Development of tools and criteria to select and prioritise candidate interventions for early-phase sarcopenia clinical trials.
Background Recent advances in skeletal muscle biology have identified multiple potential candidate therapeutic interventions for sarcopenia. A systematic approach is needed to prioritise the most promising interventions for early-phase clinical studies. Methods A multidisciplinary team with expertise in sarcopenia, early-phase clinical trials, and geriatric medicine sought to identify target product profile (TPP) and intervention selection tools for neuromuscular conditions. As none were identified for sarcopenia, the group then developed a sarcopenia TPP. An algorithm was created to select
Horizon Scanning for the Identification of Interventions for Prevention, Delay, and Treatment of Sarcopenia
Background Sarcopenia is the age-related loss of muscle strength and mass. It affects 10% to 27% of individuals aged over 60 and increases the risk of falls, hospital admissions, and early mortality. It costs the UK around £2.5 billion annually in healthcare. Currently, no approved pharmacological treatments exist—this horizon scan aimed to identify early-stage trials testing potential interventions to prevent, delay, or treat sarcopenia. Methods Five databases were searched: PubMed, MedRxiv, BioRxiv, ClinicalTrials.gov, and UK Research Funding Successes. We included studies reporting
Factors associated with high adherence to secondary preventative medications 12 months after a stroke
Introduction Prior stroke is one of the biggest risk factors for future stroke events. Secondary prevention medications are key to reducing subsequent vascular events, and guidelines recommend use of antithrombotics, antihypertensives and lipid lowering drugs. We carried out a retrospective study of adherence to these medications in a post stroke population. Methods Consecutive patients admitted with acute stroke to a Dublin hospital between July 2022 and November 2023 were invited to participate. Participant interviews were carried out at 1 year post stroke, including demographic and clinical
Effectiveness of a brief video based intervention on the intention to book future vision and hearing assessments.
Evaluation of a New Frailty On-Call Shift for Geriatric SpRs at St Thomas' Hospital (STH)
Introduction Frailty-attuned acute hospital care is a vital component of integrated services for older people. The NHS Long Term Plan requires hospitals with major emergency departments to deliver 70 hours of acute frailty services each week. Workforce limitations often prevent services from meeting this target and expanding. Geriatric specialist registrars (SpRs) must gain experience in acute frailty so that the consultant workforce of the future can meet patient needs effectively. St Thomas' Hospital (STH) Acute Frailty Service expanded hours of operation through the introduction of a
Improved Discharge Summaries for Older Patients: A Step Toward Better Continuity of Care with Comprehensive Geriatric Assessment
Introduction Effective communication between primary and secondary care teams is essential for providing continuity of care in the community for older people with frailty. Discharge summaries often lack information captured in a comprehensive geriatric assessment (CGA). Junior members of the team, tasked with writing discharge letters, have not been formally taught in this area. This project aimed to incorporate key CGA domains into discharge summaries. Methods The geriatric medicine department at Broomfield Hospital and community mid virtual frailty team identified 7 core CGA domains for
Lumbar Puncture to Diagnose Alzheimer’s Disease Within A Geriatrician-Led Memory Service Is Well-Tolerated
Introduction With the emergence of disease modifying treatments for Alzheimer’s disease (AD), there is an increasing emphasis on the earlier detection and diagnosis of AD. Cerebrospinal fluid (CSF) sampled using lumbar puncture (LP) can be used to establish a biological diagnosis of AD. One potential obstacle to the widespread adoption of CSF biomarkers for AD diagnosis has been a perceived association with poor patient tolerability and safety of LP. LPs have been undertaken within our Geriatrician-Led Memory Service since May 2022. Patients are provided with a written information sheet prior
Older adults are now the face of Major Trauma in Ireland
Using the Irish Hip Fracture Database to drive improvement in Older Adult Care
Factors influencing fall prevention programmes: The challenge of implementing the FaME programme in a complex landscape.
Comparison of Free-Cog with the Mini-Mental State Examination and Lawton-Brody Functional Scales
Introduction: The Free-Cog is a brief cognitive test designed to capture decline in both general cognition and executive function. The Free-Cog has been validated by comparison with the Mini-Addenbrooke Cognitive Examination in a UK secondary care setting. Here, we compare Free-Cog to the routinely-used Mini-Mental State Examination (MMSE) and the Lawton-Brody Instrumental Activities of Daily Living (IADL) and Physical Self-Maintenance Scales (PSMS). Methods: Patients from three memory clinics were recruited (n=318 records). The Free-Cog, MMSE, IADL and PSMS were administered in-person (n=288)
Reliability and Repeatability of a Portable Bio-Impedance Measurement Device in Early Parkinson's Disease
Introduction: Parkinson's disease (PD) is an age-related neurological condition characterized by bradykinesia, tremor, and postural instability. Weight loss within the first year of diagnosis is associated with poor prognosis. Studies suggest that if older adults lose skeletal muscle, their risk of falls and related injuries increases. Therefore, measures of body composition (e.g. muscle, fat) are important in PD, where the risk of falls is high. Established body composition analysis equipment is bulky and only used in research settings. We tested the reliability of a portable SECA mBCA 525
Daily fluid intake is reduced in people with early Parkinson's disease compared with controls
Background: Parkinson's disease (PD) is an age-related neurodegenerative condition with a range of motor and non-motor symptoms. Early non-motor symptoms include constipation and orthostatic hypotension, while dysphagia is common in established PD. Previous work by our group showed that many people lose weight within a year of diagnosis. This study explored if fluid intake was also reduced in people with newly diagnosed PD. Materials and methods: We invited people with newly diagnosed PD (within six months of a diagnosis or longer if not requiring treatment) to join the study. Controls were
Promoting the reduction of sedative use in older adults with delirium – A QI project
Introduction: Non-pharmacological de-escalation techniques are effective in managing agitated patients with delirium, yet are often overlooked in favour of pharmacological management. Sedatives are prescribed despite increased falls and extrapyramidal side effects. We used quality improvement methodology with the aim of reducing sedative use in older adults with delirium in an acute UK hospital. Methods: Utilising inpatient electronic prescribing records, we collected data on all patients aged ≥65 prescribed a sedative acutely during May 2022 in a 575-bedded acute district general hospital
Measuring vitamin D post hip fracture – should we test or just treat? Lessons learnt from an ortho-geriatric rehab unit.
Evaluating a Frailty Same Day Emergency Care Service: Patient and Family Perspectives
Development of a Regional Referral Pathway for Older People to the Medicines Adherence Service, from the Northern Ireland Ambulance Service
Title Evaluation of a new regional pathway for Medicines Optimisation in Older People (MOOP) medicines adherence pharmacist optimising medicines in older people referred by Northern Ireland Ambulance Service (NIAS) Authors & Provenance PCrawford1; SJohnston1; PGalbraith1; PTennyson1; CDarcy2; CMcGuigan2; KMiller3; JPatterson3; JAgnew4; JMcGennity4; HMcKee5; ACunningham5; CStevenson5; KBloomer6. MOOP Pharmacy Medicines Adherence Service, Belfast Health and Social Care Trust MOOP Pharmacy Medicines Adherence Service, Western Health and Social Care Trust MOOP Pharmacy Medicines Adherence Service
Route to a Streamline Transient Ischemic Attack Pathway: A Quality Improvement Initiative
Anticholinergic Burden, Falls and Mortality in a Diverse Older Population in Kuala Lumpur
A Quality Improvement Project assessing the delivery of music therapy on a Care of the Elderly Ward and its impact on patients with dementia and delirium
Introduction Music therapy (MT) can alleviate the behavioural and psychiatric symptoms of dementia (BPSD) but it is not a standard intervention. NICE recommends MT to improve wellbeing in patients with dementia. On our Care of the Elderly (COE) wards, MT is carried out by a qualified music therapist once a week, in groups, individual sessions, or both. This quality improvement project (QIP) aimed to establish what, if any impact, MT, as it was currently provided, had on BPSD, in the setting of a general district hospital ward, thereby also potentially setting new standards which could be used