEME), whose recent paper “Why Geriatric Medicine – a survey of UK specialist trainees in Geriatric medicine has recently been published in Age and Ageing. She tweets at @gibsonvmvicky

The Association for Elderly Medicine Education (AEME) was founded in 2012, by a group of trainee geriatricians with the aim of improving elderly medicine education and promoting uptake into the specialty. You can follow them at @elderlymeded

I’m still inquisitive when I hear more junior trainees spontaneously say that they want to do Geriatrics.

“Well, you know. Previously Geriatricians were in the shadow of the other -ologies – now everyone wants a piece of them when things get complicated with their older patients. They’re like the knights in shining armour.” Continue reading

Accurate delirium screening when there is no carer available – impossible, right?

Suzanne Timmons is a geriatrician working in Mercy University hospital, Cork and a senior lecturer in University College Cork. She has a big clinical and research interest in delirium and dementia care in hospitals.

delirium-flatDelirium  is common in older people admitted to hospital, and is a serious condition that needs to be identified quickly on admission. But many busy hospital staff still don’t routinely screen older people for delirium, even when they have known dementia (dementia puts people at very high risk of delirium: see the Cork Dementia Study).

In this study, we tested out five simple cognitive tests to see if they could be used to screen for delirium. The tests were: the Six-item Cognitive Impairment Test (6-CIT; measuring attention, orientation to time, and short-term memory); the Clock-Drawing test; Spatial Span Forwards (pointing to a sequence of squares in a certain order); reciting the months of the year backwards (MOTYB); and copying a shape containing two intersecting pentagons. Continue reading

Can Irish set dancing benefit your health?

Joanne Shanahan is a Chartered Physiotherapist and Irish set dancing teacher. She completed her PhD in the University of Limerick. Joanne was the lead co-author of “Set dancing for people with Parkinson’s disease: an information resource for Irish set dancing teachers”. In this blog Joanne discusses her research.

irishSet dancing is an Irish cultural and social dance form. It involves dancing in a group of eight (sometimes four) people and is accompanied by the lively distinct beat of Irish dance music. Today set dancing is enjoyed by people worldwide with classes, workshops and ceilis organised all year round. Until recently the health benefits of set dancing were unknown. Recent Age and Aging publications by Shanahan et al. (2016), presented at the Irish Gerontology Society Annual Meeting 2016, have informed this question. Continue reading

‘Five a day’ keep dementia away, say researchers

fruit-and-vegHaving 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