The Association of Regular Dog Walking with Mobility, Falls and Fear of Falling in Later Life.

Background: It has been suggested that dog walking may protect against falls and mobility problems in later life, but little work to date has examined this.The aim of this study was to assess if regular dog walking was associated with reduced likelihood of falls, fear of falling and mobility problems in a large cohort of community-dwelling older people.

Methods: Participants ≥60 years at Wave 5 of The Irish Longitudinal Study on Ageing were included.

Implementation and evaluation of a navigation program for people with cancer in old age and their family caregivers: study protocol for the EU NAVIGATE International Pragmatic Randomized Controlled Trial.

Background: Cancer navigation programs aim to support, educate, and empower patients and families, addressing barriers to diagnostics, treatment, and care. Navigators engage with people to ensure timely access to services and resources. While promising for older people with cancer, these programs are scarce in Europe, and research on their effectiveness and implementation is limited.

Inpatient referrals to a specialist falls and syncope service: prevalence of STOPPFall FRIDs and review of deprescribing patterns.

Purpose: Falls are the commonest cause of accidental death in older people and the most frequent reason for their presentation to hospital. The Screening Tool of Older Persons Prescriptions in older adults with high falls risk (STOPPFall) facilitates deprescribing by providing a clear consensus on which medications are considered fall-risk-increasing drugs (FRIDs). This study aimed to determine the prevalence of STOPPFall FRIDs in inpatients referred to a falls and syncope service (FASS).

The Association between Psychotropic Medication Use and Gait and Mobility Impairment in Community-Dwelling Older People. Data from The Irish Longitudinal Study on Ageing (TILDA).

Background: Little work to date has quantified the effect of psychotropic medications (antidepressants, benzodiazepines, 'Z' drugs, antipsychotics, anticholinergics) on mobility and gait in later life. The aim of this study is to examine the relationship between these medications and mobility/gait parameters in a large cohort of community-dwelling older people.

Methods: Participants were included if they were ≥60 years at TILDA Wave 1 and underwent gait and mobility assessment (Gaitrite system), with follow-up at Wave 3 (4 years).

Psychotropic medication use and future unexplained and injurious falls and fracture amongst community-dwelling older people: data from TILDA.

Purpose: Psychotropic medications (antidepressants, anticholinergics, benzodiazepines, 'Z'-drugs and antipsychotics) are frequently identified as Falls Risk Increasing Drugs. The aim of this study is to clarify the association of psychotropic medication use with future falls/fracture amongst community-dwelling older people.

Methods: Participants ≥ 65 years from TILDA were included and followed from Waves 1 to 5 (8-year follow-up).

The 'Bermuda Triangle' of orthostatic hypotension, cognitive impairment and reduced mobility: prospective associations with falls and fractures in The Irish Longitudinal Study on Ageing.

Background: Orthostatic hypotension (OH), cognitive impairment (Cog) and mobility impairment (MI) frequently co-occur in older adults who fall. This study examines clustering of these three geriatric syndromes and ascertains their relationship with future falls/fractures in a large cohort of community-dwelling people ≥ 65 years during 8-year follow-up.

Methods: OH was defined as an orthostatic drop ≥ 20 mmHg in systolic blood pressure (from seated to standing) and/or reporting orthostatic unsteadiness.

Asymptomatic orthostatic hypotension and risk of falls in community-dwelling older people.

Introduction: Many older people with orthostatic hypotension (OH) may not report typical symptoms of dizziness, light-headedness or unsteadiness. However, the relationships between OH and falls in the absence of typical symptoms are not yet established.

Methods: Continuous orthostatic blood pressure (BP) was measured during active stand using a Finometer at Wave 1 of The Irish Longitudinal Study on Ageing in participants aged ≥ 70 years.

Hypotensive unawareness in Parkinson's disease-related autonomic dysfunction.

This case demonstrates how orthostatic hypotension in the absence of typical symptoms of light-headedness/dizziness when changing posture, can contribute to the burden of falls in Parkinson's disease. At least one-third of people with severe orthostatic hypotension do not report typical symptoms, and this figure appears to be higher in patients with Parkinson's disease. This is important clinically as it can increase the difficulty in ascribing falls to orthostatic hypotension, especially given the other competing reasons in Parkinson's disease and orthostatic hypotension symptoms can act as a prompt for the patient to act to prevent falls-related injuries.

Deprescribing practices, habits and attitudes of geriatricians and geriatricians-in-training across Europe: a large web-based survey.

Purpose: To provide an overview of the current deprescribing attitudes, practices, and approaches of geriatricians and geriatricians-in-training across Europe.

Methods: An online survey was disseminated among European geriatricians and geriatricians-in-training. The survey comprised Likert scale and multiple-choice questions on deprescribing approaches and practices, deprescribing education and knowledge, and facilitators/barriers of deprescribing.

Scoring the Clinical Frailty Scale in the Emergency Department: The Home FIRsT Experience.

We evaluated predictors of the Clinical Frailty Scale (CFS) scored by an interdisciplinary team (Home FIRsT) performing comprehensive geriatric assessment (CGA) in our Emergency Department (ED). This was a retrospective observational study (service evaluation) utilising ED-based CGA data routinely collected by Home FIRsT between January and October 2020. A linear regression model was computed to establish independent predictors of CFS.

What factors are associated with advance care planning in community-dwelling older people? Data from TILDA.

Purpose: To assess advance care planning (ACP) in a large population-representative sample of older people.

Methods: At Wave 4 of the Irish Longitudinal Study on Ageing, participants were asked: Have you made your wishes/preferences known about the kind of care that you would like to receive in the event of serious illness?

Results: One quarter (1153/4831) had discussed ACP. Of those, 90% had discussed with family/friends, 10% documented ACP in writing, while 2% had discussed with a healthcare professional.

Trends in emergency department use by older people during the COVID-19 pandemic.

Purpose: Reports suggest that many older people deferred seeking healthcare during the COVID-19 pandemic due to fear of contracting COVID-19. The aim of this study was to examine trends of emergency department (ED) use by older people during the first wave of the COVID-19 pandemic compared to previous years.

Methods: The study site is a 1000-bed university teaching hospital with annual ED new-patient attendance of > 50,000.

A systematic scoping review of interventions to optimise medication prescribing and adherence in older adults with cancer.

Background: Older adults with cancer often require multiple medications (polypharmacy) comprising cancer-specific treatments, supportive care medications (e.g. analgesics), and medications for pre-existing health conditions.

Potentially inappropriate medication (PIM) use and severe drug interactions (SDIs) in older adults with cancer.

Background: Older adults with cancer frequently have other co-morbidities requiring prescription pharmacotherapy. The objectives of this study were to identify the prevalence of potentially inappropriate medications (PIMs), severe drug interactions (SDIs) and associated risk factors in these patients.

Materials And Methods: This twelve-month prospective observation study was conducted at an Irish Hospital.

Delayed Blood Pressure Recovery After Standing Independently Predicts Fracture in Community-Dwelling Older People.

Objectives: Orthostatic hypotension, characterized by delayed blood pressure (BP) recovery after standing, is a risk factor for falls but the longitudinal relationship with fracture is not yet known. The aim of this study was to examine the prospective risk of fracture associated with delayed BP recovery.

Design: Longitudinal study with 8-year follow-up.

Physical and mental health of older people while cocooning during the COVID-19 pandemic.

Background: Cocooning or shielding, i.e. staying at home and reducing face-to-face interaction with other people, was an important part of the response to the COVID-19 pandemic for older people.

Impact of a specialist service in the Emergency Department on admission, length of stay and readmission of patients presenting with falls, syncope and dizziness.

Background: Up to half of patients presenting with falls, syncope or dizziness are admitted to hospital. Many are discharged without a clear diagnosis for their index episode, however, and therefore a relatively high risk of readmission.

Aim: To examine the impact of ED-FASS (Emergency Department Falls and Syncope Service) a dedicated specialist service embedded within an ED, seeing patients of all ages with falls, syncope and dizziness.

Prevention of adverse drug reactions in hospitalized older patients with multi-morbidity and polypharmacy: the SENATOR* randomized controlled clinical trial.

Background: Multi-morbidity and polypharmacy increase the risk of non-trivial adverse drug reactions (ADRs) in older people during hospitalization. Despite this, there are no established interventions for hospital-acquired ADR prevention.

Methods: We undertook a pragmatic, multi-national, parallel arm prospective randomized open-label, blinded endpoint (PROBE) controlled trial enrolling patients at six European medical centres.

Interventions to optimise medication prescribing and adherence in older people with cancer: A systematic scoping review.

Background: Older adults with cancer often require multiple medications including cancer-specific treatments and supportive care medications (e.g. analgesics), as well as medications for pre-existing medical conditions.

Reducing inappropriate prescribing for older adults with advanced frailty: A review based on a survey of practice in four countries.

The management of medications in persons with frailty presents challenges. There is evidence of inappropriate prescribing and a lack of consensus among healthcare professionals on the judicious use of medications, particularly for patients with more severe frailty. This study reviews the evidence on the use of commonly prescribed pharmacological treatments in advanced frailty based on a questionnaire of prescribing practices and attitudes of healthcare professionals at different stages in their careers, in different countries.

Adverse Drug Reactions in an Oncological Population: Prevalence, Predictability, and Preventability.

Background: Our goal was to determine (a) the prevalence of multimorbidity and polypharmacy in patients with cancer and (b) the prevalence, predictability, and preventability of adverse drug reactions (ADRs) causing/contributing to hospitalization.

Materials And Methods: We conducted a 12-month prospective observational study of patients aged ≥16 years admitted to an oncology center. Older adults were aged ≥70 years.

The effect of SENATOR (Software ENgine for the Assessment and optimisation of drug and non-drug Therapy in Older peRsons) on incident adverse drug reactions (ADRs) in an older hospital cohort - Trial Protocol.

Background: The aim of this trial is to evaluate the effect of SENATOR software on incident, adverse drug reactions (ADRs) in older, multimorbid, hospitalized patients. The SENATOR software produces a report designed to optimize older patients' current prescriptions by applying the published STOPP and START criteria, highlighting drug-drug and drug-disease interactions and providing non-pharmacological recommendations aimed at reducing the risk of incident delirium.

Methods: We will conduct a multinational, pragmatic, parallel arm Prospective Randomized Open-label, Blinded Endpoint (PROBE) controlled trial.