Attitudes and opportunities: Medical students’ and doctors’ attitudes towards older patients

Dr Rajvinder Samra is a Chartered Psychologist working as a Lecturer in Health and Social Care at The Open University. She enjoys researching the influence of attitudes and personality in medical settings and tweets at @RajvinderSamra Read her Age and Ageing Paper.

Social psychologists have been interested in attitudes for about 90 years now. Debate rages on about how much of what we do can be predicted from our attitudes. No doubt, over the past year, you will have read newspaper articles about how much someone’s attitude to a prominent issue covered in the media predicted their likelihood to vote for Brexit or Trump. This is an example of the attitude-behaviour link and the media trying to establish patterns so we can understand society better. The influence of attitudes on healthcare are frequently overlooked, but doctors’ or patients’ cognitive reasoning, preferences, values and emotions (i.e. all the things that come together to make up attitudes) can have a significant and meaningful impact on how services can, or should be, delivered. Continue reading

Walking now prevents dementia later, study finds

A new study published in Age and Ageing, the scientific journal of the British Geriatrics Society, suggests maintaining a higher level of physical activity during middle age may be a key strategy for the prevention of dementia in older age.

Past studies have suggested that physical activity such as walking can be a protective factor against dementia but this study suggests that maintaining a higher level of physical activity before older age is more important for the prevention of dementia than physical activity only in older age. Continue reading

Patients with vertebral fragility fractures treated in hospital – could we do better?

Terence Ong is a Research Fellow funded by the Dunhill Medical Trust at the Department for Healthcare of Older People, Nottingham University Hospitals NHS Trust. He discusses his Age and Ageing Paper Characteristics and outcomes of hospitalised patients with vertebral fragility fractures: a systematic review. He tweets @terenceongkk

Vertebral fragility fractures have received much attention lately due to growing research interest and increased awareness driven by high-profile osteoporosis groups such as the International Osteoporosis Foundation (through its vertebral fracture initiative) and the National Osteoporosis Society.

There is growing literature to support how well vertebral fragility fractures predicts future fractures, morbidity and risk of mortality. However, what has been lacking is research exploring the specific cohort of people with vertebral fractures who are admitted to hospital. Continue reading

Who’s our jolly good Fellow?

The Editorial Board of Age and Ageing is delighted to announce the launch of a Fellowship attached to the Age and Ageing Journal.

This opportunity is intended for trainees who plan a career in geriatric medicine who are interested in medical publishing. The 2-year appointment will run concurrently with the Fellow’s usual clinical post (or during period out of programme for research).

The Fellow will learn about manuscript preparation, peer review, manuscript editing, and journal production.

Roles will include involvement in general Journal business including handling submissions (under the supervision of the Editor or Associate Editor). Continue reading

Designing safer systems of care delivery for older patients

A new study published in Age & Ageing, the scientific journal of the British Geriatrics Society, identified incidents when poor communication between secondary and primary care and failures within primary care led to patient harm and highlights how improved communications systems could help protect older patients from harm. Timely electronic transfer of information with standardised formats could reduce medication and clinical decision-making incidents. Electronic alerts and expanded use of bar-coding are examples of systems which could tackle drug administration incidents.

Older adults are frequent users of primary healthcare services and account for half of all 340 million general practice consultations in the United Kingdom each year.  The study was conducted by researchers at Cardiff University School of Medicine and examined 1,591 patient safety reports relating to patients aged over 65 in England and Wales over an eight year period. Continue reading

‘Look out’ – assessing a patient’s vision for falls prevention, what should it look like?

Dr Kawa Amin represents the BGS on the advisory group for the National Audit of Inpatient Falls (NAIF). He is a Consultant Geriatrician, Consultant lead for falls service and Geriatrics Departmental Lead for Safety & Quality at Barking, Havering and Redbridge University Hospitals NHS Trust.

As part of my role on the NAIF advisory group I have been involved in the development of a new bedside vision assessment tool which enables ward staff to quickly assess a patient’s eyesight in order to help prevent them falling or tripping while in hospital.

Being acutely unwell is and in a different environment, is a stressful experience.  Even with reassuring care from clinical teams treating them, older people often need extra support in a ward environment.  Can you imagine how frightening such an experience might be for a patient with visual impairment?  It’s perhaps no wonder that poor vision is a risk for delirium.   Continue reading

Dementia awareness is not just for one week – it’s for life

Dr Shibley Rahman is currently an academic physician in dementia and frailty. His contribution on the diagnosis of behavioural frontal frontotemporal dementia, published while he was a M.B./Ph.D. student at Cambridge in 1999, is considered widely to be an important contribution to the field even cited in the Oxford Textbook of Medicine. He has published widely on dementia, and his first book ‘Living well with dementia’ won best book for health and social care for the BMJ Awards in 2015. His third book ‘Enhancing health and wellbeing in dementia: a person-centred integrated care approach’ was published earlier this year on aspects of the integrated care pathway, and likewise has been critically acclaimed. He, furthermore, has a passionate interest in rights-based approaches which he accrued as part of his postgraduate legal training. He tweets at @dr_shibley.

This week – in England –  it’s ‘Dementia Awareness Week’ – 14-20 May 2017. But so what?

The problem is – ‘dementia awareness’ means different things to different people. In a nutshell, I hope that the workforce can embrace the notion that people living with dementia are incredibly rewarding to support and look after, and use this week as part of a celebration of this.

If you’re working in health and social care, it can be surprisingly easy to overestimate the knowledge about dementia amongst some members of the general public. Continue reading

Cognitive impairment, mortality and discharge from an acute hospital

Carole Fogg is a Senior Lecturer at the University of Portsmouth/Portsmouth Hospitals Trust, (UK). She is a PhD Fellow under the Wessex Collaboration for Leadership in Applied Healthcare and Research, exploring hospital care and outcomes for patients with cognitive impairment and dementia. Her paper “The relationship between cognitive impairment, mortality and discharge characteristics in a large cohort of older adults with unscheduled admissions to an acute hospital: a retrospective observational study has recently been published in Age and Ageing. She tweets at @Carole_Fogg 

When older people with dementia are admitted to hospital, they are more likely to die or to stay in hospital longer than people without dementia. Many older people have cognitive impairment (CI) (problems with memory and thinking) which is a main feature of dementia, but have not yet been given a diagnosis, or may have CI due to other medical conditions. We investigated how common cognitive impairment is in older patients in hospital, and what the risks are for these patients of staying longer or dying in hospital. Continue reading

Back to the Future? Please, no more studies “in the elderly”!

Shane O’Hanlon is a geriatrician and digital media editor for the British Geriatrics Society. He tweets @drohanlon Zoe Wyrko is a geriatrician and workforce lead for the British Geriatrics Society. She tweets @geri_baby

Sometime back in the 80s, when we were both nippers, Marty McFly got the chance to travel 30 years into the future and see how the world would change. Around this time in the medical literature it became common to take an interesting concept and tag “in the elderly” onto the end of it. Back then, we had articles on burns, epilepsy, even blunt chest trauma “in the elderly”. It was generally accepted that once you hit 65, *everything* changed. Suddenly you would be most unlikely to have surgery, palliation became the default, and you were fairly much on your way out. Because, after all, while nobody would ever dream of grouping neonates up to 40 year olds (the age we have just reached) into one group, surely it is acceptable to assume everyone from 65-105 is identical? Continue reading

You thought walking would keep your spine strong, but…

Dr. Dafne Zuleima Morgado Ramirez is based at the Interaction Centre (UCLIC) at University College London and is a member of the Global Disability Innovation Hub. She tweets at @zuleimamorgado. She has recently published work in Age and Ageing journal.

Walking has been promoted as a way of reducing the risk and progression of osteoporosis. Yet clinical studies have shown that walking does not increase bone mineral density at the spine unless it is performed along with other physical activities, and that even then, improvement is minimal. Physical activity produces vibration that is transmitted from the feet up to the head through the body. Although there is clear evidence that bone formation and resorption are responsive to mechanical stimulation, such as vibration, currently there is limited understanding of the vibration that is transmitted through the lumbar and thoracic spine during walking. Continue reading