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Ageing & Dementia Publications

 The anorexia of ageing and risk of mortality: More than a story of malnutrition?

Cox NJ,   Lim SE

Appetite loss or anorexia due to physiological, psychological and socioenvironmental effects of the aging process is termed the anorexia of aging.

The link between anorexia of aging and mortality has subsequently been established by a number of longitudinal studies across multiple settings.

Despite the association, clear interpretation of the mechanistic relationship between anorexia of aging and mortality, has been limited.

February 2024

Ageing & Dementia

Perfusion Imaging and Inflammation Biomarkers Provide Complementary Information in Alzheimer's Disease

Michopoulou S, Prosser A, Dickson J, Guy M, Teeling JL, Kipps C

Single photon emission tomography (SPECT) can detect early changes in brain perfusion to support the diagnosis of dementia. Inflammation is a driver for dementia progression and measures of inflammation may further support dementia diagnosis.

In this study, we assessed whether combining imaging with markers of inflammation improves prediction of the likelihood of Alzheimer's disease (AD).

January 2024

Ageing & Dementia

 How can I improve cancer services for people with dementia?

Farrington   N, Richardson A, Bridges J

Tips and guidance on making cancer services

People with dementia have poorer cancer outcomes than those without, and are more likely to experience complications and poorer overall survival (McWilliams et al 2017). Few interventions are designed for older people with cancer and complex needs, such as those with dementia (Farrington et al 2022).

doi: 10.7748/cnp.21.5.22.s10

October 2023

Ageing & Dementia

Artificial intelligence for diagnostic and prognostic neuroimaging in dementia: A systematic review

Borchert RJ, Azevedo T, Badhwar A, Bernal J, Betts M, Bruffaerts R, Burkhart MC, Dewachter I, Gellersen HM, Low A, Lourida I, Machado L, Madan CR, Malpetti M, Mejia J, Michopoulou S, Muñoz-Neira C, Pepys J, Peres M, Phillips V, Ramanan S, Tamburin S, Tantiangco HM, Thakur L, Tomassini A, Vipin A, Tang E, Newby D; Deep Dementia Phenotyping (DEMON) Network; Ranson JM, Llewellyn DJ, Veldsman M, Rittman T

Introduction: Artificial intelligence (AI) and neuroimaging offer new opportunities for diagnosis and prognosis of dementia.

Methods: We systematically reviewed studies reporting AI for neuroimaging in diagnosis and/or prognosis of cognitive neurodegenerative diseases.

August 2023

Ageing & Dementia

Case management for integrated care of older people with frailty in community settings

Sadler E, Khadjesari Z, Ziemann A, Sheehan KJ, Whitney J, Wilson D, Bakolis I, Sevdalis N, Sandall J, Soukup T, Corbett T, Gonçalves-Bradley DC, Walker DM

Ageing populations globally have contributed to increasing numbers of people living with frailty, which has significant implications for use of health and care services and costs. The British Geriatrics Society defines frailty as "a distinctive health state related to the ageing process in which multiple body systems gradually lose their inbuilt reserves". This leads to an increased susceptibility to adverse outcomes, such as reduced physical function, poorer quality of life, hospital admissions, and mortality. 

Case management interventions delivered in community settings are led by a health or social care professional, supported by a multidisciplinary team, and focus on the planning, provision, and co-ordination of care to meet the needs of the individual. Case management is one model of integrated care that has gained traction with policymakers to improve outcomes for populations at high risk of decline in health and well-being. These populations include older people living with frailty, who commonly have complex healthcare and social care needs but can experience poorly co-ordinated care due to fragmented care systems.

Objectives: To assess the effects of case management for integrated care of older people living with frailty compared with usual care.

May 2023

Ageing & Dementia

Frequency, duration, and type of physiotherapy in the week after hip fracture surgery - analysis of implications for discharge home, readmission, survival, and recovery of mobility

Almilaji O, Ayis S, Goubar A, Beaupre L, Cameron ID, Milton-Cole R, Gregson CL, Johansen A, Kristensen MT, Magaziner J, Martin FC, Sackley C, Sadler E, Smith TO, Sobolev B, Sheehan KJ

Purpose: To examine the association between physiotherapy access after hip fracture and discharge home, readmission, survival, and mobility recovery.

Methods: A 2017 Physiotherapy Hip Fracture Sprint Audit was linked to hospital records for 5383 patients. Logistic regression was used to estimate the association between physiotherapy access in the first postoperative week and discharge home, 30-day readmission post-discharge, 30-day survival and 120-days mobility recovery post-admission adjusted for age, sex, American Society of Anesthesiology grade, Hospital Frailty Risk Score and prefracture mobility/residence.

September 2023

Ageing & Dementia

Physiotherapists' perspectives of barriers and facilitators to effective community provision after hip fracture: a qualitative study in England

Adams J,   Jones GD, Sadler E, Guerra S, Sobolev B, Sackley C, Sheehan KJ.

Purpose: to investigate physiotherapists' perspectives of effective community provision following hip fracture.

Methods: qualitative semi-structured interviews were conducted with 17 community physiotherapists across England. Thematic analysis drawing on the Theoretical Domains Framework identified barriers and facilitators to implementation of effective provision. Interviews were complemented by process mapping community provision in one London borough, to identify points of care where suggested interventions are in place and/or could be implemented.

September 2023

Ageing & Dementia

What makes a multidisciplinary medication review and deprescribing intervention for older people work well in primary care?

Howard C, Sheikh C, Rutter P, Latter S, Lown M, Brad L, Fraser SDS, Bradbury K, Roberts HC, Saucedo AR, Ibrahim K

A third of older people take five or more regular medications (polypharmacy). Conducting medication reviews in primary care is key to identify and reduce/ stop inappropriate medications (deprescribing). Recent recommendations for effective deprescribing include shared-decision making and a multidisciplinary approach. Our aim was to understand when, why, and how interventions for medication review and deprescribing in primary care involving multidisciplinary teams (MDTs) work (or do not work) for older people.

September 2023

Ageing & Dementia

Factors that influence older adults' participation in physical activity: a systematic review of qualitative studies

Meredith SJ, Cox NJ, Ibrahim K, Higson J, McNiff J, Mitchell S, Rutherford M, Wijayendran A, Shenkin SD, Kilgour AHM, Lim SER

Despite the advantages of physical activity (PA), older adults are often insufficiently active to maximise health. Understanding factors that influence PA engagement will support well-designed interventions for older people. Our aim was to review the qualitative evidence exploring the factors affecting older adults' engagement in PA.

August 2023

Ageing & Dementia

Gaining access to unspoken narratives of people living with dementia on a hospital ward-A new methodology

Collins P, Bridges J, Bartlett R

This is a methodological paper that aims to advance the conceptualisation of participatory research by focusing on the value of capturing and understanding movement as a vital means of communication for older people with dementia in a general hospital ward. Qualitative research involving people with dementia tends to be word-based and reliant upon verbal fluency. This article considers a method for capturing and understanding movement as a vital means of communication.

August 2023

Ageing & Dementia

Volunteer-led online group exercise for community-dwelling older people: a feasibility and acceptability study

Lim SER, Meredith SJ, Agnew S, Clift E, Ibrahim K, Roberts HC

Despite the clear benefits of physical activity in healthy ageing, engagement in regular physical activity among community-dwelling older adults remains low, with common barriers including exertional discomfort, concerns with falling, and access difficulties. The recent rise of the use of technology and the internet among older adults presents an opportunity to engage with older people online to promote increased physical activity. This study aims to determine the feasibility and acceptability of training volunteers to deliver online group exercises for older adults attending community social clubs.

July 2023

Ageing & Dementia

‘A real fine balancing act’: A secondary qualitative analysis of power imbalance in comorbid cancer and dementia in an outpatient treatment setting

Farrington, N.,  Richardson, A., &  Bridges, J. (March 2023).

Studies of health services reveal a focus on provision of scheduled care at the expense of patient need, placing the health service in a position of power and the patient as passive recipient. This secondary qualitative analysis of a focused ethnography draws on the Foucauldian concept of power as pervasive and relational, to examine how an imbalance of power is manifested in situations where people with both cancer and dementia are being treated for cancer.

Secondary qualitative analysis of a focused ethnographic study.

Data Sources
In the original study, qualitative data were gathered from observation and interviews with people with cancer and dementia (n = 2), caregivers (n = 7) and staff (n = 20). The study was conducted in the outpatient departments of two teaching hospitals in England between January 2019 and July 2021. Data from all sources were analysed for this secondary analysis using constant comparison.

The principal theme was balance, encapsulating the competing priorities involved in delivering cancer treatment. There was tension between maintaining safety and ensuring an individual's right to treatment, and difficulty reconciling the needs of the system with the needs of individuals.

The pervasive nature of power can be harnessed to enhance the agency of people with cancer and dementia by incorporating principles of shared decision making.

Ageing & Dementia

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