Posters

Introduction  The National Hip Fracture Database (NHFD) is the mandatory national clinical audit for patients presenting with hip fracture. Since 2007, the NHFD has made admission cognitive assessment using the Abbreviated Mental Test Score (AMTS) routine for people presenting with this injury. In 2024, the NHFD plans to replace the AMTS with the 4A test (4AT), so all patients are additionally assessed for delirium on presentation. This study aims to compare the AMTS and 4AT for this patient group, so the NHFD and our local team can anticipate the consequences of this change in patient

Introduction With recent advances in surgical techniques and immunosuppressive therapy, solid organ transplantation (SOT) is increasingly accessible to older and more complex patients. Multiple previous studies have shown quality of life improvements in SOT patients post-transplant across age group and despite significant pre-transplant frailty. As such, we are investigating if SOT is associated with a reduction in frailty status post-tranplant. Methods Studies across five databases between 2000 and 2023 were included if an objective frailty status measurement was used, SOT was performed

Introduction Current NICE guideline recommends the use of either the FRAX or Qfracture score to assess the probability of future fragility fractures before measuring a patient’s bone mineral density. However, Qfracture has poor predictive ability in patients above the age of 85. As such, we investigated if the addition of clinical frailty status may enhance Qfracture risk prediction in an older age group. Methods Data were collected from consecutive admissions to an Emergency Frailty Unit (EFU) ofoin Ysbyty Ystrad Fawr Hospital, between 1 April 2015 to 31 March 2017. Demographic information

Introduction: Metabolic syndrome has been associated with an increased risk of cancer. This study evaluated this association in a South American cohort. Methods: Retrospective observational study in 100 patients older than 60 years with metabolic syndrome for more than 10 years from a hospital outpatient center. Anthropometric (waist circumference, body mass index), biochemical (triglycerides, HDL cholesterol, fasting glucose) and clinical (arterial hypertension, type 2 diabetes mellitus) parameters were evaluated. The association between metabolic syndrome, its components and cancer risk was

Introduction A quarter of people with hip fractures sustain another fragility fracture within 5 years, but most receive no osteoporosis medication as secondary prevention. To coincide with the publication of ‘A call to action: a five nations consensus on the use of intravenous zoledronate after hip fracture" Age and Ageing, September 2023, we set out to explore clinicians’ reasons for not previously using zoledronate (IV Zol). Methods Prior to first presentation of the ‘Call to Action’ at the Global Fragility Fracture Network (FFN) and British Geriatrics Society conferences in autumn 2023, we

Introduction: Symptom heterogenicity in dementia subtypes can pose diagnostic challenges, leading to potential misdiagnoses and significant implications on patient management. The NICE Guidelines for Dementia 2018 [NG97] recommend FDG-PET where diagnostic uncertainty remains after initial assessment. From 2021, a national and collaborative initiative supported using FDG-PET brain imaging for dementia in Wales to facilitate more accurate and timely diagnoses with higher degrees of confidence. This project aimed to evaluate the temporal aspects and diagnostic accuracy of FDG-PET utilization in

Introduction Inpatient fallers make up the minority of neck of femur fractures (NOF) in Morriston Hospital but it was observed that outcomes were less favourable than those in patients who sustained their fracture outside of hospital. Method Retrospective analysis was conducted of all NOF patients managed in Morriston Hospital whose injury was the result of an inpatient fall between January 2022 and December 2023. Outcomes were compared to those in all other NOF patients including pathological and occult fractures managed in the centre over the same two year period. Anonymised data were

Introduction Information-sharing between primary and secondary care is vital for patient safety and reducing duplication. The Electronic Discharge Summary (EDS) enables this but is often incomplete due to time pressures and poor team continuity. Information from the Comprehensive Geriatric Assessment (CGA) by the Perioperative care of Older People undergoing Surgery (POPS) team is often omitted, leading to queries from primary care colleagues and duplication of work on readmission to hospital. Methods Eight core CGA components were determined for inclusion in the EDS. Twenty EDS were reviewed

Introduction  Converting oral Parksinon’s disease (PD) medications to transdermal Rotigotine is sometimes required when patients have swallowing difficulties. Correct dosing is important to avoid under-treatment and deterioration of PD symptoms. Conversely, excessive dopamine agonist can cause hallucinations and confusion. In the UK, 2 main dose conversion calculators exist: PD Med Calc1 and OPTIMAL2, both utilising different formulae. We compared both to identify any dose discrepancies in their recommendations, and select one for use within revised trust guidelines.  Methods  We conducted a

Background: Previous clinical trials assessing potential disease-modifying therapies (DMTs) for Parkinson’s disease (PD) have been hugely inefficient in terms of time and resources, resulting in >10 years for a single therapy to complete phase 3 assessment. Additionally, un-representative trial populations limit the generalisability of findings. Increased efficiency of clinical trial conduct has been successfully demonstrated in multi-arm, multi-stage (MAMS) trials, which assess multiple therapies in parallel and identify ineffective therapies at early-stage analyses. New arms can be added

INTRODUCTION: Guidance around optimal management of patients with cognitive impairment within a Parkinson’s disease (PD) multidisciplinary team (MDT) is lacking. This project aimed to improve the service pathway by integrating a Parkinson’s disease specialist psychiatrist (PDSP) within the MDT rather than referring patients to a separate mental health service. METHODS: Data including mental health symptoms, time to review, diagnosis, treatment, and follow-up were collected over 12 months from the electronic clinical records of all patients referred to the PDSP with cognitive impairment. This

The UK Parkinson's Disease Clinical Studies Group The UK has a successful trial scene for Parkinson’s Disease, Multiple System Atrophy and Progressive Supranuclear Palsy neuroprotective studies, but with the growing number of trials, a formal, national structure is required to ensure the successful delivery of the studies. With funding from Cure Parkinson’s, the UK-PD-CSG launched in April-2022. The UK-PD-CSG’s goal is to further develop and support Parkinson’s clinical research across the UK and ensure more people with Parkinson’s (PwP) have the opportunity to participate in clinical trials

1. Introduction Parkinson’s Disease (PD) is a complex neurodegenerative disorder which impacts nearly all aspects of quality of life. Given the known challenges and risks of complications with PD, it is crucial to improve management prior to admission for surgery, in particular accurate medication timing and dose. Therefore a quality improvement project on this subject was initiated. 2. Method A retrospective analysis was conducted of Surgical attendances to Worthing hospital with the aim to identify patients with Parkinson’s disease (PD) admitted under their care. Each patient’s hospital

Parkinson's Disease (PD) is a progressive neurological disorder for which there is currently no cure. Palliative care should be discussed as part of PD management, both to empower patient understanding and expectations of their condition and to avoid unnecessary hospital admissions Results from the 2022 Parkinson’s UK national audit, found that the elderly care PD service in York was underperforming in having advance care planning (ACP) discussions with PD patients. The aim of this quality improvement project is to further review ACP discussions on a larger sample size and improve practice in

Background Patients living with Parkinson's disease (PD) who are sarcopenic are at significantly higher risk of falling (Cai et al., Frontiers in Neurology,2021,12,598035). Handgrip strength is a useful tool to assess for sarcopenia but is not commonly measured in clinical practice, despite the consequences that sarcopenia poses. This study aims to incorporate handgrip strength into the assessment of outpatients living with PD. Secondary objectives are to increase the understanding of whether exercise is associated with increased handgrip strength and to implement interventions for patients

Introduction Non motor symptoms (NMS) management in Parkinson disease is crucial part of the comprehensive management and have significant impact on the care and the quality of life. However, there are limitations in assessing non motor symptoms given the complexity of the symptoms , time constraint in the clinic setting and major emphasis being the motor symptoms. Objective To improve the assessment of non-motor symptoms in movement disorder clinics for the comprehensive and personalised management of patients with Parkinson disease. Service Development PD non-motor symptoms Questionnaire was

Introduction: Vitamin B12 and folate are essential for normal red blood cell production, tissue and cell repair, and DNA synthesis. B12 stores last for 3-5 years, while folate lasts for about four months. B12 or folate deficiency indicates a chronic shortage of one or both vitamins. Geriatric patients are more susceptible to Vitamin B12 and folate deficiency due to inadequate oral intake, malabsorption caused by pernicious anaemia, achlorhydria, and poor bioavailability. The clinical diagnosis is difficult in the elderly because of subtle, nonspecific, and highly variable clinical

Background Alzheimer’s disease-modifying drugs (DMDs) are in routine use in other countries. They will likely be available in the UK within the next year. It is not yet clear how many patients will be eligible for them or what resources are required to establish this eligibility. Methods Patients attending the out-patient memory clinic of a single geriatrician between 01/02/2022 and 12/01/2023 were identified. Information required to judge eligibility according to the lecanemab appropriate use recommendations (Cummings et al 2023) was extracted between 08/08/23 – 13/09/2023. Relevant data

Introduction Many patients admitted with fragility femoral fractures have established cognitive impairment but no formal diagnosis of dementia. This lack of pre-existing diagnosis impacts care, counselling and discharge planning. This audit assessed how many people aged >65 admitted with a fragility fracture had information, at the time of admission, suggesting a likely but unconfirmed diagnosis of dementia and how their length of stay (LOS) and discharge destination compared to patients with confirmed dementia. Methods 47 consecutive patients aged >65, admitted with a fragility femoral

Introduction: Neuroimaging plays an important role in assessing patients referred to a memory assessment service. CT scans are a cost-effective option and are useful to identify other causes of cognitive impairment and provide valuable information regarding the subtype of dementia. In our trust, there is no standardised request proforma for CT head scans and not all relevant criteria have been included that are in line with the guidance from the British Society of Neuroradiologists (BSNR) proposed structure dementia template for routine clinical practice. This audit aims to assess CT head scan