The systematic approach to improving care for Frail Older Patients (SAFE) study: A protocol for co-designing a frail older person's pathway.

: Frailty is the age-accelerated decline across multiple organ systems which leads to vulnerability to poor resolution of homeostasis after a stressor event. This loss of reserve means that a minor illness can result in a disproportionate loss of functional ability. Improving acute care for frail older patients is now a national priority and an important aspect of the National Programme for Older People in Ireland.

Depression: a modifiable factor in fearful older fallers transitioning to frailty?

Objective: Fear of falling is one of the most common fears among community-dwelling older people and is as serious a health problem as falls themselves. Understanding fear of falling in fallers transitioning to frailty may help us identify effective strategies to reduce it in this already vulnerable group of older people. Our aim was to evaluate the psychological factors associated with fear of falling in a group of fallers transitioning to frailty when compared with robust or non-frail fallers.

Frailty, depression, and anxiety in later life.

Background: Anxiety and depression are common in older people but are often missed; to improve detection we must focus on those elderly people at risk. Frailty is a geriatric syndrome inferring increased risk of poor outcomes. Our objective was to explore the relationship between frailty and clinically significant anxiety and depression in later life.

Orthostatic haemodynamics may be impaired in frailty.

Background: orthostatic hypotension (OH) is a physical sign that reflects a final common pathway of various forms of disordered physiology, which is the hallmark of geriatric frailty. Fried et al. recognise three increasing frailty phenotypes in older people, based on measurements of weight loss, exhaustion, grip strength, walking speed and physical activity.

Continuous noninvasive orthostatic blood pressure measurements and their relationship with orthostatic intolerance, falls, and frailty in older people.

Objectives: To identify morphological orthostatic blood pressure (BP) phenotypes in older people and assess their correlation with orthostatic intolerance (OI), falls, and frailty and to compare the discriminatory performance of a morphological classification with two established orthostatic hypotension (OH) definitions: consensus (COH) and initial (IOH).

Design: Cross-sectional.

Setting: Geriatric research clinic.

Seasonal variation of serum vitamin D and the effect of vitamin D supplementation in Irish community-dwelling older people.

Background: Ireland is at 53°N, and its population risk of vitamin D deficiency is high. Previous Irish studies suggested a significant seasonality of serum 25-hydroxyvitamin D [25(OH)D] and a beneficial effect of supplementation in raising 25(OH)D levels. However, in Irish older people, little is known about the magnitude of the supplementation effect and whether supplementation affects 25(OH)D seasonality.

Quantitative falls risk assessment using the timed up and go test.

Falls are a major problem in older adults worldwide with an estimated 30% of elderly adults over 65 years of age falling each year. The direct and indirect societal costs associated with falls are enormous. A system that could provide an accurate automated assessment of falls risk prior to falling would allow timely intervention and ease the burden on overstretched healthcare systems worldwide.

Using the Finometer to examine sex differences in hemodynamic responses to orthostasis in older people.

Objectives: In young and middle age, women have higher orthostatic intolerance (OI) than men, and hemodynamic differences have been found supporting this finding. In older people, these sex differences are less studied. Our aim was to contribute evidence.

Do older pedestrians have enough time to cross roads in Dublin? A critique of the Traffic Management Guidelines based on clinical research findings.

Background: the safety of older pedestrians at urban intersections is a matter of gerontological concern. Many older pedestrians report inability to complete crossings in the time given by pedestrian lights. Standard times for pedestrian lights in Dublin pelican crossings are specified in the Traffic Management Guidelines (TMG).

Intolerance to initial orthostasis relates to systolic BP changes in elders.

Objectives: To explore the association of early symptoms of orthostatic intolerance (OI) with systolic (SBP), diastolic (DBP) and mean arterial (MAP) blood pressure changes in a sample of community-dwelling older people undergoing an active stand test; and to establish whether SBP and DBP changes have different symptomatic correlates during early orthostasis.

Methods: A total of 224 community-dwelling older subjects (mean age 72.6 years, 68.