A5029912623- Frailty in Older Adults
- Health Systems, Economic Evaluations, Quality of Life
- Nutrition and Health in Aging
- Intensive Care Unit Cognitive Disorders
- Geriatric Care and Nursing Homes
- Global Health Care Issues
- Anesthesia and Sedative Agents
- Anesthesia and Neurotoxicity Research
- SARS-CoV-2 and COVID-19 Research
- COVID-19 Clinical Research Studies
- Long-Term Effects of COVID-19
- Chronic Disease Management Strategies
- Family and Patient Care in Intensive Care Units
- Dementia and Cognitive Impairment Research
- Atrial Fibrillation Management and Outcomes
- Pharmaceutical Practices and Patient Outcomes
- Dialysis and Renal Disease Management
- Infective Endocarditis Diagnosis and Management
- Healthcare cost, quality, practices
- Occupational and environmental lung diseases
- Blood Pressure and Hypertension Studies
- Migration, Aging, and Tourism Studies
- Body Composition Measurement Techniques
- Alcoholism and Thiamine Deficiency
- Hormonal and reproductive studies
Dalhousie University
2010-2024
Queen Elizabeth II Health Sciences Centre
2009-2024
Nova Scotia Health Authority
2019-2024
MRC Unit for Lifelong Health and Ageing
2019-2023
University College London
2019-2023
Medical Research Council
2021-2022
University of London
2022
University College London Hospitals NHS Foundation Trust
2020
Institute of Informatics of the Slovak Academy of Sciences
2020
Capital District Health Authority
2008-2015
Abstract Background Frailty can be measured in relation to the accumulation of deficits using a frailty index. A index developed from most ageing databases. Our objective is systematically describe standard procedure for constructing Methods This secondary analysis Yale Precipitating Events Project cohort study, based New Haven CT. Non-disabled people aged 70 years or older (n = 754) were enrolled and re-contacted every 18 months. The database includes variables on function, cognition,...
the Clinical Frailty Scale (CFS) was originally developed to summarise a Comprehensive Geriatric Assessment and yield care plan. Especially since COVID-19, CFS is being used widely by health professionals without training in frailty as resource allocation tool for rationing. scoring inexperienced raters might not always reflect expert judgement. For these raters, we new classification tree assist with routine scoring. Here, test that against clinical scoring.we examined agreement between...
Abstract Background The frailty index is commonly used in research and clinical practice to quantify health. Using a health deficit accumulation model, can be calculated retrospectively from data collected via survey, interview, performance test, laboratory report, or administrative medical record, any combination of these. Here, we offer detailed 10-step approach creation, with worked example. Methods We identified 10 steps guide the creation valid reliable index. then waves 5 12 Health...
Atrial fibrillation (AF) is common in older people with frailty and associated an increased risk of stroke systemic embolism. Whilst oral anticoagulation a reduction this risk, there lack data on the safety efficacy direct anticoagulants (DOACs) frailty. This study aims to report clinical outcomes patients AF Effective Anticoagulation Factor Xa Next Generation Fibrillation-Thrombolysis Myocardial Infarction 48 (ENGAGE AF-TIMI 48) trial by status.
There is an unmet public health need to understand better the relationship between baseline cognitive function, occurrence and severity of delirium, subsequent decline. Our aim was quantify cognition delirium follow-up impairment.
OBJECTIVES: To investigate how changes in frailty status and mortality risk relate to baseline state, mobility performance, age, sex. DESIGN: Cohort study. SETTING: The Yale Precipitating Events Project, New Haven, Connecticut. PARTICIPANTS: Seven hundred fifty-four community-dwelling people aged 70 older at followed up 18, 36, 54 months. MEASUREMENTS: Frailty status, assessed 18-month intervals, was defined using a index (FI) as the number of deficits 36 health variables. Mobility time...
Concern has been expressed that preventive measures in older people might increase frailty by increasing survival without improving health. We investigated the impact of exercise on probabilities health improvement, deterioration and death community-dwelling people.In Canadian Study Health Aging, status was measured a index based number deficits. Exercise classified as either high or low/no exercise, using validated, self-administered questionnaire. were re-assessed at 5 years. Of 6297...
Clinical and research interest in delirium has been rising over the last 15 years. The Scottish Intercollegiate Guidelines Network (SIGN) publication on is a state-of-the-art synthesis of field, first UK guideline since 2010. There new guidance around detection, particularly recommending 4 'A's Test (4AT). 4AT advantage being brief, embeds operationalises cognitive testing, scalable with little training. guidelines highlight importance non-pharmacological management for all hospital...
Acutely ill and frail older adults have complex social health care needs. It is important to understand how this complexity affects acute outcomes for admission hospital. We validated a frailty index using routine laboratory tests with after patients were admitted hospital.In prospective cohort of large tertiary hospital in the United Kingdom, we created from investigations (FI-Laboratory) linked data comprising outcomes. evaluated association between FI-Laboratory total days spent hospital,...
Older adults have been disproportionately affected by the COVID-19 pandemic, with many outbreaks occurring in Long Term Care Facilities (LTCFs). We discuss this vulnerability among LTCF residents using an ecological framework, on levels spanning from individual to families and caregivers, institutions, health services systems, communities, contextual government policies. Challenges abound for fully understanding burden of LTCF, including differences nomenclature, data collection cultural...
OBJECTIVES: To explore the associations between frailty and reproductive axis hormones (as an important regulatory system) in middle aged older men. DESIGN: Cross-sectional. SETTING: The European Male Aging Study. PARTICIPANTS: Three thousand two hundred nineteen community-dwelling men 40 to 79. MEASUREMENTS: Interviewer-assisted questionnaires assess physical activity, health status, mood were administered. Testosterone (T), luteinizing hormone (LH), follicle-stimulating (FSH),...
Objectives: To evaluate the impact of Animated Pancreas Patient (APP), pediatric focused online educational modules on patient and caregiver education. Methods: Retrospective study collected APP metrics over 6 years. The audience reach geographic location to site were assessed. Further, we data top 5 viewed expert videos evaluated these provider education through viewer surveys. Results: There 226,772 visitors Pediatric NPF website They 310,068 times for an average 51,678 views/year. In...
Although delirium is a significant clinical and public health problem, little understood about how specific vulnerabilities underlie the severity of its presentation. Our objective was to quantify relationship between baseline cognition subsequent severity. We prospectively investigated population-representative sample 1510 individuals aged ≥70 years, whom 209 (13.6%) were hospitalized across 371 episodes (1999 person-days assessment). Baseline cognitive function assessed using modified...
Objectives: to evaluate the relationship between neurocognitive speed (NCS) and frailty; consider how this is affected by frailty operationalised. Design: secondary analysis of baseline cohort Oxford Project To Investigate Memory Aging (OPTIMA), a longitudinal observational cohort. Subjects: 388 participants who underwent comprehensive intake assessment followed an annual follow-up for at least 3 years, data on all measures were available 164 people. Measurements: NCS was defined as combined...
Abstract Introduction Life-space and frailty are closely linked to health-related quality of life understanding their inter-relationship could indicate potential intervention targets for improving life. We set out examine the relationship between life-space relative impact on measures. Methods Using cross-sectional data from a population-representative cohort people aged ≥ 70 years, we assessed with EuroQol Health Index tool (5-levels) (EQ-5D-5L). also undertook assessment derived index....
<h3>Background:</h3> Emergency departments are a last resort for some socially vulnerable patients without an acute medical illness (colloquially known as "socially admitted" patients), resulting in their occupation of hospital beds typically designated requiring care. In this study, we aimed to explore the perceptions health care providers regarding admitted "social admissions." <h3>Methods:</h3> This qualitative study was informed by grounded theory and involved semistructured interviews...
Reducing population levels of frailty is an important goal, and preventing its development in midadulthood could be pivotal. There limited evidence on associations between childhood socioeconomic position (SEP) frailty. Using data the 1958 British birth cohort (followed from to 2016; n = 8,711), we aimed 1) establish utility measuring midlife, by examining a 34-item index at age 50 years (FI50y) mortality ages 50-58 years, 2) examine early-life SEP FI50y investigate whether these were...
Abstract Introduction Frailty and socioeconomic position (SEP) are well‐established determinants of health. However, we know less about the contributions frailty SEP in older adults, especially acute settings. We set out to answer how might influence health outcomes people, comparing a population sample patients managed by speciality service. Methods used Delirium Population Health Informatics Cohort, 1510 individuals aged ≥70 years from London Borough Camden 1750 patients. was determined...
Abstract Background Respiratory viral illness (RVI)—e.g., influenza, COVID-19—is a serious threat in long-term care (LTC) facilities. Standard infection control measures are suboptimal LTC facilities because of residents’ cognitive impairments, needs, and susceptibility to loneliness mental illness. Further, residents living with high degrees frailty who contract RVIs often develop the so-called atypical symptoms (e.g., delirium, worse mobility) instead typical cough fever, delaying...