Sir Muir Gray has worked for the National Health Service in England since 1972, occupying a variety of senior positions during that time. He is an internationally renowned authority on healthcare systems and has advised governments of several countries outside the UK including Australia, New Zealand, Italy, Spain and Germany. He tweets @muirgray
The British Geriatrics Society can be proud of the culture change it has achieved by providing leadership in the last seventy years. When the BGS was founded the prevailing beliefs of not only the public but also the medical profession, were that the problems of older people were due to the ageing process and not due to treatable disease – older people therefore needed “care” rather than accurate diagnosis, effective treatment and rehabilitation. The BGS and individual consultants should be proud of their achievements. There has been a revolution in the care of older people with disease. Continue reading →
Kimberly Miller is a Heart and Stroke Foundation Research Fellow and Research Coordinator (FAST study) at the University of British Columbia, Canada.
The World Health Organisation recommends regular physical activity for older individuals as an important preventative measure against disease and disability. While we all recognize that regular physical activity is important, it can be difficult for many people to achieve. Against this background, there has been increasing interest in the potential for using popular, commercially available gaming systems, such as the NintendoTM Wii, as a means of exercising in the comfort and convenience ones’ own home.
Alan Godfrey is a Research Associate at the Institute for Ageing and Health, Newcastle, and for the LiveWell Programme to promote improved health and well-being in later life. They tweet at: @LiveWellUK
A recent study from the Institute of Ageing and Health (IAH) at Newcastle University has suggested that retirement may have a positive effect on time spent being active (walking). To date, little is known about the effects of retirement and age on this form of physical activity as previous research has relied on diaries or estimates of activity (from self-reported time spent inactive) during a person’s daily/weekly schedule.
European populations are getting older in chronological, but not necessarily biological, terms. The association between chronological age and health status is extremely variable and decisions made in health and social care based solely on age do not reflect the complexity of older people. The Equality Act came into force in October 2012 and gives older people the right to sue if they have been denied health and/or social care based on agealone. The aim is to ensure that people are clinically assessed on the basis of their individual needs and fitness levels.
‘Fit’ individuals are resilient whereas ‘frail’ individuals are vulnerable and have an increased risk of adverse outcomes, including iatrogenesis, functional decline and death. Frail individuals can benefit from specialist multidisciplinary care and interventions but require careful identification and management. How do you determine where an individual sits along the fitness-frailty spectrum? ‘Fitness’ and ‘frailty’ are opposite ends of a challenging continuum and while experienced practitioners can (and often do) intuitively place their patients along that imaginary spectrum, this subjective ‘clinical impression’ of vulnerability may not be sufficient in the eyes of the Equality Act.
However, there is as yet no consensus on formal ‘frailty metrics’. Being able to place a person along the fitness-frailty spectrum independently of their age will become crucially important in the years ahead, both to advocate for resource and to target specialist care appropriately. Equality legislation should minimise instances of ageism and age discrimination but we need agreement on appropriate frailty metrics for health and social care to ensure that all individuals receive the most beneficial interventions.