Posters

Introduction Bone health assessment forms a standard aspect of orthogeriatric care in line with NHFD* and NOGG**. Current recommendation is to administer first dose of bone protection medication during hospital stay due to high imminent fracture risk. We identified several cases where the first dose was delayed, including near misses and adverse events with potential for patient harm. Methods A process map of 20 patients was conducted to collect data on decision-making, documentation, and implementation of bone protection plans. A staff questionnaire identified key shortcomings and areas for

Introduction: Hospitalisation of people living with dementia often leads to an increase in behavioural and psychological symptoms, a risk of poor outcomes, a higher incidence of harm, and further cognitive decline. The “This is me” leaflet was designed by the Alzheimer’s Society and, upon its completion, provides information about a person living with dementia. This helps to deliver personalised care and reduce distress and the issues associated with hospitalisation. Whilst working on the older people’s wards at Ipswich hospital, we observed a low uptake of this clinical tool. We performed a

Introduction: Falls in older people are a major public health concern causing much morbidity, mortality and cost to health and social services. Frailty and co-morbidities are important risk factors for falls and a multidisciplinary approach and geriatric services are best suited to manage older fallers. Falls clinics led by geriatricians have been developed over the last three decades. However, as there is much variation in availability of geriatric services across Europe it is unclear to what extent Falls clinics/services exist across the continent. This study aimed to assess the prevalence

Introduction Older care home (CH) residents are particularly vulnerable to infections and often experience adverse outcomes. Despite this group being prioritised for vaccination, no COVID-19 vaccine trials recruited CH residents. Given that the social and biological characteristics of CH residents may influence vaccine effectiveness, it is crucial to test vaccines in this population. Methods The Widening Access to Trials in Care Homes (WATCH) project was established to develop best practice guidance on designing and conducting vaccine trials in the CH population. As part of this project, a

Introduction Falls are a common presentation comprising 17% of all ED attendances in older people and can result in harm including fragility fractures (FFs). FFs lead to pain, functional decline, deconditioning, and high mortality. Validated tools such as FRAX can increase prescribing of antiresorptive medications (ARM), reducing harm. Comprehensive geriatric assessment (CGA) is the gold standard for assessing and managing geriatric syndromes including falls and can include fragility fracture risk assessment. Method An audit was conducted of all inpatients over one day on Colwell Ward at Isle

Background A key challenge for disease-modifying trials in Parkinson’s disease (PD) is the lack of sensitive, patient-relevant outcome measures. Digital mobility outcomes (DMOs), captured using body-worn devices, offer a novel, objective means to assess real-world gait and mobility. The Mobilise-D study validated DMOs in PD, demonstrating that the analytics software could accurately and reliably monitor mobility in the real world. However, to progress towards regulatory qualification, demonstration of responsiveness to therapy is required. The Edmond J Safra Accelerating Clinical Trials in

Introduction: Despite it's known deliriogenic properties, and contrary to trust guidelines, lorazepam is often used first line in the management of delirium at Manchester Royal Infirmary without a documented rationale. This project aims to improve adherence to trust delirium guidance - reducing the use of lorazepam in the pharmacological management of delirium and improving compliance with non-pharmacological elements. Methods: Case identification was carried out using the hospital's Electronic Patient Record (EPR) system, Epic®. A report was created to display patients with a coded diagnosis

Background Loneliness is common among older adults and linked to poor health outcomes. In the UK, around 1.4 million older people experience frequent loneliness, a number expected to rise. Despite its impact, loneliness is often unrecognized in acute hospitals. The UCLA Loneliness Scale Version 3 (UCLA-3) is a brief, validated 3-item tool with 77% sensitivity and 61% specificity, suitable for routine geriatric screening. Objectives · Assess feasibility of UCLA-3 for rapid loneliness screening · Determine loneliness prevalence in older inpatients · Explore integration of UCLA-3 into geriatric

Background 'Instant Ageing' technologies and simulated ward rounds are established parts of geriatric medicine teaching in many centres. However, these once innovative methods received negative feedback when delivered during our undergraduate BMBS programme. We set out to explore whether adding gamification to established teaching methods could enhance student knowledge, attitudes towards frailty and perceptions of their attachment. Methods We designed a 'Frailty Escape Room' where students rotated around stations completing tasks related to falls, polypharmacy, delirium, frailty assessment

Background: The global population of people aged 65 years and over is expected to rise from 761 million in 2021 to 1.6 billion by 2050. Many of these older adults have multiple comorbidities and functional impairments that make them particularly vulnerable during acute hospitalisation. Engagement in meaningful activities can be vital to older people’s care, particularly in acute hospitals. Evidence suggests that such engagement can have a positive impact on the patients’ hospital journeys. To ensure individualised support, it is important to understand the purpose of meaningful activities for

Background Pathways into care homes represent a critical yet under-researched aspect of decision-making for individuals, families, and professionals. Prior research links recent psychiatric hospital discharge to higher risk of care home entry from hospital. This retrospective cohort study used linked health and care home data to identify predictors of care home admission following psychiatric hospital discharge within the previous six months. Methods We included adults moving-in to care homes between 1/4/13 and 31/3/16, recorded in the Scottish Care Home Census. Data were linked to inpatient

Introduction Lumbar spinal stenosis is a disabling condition affecting older people and there is a need to provide effective rehabilitation. The BOOST programme is a group physical and psychological intervention for people with spinal stenosis that we evaluated in the BOOST randomised controlled trial (RCT). The BOOST programme significantly improved walking at 6 and 12 months, reduced falling risk and was cost-effective compared to best practice advice. Disability improved at 6 months. Method A two-stage implementation study. Stage 1: We worked with stakeholders to optimise the programme for

Introduction Regular exercise to improve muscle strength and balance is recommended for older people. Providing extra protein to older people may enhance the benefits of exercise especially in people who have insufficient dietary protein. Our study evaluated the feasibility of conducting a definitive trial to evaluate the effectiveness of mobility and strength training +/- protein supplements for pre-frail/frail older people with low protein intake. Method A multi-centre feasibility randomised controlled trial in 4 NHS community trusts. Recruitment: via physiotherapy caseloads, an existing

Developing a model to predict mobility decline in community dwelling older people Introduction The maintenance of mobility is a priority for older people and is key to maintaining their independence. Declining mobility is an early predictor of loss of independence, reduced quality of life, increased health care use and death. The aim of this study was to develop and validate a prediction model to identify when an older person was at risk of self-reported mobility decline over a 2-year period. Method We used self-reported data from a prospective cohort study of 5,409 people aged 65 years and

Introduction: Polypharmacy and potentially inappropriate prescribing are common in people with life-limiting conditions. While deprescribing - a structured approach to reducing or discontinuing medications - is one approach to address this, its impact in this population is not well understood. Therefore, this systematic review aimed to synthesise evidence on outcomes of deprescribing medication in this population. Method: A systematic search of MEDLINE, Embase, Scopus, PyscINFO and CINAHL was conducted to identify original studies reporting clinical-, medication-, and system-related outcomes

Introduction Measuring extended Activities of Daily Living (eADLs) is an important part of functional assessment. Several eADL scales are currently used, resulting in heterogeneity and lack of standardisation. Existing scales are potentially outdated, containing activities which are no longer considered relevant by older people. We aimed to explore the perspectives of older adults and healthcare professionals on eADL assessment to inform new approaches to eADL measurement. Method Semi-structured qualitative interviews were undertaken with older adults and healthcare professionals. Perspectives

Introduction Urinary catheterisation is frequently required in older patients on the Stroke Unit. However, inappropriate use significantly increases the risk of catheter-associated urinary tract infections (CAUTIs), which are particularly harmful in frail, geriatric populations. The appropriate use of catheters is necessary and strict documentation of the indication should be noted upon insertion. Research suggests more than a third of catheters are unnecessary (Saint et al., 2000). Recognising the need for timely review and if appropriate, removal of indwelling catheters is imperative in

Introduction: Genetic testing in medical practice is becoming increasingly commonplace. Particularly relevant to geriatric medicine and polypharmacy is the science of pharmacogenetics; the testing of an individual patient to check for drug-gene interactions, which can determine if a new or existing prescription is a good fit for them. We wanted to establish the prevalence of prescriptions for medicines that have a known pharmacogenetic target in a population of people admitted to a geriatric medicine department at a UK teaching hospital. Methods: We conducted a retrospective cohort analysis

Background: Dementia with Lewy Bodies (DLB) is the second most prevalent cause of degenerative dementia, with many DLB patients eventually developing parkinsonism. Dopaminergic agents, although somewhat efficacious in relieving motor symptoms, risk exacerbating non-motor, and especially neuropsychiatric, features. There is also limited practical guidance on managing parkinsonism in acutely admitted DLB patients with impaired swallowing. Objectives: This summary narrative assumes a critical synoptic perspective of the literature concerning the use of dopaminergic agents in DLB. Here, we aim to

Introduction Literature reviews indicate older adults are less engaged in using digital technologies due to reasons such as fear of falling and perceived lack of time. However, there is limited literature on the facilitators and barriers to engagement in digitally enabled interventions, like remote exercise programmes with sensors, among older adults with frailty. This study aimed to explore the facilitators and barriers to engagement in digital interventions among community-dwelling older adults with and without frailty. Method Community-dwelling older adults at or above 65 years old across