Burden of cardiovascular diseases in older adults using aged care services
ConclusionOur findings demonstrate the significant burden of CVD in people using both community-based and residential aged care services and highlights the importance of optimising cardiovascular care for older adults. (Source: Age and Ageing)
Source: Age and Ageing - June 18, 2021 Category: Geriatrics Source Type: research

Diagnostic complexity in the older patient: an unusual presentation of advanced biliary disease
AbstractBiliary disease is common in the older population, and gallbladder dysfunction and increased bile lithogenicity predispose to calculi formation. This case demonstrates an unusual presentation of gallbladder empyema. A 90-year-old male with metastatic prostate cancer presented with hypoactive delirium. With no localising features, normal liver function tests but persistently raised inflammatory markers, he was initially managed as a urinary tract infection. Chest wall discomfort and swelling over the right costal margin later developed. Abdominal imaging demonstrated a massive gallbladder empyema invaginating throug...
Source: Age and Ageing - June 18, 2021 Category: Geriatrics Source Type: research

Corrigendum to: Prevention of adverse drug reactions in hospitalized older patients with multi-morbidity and polypharmacy: the SENATOR* randomized controlled clinical trial
When this paper was first published, there were errors in Figure 1 and Table 3. These errors have now been corrected online. (Source: Age and Ageing)
Source: Age and Ageing - June 16, 2021 Category: Geriatrics Source Type: research

537 age, frailty and comorbidity in covid-19 inpatients 65 and older
ConclusionIn COVID-19 inpatients 65 and older, there was positive correlation between age and Clinical Frailty Scale, between age and Charlson Comorbidity Index and between frailty and comorbidity. More studies are needed to explore the interaction between age, frailty and comorbidity and COVID 19 morbidity and mortality. (Source: Age and Ageing)
Source: Age and Ageing - June 12, 2021 Category: Geriatrics Source Type: research

416 analgesia and peri-operative practice in fractured neck of femurs at york teaching hospitals nhs foundation trust
ConclusionsThe large increase in post op pain assessment is likely credited to mandatory input as part of e-observations and overall practice has improved significantly. A refresher training session will be provided for nursing staff to re-iterate the importance of assessing and responding to pain. The Hip Fracture Specialist Nurse is now competent to perform FIBs which may further increase the number performed on admission.Reference1. NICE. Hip fracture: management. Clinical guideline [CG124].https://www.nice.org.uk/guidance/cg124 (accessed 15/11/2020). (Source: Age and Ageing)
Source: Age and Ageing - June 12, 2021 Category: Geriatrics Source Type: research

529 assessing discomfort and distress in older inpatients with dementia
ConclusionsSigns of distress and agitation are common in hospitalised persons with dementia. Patients are often disoriented, which impedes communication of needs. This also has a high burden on staff, as many behavioural and psychiatric symptoms of dementia are experienced daily on wards. (Source: Age and Ageing)
Source: Age and Ageing - June 12, 2021 Category: Geriatrics Source Type: research

484 changing practices of decision making regarding do-not-attempt-cardiopulmonary-resuscitation orders amid the covid-19 pandemic
ConclusionThe COVID-19 pandemic has prompted more widespread and earlier decision-making regarding resuscitation status. Although case-fatality-rates were higher for older hospitalised patients with COVID-19, many older patients survived the illness. Advance care planning should be prioritised in all patients and should remain clinical practice despite the pandemic. (Source: Age and Ageing)
Source: Age and Ageing - June 12, 2021 Category: Geriatrics Source Type: research

462 counselling in care homes
ConclusionsIt is timely to consider the role of psychological therapy in supporting the mental health of care home residents. There is a need for further research to explore a service delivery model of counselling in care homes. (Source: Age and Ageing)
Source: Age and Ageing - June 12, 2021 Category: Geriatrics Source Type: research

551 easing the strain of constipation in care homes
ConclusionThe development& delivery of a bespoke laxative educational package along with pharmacist medication review of residents ’ current laxatives regimes resulted in a statistically improved appropriateness in laxative use. The education package developed will be shared with Medicines Optimisation for Older People (MOOP) Care Home Pharmacists for delivery in NI trusts.References1. De Giorgio et al. 2015. Chronic constipation in the elderly: a primer for gastroenterologist. BMC Gastroenterology, 14:130.2. Dennison, C et al. 2005. the health-related quality of life and economic burden of constipation. Pharmaceocon...
Source: Age and Ageing - June 12, 2021 Category: Geriatrics Source Type: research

480 information overkill: if the walls across hospitals wards could talk
ConclusionsMost people do not read the information on the walls on hospital wards. An appetite exists for alternative media. Paintings were earnestly called for at every point; a comforting ward environment should be part of the holistic care we aim to offer, especially for older patients. (Source: Age and Ageing)
Source: Age and Ageing - June 12, 2021 Category: Geriatrics Source Type: research

435 the impact of comprehensive geriatric assessment in the outcomes of older acute neurosurgical patients
ConclusionOur findings suggest that CGA input for older neurosurgical patients improves outcomes and should be incorporated routinely into neurosurgical clinical pathways. (Source: Age and Ageing)
Source: Age and Ageing - June 12, 2021 Category: Geriatrics Source Type: research

603 challenges in the management of severe orthostatic hypotension associated with supine hypertension in a patient with autonomic dysfunction on background of nasopharyngeal carcinoma and type ii diabetes mellitus
ConclusionChronic baroreflex failure is a late sequela of neck irradiation for naso-pharyngeal carcinoma due to accelerated atherosclerosis in the region of the carotid sinus baroreceptor. Treatment goal is achieved with adequate control of pre-syncopal symptoms and prevention of long term complications. Non-pharmacological interventions remain the first line of therapy, followed by pharmacological interventions as necessary. Nonetheless, management of blood pressure in these elderly patients with baroreflex dysfunction remains challenging and should be individualized. Moving forward, a prospective study on the incidence o...
Source: Age and Ageing - June 12, 2021 Category: Geriatrics Source Type: research

558 prevalence and impact of frailty in patients hospitalised with covid-19. the salford experience in waves 1 and 2
ConclusionFrailty is highly prevalent amongst patients of all ages admitted to SRFT with COVID-19. Higher scores of frailty are associated with increased mortality. (Source: Age and Ageing)
Source: Age and Ageing - June 12, 2021 Category: Geriatrics Source Type: research

514 frailty in osteoarthritis and the influence of co-morbidity
ConclusionsOur results suggest that people with OA are at increased risk of pre-frailty and frailty. The mechanisms are not fully understood, though co-morbidity appears to contribute to the risk of frailty beyond the expected additivity of risk due to OA and co-morbidity. Early diagnosis and optimal management of co-morbidities in people with OA may be beneficial. (Source: Age and Ageing)
Source: Age and Ageing - June 12, 2021 Category: Geriatrics Source Type: research

509 potentially inappropriate medication use and mortality in patients with cognitive impairment
ConclusionThe burden of PIMCog use in patients with cognitive impairment is high. PIMCog use is independently associated with all-cause mortality and vascular death. This is a potential modifiable risk factor for death in patients with neurocognitive disorders. Further research is required to independently validate this finding. (Source: Age and Ageing)
Source: Age and Ageing - June 12, 2021 Category: Geriatrics Source Type: research