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The author discusses various studies on age and aging published in the journal. Topics include an overview of current thinking in Alzheimer's disease diagnosis and management, the use of routine electronic health data to derive electronic frailty indices, and a consensus process for introducing frailty screening in emergency departments.

The article presents summaries of several research on age, ageing, vascular disease, falls, cognition, frailty and pain. A randomized controlled trial evaluated a falls prevention bundle for hospitalised patients. Another study compared nebulised ketamine with intravenous morphine for moderate-to-severe acute musculoskeletal pain in emergency departments. Researchers examined outcomes for older patients with myocardial infarction using a prospective coronary reperfusion registry.

The author comments on the World Falls Guidelines that was developed to produce relevant and practical recommendations that could be applied to prevent falls throughout the world, specifically among geriatric patients. Topics covered include the potential of the guidelines in contributing to service development, improve quality of care, and promote education on falls, how the guidelines can support clinicians in their practice, and its role in the development of falls prevention services.

An introduction is presented in which the editor discusses papers within the issue on various topics, including new models for clinical decision making, the role of genomics in understanding disease mechanisms, and a falls prevention program for care homes.

This series of articles for rehabilitation in practice aims to cover a knowledge element of the rehabilitation medicine curriculum. Nevertheless, they are intended to be of interest to a multidisciplinary audience. The competency addressed in this article is an understanding of how to develop an intervention for people with mild cognitive impairment and dementia to promote their independence, stability, and physical activity. Introduction: Older adults with dementia are at a high risk of falls. Standard interventions have not been shown to be effective in this patient population potentially due to poor consideration of dementia-specific risk factors. An intervention is required that addresses the particular needs of older people with dementia in a community setting. Methods: We followed guidelines for the development of an intervention, which recommend a structured approach considering theory, evidence and practical issues. The process used 15 information sources. Data from literature reviews, clinician workshops, expert opinion meetings, patient-relative interviews, focus groups with people with dementia and clinicians, a cross-sectional survey of risk factors, a pre-post intervention study and case studies were included. Data were synthesized using triangulation to produce an intervention suitable for feasibility testing. Practical consideration of how an intervention could be delivered and implemented were considered from the outset. Results: Elements of the intervention included individually tailored, dementia-appropriate, balance, strength and dual-task exercises, functional training, and activities aimed at improving environmental access, delivered using a motivational approach to support adherence and long-term continuation of activity. We focussed on promoting safe activity rather than risk or prevention of falls. Conclusion: We used a systematic process to develop a dementia-specific intervention to promote activity and independence while reducing falls risk in older adults with mild dementia. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses various topics within the issue, including falls prevention in older people, the threats to geriatric rehabilitation, and the decision-making process to antibiotic prescribing.

In the article, the editor discusses the various randomised clinical trials (RCT) on age and ageing that were published in the journal as of June 2022. Among the RCTs are the studies on the healthcare for older people in Central and South America, the effect of mid-life lifestyles like diet, exercise, and smoking on life expectancy, and the interventions to prevent falls in hospitals.

An introduction is presented in which the editor discusses the various topics within the issue, including geriatric medicine, hypertension treatments, and mild cognitive impairment (MCI).

The author discusses articles to be published in the next issue of "Age & Ageing." Topics include the implementation of lateral flow device testing to identify COVID-19 infected care homes staff and visitors, role of designing and evaluating complex services for complex problems in scholarly geriatric medicine, and longitudinal associations between plasma fibroblast growth factor-21 and later muscle strength.

The author explores the impact factor of the journal "Age and Ageing" and the research articles it published for 2020. Topics discussed include the increase in the journal's impact factor, its research articles relating to COVID-19, studies published relating to service effectiveness in chronic obstructive pulmonary disease and anxiety and vascular surgery, and studies it published relating falls prevention guidelines.

An introduction is presented in which the editor discusses the various topics within the issue, including the effects of COVID-19 on care homes, hyponatraemia in older people, and a guideline on elder care.

Background: people with vertebral fractures are at high risk of developing hip fractures. Falls risk is important in the pathogenesis of hip fractures. Aim: to investigate if balance tests, in conjunction with a falls history, can predict falls in older women with vertebral fractures. Methods: a cohort study of community-dwelling women aged over 60 years, with vertebral fractures. Balance tests investigated were: 5 m-timed-up-and-go-test (5 m-TUG), timed 10 m walk, TURN180 test (number of steps to turn 180°), tandem walk, ability to stand from chair with arms folded. Leg extensor power was also measured. Outcome Measure: fallers (at least one fall in a 12 month follow-up period) versus non-fallers. Results: one hundred and four women aged 63-91 years [mean = 78 ± 7], were recruited. Eighty-six (83%) completed the study. Four variables were significantly associated with fallers: previous recurrent faller (2+ falls) [OR = 6.52; 95% CI = 1.69-25.22], 5 m-TUG test [OR = 1.03; 1.00-1.06], timed 10 m walk [OR = 1.07; 1.01-1.13] and the TURN180 test [OR = 1.22; 1.00-1.49] [P<0.05]. Multi-variable analysis showed that only two variables, previous recurrent faller [OR = 5.60; 1.40-22.45] and the 5 m-TUG test [OR = 1.04; 1.00-1.08], were independently significantly associated with fallers. The optimal cut-off time for performing the 5 m-TUG test in predicting fallers was 30 s (area under ROC = 60%). Combining previous recurrent faller with the 5 m-TUG improved prediction of fallers [OR = 16.79, specificity = 100%, sensitivity = 13%]. Conclusions: a previous history of recurrent falls and the inability to perform the 5 m-TUG test within 30 s predicted falls in older women with vertebral fractures. Combining these two measures can predict fallers with a high degree of specificity (although a low sensitivity), allowing the identification of a group of patients suitable for fall and fracture prevention measures. [ABSTRACT FROM AUTHOR]

The authors reflect on benefits, and possible disadvantage in terms of cost, of second-eye cataract surgery. Topics discussed include improved quality of life after a successful cataract surgery, evidence which suggests that the rate of falling may increase after first-eye cataract surgery, and improvement of vision due to second eye cataract surgery, which is beyond to that achieved by first-eye surgery.

Objective: to determine the clinical effectiveness of a day hospital-delivered multifactorial falls prevention programme, for community-dwelling older people at high risk of future falls identified through a screening process.Design: multicentre randomised controlled trial.Setting: eight general practices and three day hospitals based in the East Midlands, UK.Participants: three hundred and sixty-four participants, mean age 79 years, with a median of three falls risk factors per person at baseline.Interventions: a day hospital-delivered multifactorial falls prevention programme, consisting of strength and balance training, a medical review and a home hazards assessment.Main outcome measure: rate of falls over 12 months of follow-up, recorded using self-completed monthly diaries.Results: one hundred and seventy-two participants in each arm contributed to the primary outcome analysis. The overall falls rate during follow-up was 1.7 falls per person-year in the intervention arm compared with 2.0 falls per person-year in the control arm. The stratum-adjusted incidence rate ratio was 0.86 (95% CI 0.73–1.01), P = 0.08, and 0.73 (95% CI 0.51–1.03), P = 0.07 when adjusted for baseline characteristics. There were no significant differences between the intervention and control arms in any secondary outcomes.Conclusion: this trial did not conclusively demonstrate the benefit of a day hospital-delivered multifactorial falls prevention programme, in a population of older people identified as being at high risk of a future fall. [ABSTRACT FROM AUTHOR]

Background: Older adults with dementia are at a high risk of losing abilities and of accidental falls. Promoting Activity, Independence and Stability in Early Dementia (PrAISED) is a 12-month person-centred exercise and activity programme which aims to increase activity and independence whilst reducing falls in people with early dementia. In this patient group, as well as many others, poor adherence to exercise interventions can undermine treatment effectiveness. We aimed to explore patterns of barriers and facilitators influencing PrAISED participants’ adherence to home-based strength and balance exercises. Methods: Participants were a subsample of 20 individuals with mild cognitive impairment or early dementia and their carer(s) taking part in the PrAISED programme. Participants (with the support of a carer where necessary) kept a daily exercise diary. Participants’ adherence were categorised based upon reported number of times a week they undertook the PrAISED strength and balance exercises over a 4 month period (<3 times a week = low adherence, 3–4 = meeting adherence expectations, >5 = exceeding adherence expectations). Semi-structured interviews were conducted in month 4 of the PrAISED programme to explore barriers and facilitators to adherence. A mixture of deductive and inductive thematic analysis was employed with themes categorised using the Theoretical Domains Framework. Findings: Participants completed on average 98 minutes of home-based strength and balance exercises per week, 3.8 sessions per week, for an average of 24 minutes per session. Five participants were categorised as exceeding adherence expectations, 7 as meeting adherence expectations, and 8 as low adherers. Analysis of interview data based on self-reported adherence revealed six interacting themes: 1) routine, 2) practical and emotional support, 3) memory support, 4) purpose, 5) past experiences of sport and exercise, and 6) belief in and experience of benefits. Conclusions: Identifiable cognitive, psychological, and practical factors influence adherence to exercise, and should be addressed in future development of interventions with this population. [ABSTRACT FROM AUTHOR]

Background: multifactorial falls prevention programmes for older people have been proved to reduce falls. However, evidence of their cost-effectiveness is mixed.Design: economic evaluation alongside pragmatic randomised controlled trial.Intervention: randomised trial of 364 people aged ≥70, living in the community, recruited via GP and identified as high risk of falling. Both arms received a falls prevention information leaflet. The intervention arm were also offered a (day hospital) multidisciplinary falls prevention programme, including physiotherapy, occupational therapy, nurse, medical review and referral to other specialists.Measurements: self-reported falls, as collected in 12 monthly diaries. Levels of health resource use associated with the falls prevention programme, screening (both attributed to intervention arm only) and other health-care contacts were monitored. Mean NHS costs and falls per person per year were estimated for both arms, along with the incremental cost-effectiveness ratio (ICER) and cost effectiveness acceptability curve.Results: in the base-case analysis, the mean falls programme cost was £349 per person. This, coupled with higher screening and other health-care costs, resulted in a mean incremental cost of £578 for the intervention arm. The mean falls rate was lower in the intervention arm (2.07 per person/year), compared with the control arm (2.24). The estimated ICER was £3,320 per fall averted.Conclusions: the estimated ICER was £3,320 per fall averted. Future research should focus on adherence to the intervention and an assessment of impact on quality of life. [ABSTRACT FROM AUTHOR]

Falls in older people are a major public health concern in terms of morbidity, mortality and cost. Previous studies suggest that multifactorial interventions can reduce falls, and many geriatric day hospitals are now offering falls intervention programmes. However, no studies have investigated whether these programmes, based in the day hospital are effective, nor whether they can be successfully applied to high-risk older people screened in primary care. The hypothesis is that a multidisciplinary falls assessment and intervention at Day hospitals can reduce the incidence of falls in older people identified within primary care as being at high risk of falling. This will be tested by a pragmatic parallel-group randomised controlled trial in which the participants, identified as at high risk of falling, will be randomised into either the intervention Day hospital arm or to a control (current practice) arm. Those participants preferring not to enter the full randomised study will be offered the opportunity to complete brief diaries only at monthly intervals. This data will be used to validate the screening questionnaire. Three day hospitals (2 Nottingham, 1 Derby) will provide the interventions, and the University of Nottingham's Departments of Primary Care, the Division of Rehabilitation and Ageing Unit, and the Trent Institute for Health Service Research will provide the methodological and statistical expertise. Four hundred subjects will be randomised into the two arms. The primary outcome measure will be the rate of falls over one year. Secondary outcome measures will include the proportion of people experiencing at least one fall, the proportion of people experiencing recurrent falls (>1), injuries, fear of falling, quality of life, institutionalisation rates, and use of health services. Cost-effectiveness analyses will be performed to inform health commissioners about resource allocation issues. The importance of this trial is that the results may be applicable to any UK day hospital setting. Sites: General practices across Nottinghamshire and Derbyshire. Day hospitals: Derbyshire Royal Infirmary (Southern Derbyshire Acute Hospitals NHS Trust) Sherwood Day Service (Nottingham City Hospital Trust) Leengate Day Hospital (Queen's Medical Centre Nottingham University Hospital NHS Trust) [ABSTRACT FROM AUTHOR]