bluuebunny/crossref_metadata_2025_split huggingface dataset:
294 The value of psycho-educational and peer groups for dementia family carers
Authors: Allen J , Cosgrave S , Flanagan C , Daly C , Dullea G , Spain M 
Published: September 2023

Abstract

Background
Approximately 60,000 informal carers are caring for Persons with Dementia (PwD) in Ireland. The care giving provided by family members often enables PwD to remain living in their own homes for longer, which is associated with more positive outcomes and quality of life for PwD. However, given that dementia is a progressive illness, affecting the whole person and their ability to fulfil their activities of daily living, the task of caring can become incrementally more difficult over time. Family carers have articulated the need for increased information and support to assist them in their caregiving role in numerous studies. Living Well with Dementia monthly family carer evenings, facilitated by experienced cross-service interdisciplinary healthcare professionals aim to provide information and support on a range of relevant issues related to caring for a PwD. The average monthly attendance is forty family carers, predominantly spouses and adult children.

Methods
A self-administered survey was completed at the final carers evening of the Spring/Summer 2023 series. The survey was also circulated to family carers subscribed to the mailing list.

Results
Carers overwhelmingly valued the opportunity to come together in a structured supportive environment. The opportunity to sit with peers and share their experiences of caring for a loved one with dementia was viewed as supportive and deeply valued. The psychoeducational component focusing on dementia and mental health; communication skills; self-care for carers; planning ahead and changes to relationships, was viewed as a means of enhancing coping skills and was greatly appreciated by family carers.

Conclusion
The Carers Evenings provide a structured supportive environment in, which family carers can come together to share experiences, enhance their knowledge of varying aspects of the dementia and caregiving journey, and develop coping strategies.
295 Don’t forget about memory: prevalence of cognitive impairment in older adults attending the integrated day hospital
Authors: Ronayne S , Alexander M , O'Malley T 
Published: September 2023

Abstract

Background
Cognitive impairment and dementia are estimated to affect 1 in 5 adults over 80 years (TILDA 2023) which impacts on participation in complex activities eg. Drving, managing finances, complex decision making. The importance of addressing these issues is to the fore with the enactment of the Assisted Decision Making Act. This review aims to provide local context to design and implementation of assessment and intervention processes for Subjective Cognitive Impairment (SCI), Mild Cognitive Impairment (MCI) and dementia in older adults attending the Integrated Day Hospital (IDH).

Methods
A retrospective analysis of health care records was undertaken on patients attending the IDH from January to May 2023. Inclusion criteria were adults over 70 years, recent history of falls or deterioration in functional or cognitive status. Evidence regarding SCI was gathered via patients’ response to specific question on comprehensive geriatric assessment. Evidence of MCI and dementia was gathered via cognitive screening scores.

Results
Preliminary results indicate a cohort of 150 patients. Preliminary analysis of cognitive screening scores reflect prevalence of MCI at 16% and dementia at 36% of older adults attending the IDH. Family-carer reported impairment is more likely to correlate to an impaired range score on testing, in comparison with self-reported impairment. 50% of older adults report SCI, with 70% of family carers reporting SCI in the same cohort. There is a prevalence of cognitive impairment in older adults presenting for falls and frailty. Final findings will be available for the purpose of this poster presentation.

Conclusion
Cognitive impairment in older adults is evidenced across a range of presentations including falls and frailty. This review highlights the need to explore the holistic needs of older adults to identify presence of SCI, MCI and dementia. Subsequently there is a need to provide person centred, co-ordinated and integrated interventions tailored to the needs of the older adults.
332 Gut reaction: Faecal Microbiota Transplantation in a multimorbid older patient with recurrent Clostridium Difficile Infections
Authors: McManus C , O'Riordan R , Kelly F 
Published: September 2023

Abstract

Background
Clostridium Difficile Infection (CDI) is a leading cause of hospital-acquired morbidity and mortality, especially among older adults. Advancing age and in particular those older adults with End-Stage Kidney Disease (ESKD) are at an increased risk for recurrent CDI due to frequent antibiotic exposure, extended hospitalisations, and compromised immunity. This report presents a unique case of an 85-year-old male with a complex medical history that also includes ESKD on haemodialysis, chronic myelomonocytic leukaemia, hypertension, Barrett’s oesophagus, and secondary hyperparathyroidism. He experienced 7 hospital admissions over a period of 12 months due to recurrent CDI, despite treatment with metronidazole, vancomycin and fidaxomicin, as well as prophylactic fidaxomicin. This amounted to a total hospital stay of 53 days. Interestingly his CDI was not associated with antibiotic use.

Methods
After consultations involving a multidisciplinary team of nephrology, infectious diseases, gastroenterology, geriatrics and haematology specialists, the decision was made to proceed with Faecal Microbiota Transplantation (FMT). Based on the patient’s preference the FMT was performed via a colonoscopy.

Results
The success of FMT in this case was notable. The patient has experienced no further CDI or immediate complications post-FMT, demonstrating the effectiveness and safety of this approach even in a complex clinical scenario.

Conclusion
In an era where recurrent CDI poses significant challenges to older patient health, especially in those with multi-morbidity like our patient, and where standard antibiotic treatments fail, this report underscores the importance of considering FMT as a potential treatment option as well as highlighting its safety in older adults. Hence, this case adds valuable insights to the growing literature advocating FMT use in managing recurrent CDI in complex older adults, potentially directing future clinical decisions and treatment guidelines.
334 Carotenoids and Parkinson’s Disease—what does the literature say?
Authors: Donoghue A O , O'Gorman M , Cooke J , Mulcahy R 
Published: September 2023

Abstract

Background
Carotenoids are brightly coloured pigments found in vegetables and fruits. There are two subgroups; Carotenes (⍺-carotene, β-carotene, lycopene) and Xanthophylls (lutein, zeaxanthin, β-cryptoxanthin). Carotenoids are solely obtained from diet, with approximately 20 present in human blood and tissue. Xanthophylls are predominantly found in the brain. Carotenoids have anti-oxidant and anti-inflammatory properties. Higher intake of carotenoids has been linked with lower risk of cardiovascular diseases, malignacies and eye disorders. Parkinson’s Disease (PD) is characterised by the progressive motor symptoms of bradykinesia, rigidity, tremor and postural instability due to the depletion of dopamine-producing neurons in the midbrain. The mechanism by which PD develops remains unclear however, research-to-date has focused on the role of inflammatory mediators and oxidative stress in its pathophysiology.

Methods
PubMed was searched for relevant papers using the terms ‘Carotenoids’;‘Anti-Oxidants’; ‘Parkinson’s Disease’;‘Neurodegenerative Disorders’. Results from 1992 to 2022 were included.

Results
73 studies were identified. 9 studies (2 case–control, 5 cohort, 2 systematic-reviews) were included in this short-review. β-carotene was most commonly associated with reduced PD risk. One study looked at the link between Carotenoids and PD progression. The majority of studies did not measure serum Carotenoids, only assessing them by dietary questionnaires. There were no Irish studies looking at PD and Carotenoids.

Conclusion
Research around PD and Carotenoids is varied and inconsistent. Majority of studies show no significant associations, most focusing on PD risk rather than progression. Xanthophylls have been poorly studied in relation to PD. Carotenoids could potentially be used in PD as an adjunct given their anti-oxidant/anti-inflammatory properties. Further studies investigating the link between Carotenoids and PD in an Irish population is warranted.
349 From the voice of experience: listening to older adults to co-design: a new frailty service in the emergency department
Authors: O'Neill S , Sankey C , Linehan D , Marks M , Carville M , Latoza W 
Published: September 2023

Abstract

Background
The Patient and Public Involvement (PPI) aspect of healthcare service evaluation is key to service development. Following the 12th month of operation, a ‘frailty at the front door’ team, in a model 3 hospital, sought feedback from the patients using the service with an emphasis on listening to their perspective on using the service and recommendations for improvement. The project aimed to collaborate with the patients to design and implement a service providing high quality care for the older person attending the ED. From this a service improvement initiative commenced.

Methods
The Model for Improvement was employed, which incorporates the plan, do, study, act methodology. A patient survey was issued to all patients who had attended the rapid access clinic on discharge from the ED. Questions included understanding the role of the team within ED, was the intervention received helpful, how was the overall experience and what could be done to improve the service.

Results
Of 12 respondents: 67% reported not understanding the role of the team as a specialised service for older persons in ED. 67% rated their experience in the follow up Rapid Access Clinic to be very good, 25% rated their experience as good and 8% reported they would prefer not to say. 100% reported that they felt the team input was helpful. A suggestion for improvement was to help patients understand the specialised role in ED.

Conclusion
A focus group was held to consult a group of over 65 patients on how to communicate the role of the team and improve visibility. As a result the team created a badge as part of their uniform and also created a patient information leaflet to issue at point of assessment. The survey will be implemented quarterly to measure the success of the new interventions or further improvements.
12 Older workers in low paid employment in Ireland: finance, fit and flexibility
Authors: O’Dare C E , Collins M 
Published: September 2023

Abstract

Background
The demographic shift to an older population has sparked research interest on the working lives of older people. Policy awareness is generally directed towards extending working lives, primarily due to pension related fiscal concerns or evoking an active ageing paradigm. This research focuses on a previously unexplored cohort, older workers in low paid employment in Ireland; bringing together themes of ageing populations, labour market participation, earnings adequacy, and active ageing to answer the question. Why do older workers enter and remain in low paid employment?

Methods
A mixed-methods approach explores the characteristics and experiences of older workers in Ireland. Quantitative analysis of the Survey on Income and Living Conditions (SILC) data provides a profile of the individual, sectoral and household characteristics of low paid older workers. This data informs the qualitative sampling strategy. Semi-structured interviews, online and by phone, were conducted with 20 workers aged 50 and over in Ireland.

Results
The older workers interviewed indicate that financial need is a significant driver into taking up, and remaining in, low paid employment—some beyond official retirement age. Other reasons identified, broadly categorised as ‘fit and flexibility’, encompass skills, location, social drivers, and a gender dimension related to motherhood. Decisions taken earlier in the life course in relation to employment and family reverberate into older age. Findings indicate that while some older workers are ‘stuck’ in low paid employment due to an array of constraints, others choose to be there.

Conclusion
Understanding the reasons why older workers participate in low paid employment has important implications for policies relating to older people in general; not only in relation to labour market participation and extended working lives, but additionally in relation to a living wage income and pension inadequacy, wellbeing and social inclusion. These findings therefore are of interest not only to policy makers, but to older workers, employee representatives and employers.
57 A review of the utilisation of the SHARE frailty instruments (SHARE-FI and SHARE-Fi75+) in the literature
Authors: Doherty H , Jennings A H , Kocka M , Neichel A , Scauso J , Lionetti E , Chen C , Romero-Ortuno R 
Published: September 2023

Abstract

Background
The Survey of Health, Ageing and Retirement in Europe (SHARE) frailty instruments SHARE-FI and SHARE-FI75+ were developed as non-commercial, open access frailty phenotype-based identification tools for rapid use in the primary care setting. This literature review examined their utilisation since their publication.

Methods
We used the Google Scholar ‘cited by’ function (accessed on February 20th, 2023) to identify all citations of the original SHARE-FI and SHARE-FI75+ studies. Included articles were categorised into four themes: epidemiological studies (prevalence and associated factors); associations with geriatric syndromes, diseases and health outcomes; randomised clinical trials (RCTs); and expert consensus and practice guidelines.

Results
Of 529 articles screened (446 citing SHARE-FI and 83 citing SHARE-FI75+), 64 (12.1%) were included in the narrative review. Sixteen (25.0%) were epidemiological; 35 (54.7%) described associations; 10 (15.6%) were RCTs; and 3 (4.7%) were expert consensus or practice guidelines. Frailty was associated with older age; female sex; higher morbidity; lower education; social isolation; worse nutrition and mobility; rheumatological, cardiovascular, and endocrine diseases; and greater healthcare utilisation and mortality. SHARE-FI was used in RCTs as entry criterion, controlling variable and intervention outcome. The most commonly studied interventions were exercise, nutrition and social support. SHARE-FI and SHARE-FI75+ have been recommended to aid the management of atrial fibrillation anticoagulation (2015 European Heart Rhythm Association (EHRA) Practical Guide on the use of non-vitamin K antagonist anticoagulants in patients with non-valvular atrial fibrillation) and hypertension (2016 Expert Opinion From the European Society of Hypertension-European Union Geriatric Medicine Society Working Group on the Management of Hypertension in Very Old, Frail Subjects), respectively.

Conclusion
SHARE-FI and SHARE-FI75+, two open access phenotypical frailty measurement tools, have been utilised for diverse purposes, and mostly in epidemiological/associational studies. The relative paucity of RCTs and guidelines vis-à-vis epidemiological and associational studies highlights scope for their future utilisation in studies that will be able to generate higher-level evidence.
97 Attending a memory clinic for assessment and diagnosis of dementia: a qualitative systematic review
Authors: Lafferty R , Daly L 
Published: September 2023

Abstract

Background
Memory clinics have gained recognition for assessment, diagnosis and treatment of a range of memory and cognitive conditions and are often the single point of access for people with suspected dementia. Few studies have focused on the experiences of those who attend a memory clinic for assessment and who receive a dementia diagnosis. The aim of the systematic review reported herein was to explore the experiences of attending a memory clinic from the perspectives of those who receive a dementia diagnosis.

Methods
A meta-synthesis systematic review was undertaken using six databases including CINAHL Complete, Medline, EMBASE, PsychINFO, ASSIA and Web of Science. An extensive grey literature search was also undertaken. The search yielded 10,490 studies, and following screening by two reviewers, those studies that met the inclusion criteria were then quality assessed using the Brunton et al. (2011) Quality Assessment Criteria and Scoring Tool. Thematic analysis was used to analyse the included studies.

Results
Ten studies met the inclusion criteria. The resultant meta-synthesis of the evidence identified three analytical themes: (1) ‘Assessment and diagnosis: an emotional journey’ demonstrated that attending a memory clinic can involve a broad range of emotions; (2) ‘Assessment: a relational experience’ highlighted the significance of the nature and quality of the clinician-person relationship; (3) ‘Information: a variable experience’ identified the importance of information and its timeliness.

Conclusion
Findings highlighted the need to raise awareness of dementia and the role of memory clinics and to keep those who attend, informed about the assessment process at each stage. This may help to alleviate some of the challenging emotions associated with attending a memory clinic. Findings further suggest the potential importance of additional communication training for clinicians, especially where difficult and complex disclosures of dementia need to be made.
216 The relationship between anxiety and physical functional decline in older Irish adults: analysis of the Irish Longitudinal Study on Ageing
Authors: Fitzgerald M 
Published: September 2023

Abstract

Background
Research has shown the prevalence of anxiety in the older adult population and its significant impact on physical health. The Irish population is ageing and will have an increasing proportion of the population experiencing physical functional decline. Both anxiety and physical functional decline are associated with reduced quality of life and increased healthcare costs. The aim of this study was to explore if there is an association between anxiety and physical functional decline in older Irish adults.

Methods
This study used data from the Irish Longitudinal Study on Ageing (TILDA). The sample cohort were derived from those who had completed the Hospital Anxiety and Depression Scale (HADS-A) and who reported having difficulty with Activities of Daily Living (ADL) at Wave 1. This cohort were analysed at Wave 2 for a possible association between anxiety, as measured by the HADS-A and physical functional decline, as measured by an ADL self-reporting questionnaire and a Timed Up and Go (TUG).

Results
The sample cohort consisted of 535 participants. The result of the logistic regression found that the odds of continuing to report an ADL difficulty at Wave 2 are 1.78 (95% Confidence Interval [CI]: 1.15, 2.76) times higher for those with anxiety compared to those without and is statistically significant at p = 0.029. The result of the logistic regression analysis found that those with anxiety are more likely to have a longer TUG time (12.4 sec) than those without (11.19 sec) and the result is statistically significant (p = 0.023).

Conclusion
Anxiety is a mental health condition that has a significant impact on physical health. This study has established that there is an association between anxiety and physical functional decline in the older adult population in Ireland. Further research is needed to establish the nature and directionality of the relationship.
Demographic and Geographic Characterization of Excess Mortality During the COVID-19 Pandemic in Baltimore City, Maryland, March 2020 to March 2021
Authors: Aune Kyle T , Grantz Kyra H , Menezes Neia Prata , Robsky Katherine O , Gurley Emily S , Marx Melissa A , Phelan-Emrick Darcy F 
Published: September 2023

Abstract
Estimates of excess mortality can provide insight into direct and indirect impacts of the coronavirus disease 2019 (COVID-19) pandemic beyond deaths specifically attributed to COVID-19. We analyzed death certificate data from Baltimore City, Maryland, from March 1, 2020, to March 31, 2021, and found that 1,725 individuals (95% confidence interval: 1,495, 1,954) died in excess of what was expected from all-cause mortality trends in 2016–2019; 1,050 (61%) excess deaths were attributed to COVID-19. Observed mortality was 23%–32% higher than expected among individuals aged 50 years and older. Non-White residents of Baltimore City also experienced 2 to 3 times higher rates of excess mortality than White residents (e.g., 37.4 vs. 10.7 excess deaths per 10,000 population among Black residents vs. White residents). There was little to no observed excess mortality among residents of hospice, long-term care, and nursing home facilities, despite accounting for nearly 30% (312/1,050) of recorded COVID-19 deaths. There was significant geographic variation in excess mortality within the city, largely following racial population distributions. These results demonstrate the substantial and unequal impact of the COVID-19 pandemic on Baltimore City residents and the importance of building robust, timely surveillance systems to track disparities and inform targeted strategies to remediate the impact of future epidemics.
Alcohol outlet density and marketing in Abeokuta, Nigeria
Authors: Odeigah Ogochukwu W , Patton Robert , Trangenstein Pamela 
Published: September 2023

Abstract
Aim: The physical availability of alcohol is a modifiable determinant of alcohol consumption and related harm. However, Nigeria currently does not have national regulations restricting the physical availability of alcohol. The study measured alcohol outlet density and marketing in Abeokuta, Nigeria. Methods: A descriptive community design was employed. Seven wards in Abeokuta South local government were surveyed street by street for functional alcohol outlets and nearby public institutions (schools and worship centres). Outlet characteristics were documented, and the location of outlets and public institutions was geocoded using a global positioning system app. The density and proximity of outlets and public institutions were analysed using QGIS 3.22. Results: Four hundred and seventy-six alcohol outlets and 194 public institutions (82 schools, 87 churches, and 25 mosques) were sampled across the 7 wards. The most common type of alcohol premises and outlets was on/off-premises and liquor/non-alcoholic drinks stores. Alcohol banners on liquor store lintels were the most prevalent marketing item. Alcohol outlet density ranged from 8.06 to 200 per km2. The smallest average distance between alcohol outlets was 28 m in Sodeke, while Ago Egun/Ijesa had the highest number of outlets and on/off premises. The shortest distance from an outlet to a school was 18.77 m in Ijaiye and 44 (14.7%) schools were located within ≤100 m of an outlet. Conclusions: Findings indicate high alcohol density, resulting in short distances between alcohol outlets and public institutions in Abeokuta South local government area. These results underscore the importance of implementing evidence-based alcohol availability policies in Nigeria.