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Editor’s view
Rowan H Harwood
doi : 10.1093/ageing/afab244
Age and Ageing, Volume 51, Issue 1, January 2022, afab244
Call for emergency action to limit global temperature increases, restore biodiversity, and protect health
Lukoye Atwoli, Abdullah H Baqui, Thomas Benfield, Raffaella Bosurgi, Fiona Godlee, Stephen Hancocks, Richard Horton, Laurie Laybourn-Langton, Carlos Augusto Monteiro, Ian Norman, Kirsten Patrick, Nigel Praities, Marcel G M Olde Rikkert, Eric J Rubin, Peush Sahni, Richard Smith, Nick Talley, Sue Turale, Damián Vázquez
doi : 10.1093/ageing/afab185
Age and Ageing, Volume 51, Issue 1, January 2022, afab185
Where next with frailty risk scores in hospital populations?
Sarah Hilmer, Ruth E Hubbard
doi : 10.1093/ageing/afab203
Age and Ageing, Volume 51, Issue 1, January 2022, afab203
Hypertension management in older patients—Are the guideline blood pressure targets appropriate?
Jane A H Masoli, James P Sheppard, Chakravarthi Rajkumar
doi : 10.1093/ageing/afab226
Age and Ageing, Volume 51, Issue 1, January 2022, afab226
Prognostic tools for the care of older adults presenting with trauma
Oliver Todd, Andrew Clegg
doi : 10.1093/ageing/afab249
Age and Ageing, Volume 51, Issue 1, January 2022, afab249
Urgent care for older people
Simon Conroy, Matt Thomas
doi : 10.1093/ageing/afab019
Age and Ageing, Volume 51, Issue 1, January 2022, afab019
Geriatric medicine is the clinical specialty that focuses upon the care of older people—especially those with frailty (a state of increased vulnerability). In hospital, older people living with frailty are at high risk of developing a range of unpleasant outcomes such as delirium, falls, fractures, pressure sores and death. Comprehensive geriatric assessment is a form of holistic care that incorporates a specific set of clinical competencies that are able to reduce these adverse outcomes. Over the years, geriatric medicine has moved from being more of a community-based service towards a more acute specialty—encroaching now upon emergency department care. The challenge now is to work out how best to deliver geriatric care across the whole hospital (older people with frailty are not just cared for in geriatric wards!). The themed collection published on the Age & Ageing journal website outlines key articles that are attempting to develop solutions to this challenging conundrum. We hope that you enjoy reading them.
Geriatric medicine in the era of climate change
Bethan Davies, Mahmood F Bhutta
doi : 10.1093/ageing/afab199
Age and Ageing, Volume 51, Issue 1, January 2022, afab199
Climate change has been termed the greatest threat to human health of the 21st century. Older people and those living with frailty are more vulnerable to the effects of climate change including heatwaves and extreme weather events, and therefore, we have a responsibility to advocate for action on the climate emergency and take steps to reduce the environmental impact of our care provision. The NHS contributes 5.7% to the carbon footprint of the UK, and by reviewing the financial costs associated with frailty, we estimate the carbon footprint of frailty to be 1.7 MtCO2e, or 7% of the total NHS carbon footprint. Resource use also increases with age with particular interventions and medical equipment such as hearing and mobility aids being predominantly associated with the care of older people. The NHS has committed to net zero carbon emissions by 2045 and in order to achieve this we all need to act—balancing the triple bottom line of environmental, social and financial impacts alongside outcomes for patients and populations when making decisions about care. The principles of sustainable healthcare are already embedded in the geriatrician’s holisitic approach to the care of older people and those living with frailty, and the imperative to reduce the carbon footprint of healthcare should add weight to the argument for extending the role of the geriatrician into other specialties. It is time to begin our journey to net-zero geriatric medicine.
Making progress: but a way to go—the age and ageing care-home collection
Adam L Gordon, Chloe Bennett, Claire Goodman, Wilco P Achterberg
doi : 10.1093/ageing/afab213
Age and Ageing, Volume 51, Issue 1, January 2022, afab213
Care homes enable people with advanced physical and cognitive impairment to live well with 24-h support from staff. They are a feature of care systems in most countries. They have proved pivotal to the coronavirus disease 2019 (COVID-19) response.
Healthcare for older people in Asia
Jean Woo
doi : 10.1093/ageing/afab189
Age and Ageing, Volume 51, Issue 1, January 2022, afab189
Populations in Asian developed economies are rapidly ageing, such that, currently, Hong Kong and Japan have the longest life expectancy at birth for both men and women. However, extended lifespan is not necessarily accompanied by prolongation of health span, such that there is increasing prevalence of frailty and dependency, which translates into increase in complex health and social needs as well as increase in absolute numbers of older adults that require such needs. Consideration of social determinants of healthy ageing would be important in the design of equitable health and social care systems. There is a trend towards development of integrated medical social care in the community in Asian countries. Long-term care insurance and also philanthropic support play a role in the financing of such care models.
Why illness is more important than disease in old age
Marcel G M Olde Rikkert, René J F Melis, Alan A Cohen, G M E E (Geeske) Peeters
doi : 10.1093/ageing/afab267
Age and Ageing, Volume 51, Issue 1, January 2022, afab267
Clinical reasoning and research in modern geriatrics often prioritises the disease concept. This is understandable as it has brought impressive advances in medicine (e.g. antibiotics, vaccines, successful cancer treatment and many effective surgeries). However, so far the disease framework has not succeeded in getting us to root causes of many age-related chronic diseases (e.g. Alzheimer’s disease, diabetes, osteoarthritis). Moreover, in aging and disease constructs alone fail to explain the variability in illness presentations.
Health care professionals and care staff challenges and experiences of managing sexual expression among older adults ?60 years in long-term care facilities: a qualitative review and meta-synthesis
Pei Juan Ho, Yong Shian Goh
doi : 10.1093/ageing/afab230
Age and Ageing, Volume 51, Issue 1, January 2022, afab230
Long-term care (LTC) facilities, in which older adults are institutionalised, have the responsibility to address their residents’ rights, privacy and comfort in expressing themselves sexually in an acceptable manner. However, many older adults have reported barriers in their sexual expression, which is often a result of the care staff’s attitudes in the facilities. This review synthesis evidence from qualitative studies on the challenges faced by care staff when supporting sexual expression of older residents in LTC facilities. The systematic review and meta-synthesis is reported according to the Enhanced Transparency in Reporting the Synthesis of Qualitative Research Statement. A systematic literature search for peer-reviewed studies was conducted on PubMed, Cochrane Library, EMBASE, Scopus, Web of Science, PsycINFO, CINAHL and ProQuest Theses and Dissertations from inception until December 2020. Sandelowski and Barroso’s two-step approach was used to synthesise the evidence. Seventeen qualitative studies published between 2004 and 2020 were included. This review encapsulated the experiences and challenges of 4,387 care staff whose age ranged from 18 to 69 years. Through the meta-synthesis, four themes were identified: varying manifestations of sexual expression and situations encountered, a spectrum of care staff’s attitudes, setting boundaries in dementia care and workplace support. Managing sexual expression can be challenging for the care staff, given the complex interplay between personal beliefs, social contexts, moral dilemmas, practical barriers and the lack of clear policies. This review highlighted the need to equip them with knowledge, skills and confidence in managing sexuality in LTC facilities.
Mobility endpoints in marketing authorisation of drugs: what gets the European medicines agency moving?
Simon U Jaeger, Martin Wohlrab, Daniel Schoene, Roman Tremmel, Michael Chambers, Letizia Leocani, Solange Corriol-Rohou, Jochen Klenk, Basil Sharrack, Judith Garcia-Aymerich, Lynn Rochester, Walter Maetzler, Milo Puhan, Matthias Schwab, Clemens Becker
doi : 10.1093/ageing/afab242
Age and Ageing, Volume 51, Issue 1, January 2022, afab242
Mobility is defined as the ability to independently move around the environment and is a key contributor to quality of life, especially in older age. The aim of this study was to evaluate the use of mobility as a decisive outcome for the marketing authorisation of drugs by the European Medicines Agency (EMA).
Behaviour change interventions to increase physical activity in hospitalised patients: a systematic review, meta-analysis and meta-regression
Nicholas F Taylor, Katherine E Harding, Amy M Dennett, Samantha Febrey, Krystal Warmoth, Abi J Hall, Luke A Prendergast, Victoria A Goodwin
doi : 10.1093/ageing/afab154
Age and Ageing, Volume 51, Issue 1, January 2022, afab154
Low physical activity levels are a major problem for people in hospital and are associated with adverse outcomes.
Traumatic brain injuries among veterans and the risk of incident dementia: A systematic review & meta-analysis
Karen K Leung, Frances M Carr, Matthew J Russell, Suzette Bremault-Phillips, Jean A C Triscott
doi : 10.1093/ageing/afab194
Age and Ageing, Volume 51, Issue 1, January 2022, afab194
Traumatic brain injuries (TBI) among military veterans are increasingly recognized as important causes of both short and long-term neuropsychological dysfunction. However, the association between TBI and the development of dementia is controversial. This systematic review and meta-analysis sought to quantify the risks of all-cause dementia including Alzheimer’s diseases and related dementias (ADRD), and to explore whether the relationships are influenced by the severity and recurrence of head injuries.
Post-hospital falls incidence and risk factors among older adults: a systematic review and meta-analysis
Xing Xing Qian, Zi Chen, Daniel Y T Fong, Mandy Ho, Pui Hing Chau
doi : 10.1093/ageing/afab209
Age and Ageing, Volume 51, Issue 1, January 2022, afab209
Post-hospital falls constitute a significant health concern for older adults who have been recently discharged from the hospital.
Do we AGREE on the targets of antihypertensive drug treatment in older adults: a systematic review of guidelines on primary prevention of cardiovascular diseases
Jonathan M K Bogaerts, Leonie M von Ballmoos, Wilco P Achterberg, Jacobijn Gussekloo, Sven Streit, Milly A van der Ploeg, Yvonne M Drewes, Rosalinde K E Poortvliet
doi : 10.1093/ageing/afab192
Age and Ageing, Volume 51, Issue 1, January 2022, afab192
translation of the available evidence concerning primary cardiovascular prevention into clinical guidance for the heterogeneous population of older adults is challenging. With this review, we aimed to give an overview of the thresholds and targets of antihypertensive drug therapy for older adults in currently used guidelines on primary cardiovascular prevention. Secondly, we evaluated the relationship between the advised targets and guideline characteristics, including guideline quality.
Fracture risks in patients with atrial fibrillation treated with different oral anticoagulants: a meta-analysis and systematic review
Xiaoping Xie, Yumeng Liu, Jiangbi Li, Feng Gu, Ke Zhang, Zhenjiang Sui, Jiting Zhang, Tiecheng Yu
doi : 10.1093/ageing/afab264
Age and Ageing, Volume 51, Issue 1, January 2022, afab264
evidence on the difference in fracture risks for patients with atrial fibrillation (AF) receiving direct oral anticoagulants (DOACs) versus warfarin remains controversial. We aim to compare the fracture risks between the DOAC and warfarin prescriptions among the AF patients.
External validation of the Hospital Frailty Risk Score in France
Thomas Gilbert, Quentin Cordier, Stéphanie Polazzi, Marc Bonnefoy, Eilìs Keeble, Andrew Street, Simon Conroy, Antoine Duclos
doi : 10.1093/ageing/afab126
Age and Ageing, Volume 51, Issue 1, January 2022, afab126
The Hospital Frailty Risk Score (HFRS) has made it possible internationally to identify subgroups of patients with characteristics of frailty from routinely collected hospital data.
Development and validation of the geriatric trauma frailty index for geriatric trauma patients based on electronic hospital records
Fangjie Zhao, Bihan Tang, Xu Liu, Weizong Weng, Bo Wang, Yincheng Wang, Zhifeng Zhang, Lulu Zhang
doi : 10.1093/ageing/afab186
Age and Ageing, Volume 51, Issue 1, January 2022, afab186
Globally, geriatric patients are the dominant population requiring global medical care. We established a frailty index for geriatric trauma patients by retrospectively analysing electronic hospital records to identify patients with frailty characteristics and poor prognostic outcomes.
Adverse effects of subcutaneous vs intravenous hydration in older adults: An assessor-blinded randomised controlled trial (RCT)
Mathias Brix Danielsen, Elisa Worthington, Jesper Scott Karmisholt, Jørn Munkhof Møller, Martin Gronbech Jørgensen, Stig Andersen
doi : 10.1093/ageing/afab193
Age and Ageing, Volume 51, Issue 1, January 2022, afab193
Hydration therapy is essential in the care of the older patient. Subcutaneous (SC) hydration is a relevant method for parenteral hydration, but clinical trials on the subject have methodological shortcomings compared to updated standards.
Trajectories of depressive symptoms and subsequent cognitive decline in older adults: a pooled analysis of two longitudinal cohorts
Yidan Zhu, Chenglong Li, Wuxiang Xie, Baoliang Zhong, Yangfeng Wu, James A Blumenthal
doi : 10.1093/ageing/afab191
Age and Ageing, Volume 51, Issue 1, January 2022, afab191
the course of depression is variable, but it is unknown how this variability over time affects long-term cognitive decline.
Effects of functional task exercise on everyday problem-solving ability and functional status in older adults with mild cognitive impairment—a randomised controlled trial
Lawla L F Law, Vincent C T Mok, Matthew K S Yau, Kenneth N K Fong
doi : 10.1093/ageing/afab210
Age and Ageing, Volume 51, Issue 1, January 2022, afab210
To investigate the effect of functional task exercise on everyday problem-solving ability and functional status in older adults with mild cognitive impairment compared to single exercise or cognitive training and no treatment control.
Potentially inappropriate medications and their effect on falls during hospital admission
Birgit A Damoiseaux-Volman, Kimmy Raven, Danielle Sent, Stephanie Medlock, Johannes A Romijn, Ameen Abu-Hanna, Nathalie van der Velde
doi : 10.1093/ageing/afab205
Age and Ageing, Volume 51, Issue 1, January 2022, afab205
to investigate the effect of potentially inappropriate medications (PIMs) on inpatient falls and to identify whether PIMs as defined by STOPPFall or the designated section K for falls of STOPP v2 have a stronger association with inpatient falls when compared to the general tool STOPP v2.
Do home adaptation interventions help to reduce emergency fall admissions? A national longitudinal data-linkage study of 657,536 older adults living in Wales (UK) between 2010 and 2017
Joe Hollinghurst, Helen Daniels, Richard Fry, Ashley Akbari, Sarah Rodgers, Alan Watkins, Sarah Hillcoat-Nallétamby, Neil Williams, Silviya Nikolova, David Meads, Andy Clegg
doi : 10.1093/ageing/afab201
Age and Ageing, Volume 51, Issue 1, January 2022, afab201
falls are common in older people, but evidence for the effectiveness of preventative home adaptations is limited.
Comprehensive geriatric assessment in newly diagnosed older myeloma patients: a multicentre, prospective, non-interventional study
Yuan Yao, Wei-Wei Sui, Ai-Jun Liao, Wei Wang, Li-Juan Chen, Xiao-Xia Chu, Li Bao, Xi-Nan Cen, Rong Fu, Hui Liu, Chun-Yan Sun, Feng-Yan Jin, Hua Yan, Lu-Qun Wang, Cheng-Lu Yuan, Guang-Xun Gao, Da Gao, Jin-Qiao Zhang, Jian-Xia He, Jian-Da Hu, Liang-Ming Ma, Lu Zhang, Dao-Bin Zhou, De-Hui Zou, Jian Li
doi : 10.1093/ageing/afab211
Age and Ageing, Volume 51, Issue 1, January 2022, afab211
Multiple myeloma is a disease of the older people, whose prognoses are highly heterogeneous. The International Myeloma Working Group (IMWG) proposed a geriatric assessment (GA) based on age, functional status and comorbidities to discriminate between fit and frail patients. Given the multidimensional nature of frailty and the relatively recent exploration of frailty in the field of MM, reaching a consensus on the measurement of frailty in MM patients remains challenging.
Medical cost of advanced illnesses in the last-year of life—retrospective database study
Palvinder Kaur, Huei Yaw Wu, Allyn Hum, Bee Hoon Heng, Woan Shin Tan
doi : 10.1093/ageing/afab212
Age and Ageing, Volume 51, Issue 1, January 2022, afab212
This study aims to quantify medical care utilisation, and to describe the cost trajectories of individuals with advanced illnesses in the last-year of life, differentiated by advanced cancer, end-stage organ failure and progressive neurological disorders.
Prevalence of malnutrition risk among older French adults with culinary dependence
Virginie Van Wymelbeke-Delannoy, Isabelle Maître, Agnès Salle, Bruno Lesourd, Nathalie Bailly, Claire Sulmont-Rossé
doi : 10.1093/ageing/afab208
Age and Ageing, Volume 51, Issue 1, January 2022, afab208
The term ‘culinary dependence’ denotes a situation in which someone delegates all or part of their daily meal-related activities to a third party. The present study aimed to explore nutritional risk among older people (?65 years) with culinary dependence.
Utility of white matter disease and atrophy on routinely acquired brain imaging for prediction of long-term delirium risk: population-based cohort study
Sarah T Pendlebury, Ross J Thomson, Sarah J V Welch, Wilhelm Kuker, Peter M Rothwell, for the Oxford Vascular Study
doi : 10.1093/ageing/afab200
Age and Ageing, Volume 51, Issue 1, January 2022, afab200
brain imaging done as part of standard care may have clinical utility beyond its immediate indication. Using delirium as an exemplar, we determined the predictive value of baseline brain imaging variables [white matter changes (WMC) and atrophy] for delirium risk on long-term follow-up after transient ischemic attack (TIA)/stroke in a population-based cohort study.
Olive oil consumption is associated with lower frailty risk: a prospective cohort study of community-dwelling older adults
Carolina Donat-Vargas, Ligia J Domínguez, Helena Sandoval-Insausti, Belén Moreno-Franco, Jimena Rey-Garcia, José R Banegas, Fernando Rodríguez-Artalejo, Pilar Guallar-Castillón
doi : 10.1093/ageing/afab198
Age and Ageing, Volume 51, Issue 1, January 2022, afab198
There is no evidence on the specific beneficial association of the main types of olive oil consumption with frailty.
Prospective determination of the incidence and severity of hyponatraemia in older hospitalised patients with acute urinary tract obstruction
Dvorah S Shapiro, Irina Alexandrovich, Moshe Sonnenblick, Linda Shavit, Gabriel Munter, Reuven Friedmann
doi : 10.1093/ageing/afab234
Age and Ageing, Volume 51, Issue 1, January 2022, afab234
acute urinary tract obstruction (aUTO) is a common finding in older hospitalised patients. Anecdotal reports described hyponatraemia in patients with aUTO, which subsides rapidly with relief of the obstruction.
COVID-19 infection risk amongst 14,104 vaccinated care home residents: a national observational longitudinal cohort study in Wales, UK, December 2020–March 2021
Joe Hollinghurst, Laura North, Malorie Perry, Ashley Akbari, Mike B Gravenor, Ronan A Lyons, Richard Fry
doi : 10.1093/ageing/afab223
Age and Ageing, Volume 51, Issue 1, January 2022, afab223
vaccinations for COVID-19 have been prioritised for older people living in care homes. However, vaccination trials included limited numbers of older people.
Age-specific rates of hospital transfers in long-stay nursing home residents
Wanzhu Tu, Ruohong Li, Timothy E Stump, Nicole R Fowler, Jennifer L Carnahan, Justin Blackburn, Greg A Sachs, Susan E Hickman, Kathleen T Unroe
doi : 10.1093/ageing/afab232
Age and Ageing, Volume 51, Issue 1, January 2022, afab232
hospital transfers and admissions are critical events in the care of nursing home residents. We sought to determine hospital transfer rates at different ages.
Performance of a trigger tool for detecting drug-related hospital admissions in older people: analysis from the OPERAM trial
Lorène Zerah, Séverine Henrard, Stefanie Thevelin, Martin Feller, Carla Meyer-Masseti, Wilma Knol, Ingeborg Wilting, Denis O’Mahony, Erin Crowley, Olivia Dalleur, Anne Spinewine
doi : 10.1093/ageing/afab196
Age and Ageing, Volume 51, Issue 1, January 2022, afab196
identifying drug-related hospital admissions (DRAs) in older people is difficult. A standardised chart review procedure has recently been developed. It includes an adjudication team (physician and pharmacist) screening using 26 triggers and then performing causality assessment to determine whether an adverse drug event (ADE) occurred (secondary to an adverse drug reaction, overuse, misuse or underuse) and whether the ADE contributed to hospital admission (DRA).
Development and validation of a model for predicting mortality in patients with hip fracture
Thomas J Hjelholt, Søren P Johnsen, Peter K Brynningsen, Jakob S Knudsen, Daniel Prieto-Alhambra, Alma B Pedersen
doi : 10.1093/ageing/afab233
Age and Ageing, Volume 51, Issue 1, January 2022, afab233
to develop a user-friendly prediction tool of 1-year mortality for patients with hip fracture, in order to guide clinicians and patients on appropriate targeted preventive measures.
Diabetes duration and the risk of dementia: a cohort study based on German health claims data
Constantin Reinke, Nikolaus Buchmann, Anne Fink, Christina Tegeler, Ilja Demuth, Gabriele Doblhammer
doi : 10.1093/ageing/afab231
Age and Ageing, Volume 51, Issue 1, January 2022, afab231
Diabetes is a risk factor for dementia but little is known about the impact of diabetes duration on the risk of dementia. We investigated the effect of type 2 diabetes duration on the risk of dementia.
Unmet healthcare needs among middle-aged and older adults in China
Qian Gao, Matthew Prina, Yu-Tzu Wu, Rosie Mayston
doi : 10.1093/ageing/afab235
Age and Ageing, Volume 51, Issue 1, January 2022, afab235
Unmet healthcare needs have increasingly been recognised as an indicator of equity of healthcare access and utilisation, having the potential to capture frailty of health and social protection systems.
Impact of vaccination on the spread of SARS-CoV-2 infection in north-east Italy nursing homes. A propensity score and risk analysis
Silvia Pierobon, Marco Braggion, Ugo Fedeli, Maurizio Nordio, Cristina Basso, Manuel Zorzi
doi : 10.1093/ageing/afab224
Age and Ageing, Volume 51, Issue 1, January 2022, afab224
In the Veneto Region, 421,000 coronavirus 2019 disease (COVID-19) cases and 11,000 deaths have been reported since 21 February 2020. The pandemic spread particularly in nursing homes (NH).
The feasibility and acceptability of assessing and managing sarcopenia and frailty among older people with upper limb fracture
Kinda Ibrahim, Mark A Mullee, Natalie Cox, Cynthia Russell, Mark Baxter, Simon Tilley, Guiqing Lily Yao, Shihua Zhu, Helen C Roberts
doi : 10.1093/ageing/afab252
Age and Ageing, Volume 51, Issue 1, January 2022, afab252
sarcopenia and frailty are associated with increased risk of falls and fractures. This study evaluated the feasibility of assessing sarcopenia and frailty among older people attending fracture clinics.
Ten-year mortality and long-term visual acuity outcomes in patients with exudative age-related macular degeneration treated with intravitreal anti-vascular endothelial growth factor injections
Su Ling Young, Martin J Anderson, Shyamanga Borooah, Ana-Maria Armbrecht, Peter D Cackett
doi : 10.1093/ageing/afab262
Age and Ageing, Volume 51, Issue 1, January 2022, afab262
There are limited real-world data on long-term mortality and visual outcomes in patients treated with anti-vascular endothelial growth factor (VEGF) for exudative age-related macular degeneration (exudative AMD). We assessed 10-year mortality and clinical outcomes in exudative AMD patients treated with intravitreal therapy (IVT) anti-VEGF injections on a pro-re-nata (PRN) regime following a standard loading regime.
Is comprehensive geriatric assessment hospital at home a cost-effective alternative to hospital admission for older people?
Surya Singh, Alastair Gray, Sasha Shepperd, David J Stott, Graham Ellis, Anthony Hemsley, Pradeep Khanna, Scott Ramsay, Rebekah Schiff, Apostolos Tsiachristas, Angela Wilkinson, John Young
doi : 10.1093/ageing/afab220
Age and Ageing, Volume 51, Issue 1, January 2022, afab220
hospital level healthcare in the home guided by comprehensive geriatric assessment (CGA) might provide a less costly alternative to hospitalisation for older people.
Association between kidney function and incidence of dementia: 10-year follow-up of the Whitehall II cohort study
Archana Singh-Manoux, Amina Oumarou-Ibrahim, Marcos D Machado-Fragua, Julien Dumurgier, Erics J Brunner, Mika Kivimaki, Aurore Fayosse, Sèverine Sabia
doi : 10.1093/ageing/afab259
Age and Ageing, Volume 51, Issue 1, January 2022, afab259
Cognitive dysfunction is common in haemodialysis patients but whether poor kidney function in the general population is also associated with higher risk of dementia remains unclear.
Association of rhythm control with incident dementia among patients with atrial fibrillation: a nationwide population-based cohort study
Daehoon Kim, Pil-Sung Yang, Seng Chan You, Jung-Hoon Sung, Eunsun Jang, Hee Tae Yu, Tae-Hoon Kim, Hui-Nam Pak, Moon-Hyoung Lee, Gregory Y H Lip, Boyoung Joung
doi : 10.1093/ageing/afab248
Age and Ageing, Volume 51, Issue 1, January 2022, afab248
Atrial fibrillation (AF) increases the risk of dementia, and catheter ablation of AF may be associated with a lower risk of dementia. We investigated the association of a rhythm-control strategy for AF with the risk of dementia, compared with a rate-control strategy.
Effects of game-based interventions on functional capacity in acutely hospitalised older adults: results of an open-label non-randomised clinical trial
César Cuevas-Lara, Mikel L Sáez de Asteasu, Robinson Ramírez-Vélez, Mikel Izquierdo, Fabiola Zambom-Ferraresi, Cristina Antoñanzas-Valencia, Arkaitz Galbete, Fabricio Zambom-Ferraresi, Nicolás Martínez-Velilla
doi : 10.1093/ageing/afab247
Age and Ageing, Volume 51, Issue 1, January 2022, afab247
Hospitalisation-associated disability due to reduced physical activity levels and prolonged bedrest episodes are highly prevalent in older adults.
Declining daily functioning as a prelude to a hip fracture in older persons—an individual patient data meta-analysis
Willeke M Ravensbergen, Jeanet W Blom, Andrew Kingston, Louise Robinson, Ngaire Kerse, Ruth O Teh, Rolf H H Groenwold, Jacobijn Gussekloo, the TULIPS consortium
doi : 10.1093/ageing/afab253
Age and Ageing, Volume 51, Issue 1, January 2022, afab253
Daily functioning is known to decline after a hip fracture, but studies of self-reported functioning before the fracture suggest this decline begins before the fracture.
Linking health service utilisation and mortality data—unravelling what happens after fall-related paramedic care
A Stefanie Mikolaizak, Lara Harvey, Barbara Toson, Stephen R Lord, Anne Tiedemann, Kirsten Howard, Jacqueline C T Close
doi : 10.1093/ageing/afab254
Age and Ageing, Volume 51, Issue 1, January 2022, afab254
A randomised controlled trial implemented and evaluated a new model of care for non-transported older fallers to prevent future falls and unplanned health service use. This current study uses linked data to evaluate the effects of the intervention beyond the initial 12-month study period.
Cardiovascular disease preventive medication dispensing for almost every New Zealander 65 years and over: a preventive treatment paradox?
Sue Wells, Yeunhyang Choi, Rod Jackson, Mariam Parwaiz, Suneela Mehta, Vanessa Selak, Matire Harwood, Corina Grey, Ngaire Kerse, Katrina Poppe
doi : 10.1093/ageing/afab265
Age and Ageing, Volume 51, Issue 1, January 2022, afab265
To describe the dispensing of cardiovascular disease (CVD) preventive medications among older New Zealanders with and without prior CVD or diabetes.
Prevalence and diagnostic agreement of sarcopenic obesity with different definitions among Chinese community-dwelling older adults
Yi-Han Mo, Chen Yang, Yi-Dong Su, Xin Dong, Wen-Yu Deng, Bei-Bei Liu, Xue-Mei Yao, Xiu-Hua Wang
doi : 10.1093/ageing/afab272
Age and Ageing, Volume 51, Issue 1, January 2022, afab272
this retrospective study aims to compare the prevalence and diagnostic agreement of sarcopenic obesity (SO) using different obesity diagnostic methods among Chinese community-dwelling older adults.
Association of longitudinal trends in thyroid function with incident carotid atherosclerosis in middle-aged and older euthyroid subjects: the Tianjin Chronic Low-Grade Systemic Inflammation and Health (TCLSIH) cohort study
Yeqing Gu, Ge Meng, Qing Zhang, Li Liu, Hongmei Wu, Shunming Zhang, Yawen Wang, Tingjing Zhang, Xuena Wang, Shaomei Sun, Xing Wang, Qiyu Jia, Kun Song, Qiang Liu, Kaijun Niu
doi : 10.1093/ageing/afab276
Age and Ageing, Volume 51, Issue 1, January 2022, afab276
Previous studies have posited that an association exists between thyroid function and the heart and vasculature. It remains unclear, however, whether longitudinal trends in thyroid function contribute to the development of atherosclerosis. We conducted a cohort study to examine the association of longitudinal trends in thyroid function with incident carotid atherosclerosis (CA) in middle-aged and older euthyroid subjects.
Aged 70 and still a child: complexities, strains and gains of older children caring for their (near) centenarian mothers
Typhanie Macedo, Liliana Sousa, Oscar Ribeiro
doi : 10.1093/ageing/afab204
Age and Ageing, Volume 51, Issue 1, January 2022, afab204
Longer lives increase the possibility of caring duties, which means that older adults looking after their ageing parents—as well as their own partners—is becoming an increasingly common scenario in developed countries.
In-home medication management by older adults: a modified ethnography study using digital photography walkabouts
Sadaf Faisal, Jessica Ivo, Colleen McMillan, Kelly Grindrod, Tejal Patel
doi : 10.1093/ageing/afab207
Age and Ageing, Volume 51, Issue 1, January 2022, afab207
Medication mismanagement can lead to non-optimal management of chronic diseases and poor health outcomes.
Preferences of newly qualified healthcare professionals for working with people with dementia: a qualitative study
Molly Hebditch, Sube Banerjee, Juliet Wright, Stephanie Daley
doi : 10.1093/ageing/afab206
Age and Ageing, Volume 51, Issue 1, January 2022, afab206
there is little research on preferences in students and newly qualified healthcare professionals for working with people with dementia. Understanding the development of these preferences can help inform strategies to increase workforce capacity in response to current suboptimal dementia care and the increasing numbers of people with dementia.
Barriers and facilitators to virtual care in a geriatric medicine clinic: a semi-structured interview study of patient, caregiver and healthcare provider perspectives
Jennifer A Watt, Christine Fahim, Sharon E Straus, Zahra Goodarzi
doi : 10.1093/ageing/afab218
Age and Ageing, Volume 51, Issue 1, January 2022, afab218
COVID-19-related physical distancing measures necessitated widespread adoption of virtual care (i.e. telephone or videoconference), but patients, caregivers and healthcare providers raised concerns about its implementation and sustainability given barriers faced by older adults.
A qualitative study and preliminary model of living with dementia and incontinence at home: beyond containment
Catherine Murphy, Christine de Laine, Margaret Macaulay, Miriam Avery, Mandy Fader
doi : 10.1093/ageing/afab221
Age and Ageing, Volume 51, Issue 1, January 2022, afab221
most people living with dementia (PLWD) will develop incontinence problems with associated harmful consequences. Well-contained incontinence is often the main treatment goal. It would therefore be expected that poorly contained incontinence would have a negative impact.
Are we allowed to visit now? Concerns and issues surrounding vaccination and infection risks in UK care homes during COVID-19
Clarissa Giebel, Kerry Hanna, Jacqueline Cannon, Paul Marlow, Hilary Tetlow, Stephen Mason, Justine Shenton, Manoj Rajagopal, Mark Gabbay
doi : 10.1093/ageing/afab229
Age and Ageing, Volume 51, Issue 1, January 2022, afab229
vaccination uptake in the UK and increased care home testing are likely affecting care home visitation. With scant scientific evidence to date, the aim of this longitudinal qualitative study was to explore the impact of both (vaccination and testing) on the conduct and experiences of care home visits.
Barriers and facilitators to nursing delirium screening in older emergency patients: a qualitative study using the theoretical domains framework
Debra Eagles, Warren J Cheung, Tanja Avlijas, Krishan Yadav, Robert Ohle, Monica Taljaard, Frank Molnar, Ian G Stiell
doi : 10.1093/ageing/afab256
Age and Ageing, Volume 51, Issue 1, January 2022, afab256
delirium is common in older emergency department (ED) patients, but vastly under-recognised, in part due to lack of standardised screening processes. Understanding local context and barriers to delirium screening are integral for successful implementation of a delirium screening protocol.
Barriers and enablers to deprescribing in long-term care facilities: a ‘best-fit’ framework synthesis of the qualitative evidence
Clara H Heinrich, Eoin Hurley, Suzanne McCarthy, Shenna McHugh, Maria D Donovan
doi : 10.1093/ageing/afab250
Age and Ageing, Volume 51, Issue 1, January 2022, afab250
older adults are at risk of adverse outcomes due to a high prevalence of polypharmacy and potentially inappropriate medications (PIMs). Deprescribing interventions have been demonstrated to reduce polypharmacy and PIMs. However, deprescribing is not performed routinely in long-term care facilities (LTCFs). This qualitative evidence synthesis aims to identify the factors which limit and enable health care workers’ (HCWs) engagement with deprescribing in LTCFs.
Chronic pain and circumstances of falls in community-living older adults: an exploratory study
Yurun Cai, Suzanne G Leveille, Ling Shi, Ping Chen, Tongjian You
doi : 10.1093/ageing/afab261
Age and Ageing, Volume 51, Issue 1, January 2022, afab261
Chronic pain is a risk factor contributing to mobility impairment and falls in older adults. Little is known about the patterns of circumstances of falls among older adults with chronicpain.
Necrotising fasciitis: clinical judgement and early multidisciplinary collaboration is the key
Jennifer Hosty, Ali Cheema, Ashish A Magdum
doi : 10.1093/ageing/afab197
Age and Ageing, Volume 51, Issue 1, January 2022, afab197
Necrotising fasciitis is a bacterial infection of subcutaneous tissue and fascia, which can rapidly progress to septic shock. Diagnosis is frequently delayed or missed due to non-specific presentation. The laboratory risk indicator for necrotising fasciitis (LRINEC) stratifies risk based on biochemical results, but external validation revealed limited accuracy.
Dermoscopic visualisation of crawling scabies mites in a centenarian with palmoplantar crusted scabies
Ling-Li Chen, Ying Jiang, Fang Qiu, Yi-Ming Fan
doi : 10.1093/ageing/afab225
Age and Ageing, Volume 51, Issue 1, January 2022, afab225
