Recent Submissions

  • World guidelines for falls prevention and management for older adults: A global initiative

    Masud, Tahir; Robinson, Katie; Ogliari, Giulia (2022)
    BACKGROUND: falls and fall-related injuries are common in older adults, have negative effects on functional independence and quality of life and are associated with increased morbidity, mortality and health related costs. Current guidelines are inconsistent, with no up-to-date, globally applicable ones present. OBJECTIVES: to create a set of evidence- and expert consensus-based falls prevention and management recommendations applicable to older adults for use by healthcare and other professionals that consider: (i) a person-centred approach that includes the perspectives of older adults with lived experience, caregivers and other stakeholders; (ii) gaps in previous guidelines; (iii) recent developments in e-health and (iv) implementation across locations with limited access to resources such as low- and middle-income countries. METHODS: a steering committee and a worldwide multidisciplinary group of experts and stakeholders, including older adults, were assembled. Geriatrics and gerontological societies were represented. Using a modified Delphi process, recommendations from 11 topic-specific working groups (WGs), 10 ad-hoc WGs and a WG dealing with the perspectives of older adults were reviewed and refined. The final recommendations were determined by voting. RECOMMENDATIONS: all older adults should be advised on falls prevention and physical activity. Opportunistic case finding for falls risk is recommended for community-dwelling older adults. Those considered at high risk should be offered a comprehensive multifactorial falls risk assessment with a view to co-design and implement personalised multidomain interventions. Other recommendations cover details of assessment and intervention components and combinations, and recommendations for specific settings and populations. CONCLUSIONS: the core set of recommendations provided will require flexible implementation strategies that consider both local context and resources. Copyright © The Author(s) 2022. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.
  • Assessing the impact of the introduction of an electronic hospital discharge system on the completeness and timeliness of discharge communication: A before and after study

    Baxendale, Bryn; Le Jeune, Ivan (2017)
    BACKGROUND: Hospital discharge summaries are a key communication tool ensuring continuity of care between primary and secondary care. Incomplete or untimely communication of information increases risk of hospital readmission and associated complications. The aim of this study was to evaluate whether the introduction of a new electronic discharge system (NewEDS) was associated with improvements in the completeness and timeliness of discharge information, in Nottingham University Hospitals NHS Trust, England. METHODS: A before and after longitudinal study design was used. Data were collected using the gold standard auditing tool from the Royal College of Physicians (RCP). This tool contains a checklist of 57 items grouped into seven categories, 28 of which are classified as mandatory by RCP. Percentage completeness (out of the 28 mandatory items) was considered to be the primary outcome measure. Data from 773 patients discharged directly from the acute medical unit over eight-week long time periods (four before and four after the change to the NewEDS) from August 2010 to May 2012 were extracted and evaluated. Results were summarised by effect size on completeness before and after changeover to NewEDS respectively. The primary outcome variable was represented with percentage of completeness score and a non-parametric technique was used to compare pre-NewEDS and post-NewEDS scores. RESULTS: The changeover to the NewEDS resulted in an increased completeness of discharge summaries from 60.7 per cent to 75.0 per cent (p < 0.001) and the proportion of summaries created under 24 h from discharge increased significantly from 78.0 per cent to 93.0 per cent (p < 0.001). Furthermore, five of the seven grouped checklist categories also showed significant improvements in levels of completeness (p < 0.001), although there were reduced levels of completeness for three items (p < 0.001). CONCLUSIONS: The introduction of a NewEDS was associated with a significant improvement in the completeness and timeliness of hospital discharge communication. Abstract]
  • Recognising and responding to deterioration in care homes: A scoping review protocol

    Hodge, Sevim Y.; Ali, Mohammad R. (2021)
    Objective: To identify the available published primary research and any relevant policies, guidelines, or protocols regarding how care home staff recognize and respond to an acutely deteriorating resident. Introduction: Older people living in care homes have complex health care needs. Chronic illnesses, comorbidities, frailty, cognitive impairment, and physical dependency can contribute to unpredictable changes in their health status that can lead to residents becoming unwell and acutely deteriorating. Exploring how care home staff recognize and respond to acutely deteriorating health among residents is important to understand whether opportunities exist to minimize these unpredictable changes in health. Inclusion criteria: This scoping review will consider studies that feature the recognition and response to acute deterioration in care home residents. This review will consider qualitative and quantitative primary research. Non-indexed and gray literature such as policies, deterioration tools, and reports from health policy organizations will also be included. Methods: The searches will be conducted using bibliographic databases, university repositories, and non-indexed and gray literature, such as reports by health care and health policy organizations. The studies will be independently selected from the inclusion criteria by two researchers based on their title and abstract. In case of disagreement, a third researcher will be consulted. An adapted version of the JBI data extraction form will be used to extrapolate data from included studies. The results will be presented in tabular form, accompanied by a narrative summary related to the objectives of the scoping review.
  • Identifying and managing frailty in Brazil: A scoping review protocol

    Robinson, Katie (2020)
    ABSTRACT Objective: The objective of this review is to scope the evidence on how researchers, health, and social care professionals in Brazil currently identify and manage frailty in older adults. Introduction: The rapidly aging population and associated increased healthcare usage by older people with frailty are challenging the sustainability of healthcare for older people in Brazil. Understanding how frailty is identified, measured, categorized, and managed in Brazil is an important part of building a response to the challenge. Inclusion criteria: This scoping review will consider studies that included older Brazilian adults (>=60 years old) recruited from different settings (community, primary care, health care centers, hospital, and long-term care institutions). Studies will be included if they involved any kind of frailty assessment (tools, scales, and measures) and/or interventions. This review will consider all study designs, regardless of their rigor. National policies for older people will be also be considered for analysis. Methods: Indexed and gray literature in English or Portuguese from 2001 to the present will be considered. The searches will be conducted using bibliographic databases, university repositories, and the Brazilian Government official database. The studies will be independently screened according to the inclusion criteria by two reviewers based on their title, abstract, and full text. In case of disagreement, a third reviewer will be consulted. A customized data extraction form will be used to extract data from the included studies. The results will be presented in tabular form, accompanied by a narrative summary related to the objective of the present scoping review.
  • Interventions incorporating physical and cognitive elements to reduce falls risk in cognitively impaired older adults: A systematic review

    Booth, Vicky; Kearney, Fiona (2016)
    EXECUTIVE SUMMARY Background Cognitive impairment is a risk factor for falls. Older adults with cognitive impairment (such as dementia) have an increased risk of falling compared with age-matched individuals without a cognitive impairment. To reduce falls in this population, interventions could theoretically target and train both physical and cognitive abilities. Combining and addressing cognitive components in falls rehabilitation is a novel and emerging area of healthcare. Objectives The objective of this review was to identify the effectiveness of combined cognitive and physical interventions on the risk of falls in cognitively impaired older adults. Inclusion criteria Search strategy A three-step search strategy was utilized in this review, including search of electronic databases: CENTRAL, JBISRIR, MEDLINE, EMBASE, AMED, CINAHL and PsychINFO. Initial keywords used were dementia, cognitive impairment, memory loss, exercise, rehabilitation and accidental falls. Grey literature (Google Scholar) and trials registers (Current Controlled Trials) searches were also completed. Methodological quality The methodological quality of included studies was assessed using Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) software. Data extraction Data was extracted from articles included in the review using the standardized data extraction tool from JBI-MAStARI. Data synthesis A quantitative meta-analysis was performed where possible. Otherwise, data synthesis was in the form of narrative review. Sub-group analysis according to level of cognitive impairment was completed where possible.
  • A 6-Year thematic review of reported incidents associated with cardiopulmonary resuscitation calls in a United Kingdom hospital

    Beed, Martin; Hussein, Sumera; Woodier, Nick; Fletcher, Cathie (2022)
    BACKGROUND: Critical incident reporting can be applied to cardiopulmonary resuscitation (CPR) events as a means of reducing further occurrences. We hypothesized that local CPR-related events might follow patterns only seen after a long period of analysis. DESIGN: We reviewed 6 years of local incidents associated with cardiac arrest calls. The following search terms were used to identify actual or potential resuscitation events: "resuscitation," "cardio-pulmonary," "CPR," "arrest," "heart attack," "DNR," "DNAR," "DNACPR," "Crash," "2222." All identified incidents were independently reviewed and categorized, looking for identifiable patterns. SETTING: Nottingham University Hospitals is a large UK tertiary referral teaching hospital. RESULTS: A total of 1017 reports were identified, relating to 1069 categorizable incidents. During the same time, there were approximately 1350 cardiac arrest calls, although it should be noted that many arrest-related incidents were not associated with cardiac arrest call (e.g., failure to have the correct equipment available in the event of a cardiac arrest). Incidents could be broadly classified into 10 thematic areas: no identifiable incident (n = 189; 18%), failure to rescue (n = 133; 12%), staffing concerns (n = 134; 13%), equipment/drug concerns (n = 133; 12%), communication issues (n = 122; 10%), do-not-attempt-CPR decisions (n = 101; 9%), appropriateness of patient location or transfer (n = 96; 9%), concerns that the arrest may have been iatrogenic (n = 76; 7%), patient or staff injury (n = 43; 4%), and miscellaneous (n = 52; 5%). Specific patterns of events were seen within each category. CONCLUSIONS: By reviewing incidents, we were able to identify patterns only noticeable over a long time frame, which may be amenable to intervention. Our findings may be generalizable to other centers or encourage others to undertake this exercise themselves. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
  • Lemierre's syndrome: A pain in the neck with far-reaching consequences

    Stubington, Thomas James; James, Paul (2018)
    Lemierre's syndrome is a potentially life-threatening consequence of oropharyngeal and ear infections and often results in critical care admission and even intubation. Due to the multisystem manifestation, multiple teams may initially be involved in the care, some of which may be unfamiliar with the features and usual clinical course. This report describes a case in a 36-year-old woman with the classic features of internal jugular vein thrombosis and septic emboli to the lungs secondary to an oropharyngeal infection. Treatment comprised antibiotic therapy, anticoagulation and fluid resuscitation, and was carried out in a high dependency unit setting. At follow-up 3 months after discharge, the patient was well with no residual symptoms off all treatment. During the events of this case, it became apparent that while ear, nose and throat and infectious diseases team members were relatively familiar with the condition, other departments including the critical care team were less so. Copyright © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
  • Guidance in an uncertain world

    Gardiner, Dale C.; Harvey, Daniel J. (2020)
  • Use of 8Fr angio-seal for closure of femoral arteriotomy following use of 8Fr and 9Fr sheaths in patients undergoing mechanical thrombectomy for acute ischaemic stroke

    Dhillon, Permesh Singh; McConachie, Norman; Lenthall, Robert; Nair, Sujit; Izzath, Wazim (2021)
    BACKGROUND: Little is known about the safety of off-label use of an 8Fr Angio-Seal VIP for large-bore arteriotomies in patients treated with mechanical thrombectomy (MT) and intravenous thrombolysis (IVT) for acute ischaemic stroke (AIS). We aimed to identify differences in the groin complication rate using an 8Fr Angio-Seal VIP for common femoral arteriotomy closures following the use of 8Fr and 9Fr sheaths. METHODS: All AIS patients who underwent MT at our tertiary neuroscience unit between January 2018 and March 2020 were retrospectively reviewed. RESULTS: 161 patients were included in the study, of whom 56 and 105 patients underwent an arteriotomy using an 8Fr sheath (36 of them receiving IVT) and a 9Fr sheath (57 of them receiving IVT). Overall, 17 groin complications were identified (10.5%) in 5 patients (8.9%) who had had 8Fr sheaths inserted and 12 patients (11.4%) who had had 9Fr sheaths inserted. Major complications were identified in only 2 patients (1.2%), one patient in each of the 8Fr and 9Fr cohorts suffering a pseudoaneurysm requiring intervention. No retroperitoneal haematoma, infection, acute limb ischaemia or ipsilateral DVT was identified. No significant difference in groin complications was observed between the 8Fr and 9Fr femoral arteriotomy cohorts or between the MT patients that did or did not receive adjunctive IVT. CONCLUSION: In the setting of MT with IVT, off-label use of an 8Fr Angio-Seal VIP for closure of a femoral arteriotomy following use of a 9Fr sheath has a similar safety profile to the licensed use of an 8Fr Angio-Seal VIP for closure of a femoral arteriotomy following use of an 8Fr sheath or smaller. Copyright © 2021 Elsevier Ltd. All rights reserved.
  • 'MORAL balance' decision-making in critical care

    Harvey, Daniel J.; Gardiner, Dale C. (2019)
  • Predicting falls in older adults: An umbrella review of instruments assessing gait, balance, and functional mobility

    Robinson, Katie; Ogliari, Giulia; Masud, Tahir (2022)
    BACKGROUND: To review the validated instruments that assess gait, balance, and functional mobility to predict falls in older adults across different settings. METHODS: Umbrella review of narrative- and systematic reviews with or without meta-analyses of all study types. Reviews that focused on older adults in any settings and included validated instruments assessing gait, balance, and functional mobility were included. Medical and allied health professional databases (MEDLINE, PsychINFO, Embase, and Cochrane) were searched from inception to April 2022. Two reviewers undertook title, abstract, and full text screening independently. Review quality was assessed through the Risk of Bias Assessment Tool for Systematic Reviews (ROBIS). Data extraction was completed in duplicate using a standardised spreadsheet and a narrative synthesis presented for each assessment tool. RESULTS: Among 2736 articles initially identified, 31 reviews were included; 11 were meta-analyses. Reviews were primarily of low quality, thus at high risk of potential bias. The most frequently reported assessments were: Timed Up and Go, Berg Balance Scale, gait speed, dual task assessments, single leg stance, functional Reach Test, tandem gait and stance and the chair stand test. Findings on the predictive ability of these tests were inconsistent across the reviews. CONCLUSIONS: In conclusion, we found that no single gait, balance or functional mobility assessment in isolation can be used to predict fall risk in older adults with high certainty. Moderate evidence suggests gait speed can be useful in predicting falls and might be included as part of a comprehensive evaluation for older adults. Copyright © 2022. The Author(s).
  • Technology based instruments for predicting falls in older people: An umbrella review

    Robinson, Katie; Ogliari, Giulia; Masud, Tahir (2021)
    Introduction: Technology based instruments (such as wearable sensors) could potentially be an alternative approach to functional measures in predicting falls in older adults. This umbrella review aims to describe the literature on the use of these technological assessments for predicting falls in older people. Method(s): We conducted an umbrella review. Medical and allied health databases were searched from their inception date to November 2020. Inclusion criteria were: all types of reviews; older adults aged >= 60 years in any setting; gait and balance assessment by accelerometers, sensors or platforms to predict falls; published in English. The screening of titles/abstracts (and then full texts) for inclusion, the data extraction using a standardised spreadsheet and the quality appraisal using the Risk of Bias in Systematic Review tool were performed in duplicate. Result(s): Eleven reviews (1 narrative review, 8 systematic review without meta-analysis and 2 systematic reviews with meta-analysis) met the inclusion criteria. Five reviews were considered to have a high risk of bias, 5 an unclear risk of bias and 1 a low risk of bias. Most reviews included independent community-dwelling older people. Kinematic measures were obtained using accelerometers, wearable sensors and platforms. Seven reviews reported some, but not all positive findings in the objective measurements in predicting falls. Three reviews reported inconsistencies in the applicability of the instrumented test for falls prediction. Key conclusions: Objective measures of technology-based instruments demonstrate early potential and warrant further high-quality prospective studies to determine their clinical ability to predict falls in older adults.
  • Pain and quality of life in older men and women: Crosssectional findings from the survey of health, ageing and retirement In Europe

    Ogliari, Giulia; Cowley, Alison; Robinson, Katie; Booth, Vicky; Gladman, John; Harwood, Rowan; Masud, Tahir (2022)
    Introduction: Pain is associated with poorer physical and mental health in older adults. We investigated the association between pain and quality of life in older adults. Method(s): Data from 34,090 community-dwelling adults >= 65 years, without cognitive impairment, who were direct respondents in Wave 6 of the Survey of Health, Ageing and Retirement in Europe (SHARE) were analysed. Participants were asked "Are you troubled with pain?", and "In the last month, have you felt that you would rather be dead?". The association between pain intensity and the response to the "rather be dead" question was analysed by binary logistic regression, adjusted for age, sex, country, self-rated health, co-morbidities, medications, physical inactivity, living alone, loneliness, and stratified by sex. Result(s): The mean age was 73.8 years (standard deviation 6.6, range 65-102); 18,775 (55.1%) participants were women. 2,475 (7.3%) reported they felt they would rather be dead: This proportion increased with the severity of pain: 758/17,524 (4.3%) with no pain, 201/3395 (5.9%) with mild pain, 779/9275 (8.4%) with moderate pain and 737/3896 (18.9%) with severe pain reported they felt they would rather be dead. In age and sex-adjusted analyses, mild, moderate and severe pain were all associated with an increased likelihood of feeling "I would rather be dead" compared to no pain. After full adjustment, severe pain was associated with an increased likelihood (odds ratio 1.56, 95% confidence interval 1.35-1.81) of feeling "I would rather be dead". Key conclusions: Pain is significantly associated with poorer quality of life in older adults.
  • Association of frailty with mortality in older inpatients with Covid-19: A cohort study.

    Aw, Darren; Woodrow, Lauren; Ogliari, Giulia; Harwood, Rowan (2020)
    BACKGROUND: COVID-19 has disproportionately affected older people. OBJECTIVE: The objective of this paper to investigate whether frailty is associated with all-cause mortality in older hospital inpatients, with COVID-19. DESIGN: Cohort study. SETTING: Secondary care acute hospital. PARTICIPANTS: Participants included are 677 consecutive inpatients aged 65 years and over. METHODS: Cox proportional hazards models were used to examine the association of frailty with mortality. Frailty was assessed at baseline, according to the Clinical Frailty Scale (CFS), where higher categories indicate worse frailty. Analyses were adjusted for age, sex, deprivation, ethnicity, previous admissions and acute illness severity. RESULTS: Six hundred and sixty-four patients were classified according to CFS. Two hundred and seventy-one died, during a mean follow-up of 34.3 days. Worse frailty at baseline was associated with increased mortality risk, even after full adjustment (P = 0.004). Patients with CFS 4 and CFS 5 had non-significant increased mortality risks, compared to those with CFS 1-3. Patients with CFS 6 had a 2.13-fold (95% CI 1.34-3.38) and those with CFS 7-9 had a 1.79-fold (95% CI 1.12-2.88) increased mortality risk, compared to those with CFS 1-3 (P = 0.001 and 0.016, respectively). Older age, male sex and acute illness severity were also associated with increased mortality risk. CONCLUSIONS: Frailty is associated with all-cause mortality risk in older inpatients with COVID-19. Copyright © The Author(s) 2020. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.
  • The impact of lockdown during the COVID-19 pandemic on osteoporotic fragility fractures: An observational study.

    Ogliari, Giulia; Lunt, Eleanor; Marshall, Lindsey; Sahota, Opinder (2020)
    We investigated whether osteoporotic fractures declined during lockdown, among adults aged 50 years and older. We showed that fewer outpatients attended the Fracture Clinic, for non-hip fractures, during lockdown; in contrast, no change in admissions for hip fractures was observed. This could be due to fewer outdoors falls, during lockdown. PURPOSE: Many countries implemented a lockdown to control the spread of the COVID-19 pandemic. We explored whether outpatient attendances to the Fracture Clinic for non-hip fragility fracture and inpatient admissions for hip fracture declined during lockdown, among adults aged 50 years and older, in a large secondary care hospital. METHODS: In our observational study, we analysed the records of 6681 outpatients attending the Fracture Clinic, for non-hip fragility fractures, and those of 1752 inpatients, admitted for hip fracture, during the time frames of interest. These were weeks 1st to 12th in 2020 ("prior to lockdown"), weeks 13th to 19th in 2020 ("lockdown") and corresponding periods over 2015 to 2019. We tested for differences in mean numbers (standard deviation (SD)) of outpatients and inpatients, respectively, per week, during the time frames of interest, across the years. RESULTS: Prior to lockdown, in 2020, 63.1 (SD 12.6) outpatients per week attended the Fracture Clinic, similar to previous years (p value 0.338). During lockdown, 26.0 (SD 7.3) outpatients per week attended the Fracture Clinic, fewer than previous years (p value < 0.001); similar findings were observed in both sexes and age groups (all p values < 0.001). During lockdown, 16.1 (SD 5.6) inpatients per week were admitted for hip fracture, similar to previous years (p value 0.776). CONCLUSION: During lockdown, fewer outpatients attended the Fracture Clinic, for non-hip fragility fractures, while no change in inpatient admissions for hip fracture was observed. This could reflect fewer non-hip fractures and may inform allocation of resources during pandemic.
  • Seasonality of adult fragility fractures and association with weather: 12-year experience of a UK Fracture Liaison Service.

    Ogliari, Giulia; Marshall, Lindsey; Sahota, Opinder (2021)
    PURPOSE: To investigate the monthly and seasonal variation in adult osteoporotic fragility fractures and the association with weather. METHODS: 12-year observational study of a UK Fracture Liaison Service (outpatient secondary care setting). Database analyses of the records of adult outpatients aged 50 years and older with fragility fractures. Weather data were obtained from the UK's national Meteorological Office. In the seasonality analyses, we tested for the association between months and seasons (determinants), respectively, and outpatient attendances, by analysis of variance (ANOVA) and Tukey's test. In the meteorological analyses, the determinants were mean temperature, mean daily maximum and minimum temperature, number of days of rain, total rainfall and number of days of frost, per month, respectively. We explored the association of each meteorological variable with outpatient attendances, by regression models. RESULTS: The Fracture Liaison Service recorded 25,454 fragility fractures. We found significant monthly and seasonal variation in attendances for fractures of the: radius or ulna; humerus; ankle, foot, tibia or fibula (ANOVA, all p-values Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.
  • Association between body mass index and falls in community-dwelling men and women: A prospective, multinational study in the Survey of Health, Ageing and Retirement in Europe (SHARE).

    Ogliari, Giulia; Masud, Tahir (2021)
    PURPOSE: To investigate the longitudinal associations between body mass index (BMI) categories and falls risk in men and women. METHODS: Prospective cohort study using data from 50,041 community-dwelling adults aged >= 50 years assessed in Wave 6 and 7 in the cross-national Survey of Health, Ageing and Retirement in Europe (SHARE). Socio-demographic and clinical factors were assessed at baseline (Wave 6). Functional impairment was defined by any limitations in activities of daily living (ADL) or instrumental ADL (IADL). Participants were classified as underweight, normal weight, overweight or obese at baseline. At 2-year follow-up (Wave 7), falls in the previous six months were recorded. The longitudinal associations between BMI categories and falls were analysed by binary logistic regression models; odds ratios (OR) and 95% confidence intervals (CI) were calculated. All analyses were adjusted for socio-demographic and clinical factors. Furthermore, analyses were stratified by sex, age and functional impairment. RESULTS: Mean age was 67.0 years (range 50-102); 28,132 participants were women; 4057 (8.1%) participants reported falls at follow-up. Participants had an increased falls risk [OR (95% CI)] if they were underweight [1.41 (1.06-1.88), p = 0.017] or obese [1.20 (1.09-1.32), p = 65 years. In participants with functional impairment, underweight was associated with higher falls risk [1.61 (1.09-2.40), p = 0.018], while obesity was not. CONCLUSION: A U-shaped relationship between BMI and falls risk was found in community-dwelling adults. Copyright © 2021. European Geriatric Medicine Society.
  • Subjective vision and hearing impairment and falls among community-dwelling adults: A prospective study in the Survey of Health, Ageing and Retirement in Europe (SHARE).

    Ogliari, Giulia; Masud, Tahir (2021)
    PURPOSE: To investigate the association between vision and hearing impairment and falls in community-dwelling adults aged >= 50 years. METHODS: This is a prospective study on 50,986 participants assessed in Waves 6 and 7 of the Survey of Health, Ageing and Retirement in Europe. At baseline, we recorded socio-demographic data, clinical factors and self-reported vision and hearing impairment. We classified participants as having good vision and hearing, impaired vision, impaired hearing or impaired vision and hearing. We recorded falls in the six months prior to the baseline and 2-year follow-up interviews. The cross-sectional and longitudinal associations between vision and hearing impairment categories and falls were analysed by binary logistic regression models; odds ratios (OR) and 95% confidence intervals (CI) were calculated. All analyses were adjusted for socio-demographic and clinical factors. RESULTS: Mean age was 67.1 years (range 50-102). At baseline, participants with impaired vision, impaired hearing, and impaired vision and hearing had an increased falls risk (OR (95% CI)) of 1.34 (1.22-1.49), 1.34 (1.20-1.50) and 1.67 (1.50-1.87), respectively, compared to those with good vision and hearing (all p Copyright © 2021. European Geriatric Medicine Society.
  • No association between frailty index and epigenetic clocks in Italian semi-supercentenarians.

    Ogliari, Giulia (2021)
    Centenarians experience successful ageing, although they still present high heterogeneity in their health status. The frailty index is a biomarker of biological age, able to capture such heterogeneity, even at extreme old age. At the same time, other biomarkers (e.g., epigenetic clocks) may be informative the biological age of the individual and potentially describe the ageing status in centenarians. In this article, we explore the relationship between epigenetic clocks and frailty index in a cohort of Italian centenarians. No association was reported, suggesting that these two approaches may describe different aspects of the same ageing process. Copyright © 2021 The Author(s). Published by Elsevier B.V. All rights reserved.

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