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Co-designing physical activity interventions for older adults with frailty: Insights from a qualitative study in retirement village

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Regan Shakya1, Alison Llewellyn1, Vincent Singh1, Michael Loizou2, Praveen Kumar1
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Introduction: The UK’s ageing population presents growing challenges for health and social care.1 Age-related impairments in mobility, strength, cognition, and endurance contribute to the development of frailty and decreased physical activity in older adults.2 Despite the World Health Organization’s recommendations for regular physical activity among older adults, participation remains low due to physical, psychological, and social barriers.3 This study is aimed to explore these barriers and understand older adults’ preferences regarding physical activity to inform the co-development of
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Frailty Record Keeping at Tiree Medical Practice: A Quality Improvement Project

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Catriona Hepburn
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Introduction Patients with frailty at Tiree Medical Practice (TMP) are identified and managed by a Multi-Disciplinary Team. That team also provide out of hours and emergency care on the island meaning quick access to patient information is essential. The aim of this project was to improve frailty record keeping at TMP. It was intended that by 30 April 2025, a full Frailty Record (FR) would be held for at least 90% of patients identified as having frailty. The process of determining the parameters of the FR was dynamic but the final definition was an entry containing: Identifying details

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Quality Improvement Project : Enhancing Stroke Unit Ward Round Documentations in a Large District Hospital

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Dr T Han1, Dr R Ehsan2, Dr A T Moe2, Dr K S Tun, Dr D Ramsey
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Quality Improvement Project : Enhancing Stroke Unit Ward Round Documentations in a Large District Hospital Author Name - T Han; R Ehsan; A T Moe; K S Tun; D Ramsey Provenance - Princess Royal University Hospital Background This improvement project was undertaken within the Stroke Unit (SU) at Princess Royal University Hospital under King’s College Hospital NHS Foundation Trust. The multidisciplinary stroke team includes consultants, registrars, junior doctors, nurses, and therapists. Patients are typically admitted from the Hyperacute Stroke Unit (HASU) following initial stabilisation and
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Improving Collateral History Acquisition in Geriatric Medicine

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Priyanka Augustine[1]; Chowdhury Sirajum Munira[1]; Doju Cheriachan[1]; Sarah Mohamed[1]; Victoria Barradell[2]
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Introduction Collateral history is a cornerstone of geriatric inpatient care, informing decisions on diagnosis, discharge planning, and long-term support. Older adults often present with cognitive impairment, frailty, or limited communication capacity, making accurate history-taking essential. A baseline audit of 30 inpatients showed only 10% had all ten domains of collateral history documented. In 46% of cases, collateral history was taken more than once. Documentation was often inconsistent across notes from different professionals, hindering holistic understanding. Based on our baseline
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Prevalence and Perioperative Incidence of Atrial fibrillation in older Hip Fracture Patients

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S. Ramanna1, E Maharjan2, A Abbas2, E Benedicta 2, N singh3
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Background: Atrial fibrillation (AF) is a common cardiac arrhythmia, particularly among older patients. Its presence in patients undergoing hip fracture surgery can complicate perioperative management and is associated with increased morbidity. Evaluating both pre-existing and new-onset AF in this population can guide more targeted interventions, vigilance and improve patient outcomes. Objective: To analyze the prevalence of pre-existing AF and the incidence of new-onset perioperative AF among older patients undergoing surgery for hip fractures. Method: A retrospective analysis of patients

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Management of acute urinary retention in older males

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NMcCourt1; MAkulich2; NSaxton2; BSamuels3
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Background This audit was conducted on a Care of the Elderly (COTE) ward in a district hospital focusing on males over 65 years of age who developed acute urinary retention (AUR) during their admission. Introduction AUR is a common emergency in males that is responsible for 30,000 hospital admissions a year. The suboptimal management of AUR can lead to failed TWOC, recurrence of AUR, as well as an increased risk of urinary tract infections and multiple hospitalizations. The aims of this audit were to review management of AUR on a COTE ward over a 3 month period and compared this against NICE
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Is data from Electronic Patient Records helpful in monitoring the number of Advance Care Planning conversations? 

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E Chan1; H Andrew1; H Miles1; C Whitehead1
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Introduction  Advance Care Planning (ACP) should be discussed with patients in the last 12-months of life. Clinical frailty scale (CFS) ≥7 correlates with a 1-year mortality of ≥50%. Optional Electronic Patient Record (EPR) ACP documentation was introduced in 2020, enabling routine data collection on ACP which showed an increase in ACP conversations documented over time. We aimed to establish if this was representative of the number of ACP conversations happening, applying the findings to configuration of a new EPR planned for October 2024.   Methods  Retrospective paper notes review of 38
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Strength in a Supplement: Can Vitamin D Combat Sarcopenia in Older Adults?

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Heidi Kressel1, Antonios Matsakas1
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Introduction: Sarcopenia, the age-related loss of muscle mass and strength, is a major contributor to frailty, falls, and functional decline in older adults, significantly increasing the risk of hospitalisations and mortality. While vitamin D is well known for its role in bone health, its potential benefit for skeletal muscle remains under investigation. This review critically evaluates the role of vitamin D supplementation in improving muscle health and function in older adults without vitamin D deficiency. Methods: A literature search across multiple databases identified 591 English-language

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Measuring the impact of polypharmacy reviews within a 'hospital at home' service.

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R Shedden 1; S Din 1; L Burton 1; J Taylor 1.
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Introduction Inappropriate polypharmacy in complex, multimorbid, and frail older adults increases risks of adverse events, hospital admissions, and nonadherence. Polypharmacy review is an important part of Comprehensive Geriatric Assessment (CGA) with national guidance emphasising the goal being harm reduction rather than deprescribing. This audit evaluated the impact of polypharmacy review within the Dundee Enhanced Care at Home Team (DECAHT) geriatrician caseload. Method A retrospective audit of the 25 most recent patient discharges under DECAHT-geriatrician care (July–August 2024) was

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Improving Antibiotic Prescribing Practices: A Quality Improvement Project

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Ali Homayooni1, Annabelle Milorde Attolico2, Anika Nathaniel3, James Jegard4
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Background: Antibiotic stewardship is critical to combating resistance. Our Quality Improvement Project (QIP) aimed to evaluate and enhance antibiotic prescribing practices across three DME wards by assessing guideline adherence, therapy duration, end date documentation, and concurrent proton pump inhibitor (PPI) use. Older adults are at higher risk of antibiotic associated complications, especially C. diff infection. Methods: Baseline data were collected from the hospital's electronic prescribing system, evaluating prescriptions for indication appropriateness, duration compliance
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"Assessment and Analgesia Prescription for Acute Pain in Older Adults Presenting to the Acute Frailty Unit"

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Muneeb Aslam, Adeel Ajmal, Jeyakumar Selwyn
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"Assessment and Analgesia Prescription for Acute Pain in Older Adults Presenting to the Acute Frailty Unit" M Aslam; A Ajmal; J Selwyn; Ageing and Health; Forth Valley Royal Hospital Introduction: Pain in older adults is a common yet frequently under-recognised and undertreated issue. Age-related physiological changes, cognitive decline, and communication barriers make accurate pain assessment challenging. Despite its subjectivity, patients self-report remains the most reliable measure of pain. A multidisciplinary, person-centred approach—guided by both qualitative and quantitative methods—is
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Adherence to Scottish Hip Fracture Audit (SHFA) on Timely Administration and Documentation of IV Zoledronic Acid

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A Basit; A Al-Oweidi; A Wass; Forth Valley Royal Hospital
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Introduction Hip fractures are a leading cause of morbidity and mortality in frail older adults, with 70,000–75,000 cases annually in the UK. Osteoporosis is a major contributor, and those with one hip fracture face a 2–3 fold risk of recurrence. Intravenous (IV) zoledronic acid reduces future fractures and improves outcomes. Scottish standards recommend a loading dose of vitamin D within 7 days and IV zoledronic acid within 30 days unless contraindicated, along with referral to the local bone health pathway. Zoledronic acid is also cost-effective, costing under £1,000 compared to over £14,000
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DNACPR: Are we discussing with patients and next of kin?

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SMZ Naqvi 1; H khan 2; S Lawangeen 2; Z Shahbaz 3.
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Introduction Working on Tameside Geriatric medicine wards in the past year, we came across several patients who had a DNACPR form, their families/NOK were not aware and they lacked mental capacity themselves to understand. Some had capacity but it wasn't discussed with them which was shocking. We believe that a decision to with-hold life saving treatment is huge and there should be more conversation and documentation surrounding it. Method We collected data from the 2 specialized Geriatric Medicine wards using a data collection tool to see how many patients had DNACPR decisions discussed with
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Appropriate prescribing of anti-psychotic medication for non-cognitive symptoms in people with dementia

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T Rauf1: H Khan2; S Inam3; O Hally4
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Introduction Dementia is marked by progressive cognitive decline and frequent neuropsychiatric symptoms, which heavily impact patients and caregivers. Antipsychotic use in dementia requires careful risk-benefit analysis due to risks like sedation, falls, extrapyramidal side effects, and increased cerebrovascular events. Recent studies show a threefold rise in stroke risk with certain antipsychotics. Methods A retrospective review of dementia patients prescribed antipsychotics for non-cognitive symptoms assessed documentation quality. Key points included comprehensive assessments, trials of non
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Standardised Medications Reviews for Frail Older Patients: Driving Change through Digital Documentation and Data

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Alison McCulloch1, Karen Lowdon1
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Background Frail older patients are at increased risk of adverse drug events due to polypharmacy and age-related pharmacokinetic changes. Standardised Medication Reviews (SMRs) are essential for optimising prescribing, reducing harm, and improving outcomes as part of comprehensive in-patient geriatric assessments. However, both inconsistent documentation and data capture limit their effectiveness. The implementation of an electronic prescribing platform within our organisation enables real-time SMR documentation and creates opportunities for service improvement. Methods In alignment with

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Bridging the Gap: A Multi-Disciplinary Community Café Connecting Afro-Caribbean Communities to Dementia Research

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Sittana Abdelmagid1, Moira Rowan2, Bianca Fritsch2, Molly Khosla2, Joana Teixeira1, Pauline Dawkins3, Georgina Silva Fortes1
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Background: In 2024, 3.5% of patients reviewed in Dementia CNS clinics at St George’s Hospital, South-West London, identified as African or Afro-Caribbean according to audit data, despite the census recording the local population of these groups as over 10%. This underrepresentation is more concerning given national findings indicate that dementia rates are 22% higher among Black individuals in the UK compared to White counterparts. The disparity highlights systemic barriers to diagnosis, care, and research; emphasising the urgent need for culturally tailored outreach strategies. The aim of

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Improving Measurement of Lying and Standing Blood Pressure in Elderly Patients Presenting with Falls.

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Kehinde Taiwo, Diane Brisbane, Amy Wass
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Introduction Orthostatic hypotension, a fall in blood pressure (systolic drop >20mmHg, diastolic drop of 10mmHg) on standing up from lying or sitting position, is an important risk factor for fall among elderly population. In this quality improvement project, we assess the proportion of eligible patients who had lying and standing BP measurement. We made some interventions to improve this rate and reassess the proportion of patients who had their lying and standing pressure done afterwards. Method This is a prospective quality improvement project that recruited patients older than 65 years old
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How to capture valuable information on an Acute Frailty Unit- a Quality Improvement Project

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Dr R.Monteith, Dr A.Burgess, Dr E.Okorie
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Introduction: A midday board round was introduced on 19 bedded frailty unit to allow the multi-disciplinary team (MDT) to discuss each patient. The information shared verbally allowed us to learn about our patients, and, to facilitate a comprehensive geriatric assessment. However this information was not being captured within the medical notes. This was sub-optimal, it meant these details were subject to uncertainty later in the day, resulting in possible repetition of work or could even compromise patient care. Method: A sticker was developed, we were cognisant that this should not add
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Exploration Of Meaningful Activities For Older Adults In Acute Hospital: A Scoping Review

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Lyndsey Dunn1, Professor Karen Watchman2.
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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

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Differences between younger (≤80 years) and older (>80 years) patients with Heart Failure with Preserved Ejection Fraction

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S Odigbo1; Y Millerick2,3; A Anand2; S Bagnall1; KJM Brooksbank1; C Corson2; R Davison1; V Dempsey2; P Fergusson1; K Gray2; A Lees2,3; Y Philipson2; J Stirton2; MC Petrie2,4; KJ Hogg2; MMY Lee2,4; J Taylor2; on behalf of Glasgow Royal Infirmary HFpEF team
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Introduction To describe differences in the baseline characteristics of two distinct patient groups, ≤80 years and >80 years enrolled the North Glasgow Heart Failure with Preserved Ejection fraction ( HFpEF ) pilot project, a joint working project with Boehringer Ingelheim. Method This is a quality improvement/equity of access project to develop a blueprint of care using a multidisciplinary team approach to manage HFpEF. Following comprehensive clinical assessment, patient data was entered onto a database (Castor) and analysed, stratifying patients by age (≤80 vs >80 years). Results From 14th