Age and ageing
-
Delirium is not only one of the most common complications that older patients develop after admission to hospital but it is also one of the most serious. Although stroke is a known predisposing factor for delirium, few studies have investigated this association and results from existing studies give conflicting results with prevalence estimates ranging from 13 to 48%. The aetiology of delirium post-stroke is poorly understood. ⋯ However, it is known that the development of delirium post-stroke has grave prognostic implications. It is associated with longer stay in hospital, increased mortality and increased risk of institutionalisation post discharge. In this article, we review the literature to date on delirium in the acute stroke setting.
-
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.
-
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.
-
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.