Objectives It is not clear whether the association between younger age at menopause and increased risk of dementia is modified by type of menopause. We examined the association of age at menopause or hysterectomy with dementia risk in three groups of women: those with natural menopause, premenopausal bilateral oophorectomy (surgical menopause) or premenopausal hysterectomy (without bilateral oophorectomy)

Introduction People from minoritised ethnic groups are diagnosed with dementia later in the disease. We explored pathways that may determine the timing of diagnoses in a UK ethnically diverse, urban area. Methods We conducted 61 semi-structured interviews: 10 community-dwelling older people from minoritised ethnic backgrounds with diagnosed and undiagnosed dementia (mean age = 72 years; males = 5/10)

Background Metabolomic scores based on age (MetaboAge) and mortality (MetaboHealth) are considered indicators of overall health, but their association with cognition in the general population is unknown. Therefore, the association between MetaboAge/MetaboHealth and level and decline in cognition was studied, as were differences between men and women. Methods Data of 2821 participants (50% women, age

Introduction This scoping review mapped evidence on physical activity (including structured exercise) and sedentary behaviour interventions (interventions to reduce sedentary behaviour) in people living with both frailty and multiple long-term conditions (MLTCs) and their informal carers. Methods Ten databases and grey literature were searched from 2000 to October 2023. Two reviewers screened studies

Objectives The relationship between nut intake and disability-free survival (healthy lifespan) in later life is unclear. The objective was to evaluate the association between nut intake and disability-free survival in a cohort of adults aged ≥70 years, and whether this varied according to overall diet quality. Methods This prospective cohort study involved 9916 participants from the ASPREE Longitudinal

Implantable cardioverter defibrillators (ICDs) are implanted in increasing numbers of patients with the aim of treating ventricular arrhythmias in high-risk patients and reducing their risk of dying. Individuals are also living longer with these devices. As a result, a greater number of patients with an ICD will deteriorate either with worsening cardiac failure, another non-cardiac condition or general

Behavioural symptoms are common manifestations of Parkinson’s disease (PD). Early behavioural symptoms characterise mild behavioural impairment (MBI). The prevalence and intensity of MBI in people with PD (PwP) have been studied across various cohorts. However, methodological differences have obscured our understanding of MBI in these individuals. This systematic review examines and synthesises findings

Hospital-associated deconditioning is a broad term, which refers non-specifically to declines in any function of the body secondary to hospitalisation. Older people, particularly those living with frailty, are known to be at greatest risk. It has historically been most commonly used as a term to describe declines in muscle mass and function (i.e. acute sarcopenia). However, declines in physical function

Background We aimed to examine whether current and lifetime night shift work is associated with accelerated biological ageing and the potential role of body mass index (BMI) in mediating the association. Methods Data were sourced from the UK Biobank cohort. This study included participants who reported detailed information on their current work schedule and had complete data to calculate PhenoAge.

BACKGROUND The rising prevalence of dementia necessitates identifying early neurobiological markers of dementia risk. Reduced cerebral white matter volume and flattening of the slope of the electrophysiological 1/f spectral power distribution provide neurobiological markers of brain ageing alongside cognitive decline. However, their association with modifiable dementia risk remains to be understood

INTRODUCTION Approximately 2 million people in Italy are currently living with dementia or mild cognitive impairment (MCI), and 4 million are involved as family members or caregivers. Considering the significant impact of dementia, the Italian Ministry of Health entrusted the Italian National Institute of Health (Istituto Superiore di Sanità) with the development of a guideline within the Italian National

OBJECTIVE Patients with chronic kidney disease (CKD) show features of premature ageing. We aimed to evaluate the association between biological ageing and adverse outcomes, including end-stage kidney disease (ESKD), cardiovascular diseases (CVD) and all-cause mortality, in patients with CKD. METHODS 23 435 participants with CKD and free of related adverse outcomes at baseline from the UK Biobank were

Existing models for the safe, timely and effective delivery of health and social care are challenged by an ageing population. Services and care pathways are often optimised for single-disease management, while many older people are presenting with multiple long-term conditions and frailty. Systems engineering describes a holistic, interdisciplinary approach to change that is focused on people, system

Background The main focus of rehabilitation following hip fracture is to regain mobility. Objectives To estimate the progression of real-world mobility the first year after hip fracture using digital mobility outcomes. Design An exploratory, prospective cohort study with pooled data from four previously conducted clinical trials. Setting and Subjects We combined data from the Trondheim Hip Fracture

Background Evidence concerning tolerability of sodium-glucose co-transporter-2 (SGLT2) inhibitors in older adults is limited due to under-representation in clinical trials. Our study aimed to determine the extent to which SGLT2 inhibitor intolerance increases with age and explore additional factors associated with intolerance. Methods This retrospective observational study included patients in the

Advance care planning (ACP) has traditionally aimed at ensuring that patients’ end-of-life (EOL) wishes are understood and respected. However, recent literature raises concerns about its effectiveness, with many trials indicating that ACP does not significantly improve goal-concordant care, enhance quality of life or reduce healthcare costs. This is because patients’ future decisions are influenced

Background Underrepresentation of care home residents in research has resulted in a poorer evidence base for health care in care homes. Fewer opportunities to take part in research, as well as assumptions made by others about their interest or wishes, creates challenges for residents’ inclusion in research. Early discussions about research preferences and wishes may be beneficial. This qualitative

Background The World Falls Guidelines (WFG) propose an algorithm that classifies patients as low-, intermediate-, and high-risk. We evaluated different operationalizations of the WFG algorithm and compared its predictive performance to other screening tools for falls, namely: the American Geriatrics Society and British Geriatrics Society (AGS/BGS) algorithm, the 3KQ on their own and fall history on

Background Automated frailty screening tools like the Hospital Frailty Risk Score (HFRS) are primarily validated for care consumption outcomes. We assessed the predictive ability of the HFRS regarding care consumption outcomes, frailty domain impairments and mortality among older adults with cancer, using the Geriatric 8 (G8) screening tool as a clinical benchmark. Methods This retrospective, linkage-based

Objective This study investigated the effectiveness of supramaximal high-intensity interval training (supramaximal HIT) on muscle capacities and physical function compared to moderate-intensity training (MIT) for older adults. Methods Sixty-eight older adults (66–79 years, 56% women), not engaged in regular exercise, were randomised to 3 months of twice-weekly supramaximal HIT (20 minutes including

Rehabilitation is a core component of comprehensive geriatric assessment and should be central to integrated care and support across the whole system. Yet access barriers and ageist practices still prevail within many rehabilitation services. This commentary reflects on a report and recommendations published by the British Geriatrics Society in May 2024. As lead author for the report, I share my personal

Background Whether changes in socioeconomic position (SEP) across generations, i.e. intergenerational social mobility, influence brain degeneration and cognition in later life is unclear. Objective To examine the association of social mobility, brain grey matter structure and global cognition. Methods We analysed T1 brain MRI data of 771 old adults (69.8 ± 5.2 years) from the Whitehall II MRI substudy

Background Loneliness is described as the subjective experience of unfulfilled personal and social needs, with emotional and social domains. Frailty is a state of vulnerability to stressors, which is often characterised by impairment in the physical, psychological and/or social domain. Objective This study aims to examine the bidirectional association between loneliness and frailty across the different

Background Cognitive decline, a common process of brain ageing, has been associated with telomere length (TL). Delving into the identification of reliable biomarkers of brain ageing is essential to prevent accelerated cognitive impairment. Methods We selected 317 non-smoking ‘Prevención con Dieta Mediterránea-Plus’ (PREDIMED-Plus) participants (mean age, 65.8 ± 5.0 years) with metabolic syndrome from

Background Continuity of care is essential to older patients’ health outcomes, especially for those with complex needs. It is a key function of primary healthcare. Despite China's policy efforts to promote continuity of care and an integrated healthcare system, primary healthcare centres (PHCs) are generally very underused. Objectives To explore the experience and perception of continuity of care in

Background Internationally, person-centred care (PCC) is embedded in the language of regulations and mandated to be practised in residential aged care (RAC). Despite this, PCC has not been fully adopted in RAC in Australia and internationally, and concerns about the quality of care persist. Over the past 2 decades, Montessori for dementia and ageing has been introduced in RAC to support and inform

The 30th Olympiad took place in July 2024. At first glance, sports science and training of elite athletes may appear to be of little relevance to geriatric medicine. However, there are important parallels between the practice of geriatric medicine and elite sports and lessons that we can learn from our sports science colleagues. Elite athletes and older people are operating at the margins of physiological

Background It is unclear whether social isolation and loneliness may precede frailty status or whether frailty may precipitate social isolation and loneliness. We investigated the reciprocal and temporal sequence of social isolation, loneliness, and frailty among older adults across 21 years. Methods We used seven waves of the Longitudinal Aging Study Amsterdam from 2302 Dutch older adults (M = 72

Background Falls have high socioeconomic costs. Information and communication technologies may support provision and monitoring of multisensory (MSR) physiotherapy programmes. The HOLOBalance platform used augmented reality holograms to provide patient-centred, individualised MSR. Objectives To determine the platform’s safety, acceptability and feasibility, investigate functional gait and dynamic balance

BACKGROUND There is growing interest in the comorbidity of vascular and neurodegenerative pathologies in patients with cerebrovascular disease (CVD) beyond cerebral amyloid angiopathy (CAA). However, the relationship between amyloid-β and vascular cognitive impairment (VCI) remains debated. OBJECTIVE To investigate the association between VCI and amyloid-β deposition in non-CAA CVD patients. METHODS

BACKGROUND Exercise referral schemes (ERS) are an effective strategy for increasing physical activity (PA) in older adults. Behavioural self-management strategies (SMS) may augment the maintenance of PA and associated benefits in this population, resulting in preservation of the functional capacity and prevention of disability over the long-term. AIM The primary aim was to investigate the long-term

BACKGROUND Tube feeding is discouraged among older adults with advanced dementia; nevertheless, caregivers often find feeding decisions challenging to navigate. AIM This study aims to gain a comprehensive understanding of tube feeding among community-dwelling older adults with advanced dementia in Singapore and its relationship to older adult quality of life (QoL) and caregiver psychological distress

BACKGROUND The aim of this study was to develop and validate a functional ability index (FAI) that incorporates aspects of intrinsic capacity and environmental factors of older individuals based on the World Health Organization framework of healthy ageing. METHODS Data of 7016 participants ≥60 years participating in the baseline survey of China Health and Retirement Longitudinal Study was used for

BACKGROUND Social isolation and loneliness are associated with increased risk of adverse health outcomes at older ages. This study evaluated whether isolation and loneliness are related to inadequate intake of micronutrients in the diet. METHODS We tested associations between social isolation and loneliness and dietary micronutrient intake 2 years later in 3713 men and women (mean age 68.26, standard

BACKGROUND Concerns about falling (CaF) are common in older people and can lead to avoidance of activities, social isolation and reduced physical function. However, there is limited knowledge about CaF in people with osteoarthritis (OA); yet, symptoms may increase CaF. We aimed to evaluate the prevalence of CaF and associated factors in people with knee or hip OA. METHODS This cross-sectional study

BACKGROUND Trials of interventions to prevent or treat delirium in older adults resident in long-term care settings (LTC) report heterogenous outcomes, hampering the identification of effective management strategies for this important condition. Our objective was to develop international consensus among key stakeholders for a core outcome set (COS) for future trials of interventions to prevent and/or

BACKGROUND Postoperative delirium (POD) significantly impacts older surgical patients, necessitating effective prevention strategies. OBJECTIVE To assess the effectiveness of the Pre-Interventional Preventive Risk Assessment (PIPRA) automated delirium risk prediction tool alongside non-pharmacological prevention strategies on POD incidence, hospital length of stay (LOS) and nursing time. METHODS This

BACKGROUND End-of-life periods are often characterised by suboptimal healthcare use (HCU) patterns in persons aged 65 years and older, with negative effects on health and quality of life. Understanding care trajectories (CTs) and transitions in this period can highlight potential areas of improvement, a subject yet only little studied. OBJECTIVE To propose a typology of CTs, including care transitions

BACKGROUND Falls in hospital remain a common and costly patient safety issue internationally. There is evidence that falls in hospitals can be prevented by multifactorial programs and by education for patients and staff, but these are often not routinely or effectively implemented in practice. Perspectives of multiple key stakeholder groups could inform implementation of fall prevention strategies

Background We conducted a secondary analysis of a cohort study to examine the World Falls Guidelines algorithm’s ability to stratify older people into sizable fall risk groups or whether minor modifications were necessary to achieve this. Methods Six hundred and ninety-three community-living people aged 70–90 years (52.4% women) were stratified into low, intermediate and high fall risk groups using

Objectives We assessed the effects of different exercise modalities and doses on depression levels in older adults. Methods Systematic searches of the PubMed, Web of Science, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Scopus databases were conducted from the start of database construction until December 2023. Studies were included if they were randomised

Background Echocardiography (Echo) is frequently utilized as part of the work up for ischemic stroke. National guidelines suggest using echo to assess for source of unexplained stroke “if detection of a structural cardiac abnormality would prompt a change of management”. This study aims to describe the use of Echocardiography post-stroke in Mayo University Hospital (MUH). Methods The study population

Background Delirium is a prevalent issue affecting older patients in acute hospitals. National guidelines mandate that all patients >65 years old admitted to an acute hospital setting are screened for delirium. Prompt assessment and management of delirium is vital in delivering optimal care to the older patient. In our institution, delirium can be under recognised and not assessed routinely as part

Background Hip fractures are a significant cause of morbidity and mortality in older adults. Bone health assessment is key in the reduction of future fracture risk. The aim of our study was to examine the adherence to the fifth Irish Hip Fracture Standard in patients >=70 years presenting to Letterkenny University Hospital (LUH) with a hip fracture and to examine the number of patients who were commenced

Background Dysphagia has been reported in almost half of hospital patients who are over 65 years.1 In 2023 a Flexible Endoscopic Evaluation of Swallowing (FEES) service was introduced into the hospital. The purpose of this study was to profile the patients who were referred for FEES and determine the prevalence and severity of dysphagia. Methods Information on patient diagnosis, dysphagia related clinical

Background Osteoporosis is a metabolic bone disorder characterised by decreased bone mineral density and mass. Due to its asymptomatic nature, it often remains undiagnosed and untreated until a fracture occurs. Traditionally, treatment decisions for osteoporosis are based on clinical appropriateness while balancing the treatment's risks and benefits. Machine learning (ML) is revolutionising healthcare

Background Dementia prevalence is expected to exponentially increase over the coming decades. Across society, an increased awareness of dementia inclusive environments is important, to promote inclusivity and foster empathy. The aim of this study was to explore the experiences of undergraduate students using virtual reality (VR) for dementia inclusive education. Methods Purposive sampling was employed

Background Do Not Attempt Cardiopulmonary Resuscitation (DNA CPR) orders and Treatment Escalation Plans (TEPs) are key components of advanced care planning for managing patients with progressive life-limiting illnesses and significant frailty. Our study aimed to determine the proportion of such patients being transferred from residential care facilities with documented TEPs upon medical admission,

Background Frailty is a treatable trait of relevance to people with various chronic respiratory diseases, especially those with severe COPD and/or lung transplantation. This has been recognised in the 2024 GOLD (Global initiative for chronic Obstructive Lung Disease) report and within recent European Respiratory Society guidelines. Central to optimisation of frailty management in those with chronic

Background Our current healthcare systems are designed around periods of acute illness and are ill equipped to meet the needs of multimorbid and frail adults with worsening mobility, cognition and function. According to The Irish Longitudinal Study on Aging (TILDA), Ireland has a high proportion of hospital deaths, indicating inadequate community and home care supports. Recognizing patients who are

Background Nursing home residents may present inappropriately to the Emergency Department at the end of life (EOL). Appropriate advance care planning (ACP) may reduce these presentations. Inpatient teams are in a position to discuss, document and support these ACPs for nursing home residents admitted under their care. Methods Building on existing inpatient and outreach specialist pathways in a model

Background Do Not Attempt Resuscitation (DNAR) orders are implemented to obviate inappropriate Cardio-Pulmonary Resuscitation (CPR) in patients with low chances of survival post-CPR. However, ambiguity regarding ceilings of care for patients with a DNAR order can arise. This re-audit aimed to review DNAR and ceilings of care documentation according to national HSE guidelines after education sessions

Background The recent NOCA report highlights a significant portion of major trauma cases resulting from falls among older adults, who often face limited access to trauma centres and age-related biases in treatment. Existing protocols and services for older trauma patients are lacking. This study aimed to audit the incidence and outcomes of MTOA admitted under the non-trauma specialties at a Major Trauma

Background There has been unprecedented progress in the development of blood-based biomarkers (BBMs such as p-tau217 to detect Alzheimer Disease (AD) pathology – characterised by the accumulation of Amyloid-Beta (Aβ) and hyper-phosphorylated tau (T). However, BBM performance in “real-world” memory clinic contexts remains unclear. Methods Using high-sensitivity immunoassays, plasma p-tau217 was assessed

Background New treatments are urgently needed for individuals with Mild Cognitive Impairment (MCI) - in particular for those with amnestic MCI, of whom a high proportion have underlying Alzheimer's Disease (AD). Transcutaneous Vagus Nerve Stimulation (tVNS) is a non-invasive neuro-modulatory treatment which has not been extensively examined in older adults with amnestic MCI. Methods A single site,

Background Incontinence is a common and troublesome feature of frailty (NCPOP 2012), routinely examined in a comprehensive geriatric assessment (CGA). It can impact on life quality, mobility, falls and overall care needs. Patients often develop incontinence during hospital admission and staff knowledge of continence status (CS) and efforts to drive improvements are often poor. We sought to explore

Background Dementia care in acute hospital settings requires targeted quality improvement initiatives based on national standards. This poster highlights key interventions to enhance care, aligning with local hospital group key performance indicators (KPIs), in one large teaching hospital. Methods Delirium screening (4AT) was implemented in the Emergency Department and geriatric ward, with education

Background The Health Service Executive (HSE) developed an Urgent and Emergency Care (UEC) Operational Plan in 2023. One UEC action was an aim to transfer “clinically appropriate” patients to alternative care settings e.g. Transitional Care Beds (TCBs) to relieve pressure caused by high occupancy rates in acute hospitals. Inclusion criteria for TCB use is ill defined and we sought to evaluate their