Benign Paroxysmal Positional Vertigo (BPPV) is the most common cause of vertigo in older adults. Due to the high incidence of BPPV in older adults presenting with falls, vestibular assessment, and diagnosis of BPPV and other vestibular disorders has become a recommendation in the World Guidelines for Falls Prevention. There has been a paucity of evidence in well conducted randomised controlled trials (RCTs) to evaluate vitamin D for prevention of BPPV recurrence and its relation to falls and function. This is a Phase IIa single centre, placebo controlled, double blind RCT to evaluate vitamin D
Introduction National surveillance shows an estimated 58,224 people in England had antibiotic-resistant infections in 2022, a rise of 4% since 2021 (ESPAUR report). Between 2022-23, our Trust had 2 nd highest C.difficile rates in the country. Geriatric population is particularly vulnerable of inappropriate antimicrobial prescribing, leading to prolonged hospital stays As part of anti-microbial stewardship (AMS), a Quality improvement project was carried out between February-May 2024. Methods Six geriatric wards (n=168) were audited between 14-16 th February 2024. Indication, route, duration
Introduction People from ethnic minorities are 1.5 times less likely to use digital technology. Within Brighton and Hove, 2021 Census reports that 26.1% described themselves as non-White-British categorised as other White (11.5%), Mixed Race (4.8%), Asian (3.7%), Black (2.0%), Chinese (1.1%), Arab (1.1%), and Other (2.0%). The aim of the project was to understand the lived experience of older ethnic minority adults in Brighton and Hove with digital technology, and how this experience affects their potential engagement with research. Methods Older people from ethnic minorities were identified
Introduction Physical and cognitive frailty combined with unfamiliar surroundings in hospitals puts elderly patients at high risk of falls. It has been demonstrated that patient-centred, non-clinical stimulating activities in hospital have been found to reduce agitation, improve affect and engagement, relieve pressure on nursing staff and reduce falls. In the Medicine of the Elderly (MOE) wards of an urban teaching hospital, after a successful pilot, a Meaningful Activity Team (MAT) was implemented. The effect of this change to patient and staff well-being was assessed, as was the frequency of
INTRODUCTION: As part of a larger quality improvement project focused on improving the management of older people living with frailty attending the Manchester Royal Infirmary, a Frailty Same Day Emergency Care Unit (Frailty SDEC) was established. This would require the merging of three teams: the Front Door Frailty team, the Acute Therapy team and an established Nursing team on the allocated ward area. It became apparent that an intervention was required to improve team-working and efficiency among these clinicians who had never all worked together in the same space before. METHODS: Board
Introduction The Assessment and Rehabilitation Centre (ARC) in Edinburgh sees around 600 new patients a year who are beginning to demonstrate signs of frailty, principally around mobility and balance. When taking a comprehensive geriatric assessment, we commonly identify concerns around cognition. We noted in some cases people were already waiting to be seen by the Memory Clinic Services, the current wait for which is approximately 10 months. We decided to see what ARC could do to help. Method From within existing resources, alongside the Psychiatry of Older Age (POA) Team, the ARC multi
Background Older adults were more likely to be socially isolated during the COVID-19 pandemic, with increased risk of depression and loneliness. The Behavioural Activation in Social Isolation (BASIL+) trial investigated whether a Behavioural Activation (BA) intervention delivered remotely could mitigate depression and loneliness in at-risk older people during the COVID-19 pandemic. Methods We undertook a multicentre randomised controlled trial [ISRCTN63034289] of BA to mitigate depression and loneliness among older adults (65+) with multiple long-term health conditions, including low mood or
Introduction: Fracture liaison services (FLS) aim to prevent secondary fractures by ensuring high-quality care to all patients with fragility fractures above 50 years. The standard recommendation by FLS Database (FLS-DB) is to identify 80% of the expected fragility fractures, commencing treatment for 50% and monitoring 80% at 16 weeks and 52 weeks. Methods: FLS team noted that only 18.4% (n=92) patients were followed at one-year of the total 875 patients identified in the year 2021 (National benchmark=22.3%). Whilst FLS team identified 42.6% (n=1649) patients in the year 2022, an 88% increase
Introduction/Background: Teamwork is very important in hospitals where the medical on-call team manage the stroke and thrombolysis alert calls. In addition to technical skills, human factors play a very significant role in meeting a target door-to-needle time. Aim: To improve door-to-needle time by improving human factors (leadership, understanding and delegation of roles and confidence in participation) and technical factors (quick NIHSS and efficient documentation of vital information on radiology request forms for urgent CT head). Method: We conducted 6 simulation-based training sessions
Introduction: Research suggests that physical and cognitive exercise can have a positive effective on those with dementia, but less is known about such interventions in those at risk for dementia. Understanding the feasibility of administering clinical assessments remotely using Zoom for Healthcare TM in the context of a dementia prevention trial for at risk older adults is not well understood. Methods: SYNERGIC@Home/SYNERGIE~Chez soi (NCT04997681) is a home-based, remotely delivered clinical trial targeting older adults at risk for dementia. Participants underwent a screening/baseline
Introduction: CGA is the gold-standard intervention for older adults living with frailty. A challenge is providing person-centred, time-efficient CGA. The CGA-questionnaire (CGA-Q) aims to facilitate person-centred CGA, allowing patients/carers to highlight concerns. We describe a two-site multi-cycle QIP implementing the CGA-Q. Methods: CGA-Q is a 19-item questionnaire covering seven CGA domains. It was adapted from the validated CGA-GOLD questionnaire. Between March 2023-June 2024, CGA-Q was established in a London and Scottish NHS Trust using ‘Plan-Do-Study-Act’ methodology. Cycle 1-3
INTRODUCTION: University Hospital Southampton (UHS) and Saints Foundation (SF) have partnered to test and deliver rehabilitation to hospitalised older adults via a non-registered Exercise Practitioner (EP) to promote physical activity (PA) and address hospital associated deconditioning. Now in its third phase, the project has evolved in response to patient and staff feedback. It delivers regular gym-based exercise classes and additional interventions, which have maintained or improved patients’ dependency levels on discharge. METHODOLOGY: From September 2023, the EP has delivered daily gym
Objectives: Older adults hospitalized with a hip fracture are at risk for adverse health outcomes depending on their level of frailty. This study examined how frailty levels prior to admission impacted length of stay (LOS), requirement for alternative level of care (ALC), returning home post-discharge, and mortality. Methods: A random sample was generated from all hip fracture patients aged 65 and older admitted to a Level One Trauma Centre in New Brunswick, Canada from 2015-2019. This sample had their frailty level determined retrospectively using the Pictorial Fit-Frail Scale and the
Introduction: Loneliness affects nearly a third of adults aged >70. It increases the risk of conditions including depression, coronary artery disease and stroke. Lonely individuals are at increased risk of falls, hospital attendances and prolonged admissions. Following hip fracture, patients are particularly at risk and pre-fracture loneliness is associated with poorer outcomes. An inpatient stay offers the opportunity to screen for and address pre-fracture loneliness. Method: Aims: 100% of patients to have a University of California Los Angeles (UCLA) 3-item loneliness score by day 5 post
An 85-year-old male presented with a hip fracture following an accidental fall. His medical history included chronic kidney disease, hypertension, high cholesterol, and type 2 diabetes mellitus. He underwent intramedullary nail insertion, supplemented with a plate and screws, for a subtrochanteric fracture. Post-operatively, he received four units of red blood cells for low haemoglobin. He was unable to mobilise due to persistent swelling and pain, and recurrent drops in haemoglobin levels despite multiple transfusions, with no evidence of visible bleeding from the wound or other sites
INTRODUCTION: Post-traumatic stress disorder (PTSD) is an anxiety disorder caused by frightening or traumatic events. Delirium is a state of acute confusion associated with acute illness, surgery, and hospitalisation. Delirium is known to be associated with a risk of PTSD in patients in the Intensive Care (ICU) setting. However, there is limited information on the prevalence of delirium in older adults outside of Intensive Care. Therefore we undertook a systematic review to ascertain the prevalence of PTSD in elderly patients after an episode of delirium on a general ward. METHODS: The
Background Dementia is a prevalent condition in an ageing population. Persons with dementia and their caregivers are often uncertain about what to expect after an initial diagnosis. Previous studies conducted on the experiences of informal caregivers show a clear demand to address these: providing adequate information, psychosocial support and access to services. Introduction The diagnosis of dementia is usually made by specialists in the tertiary hospital. However, resources in acute tertiary hospitals are expensive and valuable. To better allocate resources and improve the manpower situation
Introduction Frailty, independent of age, is associated with adverse outcomes following admission with Acute Coronary Syndrome (ACS) but is often not accounted in risk stratification scores. Those identified as frail may not be considered for invasive interventions despite evidence that they stand to benefit (1) and are at risk of worsening geriatric syndromes on discharge (2,3). Purpose We aimed to categorise clinical outcomes in older adults admitted with ACS, with or without frailty to suggest if there is a role for geriatrician input in reducing length of stay and preventing adverse events
Introduction Hyponatremia is the most common electrolyte imbalance caused by serum sodium level of less than 135mmol/L, prevailing 15 and 30% among hospitalised patients [Zhang X, Li XY. Eur Geriatr Med. 2020;11(4):685-692] Methods PRISMA guidelines were followed for this study. Pubmed was searched with the search term : (hyponatremia) AND (treatment OR control OR management[MeSH]) AND (elderly[MeSH]) with filters, timeline: 2000 to 21/07/2023, free full text articles and human species.Data extraction was done using Covidence app and depicted in PRISMA Flow diagram. Quality assessment was done
Introduction Delirium has a significant impact on morbidity and mortality. It is also associated with an increased level of institutionalisation at discharge and increased length of stay. Therefore, a diagnosis of delirium should always be considered with an assessment of risk factors. The aim of this project was to ensure 100% of patients on Geriatric wards have a diagnosis of delirium considered via the 4AT as per NICE guidelines. Methods A Plan-Do-Study-Act methodology was utilised with an initial audit exploring identification and documentation of delirium diagnosis. A Lanyard Prompt Card