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NIHR Signal Routine measurement of grip strength can help assess frailty in hospital
Training clinical staff to routinely measure grip strength can help identify frail older hospital inpatients. This could help tailor their care. This NIHR-funded study was conducted across five acute medical wards in one hospital in England over a nine-month period. Nursing staff were trained to measure grip strength of people aged over 80 years. They were instructed to assess if those with low grip required nutritional supplements and to refer them to physiotherapy for consideration of strengt...
NIHR Signal UK-wide study reveals a pattern of delay in referrals to specialist end-of-life care
Referrals to hospice-based specialist palliative care occur closer to death in older than in younger people and in those without cancer. Existing evidence shows that some people near the end of life have a better quality of life and symptom control if they receive specialist palliative care. This research highlights the need to better understand the reasons for any delay. In this large NIHR-funded hospice study people aged under 50 years were referred to hospice specialist palliative care about...
NIHR Signal Yoga-based exercise can improve well-being for older people
Yoga-based exercise offers a safe and accessible way to improve health-related quality of life and mental well-being for people over 60. Evidence for a moderate benefit of yoga in later life now extends beyond improved balance and flexibility. Yoga includes stretches, poses, breathing routines and meditation. This review focused on the physical exercise/activity components. Most of the 12 included trials took place in Western countries and classes were all run by qualified yoga instructors as i...
NIHR Signal People maintain increases in physical activity three years after receiving pedometers
Middle-aged to older adults given pedometers and a walking programme as part of two NIHR trials continued to be active three years later. In one trial they were walking around 650 extra steps a day. In both trials, they spent about 30 minutes per week extra in moderate-to-vigorous physical activity compared to controls. Brisk walking is a good way for older adults to achieve physical activity recommendations. This is the long-term follow-up of two large NIHR-funded trials that recruited adults ...
NIHR Signal Enriched food and snacks can increase nutritional intake in older people in hospital
Enriching hospital food with energy or protein may improve nutrition in older people in hospital. Studies assessed in a systematic review showed consistent effects of enriched or fortified foods compared with usual nutrition. The extent of increased consumption varied depending on the amount and type of foods added. Malnutrition is common in older people in hospital, but patients may not enjoy consuming oral nutritional supplement drinks. This finding supports the Government’s strategy f...
NIHR Signal Multi-morbidity predicted to increase in the UK over the next 20 years
Two-thirds of adults aged over 65 are expected to be living with multiple health conditions (multi-morbidity) by 2035. Seventeen percent would be living with four or more diseases, double the number in 2015. One-third of these people would have a mental illness like dementia or depression. Increased life expectancy by around three years for both men and women means people will spend longer living with multi-morbidity. This study, partly supported by NIHR, ran a computer model using data on ove...
NIHR Signal Person-centred care improves quality of life for care home residents with dementia
A person-centred care intervention for people with dementia living in care homes improved their quality of life, reduced agitation and improved interactions with staff. It may also save costs compared with usual care. The WHELD intervention involves training staff in person-centred care, with a focus on improving social interactions and appropriate use of antipsychotic medications. An early study suggested it could halve antipsychotic use. This larger-scale NIHR trial conducted across 69 UK nu...
NIHR Signal Mat Pilates probably improves balance and strength in older adults
Mat Pilates appears to improve muscle strength, flexibility, balance and cardiovascular fitness in older people compared to no exercise. There are limitations to the reliability of the evidence, but the consistent effect across all the aspects of fitness suggests this is probably a useful option for the increasing number of older people who wish to maintain their fitness. This review pooled the results of nine trials of 415 older adults from around the world, though not the UK. Pilates sessions...
NIHR Signal Short-duration dual antiplatelet treatment is possible for older people receiving drug-coated stents
Drug-eluting stents are more effective than bare-metal stents for preventing repeat procedures to open narrowed heart arteries in older adults with coronary heart disease. In this trial both types of stents were used alongside short courses of dual antiplatelet medication, outcomes for those receiving drug-eluting stents were improved with no difference in bleeding complications or rates of in-stent clots. This multi-centre European study tested 1,200 people aged 75 years or older. Duration of ...
NIHR Signal Introducing a primary care risk prediction tool did not reduce emergency admissions
Predicting emergency admissions paradoxically increased hospital admissions from primary care across all risk groups by about 3% overall. The Predictive Risk Stratification Model (PRISM) was evaluated in a trial in general practices in Wales, and there is little evidence it benefits patients by reducing deaths or improving quality of life either. The number of people living to older age with chronic health conditions is growing. Various risk stratification tools have been introduced across the...
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