Our investigation of electronic databases, including Ovid MEDLINE, PubMed, Ovid EMBASE, and CINAHL, extended from 2010 until January 1, 2023. We utilized Joanna Briggs Institute software for assessing bias risk and conducting meta-analyses of the relationships between frailty status and outcomes. A comparative analysis of the predictive value of age and frailty was performed using a narrative synthesis.
Twelve studies qualified for inclusion in the meta-analyses. The presence of frailty was strongly correlated with elevated in-hospital mortality (odds ratio [OR] = 112, 95% confidence interval [CI] 105-119), prolonged hospital stays (OR = 204, 95% CI 151-256), reduced chances of discharge to home (OR = 0.58, 95% CI 0.53-0.63), and a higher incidence of in-hospital complications (OR = 117, 95% CI 110-124). Six studies, employing multivariate regression analysis, showed frailty as a more reliable predictor of adverse outcomes and mortality in older trauma patients compared to measures of injury severity and age.
Frail, older trauma patients demonstrate higher rates of death during their hospitalisation, prolonged stays, in-hospital complications, and less favourable discharge plans. Predicting adverse outcomes in these patients, frailty is a more reliable indicator than age. A useful prognostic variable, frailty status, can be expected to contribute significantly to patient care, clinical benchmark stratification, and research trial design.
Hospital stays are frequently prolonged and characterized by increased in-hospital complications, higher in-hospital mortality, and less favorable discharge destinations for older trauma patients who also exhibit frailty. novel medications Adverse outcomes in these patients are better forecasted by frailty than age. Frailty status is anticipated to be a valuable prognostic indicator for guiding patient management and stratifying clinical benchmarks and research trials.

A concerningly common issue for older people in aged care is the potential harm associated with polypharmacy. No double-blind, randomized, controlled studies of deprescribing multiple medications have been conducted to date.
Participants aged over 65 years (n=303, aiming for a total of 954 participants) in residential aged care facilities were enrolled in a three-armed randomized controlled trial comparing an open intervention, a blinded intervention, and a blinded control. Encapsulated medication for deprescribing was given to the blinded groups, meanwhile the remaining medications underwent discontinuation (blind intervention) or were continued unchanged (blind control). Unblinding of targeted medication deprescribing occurred in the third open intervention arm.
The study's participants consisted of 76% females, with an average age of 85.075 years. Significant decreases in the overall number of medications used per participant were observed over 12 months for both intervention groups (blind: 27 fewer medications; 95% CI -35 to -19; open: 23 fewer medications; 95% CI -31 to -14). This contrasted starkly with the control group, which exhibited a trivial reduction of 0.3 medicines (95% CI -10 to 0.4), indicating a substantial and statistically significant difference (P = 0.0053) between the interventions and the control. The reduction of routine medication prescriptions was not accompanied by a considerable increment in the use of 'when required' medicines. The mortality rates in the masked intervention arm (HR 0.93; 95% CI, 0.50–1.73; p = 0.83) and the open intervention arm (HR 1.47; 95% CI, 0.83–2.61; p = 0.19) were not significantly different from those in the control group.
The application of a protocol-based approach to deprescribing led to the discontinuation of two to three medications per person in the course of this study. Despite the failure to reach the pre-determined recruitment benchmarks, the influence of deprescribing on survival and other clinical outcomes remains uncertain.
Protocol-based deprescribing, as part of this study, showed efficacy in reducing the average number of medications per person by two to three. Multibiomarker approach The pre-determined recruitment targets not having been met, the effect of deprescribing on survival and other clinical outcomes remains uncertain.

Current clinical hypertension management in older people and its concordance with guidelines, especially regarding variations based on overall health conditions, is not well established.
To explore the prevalence of successful blood pressure management in older patients meeting National Institute for Health and Care Excellence (NICE) guidelines within one year of hypertension diagnosis, and identify predictors of achieving these targets.
Data from the Secure Anonymised Information Linkage databank, pertaining to Welsh primary care, was used in a nationwide cohort study to examine patients aged 65 years, newly diagnosed with hypertension between the 1st of June 2011 and the 1st of June 2016. Achieving NICE guideline blood pressure targets, based on the final blood pressure measurement taken within one year following diagnosis, was the primary outcome. Through the lens of logistic regression, the study examined the variables that forecast target attainment.
Among the 26,392 patients (55% female, with a median age of 71 years, interquartile range 68-77), 13,939 (representing 528%) reached their target blood pressure within a median follow-up duration of 9 months. Reaching target blood pressure was significantly associated with having a history of atrial fibrillation (OR 126, 95% CI 111, 143), heart failure (OR 125, 95% CI 106, 149), and myocardial infarction (OR 120, 95% CI 110, 132), contrasted with individuals without a prior history of these ailments. After controlling for confounding variables, care home residency, the extent of frailty, and the rise in co-morbidities did not predict target achievement.
Blood pressure, despite new hypertension diagnosis, remains insufficiently controlled in nearly half of older individuals one year later, with no correlation between achievement of targets and baseline frailty, multi-morbidity, or care home status.
Despite diagnosis, insufficient blood pressure control persists in almost half of older patients with newly diagnosed hypertension a year later; remarkably, achieving target blood pressure seems independent of baseline frailty, the burden of multiple illnesses, or residence in a care home.

Earlier research initiatives have established the substantial impact that plant-based diets can have. Yet, the notion that all plant-based foods are beneficial for dementia or depression is not universally true. Employing a prospective strategy, this study investigated the connection between an overall plant-based dietary pattern and the manifestation of dementia or depression.
A total of 180,532 participants from the UK Biobank study were part of our research, presenting no history of cardiovascular disease, cancer, dementia, or depression at the beginning of the study. Based on the 17 main food categories from Oxford WebQ, we established an overall plant-based diet index (PDI), a healthful plant-based diet index (hPDI), and an unhealthful plant-based diet index (uPDI). find more Using UK Biobank's hospital inpatient data, the prevalence of dementia and depression was assessed. To assess the connection between PDIs and the development of dementia or depression, Cox proportional hazards regression models were utilized.
During the follow-up period, a total of 1428 dementia cases and 6781 depression cases were recorded. After accounting for various potential confounding factors and contrasting the highest and lowest quintiles across three plant-based dietary indices, the multivariable hazard ratios (95% confidence intervals) for dementia were 1.03 (0.87, 1.23) for PDI, 0.82 (0.68, 0.98) for hPDI, and 1.29 (1.08, 1.53) for uPDI. The hazard ratios (95% confidence interval) for depression associated with PDI, hPDI, and uPDI were: 1.06 (0.98-1.14) for PDI, 0.92 (0.85-0.99) for hPDI, and 1.15 (1.07-1.24) for uPDI.
A plant-based diet abundant in healthier plant-derived foods was found to be associated with a lower incidence of dementia and depression, contrasting with a plant-based diet emphasizing less healthy plant-derived foods, which was associated with a greater likelihood of developing dementia and depression.
A plant-based diet rich in beneficial plant foods was found to be associated with a diminished risk of dementia and depression, contrasting with a plant-based diet that prioritized less healthful plant options, which was associated with a greater risk of both dementia and depression.
Midlife hearing loss, a potentially modifiable risk, is correlated with dementia. Addressing comorbid hearing loss and cognitive impairment within older adult services may pave the way for dementia risk reduction opportunities.
UK hearing care and cognitive assessment professional perspectives and present methods of both hearing assessment in memory clinics and cognitive care within hearing aid clinics are the focus of this research.
A national study using a survey methodology. During the period from July 2021 to March 2022, NHS memory service professionals and audiologists in NHS and private adult audiology settings received the online survey link through email and QR codes used at conferences. A presentation of descriptive statistics follows.
Responses to the survey included 135 professionals working in NHS memory services and 156 audiologists. Of those audiologists, 68% were NHS employed and 32% were from the private sector. Among memory service professionals, a substantial 79% anticipate more than a quarter of their patients experience considerable hearing impairments; 98% deem inquiring about auditory challenges beneficial, and 91% actually do; however, while 56% believe hearing tests are helpful in-house, only 4% actually conduct them. Thirty-six percent of audiologists anticipate that over a quarter of their older adult patients display significant memory problems; ninety percent feel that cognitive assessments are worthwhile, but only four percent actually perform them. Significant roadblocks encountered are the lack of training opportunities, constraints on available time, and inadequate resources.
Although there was recognition among professionals in memory and audiology services regarding the usefulness of managing this co-occurring condition, the common clinical practices display significant variation, often omitting consideration of this comorbidity.