Reformulation of Processed Yogurt and Breakfast Cereals over Time: A Scoping Review.

Poor diet is responsible for a quarter of European non-communicable disease (NCD)-related deaths. The reformulation of sugar, salt, and saturated fat in processed packaged foods offers an opportunity to reduce consumption of nutrients of concern and also support a reduction in energy intake. To date, there have been no publications measuring progress in food reformulation by compiling published evidence for a food category.

Towards identifying malnutrition among infants under 6 months: a mixed-methods study of South-Sudanese refugees in Ethiopia.

Objectives: To determine (i) whether distinct groups of infants under 6 months old (U6M) were identifiable as malnourished based on anthropometric measures and if so to determine the probability of admittance to GOAL Ethiopia's Management of At Risk Mothers and Infants (MAMI) programme based on group membership; (ii) whether there were discrepancies in admission using recognised anthropometric criteria, compared with group membership and (iii) the barriers and potential solutions to identifying malnutrition within U6M.

Design: Mixed-methods approaches were used, whereby data collected by GOAL Ethiopia underwent: factor mixture modelling, χ2 analysis and logistic regression analysis. Qualitative analysis was performed through coding of key informant interviews.

Deprescribing in older people.

Polypharmacy and multimorbidity are both currently rising. The number of medicines taken is the single biggest predictor of adverse drug events. Deprescribing is an approach to managing polypharmacy and reducing adverse outcomes.

Medication prescribing in frail older people.

Purpose: While some people remain fit and active as they grow older, others experience complex problems: disease, dependency and disability. Frailty is a term used to describe this latter group, capturing differences in health status among older people. Many frail older people have multiple chronic co-morbidities and functional impairments and, according to guidelines for the management of individual conditions, should be prescribed long lists of medications.

Dyspnoea and mortality in older people in the community: a 10-year follow-up.

Background: examine baseline dyspnoea and subsequent 10-year mortality adjusting for age and gender and determine whether dyspnoea is related to early or late mortality or both. Examine the relationship between dyspnoea and mortality adjusting for confounding effects of underlying diseases.

Methods: we sent modified Medical Research Council (MRC) dyspnoea questionnaire to identify breathlessness in 1,404 randomly selected subjects from general practitioner lists of 5,002 subjects aged 70 years and over living in the community.

The impact of frailty and delirium on mortality in older inpatients.

Background: delirium and frailty are common among hospitalised older people but delirium is often missed and frailty considered difficult to measure in clinical practice.

Objective: to explore the relationship between delirium and frailty in older inpatients and determine their impact on survival.

Design And Setting: the prospective cohort study of 273 patients aged ≥75 years.

Improving recruitment of older people to research through good practice.

There is widespread evidence both of the exclusion of older people from clinical research, and of under-recruitment to clinical trials. This review and opinion piece provides practical advice to assist researchers both to adopt realistic, achievable recruitment rates and to increase the number of older people taking part in research. It analyses 14 consecutive recently published trials, providing the number needed to be screened to recruit one older participant (around 3:1), numbers excluded (up to 49%), drop out rates (5-37%) and whether the planned power was achieved.

Chemotherapy options in elderly and frail patients with metastatic colorectal cancer (MRC FOCUS2): an open-label, randomised factorial trial.

Background: Elderly and frail patients with cancer, although often treated with chemotherapy, are under-represented in clinical trials. We designed FOCUS2 to investigate reduced-dose chemotherapy options and to seek objective predictors of outcome in frail patients with advanced colorectal cancer.

Methods: We undertook an open, 2 × 2 factorial trial in 61 UK centres for patients with previously untreated advanced colorectal cancer who were considered unfit for full-dose chemotherapy.

Hospital use, institutionalisation and mortality associated with delirium.

Background: Delirium is a disorder affecting consciousness, which gives rise to core clinical features and associated symptoms. Older patients are particularly prone, owing to higher rates of pre-existing cognitive impairment, frailty, co-morbidity and polypharmacy.

Objectives: The aim of this study was to investigate the hypotheses that delirium affects the most vulnerable older adults and is associated with long-term adverse health outcome.

Anaemia in older people with chronic heart failure: The potential cost.

Studies suggest benefits from correcting anaemia in heart failure using a combination of erythropoiesis-stimulating agents (ESAs) and intravenous iron. We set out to investigate the number of older patients who would require treatment of anaemia in a large teaching hospital in the United Kingdom and the cost implications. The prevalence of anaemia and chronic kidney disease (CKD) in patients 65 years and older with systolic dysfunction attending the local heart failure clinic was determined.

Inflammation and frailty measures in older people.

Inflammation in patients defined as frail by Fried's phenotypic definition may be related to sarcopenia. This study aimed to investigate inflammation in older patients across different frailty criteria. Frailty status was determined in 110 patients aged over 75 years (mean 83.

Guidance for the assessment of pain in older adults: a literature review.

This paper presents guidance for the assessment of pain in older adults, which was developed as a collaborative project by the British Pain Society and the British Geriatric Society. The guidance was published in November 2007 and was designed to provide health professionals with practical skills to assess pain as the first step towards its effective management. The guidance did not seek to differentiate between acute and persistent pain as the literature relating to pain in older people renders such distinction impractical.

Plasma esterases and inflammation in ageing and frailty.

Objectives: Esterases are enzymes of drug metabolism known to be reduced in frail older people and during acute illness. The mechanism for this is unknown. The aim of this study was to examine esterase activity and inflammation in ageing and frailty.

Potential adverse effects of bronchodilators in the treatment of airways obstruction in older people: recommendations for prescribing.

Asthma and chronic obstructive pulmonary disease (COPD) are common disorders that are associated with increasing morbidity and mortality in older people. Bronchodilators are used widely in patients with these conditions, but even when used in inhaled form can have systemic as well as local effects. Older people experience more adverse drug effects because of pharmacodynamic and pharmacokinetic changes and particularly drug-drug and drug-disease interactions.

Nutrition, inflammation, and leptin levels in aging and frailty.

Objectives: To examine nutritional indices and levels of leptin and inflammatory markers across age and frailty.

Design: Observational study.

Setting: Continuing care wards and a day hospital in Cardiff, South Wales, United Kingdom.

Overcoming gaps in the management of asthma in older patients: new insights.

Asthma is under-recognised and undertreated in older populations. This is not surprising, given that one-third of older people experience significant breathlessness. The differential diagnosis commonly includes asthma, chronic obstructive pulmonary disease (COPD), heart failure, malignancy, aspiration and infections.

Enzymes of drug metabolism during delirium.

Background: Delirium is common in ill medical patients. Several drugs and polypharmacy are recognised risk factors, yet little is known about drug metabolism in people with delirium.

Objective: The aim of this study was to investigate the activities of plasma esterases (drug metabolising enzymes) in delirium.

The ageing of the population: implications for multidisciplinary care in hospital.

Background: Comprehensive geriatric assessment and multidisciplinary intervention are of proven benefit in the care of older people.

Objective: To determine whether patients' multidisciplinary needs in hospital can be met by current service provision.

Design: A comprehensive census assessing the multidisciplinary needs of an entire inpatient population compared to available multidisciplinary therapy time.

Left ventricular systolic dysfunction and atrial fibrillation in older people in the community--a need for screening?

Background: Heart failure and stroke are major causes of morbidity and mortality in older people. Angiotensin converting enzyme inhibitors improve symptoms and survival in left ventricular systolic dysfunction. Anticoagulants are effective in stroke prevention in atrial fibrillation with aspirin being a less effective alternative.