Ageing & Dementia Publications

Prieto J, Wilson J, Tingle A, Cooper E, Handley M, Rycroft-Malone J, Bostock J, Williams L, Loveday H

Urinary tract infection is the most diagnosed infection in older people. It accounts for more than 50% of antibiotic prescriptions in care homes and is a frequent reason for care home residents being hospitalised.

This realist review developed and refined programme theories for preventing and recognising urinary tract infection, exploring what works, for whom and in what circumstances.

https://doi.org/10.3310/dadt3410

October 2024

Andrews N, Brooks C, Board M, Fraser S, Latter S, Aplin K, McCausland B, Radcliffe E, Amin J, Lim R, Van Leeuwen E, Ibrahim K

Polypharmacy is common amongst older people with dementia or mild cognitive impairment (MCI), increasing the risk of medication-related harm. Medicine optimisation and deprescribing to reduce polypharmacy is considered feasible, safe and can lead to improved health. However, for those living with dementia or MCI, this can be challenging. This systematic review aimed to summarise the evidence on the outcomes of medicine optimisation and deprescribing interventions for older people with dementia or MCI.

https://doi.org/10.1007/s40266-025-01189-2

March 2025

Ibrahim K, Cox NJ, Lim SER, Radcliffe E, Lundby C, Prokopidis K, Thompson W, Moriarty F

Polypharmacy (concomitant prescription of ≥ 5 medications) affects a third of older people, and evidence suggests an association with sarcopenia (loss of skeletal muscle mass/quality, muscle strength, and/or physical performance). As such, deprescribing has been recommended in routine management of sarcopenia, however it’s unknown whether deprescribing is beneficial. This systematic review aimed to understand effects of deprescribing on sarcopenia parameters in older adults.

https://doi.org/10.1186/s12877-025-05819-7

March 2025

Frankland J, Lee K, Bridges J

People living with a dementia are an increasing proportion of those residing in long term care settings. A person-centred approach is widely accepted practice for this group, but there is evidence that this is not universally applied. Material Citizenship™ is a novel delivery of person-centred dementia care and training which promotes the importance of functional objects to enhance choice, control and agency.

This evaluation of Material Citizenship™ assessed mode of training delivery, perceived impact of the training on care delivery, and implementation challenges.

https://doi.org/10.31389/jltc.321

February 2025

Corbett T, Meier N, Bridges J

The study aims to explore how healthcare workers (HCWs) navigate and experience time when caring for older cancer patients living with other illnesses.

This paper presents findings from a qualitative study of how HCWs conceptualise and navigate the temporal aspects of delivering personalised care to older people living with multimorbidity. Building on research from organisation studies and the sociology of time, we interviewed 19 UK HCWs about their experiences of delivering care to this patient group.

https://doi.org/10.1108/jhom-07-2024-0295

February 2025

Collins P, Hopkins S, Milbourn H, Etkind SN

Older people often live with multiple serious illnesses and frailty with a reduced biological reserve. People living with frailty face an inherently uncertain future with the unpredictable dying trajectory of frailty being widely recognised. Uncertainty can also result from healthcare systems, from fragmented care due to multiple illnesses, or patchy communication between services. It can leave patients, carers and health professionals distressed and overwhelmed.

Advance care planning seeks to help individuals articulate their preferences and priorities for care in the face of an uncertain future . Advance care planning is thus intertwined with and inseparable from uncertainty, yet the relationship between the two is relatively under-recognised and under-investigated. The papers in this themed collection explore aspects of this relationship in the context of frailty. 

https://doi.org/10.1093/ageing/afae146

September 2024

Christie R, Sadler E, Sait M, Light K, Cox C, Board M, Thomas S, Walker DM, Allen-Pick M, Bradbury K, Murphy J

Globally, the prevalence of long-term conditions (LTCs) continues to rise. The impact of LTCs presents significant challenges for international health and social care systems and continues to be a leading cause of mortality. Despite this, digital health coaching interventions (DHCIs) appear to be a promising strategy for managing chronic disease. The aims of this systematic review and narrative synthesis were to explore the barriers and enablers for the use of DHCIs and to gather valuable information to inform the development of a new DHCI for LTC management.

https://doi.org/10.1177/20552076241302230

December 2024

Boateng I, Pascual CR, Grassby P, Asghar Z, Ibrahim K

Polypharmacy is commonly defined as the use of five or more medicines. Its prevalence among over 65-year-olds has been estimated between 17–52% . Medication non-adherence, cognitive impairment and Adverse Drug Reactions (ADRs) are associated with polypharmacy. The risk associated with ADRs increases as the number of medicines increase. Older patients are particularly susceptible to ADRs due to multiple comorbidities, a high prevalence of multiple medications and age-related changes in pharmacokinetics and pharmacodynamics activities.

Most of the research into polypharmacy has been done in over 65-year-olds and have sought to establish its relationship with sociodemographic and clinical factors . The findings have been inconsistent and in some comorbidity was poorly adjusted or not adjusted for. Participants from single centre settings were used by others and the short- and long-term effects of polypharmacy and mortality has only been estimated by one study. Misclassification of polypharmacy was also possible in some studies as it was only estimated at baseline. This poses a problem as new medicines can be prescribed, or existing medicines reduced during the follow up period. 

This study aims to address these gaps by estimating polypharmacy as the average number of medicines and determining its association with mortality, falls, ADRs and hospitalizations at one and five years in over 75-year-olds

https://doi.org/10.1371/journal.pone.0317907

February 2025

Murphy T, Culliford DJ, Hawley S, Johansen A, Whitehouse MR, Judge A, Matharu GS

Hip fractures are common and cause a huge socioeconomic burden to patients, their carers, and healthcare services worldwide. Our aim was to examine how much hip fracture numbers would be expected to rise over coming decades, simply as a consequence of the ageing of the population.

https://doi.org/10.1016/j.injury.2024.111863

September 2024

Meredith SJ, Shepherd AI, Saynor ZL, Scott A, Gorczynski P, Perissiou M, Horne M, McNarry MA, Mackintosh KA, Witcher CSG

This study examines changes in device-based 24-hour movement behaviours (MB), and facilitators and barriers to physical activity (PA) and exercise, during remotely-delivered cardiac rehabilitation (RDCR).

This prospective observational study used wrist-worn GENEActiv accelerometers to assess MB of 10 service-users (63 ± 10 years) at the start, middle, and end of three-months of RDCR. Barriers and facilitators to PA and exercise were explored through self-report diaries and analysed using content analysis.

https://doi.org/10.1080/09638288.2024.2397086

September 2024

Prieto J, Wilson J, Tingle A, Cooper E, Handley M, Rycroft Malone J, Bostock J, Loveday H

Urinary tract infection (UTI) is the most diagnosed infection in older people living in care homes. Our objective was to identify interventions for recognising and preventing UTI in older people living in care homes in the UK and explain the mechanisms by which they work, for whom and under what circumstances.

https://doi.org/10.1136/bmjqs-2023-016967

August 2024

Sait MI, Christie RA, Cox C, Board M, Thomas S, O'Sullivan C, Davies C, Walker DM, Vassallo M, Sadler EA, Allen-Pick M, Moore P, Bradbury K, Murphy J.

Multidomain interventions in older adults offer the best opportunity to prevent, delay or reverse existing symptoms in the earlier stages of frailty and improve independence but can be costly, and difficult to deliver at scale. However, digital health interventions enable personalised care and empowerment through self-management of long-term conditions, used at any time and when combined with health coaching offer the potential to enhance well-being and facilitate the achievement of health-related goals. 

We aim to evaluate the feasibility and acceptability of a digital health platform for long-term disease management combined with health coaching for people living with mild-moderate frailty, targeting self-identified goals-activity, nutrition, mood, enhancing social engagement and well-being.

https://doi.org/10.1136/bmjopen-2023-080480

May 2024