The September 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 this issue include:
Shock absorbing floors and injury prevention
Alcohol consumption in older people
Osteoarthritis and falls fracture risk assessment
The needs of older prisoners
The Editor’s Pick can be read here. This issue’s free access papers are:
Falls in older adults are common and the rate is three times higher in people in care homes than in those living in their own homes. Falls in care homes are associated with considerable mortality and morbidity-hip fractures are significantly more prevalent than in community-dwelling older people, with rates in female care home residents estimated as high as 50.8 hip fractures per 1000 person-years.
Although extensive research has been carried out into interventions to reduce falls in community-dwelling older people, there is limited evidence of the effectiveness of such measures within care homes. Oliver concluded that it makes sense to identify risk factors for the individual so that they can be reversed or reduced where possible. However the protocols used to perform risk assessments for falls in care homes are often not validated, vary from care home to care home, and do not necessarily trigger individually-tailored interventions. These assessments invariably attempt to stratify risk but because each individual within the care home is already at high risk, opportunities for interventions to reduce the risk of falling are often missed.
Danielle Ní Chróinín is a Specialist Registrar in Geriatric Medicine and an enthusiastic educator. The degree to which geriatricians are involved in the community in Europe varies from country to country, but in the United Kingdom and the Republic of Ireland community geriatrics is becoming an increasing element of the geriatrician’s work. (This article has been re-blogged from the British Geriatrics Society blog).
Would you be a geriatrician? It’s not a hard question for some of us to answer. Challenging, rewarding, dynamic; every day brings new stories, new lessons, new opportunities to share in the life of each older person who comes under your care. But for students on the path to becoming doctors, geriatric medicine may not be a preferred career choice. Yet these very students are potentially the colleagues we’ll have tomorrow. So who may want to be a geriatrician, and why? Continue reading →
Telecare and telehealth are being championed as important components in the response to the needs of an ageing population. What happens when you ‘open the black box’ and take a look inside? A review of a large scale piece of research suggests the answer might not be as clear cut as we might like. Continue reading →
Prof Kenneth Rockwood is Director of Geriatric Medicine Research at Dalhousie University, Canada and serves on the International Advisory Panel of Age and Ageing journal.
Prof Susan Howlett is also at Dalhousie, University, Canada in the Department of Pharmacology.
A lot happens at the molecular and cellular levels as we age. A recent review in Cell identified nine hallmarks of ageing, including genomic instability, mitochondrial dysfunction, cellular senescence and stem cell exhaustion. These, of course, are intrinsically inter-related; the DNA damage that underlies the hallmark genomic instability accelerates with telomere shortening (another hallmark) and is associated with altered protein homeostasis (another hallmark still). This molecular and cellular deficit accumulation is now widely understood as the basis of how we age. Continue reading →
The inaugural UK conference on sarcopenia was held in central London on 9th July 2013.
Delegates included clinicians, therapists, nutritionists and scientists, with representatives from Spain, Belgium, the Netherlands, Poland, the Ukraine, the United States and Japan.
Professor Doug Turnbull, Professor of Neurology at Newcastle University and Director of the LLHW Centre for Ageing and Vitality and of the Wellcome Trust Centre for Mitochondrial Research, outlined the role of mitochondrial dysfunction in the development of sarcopenia. He explained that two types of mitochondria are found in muscle, subsarcolemma and intermyofibrillar: the latter are the majority and are heavily networked. Numerous studies have shown a decline in mitochondrial oxidative metabolism with age, and specifically that segments of muscle have severe deficiency. The mechanism for this involves high levels of mutations within the mitochondrial genome, with evidence that this leads to muscle fibre splitting and breakage. There is also increasing evidence that mitochondria are implicated in motor neurone loss, typically reduced by 34 per cent in people aged 80-90 years compared to those aged 30-40 years. Professor Turnbull concluded by commenting that exercise has been demonstrated to increase mitochondrial density and function, highlighting a possible mechanism for the treatment of sarcopenia. Continue reading →