Posters

Introduction Up to 30% of adults over 65 experience postural hypotension (PH) – a significant drop in blood pressure (BP) upon standing. PH is associated with increased risk of falls, frailty, and mortality. Using derived accelerometer data and linked healthcare records, we assessed the relationship between PH and physical activity (PA) in UK Biobank participants. Methods We used UK Biobank derived accelerometery data detailing the average time participants spent sleeping (SlA), sedentary (SeA), doing light activity (LA), or moderate & vigorous activity (MVPA). We ascertained participants with

Introduction Evidence suggests a significant relationship between delirium and mood disorders. Pre-existing depression is a risk factor for delirium, and depressive symptoms frequently emerge as a sequela of an acute episode. Despite considerable symptom overlap, these conditions are distinct and require targeted management. This audit evaluated whether the introduction of formal mood assessment tools improves the detection and early treatment of mood disorders in a delirium follow-up setting. Methods A two-cycle clinical audit was conducted at a specialist delirium follow-up clinic. In Cycle

Introduction Treatment decision regret (DR) in chronic disease is linked to suboptimal adherence and poor health outcomes. However, evidence for older people remains fragmented across diseases and lacks consistent synthesis of determinants. This study aimed to estimate the pooled prevalence of DR and identify factors associated with regret in this population. Method Seven English and four Chinese databases were searched from inception to August 2025. Two researchers independently screened studies reporting the prevalence or determinants of DR among older people with chronic diseases. Study

Trends in secondary prevention of hip fracture: National Hip Fracture Database (NHFD) data for England, Wales and Northern Ireland Antony Johansen, Will Eardley and Liz Fagan Introduction Patients with a hip fracture are at ‘imminent risk’ of further fragility fractures. In 2021 the NHFD introduced a new ‘key performance indicator’ (KPI7: the proportion of people known to be on bone protection 120-days after hip fracture) specifically to address this. In 2023 the ‘Call to Action’ paper published in Age and Ageing challenged clinicians to respond by giving a first dose of intravenous

Introduction: Eating and Drinking with Acknowledged Risks is an individualised clinical decision balancing risks (may refer to aspiration, malnutrition, dehydration and choking) and benefits (quality of life, pleasure of eating). It may be applied in patients who have irreversible swallowing difficulty, with swallow reflex present where alternative means of providing nutrition are not appropriate. Method: Previous work completed in 2023 looked at cohort of patients where “Eating and Drinking with acknowledged risk” decision was made on Ageing and Complex Medicine ward over 12month period (n=22

Introduction: NHS England has set out an ambitious target of delivering the world’s first net zero health service and responding to climate change, improving health now and for future generations. Medicines account for around 25% of emissions from the NHS, from inhalers. anaesthetic and medical gases (5%) and emissions that are embedded in the supply chain of pharmaceuticals (20%). Reducing waste and ensuring appropriate polypharmacy are cornerstones of the NHS strategy to address this, as summarised in the Overprescribing Report. Method: The 3 aims of the project were: Improve deprescribing

Introduction: Vascular dementia is the second most common subtype of dementia, yet perhaps the most preventable as the underlying pathology is cerebrovascular damage. Therefore, managing vascular risk factors is vital to reduce disease progression. The aim of this study was to assess the management of various risk factors contributing to vascular and mixed dementia patients of the Cardiff and Vale memory clinic. Methods: A retrospective cross-sectional study was conducted, collecting data from 100 patients diagnosed with mixed or vascular dementia between 2022-2024 using WCP and PARIS. Factors

Introduction The Battle score is a validated risk stratification model for traumatic rib fracture presentations to secondary care. When combined with the Clinical Frailty Score (CFS), it aids identification of older patients living with frailty with increased risk of rib fracture complications. Multimodal analgesia is central to rib fracture management. NICE guidance states Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) should not be prescribed for these patients. The audit aimed to determine whether Rib Fracture Risk Stratification Scores (RFRSS) were used, if appropriate analgesia was

Introduction The GRACE initiative was a pilot designed to enhance inpatient experience of older adults. Proportionate moving and handling techniques were introduced as well as increasing the number of therapy staff on a ward reducing reliance on multiple staff for routine ward care. We aimed to improve patients’ functional independence and prevent deconditioning. Methods A ward of 26 patients was chosen with a control comparison and nursing staff were upskilled in proportionate manual handling. For 4 weeks, therapy staffing was increased from 2 therapists to 4 and patients given additional

Introduction In 2023 the ‘Call to action’ paper recommended giving a first dose of intravenous zoledronate (IV Zol) during hip fracture patients' inpatient stay. However the HORIZON study demonstrated the benefit of annual infusions. To help plan service provision we set out to define the constraints on patients reattending for repeated outpatient IV Zol. Method We reviewed local National Hip Fracture Database (NHFD) data for all patients presenting with a femur fracture in 2024. At 120-days a follow-up questionnaire is sent to all patients and we used this to identify those most physically

Introduction Hospital At Home (HaH) provides hospital-level care for acute medical issues that would traditionally require admission to an acute hospital bed. HaH with Comprehensive Geriatric Assessment has shown similar outcomes for older people living at home compared to those admitted to an acute hospital (Shepperd et al, 2021). Referral to an alternative from hospital can be slow and tortuous. To reduce this delay and chance of hospital admission, a pilot scheme of patient self-referral into HaH was launched in May 2024 and evaluated. Method Anonymised patient data was retrospectively

Introduction: Dementia affects approximately 40% of hospitalised older adults (1-2) often leading to distress, communication challenges, and a decline in functional independence during admission (3). Although multidisciplinary team (MDT) geriatric care improves clinical outcomes,(4) the psychosocial and biographical needs of patients are overshadowed by immediate medical priorities. To address this, our QIP implemented the “About Me” form, a document capturing individual preferences and daily routines, with the aim of increasing staff confidence and supporting more personalised, meaningful

Background: Universal Design for Learning (UDL) is an educational framework promoting multiple means of engagement, representation, and expression to align with diverse learning needs. We applied UDL principles to evaluate teaching methods within the Geriatric Medicine placement at Cardiff University’s School of Medicine, aiming to identify student preferences, explore factors influencing engagement, and inform development of a more inclusive teaching portfolio. Methods: Fourth-year medical students on their Geriatric Medicine placement completed a structured survey about teaching modalities

Introduction Clinicians are regularly encouraged to make discussion and documentation of Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) status a routine part of their assessment and care of older patients. However, patients, their families and clinicians often question whether a DNACPR decision may affect the attention paid to other aspects of patient care, or their access to interventions unrelated to CPR. We set out to directly test and address this question using a randomised controlled study of a clinical vignette. Methods We presented a clinical scenario of a deteriorating patient

Introduction: The very high-risk patients remain at a comparatively higher risk of sustaining a subsequent fracture following an initial fragility fracture, with the risk being greatest within the first 1-2 years. The current guidance advocates a “treat-to-target” strategy, recommending initiation of anabolic therapy followed by sequential antiresorptive treatment. The objective of this study was to quantify imminent fracture risk before and after commencing anabolic agents. Materials and Methods: We conducted a retrospective review of all patients who were commenced anabolic therapy between

Introduction: Osteoporosis affects approximately 3.5 million individuals in the UK, resulting in over 500,000 fragility fractures annually. An initial fracture significantly increases the risk of subsequent fractures, particularly in very high-risk patients. Current clinical guidelines advocate a "treat-to-target" strategy using ‘anabolic first’ for individuals at very high risk of fracture. The aim of this study is to develop and evaluate an innovative approach to improve system efficiency, timeliness and prudent delivery of anabolic osteoporosis drugs. Methods: Specialist anabolic

Introduction: Dual-energy X-ray absorptiometry (DXA) is the gold standard for diagnosing osteoporosis; however, due to limited capacity it is not available to all patients with fragility fractures. A multidimensional quality improvement project, using the Plan–Do–Study–Act (PDSA) model, led to the implementation of several initiatives between 2022 and 2023. These included increasing scanning capacity, vetting repeat DXA requests, upskilling the bone health team, and strengthening partnerships with primary care. The objective of this study is to assess the sustainability of these initiatives in

Introduction Deprescribing is central to frailty care. We evaluated whether a Frailty Enhanced Specialist Service (FESS) was associated with higher deprescribing rates. Method Single-centre retrospective observational study using routinely collected data from inpatients admitted from care homes before the existence of FESS (January; n=78) and, post-implementation, to FESS or non-FESS wards in June (FESS n=54; non-FESS n=37) and December (FESS n=32; non-FESS n=49). We recorded total regular medicines and Anticholinergic Cognitive Burden (ACB) scores at admission and discharge, plus age, sex

Enhancing assessment and continence care in a community hospital setting: A quality improvement project. Introduction: It was noted that continence was frequently not addressed prior to transfer to a community hospital setting. The project aimed to recognise and offer opportunities for improved continence care. Method: Patients were screened for continence problems through comprehensive geriatric assessment on arrival at a community hospital from acute settings. The first cycle identified whether continence assessment was considered on arrival at our community site. Subsequent cycles improved

Introduction: Chronic Kidney Disease (CKD) is associated with abnormal bone metabolism and increased fragility fracture risk. However, many older people often have both CKD and osteoporosis, go undiagnosed and untreated. The objective of this study is to measure prevalence of CKD among patients presenting with fragility fractures. Methods: 3839 fragility fracture patients seen by Aneurin Bevan Fracture Liaison Service (AB-FLS) between January 2022 and December 2023 were reviewed retrospectively. 1325 patients’ fragility fracture were excluded due to non-availability of estimated glomerular