Emergency department attendance stratified by cause and frailty status: A national retrospective cohort study.

Aim: The aim of this study was to determine whether the causes of emergency department (ED) attendance and clinical outcomes vary by frailty status.

Methods: Using the Nationwide ED Sample, causes of attendance were stratified by Hospital Frailty Risk Score (HFRS). Logistic regression was used to determine adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) of ED and overall mortality.

Ten-Year Outcomes of Anticholinergic Use Among Older Adults With Intellectual Disability: Findings From the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS-TILDA).

Background: People with intellectual disability are frequently exposed to medication with anticholinergic activity. In the general population, the long-term exposure to anticholinergics has been associated with declines in both physical and cognitive function. This study aimed to examine anticholinergic exposure longitudinally in a cohort of older adults with intellectual disability (aged 40 years or over).

Consensus statement on exploring the Nexus between nutrition, brain health and dementia prevention.

An international expert panel convened to evaluate nutrition-based approaches to brain health and dementia prevention. This consensus statement integrates perspectives from lived experiences, mechanistic evidence, epidemiology, and clinical interventions. Nutrition plays a crucial role in brain health throughout life and in cognitive decline pathogenesis, particularly through the food-gut-brain axis.

Changes in anticholinergic cognitive burden and risk of single and recurrent falls: population-based cohort study.

Background: Medications with high anticholinergic cognitive burden (ACB) are associated with increased fall risk in older adults. However, the potential alteration of risk with changes in ACB over time has yet to be established.

Objective: To estimate the association between the changes in ACB with single and recurrent falls.

Predicting mortality risk using the PREVENT equation across diverse racial groups.

Objectives: The Predicting Risk of CVD Events (PREVENT) score offers a contemporary tool for assessing cardiovascular risk without incorporating race, which has raised concerns about its performance across diverse racial and ethnic groups. We aimed to validate the performance of the PREVENT cardiovascular risk equation across diverse racial and ethnic groups and assess its association with long-term all-cause and cardiovascular mortality.

Study Design: Observational cohort study using nationally representative data from the National Health and Nutrition Examination Survey (NHANES) linked with mortality data.

Metal-on-metal arthroplasty, cobalt toxicity, and development of cognitive impairment: a systematic review.

Background: Neurological dysfunction secondary to cobalt toxicity has been described as a potential complication of metal on metal (MoM) arthroplasty, however, to date the full extent of this association remains unclear. Currently, no national guideline on the management or follow-up of MoM arthroplasty patients recommends monitoring for potential insidious cognitive decline or long term consequences. The aim of this study was to summarise the available evidence regarding the relationship between MoM arthroplasty associated cobalt toxicity and cognitive impairment (CI).

Patient and healthcare professionals' perception of weekly prophylactic catheter washout in adults living with long-term catheters: qualitative study of the CATHETER II trial.

Objectives: To explore trial participants' experience of long-term catheters (LTC), the acceptability of washout policies, their experience of the CATHETER II trial (a randomised controlled trial comparing the clinical effectiveness of various washout policies versus no washout policy in preventing catheter associated complications in adults living with long-term catheters) and their satisfaction with the outcomes. The objectives of the healthcare professionals (HCPs) focus group and interview were to explore their attitudes towards weekly prophylactic catheter washout, views on the provision of training and participants' ability to enact washout behaviours.

Methodology: A longitudinal qualitative study embedded within the CATHETER II randomised controlled trial, which included semi-structured interviews and focus groups with participants from multiple trial sites.

Aging Gut-Brain Interactions: Pro-Inflammatory Gut Bacteria Are Elevated in Fecal Samples from Individuals Living with Alzheimer's Dementia.

: Alzheimer's disease (AD) is the most common form of dementia, characterized by an irreversible decline in cognitive function. The pathogenesis of several neurodegenerative disorders has been linked to changes in the gut microbiota, transmitted through the gut-brain axis. : We set out to establish by case-control study methodology whether there were any differences in the composition and/or function of the gut microbiota between older resident adults in care homes with or without an AD diagnosis via analysis of the microbial composition from fecal samples.

Sex-related differences in heart failure patients: physiological mechanisms of cardiovascular ageing and evidence-based sex-specific medical therapies.

This review aims to describe the sex differences in heart failure (HF) patients, with a particular emphasis on the effect of cardiovascular ageing. Additionally, it takes into consideration the sex-related variation in cardiovascular health and physiology and the role ageing plays in HF and its implications in drug therapy. The pharmacokinetics and pharmacodynamics of the common HF medications, classified according to the established sub-types, are summarised with respect to sex-specific documented findings.

The REGENERATE Study: A Non-Randomized Feasibility Study of an Intervention to REduce anticholinerGic burdEN in oldER pATiEnts.

Anticholinergic burden (ACB) from medications has been associated with adverse outcomes in older adults. The aim was to conduct a non-randomized feasibility study of an intervention to reduce the anticholinergic burden in older patients (REGENERATE) to inform a subsequent definitive trial. The development and evaluation of an ACB reduction intervention was guided by the Medical Research Council framework.

CATHETER II: a randomised controlled trial comparing the clinical effectiveness of various washout policies versus no washout policy in preventing catheter-associated complications in adults living with long-term catheters.

Objectives: Do weekly prophylactic saline or acidic catheter washouts in addition to standard long-term catheter (LTC) care improve the outcomes of adults with LTC compared with standard LTC care only.

Design: Three-arm superiority open-label randomised controlled trial.

Setting: UK community-based study.

Sex differences in myocardial infarction care and outcomes: a longitudinal Scottish National Data-Linkage Study.

Aims: We investigate sex disparities in management and outcomes of myocardial infarction (MI) in contemporary practice in Scotland.

Methods And Results: This was a longitudinal cohort study including all MI admissions aged 45-80 years across Scotland between 2010-2016 and 2:1 age, sex, and general practice-matched general population controls. Participants were followed up until the end of 2021.

Association between weight and body composition changes with falls risk in the Malaysian Elders Longitudinal Research (MELoR) study.

Objective: Both changes in body composition and increased fall risk occur with increasing age. While weight management may be considered a component of falls prevention, the long-term consequences of changes in weight, however, remain uncertain. This prospective study aimed to evaluate the relationship between weight and body composition changes over 5 years with fall occurrence.

Time for a Re-Think? The Rationale for Multi-Component Intervention to Prevent Malnutrition in At-Risk Community-Dwelling Older Adults.

Dietary strategies for early intervention in older adults are highly desirable, as they encourage individuals to retain a good functional status despite morbidity [...

Enhancing medication management of older adults in Qatar: healthcare professionals' perspectives on challenges, barriers and enabling solutions.

Background: Polypharmacy and potentially inappropriate medications are significant challenges in older adults' medication management. The Consolidated Framework for Implementation Research (CFIR) is a comprehensive approach used to explore barriers and enablers to the healthcare system in guiding the effective implementation of evidence-based practices.

Objectives: This study examines the barriers and enablers to promote safe medication management among older adults in Qatar from healthcare professionals' perspectives.

Understanding the medication regimens associated with anticholinergic burden in older people's mental health services in the UK.

Background: Medications with anticholinergic properties are associated with a range of adverse effects that tend to be worse in older people.

Aims: To investigate medication regimens with high anticholinergic burden, prescribed for older adults under the care of mental health services.

Method: Clinical audit of prescribing practice, using a standardised data collection tool.

The usage of anticholinergic medications in a low- and middle-income country: a longitudinal comparison of 2013-15 and 2020-22 datasets.

Background: While the effects of anticholinergic drug use have been increasingly highlighted, trends in anticholinergic use remain poorly understood.

Aim: To determine the changes in frequency and pattern of anticholinergic drug use within a low- and middle-income country.

Method: Comparisons were made between population-based datasets collected from Malaysian residents aged 55 years and older in 2013-15 and 2020-22.

The individual and combined impacts of pre-existing diabetes and dementia on ischemic stroke outcomes: a registry-based cohort study.

Background: Individually, diabetes mellitus and dementia are associated with poorer outcomes after stroke. However, the combined impact of these pre-existing factors on acute ischemic stroke (AIS) outcomes has not been examined.

Methods: All consecutive patients with AIS admitted to Norfolk and Norwich University Hospitals between 2003 and 2016 (catchment population ~ 900,000) were divided into four groups: those with neither diabetes nor dementia (reference), with diabetes without dementia, with dementia without diabetes, and with both co-morbidities.

Drug Exposure As a Predictor in Diabetic Retinopathy Risk Prediction Models-A Systematic Review and Meta-Analysis.

Purpose: To conduct a systematic review to assess drug exposure handling in diabetic retinopathy (DR) risk prediction models, a network-meta-analysis to identify drugs associated with DR and a meta-analysis to determine which drugs contributed to enhanced model performance.

Design: Systematic review and meta-analysis.

Methods: We included studies presenting DR models incorporating drug exposure as a predictor.

Anticholinergic burden and health-related quality of life among adult patients in a resource-limited setting: a cross-sectional study.

Background: Anticholinergic medications are now widely acknowledged for their unfavorable risk-to-benefit profile owing to their adverse effects. Health-related quality of life (HRQoL) is commonly regarded as a crucial person-centered outcome.

Aim: This study aimed to investigate the association between anticholinergic burden and HRQoL in hospitalized and ambulatory patients seen in Ethiopia.

Enhancing Medication Safety through Implementing the Qatar Tool for Reducing Inappropriate Medication (QTRIM) in Ambulatory Older Adults.

Introduction: To promote optimal healthcare delivery, safeguarding older adults from the risks associated with inappropriate medication use is paramount.

Objective: This study aims to evaluate the effectiveness of implementing the Qatar Tool for Reducing Inappropriate Medication (QTRIM) in ambulatory older adults to enhance medication safety.

Method: The QTRIM was developed by an expert consensus panel using the Beers Criteria and contained a list of potentially inappropriate medications (PIMs) based on the local formulary.

Anticholinergic burden among in-patients: a cross-sectional study on prevalence, determinants, and impact on mortality in Ethiopia.

Background: Numerous studies report that anticholinergic burden (ACB) has been linked with several health consequences, including increased hospital admissions, prolonged hospitalization, and physical and cognitive impairment. However, low- and middle-income settings, as well as younger individuals, are underrepresented.

Objectives: To assess the prevalence and determinants of ACB, and to assess the impact of ACB on in-hospital mortality among adult in-patients at University of Gondar Comprehensive Specialized Hospital (UOGCSH).

An increasing proportion of the population is not covered by the current RDA for vitamin C - interrogation of EPIC-Norfolk and NHANES 2017/2018 cohorts.

With the rising prevalence of obesity globally, increasing proportions of the population may not be covered by current recommended daily allowances (RDAs) that are supposed to provide 97.5% of the population with a sufficient nutrient status but are typically based on a healthy young 70 kg male reference person. Using the EPIC-Norfolk (UK) and the NHANES (US) cohorts, we estimated the effect of body weight on the dose-concentration relationship to derive weight-based requirements to achieve an 'adequate' plasma concentration of vitamin C estimated to be 50 µmol/L.

Serum Albumin and Post-Stroke Outcomes: Analysis of UK Regional Registry Data, Systematic Review, and Meta-Analysis.

Hypoalbuminemia associates with poor acute ischemic stroke (AIS) outcomes. We hypothesised a non-linear relationship and aimed to systematically assess this association using prospective stroke data from the Norfolk and Norwich Stroke and TIA Register. Consecutive AIS patients aged ≥40 years admitted December 2003-December 2016 were included.

The Impact of Hospital Transfers on Surgical Delay and Associated Postoperative Outcomes for Hip Fracture Patients in Scotland: A Cohort Study.

: Hip fractures exert a substantial burden on hospital systems. Within Scotland 20% of the population resides rurally, warranting investigation of how this impacts prompt access to surgical care. This study aims to determine whether indirect hospital admission via hospital transfer affects the likelihood of surgical management within 36 h for hip fracture patients.