Posters

Introduction: Delirium is a neuropsychiatric condition which is independently associated with poorer outcomes, and is prevalent in those aged over 75. Early recognition and standardised pathways are key to delivering good delirium care. Despite this, there are no formal screening and standardised pathways in RIE ED. Baseline data suggested around 4% are being screened for delirium. Aim: To increase screening for delirium from a baseline figure of 4% to 75% for patients aged over 75 years of age attending RIE ED, and also to ensure initial investigations were initiated in any patients who were

Introduction: Orthostatic hypotension (OH) is common in geriatric inpatients and associated with an increased risk of falls, fractures, reduced quality of life and death. Therefore, recognizing OH early is important in prevention of this associated morbidity and mortality. A lying and standing blood pressure (LSBP) measurement is required for the diagnosis of OH and guidelines advice LSBP measurement in patients 65 years and older. Aim: This Quality Improvement Project aimed to improve rates of LSBP measurement on all geriatric inpatients during their current admission. To carry this out we

Introduction People who recover poorly after delirium are likely to require an increased level of care. It is presently unknown whether interventions to improve recovery after delirium are effective and cost-effective. This research aimed to develop a programme theory to inform the design of an intervention to improve recovery after delirium. Method A rapid realist review of literature was conducted to develop an initial programme theory. Following this, a qualitative investigation of the perceived rehabilitation needs of older people who have experienced delirium during a hospital stay was

Background The increased operative risk for older adults remains a growing concern in neurosurgery. One method of managing this is the addition of embedded geriatric liaison teams for proactive management of older and frail patients in surgical settings. This study aims to evaluate the attitudes of healthcare professionals towards the Medicine of the Elderly Liaison to Neurosurgery Team at the Royal Infirmary of Edinburgh and to investigate the impact that the team has made since its inception in February 2021. Methods 17 staff members were interviewed: medical and surgical doctors as well as

Abstract Introduction: Chronic pain is associated with frailty. We hypothesised that painful comorbidities would be more strongly associated with frailty than non-painful comorbidities. Method: Data were from Investigating Musculoskeletal Health and Wellbeing, a UK-based cohort of people with or at risk of musculoskeletal problems or frailty. Average pain over the previous month was assessed using an 11-point numerical rating scale (NRS). The original FRAIL questionnaire comprises five self-report items: Fatigue, Resistance, Ambulation, Illnesses and Loss of weight. In this study, risk of

Introduction: Moving into a care home is a significant, life-changing experience which occurs to address care needs which cannot be supported elsewhere. UK health policy recommends against moving into a care home from the acute hospital. However, this occurs in practice. Better understanding pathways into care homes could improve support for individuals and families, service planning and policymaking. Our aim was to characterise individuals who move-in to a care home from hospital and those moving-in from the community, identifying factors associated with moving-in from hospital. Method: A

Introduction: Comprehensive Geriatric Assessment (CGA) improves outcomes for frail older adults in acute hospitals. Patients aged 75 and over admitted into the Emergency Department (ED) at the QEUH will automatically generate a “frailty icon” on their electronic record. The number of frail people accessing emergency care is increasing. This Healthcare Improvement Scotland (HIS) frailty tool prompts staff to assess for frailty and refer to the local Frailty Pathway if appropriate. We designed a multidisciplinary quality improvement project (QIP) to increase completion of the frailty icon and

INTRODUCTION: The number of transcatheter aortic valve implantations (TAVIs) performed in the UK is increasing exponentially, providing a new treatment avenue for patients with severe symptomatic aortic stenosis previously deemed too frail for surgical intervention. Frailty is known to be associated with poor outcomes following TAVI, however little is known as to whether comprehensive geriatric assessment (CGA), the gold standard intervention for older adults in a range of clinical settings, can change outcomes for older adults undergoing this procedure. METHODS: Databases EMBASE, MEDLINE

Background: Multimorbidity has negative impacts on the health outcomes of older adults. Previous research has discovered different patterns of multimorbidity. However, evidence is scarce for associations between multimorbidity patterns and depression, especially the role of social participation in it. This study aimed to explore the relationship between multimorbidity patterns and depression among older adults in Taiwan and the effect of social participation in different multimorbidity patterns. Methods: This population-based cohort study used data from the Taiwan Longitudinal Study on Aging

Intracerebroventricular streptozotocin injection at 3mg/kg of b/w causes phenotypes similar to that of sporadic Alzheimer’s disease (sAD) from 14th day post-injection. On the other hand, body of evidences indicated that impairment in the sAD is the major contributor for cognitive decline. Taken together, we tested the adult neurogenesis hypothesis in streptozotocin model of sAD in female Wistar rats after extremely low magnetic stimulation (MF: 17.96, 50Hz, 2hr/day, 21days). To do so, 33 rats were randomly divided into three groups viz. Sham+MF, AD and AD+MF. Consequently, animals were first

Introduction: Bowel health is affected in acutely admitted patients due to illness, change in diet, dehydration, and reduced mobility. Constipation is common and older patients are particularly at risk of constipation due to reduced bowel transit speed. Bowel motion monitoring can help improve bowel health and reduce complications including delirium, which can prolong hospital admission. To increase detection of constipation, a quality improvement project was carried out in the Department of Medicine for the Elderly at Southend Hospital, with aims to increase compliance of daily stool chart

Intracerebroventricular streptozotocin (ICV-STZ) injection is among the best animal models to simulate sporadic Alzheimer’s disease (sAD). Abnormality in brain insulin signaling, neurodegeneration, neuroinflammation, cholinergic damage, mitochondrial dysfunction, genetic abnormality, respiratory problem, oxidative stress, gliosis, sleep disturbances are associated with cognitive abnormalities seen in ICV-STZ injected rats. Available experimental evidence has used varying doses of STZ (

Introduction: The COVID-19 pandemic has resulted in many people experiencing bereavement in challenging circumstances. In April 2020 at a large London Trust, a “Bereavement Welfare Hub” (BWH) was established to offer support and advice by telephone to relatives and carers of all adults who died as inpatients. Data from these calls has been used to examine and learn from experiences of the bereaved at this time. Methods: Data from BWH call records regarding 809 adults who died at the Trust in March - May 2020 were collated and analysed quantitatively. A random selection of 149 call records were

Introduction The therapeutic benefits of narrative in terminally ill patients is widely studied and evidenced in the research literature. The Hospice Biographers are a charity offering a professional free service for end-of-life patients the opportunity to audio-record their life story in a memory stick and to keep copies for themselves and for their families. The objective of this qualitative study is to explore the experience of a group of people either recording or listening to an audio-biography. Methods Five semi-structured in-depth interviews with terminally ill adults who recorded an

Introduction Medication-related harm (MRH) events are increasing among older adults especially in the 8-weeks after hospital discharge. The Discharge Medical Service (DMS), a UK initiative, aims to reduce post-discharge MRH. In this study, we will compare the clinical, economic, and service outcomes of the DMS. Method Using a randomized control trial design, 682 older adults ≥ 65years due for hospital-discharge will be recruited. Participants will be randomized to either intervention arm (medicine management plan (MMP) and DMS), or control arm (DMS only) using a 1:1 stratification. The MMP

Introduction Empowering patients to ‘age well’ (NHS England Long Term Plan, 2019) has become a key driver to meet the rising demand for healthcare. Despite a growing body of evidence regarding ageing well and the benefits of patient empowerment (Selman et al, 2017) and reducing demand on resources (Age UK, 2020), there remains confusion regarding applied meaning for the spectrum of older persons health. This research will consider expert view on the topic of ‘ageing well’ related to the predictable patterns of ageing. The aims of this study will be to develop a new interventional frailty

Introduction Older people living in care homes sometimes experience episodes of acute functional decline. These represent a diagnostic challenge to healthcare professionals and can result in antibiotic prescriptions or hospital admissions, though this may not always the most appropriate management strategy. We aimed to understand how episodes of acute functional decline are recognised, managed and escalated by care home staff in the UK. Method This was a qualitative interview study with UK care home staff, including managers, nurses and carers. Participants were recruited through

Introduction: Neck of femur fractures (NOFFs) are a clinically significant diagnosis, with 10% of patients dying within one month of diagnosis [1]. There is a strong association between earlier surgery and improvement in postoperative outcomes [2]. Taking anticoagulation can cause delays in patients being operated on. At Homerton University Hospital (HUH), no previous guideline existed to aid specifically in the management of patients with NOFFs on anticoagulation. We created a guideline in order to reduce delays to theatre, in keeping with national guidance (

Introduction During hospital admissions, there are individuals with rapidly deteriorating conditions that may be entering a terminal phase and clinicians decide ‘fast tracking’. The purpose of this audit is for better understanding of fast track process, to estimate, improve the process and develop a checklist applicable to all Care of Elderly wards. As a prerequisite for establishing NHS funding, documents are submitted to Clinical Commission Groups (CCG) depends on patients’ Boroughs. After CCG approval, discharge planning is facilitated by OT and doctors (package of care, discharge summary

Background: Guidelines recommend that all older hospital patients are screened for cognitive comorbidity (i.e. dementia, delirium) and frailty to inform care and target multidisciplinary team resources, based mainly on evidence from studies in elective or specialty-specific settings. Unselected hospital-wide data are needed to inform guidance and service design and delivery, so we set up the Oxford Cognitive Comorbidity and Ageing Research Database (ORCHARD) using routinely-acquired electronic patient record (EPR) data. Methods: ORCHARD includes pseudonymised EPR data on all patients >65 years