bluuebunny/crossref_metadata_2025_split huggingface dataset:
166 Effect of religious attendance on loneliness, quality of life, stress and anxiety among older adults during COVID-19 in Ireland
Authors: O'Maoileidigh B , Kenny R A , Ward M , Scarlett S 
Published: September 2023

Abstract

Background
Religious attendance has been shown to have a positive effect on psychological health among the older population of Ireland. Due to COVID-19 lockdown restrictions and precautionary health advice, many older adults struggled to attend service in person. However, 87% of faith organisations provided a form of remote service.

Methods
Data were from Wave 6 (2021) of The Irish Longitudinal Study on Ageing (TILDA). The analysis sample was made up of 3,961 community-dwelling adults living in Ireland aged 60 years and older. To assess religious attendance, participants were asked about how often they attended in person and how often they attended remotely using radio, television, or internet streaming. Relationships between religious attendance, Quality of Life (QoL), Loneliness, Stress, and Anxiety were modelled using linear regressions.

Results
The sample was 44.1% male and 55.9%female, with a mean age of 72.0 years. In person religious attendance was found to be positively associated with higher QoL [Beta = 0.07, 95% Confidence Intervals (CI) = 059.45, 564.16, p &lt; 0.001] and negatively associated with Loneliness [Incidence Rate Ratio = 0.98, 95% CI = 0.97, 0.99, p &lt; 0.001]. Remote religious attendance was positively related to higher anxiety [IRR = 1.03, 95% CI = 1.02, 1.04, p &lt; 0.001].

Conclusion
These results suggest that in person religious attendance had some positive effect on QoL and Loneliness among older adults during the COVID-19 pandemic. Digital religious attendance was not shown to have the same positive effect on psychological health as in person attendance, and, in fact was associated with higher anxiety. This could be due to the lack of social benefit that would typically be found from in person attendance. Future research should be done to assess how the relationship that older people have with digital religious services.
172 Using the early identification and management of delirium to optimise memory pathway referrals and resources
Authors: Prendergast A , Doyle M , Doherty-Walsh A , Byrne E , Simpson S , Murphy G , Nugent M , Bambrick P 
Published: September 2023

Abstract

Background
Priority actions within the National Dementia Strategy are to ensure early diagnosis of dementia and to develop appropriate referral pathways and interventions to support patients. One element is the consideration of referral to memory services for patients who develop delirium within the acute hospital setting, which may suggest possible underlying cognitive impairment. We examined the effect of early identification and diagnosis of delirium via an inpatient frailty service on this process.

Methods
Over a 9-month period (September 2022–May 2023), patients &gt;75 years admitted to the acute medical floor were screened with the Rockwood Clinical Frailty Scale (CFS) by a multi-disciplinary in-patient frailty team. Those with a CFS score of 5–6 (mild to moderate frailty) were prioritised for Comprehensive Geriatric Assessment (CGA), which included the 4AT delirium screening tool. Patients presenting with a 4AT of 1–3 indicating cognitive vulnerability and those with a 4AT of &gt;4 suggesting a probable delirium with possible dementia were identified for assessment.

Results
3,200 patients &gt;75 years were admitted to the medical floor during the 9 months. Over 2,100 patients were screened for mild to moderate frailty and 495 CGA’s were completed. 105 patients presented with a 4AT of &gt;4 with 44% not having a formal diagnosis of cognitive impairment. 74% of this cohort were referred onward to memory streams. 143 patients presented with a 4AT of 1–3. 66% did not have a formal diagnosis of cognitive impairment, of which 61% were referred onward to memory services.

Conclusion
The development of delirium in the acute hospital setting is an important opportunity to assess for the presence of an underlying neurodegenerative process. Early identification and management pathways for delirium can allow timely initiation of referral to specialist memory streams to aid prompt diagnosis of dementia, facilitating optimisation of care, supports, and advanced planning.
218 An analysis of the impact of psychotropic medications on gait in the Irish longitudinal study on ageing (TILDA)
Authors: O’Donnell D , Moriarty F , Lavan A , Kenny R A , Briggs R 
Published: September 2023

Abstract

Background
Prescriptions of psychotropic medications for older adults have become increasingly prevalent, despite older adults being most susceptible to their side effects. There is currently a paucity of information regarding how psychotropics effect gait parameters.

Methods
Participants were included if they: were aged ≥60 years at Wave 1, had a medication list examined for medications of interest and underwent the TILDA health assessment with measures of gait and mobility (Timed-Up-and-Go [TUG], gait speed, double support time, stride length, stride width). Antidepressants were identified with an ATC code of N06A. Benzodiazepines were coded N05BA, N05CD and N03AE. ‘Z’ drugs were coded as N05CF and antipsychotics N05A. Linear regression models assessed the relationship between psychotropics and individual gait parameters. Logistic regression assessed the relationship between psychotropic use at Wave 1 and gait parameters at Wave 3.The likelihood of transitioning from a normal to an abnormal TUG and to the lowest quartile of each gait parameter was examined. Models were adjusted for age, sex, educational attainment, alcohol intake, chronic disease burden, heart disease, depressive symptoms, poor sleep and cognitive impairment.

Results
Of 2,620 participants, 12% were prescribed a psychotropic medication (0.12 [95% Confidence Interval [CI] 0.11–0.13]), with 4% prescribed 2 or more psychotropics (0.04 [95% CI 0.03–0.05]). Participants prescribed one (mean TUG 9.9 seconds [95% CI 9.5–10.3]; n = 201) or more psychotropics (10.2 seconds [95% CI 9.7–10.6]; n = 105) had a significantly longer TUG than those not prescribed psychotropics (9.0 seconds [95% CI 8.9–9.1]; n = 2,314). Step length was shorter in participants prescribed one (64.6 cm (95% CI 63.4–65.9)) or more (63.4 cm (95% CI 61.6–65.1)) psychotropics, compared to participants not prescribed psychotropics (69.1 cm (95% CI 68.7–69.5)).

Conclusion
Psychotropic medications adversely affect mobility by slowing gait speed, reducing stride length and increasing double support time. Patients should be counselled regarding these potential effects.
243 A missed opportunity for intervention: vertebral fracture reporting
Authors: McGurk C , Alnajjar A , Carvalho J , Ong J , Paponette B , Hickey P , O'Sullivan F 
Published: September 2023

Abstract

Background
Vertebral Fractures (VFs) are the most common fragility fracture—with an incidence of 1 in 5 women over 70. A Vertebral Fragility Fracture (VFF) is a powerful predictor of another VF and of future hip fractures. Yet nearly 70% of VFs do not come to medical attention. Opportunities to identify a VFF and institute secondary prevention arises when a patient is referred for imaging for any clinical reason. However, VFFs are commonly unrecognised radiologically or reported ambiguously. The aim of this audit was to retrospectively evaluate VFF reporting terminology and recommendations as per published guidelines.

Methods
All radiographic reports from 2021–2023 in an Irish hospital were screened for osteoporotic and VFF key-terms in patients &gt;65 years via the PACs platform. Data was analysed for 1) comments on vertebral integrity; 2) usage of the term ‘vertebral fracture’; 3) inclusion of actionable recommendations.

Results
A resultant total of 250 reports were reviewed, 223/250 from plain films. Fracture was reported 50.8% (n = 127) of the time. Ambiguous terminology like ‘compression’; ‘sagging’; ‘height loss’ ‘collapse’; ‘wedging’ was used in 49.2% (n = 123). Even where vertebral height loss was reported as 20% or greater, the term ‘fracture’ was not used in 59% (29/49). No report made recommendations for further investigation.

Conclusion
This audit highlights that even when osteoporotic challenges to vertebral integrity are recognised, they are not reported in a standardised way that reflects the ‘red flag’ significance of a VFF. The heterogeneous and ambiguous reporting fails to alert other clinicians to their significance—resulting in a missed opportunity to intervene. A reporting template and addition of actionable recommendations is for review at the internal monthly radiology quality forum.
275 Changing patient preferences: from the greatest generation to millennials
Authors: Chapman L , Daly S , Doyle R 
Published: September 2023

Abstract

Background
A study in an urban teaching tertiary hospital in 1999 surveyed patient preferences regarding the use of first names in doctor-patient interactions, doctors’ age and gender as well as room preference. We sought to replicate this survey to assess changing preferences.

Methods
A 10-item survey was administered to hospitalised inpatients in April 2023. Comparison between preferences in 1999 and 2023 and between those aged under and over 65 years were performed using Chi-Square.

Results
Of the 167 inpatients surveyed, 52% (n = 87) were male. Median age was 66 years. In 1999, 206 patients were surveyed. Median age was 60 years. In 2023, the overwhelming majority (98%) preferred to be addressed by their first name compared with 74% (n = 151) of the 1999 cohort (p &lt; 0.0001). Almost two-thirds (62%) preferred their doctor to introduce themselves by their first name compared to 14% (n = 29) of the 1999 cohort (p &lt; 0.0001). Among those over 65 years, a significant decline in preference of doctors using their full title was observed (90% in 1999 versus 38% presently; p &lt; 0.0001). Previously, 93% indicated no preference regarding physician’s gender versus 80% currently (p = 0.0006). Among those over 65 years, preference for male doctors fell significantly from 22% in 1999 to 1% in 2023 (p = 0.0003). A single room was preferred by 39% (n = 64) now compared with 27% (n = 56) in 1999 (p = 0.03). However, half (52%) of those over 65 years and 38% (n = 30) of those under 65 years still prefer multi-bed wards (p = 0.08). A reduction in those favouring mixed-sex wards was observed from 15% in 1999 to 4% presently (p = 0.01). Less patients under 65 years favour a mixed-sex ward now (3%) compared to 1999 (20%; p = 0.0003) Almost all (98%) patients agreed with medical students (68% in 1999; p &lt; 0.0001).

Conclusion
Agreement with first name use in the doctor-patient relationship as well as medical student education is increasing. Single rooms are increasingly preferred although multi-bed wards are still favoured.
338 Profile of older adults post hip fracture: a pre and post-Covid comparison
Authors: Costello R , Larkin J , O'Connor M 
Published: September 2023

Abstract

Background
The Irish Government implemented public health measures during the COVID-19 pandemic, including self-isolation among older citizens. Within our rehabilitation centre, the multidisciplinary team remarked on what they perceived to be negative health repercussions from ‘cocooning’, particularly those admitted following hip fracture. We sought to compare patient cohorts in 2019 and 2022.

Methods
Data was examined from the Irish Hip Fracture Database online portal specific to our Model 3 hospital for 2019 and 2022. Subset analysis was performed on hip fracture patients admitted to an off-site rehabilitation centre using that hospital’s electronic patient database.

Results
245 hip fractures were recorded in 2019 and 380 in 2022. In 2019 37% were aged between 80–89, 12% were over 90. In 2022 45% were aged between 80–89, 14% were over 90. ASA grade pre-operatively; in 2019, 33% were classed as normal or with mild systemic disease, 61% were in the severe systemic disease category. The same categories in 2022 were 41% and 55% respectively. Discharge destination for patients in 2019 and 2022 respectively were as follows: discharged directly home 27% vs 25%, discharged to offsite rehabilitation 32% vs. 38%, new Long-Term Care (LTC) admission 2% vs 3%. Our rehabilitation unit received 26 patients in 2019 and 39 in 2022. The average timed up and go (TUG) on admission in 2019 vs 2022 was 38.7 and 53.7 seconds respectively.

Conclusion
There was a 55% increase in the number of patients presenting with hip fracture post Covid. Despite similar age and co-morbidity profiles patients average TUG was 39% slower post Covid. Less patients were discharged directly home in 2022, more patients required a period of rehabilitation and the number of new admissions to LTC increased. This small study supports our hypothesis surrounding the detrimental effects of cocooning on older patients.
350 Evaluation of analgesia prescribing in hospitalised adults ≥ 65
Authors: Ryan M , Russell T , Khan P , Briggs R , Cunningham C , Relihan E , Lavan A 
Published: September 2023

Abstract

Background
Pain is common in hospitalised patients aged ≥65. It is recommended to follow the World Health Organisation pain ladder but special consideration should be given to the adverse effects of opiates and Non-Steroidal Anti-Inflammatory Drugs (NSAIDs).

Methods
A retrospective review of geriatric medicine inpatients aged ≥65 years was conducted. Data was collected from August 2023 over a 24-hour period using electronic patient records.

Results
One hundred and nineteen patient records were reviewed. The average age was 84 years (SD = 3.53 years); 56% female. One hundred and eleven patients (93%) were prescribed analgesia. Seventy patients (56%) had pain documented as a clinical issue with musculoskeletal (MSK) pain, the most common type at 64%(n = 45)), 10% (n = 7) undocumented pain source, 8.5%(n = 6) visceral pain, 8.5% (n = 6) vascular pain, 3% (n = 2) neuropathic pain, 3% (n = 2) cancer related pain, and 3% (n = 2) dental pain. Fifty-five patients (49.5%) were prescribed regular paracetamol, and fifty-one (46%) as required (PRN) paracetamol. Twenty-two (20%) were on a regular opiate and forty-two (38%) on a PRN opiate. Oramorph was the most common opiate prescribed (n = 26). Nineteen patients (17%) were on a regular NSAID; with twenty-one (19%) on a PRN NSAID. Topical diclofenac was the most common agent (28 patients). Sixteen (14%) patients were on a neuropathic agent, of which pregabalin was the most common (9 patients). 53% (N = 63) of patients were newly prescribed paracetamol, 26% (N = 31) opiates, 18% (N = 21) NSAIDs and 8% (N = 9) neuropathic agents. Twelve patients without an active pain issue were charted regular paracetamol. Thirty-four patients prescribed opiates had renal impairment.

Conclusion
There was a high rate of analgesia prescribing among older hospitalised patients (93%). Paracetamol was followed by opiates, NSAIDS and neuropathic agents in frequency. Issues identified include paracetamol over prescribing, NSAID underuse and use of opiates in renal impairment. These findings suggest that clinicians would benefit from a local guideline for the management of pain in the older population.
4 How do befriending services impact health? A mixed-methods analysis of potential mechanistic pathways
Authors: Power J M , O'Reilly A , Hannigan C 
Published: September 2023

Abstract

Background
Befriending services do not appear to impact loneliness, but they may have an effect on health. To understand their effect further, we conducted a mixed methods study of the ALONE Befriending and Practical Support Service, using a single case experimental design and supplementary dyadic constructivist grounded theory interviews.

Methods
To understand the potential mechanistic pathways between befriending services and health outcomes, we integrated qualitative and quantitative findings using a pluralistic triangulation approach. Qualitative and quantitative findings were sequentially paired and described as either in agreement, in partial agreement, dissonant, or silent.

Results
Qualitative and quantitative findings were in full agreement that befriending had a direct impact on the health of older adults. There was dissonance on the impact of befriending on loneliness; while quantitative findings showed no direct effect of befriending on loneliness, the qualitative findings suggested that befriending reduced loneliness. The quantitative findings supplemented the qualitative by demonstrating that the befriending service is likely to buffer the negative effect of loneliness on health. The qualitative study revealed four other mechanisms through which befriending may impact health (by providing emotional support, lifting mood, opportunities for engagement in health behaviours, and cognitive stimulation) which were not explored in the quantitative study.

Conclusion
Findings suggest that further research is still required to unpick the nature of the link between befriending and loneliness. It is possible that gratitude for the service mediates this link, which warrants further exploration. Overall we can recommend that befriending services are useful for older adults for protecting health.
7 Designing and testing an integrated community care model with a remote home monitoring-alert device: a pilot study in Japan
Authors: Obayashi K , Kodate N , Kondo H , Okamoto Y , Kurishima S , Ishii Y , Nonoda T , Yasukawa T , Masuyama S 
Published: September 2023

Abstract

Background
An integrated model of health and social care in the community has been considered to be the gold standard, although many obstacles and challenges still exist. Living at one’s private home for as long as one wishes requires highly personalised arrangements, and therefore is costly, but assistive technologies can potentially facilitate this. In order to test the concept, a remote monitoring and care delivery system was developed. The usability and efficacy of the model were examined.

Methods
Sensor devices (biometric, temperature sensor and infrared camera sensor) were set up in the homes of five older people (aged 70 years and over), and the information was sent online to each older person, plus his/her family and caregivers. Using these devices, fifteen care professionals delivered home care and remotely supported the home life of the older adults between December 2022 and January 2023. A pre-post study design was adopted, collecting the System Usability Score (SUS), the International Classification of Functioning, Disability and Health (ICF) and the InterRAI assessments. The participating older adults and family members all consented to the research, which involved being observed or watched (all images are silhouettes only) when the system was in operation.

Results
Remote monitoring with alerts and two-way communication functions was highly valued by caregivers, as it provided an alternative model of care delivery, particularly for those living alone. While the device usability was not highly rated (D), several improvements in ICF and InterRAI scores were recorded (e.g. interpersonal communication, self-care, depressive tendencies).

Conclusion
While more research is necessary to increase the sample size and the duration of the data collection period, there is great potential for this model, embedding the use of assistive technologies into home care delivery. The study was funded in part by the Japan Agency for Medical Research and Development (22he2002023j0002).
14 How can remote rural island place influence the ageing of mid-life women?
Authors: Herbert A 
Published: September 2023

Abstract

Background
This contribution to social gerontology and nissology addresses a knowledge gap in contemporary gendered ageing within remote, rural island place. Reflecting participant narrative, this study explores personal and place identity, place attachment, and perspectives on gendered island ageing at mid-life and in older age.
Methods: Drwing on empirical data gathered through in-depth interviews with 12 mid-life (48–69 years old) women living in remote islands of Scotland, the relationship between ageing and remote rural island living is examined. This qualitative work adopts a life-course framework in order to acknowledge lived experience and cultural context from childhood to adulthood. Data were analysed and informed by constructivist grounded theory, a methodology well placed for exploratory research about which little is known.

Results
Data found no island mono-culturalism. Remote rural island ageing appears distinct from mainland rural ageing. Findings indicate diverse relationships between ageing and place among mid-life women living in the islands of this study. The connection between ageing and island place is influenced by a range of socio-economic factors, the primary one of which is the natural environment. Other influencing factors include social relationships, employment, health, and demographic status. Perspectives on ageing vary between those native and non-native to the islands; those who live with partners or alone; those who have children and those child-free; and between those who enjoy socio-economic stability and those who do not.

Conclusion
Despite remote location, and limitations of employment, education, health and transport, participant data reveals an overall positive relationship between remote rural island living and ageing among this study’s indigenous and in-migrant women. The physical, mental and spiritual benefits derived from the natural landscape of island home place proved primarily to be the greatest positive influence reported towards perceived better ageing.
18 Early supported discharge for older adults admitted to hospital with medical complaints: a qualitative study exploring the views of stakeholders
Authors: Williams S , O'Riordan C , Steed F , Leahy A , Shanahan E , Peters C , O’Connor M , Galvin R , Morrissey A-M 
Published: September 2023

Abstract

Background
Early Supported Discharge (ESD) is well established as a model of health service delivery for people with stroke. Emerging evidence indicates that ESD reduces length of stay for older medical inpatients. There is a dearth of evidence exploring the views of stakeholders on ESD as a model of care for older medical inpatients. The overall aim of this study is to explore the views and perceptions of older adults, family carers and healthcare professionals on the potential role of ESD for older adults admitted to hospital with medical complaints.

Methods
We conducted a qualitative interview and focus group study at University Hospital Limerick (UHL) from November 2021 to January 2022. Purposeful sampling was used to recruit older adults and family carers for interview. For Healthcare Professionals (HCPs), snowball purposeful sampling was used for focus groups. Braun and Clarke’s approach to thematic analysis was used. Ethical approval was granted by the HSE Mid-Western Area Regional Ethics Committee in November 2021 (REC Ref. 096/2021).

Results
Fifteen HCPs took part across three focus groups, with six older adults and two family members participating in one-to-one interviews. Three themes were identified: (1) Pre-ESD experiences of providing and receiving older adult inpatient care, (2) Navigating discharge procedures from acute hospital services and (3) A vision for more integrated model of care and a medical ESD team.

Conclusion
This qualitative study was the first to explore the views and perceptions of older adults and healthcare professionals on the potential role of ESD for older adults admitted to hospital with medical complaints. The current experiences and barriers to efficient and safe discharge home from hospital were highlighted by stakeholders. The potential role for ESD in this population group was discussed, as well as the key factors to be considered in running an ESD service for medical older adults.