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 blog

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.

Stressful life events significantly raise the risk of falls in older men

A study of around 5,000 older men has shown that stressful life events such as death of a loved one, or serious financial problems, significantly raised the risk of falls in the year following the incident. The research is published in the journal Age and Ageing. (First blogged on the BGS blog)

Dr Howard A. Fink of the VA Medical Center in Minneapolis and colleagues conducted a study of 5,994 community-dwelling men over the age of 65 who were enrolled in the Osteoporotic Fractures in Men (MrOS) study in six locations across the United States. 5,125 participated in a second study visit and answered questions on stressful life events in the prior year. A further subset of 4,981 men reported complete data on falls for one year after the second visit.

September issue of Age and Ageing journal now available

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:

• Unnecessary ward moves
• Six-month outcomes following an emergency hospital admission for older adults with co-morbid mental health problems indicate complexity of care needs
• Older Europeans and the European Court of Justice

Preventing falls in care homes: a question of balance

Ahead of her session at the British Geriatrics Society Falls and Postural Stability Conference in September, Kate Robertson writes with Alex Macdonald for the Geriatric Medicine blog  (re-blogged from the British Geriatrics Society blog) about falls in care homes.

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.

Read the full article on the GM blog here.

Sarcopenia (Part 2)

The inaugural UK conference on sarcopenia was held in central London on 9th July 2013.

Sarcopenia

Delegates included clinicians, therapists, nutritionists and scientists, with representatives from Spain, Belgium, the Netherlands, Poland, the Ukraine, the United States and Japan.

Mitochondrial dysfunction

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.

Sarcopenia under the spotlight (Part 1)

Sarcopenia

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. The meeting was organised and chaired by Professor Avan Aihie Sayer, MRC Clinical Scientist and Professor of Geriatric Medicine at the MRC Lifecourse Epidemiology Unit in Southampton, who opened the meeting with an overview of why sarcopenia is important. Sarcopenia is the loss of skeletal muscle mass and function with age. It is common in older men and women and has serious health consequences and significant healthcare costs.