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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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Development and early impact of a Dementia and Delirium Outreach Team in an acute hospital setting

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C Rowley
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Introduction Hospital admission can precipitate delirium and worsen outcomes for people living with dementia (PLwD), increasing length of stay (LoS), carer distress, and discharge to long‑term care. National Audit of Dementia data identified higher LoS and rates of discharge to 24‑hour care at SWFT compared with national averages. In response, a Dementia and Delirium Outreach Team (DDOT) was established in October 2024. This evaluation describes the development and early impact of this multidisciplinary intervention. Method DDOT comprises a Consultant Psychologist, Geriatricians, a Dementia
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Evaluation of Heidi AI Scribing Technology in Improving Efficiency and Documentation Quality in Frailty Services

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C Buckley1; J Hanlon1; R Macdonald1; B Hyde1; A Ward2; A Noble3; D Harman3; A Folwell3; M Choudhury3
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Introduction: Traditional clinical documentation methods were time-consuming and prone to inconsistency within the Frailty Team at City Health Care Partnership (CHCP), affecting productivity across workstreams including Urgent Community Response (UCR) and Comprehensive Geriatric Assessment (CGA). Heidi, an AI scribe developed by Heidi Health UK, generates clinical notes and structured care plans by interpreting patient-clinician discussions, reducing administrative burden and improving note quality. Methods: York Health Economics Consortium (YHEC) conducted a mixed-methods evaluation of Heidi

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Improving multidisciplinary team working: Phase 2 of a quality improvement project in a tertiary care university hospital

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Dr L Reilly1, Dr P Nicolson2, M Toner3, S Fream4, Dr P Sharma5, Dr B Cowdry6
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Introduction The Multi-disciplinary team meeting (MDM) underpins geriatric medicine. The previously-described first phase of this project addressed variations in MDM frequency and practice across Healthcare of Older People (HCOP) wards. This second phase built on those changes with the aim of improving three key areas; process, values and skills. efficiency / effectiveness of meetings (process) team-working (values) empowering of individuals (skills) quality of the documentation (skills) Methods A previous survey of MDT members on 2 HCOP wards identified areas of focus and suggestions for

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Association Between Frailty and Incident Urinary Incontinence in Older Adults: An Updated Systematic Review and Meta-Analysis

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Afra Wasama Islam1, Harsahaj Singh Wilkhoo1
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Background Frailty and urinary incontinence (UI) are common in older adults, contributing to functional decline, reduced quality of life, and increased healthcare use. The role of frailty in predicting new-onset UI remains unclear, as prior reviews focused on prevalence and cross-sectional data. We conducted an updated systematic review and meta-analysis of longitudinal studies to quantify the association between frailty and incident UI. Methods We searched MEDLINE, EMBASE, CINAHL, and Cochrane Library from January 2015 to December 2025 for studies examining frailty and incident UI in adults
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Improving Delirium Screening in Older Adults Presenting to the Emergency Assessment Unit (EAU), Horton Hospital

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Robert Smith1, Sarah McKelvie 1
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Introduction Delirium is a common, serious, and often under-recognised condition in older hospitalised adults. Early identification and management of reversible causes can reduce associated morbidity, mortality, length of stay, and long-term cognitive decline. The 4AT is a validated delirium screening tool recommended for acute hospital settings; however, completion rates in the Emergency Assessment Unit (EAU) were perceived to be low. This project aimed to improve delirium screening and detection in patients aged 65 years and over presenting to the EAU at Horton Hospital. Method All patients

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Impact of delirium and dementia on 30-day readmission to hospital by place of residence in older adults: ORCHARD-EPR cohort

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Emily L Boucher1,2, Sasha Shepperd3, Sarah T Pendlebury2,4
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Background: Cognitive frailty, defined as dementia, delirium or low cognitive test score, is prevalent in older in-patients. Current guidance (eg National Audit Dementia 2022) suggests hospital readmission as a performance metric in dementia care but reliable data are lacking. We therefore determined readmission risk by cognitive frailty status in care home residents vs those living at home. Methods: ORCHARD-EPR (2017-2019) includes de-identified EPR data for patients ≥70 years with length of stay (LoS)≥1 day (2017–2019) admitted to four Oxfordshire, UK hospitals. Cognitive frailty was
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Prevalence and outcomes of physical frailty by cognitive status in older people with emergency hospitalisation in ORCHARD-EPR

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Emily L Boucher1,2, Sasha Shepperd3, Sarah T Pendlebury2,4
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Background: Over one-third of older people with unplanned admissions to hospital have physical frailty, but there are few data on prevalence and outcomes by cognitive status necessary to individualise care. Methods: ORCHARD-EPR includes consecutive patients ≥70 years with length of stay (LoS) of ≥1 day (2017–2019) admitted to four Oxfordshire, UK hospitals. Physical frailty was determined using a modified Hospital Frailty Risk Score excluding dementia and delirium (mHFRS). Cognitive frailty was defined using a mandatory on-admission cognitive screen as one or more of 10-point Abbreviated
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Distinct Clinical Phenotypes of Long COVID: Autonomic vs Inflammatory Presentations in Younger and Older Adults.

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E OGBEBOR1,2; S H X CHEONG3; S J LINNANE1
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Introduction While Post-Acute Sequelae of SARS-CoV-2 (PASC) is a recognised global priority, clinical definitions derive largely from working-age cohorts. Older adults face high acute severity risk, yet long-term survivorship remains under-characterised. We aimed to characterise and compare clinical PASC phenotypes in older (≥65 years) versus younger (<65 years) adults, distinguishing autonomic, inflammatory and psychosocial manifestations. Method We conducted a retrospective single-centre cohort study of 336 patients attending a dedicated Long COVID clinic at The Beacon Hospital, Ireland

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An overview of the Dementia UK Consultant Admiral Nurse service supporting families affected by frailty and dementia

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Melissa Grundy Marie Mumby
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Abstract Content : An overview of the Dementia UK Consultant Admiral Nurse service supporting families affected by frailty and dementia Introduction: Emerging and increasing frailty often goes unidentified, and families living with dementia and frailty are missing vital opportunities to receive the right support at the right time. People living with frailty are less able to adapt to stress factors such as acute illness, injury, or changes in their environment, personal or social circumstances, leading to adverse health outcomes and an earlier loss of independence. Method: We have developed a

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Physical activity is reduced in UK Biobank participants that develop postural hypotension

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Jay Rothery1, Maedeh Mansoubi1, Helen Dawes1, Sinead McDonagh1, Jane Masoli1 2
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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

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The Discrepancy Between Perceived Fall Efficacy and Actual Physical Performance Using TUG and Chair Rise Tests

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Indri Hapsari Susilowati1*, Susiana Nugraha2, Rosy Armelia3, Robiana Modjo1
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Background: Falls are a leading cause of morbidity among older adults and are influenced by both physiological declines in mobility and psychological factors such as fall-related self efficacy. Previous studies suggest that subjective confidence in avoiding falls does not always align with objective functional performance. However, few studies have concurrently examined perceived fall efficacy alongside standardized physical performance measures such as the Timed Up and Go (TUG) and chair rise tests. This study aimed to examine the relationship between fall efficacy and objective functional
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Improving the Diagnosis and Treatment of Mood Disorders in a Delirium Clinic

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Shona Mitchelmore; Graham Lamph; Claire Cullen
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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

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Systematic review and meta-analysis on the prevalence and determinants of decision regret in older people with chronic diseases

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Liying Men1, Zhiyi Chen1, Yang Bai1, Chen Yang1
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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
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Trends in secondary prevention of hip fracture: National Hip Fracture Database (NHFD) data for England, Wales and Northern Ireland

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Antony Johansen, Will Eardley, Liz Fagan
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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

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