Posters for 2025 Autumn Meeting

Background: Sarcopenia, a prevalent geriatric syndrome with multifactorial origins, is strongly influenced by malnutrition alongside immobility and chronic illness and contributes substantially to falls, disability, and mortality. The SARC-F (Strength, Assistance with walking, Rise from a chair, Climb stairs, and Falls) questionnaire is widely used to screen for probable sarcopenia; however, the conventional cut-off of ≥4 has yielded insufficient sensitivity across studies. Objective: To evaluate how SARC-F scores correspond to muscle strength and physical performance tests endorsed by the

Background Cumulative deficit frailty indices from randomised controlled trials (RCT) are increasingly used to assess whether trial findings are applicable to people living with frailty. The aim of this study was to examine the range and type of deficits included in these frailty indices and compare these to those from cohort studies. Methods We identified RCTs assessing treatment effect modification using the cumulative deficit frailty index, as well as cohort studies assessing mortality risk associated with frailty, from recent systematic reviews. We extracted the deficits included in the

Aims This study assesses national trends and, sociodemographic and clinical factors associated with polypharmacy and potentially in appropriate prescribing among people with type 2 diabetes in Scotland from 2012 to 2022. Methods Retrospective cohort study using nationwide data from the Scottish Care Information – Diabetes database. Individuals aged ≥40 years with type 2 diabetes were included. Medication counts were based on unique medications dispensed per calendar year. Potentially inappropriate medications were based on the 2023 Beers criteria and applied to people aged over 65 years. A

Background Randomised controlled trials are often criticised for excluding older people with multiple long-term conditions. This study used individual participant data (IPD) for 25 trials of sodium glucose co-transporter-2 inhibitors (SGLT2i) to compare baseline characteristics, comorbidities, and event rates between trial participants and community SGLT2i-treated people. Methods Trials were identified through a systematic review with subsequent application for IPD. Community SGLT2i-treated people in routine care were identified from SAIL databank. For each trial, we applied the eligibility

Introduction: Anticholinergic medications are widely prescribed to manage pain, urinary incontinence, allergies. Patients with high frailty scores are more susceptible to anticholinergic adverse effects such as falls, cognitive impairment, urinary retention. The Anticholinergic Burden Score (ACB) is a tool used to quantify the cumulative anticholinergic effect of patients' medications. A score of 3 or more is associated with an increased risk of mortality and worse cognitive function. This quality improvement project aims to quantify and reduce ACB scores of patients admitted to the Acute

Introduction: In October 2023, the electronic patient record system Epic® was introduced across two London NHS Foundation Trusts — King's College Hospital (KCH) and Guy's & St Thomas' (GSTT). This replaced legacy documentation processes, including the Comprehensive Geriatric Assessment (CGA). At KCH, a CGA template widely used by the multidisciplinary team was lost, leading to inconsistent CGA documentation, poor communication of outcomes at discharge, and reduced data usability. This quality improvement project aimed to standardise CGA documentation and communication across care settings

Introduction Older people living in Nursing Homes (NH) are often admitted to Acute Hospitals (AH) toward their end-of-life (EOL) due to the limited capacity to manage exacerbations and symptoms within NHs. The EAGLEcare (Enhancing Advance care planning, Geriatric and End-of-Life care in NHs in the East) Programme was set up to improve in-NH care and to reduce avoidable AH admissions and their unintended consequences. Methods A system of proactive case-finding for residents with specific and general indicators of advanced life-limiting illnesses was developed in collaboration with NH partners

Introduction: Emergency laparotomy is associated with high risk of mortality and morbidity. NELA best practice tariff identifies Geriatrician input as a key performance indicator for all patients over 80 years of age and those who are over 65 and living with frailty. Evidence suggests geriatrician-led comprehensive geriatric assessment (CGA) may improve post-operative outcomes, but only 8% received one between 2019-2020 in our Trust (national average 27%). The aim of this project was to create a standardised referral system between general surgeons and ageing and complex medicine (ACM) team

Introduction Pain is a major concern in cognitively impaired patients. Communication challenges contribute to poor recognition and undertreatment, negatively impacting prognosis and quality of life. The National Dementia Audit highlighted that structured pain assessment for people with dementia admitted to hospitals remains a significant area for improvement. The PAINAD (Pain Assessment in Advanced Dementia) scale aids in structured pain recognition through objective assessment. We implemented a quality improvement project aiming to improve PAINAD utilisation in inpatient geriatric wards

Background The NHS 10 year plan outlines the ambition to shift care from a Hospital centric model, to integrated community based systems, but little is known about how to implement this change. The integrated frailty crisis multidisciplinary team working across acute and community settings were motivated to improve services but lacked the confidence/knowledge to lead quality improvement (QI). A whole pathway QI practitioner development programme was established with projects aligned to the overarching system strategy to embed the change. Methods A structured training and coaching programme was

Introduction Indwelling urinary catheters are commonly used in hospitalised adults. Measuring bags, while necessary for fluid monitoring in specific cases, are often used by default without clear indication. This can restrict mobility, affect dignity, and contribute to functional decline in patients with preserved mobility. This project aimed to evaluate the usage of urine collection systems and their impact on patient well-being and improve the usage of less restrictive leg bags where appropriate. Methods QIP was conducted on medical wards at two hospital sites. Cycle 1 (Jan–Feb 2024)

Introduction Out-of-hours (OOH) services provide emergency primary care outside normal GP hours, serving patients with higher health needs. Delirium affects 25% of hospitalised older adults, causes distress to patients and carers, and leads to poor outcomes. However, little is known about delirium presentations and prevalence in OOH services. We aimed to investigate delirium occurrence and management using case records from an OOH service in South-West England. Methods The OPEN database contains 33,345 consultations of patients ≥65 attending the OOH service between April 2019–March 2020. We

Title: Therapists’ perspectives on a new Structured Tailored approach to Rehabilitation AfTer HIp FragilitY Fracture – the Stratify Feasibility Randomised Controlled Trial. Background: The stratify feasibility randomised controlled trial explored a risk-stratified rehabilitation intervention, where patients with hip fracture were categorised as low, medium, or high risk of poor outcome and received tailored interventions accordingly. This qualitative study aimed to understand therapists’ views on the acceptability of the approach, as well as barriers and facilitators to its implementation, to

Introduction: People with deafness or hearing loss (PDHL) face substantial communication barriers within the UK’s National Health Service (NHS), leading to reduced access to care, lower engagement with services, and poorer health outcomes. Deafness can affect anyone, but acquired hearing loss increases in prevalence and severity with age. A multidisciplinary working group comprising patients, clinicians, researchers, and charity representatives was formed to explore accessibility, communication practices, and deaf awareness across NHS services. Method: A cross-sectional survey assessed the

Background Frailty is a poor prognostic indicator following cardiopulmonary resuscitation (CPR). Discussions about Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions are often contentious. While existing research focuses on patients’ and relatives’ perspectives, there is a lack of in-depth studies exploring clinicians' experiences of DNACPR discussions. This study aims to explore how clinicians' personal and professional beliefs and experiences influence their approach to DNACPR conversations with frail, older adults. Methods Ninety clinicians from primary and secondary care

Introduction: The UK and global life expectancy is increasing, but life years lived in ill health is also increasing. Disease burden, and health and social care service use is highest in older age. Prevention, treatment and management of conditions of older age (e.g. frailty and multi-morbidity) is a research priority. Efficient trials need to better recruit and retain older participants to produce robust and generalisable evidence for our aging population. Synthesised qualitative and quantitative evidence regarding trial retention does not generally include the oldest and frail in society

Background: National and local standards in acute frailty recommend a seven-day service, with front-door assessment and a dedicated frailty area. Many acute frailty teams struggle to maintain a dedicated space as they are vulnerable to becoming inpatient areas when bed pressures increase. The Acute Older Persons Unit (AOPU) at Guys and St Thomas' has faced similar challenges and is based on the Acute Admissions Ward and the Emergency Department. This project assessed whether a dedicated Acute Frailty SDEC (F-SDEC) space increased the number of patients seen and the number of same-day

Introduction Adverse drug events (ADEs) in older adults contribute to preventable harm, hospitalisation, and health inequalities. While age-related physiological changes affecting drug safety are recognised, less attention is given to how sociodemographic and structural factors such as ethnicity and deprivation jointly shape vulnerability to ADEs. This limits the development of equitable medication safety strategies. This review examines how intersectional risks are conceptualised and analysed in ADE research to inform more inclusive approaches to medication safety. Method A scoping review was

Introduction The Comprehensive Geriatric Assessment (CGA) is the gold standard for managing frailty in older adults, with strong support in the literature. However, gaps remain in the evaluation of electronic CGA's (eCGA's) and standardised implementation. The Frailty Intervention Team at Sandwell and West Birmingham delivers multidisciplinary care via CGA, but prior to intervention, assessments were often incomplete, with baseline compliance at just 23%. This was largely due to the absence of a user-friendly, embedded electronic solution. Method A root cause analysis identified key barriers

Introduction: Fragility fractures can have a profound impact on older adults’ quality of life. Optimising bone health by checking vitamin D level, FRAX score, and actioning outcomes provides a cost-effective strategy for reducing the incidence of these fractures. Our aim therefore is to promote awareness and undertaking of bone health assessments in the Older Persons Unit (OPU) Methods: This was a pre-post cross-sectional study. Data was collected from 212 patient records over two separate days, one month apart. Patients admitted to the OPU at St Thomas’ Hospital were included and data was