July 2018 issue of Age and Ageing journal is out now

The July 2018 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 in this issue include:

• Blood pressure targets in treatment of hypertension
• Falls prevention
• Probiotics and prevention of infection
• Improving healthcare outcomes in care homes
• Caregiver relationships and Parkinson’s disease

The Editor’s View article gives an overview of the issue with a summary of highlights. This article is free to read and can be viewed here.

May 2018 issue of Age and Ageing journal is out now

The May 2018 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 in this issue include:

• New pain assessment guideline
• Future population burden of
  multimorbidity
• Systemic anti-cancer treatment for
  older people
• Treating malnutrition in care homes
• Effects of different types of
  exercise in older people
• Research methods – diagnostic test
  accuracy studies

The Editor’s View article gives an overview of the issue with a summary of highlights. This article is free to read and can be viewed here.

November 2017 issue of Age and Ageing journal is out now

The November 2017 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 in this issue include:

• Multimorbidity
• Frailty and recovery from acute illness
• In-hospital geriatric consultation
• Acupuncture for frail older people
• Including older people in research

The Editor’s View article gives an overview of the issue with a summary of highlights. This article is free to read and can be viewed here.

New Horizons in multimorbidity

Dr John V. Hindle was appointed Senior Clinical Lecturer in Care of the Elderly, to the School of Medical Sciences, in 2009. He has also held an honorary appointment as Senior Lecturer in Bangor University’s School of Psychology, since 1998. Here he discusses his Age and Ageing paper New horizons in multimorbidity in older adults.

There is increasing political and clinical interests in the concepts of multimorbidity and frailty. For those of us working with older people in primary and secondary care we feel that intuitively we understand these concepts. After all, we have been working towards improvement in care people with multimorbidity and frailty for many decades, and in some ways this was the origin of the specialty of Geriatric Medicine. However, although I have been working as a geriatrician for over 30 years, armed with my intuition, it is only in recent times that I have begun to truly understand the complexities of these issues. In recent years the concept of multimorbidity and particularly frailty have been injected with scientific understanding and explanation. We have come to understand the great impact that these issues have on health and social care, and the pressures that they bring to bear. The complexity of multimorbidity in the context of frailty, dementia and polypharmacy particularly bears a substantial healthcare burden. If like me you struggle to understand the full picture of the relationship between frailty and multi-morbidity, it is worth reading the article on New Horizons on Multimorbidity in Older Adults [1]. This overview helps explain the link between the concepts of multi-mobility and frailty and their relevance to the healthcare of older people. Although many people live with multimorbidity in midlife, particularly contributed to by social deprivation, it is important to understand that complex multimorbidity increases with increasing age.  The majority of older people have two or more long term conditions with care home residents having significant levels of multimorbidity.   

New Collaboration Looks for Trans-Atlantic Common Ground in Geriatrics

Top research journals launch international editorial series tackling the latest in geriatrics clinical practice & public policy. Up first: commonalities “across the pond” for older adults with multimorbidity.

Healthcare professionals across the Atlantic and around the world need to think beyond single-disease guidelines as they look to provide high-quality, person-centered care for more and more older adults living with multiple chronic conditions, so say editors from the Journal of the American Geriatrics Society and the British Geriatrics Society’s (BGS’s) Age and Ageing in the first from a series of joint editorials launched today. The series will look for common ground in geriatrics “across the pond,” beginning here with the U.K.’s National Institute for Health and Care Excellence (NICE) guideline on multimorbidity, the medical term for those living with several chronic health concerns.

Getting to grips with multimorbidity and polypharmacy for older people

Dr Kevin Mc Namara is a Senior Research Fellow at Deakin University’s School of Medicine and Centre for Population Health Research. He has a particularly interest in the implementation of models for chronic disease prevention and management, including the management of multimorbidity. His paper, Health professional perspectives on the management of multimorbidity and polypharmacy for older patients in Australia, has been published in Age and Ageing.

Researchers from Australia offer some valuable insights about effective multidisciplinary care for older people who often have multiple health conditions (multimorbidity) and take multiple medications (polypharmacy). In ageing populations across the developed world, multimorbidity and polypharmacy pose unique and growing challenges for health professionals and systems. Treatments and goals for different health conditions are often not compatible, guideline recommendations may not be feasible, the evidence often lacking for older adults, and health systems are not designed to coordinate the activities of multiple health professionals often involved with care.

Multi-morbidity – the case for change

David Paynton is a GP in an inner city surgery. He is also the Clinical Lead for Commissioning for the RCGP.

Generalists are the solution.

For too long policy makers have ignored what clinicians on the front line have been telling them, people with multiple conditions not only exist but are the mainstream.

It is our failure to recognise this fact that has put pressure in the system as the NHS struggles to keep its head above water especially when one adds social factors, depression and mental health into the mix of complexity.

The RCGP “responding to the needs of patient with multi-morbidity” has created a powerful case for change with the need to substitute ever-increasing investment into super specialism by a call for the generalist to support those with multi-morbidity in the community.

Getting to grips with multimorbidity and polypharmacy for older people

Dr Kevin Mc Namara is a Senior Research Fellow at Deakin University’s School of Medicine and Centre for Population Health Research. He has a particularly interest in the implementation of models for chronic disease prevention and management, including the management of multimorbidity. His paper, Health professional perspectives on the management of multimorbidity and polypharmacy for older patients in Australia, has been published in Age and Ageing journal.

Researchers from Australia offer some valuable insights about effective multidisciplinary care for older people who often have multiple health conditions (multimorbidity) and take multiple medications (polypharmacy). In ageing populations across the developed world, multimorbidity and polypharmacy pose unique and growing challenges for health professionals and systems. Treatments and goals for different health conditions are often not compatible, guideline recommendations may not be feasible, the evidence often lacking for older adults, and health systems are not designed to coordinate the activities of multiple health professionals often involved with care.

Perioperative Assessment at the BGS Autumn Meeting

Dr Jugdeep Dhesi is Chair of the BGS Perioperative Care of Older People Ungergoing Surgery SIG (POPS) and is consultant physician and clinical lead for the POPS service at Guy’s and St Thomas’ Hospitals. She will be Chairing the POPS Session at the BGS Autumn Meeting.

Older surgical patients are presenting us geriatricians with challenges. How should geriatric medicine fit into the national agenda for perioperative medicine? Which models of care work best in improving outcomes for this complex multimorbid group of patients? Do different surgical subspecialties require different approaches? How should these services differ between the district general and teaching hospital? Should elective and emergency older surgical patients be given equivalent geriatric medicine input? How can we balance the frequent calls to involve geriatricians in the care of older surgical patients against the numerous unfilled consultant posts in ‘traditional’ geriatric medicine that already exist? These issues will be explored in the POPS SIG session at the BGS meeting in Glasgow (Friday 25th November).

Musculoskeletal conditions: the case for better data

Musculoskeletal conditions are a major contributor to multimorbidity and are more likely to develop with age. Amy Forbes, Policy Officer at Arthritis Research UK explores the health data issues around musculoskeletal conditions.

Musculoskeletal conditions have a substantial impact on individuals, the health service and society as a whole. A musculoskeletal condition can hinder someone’s ability to do normal activities, significantly affecting their quality of life and limiting independence: common symptoms include pain, stiffness and loss of mobility and dexterity.

Musculoskeletal conditions are a major contributor to multimorbidity. They are the single biggest cause of disability in the UK, accounting for 30.5% of all years lived with disability. Around 20% of the general population consult their GP about a musculoskeletal problem each year, and 82% of people with osteoarthritis have at least one other long term condition like cardiovascular disease, hypertension or depression.