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Background in 2010, the European Working Group on Sarcopenia in Older People (EWGSOP) published a sarcopenia definition that aimed to foster advances in identifying and caring for people with sarcopenia. In early 2018, the Working Group met again (EWGSOP2) to update the original definition in order to reflect scientific and clinical evidence that has built over the last decade. This paper presents our updated findings. Objectives to increase consistency of research design, clinical diagnoses and ultimately, care for people with sarcopenia. Recommendations sarcopenia is a muscle disease (muscle failure) rooted in adverse muscle changes that accrue across a lifetime; sarcopenia is common among adults of older age but can also occur earlier in life. In this updated consensus paper on sarcopenia, EWGSOP2: (1) focuses on low muscle strength as a key characteristic of sarcopenia, uses detection of low muscle quantity and quality to confirm the sarcopenia diagnosis, and identifies poor physical performance as indicative of severe sarcopenia; (2) updates the clinical algorithm that can be used for sarcopenia case-finding, diagnosis and confirmation, and severity determination and (3) provides clear cut-off points for measurements of variables that identify and characterise sarcopenia. Conclusions EWGSOP2's updated recommendations aim to increase awareness of sarcopenia and its risk. With these new recommendations, EWGSOP2 calls for healthcare professionals who treat patients at risk for sarcopenia to take actions that will promote early detection and treatment. We also encourage more research in the field of sarcopenia in order to prevent or delay adverse health outcomes that incur a heavy burden for patients and healthcare systems. [ABSTRACT FROM AUTHOR]

Background in 2010, the European Working Group on Sarcopenia in Older People (EWGSOP) published a sarcopenia definition that aimed to foster advances in identifying and caring for people with sarcopenia. In early 2018, the Working Group met again (EWGSOP2) to update the original definition in order to reflect scientific and clinical evidence that has built over the last decade. This paper presents our updated findings. Objectives to increase consistency of research design, clinical diagnoses and ultimately, care for people with sarcopenia. Recommendations sarcopenia is a muscle disease (muscle failure) rooted in adverse muscle changes that accrue across a lifetime; sarcopenia is common among adults of older age but can also occur earlier in life. In this updated consensus paper on sarcopenia, EWGSOP2: (1) focuses on low muscle strength as a key characteristic of sarcopenia, uses detection of low muscle quantity and quality to confirm the sarcopenia diagnosis, and identifies poor physical performance as indicative of severe sarcopenia; (2) updates the clinical algorithm that can be used for sarcopenia case-finding, diagnosis and confirmation, and severity determination and (3) provides clear cut-off points for measurements of variables that identify and characterise sarcopenia. Conclusions EWGSOP2's updated recommendations aim to increase awareness of sarcopenia and its risk. With these new recommendations, EWGSOP2 calls for healthcare professionals who treat patients at risk for sarcopenia to take actions that will promote early detection and treatment. We also encourage more research in the field of sarcopenia in order to prevent or delay adverse health outcomes that incur a heavy burden for patients and healthcare systems. [ABSTRACT FROM AUTHOR]

Explicit criteria, such as the STOPP/START criteria, are increasingly used both in clinical practice and in research to identify potentially inappropriate prescribing in older people. In an article on the STOPP/START criteria version 2, O'Mahony et al. have pointed out the advantages of developing computerised criteria. Both clinical decision support systems to support healthcare professionals and software applications to automatically detect inappropriate prescribing in research studies can be developed. In the process of developing such tools, difficulties may occur. In the context of a research study, we have developed an algorithm to automatically apply STOPP/START criteria version 2 to our research database. We comment in this paper on different kinds of difficulties encountered and make suggestions that could be taken into account when developing the next version of the criteria. [ABSTRACT FROM AUTHOR]

Evidence-base: Deprivation of Liberty Safeguards (DOLS) addresses processes by which best interest decisions are made for vulnerable patients. DOLS forms part of the Mental Capacity Act but has not been given much prominence despite its clinical and ethical relevance. This audit evaluated local understanding, recognition and reporting processes of DOLS in a DGH. A quantitative survey was performed using a paper-based questionnaire targeted at all healthcare professionals. During the initial audit (n = 59), on-the-job DOLS teaching was available. The initial survey revealed 29% (n = 17) of healthcare professionals recognised the need for a DOLS and only 31% (n = 18) described the correct reporting process.Change-strategies: The initial stage of the audit illustrated the need for more robust interventions than education alone. In collaboration with the Trust's Safeguarding team, an algorithm (DOLS Action-Bundle) was formulated focusing on local deficiencies in knowledge and clinical practice, and made widely available. In addition, focused training sessions were planned. Due to time constraints, these sessions were preferentially offered to doctors.Change-effects: Post implementation of interventions, a further survey (n = 59) was conducted. Descriptive analysis revealed improvement in recognition of vulnerable patients (71%, n = 42) requiring DOLS across all healthcare professional groups. Similarly, 56% of staff (n = 33) correctly identified the reporting process. Sub-group analysis revealed a statistically significant improvement in both these domains amongst doctors (p < 0.05) which is particularly relevant as this was the group targeted during focused education sessions.Conclusion: There is a paucity of knowledge regarding DOLS. Education alone is ineffective in making the required changes. Interventions incorporating focused education, development of DOLS Action-bundle and collaborative working with a safeguarding agency have impacted significantly on recognition and reporting of DOLS amongst doctors. Future plans include extension of focused education across all healthcare professional groups and identification of ward DOLS champions with a repeat audit to assess impact of changes. [ABSTRACT FROM AUTHOR]