Pub Date : 2025-12-05DOI: 10.1093/ageing/afaf318.022
Denis O'Mahony, John Cooke, Mirko Petrovic, Annemie Somers, Stephen Byrne, Kieran Dalton, Ruth Daunt, Siobhan McGettigan, Paula Fuller, Alice O'Donoghue, Ornaith Keane, Kevin Casey, Bronagh Bolger, Ine Simal, Hilde Vlieghe, Jen O'Sullivan, Darren Dahly, Brendan Palmer
Background Older patients with multimorbidity and polypharmacy experience excess adverse drug reactions which contribute to frequent emergency department (ED) attendance, unscheduled readmission and increased mortality. Implementing medication optimization strategies through STOPP/START criteria and drug-drug interaction (DDI) avoidance could mitigate these adverse clinical outcomes. Methods We designed a comprehensive medication-optimizing definitive intervention (DI) based on STOPP/STARTv3 criteria and Stockley’s®DDI checker and evaluated it by randomized clinical trial in 3 large university hospitals. We enrolled 636 older patients (mean age=80.3, 49.5% female) with ≥3 chronic conditions and polypharmacy (≥5 daily medications) admitted acutely in 2023-24. Patients were randomized to standard pharmaceutical care arm (n=217), physician-delivered-DI arm (n=210) or pharmacist-delivered-DI arm (n=209). For DI patients, written and verbal medication optimization advice was delivered to senior attending doctors at admission and pre-discharge. Prioritized STOPP/STARTv3/Stockley’s®DDI medication advice was further discussed with DI-arm patients’ general practitioners at 10+/-3 days post-discharge. Primary endpoints determined at 30+/-7 days (T4) and 90-180 days (T5) post-discharge were ED attendance, readmission and all-cause mortality. Composite endpoints included (i) ED attendance, readmission or all-cause mortality, and (ii) ED attendance or readmission. Data were evaluated by logistic regression analysis with results expressed as odds ratios (OR’s) with 95% confidence intervals (CI’s). Results Both composite endpoints (i) and (ii) were significantly reduced in the combined DI arms versus controls (adjusted OR=0.68 [95%CI 0.46-0.99], p<0.05; adjusted OR = 0.65 [95%CI 0.44-0.96], p=0.03 respectively). Composite endpoint (i) was also significantly reduced in the pharmacist-delivered DI arm versus controls at T5 (adjusted OR=0.59 [95%CI 0.37-0.94], p=0.03). ED attendance was significantly reduced at T4 in the physician-delivered DI arm versus controls (adjusted OR=0.53 [95%CI 0.28-0.98], p<0.05). We found no significant endpoint differences between the two DI arms. Conclusion Implementing clinically relevant STOPP/STARTv3 inappropriate prescribing criteria and Stockley’s® DDI recommendations reduced adverse clinical outcomes in older multimorbid patients with polypharmacy.
{"title":"The OPTIMATE Multi-centre Clinical Trial: A Definitive Intervention to Reduce Clinically Important Adverse Effects of Polypharmacy in Multimorbid Older Adults","authors":"Denis O'Mahony, John Cooke, Mirko Petrovic, Annemie Somers, Stephen Byrne, Kieran Dalton, Ruth Daunt, Siobhan McGettigan, Paula Fuller, Alice O'Donoghue, Ornaith Keane, Kevin Casey, Bronagh Bolger, Ine Simal, Hilde Vlieghe, Jen O'Sullivan, Darren Dahly, Brendan Palmer","doi":"10.1093/ageing/afaf318.022","DOIUrl":"https://doi.org/10.1093/ageing/afaf318.022","url":null,"abstract":"Background Older patients with multimorbidity and polypharmacy experience excess adverse drug reactions which contribute to frequent emergency department (ED) attendance, unscheduled readmission and increased mortality. Implementing medication optimization strategies through STOPP/START criteria and drug-drug interaction (DDI) avoidance could mitigate these adverse clinical outcomes. Methods We designed a comprehensive medication-optimizing definitive intervention (DI) based on STOPP/STARTv3 criteria and Stockley’s®DDI checker and evaluated it by randomized clinical trial in 3 large university hospitals. We enrolled 636 older patients (mean age=80.3, 49.5% female) with ≥3 chronic conditions and polypharmacy (≥5 daily medications) admitted acutely in 2023-24. Patients were randomized to standard pharmaceutical care arm (n=217), physician-delivered-DI arm (n=210) or pharmacist-delivered-DI arm (n=209). For DI patients, written and verbal medication optimization advice was delivered to senior attending doctors at admission and pre-discharge. Prioritized STOPP/STARTv3/Stockley’s®DDI medication advice was further discussed with DI-arm patients’ general practitioners at 10+/-3 days post-discharge. Primary endpoints determined at 30+/-7 days (T4) and 90-180 days (T5) post-discharge were ED attendance, readmission and all-cause mortality. Composite endpoints included (i) ED attendance, readmission or all-cause mortality, and (ii) ED attendance or readmission. Data were evaluated by logistic regression analysis with results expressed as odds ratios (OR’s) with 95% confidence intervals (CI’s). Results Both composite endpoints (i) and (ii) were significantly reduced in the combined DI arms versus controls (adjusted OR=0.68 [95%CI 0.46-0.99], p&lt;0.05; adjusted OR = 0.65 [95%CI 0.44-0.96], p=0.03 respectively). Composite endpoint (i) was also significantly reduced in the pharmacist-delivered DI arm versus controls at T5 (adjusted OR=0.59 [95%CI 0.37-0.94], p=0.03). ED attendance was significantly reduced at T4 in the physician-delivered DI arm versus controls (adjusted OR=0.53 [95%CI 0.28-0.98], p&lt;0.05). We found no significant endpoint differences between the two DI arms. Conclusion Implementing clinically relevant STOPP/STARTv3 inappropriate prescribing criteria and Stockley’s® DDI recommendations reduced adverse clinical outcomes in older multimorbid patients with polypharmacy.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"124 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145673695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-05DOI: 10.1093/ageing/afaf318.060
Anita Hayes, Edel Tierney, Sarah McMahon, Lynne O'Keeffe, Lucy Curtayne, Marie Lydon, Olwyn Hanley
Background Falls and fall-related injuries are the most common reportable incident in the HSE. The World Guidelines for Falls Prevention (Montero-Odasso et al 2022) highlight the importance of opportunistic case finding. They recommend that clinicians ask all older adults the 3 Key Questions (3KQ) annually. The questions are: 1: “Have you fallen in the past 12 months”, 2: “Do you feel unsteady when standing or walking?” and 3: “Do you worry about falling”. Tools, like the 3KQ, that assess multiple fall risk factors are more sensitive at predicting risk. This helps identify more older adults at intermediate or high risk of falls with a goal of primary/secondary prevention of falls. The aim of this audit was to evaluate the inclusion and documentation of opportunistic case finding using the 3KQ in initial physiotherapy assessments for adults 65 years and over. Methods Physiotherapy initial assessment documentation for patients 65 years and over across 6 Primary Care teams were audited. The standard was opportunistic case finding as per the World Guidelines for Falls Prevention. The criterion was: All adults 65 years and older should be asked the 3KQ. If they answer yes to any of the questions, they should be assessed for falls risk severity and referred for tailored interventions. Results 60 charts were audited. There was 70% compliance for Question 1, 36.7% compliance for Question 2 and 23.3% compliance for Question 3. 66.7% included detail of follow-up actions and clinical decisions based on responses to the questions that were asked. Conclusion Primary care physiotherapists do not routinely ask the 3KQ during an initial assessment. Interventions post audit include: inclusion of the 3KQ on physiotherapy assessment forms; a copy of the World Fall Guidelines Risk Stratification Algorithm displayed in treatment rooms; and guidance for staff on where to refer patients for further assessment/intervention if required.
在HSE中，跌倒和跌倒相关伤害是最常见的报告事件。《世界预防跌倒指南》（Montero-Odasso et al 2022）强调了机会性病例发现的重要性。他们建议临床医生每年向所有老年人询问3个关键问题（3KQ）。这些问题包括：1：“你在过去的12个月里跌倒过吗？”2：“你在站立或行走时是否感到不稳？”3：“你是否担心摔倒？”像3KQ这样评估多种跌倒风险因素的工具在预测风险方面更为敏感。这有助于识别更多处于中等或高度跌倒风险的老年人，并以一级/二级预防跌倒为目标。本次审核的目的是评估在65岁及以上成人的初始物理治疗评估中使用3KQ的机会性病例发现的纳入和记录。方法对6个初级保健小组65岁及以上患者的物理治疗初始评估文件进行审核。这个标准是根据世界预防跌倒指南发现的机会性病例。标准是：所有65岁及以上的成年人都应该被问及3KQ。如果他们对任何一个问题的回答是肯定的，他们应该被评估跌倒风险的严重程度，并转介进行量身定制的干预。结果共审核60张图表。问题1的依从性为70%，问题2的依从性为36.7%，问题3的依从性为23.3%。66.7%包括基于对所问问题的回答的随访行动和临床决策的细节。结论：初级保健物理治疗师在初始评估时不会例行询问3KQ。审核后的干预措施包括：将3KQ纳入物理治疗评估表格；在治疗室展示的《世界跌倒指南风险分层算法》副本；并指导工作人员在需要时将患者转介到何处进行进一步评估/干预。
{"title":"An Audit Of Fall Risk Screening, Using The 3 Key Questions, In Physiotherapy Initial Assessment Documentation In Primary Care","authors":"Anita Hayes, Edel Tierney, Sarah McMahon, Lynne O'Keeffe, Lucy Curtayne, Marie Lydon, Olwyn Hanley","doi":"10.1093/ageing/afaf318.060","DOIUrl":"https://doi.org/10.1093/ageing/afaf318.060","url":null,"abstract":"Background Falls and fall-related injuries are the most common reportable incident in the HSE. The World Guidelines for Falls Prevention (Montero-Odasso et al 2022) highlight the importance of opportunistic case finding. They recommend that clinicians ask all older adults the 3 Key Questions (3KQ) annually. The questions are: 1: “Have you fallen in the past 12 months”, 2: “Do you feel unsteady when standing or walking?” and 3: “Do you worry about falling”. Tools, like the 3KQ, that assess multiple fall risk factors are more sensitive at predicting risk. This helps identify more older adults at intermediate or high risk of falls with a goal of primary/secondary prevention of falls. The aim of this audit was to evaluate the inclusion and documentation of opportunistic case finding using the 3KQ in initial physiotherapy assessments for adults 65 years and over. Methods Physiotherapy initial assessment documentation for patients 65 years and over across 6 Primary Care teams were audited. The standard was opportunistic case finding as per the World Guidelines for Falls Prevention. The criterion was: All adults 65 years and older should be asked the 3KQ. If they answer yes to any of the questions, they should be assessed for falls risk severity and referred for tailored interventions. Results 60 charts were audited. There was 70% compliance for Question 1, 36.7% compliance for Question 2 and 23.3% compliance for Question 3. 66.7% included detail of follow-up actions and clinical decisions based on responses to the questions that were asked. Conclusion Primary care physiotherapists do not routinely ask the 3KQ during an initial assessment. Interventions post audit include: inclusion of the 3KQ on physiotherapy assessment forms; a copy of the World Fall Guidelines Risk Stratification Algorithm displayed in treatment rooms; and guidance for staff on where to refer patients for further assessment/intervention if required.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"55 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145673699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-05DOI: 10.1093/ageing/afaf318.046
Eimear Duffy, Molly Curtis, Sinead Feehan
Background The ‘Mealtimes Matter’ framework and best practice guidelines (BPGs) emphasise the importance of providing adequate mealtime assistance, a pleasant dining environment, and shared mealtimes for older adults in institutionalised settings. A ‘Mealtimes Matter’ audit completed in Tymon North showed poor compliance with the provision of mealtime assistance to patients. The study aims were to pilot a communal dining room initiative in order to better align with BPGs, and to assess patients’ experience of the dining room. Methods Data was collected over three weeks in May 2024. Patients were invited to attend the dining room each day. Mealtime observations were completed by the dietetic therapy assistant. Qualitative data on patient’s experience were collected in a separate interview and analysed by a dietitian. Results In total, 26 patients attended the dining room during the study period and 16 patients provided feedback. The mean age was 81 years old (range 63 – 91 years); 62% of attendees were female (n=16). Two main themes emerged from the qualitative data: the significance of the social aspect of dining, and the impact of environment and ambience on mealtime experience. Almost all patients (94%) reported enjoying eating in the company of others, describing the dining room atmosphere as ‘good’ or ‘very good’. Most patients (82%) expressed preference for communal dining. All attendees reported receiving adequate mealtime assistance in the dining room, whilst only 64% reported having enough help when eating in their room. One-third (35%) of patients reported disliking eating in their bedrooms, citing reasons such as loneliness and inadequate assistance. Conclusion The introduction of a communal dining room in Tymon North allowed better alignment with BPGs by supporting the provision of adequate mealtime assistance, a pleasant dining environment and shared mealtimes for patients.
{"title":"Patient’s experience of using a communal dining space in Tymon North Rehabilitation Unit: A Pilot Project","authors":"Eimear Duffy, Molly Curtis, Sinead Feehan","doi":"10.1093/ageing/afaf318.046","DOIUrl":"https://doi.org/10.1093/ageing/afaf318.046","url":null,"abstract":"Background The ‘Mealtimes Matter’ framework and best practice guidelines (BPGs) emphasise the importance of providing adequate mealtime assistance, a pleasant dining environment, and shared mealtimes for older adults in institutionalised settings. A ‘Mealtimes Matter’ audit completed in Tymon North showed poor compliance with the provision of mealtime assistance to patients. The study aims were to pilot a communal dining room initiative in order to better align with BPGs, and to assess patients’ experience of the dining room. Methods Data was collected over three weeks in May 2024. Patients were invited to attend the dining room each day. Mealtime observations were completed by the dietetic therapy assistant. Qualitative data on patient’s experience were collected in a separate interview and analysed by a dietitian. Results In total, 26 patients attended the dining room during the study period and 16 patients provided feedback. The mean age was 81 years old (range 63 – 91 years); 62% of attendees were female (n=16). Two main themes emerged from the qualitative data: the significance of the social aspect of dining, and the impact of environment and ambience on mealtime experience. Almost all patients (94%) reported enjoying eating in the company of others, describing the dining room atmosphere as ‘good’ or ‘very good’. Most patients (82%) expressed preference for communal dining. All attendees reported receiving adequate mealtime assistance in the dining room, whilst only 64% reported having enough help when eating in their room. One-third (35%) of patients reported disliking eating in their bedrooms, citing reasons such as loneliness and inadequate assistance. Conclusion The introduction of a communal dining room in Tymon North allowed better alignment with BPGs by supporting the provision of adequate mealtime assistance, a pleasant dining environment and shared mealtimes for patients.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"156 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145674102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-05DOI: 10.1093/ageing/afaf318.186
Claire Noonan, Cherhasna Rampaul, Josephine Soh
Background Nursing home residents (NHRs) are a medically complex and vulnerable population. Despite often presenting to emergency departments (EDs) with seemingly straightforward complaints, their underlying health issues frequently reveal significant medical, psychological, and social complexities. This underscores the need for comprehensive and specialised geriatric care. Methods This retrospective study examined hospital admissions of NHRs over a six-month period (June–December 2024) at a University Teaching Hospital. Key variables included admission diagnoses, Charlson Comorbidity Index (CCI) scores, and mortality outcomes. Results Of 312 NHRs who presented to the ED, 63.8% (n=199) were admitted. Among these, 68.3% (n=136) were admitted under geriatric services, while 31.7% (n=63) were managed by other specialties. Overall, 88% (n=175) of admitted residents had a CCI score ≥5, indicating high medical complexity. This figure rose to 91% among those under geriatric care, compared to 84% in other services. The average length of stay was 8 days. Upon discharge, 80% (n=109) had two or more diagnoses, and 25% had four or more. Common discharge diagnoses included lower respiratory tract infections (n=56), falls (n=36), acute kidney injury (n=33), urinary tract infections (n=30), aspiration pneumonia (n=29), and constipation (n=20). The in-hospital mortality rate was 8.8% (n=12), with a three-month post-discharge mortality rate of 15% (n=19). Dementia was present in 47% of admitted residents, and 9% had mild cognitive impairment. Delirium occurred in 25% of cases. Conclusion Nursing home residents admitted to hospital present with high levels of medical complexity and multiple co-morbidities, contributing to significant morbidity and mortality. These findings highlight the urgent need for enhanced, multidisciplinary acute geriatric care models to better address the complex needs of this population and improve clinical outcomes.
{"title":"Complex Co-Morbidities in Nursing Home Residents: Hospital Admissions and Outcomes","authors":"Claire Noonan, Cherhasna Rampaul, Josephine Soh","doi":"10.1093/ageing/afaf318.186","DOIUrl":"https://doi.org/10.1093/ageing/afaf318.186","url":null,"abstract":"Background Nursing home residents (NHRs) are a medically complex and vulnerable population. Despite often presenting to emergency departments (EDs) with seemingly straightforward complaints, their underlying health issues frequently reveal significant medical, psychological, and social complexities. This underscores the need for comprehensive and specialised geriatric care. Methods This retrospective study examined hospital admissions of NHRs over a six-month period (June–December 2024) at a University Teaching Hospital. Key variables included admission diagnoses, Charlson Comorbidity Index (CCI) scores, and mortality outcomes. Results Of 312 NHRs who presented to the ED, 63.8% (n=199) were admitted. Among these, 68.3% (n=136) were admitted under geriatric services, while 31.7% (n=63) were managed by other specialties. Overall, 88% (n=175) of admitted residents had a CCI score ≥5, indicating high medical complexity. This figure rose to 91% among those under geriatric care, compared to 84% in other services. The average length of stay was 8 days. Upon discharge, 80% (n=109) had two or more diagnoses, and 25% had four or more. Common discharge diagnoses included lower respiratory tract infections (n=56), falls (n=36), acute kidney injury (n=33), urinary tract infections (n=30), aspiration pneumonia (n=29), and constipation (n=20). The in-hospital mortality rate was 8.8% (n=12), with a three-month post-discharge mortality rate of 15% (n=19). Dementia was present in 47% of admitted residents, and 9% had mild cognitive impairment. Delirium occurred in 25% of cases. Conclusion Nursing home residents admitted to hospital present with high levels of medical complexity and multiple co-morbidities, contributing to significant morbidity and mortality. These findings highlight the urgent need for enhanced, multidisciplinary acute geriatric care models to better address the complex needs of this population and improve clinical outcomes.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"33 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145674104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Incontinence is a common condition among older adults and has been linked to adverse outcomes such as falls, infections, psychological distress, functional decline, institutionalisation, and caregiver burden. Despite its clinical significance, the impact of incontinence among community-dwelling older adults in Ireland remains poorly characterised. This study aimed to evaluate and compare the clinical characteristics and care-related outcomes of older adults with incontinence with those who are continent, using data from comprehensive geriatric assessments (CGA) conducted by an Integrated Care Programme for Older Persons (ICPOP) community specialist team (CST). Methods This was a retrospective cross-sectional study involving older adults who underwent CGA over a six-month period. Data was collected on continence status, demographic and clinical characteristics, functional ability, and caregiver involvement. Emergency department presentations and hospital admissions within 90 days of CGA were recorded. Incontinence was defined as the presence of either urinary or bowel incontinence. Statistical analysis was performed using STATA v18.0. Results Of the 146 participants, 76 (52%) were classified as incontinent. Compared to continent individuals, those with incontinence had significantly lower Barthel scores (median 85 vs 95, p < 0.001) and higher levels of frailty (median CFS 6 vs 5, p < 0.001). Incontinence was significantly associated with the presence of a carer (p = 0.012). No significant differences were observed in age, acute care utilisation, or socioeconomic indicators. Conclusion Incontinence was highly prevalent in this cohort and associated with greater frailty, functional dependence, and increased presence of caregivers. These findings highlight the need for early identification and proactive management of incontinence, and for investment in multidisciplinary supports. Efforts should also recognise and support the essential role of both formal and informal caregivers in enabling older adults with incontinence to remain living at home safely and with dignity.
{"title":"Incontinence, Frailty and Care Needs in Community-Dwelling Older Adults: Findings from an ICPOP Community Specialist Team","authors":"Aidan Stankard, Fiona Mulligan, Anna Healy, Emily Buckley, Alison Murphy, Amy Phillips, Caoimhe Reilly, Caroline Curran, Caroline Fox, Deirdre McNally, Elizabeth Hancock, Jodie Keating, Linda Davidson Lee, Maeve Doyle, Neasa Malone, Niamh McDonagh, Nicola Gibbons, Róisín Lyons, Aoife Fallon, Paul McElwaine","doi":"10.1093/ageing/afaf318.037","DOIUrl":"https://doi.org/10.1093/ageing/afaf318.037","url":null,"abstract":"Background Incontinence is a common condition among older adults and has been linked to adverse outcomes such as falls, infections, psychological distress, functional decline, institutionalisation, and caregiver burden. Despite its clinical significance, the impact of incontinence among community-dwelling older adults in Ireland remains poorly characterised. This study aimed to evaluate and compare the clinical characteristics and care-related outcomes of older adults with incontinence with those who are continent, using data from comprehensive geriatric assessments (CGA) conducted by an Integrated Care Programme for Older Persons (ICPOP) community specialist team (CST). Methods This was a retrospective cross-sectional study involving older adults who underwent CGA over a six-month period. Data was collected on continence status, demographic and clinical characteristics, functional ability, and caregiver involvement. Emergency department presentations and hospital admissions within 90 days of CGA were recorded. Incontinence was defined as the presence of either urinary or bowel incontinence. Statistical analysis was performed using STATA v18.0. Results Of the 146 participants, 76 (52%) were classified as incontinent. Compared to continent individuals, those with incontinence had significantly lower Barthel scores (median 85 vs 95, p &lt; 0.001) and higher levels of frailty (median CFS 6 vs 5, p &lt; 0.001). Incontinence was significantly associated with the presence of a carer (p = 0.012). No significant differences were observed in age, acute care utilisation, or socioeconomic indicators. Conclusion Incontinence was highly prevalent in this cohort and associated with greater frailty, functional dependence, and increased presence of caregivers. These findings highlight the need for early identification and proactive management of incontinence, and for investment in multidisciplinary supports. Efforts should also recognise and support the essential role of both formal and informal caregivers in enabling older adults with incontinence to remain living at home safely and with dignity.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"204 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145674108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-05DOI: 10.1093/ageing/afaf318.036
Giulia Cavrini, Agostino Stavolo, Viviana Egidi, Román Romero-Ortuño
Background Using data from the Survey of Health, Ageing, and Retirement in Europe (SHARE), this study aims to examine the prevalence and progression of frailty among older adults across Europe, explore regional disparities, and identify key sociodemographic and social factors, such as loneliness, social engagement, and family support, associated with frailty status. Methods A cross-sectional analysis of SHARE data from Waves 6 and 8 (release 9.0.0) was conducted, including non-institutionalised individuals aged 50 or older at both time points, across 17 European countries. Frailty was operationalised using variables defined by Santos-Eggimann (muscle weakness, exhaustion, unintentional weight loss, slowness, and low physical activity). One point was assigned for each criterion met, and participants were categorised as: Non-frail (0 points), Pre-frail (1-2 points), Frail (3-5 points). Adjusted Multilevel Multinomial Logistic regression models were then estimated for the frail and pre-frail groups, using the non-frail group as the reference category, to identify the explanatory factors that underlie individual and country-level effects, focusing on welfare characteristics as a country-level predictor of frailty. Results Significant differences in frailty prevalence were observed across countries. Multilevel multinomial logistic regression indicated that approximately 20% of the variability in frailty prevalence could be attributed to differences at the national level. Frailty and pre-frailty were more common among older adults, women, and individuals with lower educational attainment. Perceived loneliness and limited participation in social activities emerged as the most significant social variables associated with frailty. Notably, the poverty index accounted for about 8% of this between-country variability. Conclusion Our findings reveal substantial variability in frailty prevalence across European countries, where significantly higher rates of frailty and pre-frailty are observed in Southern Europe. These geographic disparities suggest that psychosocial and cultural factors, along with the structure and strength of national welfare characteristics, may play a critical role in influencing frailty outcomes.
{"title":"The Role of Social and Demographic Factors in Shaping Frailty in Europe","authors":"Giulia Cavrini, Agostino Stavolo, Viviana Egidi, Román Romero-Ortuño","doi":"10.1093/ageing/afaf318.036","DOIUrl":"https://doi.org/10.1093/ageing/afaf318.036","url":null,"abstract":"Background Using data from the Survey of Health, Ageing, and Retirement in Europe (SHARE), this study aims to examine the prevalence and progression of frailty among older adults across Europe, explore regional disparities, and identify key sociodemographic and social factors, such as loneliness, social engagement, and family support, associated with frailty status. Methods A cross-sectional analysis of SHARE data from Waves 6 and 8 (release 9.0.0) was conducted, including non-institutionalised individuals aged 50 or older at both time points, across 17 European countries. Frailty was operationalised using variables defined by Santos-Eggimann (muscle weakness, exhaustion, unintentional weight loss, slowness, and low physical activity). One point was assigned for each criterion met, and participants were categorised as: Non-frail (0 points), Pre-frail (1-2 points), Frail (3-5 points). Adjusted Multilevel Multinomial Logistic regression models were then estimated for the frail and pre-frail groups, using the non-frail group as the reference category, to identify the explanatory factors that underlie individual and country-level effects, focusing on welfare characteristics as a country-level predictor of frailty. Results Significant differences in frailty prevalence were observed across countries. Multilevel multinomial logistic regression indicated that approximately 20% of the variability in frailty prevalence could be attributed to differences at the national level. Frailty and pre-frailty were more common among older adults, women, and individuals with lower educational attainment. Perceived loneliness and limited participation in social activities emerged as the most significant social variables associated with frailty. Notably, the poverty index accounted for about 8% of this between-country variability. Conclusion Our findings reveal substantial variability in frailty prevalence across European countries, where significantly higher rates of frailty and pre-frailty are observed in Southern Europe. These geographic disparities suggest that psychosocial and cultural factors, along with the structure and strength of national welfare characteristics, may play a critical role in influencing frailty outcomes.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"15 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145680369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-05DOI: 10.1093/ageing/afaf318.161
Elizabeth Morrow, Mary Lynch, Edward Naessens, Carmel Kelly, Clodagh Killeen
Background As populations age, there is a growing global shift toward supporting older adults to live independently at home rather than in institutional settings. Health systeworldwide are grappling with how to deliver effective, person-centred home care while ensuring safety, sustainability, and workforce stability. A major barrier is the limited professional recognition, training opportunities, and career development available to home support workers, contributing to high staff turnover and persistent recruitment difficulties. In Ireland, these issues have created significant service backlogs, leaving thousands of older people waiting for essential home support. This scoping review examined international evidence and best practices to inform the development of a structured career pathway for Ireland’s home support workforce, aligned with training and system-wide workforce development priorities. Methods A scoping review was undertaken using Joanna Briggs Institute methodology, with structured searches across relevant databases and grey literature. Inclusion criteria and relevance grading were applied, and findings were thematically analysed using a “what works, for whom, when, and why” lens. Results The 261 included articles highlight the global significance of the issues. Four overarching themes were identified: 1) Attract and develop a competent and motivated workforce 2) Enhance working lives and retention 3) Utilise career pathways for quality and impact 4) Invest in data and digital for home care. Conclusion Based on the evidence, a Green Paper was developed proposing a safe, sustainable model for ageing in place. Following stakeholder consultation, which confirmed the proposals’ relevance, a White Paper was produced. It integrates feedback and presents recommendations grounded in the best available evidence and stakeholder input on advancing a career pathway for home support workers—targeted at providers, policymakers, educators, workers, clients, and family caregivers. Key aspects includes roles and responsibilities, career progression, training and development, quality careers and data analysis.
{"title":"Supporting Ageing at Home: Developing Ireland’s Home Care Workforce","authors":"Elizabeth Morrow, Mary Lynch, Edward Naessens, Carmel Kelly, Clodagh Killeen","doi":"10.1093/ageing/afaf318.161","DOIUrl":"https://doi.org/10.1093/ageing/afaf318.161","url":null,"abstract":"Background As populations age, there is a growing global shift toward supporting older adults to live independently at home rather than in institutional settings. Health systeworldwide are grappling with how to deliver effective, person-centred home care while ensuring safety, sustainability, and workforce stability. A major barrier is the limited professional recognition, training opportunities, and career development available to home support workers, contributing to high staff turnover and persistent recruitment difficulties. In Ireland, these issues have created significant service backlogs, leaving thousands of older people waiting for essential home support. This scoping review examined international evidence and best practices to inform the development of a structured career pathway for Ireland’s home support workforce, aligned with training and system-wide workforce development priorities. Methods A scoping review was undertaken using Joanna Briggs Institute methodology, with structured searches across relevant databases and grey literature. Inclusion criteria and relevance grading were applied, and findings were thematically analysed using a “what works, for whom, when, and why” lens. Results The 261 included articles highlight the global significance of the issues. Four overarching themes were identified: 1) Attract and develop a competent and motivated workforce 2) Enhance working lives and retention 3) Utilise career pathways for quality and impact 4) Invest in data and digital for home care. Conclusion Based on the evidence, a Green Paper was developed proposing a safe, sustainable model for ageing in place. Following stakeholder consultation, which confirmed the proposals’ relevance, a White Paper was produced. It integrates feedback and presents recommendations grounded in the best available evidence and stakeholder input on advancing a career pathway for home support workers—targeted at providers, policymakers, educators, workers, clients, and family caregivers. Key aspects includes roles and responsibilities, career progression, training and development, quality careers and data analysis.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"156 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145673527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-05DOI: 10.1093/ageing/afaf318.201
Clarissa Leydon, Eithne Sexton, Janas Harrington
Background Shifting toward sustainable diets is a key strategy for addressing both climate change and public health challenges. However, many proposed sustainable diets rely on theoretical models that differ markedly from current eating habits and may overlook important trade-offs. This study aimed to identify self-selected eating patterns in older adults in Ireland that are both nutritionally adequate and environmentally favorable. Methods Dietary data were analysed from 1,860 free-living, older adults from a population-based cohort in the southwest of Ireland (2010–2011). Diet quality was assessed using the Mean Adequacy Ratio (MAR) and Mean Excess Ratio (MER). Environmental impact was estimated for each diet using greenhouse gas emissions (GHGE) and blue water use (BWU) indicators, based on life cycle assessment data from UK studies. Energy-adjusted multiple factor analysis, followed by hierarchical clustering identified dietary patterns with lower environmental impacts and higher nutritional quality. Results Four distinct dietary clusters were identified. One cluster, comprising 31% of the sample, had the highest micronutrient adequacy and moderate daily GHGE (6.3 kg CO₂-equivalent) and BWU (344 litres), making it the most nutritionally and environmentally balanced pattern. The cluster with the lowest environmental impact had the lowest nutritional quality. In contrast, the cluster with the highest GHGE (9.63 kg CO₂-equivalent/day) had the highest protein intake, with a greater proportion of participants meeting proposed higher protein targets important for preserving muscle mass and function. Conclusion One cluster had the highest nutritional quality and moderate environmental impacts, offering a promising compromise. While not the lowest in environmental burden, it highlights the potential to identify healthier, more sustainable diets grounded in existing eating behaviours. For older adults, dietary shifts that promote healthy ageing and advance environmental goals are more likely to succeed when grounded in realistic, culturally acceptable changes rather than idealised or prescriptive models that diverge from current practices.
向可持续饮食转变是应对气候变化和公共卫生挑战的一项关键战略。然而，许多提出的可持续饮食依赖于与当前饮食习惯明显不同的理论模型，可能忽略了重要的权衡。这项研究旨在确定爱尔兰老年人自我选择的饮食模式，既营养充足又有利于环境。方法对爱尔兰西南部（2010-2011年）1860名自由生活的老年人的饮食数据进行分析。采用平均充足比（MAR）和平均过剩比（MER）评价饲粮质量。根据英国研究的生命周期评估数据，使用温室气体排放（GHGE）和蓝水利用（BWU）指标估计每种饮食对环境的影响。通过能量调整后的多因素分析，确定了环境影响较小、营养质量较高的膳食模式。结果鉴定出4种不同的膳食群。其中一个集群（占样本的31%）具有最高的微量营养素充足性和中等的每日温室气体排放量（6.3 kg CO₂当量）和BWU（344升），使其成为营养和环境最平衡的模式。环境影响最小的群集营养质量最低。相比之下，温室气体排放量最高的群体（9.63 kg CO₂当量/天）的蛋白质摄入量最高，更大比例的参与者达到了对保持肌肉质量和功能重要的更高蛋白质目标。结论其中一个群体的营养质量最高，对环境的影响较小，是一个有希望的折衷方案。虽然不是环境负担最低的，但它强调了在现有饮食行为基础上确定更健康、更可持续饮食的潜力。对于老年人来说，促进健康老龄化和推进环境目标的饮食转变，如果以现实的、文化上可接受的变化为基础，而不是以偏离当前做法的理想化或规定性模式为基础，就更有可能取得成功。
{"title":"Balancing Diet Quality and Environmental Impact in Self-Selected Diets of Older Adults in Ireland","authors":"Clarissa Leydon, Eithne Sexton, Janas Harrington","doi":"10.1093/ageing/afaf318.201","DOIUrl":"https://doi.org/10.1093/ageing/afaf318.201","url":null,"abstract":"Background Shifting toward sustainable diets is a key strategy for addressing both climate change and public health challenges. However, many proposed sustainable diets rely on theoretical models that differ markedly from current eating habits and may overlook important trade-offs. This study aimed to identify self-selected eating patterns in older adults in Ireland that are both nutritionally adequate and environmentally favorable. Methods Dietary data were analysed from 1,860 free-living, older adults from a population-based cohort in the southwest of Ireland (2010–2011). Diet quality was assessed using the Mean Adequacy Ratio (MAR) and Mean Excess Ratio (MER). Environmental impact was estimated for each diet using greenhouse gas emissions (GHGE) and blue water use (BWU) indicators, based on life cycle assessment data from UK studies. Energy-adjusted multiple factor analysis, followed by hierarchical clustering identified dietary patterns with lower environmental impacts and higher nutritional quality. Results Four distinct dietary clusters were identified. One cluster, comprising 31% of the sample, had the highest micronutrient adequacy and moderate daily GHGE (6.3 kg CO₂-equivalent) and BWU (344 litres), making it the most nutritionally and environmentally balanced pattern. The cluster with the lowest environmental impact had the lowest nutritional quality. In contrast, the cluster with the highest GHGE (9.63 kg CO₂-equivalent/day) had the highest protein intake, with a greater proportion of participants meeting proposed higher protein targets important for preserving muscle mass and function. Conclusion One cluster had the highest nutritional quality and moderate environmental impacts, offering a promising compromise. While not the lowest in environmental burden, it highlights the potential to identify healthier, more sustainable diets grounded in existing eating behaviours. For older adults, dietary shifts that promote healthy ageing and advance environmental goals are more likely to succeed when grounded in realistic, culturally acceptable changes rather than idealised or prescriptive models that diverge from current practices.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"198 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145673700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-05DOI: 10.1093/ageing/afaf318.035
Finlay Brennan, Aisling Carroll, Donal Fitzpatrick, Eamon Laird, Leanne Hoey, Catherine Hughes, JJ Strain, Anne Molloy, Helene McNulty, Conal Cunningham, Rosaleen Lannon, Kevin McCarroll
Background Recent studies have shown an association between PPI use and increased risk of falls. A meta-analysis of eight studies (n=367,068) identified a 27% increased falls risk in PPI users. Potential mechanisms include reduced gut absorption of calcium, magnesium and other nutrients, altered gut microbiome and possible effects on muscle function. We aimed to explore the association between PPI use and falls risk in older adults. Methods Participants were adults aged >60 yrs from the TUDA study. Exclusion criteria were MMSE <24, history of stroke and current or long-term steroid use. The relationship between PPI use and self- reported falls in the last year was explored in multinomial regression adjusting for age, sex, BMI, timed up and go (TUG), diabetes, vitamin D, serum B12, parathyroid hormone, depression, dizziness on standing, ischemic heart disease, MMSE, medications (antihypertensives, loop diuretics, NSAIDs, benzodiazepines, opioids, Z drugs). We also explored for an association in those with normal TUG (<10 seconds) and in high dose PPI users versus non-users. Results 3701 participants, mean age 73.1, 68.8% female, 32.6% fallen in last year, 35.3% PPI users. PPI use was associated with an increased risk of falls before and after multivariate adjustment (OR 1.29 CI 1.11-1.50, P<0.001). In a subsample (n=3059), high dose PPI users versus non-users had a greater risk of falls (OR 1.43, CI 1.17-1.75, p=0.0003). In those with normal TUG, the overall relationship remained significant (OR 1.34, CI 1.07-1.69, p=0.011) and also in high dose PPI users versus non-users (OR 1.89, CI 1.39-2.58, p<0.0001). Conclusion Overall, PPI users had a 29% increased risk of falls independent of numerous factors and this remained significant in those without physical frailty. Furthermore, risk was greater risk in high dose PPI users. Future studies are needed to further explore this and the potential mechanisms.
最近的研究显示PPI的使用与跌倒风险增加之间存在关联。8项研究（n=367,068）的荟萃分析发现，PPI使用者的跌倒风险增加27%。潜在的机制包括肠道对钙、镁和其他营养物质的吸收减少，肠道微生物群的改变以及对肌肉功能的可能影响。我们的目的是探讨老年人使用PPI与跌倒风险之间的关系。方法参与者为年龄为&；gt；从TUDA研究开始的60年。排除标准为MMSE &；lt；24、中风史和目前或长期使用类固醇。使用PPI与去年自我报告跌倒之间的关系通过多项回归调整年龄、性别、BMI、timed up and go （TUG）、糖尿病、维生素D、血清B12、甲状旁腺激素、抑郁、站立头晕、缺血性心脏病、MMSE、药物（降压药、利尿剂、非甾体抗炎药、苯二氮平类药物、阿片类药物、Z类药物）进行了探讨。我们还探讨了正常TUG （<；10秒）和高剂量PPI使用者与非使用者之间的关联。结果3701名参与者，平均年龄73.1岁，女性68.8%，去年下降32.6%，PPI使用者占35.3%。多因素调整前后，PPI使用与跌倒风险增加相关（OR 1.29 CI 1.11-1.50, P<0.001）。在一个子样本（n=3059）中，高剂量PPI使用者与非使用者相比有更大的跌倒风险（OR 1.43, CI 1.17-1.75, p=0.0003）。在TUG正常的患者中，总体关系仍然显著（OR 1.34, CI 1.07-1.69, p=0.011），高剂量PPI使用者与非PPI使用者之间的关系也是如此（OR 1.89, CI 1.39-2.58, p amp;lt;0.0001）。总体而言，PPI使用者跌倒的风险增加了29%，独立于许多因素，这在那些没有身体虚弱的人中仍然很明显。此外，高剂量PPI使用者的风险更大。未来的研究需要进一步探讨这一点和潜在的机制。
{"title":"Proton pump inhibitors independently associated with an increased risk of falls in older Irish adults","authors":"Finlay Brennan, Aisling Carroll, Donal Fitzpatrick, Eamon Laird, Leanne Hoey, Catherine Hughes, JJ Strain, Anne Molloy, Helene McNulty, Conal Cunningham, Rosaleen Lannon, Kevin McCarroll","doi":"10.1093/ageing/afaf318.035","DOIUrl":"https://doi.org/10.1093/ageing/afaf318.035","url":null,"abstract":"Background Recent studies have shown an association between PPI use and increased risk of falls. A meta-analysis of eight studies (n=367,068) identified a 27% increased falls risk in PPI users. Potential mechanisms include reduced gut absorption of calcium, magnesium and other nutrients, altered gut microbiome and possible effects on muscle function. We aimed to explore the association between PPI use and falls risk in older adults. Methods Participants were adults aged &gt;60 yrs from the TUDA study. Exclusion criteria were MMSE &lt;24, history of stroke and current or long-term steroid use. The relationship between PPI use and self- reported falls in the last year was explored in multinomial regression adjusting for age, sex, BMI, timed up and go (TUG), diabetes, vitamin D, serum B12, parathyroid hormone, depression, dizziness on standing, ischemic heart disease, MMSE, medications (antihypertensives, loop diuretics, NSAIDs, benzodiazepines, opioids, Z drugs). We also explored for an association in those with normal TUG (&lt;10 seconds) and in high dose PPI users versus non-users. Results 3701 participants, mean age 73.1, 68.8% female, 32.6% fallen in last year, 35.3% PPI users. PPI use was associated with an increased risk of falls before and after multivariate adjustment (OR 1.29 CI 1.11-1.50, P&lt;0.001). In a subsample (n=3059), high dose PPI users versus non-users had a greater risk of falls (OR 1.43, CI 1.17-1.75, p=0.0003). In those with normal TUG, the overall relationship remained significant (OR 1.34, CI 1.07-1.69, p=0.011) and also in high dose PPI users versus non-users (OR 1.89, CI 1.39-2.58, p&lt;0.0001). Conclusion Overall, PPI users had a 29% increased risk of falls independent of numerous factors and this remained significant in those without physical frailty. Furthermore, risk was greater risk in high dose PPI users. Future studies are needed to further explore this and the potential mechanisms.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"15 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145673753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-05DOI: 10.1093/ageing/afaf318.041
Norma O' Leary, Helen Kelly
Background The Irish National Stroke Strategy 2022-2027 (HSE, 2022) has recommended the introduction of a patient held resource such as a ‘Stroke Passport’ to allow patients to keep clear and current records of health treatment and support throughout their rehabilitation. Given that a Stroke Passport can be categorised as a complex intervention, characterised by multiple interacting components and the need to modify established practices, it is crucial to explore current practices related to information provision across the stroke care continuum. Methods An online survey explored the opinions of healthcare professionals based in Ireland and the UK who worked in stroke care. Numerical data was analysed using descriptive and inferential statistics. Opinions and comments made by participants were analysed using Thematic Content Analysis based on the Theoretical Domains Framework. Results A total of 111 (64% Ireland; 36% United Kingdom (UK)) healthcare professionals completed the survey. The survey respondents identified the most common methods that stroke information was provided to patients across settings were verbal discussions, booklets, leaflets, and telephone calls. There was consensus that information should be provided at multiple care pathway timepoints. UK respondents indicated a significantly greater perceived satisfaction by patients and family/caregiver with current information provision compared to their Irish counterparts (p<.001). Most participants stated that a Stroke Passport should ideally be provided in both digital and paper formats. Conclusion This survey provides important insights into current information provision practices of healthcare professionals working in the area of stroke. There was agreement about the importance of the provision of a standardised information resource, such as a Stroke Passport, to enhance stroke patient care. This ultimately has the potential to equip stroke patients in the active management of their healthcare.
{"title":"Healthcare Professional Perspectives of a Health Communication Passport for Stroke: An International UK and Ireland Survey","authors":"Norma O' Leary, Helen Kelly","doi":"10.1093/ageing/afaf318.041","DOIUrl":"https://doi.org/10.1093/ageing/afaf318.041","url":null,"abstract":"Background The Irish National Stroke Strategy 2022-2027 (HSE, 2022) has recommended the introduction of a patient held resource such as a ‘Stroke Passport’ to allow patients to keep clear and current records of health treatment and support throughout their rehabilitation. Given that a Stroke Passport can be categorised as a complex intervention, characterised by multiple interacting components and the need to modify established practices, it is crucial to explore current practices related to information provision across the stroke care continuum. Methods An online survey explored the opinions of healthcare professionals based in Ireland and the UK who worked in stroke care. Numerical data was analysed using descriptive and inferential statistics. Opinions and comments made by participants were analysed using Thematic Content Analysis based on the Theoretical Domains Framework. Results A total of 111 (64% Ireland; 36% United Kingdom (UK)) healthcare professionals completed the survey. The survey respondents identified the most common methods that stroke information was provided to patients across settings were verbal discussions, booklets, leaflets, and telephone calls. There was consensus that information should be provided at multiple care pathway timepoints. UK respondents indicated a significantly greater perceived satisfaction by patients and family/caregiver with current information provision compared to their Irish counterparts (p&lt;.001). Most participants stated that a Stroke Passport should ideally be provided in both digital and paper formats. Conclusion This survey provides important insights into current information provision practices of healthcare professionals working in the area of stroke. There was agreement about the importance of the provision of a standardised information resource, such as a Stroke Passport, to enhance stroke patient care. This ultimately has the potential to equip stroke patients in the active management of their healthcare.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"21 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145673758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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