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Reducing Falls through targeted Sarcopenia Management: Findings from an MDT Sarcopenia Clinic from Qatar

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 I MUNEEB 1; Dr Hanadi Al Hamad 1; AL ANOUD FEHAIDI 1; S KANNU1; S Khan 1
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Introduction: Sarcopenia is recognized as a correlate of ageing and is associated with increased likelihood of adverse outcomes such as decreased mobility, impaired standing balance, functional decline, Falls and Frailty. To address age related Sarcopenia, an MDT clinic was established in Rumailah hospital which brought expertise from Geriatricians, Physiotherapists and Clinical Dietitians. Methods: The Sarcopenia clinic enrolled older adults (>60 years) in the and assessments included SARC-F, handgrip dynamometry, frailty measurements, SPPB, TUG, and BIA. Interventions comprised CGA
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Improving inpatient falls reviews: a quality improvement project at the University Hospital

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K. Murray1, E.Mwenda2, S.Rees3, M. Devindan4
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Introduction Inpatient falls occur frequently with over 27,000 falls reported in Scottish hospitals annually (1). Inpatient falls can lead to adverse health-related outcomes and increased healthcare-related spending in older people. A thorough post falls assessment, as recommended by The World Falls Guidelines Task Force, is vital to characterise the fall and any preceding factors, ensure injuries are not missed and prevent further falls (2). Structuring medical records can improve patient outcomes and doctors’ performance (3). Our overall aim was to improve inpatient falls assessment and
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Evaluate Silver Trauma Risk Factors in Older People Undergoing CT Polytrauma

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S Siu 1; D Sebastian 1; V Shenoy Bellare 1; T Lewis 1; C Bronze 1; N Marriage 1
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Introduction Older people are at increased risk of significant injury following low-energy trauma and may present without physiological compromise. This can lead to under-recognition of injury and delayed management. The Norfolk and Norwich University Hospital (NNUH) Emergency Department uses an adopted Silver Trauma triage tool incorporating multiple clinical risk factors to guide senior review and CT polytrauma imaging. However, the predictive value of individual risk factors within this tool remains uncertain. This project aimed to evaluate the performance of individual risk factors in
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Hypomagnesemia: An Overlooked Cause of Delirium and Cardiac Complications in an Elderly Patient

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K CHERRY PHYO1; Z KYAW2; T THYN3
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Abstract Delirium is a frequent complication in elderly patients and is often multifactorial, with electrolyte imbalances representing a major contributor. While sodium, potassium, and calcium disorders are commonly evaluated, hypomagnesemia is an overlooked but clinically significant cause of both neurological and cardiac manifestations. Magnesium is essential for neuronal stability, neurotransmitter regulation, and calcium channel modulation. Its deficiency can lead to neuropsychiatric symptoms, arrhythmias, and myocardial injury. We report the case of an 81-year-old woman who presented with
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Implementing an Orthogeriatric Multidisciplinary Team Grand Round to Improve Multidisciplinary Care for Older Trauma patients

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T Idris1, P Sarda1, S Colman1, S Boswell1, D Moll1, R Ranadive2, G Pyakurel1
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Introduction Older adults admitted with femoral fragility fractures require coordinated multidisciplinary team (MDT) approach. On a 33-bed orthopaedic trauma ward with predominantly older people with frailty, MDT identified systemic challenges causing prolonged length of stay and suboptimal patient experience. Key issues included fragmented MDT processes, duplication between board rounds and ward reviews, delays in investigations and decision-making, inconsistent communication with patients and families, and frequent outlying of patients to other wards. Although national guidance emphasises
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Improving Early Delirium Recognition Through Structured 4AT Integration

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R Gurung; P Gurung; Z Iftikhar; K Karunatilake
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Introduction: Delirium affects up to one in four older adults admitted to hospital and is associated with increased mortality, prolonged admission and long-term cognitive decline. Early recognition is recommended by NICE and international guidelines. The 4 ‘A’s Test (4AT) is a validated, rapid bedside screening tool widely used in acute settings. Despite this, timely completion in routine practice remains inconsistent. This quality improvement project aimed to improve compliance with 4AT completion within 24 hours of admission in patients aged ≥65 years. Method: A retrospective audit was
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Characteristics and Outcomes of a Frailty-Led Dementia MDT: Exploring the Evidence for Hospital Admission Avoidance

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A Hinchcliffe1; A Symes2; A Noble 2; A Folwell 2; D Harman 2
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Introduction: The Jean Bishop Integrated Care Centre (JBC) operates a unique, primary care-led Dementia Multidisciplinary Team (MDT) specifically designed for patients living with frailty. Unlike traditional memory services, this model integrates dementia specialists with frailty practitioners to manage complex needs in the community. It is also attended by staff from third party sector (alzhiemers society), local CMHTs, social services and carer support. This audit aimed to characterise the patient cohort, evaluate clinical outputs, and examine preliminary evidence regarding the MDT's role in

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Falls Consultant Geriatrician Clinic Referrals Review: Improving Access to Multi-professional Falls Services.

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Wendy Wilkinson
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Introduction: In 2022, new Consultant Therapist roles were recruited to the Care of the Elderly Team at Wrexham Maelor Hospital, when n=189 people were waiting to see a Consultant Geriatrician for falls. The longest wait was n=658 days. A waiting list review commenced in partnership with Community Falls Prevention, Physiotherapy, Pharmacy and Occupational Therapy, Welsh Ambulance services. People with long waits for Falls Clinic were assessed by a Consultant Therapist at home, which saw a reduction in the overall waiting list and highlighted the risk that people were not being referred to the

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The Architecture of Confidence: Mapping the Relationship Between Cognition, Age, and Falls Efficacy

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Rosy Armelia¹*, Susiana Nugraha², Indri Hapsari Susilowati³; Hari Purnomo¹; Hartomo²
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The aging process leads to a decline in body awareness and perception, which significantly impairs balance, coordination, and daily motor functions, thereby increasing vulnerability to mobility limitations. Globally, 45.6 million falls were recorded among individuals aged ≥65 years in 2021. In Indonesia, 29.0% of older adults report a history of falls, with recurrence rates reaching 45.4%. A key concept underlying this issue is falls efficacy, defined as an individual’s confidence in performing daily activities without falling. Low falls efficacy can trigger a maladaptive cycle in which fear
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Impact of a Digital Proactive Care tool, Fr EDA (Frailty End of life Dementia Assessment) on improving quality of care & outcomes across an ICS population of 1.34 million

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Zaidi. S 1,2 ; Dinnage. S 1,2 ; Aggarwal. D 2 ; Little. S 3 ; Lew. E 1, 4
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Introduction: Adults living with frailty, dementia or nearing end of life, frequently experience identification/diagnosis delays, inequalities, avoidable harms, poorer outcomes and premature mortality. Frailty and End of Life Care (EOLC) evidence based Proactive interventions can improve outcomes, yet delivery across providers is low and inconsistent. Mid & South Essex (MSE) has a population of 1.3 million, 114,000 (9%) are estimated to be living with frailty, dementia or may have EOLC needs (most unrecognized), generating over 62% of 999 calls, 90% of hospital occupied bed days, 71% of

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Improving Inpatient Medication Reviews for Older Adults: A Quality Improvement Project at a District General Hospital

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T Anjum 1; M.Abbasi 2;H Anum 2; P Firouznia2
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Introduction Polypharmacy is highly prevalent among older adults and is associated with adverse drug events, falls, delirium, and hospital readmissions. In busy inpatient settings, medication reviews may be inconsistent in timing, structure, and documentation. This Quality Improvement Project (QIP) aimed to improve the quality and consistency of inpatient medication reviews for older adults admitted to geriatric wards at Good Hope Hospital. Method A prospective audit was conducted across five geriatric wards (Wards 9, 11, 12, 15, and 28). Patients aged ≥75 years prescribed ≥5 regular

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Improving the Pathway for Older Patients with Rib Fractures: A Multidisciplinary Quality Improvement Initiative

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Sharon Budd1, Jeffrey Ting1, Lesley Harris2, Amanda Rougeolle3, Maria Kolokotroni4,
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Introduction Rib fractures in older adults are associated with significant morbidity and mortality, mainly due to inadequate pain control and subsequent respiratory complications. Baseline audit demonstrated fragmented care, with admission across multiple specialties and wards and delayed access to specialist input and analgesia. Aims To improve pain management, coordination of care and clinical outcomes for older adults with rib fractures through the implementation of a multidisciplinary care pathway. Methods A multidisciplinary pathway was developed involving emergency medicine, radiology

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A Proxy-Based Adaptation of the Nottingham Trauma Frailty Index for Older Saudi Trauma Patients

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A G ALQARNI1; N ALQURASHI1; N HARTHI3; S CHOWDHURY2; B OLLIVERE4; T NOUH5
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Introduction Frailty is increasingly recognised as a stronger predictor of adverse outcomes following major trauma than chronological age alone. The Nottingham Trauma Frailty Index (NTFI) conceptualises frailty as a multidimensional construct incorporating functional dependence, cognitive impairment, and physiological vulnerability. However, several original NTFI variables are not routinely available at emergency department (ED) presentation. We aimed to develop and evaluate a proxy-based adaptation of the NTFI using routinely collected trauma registry data in Saudi Arabia. Methods We analysed
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The Hospital Mortality scorecard: Its impact on learning from deaths

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James Alegbeleye1, Alison Davies2, Wayne Blower2, Sofia Power 2
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Introduction and Literature The importance of balanced scorecard (BSC) has been studied in various management perspectives and likewise its role in the emergency hospitals in the Western World. However, the use of this Balanced scorecard among clinicians especially in the hospital setting with regards to performance monitoring and strategy implementation is still needed. As Mortality rates become an important national metric among hospitals in the UK, we examined the impact Balanced scorecard on learning from deaths. Methodology The Learning from Deaths (LfD) framework in the NHS requires that

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Outcomes for Older Patients Taking Anti-Platelet Therapy Presenting to the Emergency Department with Injury

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L Barrett 1; S Goodarzi2; M Lawson2; C Deane2; Y Nandakumar2; A Collins2; J Abu-Hana1,2; N Curry1,2
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Title: Outcomes for Older Patients Taking Anti-Platelet Therapy Presenting to the Emergency Department with Injury: A Prospective Observational Cohort Study Abstract Introduction Older patients taking anti-platelet agents (APA) frequently present to the emergency department with injury. In the UK, almost half of patients admitted following injury are aged ≥65 years, and anti-platelet therapy is used in approximately 40% of older adults. The clinical impact of APA use on bleeding outcomes remains uncertain, with conflicting evidence and limited prospective data. Methods We conducted a
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Comprehensive Nutritional Intervention for Delirium Prevention and Management in Geriatric Care

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ALAnoud Ali ALFehaidi
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Introduction: Delirium represents a significant healthcare challenge affecting up to 60% of older adults in inpatient settings, associated with increased mortality, prolonged hospitalization, and accelerated cognitive decline. Despite established multifactorial etiology, nutritional contributors to delirium—including dehydration, malnutrition, and micronutrient deficiencies—remain insufficiently addressed in standard care protocols. Evidence suggests that nutritional optimization may represent a potent, yet underutilized non-pharmacological approach to delirium management. Aim: This quality
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Frailty Assessment & Needs in Older Adults with Myeloma

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Joanna Preston1, Fenella Willis2, Yasmin Reyal2, Theodora Vatopoulou2, Angelica Edge2, Jay Parekh2, Reena Kaur1, Haleema S Adil1.
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Background & Aim We present findings from a joint Geriatrician and Haematologist Myeloma clinic pilot, specifically a) frailty needs of the cohort and b) performance of frailty screening tools including International Myeloma Working Group Frailty Index (IMWG-FI, Performance Status (PS), Geriatric 8 (G8), Clinical Frailty Score (CFS) and Edmonton Frail Scale (EFS), against expert opinion of frailty. Methods During pre-clinic MDM, patients were flagged for Geriatrician review following concern from either Geriatrician or Haematologist. This review was used to benchmark the presence of frailty by

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Improving delirium management through earily dection and proper documentation for continous care.

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A Abusbaeh1; M Tantoush1; N Ahmed2.
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Delirium is an acute confusion that affects patients' mental function and behaviour, also affecting attention and awareness. In hospitalized patients, it reaches about 20% and can reach up to 60% in patients on palliative care. Geriatric patients tend to have higher risk to develop delirium, which is also linked to increased hospital stay, falls, pressure ulcers, and death rates. Common risk factors for delirium include pain, infection, decreased nutrition or dehydration, constipation, hypoxia, certain medications, and change in environment. Despite its clinical importance and impact on
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Improving frequency of 4AT scoring through micro teaching

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A Fernandes1; V Ketheeswaranathan1 ;T Serafimova1; G Meredith1
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Introduction Delirium is a neuropsychiatric condition affecting over 1 in 4 hospitalised older adults. Regular assessment of delirium throughout admission leads to earlier diagnosis and management and may potentially improve outcomes. The 4AT is a NICE recommended tool to detect delirium. Methods Retrospective case review was undertaken for a cross-section of older adults (n= 90) admitted to an inpatient geriatric ward in a tertiary London hospital. We recorded whether 4AT was completed at 3 key time points; during clerking, post-take ward round and at any point during inpatient stay. A plan

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Determining the educational needs of healthcare professionals in communicating the Recommended Summary Plan for Emergency Care and Treatment

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D White1; C Beddow2;S Budd 3;K Lipas4; A Nair5; E Randall6; J Ting7; B O’Connell8; L Lees-Deutsch9.
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Introduction: The Care of the Elderly/Frailty team at UHCW sought to improve practice in the application of the Recommended Summary Plan for Emergency Care and Treatment plan (ReSPECT A rapid review of the evidence was undertaken, focusing on a broad review question: what are the educational needs of healthcare professionals regarding the optimal communication and understanding of ReSPECT needs with patients and other healthcare colleagues? Methods: A multi-professional Critically Appraised Topic group (CAT) with 6 clinicians from the frailty team at UHCW was established engaging appropriate

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