Age and ageing
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Reducing hospital length of stay (LOS) in older acute medical inpatients is a key productivity measure. Evidence-based predictors of greater LOS may be targeted through Comprehensive Geriatric Assessment (CGA). ⋯ CGA screening of acute medical inpatients leading to early geriatric intervention (ward-based case management, appropriate transfer to geriatric wards), improved clinical effectiveness and general hospital performance.
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Various modalities of exercise have been demonstrated to improve physical function and quality of life in older adults. Current guidelines stress the importance of multi-modal exercise for this cohort, including strengthening exercises, cardiovascular, flexibility and balance training. There is a lack of evidence, however, that simultaneously prescribed doses and intensities of strength, aerobic, and balance training in older adults are both feasible and capable of eliciting changes in physical function and quality of life. ⋯ Multi-modal exercise has a positive effect on falls prevention. The limited data available suggests that multi-modal exercise has a small effect on physical, functional and quality of life outcomes. Future research should include robustly designed trials that involve multi-modal exercise at individually prescribed intensities based on doses found to be effective in single-modality studies.
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To determine the association between functional and nutritional changes caused by an acute illness requiring hospitalisation and 6-month mortality. ⋯ Functional and nutritional changes due to an acute illness have a statistical and clinical prognostic value and should be assessed along with other well-known relevant prognostic factors.
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Multicenter Study Comparative Study
Access to stroke care in England, Wales and Northern Ireland: the effect of age, gender and weekend admission.
To determine whether access to high-quality stroke care is affected by the age or gender of the patient or by weekend admission. ⋯ There is clear evidence of an age effect on the delivery of stroke care in England, Wales, and Northern Ireland, with older patients being less likely to receive care in line with current clinical guidelines. Quality of acute care is also less good for patients admitted at weekends. No systematic evidence for sexism was identified.