The effect of perindopril on postural instability in older people with a history of falls-a randomised controlled trial.

Design: double-blind, parallel group, placebo-controlled randomised trial.

Methods: we recruited people aged >65 years with at least one fall in the previous year. Participants received 4 mg perindopril or placebo daily for 15 weeks.

Factors associated with change in objectively measured physical activity in older people - data from the physical activity cohort Scotland study.

Background: Cross-sectional relationships between physical activity and health have been explored extensively, but less is known about how physical activity changes with time in older people. The aim of this study was to assess baseline predictors of how objectively measured physical activity changes with time in older people.

Methods: Longitudinal cohort study using data from the Physical Activity Cohort Scotland.

How active are women who play bingo: a cross-sectional study from the Well!Bingo project.

Background: The benefits of physical activity are well established, yet large numbers of people are not sufficiently active to gain health benefits. Certain population groups are less physically active than others, including older women from areas of high economic deprivation. The Well!Bingo project was established with the aim of engaging such women in the development of a health promotion intervention in a bingo club.

Association between bisphosphonate therapy and outcomes from rehabilitation in older people.

Background: Bisphosphonate therapy may have actions beyond bone, including effects on cardiovascular, immune and muscle function. We tested whether bisphosphonate treatment is associated with improved outcomes in older people undergoing inpatient rehabilitation.

Methods: Analysis of prospectively collected, linked routine clinical datasets.

Sufficient levels of 25-hydroxyvitamin D and protein intake required to increase muscle mass in sarcopenic older adults - The PROVIDE study.

Background: Inadequate nutritional intake and altered response of aging muscles to anabolic stimuli from nutrients contribute to the development of sarcopenia. Nutritional interventions show inconsistent results in sarcopenic older adults, which might be influenced by their basal nutritional status.

Objective: To test if baseline serum 25-hydroxyvitamin D (25(OH)D) concentrations and dietary protein intake influenced changes in muscle mass and function in older adults who received nutritional intervention.

Association between GDF-15 levels and changes in vascular and physical function in older patients with hypertension.

Background: Growth differentiation factor-15 (GDF-15) may be a biomarker of disease, protective response and/or prognosis, in older people with hypertension.

Aims: To correlate baseline GDF-15 levels with physical and vascular health data in this population.

Methods: Baseline blood samples were analysed using a GDF-15 ELISA assay kit.

Slower Decline in C-Reactive Protein after an Inflammatory Insult Is Associated with Longer Survival in Older Hospitalised Patients.

Background: Enhancing biological resilience may offer a novel way to prevent and ameliorate disease in older patients. We investigated whether changes in C-reactive protein (CRP), as a dynamic marker of the acute inflammatory response to diverse stressors, may provide a way to operationalize the concept of resilience in older adults. We tested this hypothesis by examining whether such changes could predict prognosis by identifying which individuals are at greater risk of 6-month mortality.

Validation of the AX3 triaxial accelerometer in older functionally impaired people.

Background: Studying physical activity (PA) trends in older populations and potential interventions for increasing PA is important, as PA is a factor in many age-related health outcomes such as chronic disease, premature mortality, physical function and injuries from falls. Objective measures of PA provide valuable information regarding the functional impact that ageing and chronic disease states may have on a patient's life.

Aims: The purpose of this study was to test the validity of the AX3 PA monitor in an older population and to investigate whether the AX3 is a valid measure of distinct types or levels of activity in older people with a spectrum of mobility.

Accessing and engaging women from socio-economically disadvantaged areas: a participatory approach to the design of a public health intervention for delivery in a Bingo club.

Background: Our aim was to use participatory methods to investigate the feasibility and acceptability of using Bingo clubs for the design and delivery of an evidence-based physical activity and/or healthy eating intervention to socio-economically disadvantaged women. This paper describes the participatory process that has resulted in a physical activity intervention for women aged >55 years, ready for pilot-testing in a Bingo club setting.

Methods: Studies using different quantitative and qualitative approaches were conducted among customers and staff of a Bingo club in a city of 85,000 inhabitants in central Scotland.

Association between allopurinol use and hip fracture in older patients.

Background: Allopurinol reduces oxidative stress and interacts with purinergic signalling systems important in bone metabolism and muscle function. We assessed whether allopurinol use was associated with a reduced incidence of hip fracture in older people.

Methods: Analysis of prospective, routinely-collected health and social care data on patients undergoing health and social work assessment in a single geographical area over a 12year period.

Hospital-acquired pneumonia incidence and diagnosis in older patients.

Background: hospital-acquired pneumonia poses a hazard to older people who are hospitalised, yet few data exist on the incidence or risk factors in non-intensive care patients. This study aimed to determine the incidence of hospital-acquired pneumonia (HAP) in a sample of hospitalised older people.

Methods: prospective survey of hospitalised older patients (>65 years) at a single centre over a 12-month period.

Spironolactone for People Age 70 Years and Older With Osteoarthritic Knee Pain: A Proof-of-Concept Trial.

Objective: To determine whether spironolactone could benefit older people with osteoarthritis (OA), based on a previous study showing that spironolactone improved quality of life.

Methods: This parallel-group, randomized, placebo-controlled, double-blind trial randomized community-dwelling people ages ≥70 years with symptomatic knee OA to 12 weeks of 25 mg daily oral spironolactone or matching placebo. The primary outcome was between-group difference in change in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale scores.

Does oral sodium bicarbonate therapy improve function and quality of life in older patients with chronic kidney disease and low-grade acidosis (the BiCARB trial)? Study protocol for a randomized controlled trial.

Background: Metabolic acidosis is more common with advancing chronic kidney disease, and has been associated with impaired physical function, impaired bone health, accelerated decline in kidney function and increased vascular risk. Although oral sodium bicarbonate is widely used to correct metabolic acidosis, there exist potential risks of therapy including worsening hypertension and fluid overload. Little trial evidence exists to decide whether oral bicarbonate therapy is of net benefit in advanced chronic kidney disease, particularly in older people who are most commonly affected, and in whom physical function, quality of life and vascular health are at least as important outcomes as decline in renal function.

Effects of a vitamin D and leucine-enriched whey protein nutritional supplement on measures of sarcopenia in older adults, the PROVIDE study: a randomized, double-blind, placebo-controlled trial.

Background: Age-related losses of muscle mass, strength, and function (sarcopenia) pose significant threats to physical performance, independence, and quality of life. Nutritional supplementation could positively influence aspects of sarcopenia and thereby prevent mobility disability.

Objective: To test the hypothesis that a specific oral nutritional supplement can result in improvements in measures of sarcopenia.

Association between kidney function, rehabilitation outcome, and survival in older patients discharged from inpatient rehabilitation.

Background: Chronic kidney disease (CKD) is common in older people, but it is unclear if it affects survival and rehabilitation outcomes independent of comorbid conditions and physical function in this population.

Study Design: Cohort analysis of prospective, routinely collected, linked clinical data sets.

Setting & Participants: Patients discharged from a single inpatient geriatric rehabilitation center over a 12-year period.

Psychoactive prescribing for older people--what difference does 15 years make?

Objective: The objective of the study was to review prescribing of psychoactive medications for older residents of the Tayside region of Scotland.

Methods: The analysis used community prescribing data in 1995 and 2010 for all older residents in Tayside. For each psychoactive drug class, the name of the most recently prescribed drug and the date prescribed were extracted.

The role of perceived barriers and objectively measured physical activity in adults aged 65-100.

Objective: to test the predictive utility of perceived barriers to objectively measured physical activity levels in a stratified sample of older adults when accounting for social-cognitive determinants proposed by the Theory of Planned Behaviour (TPB), and economic and demographic factors.

Methods: data were analysed from the Physical Activity Cohort Scotland survey, a representative and stratified (65-80 and 80+ years; deprived and affluent) sample of 584 community-dwelling older people, resident in Tayside, Scotland. Physical activity was measured objectively by accelerometry.

Dog ownership and physical activity in later life: a cross-sectional observational study.

Objective: To examine whether dog ownership amongst community dwelling older adults (≥ 65 years) is associated with objectively measured physical activity (PA).

Methods: We used data from the Physical Activity Cohort Scotland (PACS) which consists of 547 people aged 65 and over, resident in the community in Tayside, Scotland. The data was collected in 2009-2011.

Effect of vitamin D supplementation on orthostatic hypotension: data from the vitamin D in isolated systolic hypertension randomized controlled trial.

Objective: Orthostatic hypotension commonly accompanies supine hypertension, and is associated with low 25-hydroxyvitamin D levels. We tested whether high-dose intermittent oral vitamin D therapy could ameliorate orthostatic hypotension in older patients with isolated systolic hypertension.

Methods: We conducted a subgroup analysis of data from a parallel-group, double-blind, randomized, placebo-controlled trial.

ACE inhibitors, statins and thiazides: no association with change in grip strength among community dwelling older men and women from the Hertfordshire Cohort Study.

Background: vascular disease has been postulated to contribute to muscle dysfunction in old age. Previous studies examining the effects of cardiovascular drugs on muscle function have shown conflicting results. We therefore examined the association of angiotensin converting enzyme (ACE) inhibitor, thiazide and statin use with decline in grip strength in a well-characterised cohort.

Association of day length and weather conditions with physical activity levels in older community dwelling people.

Background: Weather is a potentially important determinant of physical activity. Little work has been done examining the relationship between weather and physical activity, and potential modifiers of any relationship in older people. We therefore examined the relationship between weather and physical activity in a cohort of older community-dwelling people.

A qualitative theory guided analysis of stroke survivors' perceived barriers and facilitators to physical activity.

Purpose: After stroke, physical activity and physical fitness levels are low, impacting on health, activity and participation. It is unclear how best to support stroke survivors to increase physical activity. Little is known about the barriers and facilitators to physical activity after stroke.

Temporal trends in anticholinergic medication prescription in older people: repeated cross-sectional analysis of population prescribing data.

Background: in older people, medications with anticholinergic (antimuscarinic) effects are associated with adverse clinical outcomes, the risk increasing with increasing anticholinergic exposure. Many anticholinergics are recognised as potentially inappropriate and efforts to reduce prescription have been ongoing. We examined temporal trends of anticholinergic prescription and exposure in older people.