Pub Date : 2025-12-05DOI: 10.1093/ageing/afaf318.110
Claire O'Sullivan, Adam McDermott, Emma May Curran, Rachel Price, Niamh Mitchell
Background The NICE guidelines are used to rationalise the referrals for brain imaging in older adults (OA). Despite NICE recommending a CT brain (CBT) for all patients over 65 on a direct-acting oral anticoagulant (DOAC), research has shown that the risk of adverse outcomes following mild head injury (MHI) in patients taking DOACs appears low. The aim of this project was to examine the incidence of CTB use in OA presenting to the Emergency department (ED) with MHI and compare the CT referral rates between nursing home residents (NHR) and non-nursing home residents (NNHR). Methods A chart audit of OA who presented to ED within a six month period with a primary complaint of fall, with either a suspected or confirmed head strike was completed. Exclusion criteria included witnessed seizures, Glasgow coma scale of < 14 at triage or extensive head lacerations or a presumed cardiac cause to the fall. Audit included a review of whether: a CT brain was completed, did the OA meet the NICE criteria for CT Brain, was the patient on a DOAC, GCS and 4AT, CTB result, neurosurgical consultation +/- intervention, discharge destination. Results 186 OA (93 NHR and 93 NNHR) were included in the audit. Overall, 64% of patients received a CT Brain, of which only 45% met the NICE criteria for CT Brain. 6% of CT scans displayed evidence of ICH. The rate of referral for CTB was similar between NHR (62%) and NNHR (67%). A higher percentage of NHR met the NICE criteria than NNHR (55% vs 37%). 100% of NHR were discharged home compared to 77% of NNHR. Conclusion Regardless of whether these patients were prescribed a DOAC, results suggest that a significant number of CTB are being completed without a clear clinical rational or a justified benefit to the patient.
NICE指南用于合理化老年人脑成像（OA）的转诊。尽管NICE推荐所有65岁以上使用直接作用口服抗凝剂（DOAC）的患者进行CT脑（CBT）治疗，但研究表明，服用DOAC的患者轻度脑损伤（MHI）后不良后果的风险似乎很低。本研究的目的是研究患有MHI的OA患者在急诊科（ED）使用CTB的发生率，并比较疗养院居民（NHR）和非疗养院居民（NNHR）的CT转诊率。方法对6个月内以跌倒为主诉就诊于急诊科的OA患者进行图表审计，这些患者疑似或确诊为头部撞击。排除标准包括：目击发作、格拉斯哥昏迷量表(<；有14人死于分诊或大面积头部撕裂伤或疑似心脏原因。审核内容包括：脑部CT是否完成，OA是否符合NICE的脑部CT标准，患者是否处于DOAC， GCS和4AT， CTB结果，神经外科咨询+/-干预，出院目的地。结果纳入审计的OA 186例，其中NHR 93例，NHR 93例。总体而言，64%的患者接受了CT脑扫描，其中只有45%的患者符合NICE的CT脑扫描标准，6%的CT扫描显示脑出血的证据。CTB转诊率在NHR（62%）和NNHR（67%）之间相似。NHR符合NICE标准的比例高于NNHR （55% vs 37%）。100%的非住院病人出院回家，而非住院病人只有77%出院回家。无论这些患者是否开了DOAC，结果表明，大量的CTB在没有明确的临床合理性或对患者的合理益处的情况下完成。
{"title":"Computerise Tomography of the Brain in Older Adults Presenting with Minor head injury within the Irish Emergency Department Setting","authors":"Claire O'Sullivan, Adam McDermott, Emma May Curran, Rachel Price, Niamh Mitchell","doi":"10.1093/ageing/afaf318.110","DOIUrl":"https://doi.org/10.1093/ageing/afaf318.110","url":null,"abstract":"Background The NICE guidelines are used to rationalise the referrals for brain imaging in older adults (OA). Despite NICE recommending a CT brain (CBT) for all patients over 65 on a direct-acting oral anticoagulant (DOAC), research has shown that the risk of adverse outcomes following mild head injury (MHI) in patients taking DOACs appears low. The aim of this project was to examine the incidence of CTB use in OA presenting to the Emergency department (ED) with MHI and compare the CT referral rates between nursing home residents (NHR) and non-nursing home residents (NNHR). Methods A chart audit of OA who presented to ED within a six month period with a primary complaint of fall, with either a suspected or confirmed head strike was completed. Exclusion criteria included witnessed seizures, Glasgow coma scale of &lt; 14 at triage or extensive head lacerations or a presumed cardiac cause to the fall. Audit included a review of whether: a CT brain was completed, did the OA meet the NICE criteria for CT Brain, was the patient on a DOAC, GCS and 4AT, CTB result, neurosurgical consultation +/- intervention, discharge destination. Results 186 OA (93 NHR and 93 NNHR) were included in the audit. Overall, 64% of patients received a CT Brain, of which only 45% met the NICE criteria for CT Brain. 6% of CT scans displayed evidence of ICH. The rate of referral for CTB was similar between NHR (62%) and NNHR (67%). A higher percentage of NHR met the NICE criteria than NNHR (55% vs 37%). 100% of NHR were discharged home compared to 77% of NNHR. Conclusion Regardless of whether these patients were prescribed a DOAC, results suggest that a significant number of CTB are being completed without a clear clinical rational or a justified benefit to the patient.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"34 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145673971","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/afaf318.074
Loredana Frau, Panos Alexopoulos, Heather Dignam, David Bradley, Anna Mullen, Iracema Leroi
Background Mild Cognitive Impairment (MCI) is often considered a prodromal phase of Lewy Body Dementia (LBD). While both conditions involve cognitive difficulties, they differ in the type and severity of non-cognitive symptoms. MCI is generally associated with mild cognitive changes and subtle neuropsychiatric, motor, and sleep disturbances. In contrast, LBD presents with more pronounced neuropsychiatric, motor, and sleep-related symptoms, which can affect cognitive performance. This study explores how these symptoms predict cognitive function in individuals with MCI and LBD, highlighting their distinct contribution to cognitive performance in each condition. Methods Data from N=36 patients with MCI, primarily Parkinson’s Disease-MCI (PD-MCI), and N=48 patients with LBD, including Parkinson’s Disease Dementia (PDD) and Dementia with Lewy Bodies (DLB) were analysed. Neuropsychiatric symptoms were assessed using the Neuropsychiatric Inventory, sleep with the Epworth Sleepiness Scale, motor symptoms with the Hoehn and Yahr scale, and cognitive function with the Addenbrooke’s Cognitive Examination. Correlation and regression analyses explored the relationship between these factors and their role in predicting performance Results In the MCI group, neuropsychiatric symptoms were positively correlated with motor symptoms (p = 0.004). In the LBD group, neuropsychiatric (p < 0.001) and motor symptoms (p = 0.03) were significantly associated with lower cognitive functioning. Additionally, in LBD, neuropsychiatric symptoms were positively correlated with both motor (p = 0.02) and sleep symptoms (p < 0.001). In MCI, sleep symptoms significantly predicted poorer cognitive functioning (p = 0.03), whereas in LBD, neuropsychiatric symptoms were the strongest predictor of reduced cognitive functioning (p = 0.02), even after adjusting for age and gender. Conclusion Different patterns were observed in how neuropsychiatric, motor, and sleep symptoms influence cognitive functioning in the MCI and LBD groups, highlighting the distinct roles of non-cognitive symptoms in each condition. Early identification of these symptoms may offer valuable insights for monitoring cognitive functioning over time in these clinical populations.
{"title":"Predicting Cognitive Function in Mild Cognitive Impairment and Lewy Body Dementia: The Role of Neuropsychiatric, Motor, and Sleep Symptoms","authors":"Loredana Frau, Panos Alexopoulos, Heather Dignam, David Bradley, Anna Mullen, Iracema Leroi","doi":"10.1093/ageing/afaf318.074","DOIUrl":"https://doi.org/10.1093/ageing/afaf318.074","url":null,"abstract":"Background Mild Cognitive Impairment (MCI) is often considered a prodromal phase of Lewy Body Dementia (LBD). While both conditions involve cognitive difficulties, they differ in the type and severity of non-cognitive symptoms. MCI is generally associated with mild cognitive changes and subtle neuropsychiatric, motor, and sleep disturbances. In contrast, LBD presents with more pronounced neuropsychiatric, motor, and sleep-related symptoms, which can affect cognitive performance. This study explores how these symptoms predict cognitive function in individuals with MCI and LBD, highlighting their distinct contribution to cognitive performance in each condition. Methods Data from N=36 patients with MCI, primarily Parkinson’s Disease-MCI (PD-MCI), and N=48 patients with LBD, including Parkinson’s Disease Dementia (PDD) and Dementia with Lewy Bodies (DLB) were analysed. Neuropsychiatric symptoms were assessed using the Neuropsychiatric Inventory, sleep with the Epworth Sleepiness Scale, motor symptoms with the Hoehn and Yahr scale, and cognitive function with the Addenbrooke’s Cognitive Examination. Correlation and regression analyses explored the relationship between these factors and their role in predicting performance Results In the MCI group, neuropsychiatric symptoms were positively correlated with motor symptoms (p = 0.004). In the LBD group, neuropsychiatric (p &lt; 0.001) and motor symptoms (p = 0.03) were significantly associated with lower cognitive functioning. Additionally, in LBD, neuropsychiatric symptoms were positively correlated with both motor (p = 0.02) and sleep symptoms (p &lt; 0.001). In MCI, sleep symptoms significantly predicted poorer cognitive functioning (p = 0.03), whereas in LBD, neuropsychiatric symptoms were the strongest predictor of reduced cognitive functioning (p = 0.02), even after adjusting for age and gender. Conclusion Different patterns were observed in how neuropsychiatric, motor, and sleep symptoms influence cognitive functioning in the MCI and LBD groups, highlighting the distinct roles of non-cognitive symptoms in each condition. Early identification of these symptoms may offer valuable insights for monitoring cognitive functioning over time in these clinical populations.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"27 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145674101","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/afaf318.172
Muhammad Abrar ul haq, Ayesha Hina, Areeba Khan, Izhar Rashid, Yasir Ali, Aziz Ahmad, Marie Hayden
Background Older nursing home residents (NHRs) typically present with multiple comorbidities and high frailty, necessitating careful management to avoid potentially avoidable hospital transfers . International reports indicate that between 6.8 % and 45.7 % of NHRs are transferred to acute hospitals over variable follow-up periods . Such transfers carry increased risks of in-hospital complications, including pressure ulcers, nosocomial infections, delirium, functional decline, and substantial healthcare costs. Moreover, nearly 40 % of care home residents who die in hospital do so within 24 hours of admission, suggesting that many transfers may be inappropriate. Methods To characterize referral processes and outcomes, we performed a retrospective chart analysis audit of 38 consecutive NHR admissions to our model 3 hospital over a 30 day period. Results The cohort’s mean age was 83 years. Sepsis accounted for 50% of admissions, with falls, delirium, acute kidney injury, and lower respiratory tract infections also common. 35% of referrals occurred at weekends, and 50% of weekday referrals were out-of-hours. Only 10 % underwent in-person general practitioner review and 20 % had telephone assessment before transfer. Transfer documentation was complete in 12 % of cases, incomplete in 65 %, and absent in 23 %, while 90 % had full medication lists. Advance directives precluding hospital admission existed for 13 % of admissions. In-hospital mortality within 24 hours occurred in 5 % of admissions, 15 % were discharged on oral therapy within 24 hours, and 27 % were readmitted within 30 days. Conclusion These findings highlight significant deficiencies in pre-transfer clinical review and communication, particularly during out-of-hours periods, underscoring the need to strengthen community-based care pathways, standardize documentation, and ensure timely GP involvement to reduce avoidable hospitalizations in this vulnerable population.
{"title":"Evaluation of Nursing Home Referrals: A retrospective study of Nursing home admissions to acute hospital","authors":"Muhammad Abrar ul haq, Ayesha Hina, Areeba Khan, Izhar Rashid, Yasir Ali, Aziz Ahmad, Marie Hayden","doi":"10.1093/ageing/afaf318.172","DOIUrl":"https://doi.org/10.1093/ageing/afaf318.172","url":null,"abstract":"Background Older nursing home residents (NHRs) typically present with multiple comorbidities and high frailty, necessitating careful management to avoid potentially avoidable hospital transfers . International reports indicate that between 6.8 % and 45.7 % of NHRs are transferred to acute hospitals over variable follow-up periods . Such transfers carry increased risks of in-hospital complications, including pressure ulcers, nosocomial infections, delirium, functional decline, and substantial healthcare costs. Moreover, nearly 40 % of care home residents who die in hospital do so within 24 hours of admission, suggesting that many transfers may be inappropriate. Methods To characterize referral processes and outcomes, we performed a retrospective chart analysis audit of 38 consecutive NHR admissions to our model 3 hospital over a 30 day period. Results The cohort’s mean age was 83 years. Sepsis accounted for 50% of admissions, with falls, delirium, acute kidney injury, and lower respiratory tract infections also common. 35% of referrals occurred at weekends, and 50% of weekday referrals were out-of-hours. Only 10 % underwent in-person general practitioner review and 20 % had telephone assessment before transfer. Transfer documentation was complete in 12 % of cases, incomplete in 65 %, and absent in 23 %, while 90 % had full medication lists. Advance directives precluding hospital admission existed for 13 % of admissions. In-hospital mortality within 24 hours occurred in 5 % of admissions, 15 % were discharged on oral therapy within 24 hours, and 27 % were readmitted within 30 days. Conclusion These findings highlight significant deficiencies in pre-transfer clinical review and communication, particularly during out-of-hours periods, underscoring the need to strengthen community-based care pathways, standardize documentation, and ensure timely GP involvement to reduce avoidable hospitalizations in this vulnerable population.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"40 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145674126","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 Non-cognitive symptoms of dementia encompass behavioural, affective and psychotic symptoms that can occur in patients living with dementia. National Clinical Guideline No.21 recommends that a comprehensive assessment should be conducted prior to considering psychotropic medicine to treat non-cognitive symptoms in a person with dementia and that non-pharmacological interventions should be trialled before considering anti-psychotic medication (1). However, 41% of patients with dementia are prescribed new psychotropic and/or existing psychotropic medication is increased during an inpatient admission (2). The aim of this study was to implement National Clinical Guideline No.21 in an acute hospital setting using simulation-based education (SBE). Methods An interdisciplinary simulation scenario focusing on non-pharmacological management of non-cognitive symptoms in patients with dementia was developed. We employed a multi-component intervention approach combing a didactic lecture followed by a simulation scenario and debrief. Healthcare professionals from multiple specialties were invited to participate in simulation scenario which was delivered multiple times over one month. The scenario was facilitated utilising minimal resources and two embedded simulation participants from the Age-Related Healthcare department. The intervention was evaluated using a self-developed questionnaire. Responses were measured on a five-point Likert scale. Results The intervention was conducted three times. Twenty participants completed the questionnaire, including HCPs from occupational therapy (n=3), nursing (n=2), and medicine (n=15). Most (n=13) were previously unaware of National Clinical Guideline No. 21. Following participation, all participants were confident in recognising contributing factors to non-cognitive symptoms of dementia. Fifteen participants agreed they could now manage non-cognitive symptoms. Seventeen participants were confident in their knowledge of when pharmacological measures should be considered. Conclusion This study demonstrates that SBE may be a feasible intervention to implement the management of non-cognitive symptoms of dementia in an acute hospital setting. Next steps should focus on the impact of SBE on clinical practice, including psychotropic medication prescribing and patient outcomes.
{"title":"Simulation-based Education To Implement National Clinical Guideline No.21 Guidelines In An Acute Hospital Setting","authors":"Emily Buckley, Patrick Doyle, Aoife McFeely, Dilara Ensar, Annie Shabu, Cathy Mullen, Aoife Fallon","doi":"10.1093/ageing/afaf318.034","DOIUrl":"https://doi.org/10.1093/ageing/afaf318.034","url":null,"abstract":"Background Non-cognitive symptoms of dementia encompass behavioural, affective and psychotic symptoms that can occur in patients living with dementia. National Clinical Guideline No.21 recommends that a comprehensive assessment should be conducted prior to considering psychotropic medicine to treat non-cognitive symptoms in a person with dementia and that non-pharmacological interventions should be trialled before considering anti-psychotic medication (1). However, 41% of patients with dementia are prescribed new psychotropic and/or existing psychotropic medication is increased during an inpatient admission (2). The aim of this study was to implement National Clinical Guideline No.21 in an acute hospital setting using simulation-based education (SBE). Methods An interdisciplinary simulation scenario focusing on non-pharmacological management of non-cognitive symptoms in patients with dementia was developed. We employed a multi-component intervention approach combing a didactic lecture followed by a simulation scenario and debrief. Healthcare professionals from multiple specialties were invited to participate in simulation scenario which was delivered multiple times over one month. The scenario was facilitated utilising minimal resources and two embedded simulation participants from the Age-Related Healthcare department. The intervention was evaluated using a self-developed questionnaire. Responses were measured on a five-point Likert scale. Results The intervention was conducted three times. Twenty participants completed the questionnaire, including HCPs from occupational therapy (n=3), nursing (n=2), and medicine (n=15). Most (n=13) were previously unaware of National Clinical Guideline No. 21. Following participation, all participants were confident in recognising contributing factors to non-cognitive symptoms of dementia. Fifteen participants agreed they could now manage non-cognitive symptoms. Seventeen participants were confident in their knowledge of when pharmacological measures should be considered. Conclusion This study demonstrates that SBE may be a feasible intervention to implement the management of non-cognitive symptoms of dementia in an acute hospital setting. Next steps should focus on the impact of SBE on clinical practice, including psychotropic medication prescribing and patient outcomes.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"28 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145680035","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/afaf318.058
Lauren O Mahony, Lorna Kenny, Marco Sica, Colum Crowe, Savatore Tedesco, John Barton, Brendan O'Flynn, Suzanne Timmons
Background Parkinson’s Disease (PD) symptoms vary widely, making objective assessment challenging. PragmaClin Research Inc. developed the Parkinson's Remote Interactive Monitoring system (PRIMS), which collects the Movement Disorder Society’s Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) motor examination data via an instruction screen and Microsoft Kinect Depth cameras, and assigns severity ratings using machine-learning algorithms. We captured the experiences of people with PD (PwPD) trialing the system. Methods PwPD were recruited via local PD, neurology and geriatric clinics and PD social/support groups. Participants completed the PRIMS trial (performing actions in front of the camera system), a post-assessment survey (including the System Usability Scale (SUS)), and an optional audio-recorded interview. Survey data were analysed descriptively, with interview findings providing additional context. Results Twenty-seven participants completed the PRIMS trial and survey; 13 completed an optional interview. Most participants were aged 65-69 (44.4%) or 75-79 (33.3%), and male (66.7%), across Hoehn & Yahr stages 1-4. Almost all (95.6%) users reported being ‘extremely’ or ‘somewhat’ satisfied with the assessment, considering PRIMS potentially valuable for symptom monitoring over time, where video-based assessments could complement in-person consultations and communication with healthcare providers. SUS scores (80–85+) reflected excellent usability, with strong agreement on ease-of-use and low perceived-complexity. However, 52.1% 'somewhat' or 'strongly' disagreed that PRIMS could replace face-to-face consultations, noting usability may depend on technological ability, and some questioned whether clinicians would "trust it". Suggestions for improvement included clarified movement demonstrations and addressing participants’ varied perspectives on viewing themselves on camera. Participants considered PRIMS could be available in GP surgeries or health centers, but that home-based (laptop/phone) assessment would be most accessible. Conclusion PwPD suggest that remote video-based symptom assessment such as PRIMS would be acceptable and usable, aiding communication with healthcare teams on symptom variability, but this must consider technological abilities and setting convenience.
{"title":"Experiences Of People With Parkinson’s Disease Of Video-Based Motor Symptom Assessment","authors":"Lauren O Mahony, Lorna Kenny, Marco Sica, Colum Crowe, Savatore Tedesco, John Barton, Brendan O'Flynn, Suzanne Timmons","doi":"10.1093/ageing/afaf318.058","DOIUrl":"https://doi.org/10.1093/ageing/afaf318.058","url":null,"abstract":"Background Parkinson’s Disease (PD) symptoms vary widely, making objective assessment challenging. PragmaClin Research Inc. developed the Parkinson's Remote Interactive Monitoring system (PRIMS), which collects the Movement Disorder Society’s Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) motor examination data via an instruction screen and Microsoft Kinect Depth cameras, and assigns severity ratings using machine-learning algorithms. We captured the experiences of people with PD (PwPD) trialing the system. Methods PwPD were recruited via local PD, neurology and geriatric clinics and PD social/support groups. Participants completed the PRIMS trial (performing actions in front of the camera system), a post-assessment survey (including the System Usability Scale (SUS)), and an optional audio-recorded interview. Survey data were analysed descriptively, with interview findings providing additional context. Results Twenty-seven participants completed the PRIMS trial and survey; 13 completed an optional interview. Most participants were aged 65-69 (44.4%) or 75-79 (33.3%), and male (66.7%), across Hoehn & Yahr stages 1-4. Almost all (95.6%) users reported being ‘extremely’ or ‘somewhat’ satisfied with the assessment, considering PRIMS potentially valuable for symptom monitoring over time, where video-based assessments could complement in-person consultations and communication with healthcare providers. SUS scores (80–85+) reflected excellent usability, with strong agreement on ease-of-use and low perceived-complexity. However, 52.1% 'somewhat' or 'strongly' disagreed that PRIMS could replace face-to-face consultations, noting usability may depend on technological ability, and some questioned whether clinicians would \"trust it\". Suggestions for improvement included clarified movement demonstrations and addressing participants’ varied perspectives on viewing themselves on camera. Participants considered PRIMS could be available in GP surgeries or health centers, but that home-based (laptop/phone) assessment would be most accessible. Conclusion PwPD suggest that remote video-based symptom assessment such as PRIMS would be acceptable and usable, aiding communication with healthcare teams on symptom variability, but this must consider technological abilities and setting convenience.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"40 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145680501","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/afaf318.127
Kei Yen Chan, Bláithin Ní Bhuachalla
Background Parkinson’s disease (PD) is Ireland’s second most common neurodegenerative disorder. Multidisciplinary rehabilitation improves motor and cognitive outcomes. Access remains limited and fragmented. The aim of this analysis was to compare the functional outcomes of patients with and without a PD diagnosis admitted to our rehabilitation unit. Methods Using medical records, data was retrospectively collated on all patients admitted to a 10 bed rehabilitation unit from January 2024-March 2025. Data collated included demographics, source of referral for rehabilitation, length of stay (LOS), clinical frailty scale (CFS) on discharge and discharge destination. The following outcome measures on admission and discharge were collated: Barthel score, Berg Balance, Timed Up and Go (TUG), de Morton Mobility Index (DEMMI) and Lindop Parkinson’s Assessment Scale (LPAS). Excluded from analysis were those who did not have discharge outcome measures, due to being transferred back to acute hospital/unplanned discharge/death (n=22). Data was analysed using Microsoft Excel. Results 160 patients were admitted to the unit over the 15 month period. Of those 10% had PD (n=16), 38% (n=6) were newly diagnosed, 63% (n=10) male and in 38% (n=6) presenting complaint was a fall. Source of referral: General Medicine 81% (n=13), Orthopaedics 13% (n=2), General Surgery 6% (n=1). In the PD cohort (n=16), from admission to discharge the following were the changes in outcome measures: Barthel (48/100 to 67/100), Berg (29/56 to 42/56), TUG (50.6s to 32.1s), DEMMI (41/100 to 54/100) and Lindop (14/30 to 21/30). In the non-PD cohort (n=122), Barthel (50/100 to 70/100), Berg (29/56 to 43/56), TUG (40.4s to 27.9s), DEMMI (43/100 to 54/100). On discharge, PD versus Non-PD cohort: CFS 6 versus 5.5, LOS 36 versus 34 days, discharge home 95% versus 90%. Conclusion PD patients showed functional improvement during rehabilitation, although starting from a lower baseline and with slightly longer stays than the general cohort.
帕金森氏病（PD）是爱尔兰第二常见的神经退行性疾病。多学科康复改善运动和认知预后。访问仍然是有限和分散的。本分析的目的是比较我们康复部门收治的有和没有PD诊断的患者的功能结果。方法回顾性整理2024年1月至2025年3月收治的10张床位康复病房的所有患者的病历资料。整理的数据包括人口统计、康复转诊来源、住院时间（LOS）、出院时的临床虚弱量表（CFS）和出院目的地。整理入院和出院时的预后指标：Barthel评分、Berg Balance、Timed Up and Go （TUG）、de Morton活动指数（DEMMI）和Lindop帕金森评估量表（LPAS）。分析排除了那些由于转回急性住院/计划外出院/死亡而没有出院结果测量的患者（n=22）。数据采用Microsoft Excel进行分析。结果在15个月内共收治160例患者。在这10%的PD患者（n=16）中，38% （n=6）是新诊断的，63% （n=10）是男性，38% （n=6）的主诉是跌倒。转诊来源：普通内科81% (n=13)，骨科13% (n=2)，普通外科6% （n=1）。在PD队列（n=16）中，从入院到出院的结局指标变化如下：Barthel（48/100至67/100）、Berg（29/56至42/56）、TUG （50.6s至321 s）、DEMMI（41/100至54/100）和Lindop（14/30至21/30）。在非pd组（n=122）中，Barthel(50/100至70/100),Berg(29/56至43/56)，TUG(40.4至27.9)，DEMMI（43/100至54/100）。出院时，PD组与非PD组：CFS 6 vs 5.5， LOS 36 vs 34天，出院95% vs 90%。结论PD患者在康复过程中表现出功能的改善，尽管从较低的基线开始，停留时间略长于一般队列。
{"title":"Comparison Of Demographics And Outcome Measures Of Patients > 65yrs Admitted To A Rehabilitation Unit With And Without Parkinson’s Disease","authors":"Kei Yen Chan, Bláithin Ní Bhuachalla","doi":"10.1093/ageing/afaf318.127","DOIUrl":"https://doi.org/10.1093/ageing/afaf318.127","url":null,"abstract":"Background Parkinson’s disease (PD) is Ireland’s second most common neurodegenerative disorder. Multidisciplinary rehabilitation improves motor and cognitive outcomes. Access remains limited and fragmented. The aim of this analysis was to compare the functional outcomes of patients with and without a PD diagnosis admitted to our rehabilitation unit. Methods Using medical records, data was retrospectively collated on all patients admitted to a 10 bed rehabilitation unit from January 2024-March 2025. Data collated included demographics, source of referral for rehabilitation, length of stay (LOS), clinical frailty scale (CFS) on discharge and discharge destination. The following outcome measures on admission and discharge were collated: Barthel score, Berg Balance, Timed Up and Go (TUG), de Morton Mobility Index (DEMMI) and Lindop Parkinson’s Assessment Scale (LPAS). Excluded from analysis were those who did not have discharge outcome measures, due to being transferred back to acute hospital/unplanned discharge/death (n=22). Data was analysed using Microsoft Excel. Results 160 patients were admitted to the unit over the 15 month period. Of those 10% had PD (n=16), 38% (n=6) were newly diagnosed, 63% (n=10) male and in 38% (n=6) presenting complaint was a fall. Source of referral: General Medicine 81% (n=13), Orthopaedics 13% (n=2), General Surgery 6% (n=1). In the PD cohort (n=16), from admission to discharge the following were the changes in outcome measures: Barthel (48/100 to 67/100), Berg (29/56 to 42/56), TUG (50.6s to 32.1s), DEMMI (41/100 to 54/100) and Lindop (14/30 to 21/30). In the non-PD cohort (n=122), Barthel (50/100 to 70/100), Berg (29/56 to 43/56), TUG (40.4s to 27.9s), DEMMI (43/100 to 54/100). On discharge, PD versus Non-PD cohort: CFS 6 versus 5.5, LOS 36 versus 34 days, discharge home 95% versus 90%. Conclusion PD patients showed functional improvement during rehabilitation, although starting from a lower baseline and with slightly longer stays than the general cohort.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"48 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145680507","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 Early Comprehensive Geriatric Assessment (CGA) and Multidisciplinary Team (MDT) intervention is one of 12 core principles of the Management of Major Trauma in Older Adults. At our Model 4 University Teaching Hospital, a designated Trauma Unit, all low-impact hip fracture patients aged 60 and above are seen by the Orthogeriatric Service, however due to staffing constraints, other older orthopaedic trauma patients are not routinely seen. In early 2025 we piloted an Older Persons Trauma Service, as part of an Aspire Fellowship programme, to provide Orthogeriatric care to older adults who had sustained a fracture, other than hip fracture, due to trauma. We emulated the care provided to hip fracture patients, i.e. CGA focusing on preventing future falls and fractures. Here we present some patient demographics of the pilot service. Methods Included patients were aged 75 and above, admitted under Orthopaedics on an Orthopaedic ward, with a fracture(s) (other than hip fracture) due to trauma. Patients were seen and followed by a Clinical Fellow and discussed at weekly MDT. CGA was conducted for all patients. Results Forty-one patients were reviewed during the c. 14-week pilot service. Average age was 82, Clinical Frailty Scale ranged from 1 to 7. Two thirds were female (n = 27) and 68% were from out of county (n= 28). The most common fractures were C-Spine fractures (24%), followed by ankle fractures (20%). Most injuries were from low falls. Feedback to date has been positive from patients, carers, and the MDT, and service evaluation is ongoing. Conclusion In this pilot service, 41 older trauma patients received CGA including falls and bone health assessment. Low falls were the leading cause of trauma, consistent with the results of the NOCA Major Trauma Audit 2021. Formal evaluation of the service is ongoing, however to date feedback has been encouraging.
{"title":"A Pilot Older Persons Trauma Service at a University Teaching Hospital and Designated Trauma Unit","authors":"Claire McAteer, Tadhg Cronin, Aoife Dunphy, Louise Hogan, Suzanne Laffan, Eleanor Maher, Kirsty Mason, Aleisha McDonald, Katie Ronan, Terence Murphy, Niamh O'Regan","doi":"10.1093/ageing/afaf318.163","DOIUrl":"https://doi.org/10.1093/ageing/afaf318.163","url":null,"abstract":"Background Early Comprehensive Geriatric Assessment (CGA) and Multidisciplinary Team (MDT) intervention is one of 12 core principles of the Management of Major Trauma in Older Adults. At our Model 4 University Teaching Hospital, a designated Trauma Unit, all low-impact hip fracture patients aged 60 and above are seen by the Orthogeriatric Service, however due to staffing constraints, other older orthopaedic trauma patients are not routinely seen. In early 2025 we piloted an Older Persons Trauma Service, as part of an Aspire Fellowship programme, to provide Orthogeriatric care to older adults who had sustained a fracture, other than hip fracture, due to trauma. We emulated the care provided to hip fracture patients, i.e. CGA focusing on preventing future falls and fractures. Here we present some patient demographics of the pilot service. Methods Included patients were aged 75 and above, admitted under Orthopaedics on an Orthopaedic ward, with a fracture(s) (other than hip fracture) due to trauma. Patients were seen and followed by a Clinical Fellow and discussed at weekly MDT. CGA was conducted for all patients. Results Forty-one patients were reviewed during the c. 14-week pilot service. Average age was 82, Clinical Frailty Scale ranged from 1 to 7. Two thirds were female (n = 27) and 68% were from out of county (n= 28). The most common fractures were C-Spine fractures (24%), followed by ankle fractures (20%). Most injuries were from low falls. Feedback to date has been positive from patients, carers, and the MDT, and service evaluation is ongoing. Conclusion In this pilot service, 41 older trauma patients received CGA including falls and bone health assessment. Low falls were the leading cause of trauma, consistent with the results of the NOCA Major Trauma Audit 2021. Formal evaluation of the service is ongoing, however to date feedback has been encouraging.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"128 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145673579","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/afaf318.053
Karen Sayers, Lorna King, Siobhan Ryan, Josephine Keating, Christina Donnellan
Background The aim of this study was to evaluate the falls risk stratification, assessment and management of older adults who receive Comprehensive Geriatric Assessment (CGA). Methods A retrospective evaluation was undertaken of all patients ≥65 years who attended a Community Specialist Team over a 7-month period. Falls risk stratification and Multifactorial Falls Risk Assessment (MFRA) were undertaken as part of CGA. Data was analysed using descriptive statistics and binary logistic regression. Results Ninety-six patients attended during the study period, 37 male, 59 female, mean age: 80 years (SD=7), median Clinical Frailty Scale score: 5 (mild frailty), Barthel score: 17/20 (low dependency). Forty-four percent (n=42) were referred for CGA because of falling. Opportunistic screening identified 97% (n=93) had falls risks, 86% (n=83) were high risk and 66% (n=63) reported falling in the past year. Balance and gait impairment was an independent predictor of falls (OR=3.167, CI=1.157-8.668, p<0.025). Other risk factors were musculoskeletal disorder (68% n=65), cognitive impairment (66% n=63), Falls-Risk-Increasing-Drgs (62% n=59), probable sarcopenia (40% n=38) and Orthostatic Hypotension (30% n=28). Median number of falls-specific interventions required was 4 (range 0-9). Most frequent interventions were Physiotherapy (51% n=49), medication changes (47% n=45), Dietetics (42% n=40), Occupational Therapy (38% n=36), Pharmacy (35% n=33), Memory Clinic (35% n=34) and Cardiology (13% n=12). Conclusion Older adults attending for CGA are at high risk for falls. MFRA is an essential component of CGA. This evaluation will guide multi-domain service delivery to address the key risk factors.
{"title":"Falls Profile of Older Adults Attending a Community Specialist Team for Comprehensive Geriatric Assessment","authors":"Karen Sayers, Lorna King, Siobhan Ryan, Josephine Keating, Christina Donnellan","doi":"10.1093/ageing/afaf318.053","DOIUrl":"https://doi.org/10.1093/ageing/afaf318.053","url":null,"abstract":"Background The aim of this study was to evaluate the falls risk stratification, assessment and management of older adults who receive Comprehensive Geriatric Assessment (CGA). Methods A retrospective evaluation was undertaken of all patients ≥65 years who attended a Community Specialist Team over a 7-month period. Falls risk stratification and Multifactorial Falls Risk Assessment (MFRA) were undertaken as part of CGA. Data was analysed using descriptive statistics and binary logistic regression. Results Ninety-six patients attended during the study period, 37 male, 59 female, mean age: 80 years (SD=7), median Clinical Frailty Scale score: 5 (mild frailty), Barthel score: 17/20 (low dependency). Forty-four percent (n=42) were referred for CGA because of falling. Opportunistic screening identified 97% (n=93) had falls risks, 86% (n=83) were high risk and 66% (n=63) reported falling in the past year. Balance and gait impairment was an independent predictor of falls (OR=3.167, CI=1.157-8.668, p&lt;0.025). Other risk factors were musculoskeletal disorder (68% n=65), cognitive impairment (66% n=63), Falls-Risk-Increasing-Drgs (62% n=59), probable sarcopenia (40% n=38) and Orthostatic Hypotension (30% n=28). Median number of falls-specific interventions required was 4 (range 0-9). Most frequent interventions were Physiotherapy (51% n=49), medication changes (47% n=45), Dietetics (42% n=40), Occupational Therapy (38% n=36), Pharmacy (35% n=33), Memory Clinic (35% n=34) and Cardiology (13% n=12). Conclusion Older adults attending for CGA are at high risk for falls. MFRA is an essential component of CGA. This evaluation will guide multi-domain service delivery to address the key risk factors.","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":"145673580","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/afaf318.092
Caoimhe Murphy, Kieran O’Connor
Background Communication is the cornerstone of our interaction with people. Effective doctor-patient communication is central to building a therapeutic doctor-patient relationship. Some older patients may have challenges with communication due to hearing loss, various co-morbidities, and possible cognitive impairments. However, there is limited Irish research into understanding specific communication challenges. Our objective was to explore doctors’ and older patients’ perceptions of hospital-based communication and to identify perceived aids and barriers to effective doctor-patient communication. Methods A cross-sectional study design was used. Two previously validated Doctor-Patient Communication Scales (one for patients and one for doctors) were utilised to assess our two groups, inpatients aged 65 years and older and doctors treating this population. The questionnaires included similar questions about doctor-patient communication, with some variations to suit the different populations. Quantitative data was generated by graded responses (Likert Scale 1-4). A qualitative component was additionally incorporated into both questionnaires to explore perceived communication barriers, time spent by doctors per patient, and prior training received in communication. A total of 100 in-patients and 38 doctors participated. Results Patients reported a mean communication score of 42.27/52 (SD=8.35); doctors averaged 39.21/44 (SD=3.11), suggesting generally positive perceptions. However, a significant negative correlation was found between patient scores and number of co-morbidities (r = -0.327, p < 0.001), indicating poorer communication experiences among patients with more conditions. Notably, 43% of patients had difficulty understanding their doctor. Cited barriers included time constraints, hearing impairments, hospital noise, medical jargon, and doctors’ varying accents. Among doctors, 39.5% had not received post-graduate communication training. Positive influences on satisfaction included doctors’ friendly demeanours, involving patients in decisions, and use of clear, simple language. Conclusion Doctor-patient communication must be improved for older adults with complex needs. Addressing key barriers—such as limited consultation time and insufficient communication training—may enhance patient understanding and outcomes.
交流是我们与人互动的基石。有效的医患沟通是建立治疗性医患关系的核心。一些老年患者可能由于听力损失、各种合并症和可能的认知障碍而面临沟通方面的挑战。然而，爱尔兰在理解具体的沟通挑战方面的研究有限。我们的目的是探讨医生和老年患者对医院沟通的看法，并确定有效医患沟通的辅助因素和障碍。方法采用横断面研究设计。两个先前验证的医患沟通量表（一个用于患者，一个用于医生）用于评估我们的两组，65岁及以上的住院患者和治疗该人群的医生。调查问卷包括了类似的关于医患沟通的问题，并针对不同人群做了一些调整。定量数据采用分级反应（Likert Scale 1-4）生成。另外，在这两份问卷中都加入了定性成分，以探讨感知到的沟通障碍、医生在每个病人身上花费的时间以及之前接受的沟通培训。共有100名住院病人和38名医生参与。结果患者平均沟通评分为42.27/52 (SD=8.35)；医生的平均得分为39.21/44 (SD=3.11)，总体上持积极态度。然而，患者评分与共病数量呈显著负相关（r = -0.327, p < 0.001），表明患者的沟通体验越差，病情越多。值得注意的是，43%的患者难以理解他们的医生。被提到的障碍包括时间限制、听力障碍、医院噪音、医学术语和医生不同的口音。39.5%的医生未接受过研究生沟通培训。对满意度的积极影响包括医生友好的举止，让病人参与决策，以及使用清晰、简单的语言。结论对有复杂需求的老年人，需加强医患沟通。解决关键障碍，如有限的咨询时间和沟通培训不足，可能会提高患者的理解和结果。
{"title":"Understanding The Whole Story: Assessing Doctor-Patient Communication with Older People in Acute Care","authors":"Caoimhe Murphy, Kieran O’Connor","doi":"10.1093/ageing/afaf318.092","DOIUrl":"https://doi.org/10.1093/ageing/afaf318.092","url":null,"abstract":"Background Communication is the cornerstone of our interaction with people. Effective doctor-patient communication is central to building a therapeutic doctor-patient relationship. Some older patients may have challenges with communication due to hearing loss, various co-morbidities, and possible cognitive impairments. However, there is limited Irish research into understanding specific communication challenges. Our objective was to explore doctors’ and older patients’ perceptions of hospital-based communication and to identify perceived aids and barriers to effective doctor-patient communication. Methods A cross-sectional study design was used. Two previously validated Doctor-Patient Communication Scales (one for patients and one for doctors) were utilised to assess our two groups, inpatients aged 65 years and older and doctors treating this population. The questionnaires included similar questions about doctor-patient communication, with some variations to suit the different populations. Quantitative data was generated by graded responses (Likert Scale 1-4). A qualitative component was additionally incorporated into both questionnaires to explore perceived communication barriers, time spent by doctors per patient, and prior training received in communication. A total of 100 in-patients and 38 doctors participated. Results Patients reported a mean communication score of 42.27/52 (SD=8.35); doctors averaged 39.21/44 (SD=3.11), suggesting generally positive perceptions. However, a significant negative correlation was found between patient scores and number of co-morbidities (r = -0.327, p &lt; 0.001), indicating poorer communication experiences among patients with more conditions. Notably, 43% of patients had difficulty understanding their doctor. Cited barriers included time constraints, hearing impairments, hospital noise, medical jargon, and doctors’ varying accents. Among doctors, 39.5% had not received post-graduate communication training. Positive influences on satisfaction included doctors’ friendly demeanours, involving patients in decisions, and use of clear, simple language. Conclusion Doctor-patient communication must be improved for older adults with complex needs. Addressing key barriers—such as limited consultation time and insufficient communication training—may enhance patient understanding and outcomes.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"1 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145673638","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/afaf318.114
Zubair Mughal, Kuruvilla Sebastian, Ali Sibtain Azhar, Abdirahman Shiekh Mohamed, Ahmed Gabr, Yousuf Ibrahim, Tala Abdelatif, Adlin Wahab, Donatas Galickas, Ming Cheun Chong, Aneesa Mangalam, Jennita Ariaratnam, Nouman Niaz, Raihan Alheyali, Hye Won Yang, Natasha Slattery, Lisa Woodland, Ida Carroll, Claire Collins, Margaret O'Connor, Nora Cunningham, Virginie McCarty
Background Post-stroke mood disturbances are common, negatively impact recovery and quality of life and are amenable to treatment. The National Clinical Guidelines for Stroke 2023 recommended the routine assessment of mood as an essential component of comprehensive stroke management. A quality improvement (QI) project was initiated to standardise mood screening in 2022 at a university teaching hospital. Consensus was reached on a shared multidisciplinary team-based model for the implementation of the SODS (S: Sadness, O: Outlook, D: Decision-making, S: Sleep) mood screening tool, incorporating routine verification of mood screening completion at the weekly multidisciplinary team meeting. Patients screening positive were referred for psychological assessment. This audit aimed to evaluate the longer term impact on mood screening in the subsequent years 2023-2024. Methods This was a retrospective audit reviewing stroke admissions from 2022-2024 using data extracted from the HIPE database and Institutional Stroke Portal. All patients admitted with a confirmed diagnosis of stroke were included. Data collected included demographics, outcomes, and mood assessment completion. Descriptive analysis was conducted. Results A total of 1,624 stroke cases were reviewed: 512 in 2022, 561 in 2023, and 551 in 2024. Mood assessment completion rates were 71.7% (367/512) in 2022, 75.9% (426/561) in 2023, and 84.0% (463/551) in 2024. This is benchmarked to a mood screening rate of 34% nationally (2023). Conclusion This audit demonstrated a progressive improvement in mood assessment compliance following implementation of a QI project in 2022, highlighting the sustainability of such an initiative when supported by the multidisciplinary team and psychology resource. Other QI interventions could benefit from extending beyond educational initiatives to include elements such as process changes and protocols supported by multidisciplinary engagement and participation.
{"title":"Audit of Mood Assessment Post Stroke At a University Hospital","authors":"Zubair Mughal, Kuruvilla Sebastian, Ali Sibtain Azhar, Abdirahman Shiekh Mohamed, Ahmed Gabr, Yousuf Ibrahim, Tala Abdelatif, Adlin Wahab, Donatas Galickas, Ming Cheun Chong, Aneesa Mangalam, Jennita Ariaratnam, Nouman Niaz, Raihan Alheyali, Hye Won Yang, Natasha Slattery, Lisa Woodland, Ida Carroll, Claire Collins, Margaret O'Connor, Nora Cunningham, Virginie McCarty","doi":"10.1093/ageing/afaf318.114","DOIUrl":"https://doi.org/10.1093/ageing/afaf318.114","url":null,"abstract":"Background Post-stroke mood disturbances are common, negatively impact recovery and quality of life and are amenable to treatment. The National Clinical Guidelines for Stroke 2023 recommended the routine assessment of mood as an essential component of comprehensive stroke management. A quality improvement (QI) project was initiated to standardise mood screening in 2022 at a university teaching hospital. Consensus was reached on a shared multidisciplinary team-based model for the implementation of the SODS (S: Sadness, O: Outlook, D: Decision-making, S: Sleep) mood screening tool, incorporating routine verification of mood screening completion at the weekly multidisciplinary team meeting. Patients screening positive were referred for psychological assessment. This audit aimed to evaluate the longer term impact on mood screening in the subsequent years 2023-2024. Methods This was a retrospective audit reviewing stroke admissions from 2022-2024 using data extracted from the HIPE database and Institutional Stroke Portal. All patients admitted with a confirmed diagnosis of stroke were included. Data collected included demographics, outcomes, and mood assessment completion. Descriptive analysis was conducted. Results A total of 1,624 stroke cases were reviewed: 512 in 2022, 561 in 2023, and 551 in 2024. Mood assessment completion rates were 71.7% (367/512) in 2022, 75.9% (426/561) in 2023, and 84.0% (463/551) in 2024. This is benchmarked to a mood screening rate of 34% nationally (2023). Conclusion This audit demonstrated a progressive improvement in mood assessment compliance following implementation of a QI project in 2022, highlighting the sustainability of such an initiative when supported by the multidisciplinary team and psychology resource. Other QI interventions could benefit from extending beyond educational initiatives to include elements such as process changes and protocols supported by multidisciplinary engagement and participation.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"6 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145673640","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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