Age and Ageing journal

Featured content includes: 

• Prevalence, incidence and mortality of delirium in patients with COVID-19: a systematic review and meta-analysis demonstrating that a third of older patients with COVID-19 had associated delirium. Prevalence in those with prior dementia was nearly half.
• Delirium in COVID-19: Common, distressing and linked with poor outcomes . . . Can we do better? discusses why, implications for patients and services, and problems occurring after recovery.
• Magnitude, change over time, demographic characteristics and geographic distribution of excess deaths among nursing home residents during the first wave of COVID-19 in France: a nationwide cohort study reports that mortality increased by 43% and represented half of all excess deaths in the care home population.
• Care-home outbreaks of COVID-19 in Scotland March to May 2020: National linked data cohort analysis reports that 40% of Scottish care homes experienced an outbreak in the first wave.
• Are presymptomatic SARS-CoV-2 infections in nursing home residents unrecognised symptomatic infections? Sequence and metadata from weekly testing in an extensive nursing home outbreak suggests that ‘Asymptomatic’ cases were often ‘pre-symptomatic,’ with symptoms appearing up to 8 days after test positivity
• Is point-of-care testing feasible and safe in care homes in England? An exploratory usability and accuracy evaluation of a point-of-care polymerase chain reaction test for SARS-CoV-2 describes a pilot of (PCR) testing using an automated ‘benchtop’ machine in care homes, delivering results in 1.5 hours.
• COVID-19 testing during care home outbreaks: the more the better? and COVID-19 point-of-care testing in care homes: what are the lessons for policy and practice? discuss the balance between testing and other infection control procedures, noting that each has costs, opportunity costs and undesired consequences.
• Measuring the impact of a Chronic Obstructive Pulmonary Disease Community Respiratory Programme on emergency admissions to hospital: a controlled interrupted time series analysis  revealed fewer hospital admissions for people with a primary, but not a secondary, diagnosis of COPD, compared with a control area
• Mortality in hip fracture patients after implementation of a nurse practitioner-led orthogeriatric care program: results of a 1-year follow-up found that mortality halved up to 1 year later, length of stay reduced, and proportion discharged home increased.
• Acceptance and commitment therapy for late-life treatment-resistant generalised anxiety disorder: a feasibility study describes a successful programme for treatment-resistant generalised anxiety disorder.
• Preoperative comprehensive geriatric assessment and optimisation prior to elective arterial vascular surgery: a health economic analysis supports pre- and peri-operative geriatric surgical liaison services, in this case for vascular surgery and shows that this is cost-effective in terms of quality of life outcomes.
• New horizons in falls prevention and management for older adults: a global initiative describes an ambitious initiative to develop a world guideline on falls prevention, using the most up-to-date evidence review and synthesis, and modern ideas on co-production with stakeholders, across 10 different areas of practice.
• Prevalence of initial orthostatic hypotension in older adults: a systematic review and meta-analysis reports that prevalence of orthostatic hypotension was 28% in the general population over 65 and 35% in geriatric outpatients.
• Efficacy of exercise-based interventions in preventing falls among community-dwelling older persons with cognitive impairment: is there enough evidence? An updated systematic review and meta-analysis reports that strength and balance exercises reduce rate of falls by 30% in people with cognitive impairment
• Differential risk of falls associated with pain medication among community-dwelling older adults by cognitive status found that analgesic use doubled the risk of falls among people living with dementia.
• New horizons in understanding the experience of Chinese people living with dementia: a positive psychology approach notes that there can be tensions between Western and East Asian approaches to dementia care, but that positive psychology can be in keeping with traditional Chinese cultural values
• How do people living with dementia perceive eating and drinking difficulties? A qualitative study interviewed people living with dementia and their wishes in the event of eating and drinking problems.
• Hospitalisation without delirium is not associated with cognitive decline in a population-based sample of older people—results from a nested, longitudinal cohort study adds to evidence that the cognitive effects of delirium are not fully reversed on recovery, and emphasises the importance of prevention.
• Appropriate deprescribing in older people: a challenging necessity. The commentary to accompany the A&A themed collection on deprescribing
• The effect of opioids on the cognitive function of older adults: results from the Personality and Total Health through life study reports that those taking more than a cumulative morphine equivalent dose of 3 g over 4 years had greater cognitive decline.
• Duration of antibiotic treatment using procalcitonin-guided treatment algorithms in older patients: a patient-level meta-analysis from randomized controlled trials demonstrated that procalcitonin-guided treatment duration reduced antibiotic used by 25%.
• Developing a UK sarcopenia registry: recruitment and baseline characteristics of the SarcNet pilot describes the successful development of a primary-care-based sarcopenia registry, SarcNet, screening members of the population and gaining agreement for re-contact for research.