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Cognitive function in people with Parkinson’s disease in northern Tanzania.

Authors' names
I Terry; C Dotchin; N Fothergill-Misbah; W Eliamini; M Dekker; S Urasa; R Walker
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Background: Cognitive impairment (CI) is a common non-motor symptom of Parkinson’s Disease (PD), but little is known about its profile and assessment in Sub-Saharan Africa (SSA). This study aims to characterise cognitive function in a cohort of people with PD (PwP) in northern Tanzania, and evaluate the feasibility and acceptability of cognitive screening tools in a low-resource, community setting. Methods: Twenty-eight PwP identified in a previous door-to-door survey were followed up. Cognitive function was assessed using the Identification and Intervention for Dementia in Elderly Africans
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Known, and unknown, hypertension in the Transforming Parkinsons care in Africa ( TraPCAf) cohort: pilot data

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Jessica Walker 1; Yasin Okkaoglu 2; Catherine Dotchin 3; Natasha Fothergill-Misbah 2; Njideka Okubadejo 4; Richard Walker 1,2 on behalf of TraPCAf collaboration
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Introduction There are few data on Parkinson’s disease (PD) in Africa, particularly in sub-Saharan Africa (SSA). The NIHR Global Health Research Group Transforming Parkinson’s Care in Africa (TraPCAf) is a four-year study, running from September 2022, investigating PD in seven African countries (1). In SSA, hypertension is highly prevalent, with many individuals remaining undiagnosed and, among those diagnosed, many untreated or poorly controlled (2). Method The TraPCAf project is recruiting a target of 1,000 people with PD (PwP) and 2,000 age- and sex-matched healthy controls. Data collected
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Mortality and Institutionalisation Following de Novo Use of Rotigotine Patches in Hospitalised Patients with Parkinson’s Disease

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EKaye1; KMillington2; RSkelly2
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Objective: Guidelines recommend use of rotigotine patches as an option if Parkinson’s patients are unable to take their usual oral medication, but this strategy has not been tested in clinical trials. We audited outcomes for such patients in a large UK teaching hospital. Background: This project was undertaken at University Hospitals of Derby and Burton. Method: In this retrospective study, data was extracted from the hospital’s electronic prescribing and medication administration system, Lorenzo. We examined data on every hospitalised Parkinson’s patient prescribed rotigotine at Royal Derby
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Music: Reclaiming the Sense of Self in People Living with Alzheimer's Disease

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Shriya Karlapudi1
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Introduction: Alzheimer’s disease (AD) is a progressive neurodegenerative disease, characterised by memory and cognitive impairment. Autobiographical memory, or the memory of oneself, consists of episodic, self-defining and semantic components. AD profoundly disrupts autobiographical memory, causing individuals to lose their self-identity. Although previous research has shown that music can facilitate the recall of autobiographical memories, the extent and nature of this effect in AD is unclear. Specifically, it is debated whether music preserves neural networks involved in autobiographical

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Systematic Review of Cardiovascular Autonomic Dysfunction in Lewy Body Dementia

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C Gibbons1; E Georgiou 1; D Mockler 1; R R Ortuno 1; I Leroi 1
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Introduction: The Lewy Body Dementias (LBD) incorporate both Parkinson’s Disease Dementia (PDD) and Dementia with Lewy Bodies (DLB). These conditions have a heterogeneous presentation and disease trajectory with much inter-individual variability. Accurate diagnostics and prognostication are becoming increasingly important in the potential disease modifying era. Cardiovascular autonomic dysfunction is a supportive diagnostic feature of DLB and a well-known non-motor phenotype of Parkinson’s Disease. It most commonly presents with orthostatic hypotension (OH) which can be easily measure
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Opportunistic Review of CT scans to Identify Unreported Vertebral Fractures in Patients with Parkinson’s Disease

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S Ow1; A Kitson1; H Ali2; B Mohammed3; J Boylan3; S Jones4
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Introduction Patients with Parkinson’s Disease (PD) are at an increased risk of developing osteoporosis. Vertebral fractures (VFs) are the commonest type of osteoporotic fracture and are frequently underdiagnosed, up to 70% going unreported. Individuals with VFs are at a significantly higher risk of experiencing subsequent fractures (relative risk increase of 2.8 for hip fractures and 5.4 for additional VFs). The presence of VFs are often not formally reported. VFs are also associated with an eightfold increase in morbidity. These complications could result in reduced independence and

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Survey Of General Practitioners' Attitudes To Using Blood-Based Dementia Markers

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J Lynch1; N Hart2; P Passmore1; E Cunningham1.
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Introduction Blood-based biomarkers (BBMs) of Alzheimer’s and other dementia-causing diseases will be available for clinical use in Northern Ireland (NI) within the next five years. Globally, it has been proposed that BBMs will be utilised in primary care before referral to memory services. This study assessed GP willingness to use BBMs and identified requirements for implementation. Method Ethical and governance approvals were granted by QUB. A short, anonymous questionnaire assessing GP attitudes towards BBMs was distributed primarily via email. The Eastern GP Federations Support Unit (FSU)

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Re-evaluating Diabetes Targets in Older Adults - Does Frailty Matter?

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J Chiu1, L Olding 1, A Lisitsyna 1,2, R Gurung 2, H Matharu 2, Y Han 2, Z Hobart 2, N Shofique 2
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Introduction The management of type 2 diabetes in older adults should be optimised with treatment plans that balance glycaemic control with the risks of hypoglycaemia and overtreatment. Overly strict glucose control has been linked to higher mortality, with inappropriate medication use contributing to dangerous hypoglycaemic episodes. NICE guidelines currently suggest an HbA1c target of ≤53 mmol/mol on a hypoglycaemic agent, with less ambitious targets for older or frail individuals to avoid risks such as hypoglycaemia and falls. This audit aims to assess glycaemic control in older adults
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Improving Advance Care Planning Completion in Primary Care

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E Saudella1; A Biju1
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Introduction Advance care planning (ACP) is a patient-centred discussion involving the patient, family, and healthcare professional to ensure care aligns with patient wishes. In Wales, this includes two recognised documents for those with capacity, and a best interests form for those without, completed by a Lasting Power of Attorney or IMCA. ACPs in the elderly population enhance quality of life, communication, and reduce hospital admissions. This project aimed to improve ACP completion in primary care. Method Forty-one residents, who were registered to Roath House Surgery, were sampled from

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A Quality Improvement Project to incorporate routine Bone Health assessment into a Parkinson’s Clinic

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A Kitson1; H Ali1; S Page2; B Mohamed2
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Introduction People with Parkinson’s (PWP) are twice as likely to fracture and over twice as likely to develop osteoporosis (1. Henderson et al, Parkinsonism & Related Disorders, 2019, Vol.64, pp.181-187). This is associated with significant morbidity (1). Assessment of bone health is often overlooked in clinic (2. UK Parkinson’s Excellence Network, 2019, pp.4-56), deeming it a priority area for improvement. Our project focuses on implementing routine bone health assessment for PWP in clinic, to achieve better standards of care. Methods This was a 12-week medical student led project, supported
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Improving Medication Safety in Dysphagic Parkinson’s Disease Patients through the Dysphagia Alert Card Initiative

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Dr N Silva1; Dr S Ulikova1
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Introduction: Dysphagia in Parkinson’s disease (PD) increases the risk of aspiration pneumonia and medication harm during acute admissions. When patients are made nil by mouth (NBM), time critical PD medicines may be delayed while clinicians calculate levodopa equivalent dose (LED) and convert to alternative formulations. We introduced a patient held Dysphagia Alert Card to provide a specialist approved emergency prescribing plan and improve timely prescribing and review. Method: Patients with established dysphagia or high risk were identified during routine specialist reviews and inpatient
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Improving Inpatient Sleep in orthogeriatric patients - Quality Improvement Project

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C Pang1; O Abu Baker1; Y Abdelmegeid2
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Background: In orthogeriatric patients, sleep quality is often overlooked despite its association with pain, mobility, and rehabilitation outcomes. This project assessed inpatient sleep quality on Elm Ward at Trafford General Hospital and evaluated interventions to improve sleep. Aim: To assess inpatient sleep quality and implement non-pharmacological and pharmacological interventions. Methodology: Baseline sleep quality data were collected from eligible inpatients using a sleep questionnaire prior to two Plan–Do–Study–Act (PDSA) cycles. The first cycle introduced non-pharmacological
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Co-designing an intervention to promote shared decision-making with older people, with frailty, in planning discharge from hospital

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Kerrie McLarnon1, Deirdre McGrath1, Peter O'Halloran1, Anita Mallon1, Christine Brown Wilson1
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Background: Effective planning for hospital discharge can best be achieved through shared decision-making to make fully informed decisions. However shared decision-making is challenging for both healthcare professionals and older people with frailty. There is limited consensus on the optimum way to achieve shared decision-making. This project aims to develop a multi-component intervention to prepare healthcare professionals, older people, and relatives/carers of older people to engage in shared decision-making. We will test the feasibility of implementing the intervention in Northern Ireland
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Taking dementia care to the high street: Dementia UK and Nationwide Building Society clinics programme

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LWilliamson1; RGuild2
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Introduction When facing a sharp rise in the number of people living with dementia in Northern Ireland, delays in receiving a timely diagnosis and accessing specialist dementia support, it is imperative to find new ways to bring dementia care closer to home. An innovative 3-year partnership, established in 2024, between Dementia UK and Nationwide Building Society, aims to provide specialist nursing support to 100,000 families living with dementia across the UK. Recurrent clinics are delivered in Nationwide high street branches across Northern Ireland by a specialist dementia nurse, known as an
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Impact of Cataract Surgery on Falls Risk in Older Adults: A Systematic Review

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Ashley Lim1
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Introduction: Falls are a major cause of morbidity, functional decline, and loss of independence in older adults. Visual impairment is a well-recognised and potentially modifiable risk factor for falls, with cataract being the leading cause of reversible visual loss worldwide. Cataract surgery improves visual acuity, contrast sensitivity, and depth perception, all of which are essential for safe mobility. However, evidence regarding the effect of cataract surgery on falls risk in older adults remains inconsistent and has not been comprehensively synthesised. Clarifying this relationship is
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A Qualitative Audit of ReSPECT Form Discussions in Dementia Inpatient Units

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Dr Alexander Jelloo
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Introduction: What is the most significant conversation you’ve ever had? A question for which everyone reading will have their own answer. You may vividly recall what was said, where, by whom, and in what manner. In a healthcare setting, a clinician must always consider the ways in which our daily work can involve conversations as salient as this for our patients, their families and carers. Discussing ceiling of care is one such instance. With ReSPECT now reflected in HPFT policy as standard practice, this audit explores how patients and carers experience these discussions. ReSPECT forms
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Factors Impacting The Experiences of Dementia Patients & Carers when Accessing Emergency Department Care in Northern Ireland

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Abbie Magowan
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Introduction It is acknowledged that older people with a background of dementia are frequent attenders of Emergency Departments (EDs), where overcrowding, long waits and an unfamiliar environment can create a distressing experience for these patients and their carers. By identifying and understanding modifiable factors that shape these patient’s experiences, healthcare systems and professionals can aim to improve experiences for both this patient group and their carers. This qualitative analysis aims to identify and explore the factors that can impact the experiences of patients with dementia

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Think Delirium: A Quality Improvement Project

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E McIntyre1; ESY Lau1, J Jones1; C Veitch1
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Introduction Delirium affects up to 50% of older patients (aged over 65 years) in hospital and is associated with serious consequences including greater morbidity and mortality, longer hospital stays with consequent hospital acquired complications, and an increased likelihood of hospital readmission. Early recognition prompting effective management is critical in improving outcomes for patients with delirium.  Methods  This QIP was conducted amongst Foundation Year 1 doctors (FY1) working across all wards in a busy district general hospital to improve knowledge of delirium through educational

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A qualitative rapid review of factors that affect the implementation of physical activity programmes for older adults in the community setting

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A Mahmoud1; J.P Ventre2,E Orton3; V A. Goodwin1; H Hawley-Hague2; D A Skelton4; D Kendrick3; C Todd2; G Brough3; C Quigley2; K Taylor1,5; T Walton1,6 & F.M. Manning1
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Background Physical inactivity in community-dwelling older adults is modifiable, and physical interventions are effective in reducing age-related decline and disease. Despite this, engagement and retention of older adults in community physical activity (PA) programmes are limited. This review explores factors affecting implementation of effective PA programmes for older people in the community. Methods Review of qualitative literature identified from MEDLINE, Social Policy and Practice, PsycINFO, CINAHL, Cochrane Library and Frontiers in Rehabilitation Science from 1999-2024. Data were
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Effects of metformin on metabolic and inflammatory markers in older people with sarcopenia and frailty: analysis from the MET-PREVENT randomised controlled trial

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Ihfaz Islam1, Jasmine Wilson1, Andrew Clegg2, Helen Hancock3, Carmen Martin-Ruiz4, Claire McDonald1, Avan Aihie Sayer1, Claire Steves5, Thomas von Zglinicki4, Miles D Witham1
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Background Chronic inflammation and metabolic dysfunction are posited to contribute to sarcopenia and physical frailty; both are targets for metformin therapy. We investigated correlations between physical performance measures and inflammatory and metabolic biomarkers in a group of older people with sarcopenia and frailty/prefrailty and investigated the effect of metformin treatment on this biomarker panel. Methods We analysed samples collected at baseline and follow-up (4 months) from the randomised controlled MET-PREVENT trial. MET-PREVENT recruited participants aged 65 and over with

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