Posters

Introduction There are approximately 600 patients in the Pembrokeshire Movement disorder service, of whom, around 10% are either housebound or live in placements. There is concern these patients struggle to access follow up due to difficulties in attending face to face clinics. NICE and Parkinson’s UK recommend that people with Parkinson’s should be seen by a specialist healthcare professional every 6 to 12 months. Method A retrospective case note analysis was carried out for 55 patients that were identified as being either housebound or living in residential or nursing homes. Data were

Pneumococcal pneumonia in a confused older person – is it enough for diagnosis of delirium? Objective: To discuss the high suspicion of meningitis in an immunocompromised patient presenting with pneumococcal bacteraemia as Streptococcus pneumoniae (SP) exhibits a notable tropism for the meninges. With the recent rise in non-PCV13 serotypes, it is important to remain vigilant about the possibility of pneumococcal meningitis in susceptible individuals despite the widespread use of pneumococcal vaccines. Health promotion through vaccination should be encouraged to prevent an increase in invasive

The Frailty Virtual Ward Pathway aims to optimise the care for frail patients (with a frailty score between 4 and 7) aged 65 and above. by addressing the main frailty domains falls, polypharmacy, functional decline, and new incontinence. Timely referrals can enhance patient outcomes and reduce hospital length of stay. However, awareness and utilisation of the pathway among medical teams remain unclear. This project aimed to assess the awareness and usage of the pathway on three medical wards at West Suffolk Hospital, F7, G3, and G10, and to implement a quality improvement intervention to

Introduction In conjunction with Roche, a 18 month project was proposed to facilitate a more holistic approach in managing this patient cohort post-diagnosis and in turn improve outcomes, reduce length of stay and improve patient experience. Method The aim of the project was to design the MDT, ensure there is sufficient clinician capacity for implementation as well as develop accompanying pathways. The patient cohort was all patients with a diagnosis of Non-Hodgkin’s Lymphoma over the age of 65. Whilst all patients meeting these criteria would potentially be eligible to be reviewed by the MDT

Mental-physical multimorbidity (MP-MM) is defined by the presence of two or more morbidities, including at least one mental morbidity. Especially among the elderly it is associated with important negative outcomes like the high burden of healthcare utilisation. This study aimed to analyse the prevalence of MP-MM and associated factors among 6.929 participants of the second wave (2019-2020) of the Brazilian Longitudinal Study of Ageing (ELSI-Brazil). MP-MM was defined as the presence of two or more morbidities, including at least one mental morbidity, and was evaluated using a list of 16

The coexistence of two or more morbidities, including at least one mental morbidity, is defined as mental-physical multimorbidity (MP-MM). It is linked to significant poor outcomes, such as a high burden of healthcare utilisation, particularly in the elderly. To evaluate the complex connections between the 16 physical and mental morbidities among Brazilian older people from the Brazilian Longitudinal Study of Ageing, we performed a network analysis (NA), a sophisticated multivariate statistical technique to estimate all relationships between morbidities represented by an undirected grafus. The

Subjective cognitive decline (SCD) is defined by cognitive complaints expressed by the individual, without evidence of cognitive impairment on objective neuropsychological tests. Studies have analyzed SCD among patients with specific groups of diseases. An increased understanding of the association between disease patterns and subjective cognitive decline is essential to develop targeted interventions for these groups. Using data from the baseline of the Brazilian Longitudinal Study of Aging (ELSI-Brazil), this cross-sectional study included 2,508 participants. Subjective Cognitive Decline

Introduction There has been a recent shift in guidelines regarding HbA1c targets in the frail population. NICE (June 2022) advocate individualised HbA1c targets for frail patients with diabetes in circumstances where the long-term benefit is uncertain or when a tight glycaemic control would increase the risk of poor clinical outcomes. This is backed up by randomised control trials that have showed that Hba1c levels < 53 mmol/mol (7%) because of anti-hyperglycaemic therapy are associated with increased morbidity and mortality in frail patients with diabetes. This led us to explore the current

Background: Frailty has both health + health economic consequences. There are however few data concerning occurrence of frailty in different ethnic groups in the United Kingdom (UK). The aim of this analysis was to determine frailty prevalence across an ethnically diverse city and to explore the influence of age/social-disadvantage/ethnicity on occurrence. We looked also at frailty related risk of severe illness in relation to COVID-19 infection. Methods: Using data from the Greater Manchester Health Record(GMCR), we defined frailty index based on the presence/absence of up to 36 deficits

Introduction: The incidence of dementia among patients in perioperative settings is on the rise, presenting significant challenges for healthcare professionals in delivering adequate and appropriate care to this patient population. In order to gain a deeper understanding of the perioperative care needs of patients with dementia, thirty healthcare professionals were interviewed. The focus was on their experiences and perspectives regarding the fulfilment of these needs. Key factors influencing perioperative care were identified and categorized into three main themes: patient-related factors

Introduction There are multiple national drivers promoting person-centered healthcare. In the face of competing pressures, patient experience is often compromised. Aim: To increase the percentage of service users in our orthogeriatric rehabilitation ward rating experience as more than 6/10 to 90% by June 2024. Methods A multidisciplinary project using quality improvement methodology. Patients and carers were involved throughout. Patient, staff and carer interviews shaped improvement themes and change ideas. Broad themes identified: • Communication • Provision, and facilitation of, ward

Background: Informal caregivers play a critical role in providing continuous, unpaid care to individuals with dementia, helping to improve their quality of life and reduce the demand on formal care services. The caregiving relationship is a complex, dyadic process that can have profound effects on both the caregiver and the care recipient, underscoring the need to alleviate caregiver burden and support their well-being. Understanding the motivations behind why individuals take on caregiving roles is essential, as it can predict their experiences, perceptions, and the overall impact of

Introduction Thomas Sydenham, English physician stated, “a man is as old as his arteries”. Chronological age has been noted to correlate strongly with vascular/ biological age. However, little is known about how chronological and vascular parameters of ageing, correlate with frailty. In this study, we sought to study the correlations between frailty, chronological age and parameters of vascular ageing. Methods Data from two studies with participants aged ≥ 60years investigating the associations between Cytomegalovirus infection and frailty indices and vascular parameters were included. Two

Ethnic variations in frailty lack comprehensive understanding 1. This systematic review examined ethnic variations in the prevalence, incidence, and trajectories of frailty; associations between frailty and sociodemographic/lifestyle risk factors; and health-related outcomes of frailty. Methods: MEDLINE, Embase, Web of Science Core Collection, and CINAHL were searched (2000–July 2023). Searches supplemented by forward citation searching and hand-searching reference lists. Inclusion criteria: observational studies (using any frailty measure) in adults (>18 years) assessing frailty prevalence

Background: Worldwide population ageing is motivating how to measure the health of ageing populations. One approach is to compare dynamics of frailty, assessed by the cumulative-deficit frailty index, across different populations. We aim to compare the frailty distribution, mortality risk, and change in frailty over time between 18 countries. Methods: Using data from five harmonised international surveys (HRS, SHARE, ELSA, CHARLS and MHAS) we assessed frailty with a 40-item frailty index (baseline, 2-, 4- and 6-year follow-up), along with mortality status. We constructed separate regression

Introduction: People living with multiple long-term conditions (MLTC) are more likely to experience hospital admission, which is often associated with unintended consequences. Preventing or providing alternatives to admission by predicting adverse admission-related outcomes is important. This study aims to provide an overview of the association between MLTCs and adverse outcomes following hospital admission through a systematic review of systematic reviews. Method: We searched Medline, Embase, CINAHL, Web of Science and PsycINFO for systematic reviews assessing risk factors/predictors of

Introduction: The representation of frailty in type 2 diabetes trials is unclear. This study used individual patient data (IPD) from trials of newer glucose-lowering therapies to quantify frailty and assess the association between frailty and treatment efficacy and adverse events. Methods: We analysed IPD from 34 trials of sodium glucose cotransporter 2 inhibitors, glucagon-like peptide-1 receptor analogues and dipeptidyl peptidase-4 inhibitors. Frailty was quantified using a cumulative deficit frailty index (FI). For each trial we assessed the distribution of the FI; interactions between

Introduction The recent introduction of the Medical Examiner (ME) service changed the process for Medical Certificate of Cause of Death (MCCD) completion across Wales. This offered opportunity for local process redesign and embedding of team-based education and reflective practice, whilst reducing delays in MCCD completion for bereaved families. Methods We produced a process map and discussed with key stakeholders - ward teams, bereavement staff and the ME Office. We developed a team–based Proposed Cause of Death form (several PDSA Cycles) to prompt and stimulate early medical team discussion

Background: Newer glucose-lowering agents for type 2 diabetes (sodium glucose cotransporter 2 inhibitors (SGLT2i), glucagon-like peptide-1 receptor analogues (GLP1ra) and dipeptidyl peptidase-4 inhibitors (DPP4i)) improve hyperglycaemia and SGLT2i and GLP1ra reduce the risk of major adverse cardiovascular events (MACE). It is not clear whether the efficacy of these agents varies by age. Methods: We searched Medline and Embase, plus clinical trial registries, for randomised controlled trials of SGLT2i, GLP1ra and DPP4i, versus placebo or active comparator, in adults with type 2 diabetes

Introduction: The aging population has increased the demand for family caregivers, who often suffer from psychological distress, especially compassion fatigue. This systematic review and meta-analysis evaluate the effectiveness of web-based compassion interventions in improving the mental well-being of family caregivers. Methods: MEDLINE, Embase, PsycINFO, Web of Science, Cochrane Library, and Proquest were searched from database inception until manuscript submission date. Eligible studies included family caregivers participating in web-based compassionate interventions with reported mental