scholarly journals Assessing fitness to drive in dementia and other psychiatric conditions: a higher training learning opportunity at a driving assessment centre

2012 ◽  
Vol 36 (3) ◽  
pp. 113-116 ◽  
Author(s):  
Matthew P. Sheridan
Keyword(s):  
Older Adults ◽  
Driving Safety ◽  
Ageing Population ◽  
Fitness To Drive ◽  
Learning Opportunity ◽  
Professional Obligation ◽  
Assessment Centre ◽  
Psychiatric Conditions ◽  
Road Performance ◽  
The Uk

SummaryWith an ageing population and expected rise in cases of dementia, driving safety will become increasingly important. Doctors have a professional obligation to identify patients who are unsafe to drive and in cases of dementia this decision is often complex. As a result, many centres in the UK offer driving assessments for people with medical conditions that may affect their on-road performance. I aim to identify a valuable learning opportunity for psychiatrists in training, particularly those working with older adults, to improve their knowledge of driving assessment. I also provide an overview of the Scottish Driving Assessment Service and reflect on my visit there.

scholarly journals Innovative solutions to enhance safe and green environments for ageing well using stakeholder co-design.

2020 ◽  
Author(s):  
Anna L Hatton ◽  
Catherine Haslam ◽  
Sarah Bell ◽  
Joe Langley ◽  
Ryan Woolrych ◽  
...  
Keyword(s):  
Older Adults ◽  
Small Group ◽  
Social Connectedness ◽  
Interdisciplinary Approach ◽  
Human Movement ◽  
Evidence Base ◽  
Ageing Population ◽  
Physical Environments ◽  
Innovative Solutions ◽  
The Uk

Abstract Background There is a need to develop innovative solutions to enhance safe and green physical environments, which optimise health, wellbeing and community participation among older adults. In order to develop solutions that meet the needs of a diverse ageing population, an interdisciplinary approach is needed. Our aim was to identify the needs of older people in relation to ageing well in the environment by bringing together knowledge from different stakeholder and interdisciplinary perspectives. Methods An international consortium (Retrofit living For ageing well through Understanding and Redesign of Built environments consortium: ReFURB) was established in April 2018, including ten core members, to (i) explore cutting-edge solutions to safe living for ageing populations and (ii) develop innovative approaches to everyday physical environments, which bring about health benefits. We used a co-design, interdisciplinary framework involving older adults, carers, physiotherapists, geriatricians, engineers, human movement experts, geographers and psychologists from the UK and Australia. This engaged people in a one day workshop that comprised a series of presentations from international speakers on urban design, social connectedness, hazards and injury prevention, and the physical environment. Small group discussions (facilitated by consortium members) followed presentations to consider the opportunities, challenges and barriers encountered with ageing, which included the use of creative engagement activities (LEGO® Serious Play, mind maps, poster gallery walk), to help participants share personal stories and reflect on the issues raised. Thematic coding was used to synthesise the outputs of the small group work. Results Five themes emerged across the workshops, comprising: access and transport; involvement of the whole community; restoration rather than redesign; assistive and digital technology; and intergenerational approaches. These dimensions related to the physical, social and nature-based qualities of everyday environments, as they pertain to ageing well. Conclusions Co-design was a valuable tool that helped understand the perceptions of stakeholders and essential to develop effective interventions and solutions. Participants highlighted several issues affecting people as they age and key environmental considerations to promote wellbeing, activity, and participation. The consortium identified gaps in the existing evidence base and are now planning activities to further develop research ideas in collaboration with our co-design participants.

scholarly journals Defining the older patient population that require, but do not undergo emergency laparotomy: an observational cohort study protocol

2021 ◽  
Author(s):  
Nicola Reeves ◽  
Susan Chandler ◽  
Elizabeth McLennan ◽  
Angeline Price ◽  
Jemma Boyle ◽  
...  
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
Cohort Study ◽  
Emergency Laparotomy ◽  
Ageing Population ◽  
Older Patient ◽  
Vulnerable Patient ◽  
The Uk ◽  
National Emergency ◽  
Vulnerable Patient Group

<p><strong>Background: </strong>Despite older adults (65 years and above) accounting for almost half of emergency laparotomies and an ageing population, there remains a paucity of research in the older adult emergency surgery population. One key clinical area that requires urgent assessment is the older patient who presents with acute abdominal pathology treatable by laparotomy, but who does not undergo surgery (NoLAP). <strong></strong></p><p><strong>Methods: </strong>This multicentre prospective cohort study [defining the denominator: emergency laparotomy and frailty study 2 (ELF2)] will recruit consecutive older adults that require but do not undergo emergency laparotomy (NoLAP). We will recruit from 47 national health service hospitals over a 3-month timeframe. The same criteria as NELA for inclusion and exclusion will be applied. The primary aim is 90-day mortality. Secondary aims include characterisation of the NoLAP group, frailty and sarcopenia with comparison to those older adults that have undergone emergency laparotomy (ELAP). Decision-making will also be explored. Assuming a NoLAP rate of 32% and 10% dropout, a minimum of 700 patients are required for 95% power (alpha=0.05).</p><p><strong>Conclusions: </strong>The UK national emergency laparotomy audit has provided vital information on those patients undergoing emergency laparotomy and driven standards in operative and perioperative care. However, little is known of outcomes in those patients who do not undergo emergency laparotomy.  Improved understanding of this NoLAP population would aid shared decision-making and improve standards for this otherwise poorly understood vulnerable patient group.</p><p><strong>Trial registration:</strong> This study is registered online at www.clinicaltrial.gov (Reg number: ISRCTN14556210).</p><p><strong> </strong></p>

scholarly journals General practitioners’ attitudes and decision making regarding admission for older adults with infection: a UK qualitative interview study

2018 ◽  
Vol 36 (4) ◽  
pp. 493-500 ◽  
Author(s):  
Abigail Moore ◽  
Caroline Croxson ◽  
Sara McKelvie ◽  
Dan Lasserson ◽  
Gail Hayward
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
General Practitioners ◽  
Older Patients ◽  
Ageing Population ◽  
Structured Interviews ◽  
Suspected Infection ◽  
Qualitative Interview Study ◽  
System Factors ◽  
The Uk

Abstract Background The world has an ageing population. Infection is common in older adults; serious infection has a high mortality rate and is associated with unplanned admissions. In the UK, general practitioners (GPs) must identify which older patients require admission to hospital and provide appropriate care and support for those staying at home. Objectives To explore attitudes of UK GPs towards referring older patients with suspected infection to hospital, how they weigh up the decision to admit against the alternatives and how alternatives to admission could be made more effective. Methods. Qualitative study using semi-structured interviews. GPs were purposively sampled from across the UK to achieve maximum variation in terms of GP role, experience and practice population. Interview transcripts were coded and analysed using a modified framework approach. Results GPs’ key influences on decision making were grouped into patient, GP and system factors. Patient factors included clinical factors, social factors and shared decision making. GP factors included gut instinct, risk management and acknowledging an associated personal emotional burden. System factors involved weighing up the pressure on secondary care beds against increasing GP workload. GPs described that finding an alternative to admission could be more time consuming, complex to arrange or were restricted by lack of capacity. Conclusion GPs need to be empowered to make safe decisions about place of care for older adults with suspected infection. This may mean developing strategies to support decision making as well as improving the ease of access to, and capacity of, any alternatives to admission.

scholarly journals Improving indoor thermal comfort, air quality and the health of older adults through environmental policies in London

2021 ◽  
Vol 2069 (1) ◽  
pp. 012240
Author(s):  
I Tsoulou ◽  
J Taylor ◽  
P Symonds ◽  
N Mohajeri ◽  
M Davies
Keyword(s):  
Older Adults ◽  
Air Quality ◽  
Thermal Comfort ◽  
Rapid Assessment ◽  
Environmental Policies ◽  
Vulnerable Groups ◽  
Ageing Population ◽  
Quality Improvements ◽  
Indoor Thermal Comfort ◽  
The Uk

Abstract In this work we evaluate the potential of selected environmental strategies in reducing air pollution and summertime indoor overheating. Associated changes in mortality rates are also calculated for older adults in London. Reducing these risks for vulnerable groups is an immediate priority and given that seniors spend most of their time indoors, our focus is on strategies that prioritize the transformation of residential environments for indoor thermal comfort and air quality improvements. For each strategy, we develop specific scenarios related to building adaptations and test potential reductions on indoor overheating and pollutant exposures from outdoor sources (PM2.5), as well as on senior mortality through the CRAFT tool (Cities Rapid Assessment Framework for Transformation). We then pick the scenarios with highest impacts on mortality, aiming to formulate effective policy recommendations for Greater London. Preliminary results suggest that environmental policies related to the installation of shading could have the highest reduction in heat and pollution-related senior mortality, followed by moderate effects due to building insulation retrofits and the greening of roofs. With an increasing ageing population in the UK and beyond, our work highlights the need for city-level policies to address building modifications, considering the importance of indoor spaces for older adults.

Factors Associated With Fitness to Drive for Older Adults With Dementia or MCI: A Pilot Study

2021 ◽  
Vol 75 (Supplement_2) ◽  
pp. 7512505121p1-7512505121p1
Author(s):  
Susan L. Iliff ◽  
Christy S. Horner ◽  
Ryan Heuer ◽  
Kerri Reid ◽  
Kara Reed ◽  
...  
Keyword(s):  
Older Adults ◽  
Fitness To Drive ◽  
Factors Associated ◽  
Assessment Scores ◽  
The Road ◽  
Road Performance ◽  
Relationship Of ◽  
The Relationship ◽  
Vanderbilt University ◽  
Primary Author

Abstract Date Presented 04/21/21 This study examined the relationship of clinical and road portions of Vanderbilt University Medical Center's driver evaluation. Data were collected retrospectively on adults with mild cognitive impairment or dementia. Findings revealed a significant relationship between the driving recommendation and the road assessment scores but not the clinical scores. Results indicated a need for OT practitioners to explore clinical assessment methods to more accurately predict road performance for determining fitness-to-drive recommendations. Primary Author and Speaker: Susan L. Iliff Contributing Authors: Patricia Bowyer

NESTORE Ontology: a Multi-Domain Semantic Tool for the Characterization of Older Adults Status and Behaviour to Promote Healthy Ageing by IoT Systems (Preprint)

2020 ◽  
Author(s):  
Alfonso Mastropietro ◽  
Filippo Palumbo ◽  
Silvia Orte ◽  
Michele Girolami ◽  
Francesco Furfari ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Mental Status ◽  
Scientific Knowledge ◽  
Social Behaviour ◽  
Physical Activity Behaviour ◽  
Healthy Ageing ◽  
Physiological Status ◽  
Ageing Population ◽  
Activity Behaviour

BACKGROUND The constant progression in number and share of the ageing population will likely have deep effects in most of the industrialized countries. The Internet of Things (IoT) paradigm can play a key role in facilitating independent living of the ageing population thus trying to reduce the burden on the society. Considering that ageing is a multi-factorial physiological process, the development of novel IoT systems, tools and devices, specifically targeted to older people, must be based on a holistic framework built on robust scientific knowledge in different scientific domains. OBJECTIVE A novel semantic formalization was developed, based on a multidomain healthy ageing model, to support structuring and standardizing heterogeneous scientific knowledge about ageing. The main aim of the paper is to present the new NESTORE ontology, with the purpose thus extending the available ontologies provided by universAAL-IoT (uAAL-IoT). METHODS Well-assessed scientific knowledge, specifically selected to target older adults aged between 65 and 75, was formalized into a holistic model using a multi-domain approach including three main different dimensions related to well-being: (i) Physiological Status and Physical Activity Behaviour, (ii) Nutrition, and (iii) Cognitive and Mental Status and Social Behaviour. Based on this model, within the NESTORE H2020 project, a new ontology was developed in the uAAL-IoT framework, which provides modelling tools and a set of core ontologies. RESULTS The NESTORE ontologies cover all the needed concepts to represent 5 significant domains of ageing. In total, 12 sub-ontologies were modelled with more than 60 classes and sub-classes referenced among them by using more than 100 relations and around 20 enumerations. NESTORE increases the uAAL ontologies collection by 40% and expand the uAAL domain usage for Physiological Status and Physical Activity Behaviour (8 ontologies), Nutrition (3 ontologies) and Cognitive and Mental Status and Social Behaviour (4 ontologies). CONCLUSIONS NESTORE ontology provides innovation both in terms of semantic content and technological approach. The thoroughly use of this ontology can support the development of a decision support system, to promote healthy ageing, with the capacity to do dynamic multi-scale modelling of user-specific data based on the semantic annotations of users’ profile.

scholarly journals Observations from a small country: mental health policy, services and nursing in Wales

2021 ◽  
pp. 1-12
Author(s):  
Ben Hannigan
Keyword(s):  
Mental Health ◽  
Health Policy ◽  
Mental Health Policy ◽  
National Policy ◽  
Ageing Population ◽  
Small Country ◽  
Mental Health Nurses ◽  
Face To Face ◽  
Health Need ◽  
The Uk

Abstract Wales is a small country, with an ageing population, high levels of population health need and an economy with a significant reliance on public services. Its health system attracts little attention, with analyses tending to underplay the differences between the four countries of the UK. This paper helps redress this via a case study of Welsh mental health policy, services and nursing practice. Distinctively, successive devolved governments in Wales have emphasised public planning and provision. Wales also has primary legislation addressing sustainability and future generations, safe nurse staffing and rights of access to mental health services. However, in a context in which gaps always exist between national policy, local services and face-to-face care, evidence points to the existence of tension between Welsh policy aspirations and realities. Mental health nurses in Wales have produced a framework for action, which describes practice exemplars and looks forward to a secure future for the profession. With policy, however enlightened, lacking the singular potency to bring about intended change, nurses as the largest of the professional groups involved in mental health care have opportunities to make a difference in Wales through leadership, influence and collective action.

scholarly journals 1381. Rotavirus Gastroenteritis among older adults: discussion based on a systematic literature review

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S700-S701
Author(s):  
Cristina Carias ◽  
Susanne Hartwig ◽  
M Nabi Kanibir ◽  
Ya-Ting Chen
Keyword(s):  
Older Adults ◽  
High Risk ◽  
Acute Gastroenteritis ◽  
Rate Ratio ◽  
Rotavirus Gastroenteritis ◽  
Incident Rate Ratio ◽  
The Us ◽  
Incident Rate ◽  
The Uk ◽  
Retrospective Database

Abstract Background While the burden of Rotavirus Gastroenteritis (RGE) is well recognized in young children, it is less so in older adults. However, older adults are also at high-risk of Acute Gastroenteritis (AGE) severe outcomes. In this review, we thus aimed to comprehensively assess RGE burden and vaccination impact in older individuals. Methods We performed a systematic literature review with PubMed and Scopus, from 2000 to 2019, using MESH and free-range terms. We included only studies that reported the incidence, and/or RV vaccination impact, in adults aged 60 and above and using regional specific data-sources. Results We analyzed 11 manuscripts for individuals aged 60 and above (Figure 1). Studies spanned Australia, Sweden, Netherlands, Canada (2), Germany (2), UK (2), and the US (2). Yearly inpatient RV incidence varied between 1.6 per 100,000 in Australia for those 65+ (retrospective database analyses, pre-vaccine); and 26 per 100,000 for those 85+ in Canada (modeling estimates for 2006-10, pre-vaccine). The incidence rate ratio for inpatient RGE between the post and pre-vaccine periods for those 65+ was 0.57 [95% CI: 0.10 – 3.15] in Canada, but 2.24 [95%CI: 1.78-2.83] in Australia, which may be due to increased testing for RV in the elderly post-vaccine. Reductions in the post-vaccination burden of RV and AGE among 60+ were reported in the UK (2 studies), and the US (2 studies) via retrospective database analyses In the UK, post-vaccine reductions in AGE health care-utilization were reported in the Emergency Department (21%), and outpatient centers (walk-in centers: 47%; general practice consultations: 36%). Retrospective database analyses documenting the incident rate ratio (IRR) of Rotavirus Gastroenteritis (RGE) and Acute Gastroenteritis (AGE) in older adults between the pre and post-vaccine period. Retrospective database analyses documenting the incident rate ratio (IRR) of Rotavirus Gastroenteritis (RGE) and Acute Gastroenteritis (AGE) in older adults between the pre and post-vaccine period. Conclusion While the burden of RGE mainly falls on young children, it also affects older adults. Retrospective database analyses reveal that, likely due to indirect vaccination benefits, increases in RV vaccination coverage have had an impact on lowering RGE, and AGE cases and healthcare utilization in older adults, a group at high-risk of severe outcomes for AGE. Disclosures Cristina Carias, PhD, Merck (Employee, Shareholder) Susanne Hartwig, n/a, MSD Vaccins (Employee) M.Nabi Kanibir, MD, Merck/MSD (Employee, Shareholder) Ya-Ting Chen, PhD, Merck & Co., Inc. (Employee, Shareholder)

scholarly journals How wearable sensors have been utilised to evaluate frailty in older adults: a systematic review

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Grainne Vavasour ◽  
Oonagh M. Giggins ◽  
Julie Doyle ◽  
Daniel Kelly
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Gait Speed ◽  
Outcome Measurement ◽  
Wearable Sensors ◽  
Adverse Outcomes ◽  
Community Dwelling ◽  
Ageing Population ◽  
Application Development ◽  
Community Dwelling Older Adults

Abstract Background Globally the population of older adults is increasing. It is estimated that by 2050 the number of adults over the age of 60 will represent over 21% of the world’s population. Frailty is a clinical condition associated with ageing resulting in an increase in adverse outcomes. It is considered the greatest challenge facing an ageing population affecting an estimated 16% of community-dwelling populations worldwide. Aim The aim of this systematic review is to explore how wearable sensors have been used to assess frailty in older adults. Method Electronic databases Medline, Science Direct, Scopus, and CINAHL were systematically searched March 2020 and November 2020. A search constraint of articles published in English, between January 2010 and November 2020 was applied. Papers included were primary observational studies involving; older adults aged > 60 years, used a wearable sensor to provide quantitative measurements of physical activity (PA) or mobility and a measure of frailty. Studies were excluded if they used non-wearable sensors for outcome measurement or outlined an algorithm or application development exclusively. The methodological quality of the selected studies was assessed using the Appraisal Tool for Cross-sectional Studies (AXIS). Results Twenty-nine studies examining the use of wearable sensors to assess and discriminate between stages of frailty in older adults were included. Thirteen different body-worn sensors were used in eight different body-locations. Participants were community-dwelling older adults. Studies were performed in home, laboratory or hospital settings. Postural transitions, number of steps, percentage of time in PA and intensity of PA together were the most frequently measured parameters followed closely by gait speed. All but one study demonstrated an association between PA and level of frailty. All reports of gait speed indicate correlation with frailty. Conclusions Wearable sensors have been successfully used to evaluate frailty in older adults. Further research is needed to identify a feasible, user-friendly device and body-location that can be used to identify signs of pre-frailty in community-dwelling older adults. This would facilitate early identification and targeted intervention to reduce the burden of frailty in an ageing population.

scholarly journals Places Visited, Maintained, or Abandoned Outside Home: A Community Mobility Need of Older Adults With Dementia

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 673-673
Author(s):  
Isabel Margot-Cattin ◽  
Sophie Gaber ◽  
Nicolas Kuhne ◽  
Camilla Malinowski ◽  
Louise Nygard
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Health Condition ◽  
Driving Cessation ◽  
Age In Place ◽  
Community Mobility ◽  
People With Dementia ◽  
The Uk ◽  
The Impact

Abstract For older adults to “age in place”, they need to keep engaged and mobile in their communities, whatever their health condition. The impact of age and cognitive decline on community mobility is a growing problem in Europe and worldwide. Engaging in occupations outside home implies being able to get to those places where activities are performed. Yet little is known regarding the types of places visited, maintained or abandoned for older adults with/without dementia. This study addresses community mobility needs through the places people visit, maintain or abandon. People with and without dementia, aged 55+, were interviewed using the Participation in ACTivities and Places OUTside the Home (ACT-OUT) questionnaire across Switzerland (n=70), Sweden (n=69) and the UK (n=128). Results show that people with dementia experience a higher rate of abandonment for more places than regular older adults. Insights about driving cessation and access to travel passes will be presented.

Sign in / Sign up

Export Citation Format

Share Document