Category Archives: Epidemiology

The frailty syndrome in the “frail” healthcare systems

Matteo Cesari, MD, PhD is Chargé de Mission at the Gérontopôle of the Centre Hospitalier Universitaire de Toulouse, researcher at the INSERM UMR1027, and Professor at the Université de Toulouse III Paul Sabatier (Toulouse, France). He is Editor-in-Chief of the Journal of Frailty & Aging. Reblogged from the British Geriatrics Society BlogFail lady

Our societies are ageing. The number of older people is steadily growing, threatening the sustainability of public services including healthcare. Age-related chronic and disabling conditions not only adversely influence older people’s quality of life, but also represent a burden for public health expenditures. It is a fact that something has to be done in order to prevent the (often irreversible) loss of physical function that occurs with advancing age. If we are to accomplish such an ambitious task, a major revision is needed in our approach to older people and, consequently, in the concept of geriatric medicine. Continue reading

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Frailsafe: A new checklist for the acute care of frail older people

Professor Tom Downes is  consultant geriatrician and has expertise in the design of acute interface geriatric care. He is the Clinical Lead for Quality Improvement at Sheffield Teaching Hospitals. Saira Ghafur is a Quality Improvement and Leadership Fellow and Respiratory Registrar at Sheffield Teaching Hospitals NHS Foundation Trust. Reblogged from the British Geriatrics Society blog.

‘Something as mundane as a checklist can be a powerful tool for simplifying the complexity of the world and, in the context of medical procedures, save lives’ Atul Gawande 2010

FrailSafe

International studies have indicated that approximately 10% of all patients who are admitted to hospital suffer some form of adverse event (AE)- defined as an unintended harm to a patient resulting in injury, death or a prolonged admission.  Older people are more likely to suffer AEs and the consequences of these are often more severe in frail, older patients. Continue reading

The more you study, the later you drop – Education and terminal cognitive decline

Graciela Muniz-Terrera is a Senior Investigator Scientist at the MRC Lifelong Health and Ageing Unit at UCL. Reblogged from the British Geriatrics Society Blogshutterstock_21757213

The terminal decline hypothesis suggests an acceleration of rate of cognitive decline before death, although information about the onset of faster decline is inconsistent and varies by ability examined. The identification of factors that may delay such onset is crucial for policy implementation, as such delay would imply that individuals spend a shorter period of time in the fast declining stages of life. Education is a modifiable risk factor usually considered as a proxy for cognitive reserve that has been shown to be associated with cognitive function and, in a few American studies, has also been shown to be associated with a later onset of pre-clinical dementia. Continue reading

Assessment of pain in older adults with dementia – there’s an app for that

Professor Pat Schofield leads research around pain, ageing and dementia at the University of Greenwich. She is the Chair of the Pain in Older People SIG at the British Pain Society. She describes the development and initial trial of a new Pain App that is targeted at frail, older patients.  This has been re-blogged from the British Geriatrics Society blogpain app

Pain in the older population is a common problem, and can be under-recognised and under-treated. Recent prevalence studies suggest that chronic pain exists in over 50% of community dwelling older adults and this increases to over 80% when we look at those living in long term care. We also know that the incidence of dementia in the UK and the rest of the world is high and set to increase significantly over the next 20 years. Continue reading

November issue of Age and Ageing journal out now

Reblogged from the BGS Blog

The November 2013 issue of Age and Ageing, the journal of the British Geriatrics Society is out now.

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:

  • Screening for dementia
  • Cancer screening in later life
  • Diagnostic accuracy of temperature measurement
  • Dysphagia in patients with hip fracture
  • The Cochrane Collaboration and Geriatric Medicine

The Editor’s Pick can be read here.

This issue’s free access papers are:

Too old to drink? At risk drinking in over-75s

Prof Margda Waern, psychiatrist and professor at the Sahlgrenska Academy, University of Gothenburg. This has been re-blogged from the British Geriatrics Society blogdrinker

Health benefits related to mild to moderate alcohol consumption include better cardiac and cerebrovascular health, decreased risk of dementia and improved quality of life. This might help to explain why we are nowadays less likely to discontinue drinking as we age. There may, however, be a down side. Over-consumption of alcohol can increase risk of cognitive impairment, self-neglect and falls. Considering this, it is surprising that we know so little about the extent to which older people engage in potentially harmful drinking.

I was part of a group of researchers at the University of Gothenburg in Sweden who set out to study at-risk alcohol consumption in older people.  We did this using data from two long-running surveys on health and ageing: theH70 study and the Prospective Population Study of Women.  We compared at-risk drinking in two groups of 75-year-olds: 303 persons born in 1901, and 753 born three decades later in 1930. Participants were asked about their intake of beer, wine and spirits; at-risk drinking was defined as ≥ 100g/week (corresponding roughly to more than 2 drinks/day). We found at-risk drinking in 19% of men who took part in the mid-seventies study, compared with 27% of those who participated in 2005. There was a tenfold increase in at-risk drinking in women, from 0.6 % in 1976 to 10% in 2005.

We concluded that alcohol consumption has changed markedly in 75 year olds, especially in women. It is important to note that the study was set in Scandinavia, where gender differences may be less pronounced than in other parts of Europe. Studies are needed in varied settings in order to evaluate the health implications of changing trends in alcohol consumption in later life.

The full paper can be read in Age and Ageing today.