1
|
Kharicha K, Manthorpe J, Iliffe S, Chew-Graham CA, Cattan M, Goodman C, Kirby-Barr M, Whitehouse JH, Walters K. Managing loneliness: a qualitative study of older people's views. Aging Ment Health 2021; 25:1206-1213. [PMID: 32091237 DOI: 10.1080/13607863.2020.1729337] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Engaging with older people who self-identify as lonely may help professionals in mental health and other services understand how they deal with loneliness. The evidence-base for effective interventions to address loneliness is inconclusive. This study aimed to explore how community-dwelling lonely older people in England manage their experiences of loneliness. Twenty eight community-dwelling older people identifying as lonely, based on responses to two loneliness measures (self-report and a standardised instrument), participated in in-depth interviews between 2013 and 2014. Fifteen lived alone. Thematic analysis of transcribed interviews was conducted by a multidisciplinary team including older people.Participants drew on a range of strategies to ameliorate their distress which had been developed over their lives and shaped according to individual coping styles and contexts. Strategies included physical engagement with the world beyond their home, using technologies, planning, and engagement with purpose in an 'outside world', and acceptance, endurance, revealing and hiding, positive attitude and motivation, and distraction within an 'inside world'. Strategies of interests and hobbies, comparative thinking, religion and spirituality and use of alcohol straddled both the inside and outside worlds. Participants conveyed a personal responsibility for managing feelings of loneliness rather than relying on others. This study includes the experiences of those living with loneliness whilst also living with other people. When developing policy and practice responses to loneliness it is important to listen attentively to the views of those who may not be engaging with services designed for 'the lonely' and to consider their own strategies for managing it.
Collapse
|
2
|
Brooke-Wavell K, Duckham RL, Iliffe S, Kendrick D, Skelton DA, Taylor R, Masud T. 77INFLUENCE OF FALL PREVENTION EXERCISE PROGRAMMES ON MARKERS OF INFLAMMATION AND CARDIOVASCULAR RISK IN OLDER PEOPLE. Age Ageing 2019. [DOI: 10.1093/ageing/afz059.08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
3
|
Kojima G, Avgerinou C, Iliffe S, Jivraj S, Sekiguchi K, Walters K. Erratum to: Fruit and Vegetable Consumption and Frailty: A Systematic Review. J Nutr Health Aging 2018. [DOI: 10.1007/s12603-018-1074-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
4
|
Kendrick D, Orton E, Lafond N, Audsley S, Maula A, Morris R, Vedhara K, Iliffe S. Keeping active: maintenance of physical activity after exercise programmes for older adults. Public Health 2018; 164:118-127. [PMID: 30286342 DOI: 10.1016/j.puhe.2018.08.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 07/09/2018] [Accepted: 08/03/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES To explore factors associated with maintenance of moderate-to-vigorous physical activity (MVPA) in community-dwelling adults aged ≥65 years after completing a 24-week exercise programme. STUDY DESIGN This is a cohort study nested within a randomised controlled trial evaluating group- and home-based exercise programmes for older people in England. METHODS MVPA levels and factors potentially associated with physical activity (PA) were self-reported at recruitment, 6, 12, 18 and 24 months after exercise programme. Multilevel logistic regression estimated odds ratios (ORs) for achieving target MVPA level (150 min/week) 6-24 months after exercise programmes ended. RESULTS Older people (OR per year increase: 0.89, 95% confidence interval [CI] 0.86, 0.93) and women (OR 0.47, 95% CI 0.33, 0.67) were less likely to achieve target MVPA. Those physically active at recruitment (OR 11.28, 95% CI 7.95, 16.01), with wider social networks (OR per unit increase in Lubben Social Network Scale: 1.06, 95% CI 1.03, 1.10) and performing more sit-to-stands in 30 s (OR for quartile 3 compared with quartile 1: 1.87, 95% CI 1.12, 3.10), were more likely to achieve target MVPA. Negative exercise expectations increased the odds of achieving target MVPA but only among the less active at recruitment (OR per unit increase in Outcome and Expectation for Exercise negative subscale: 1.90, 95% CI 1.39, 2.60). Associations did not differ significantly across the follow-up period. CONCLUSION A range of factors are associated with maintenance of PA 6-24 months after exercise programmes. Factors are not more strongly associated with shorter vs longer term PA maintenance. Commissioners and providers should consider targeting maintenance interventions to those least likely to maintain PA.
Collapse
|
5
|
Kojima G, Avgerinou C, Iliffe S, Jivraj S, Sekiguchi K, Walters K. 15FRUIT AND VEGETABLE CONSUMPTION AND FRAILTY: A SYSTEMATIC REVIEW. Age Ageing 2018. [DOI: 10.1093/ageing/afy134.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
6
|
Austin T, Wilcock J, Bryans M, Turner S, Downs M, Iliffe S. Design and Implementation of a Computer Decision Support System for the Diagnosis and Management of Dementia Syndromes in Primary Care. Methods Inf Med 2018. [DOI: 10.1055/s-0038-1634292] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Summary
Background:
Diagnosis and management of dementia is a complex process and primary care physicians are under-equipped to deal with uncertainties in the provision of optimal care for the patient.
Objective:
To develop a computer decision support system (CDSS) which could assist physicians with diagnosis and management and improve patient care.
Methods:
A design group including general practitioners derived logic pathways for diagnosis and management of dementia and validated them with a multi-professional expert group. Logic pathways were used to construct a comprehensive CDSS rendered as a series of expert consultations. The CDSS was inserted into commercially available GP systems and bench and field-tested.
Results:
The complexity of dementia diagnosis and management can be captured in logic pathways which can be expressed as decision trees within existing electronic patient records. The resulting CDSS appears useable in routine practice.
Conclusion:
The impact of this CDSS will be evaluated in a randomised controlled trial of educational interventions in primary care.
Collapse
|
7
|
Kojima G, Avgerinou C, Iliffe S, Jivraj S, Sekiguchi K, Walters K. Fruit and Vegetable Consumption and Frailty: A Systematic Review. J Nutr Health Aging 2018; 22:1010-1017. [PMID: 30272107 PMCID: PMC6182506 DOI: 10.1007/s12603-018-1069-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 03/16/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To identify currently available evidence on fruit and vegetable consumption in association with frailty by conducting a systematic review of the literature and to summarise and critically evaluate it. DESIGN Systematic review. SETTING Four electronic databases (Embase, MEDLINE, CINAHL and PsycINFO) were systematically searched in August 2017 for observational cohort studies providing cross-sectional or prospective associations between fruit and vegetable consumption and frailty risks. Additional studies were searched by manually reviewing the reference lists of the included studies and related review papers and conducting forward citation tracking of the included studies. The methodological quality of prospective studies was assessed using the Newcastle-Ottawa scale. PARTICIPANTS Community-dwelling general populations. RESULTS A total of 6251 studies were identified, of which five prospective studies with follow-up periods of 2-10.5 years and two cross-sectional studies were included. Among the five prospective studies, three had adequate methodological quality. Because of different measurements and statistical methodologies, a meta-analysis was not possible. The two studies of good quality showed that fruit and vegetable consumption was mostly associated with lower risk of incident frailty. The other study as a sub-analysis retrospectively examined baseline fruit and vegetable consumption of those who developed frailty and those who did not at follow-up and showed no significant associations. CONCLUSIONS Although good quality studies on this topic are scarce, there is some suggestion that higher fruit and vegetable consumption may be associated with lower frailty risk. More high quality research is needed.
Collapse
|
8
|
Hanratty B, Stow D, Clegg A, Iliffe S, Barclay S, Robinson L, Matthews F, Exley C. PRIMARY CARE FOR FRAIL OLDER ADULTS AT THE END OF LIFE: CAN A FRAILTY INDEX ENHANCE ROUTINE CARE? Innov Aging 2017. [DOI: 10.1093/geroni/igx004.5077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
9
|
Gordon A, Goodman C, Davies S, Handley M, Iliffe S, Bowman C, Victor C, Martin F. DEVELOPING A PROGRAMME THEORY OF HEALTH CARE IN UK CARE HOMES—REVIEWS, SURVEYS, AND INTERVIEWS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.3849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
10
|
Davies N, Lamahewa K, Mathew R, Wilcock J, Manthorpe J, Sampson E, Iliffe S. DEVELOPMENT OF HEURISTICS TO GUIDE DECISION MAKING AT THE END OF LIFE FOR SOMEONE WITH DEMENTIA. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
11
|
Kharicha K, Iliffe S, Manthorpe J, Chew-Graham C, Cattan M, Kirby-Barr M, Goodman C, Walters K. HOW DO OLDER PEOPLE MANAGE LONELINESS FOR THEMSELVES? A QUALITATIVE STUDY IN ENGLAND. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.3427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
12
|
Harris T, Furness C, Limb E, Kerry S, Victor C, Whincup P, Iliffe S, Ussher M, Wahlich C, Cook D. P98 From effective trial to NHS implementation: progressing the primary care Pedometer and consultation evaluation (PACE-UP) randomised controlled trial into routine practice. Br J Soc Med 2016. [DOI: 10.1136/jech-2016-208064.196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
13
|
Papachristou E, Wannamethee SG, Iliffe S, Papacosta AO, Lennon LT, Whincup PH, Ramsay SE. OP26 Self-reported frailty components predict incident disability, falls and all-cause mortality in later life: results from a prospective study of older British men. Br J Soc Med 2016. [DOI: 10.1136/jech-2016-208064.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
14
|
Mathew R, Davies N, Manthorpe J, Iliffe S. Making decisions at the end of life when caring for a person with dementia: a literature review to explore the potential use of heuristics in difficult decision-making. BMJ Open 2016; 6:e010416. [PMID: 27436665 PMCID: PMC4964249 DOI: 10.1136/bmjopen-2015-010416] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE Decision-making, when providing care and treatment for a person with dementia at the end of life, can be complex and challenging. There is a lack of guidance available to support practitioners and family carers, and even those experienced in end of life dementia care report a lack of confidence in decision-making. It is thought that the use of heuristics (rules of thumb) may aid decision-making. The aim of this study is to identify whether heuristics are used in end of life dementia care, and if so, to identify the context in which they are being used. DESIGN A narrative literature review was conducted taking a systematic approach to the search strategy, using the Centre for Reviews and Dissemination guidelines. Rapid appraisal methodology was used in order to source specific and relevant literature regarding the use of heuristics in end of life dementia care. DATA SOURCES A search using terms related to dementia, palliative care and decision-making was conducted across 4 English language electronic databases (MEDLINE, EMBASE, PsycINFO and CINAHL) in 2015. RESULTS The search identified 12 papers that contained an algorithm, guideline, decision tool or set of principles that we considered compatible with heuristic decision-making. The papers addressed swallowing and feeding difficulties, the treatment of pneumonia, management of pain and agitation, rationalising medication, ending life-sustaining treatment, and ensuring a good death. CONCLUSIONS The use of heuristics in palliative or end of life dementia care is not described in the research literature. However, this review identified important decision-making principles, which are largely a reflection of expert opinion. These principles may have the potential to be developed into simple heuristics that could be used in practice.
Collapse
|
15
|
Gawler S, Skelton DA, Dinan-Young S, Masud T, Morris RW, Griffin M, Kendrick D, Iliffe S. Reducing falls among older people in general practice: The ProAct65+ exercise intervention trial. Arch Gerontol Geriatr 2016; 67:46-54. [PMID: 27420150 DOI: 10.1016/j.archger.2016.06.019] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Revised: 06/22/2016] [Accepted: 06/23/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Falls are common in the older UK population and associated costs to the NHS are high. Systematic reviews suggest that home exercise and group-based exercise interventions, which focus on progressively challenging balance and increasing strength, can reduce up to 42% of falls in those with a history of falls. The evidence is less clear for those older adults who are currently at low risk of falls. AIM ProAct65+, a large, cluster-randomised, controlled trial, investigated the effectiveness of a home exercise programme (Otago Exercise Programme (OEP)) and a group-based exercise programme (Falls Management Exercise (FaME)) compared to usual care (UC) at increasing moderate to vigorous physical activity (MVPA). This paper examines the trial's secondary outcomes; the effectiveness of the interventions at reducing falls and falls-related injuries. SETTING & PARTICIPANTS 1256 community-dwelling older adults (aged 65+) were recruited through GP practices in two sites (London and Nottingham). Frequent fallers (≥3 falls in last year) and those with unstable medical conditions were excluded, as were those already reaching the UK Government recommended levels of physical activity (PA) for health. METHODS Baseline assessment (including assessment of health, function and previous falls) occurred before randomisation; the intervention period lasted 24 weeks and there was an immediate post-intervention assessment; participants were followed up every six months for 24 months. Falls data were analysed using negative binomial modelling. OUTCOME MEASURES Falls data were collected prospectively during the intervention period by 4-weekly diaries (6 in total). Falls recall was recorded at the 3-monthly follow-ups for a total of 24 months. Balance was measured at baseline and at the end of the intervention period using the Timed Up & Go and Functional Reach tests. Balance confidence (CONFbal), falls risk (FRAT) and falls self-efficacy (FES-I) were measured by questionnaire at baseline and at all subsequent assessment points. RESULTS 294 participants (24%) reported one or two falls in the previous year. There was no increase in falls in either exercise group compared to UC during the intervention period (resulting from increased exposure to risk). The FaME arm experienced a significant reduction in injurious falls compared to UC (incidence rate ratio (IRR) 0.55, 95% CI 0.31, 0.96; p=0.04) and this continued during the 12 months after the end of the intervention (IRR 0.73, 95% CI 0.54, 0.99; p=0.05). There was also a significant reduction in the incidence of all falls (injurious and non-injurious) in the FaME arm compared with UC (IRR 0.74, 95% CI 0.55, 0.99; p=0.04) in the 12 month period following the cessation of the intervention. There was a non-significant reduction in the incidence of all falls in the OEP arm compared with UC (IRR 0.76, 95% CI 0.53, 1.09; p=0.14) in the 12 months following the cessation of the intervention. The effects on falls did not persist at the 24 months assessment in either exercise arm. However, when those in the FaME group who continued to achieve 150min of MVPA per week into the second post-intervention year were compared to those in the FaME group who did not maintain their physical activity, there was a significant reduction in falls incidence (IRR=0.49, 95% CI 0.30, 0.79; p=0.004). CONFbal was significantly improved at 12 months post intervention in both intervention arms compared with UC. There were no significant changes in any of the functional balance measures, FES-I or FRAT, between baseline and the end of the intervention period. CONCLUSION Community-dwelling older adults who joined an exercise intervention (FaME) aimed at increasing MVPA did not fall more during the intervention period, fell less and had fewer injurious falls in the 12 months after cessation of the intervention. However, 24 months after cessation of exercise, the beneficial effects of FaME on falls reduction ceased, except in those who maintained higher levels of MVPA. OEP exercise appears less effective at reducing falls in this functionally more able population of older adults.
Collapse
|
16
|
Kojima G, Iliffe S, Walters K. 61SMOKING AS A PREDICTOR OF FRAILTY: A SYSTEMATIC REVIEW. Age Ageing 2016. [DOI: 10.1093/ageing/afw033.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
17
|
Walters K, Hardoon S, Petersen I, Iliffe S, Omar RZ, Nazareth I, Rait G. Predicting dementia risk in primary care: development and validation of the Dementia Risk Score using routinely collected data. BMC Med 2016; 14:6. [PMID: 26797096 PMCID: PMC4722622 DOI: 10.1186/s12916-016-0549-y] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 12/16/2015] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Existing dementia risk scores require collection of additional data from patients, limiting their use in practice. Routinely collected healthcare data have the potential to assess dementia risk without the need to collect further information. Our objective was to develop and validate a 5-year dementia risk score derived from primary healthcare data. METHODS We used data from general practices in The Health Improvement Network (THIN) database from across the UK, randomly selecting 377 practices for a development cohort and identifying 930,395 patients aged 60-95 years without a recording of dementia, cognitive impairment or memory symptoms at baseline. We developed risk algorithm models for two age groups (60-79 and 80-95 years). An external validation was conducted by validating the model on a separate cohort of 264,224 patients from 95 randomly chosen THIN practices that did not contribute to the development cohort. Our main outcome was 5-year risk of first recorded dementia diagnosis. Potential predictors included sociodemographic, cardiovascular, lifestyle and mental health variables. RESULTS Dementia incidence was 1.88 (95% CI, 1.83-1.93) and 16.53 (95% CI, 16.15-16.92) per 1000 PYAR for those aged 60-79 (n = 6017) and 80-95 years (n = 7104), respectively. Predictors for those aged 60-79 included age, sex, social deprivation, smoking, BMI, heavy alcohol use, anti-hypertensive drugs, diabetes, stroke/TIA, atrial fibrillation, aspirin, depression. The discrimination and calibration of the risk algorithm were good for the 60-79 years model; D statistic 2.03 (95% CI, 1.95-2.11), C index 0.84 (95% CI, 0.81-0.87), and calibration slope 0.98 (95% CI, 0.93-1.02). The algorithm had a high negative predictive value, but lower positive predictive value at most risk thresholds. Discrimination and calibration were poor for the 80-95 years model. CONCLUSIONS Routinely collected data predicts 5-year risk of recorded diagnosis of dementia for those aged 60-79, but not those aged 80+. This algorithm can identify higher risk populations for dementia in primary care. The risk score has a high negative predictive value and may be most helpful in 'ruling out' those at very low risk from further testing or intensive preventative activities.
Collapse
|
18
|
Liljas AEM, Wannamethee S, Whincup P, Papacosta O, Walters K, Iliffe S, Lennon L, Carvalho L, Ramsay S. 52SENSORY IMPAIRMENTS AND MORTALITY IN OLDER BRITISH COMMUNITY-DWELLING MEN: A 10-YEAR FOLLOW-UP STUDY. Age Ageing 2015. [DOI: 10.1093/ageing/afv109.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
19
|
Brooke-Wavell K, Duckham RL, Taylor R, Kendrick D, Carpenter H, Iliffe S, Morris R, Skelton DA, Dinan S, Gage H, Masud T. 46DOES ADHERENCE TO FALLS PREVENTION EXERCISE PROGRAMMES BENEFIT BONE MINERAL DENSITY IN OLDER PEOPLE? THE PROACT65+ BONE STUDY. Age Ageing 2015. [DOI: 10.1093/ageing/afv108.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
20
|
Davies N, Manthorpe J, Sampson EL, Iliffe S. After the Liverpool Care Pathway--development of heuristics to guide end of life care for people with dementia: protocol of the ALCP study. BMJ Open 2015; 5:e008832. [PMID: 26338688 PMCID: PMC4563245 DOI: 10.1136/bmjopen-2015-008832] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION End of life care guidance for people with dementia is lacking and this has been made more problematic in England with the removal of one of the main end of life care guidelines which offered some structure, the Liverpool Care Pathway. This guidance gap may be eased with the development of heuristics (rules of thumb) which offer a fast and frugal form of decision-making. OBJECTIVE To develop a toolkit of heuristics (rules of thumb) for practitioners to use when caring for people with dementia at the end of life. METHOD AND ANALYSIS A mixed-method study using a co-design approach to develop heuristics in three phases. In phase 1, we will conduct at least six focus groups with family carers, health and social care practitioners from both hospital and community care services, using the 'think-aloud' method to understand decision-making processes and to develop a set of heuristics. The focus group topic guide will be developed from the findings of a previous study of 46 interviews of family carers about quality end-of-life care for people with dementia and a review of the literature. A multidisciplinary development team of health and social care practitioners will synthesise the findings from the focus groups to devise and refine a toolkit of heuristics. Phase 2 will test the use of heuristics in practice in five sites: one general practice, one community nursing team, one hospital ward and two palliative care teams working in the community. Phase 3 will evaluate and further refine the toolkit of heuristics through group interviews, online questionnaires and semistructured interviews. ETHICS AND DISSEMINATION This study has received ethical approval from a local NHS research ethics committee (Rec ref: 15/LO/0156). The findings of this study will be presented in peer-reviewed publications and national and international conferences.
Collapse
|
21
|
Sartini C, Wannamethee SG, Iliffe S, Morris RW, Ash S, Lennon L, Whincup PH, Jefferis BJ. OP93 Objectively measured physical activity and sedentary behaviour in older men: diurnal patterns and their determinants. Br J Soc Med 2015. [DOI: 10.1136/jech-2015-206256.92] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
22
|
Furness CA, Howard EL, Harris T, Kerry SM, Victor CR, Ussher M, Whincup P, Shah S, Iliffe S, Ekelund U, Limb E, Fox-Rushby J, Cook DG. OP95 Evaluating implementation fidelity in the pace-up (pedometer and consultation evaluation-up) complex walking intervention. Br J Soc Med 2015. [DOI: 10.1136/jech-2015-206256.94] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
23
|
Liljas AEM, Wannamethee SG, Whincup PH, Papacosta O, Walters K, Iliffe S, Lennon LT, Carvalho LA, Ramsay SE. OP07 Sensory impairments and mortality in older british community-dwelling men: a 10-year follow-up study. J Epidemiol Community Health 2015. [DOI: 10.1136/jech-2015-206256.7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
24
|
Liljas AEM, Wannamethee SG, Whincup PH, Papacosta O, Walters K, Iliffe S, Lennon LT, Carvalho LA, Ramsay SE. Socio-demographic characteristics, lifestyle factors and burden of morbidity associated with self-reported hearing and vision impairments in older British community-dwelling men: a cross-sectional study. J Public Health (Oxf) 2015; 38:e21-8. [PMID: 26177816 DOI: 10.1093/pubmed/fdv095] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Hearing and vision problems are common in older adults. We investigated the association of self-reported sensory impairment with lifestyle factors, chronic conditions, physical functioning, quality of life and social interaction. METHODS A population-based cross-sectional study of participants of the British Regional Heart Study aged 63-85 years. RESULTS A total of 3981 men (82% response rate) provided data. Twenty-seven per cent (n = 1074) reported hearing impairment including being able to hear with aid (n = 482), being unable to hear (no aid) (n = 424) and being unable to hear despite aid (n = 168). Three per cent (n = 124) reported vision impairment. Not being able to hear, irrespective of use of hearing aid, was associated with poor quality of life, poor social interaction and poor physical functioning. Men who could not hear despite hearing aid were more likely to report coronary heart disease (CHD) [age-adjusted odds ratios (ORs) 1.89 (95% confidence interval 1.36-2.63)]. Vision impairment was associated with symptoms of CHD including breathlessness [OR 2.06 (1.38-3.06)] and chest pain [OR 1.58 (1.07-2.35)]. Vision impairment was also associated with poor quality of life, poor social interaction and poor physical functioning. CONCLUSIONS Sensory impairment is associated with poor physical functioning, poor health and poor social interaction in older men. Further research is warranted on pathways underlying these associations.
Collapse
|
25
|
Voss S, Benger J, Black S, Cheston R, Cullum S, Purdy S, Iliffe S. Training on dementia for emergency ambulance staff: research agenda and opportunities. Int J Geriatr Psychiatry 2015; 30:549-50. [PMID: 25855208 DOI: 10.1002/gps.4270] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 01/23/2015] [Indexed: 11/11/2022]
|