Discover and read the best of Twitter Threads about #Frailty
Most recents (17)
The challenge with NHS @ Home is we are not currently working to keep patients at home.
In the #BNSSG area:
84% of patients could have left hospital earlier. With an average of 16 extra bed days per patient.
In the #BNSSG area:
84% of patients could have left hospital earlier. With an average of 16 extra bed days per patient.
“We can do better”
➡️ frailty and increased care needs are not a surprise.
Patients aged 80+ (3% gen pop) account for 30,000 bed days annually.
#SWPiPC
➡️ frailty and increased care needs are not a surprise.
Patients aged 80+ (3% gen pop) account for 30,000 bed days annually.
#SWPiPC
Lovely to see @l_whyte at the #bgsconf today in Glasgow!
Lots of great work in @NHSLanarkshire on #Frailty and their work as a community multidisciplinary team. 👏👏
Lots of great work in @NHSLanarkshire on #Frailty and their work as a community multidisciplinary team. 👏👏
There is research evidence to back up what’s being done. GPs and Primary Care Teams can do this, but don’t have time so having the MDT is working well.
#bgsconf
#bgsconf
Next up at the #bgsconf meeting is @GrahamEllis247, talking about the Older People’s Strategy.
How do we address the health inequalities that afflict our country so badly?
#SDOH #inequality
How do we address the health inequalities that afflict our country so badly?
#SDOH #inequality
So many challenges. Older people are often discriminated against and yet are also often quite passive in accepting what they experience.
#bgsconf
#bgsconf
Thank you to everyone who responded to our call below.
All signposts to resources/networks/committees will appear in the following Wiley texts (if proposals accepted), see thread 🧵👇🏻
#AdvancedPractice #ACP #ACCP #SCP #CNS #FCP #ANP @HonoraryGeordi_
All signposts to resources/networks/committees will appear in the following Wiley texts (if proposals accepted), see thread 🧵👇🏻
#AdvancedPractice #ACP #ACCP #SCP #CNS #FCP #ANP @HonoraryGeordi_
📕#ACP at a glance - approved, due in print Autumn/Winter 2022
📙#AdvancedPractice Framework (APF) for UK practice - approved, due in print Autumn/Winter 2022
📘 APF for Acute, Emergency & Crit Care - proposal under peer review
#CriticalCare #emergencymedicine #ACCP #ECACP
📙#AdvancedPractice Framework (APF) for UK practice - approved, due in print Autumn/Winter 2022
📘 APF for Acute, Emergency & Crit Care - proposal under peer review
#CriticalCare #emergencymedicine #ACCP #ECACP
📗 APF for #Paediatric & Child Health - proposal in development
📙 APF for MH, LD & Autism - initial expressions of interest (EOIs)
📕 APF for #PrimaryCare - initial EOIs
📘 APF for #Frailty , Rehabilitation & community-based care - (initial EOIs!)
#AdvancedPractice #ACP #AP
📙 APF for MH, LD & Autism - initial expressions of interest (EOIs)
📕 APF for #PrimaryCare - initial EOIs
📘 APF for #Frailty , Rehabilitation & community-based care - (initial EOIs!)
#AdvancedPractice #ACP #AP
Excited to share thesis: Socioeconomic inequalities in multimorbidity and joint associations with mortality in a general population. @theHUNTstudy
hdl.handle.net/11250/2735980
#socialepi #sdoh #multimorbidity #frailty #publichealth @NTNU_ISM @ANUmedia 🧵(12+thanks)
hdl.handle.net/11250/2735980
#socialepi #sdoh #multimorbidity #frailty #publichealth @NTNU_ISM @ANUmedia 🧵(12+thanks)
Multimorbidity(MM), the co-occurrence of multiple, chronic conditions, where none is more central, is the norm worldwide. MM challenges the person and clinicians in a fragmented healthcare system, aided by single disease guidelines. #medtwitter soundcloud.com/bmjpodcasts/wh…
Complexity in MM vary and relate to conditions, individual & social context. I aimed to investigate clinically relevant measures of MM and how socioeconomic position (SEP), a known complicating context, related to these in prevalence distribution and joint impact on mortality.
1/n
Thread
SOLUTIONS to avoid the disproportionate burden of Covid19 on elderly care.
The vast majority of Covid19 deaths are in nursing homes and to a lesser degree in at home care.
@LTCcovid @SwissScience_TF @keiserolivia @MBattegay @eggersnsf @EicherManuela @curaviva_ch
Thread
SOLUTIONS to avoid the disproportionate burden of Covid19 on elderly care.
The vast majority of Covid19 deaths are in nursing homes and to a lesser degree in at home care.
@LTCcovid @SwissScience_TF @keiserolivia @MBattegay @eggersnsf @EicherManuela @curaviva_ch
2a/n nursing homes make up roughly ~1% of the overall population.
It MUST be possible to focus resources on this tiny population minority and achieve better outcomes.
We have 100'000 beds in Switzerland = 1.2% of population. Death share >>50%
gateway.euro.who.int/en/indicators/…
It MUST be possible to focus resources on this tiny population minority and achieve better outcomes.
We have 100'000 beds in Switzerland = 1.2% of population. Death share >>50%
gateway.euro.who.int/en/indicators/…
2b/n
we have made multiple threads with data and questions as to how and potentially why elderly care was/is hit so hard by Covid19
First: The patterns are similar all over the Western world and have WORSENED in many countries in the 2nd wave
we have made multiple threads with data and questions as to how and potentially why elderly care was/is hit so hard by Covid19
First: The patterns are similar all over the Western world and have WORSENED in many countries in the 2nd wave
1/n
#Frailty is the MAIN #Covid19 risk
Swedish per capita excess mortality over 70 is almost EXCLUSIVELY in nursing homes ("särskilt boende") and home care ("hemtjänst").
Almost NO excess in no care ("ej").
@LTCcovid @MBattegay
socialstyrelsen.se/globalassets/1…
#Frailty is the MAIN #Covid19 risk
Swedish per capita excess mortality over 70 is almost EXCLUSIVELY in nursing homes ("särskilt boende") and home care ("hemtjänst").
Almost NO excess in no care ("ej").
@LTCcovid @MBattegay
socialstyrelsen.se/globalassets/1…
2/n
baseline of previous years shows
1. per capita mortality risk is always much higher in elderly care settings. that means life expectancy is much shorter.
2. always MILD seasonality in deaths of all causes +/- 12.5%.
this year is different... cont.
baseline of previous years shows
1. per capita mortality risk is always much higher in elderly care settings. that means life expectancy is much shorter.
2. always MILD seasonality in deaths of all causes +/- 12.5%.
this year is different... cont.
3/n
Peak excess mortality in Sweden during 1st wave this year +~100% in nursing homes,
+~33% in at home elderly care.
maybe briefly in some weeks ~+25% in no care in 70+ years, this one is difficult to estimate from chart due to low baseline number.
Peak excess mortality in Sweden during 1st wave this year +~100% in nursing homes,
+~33% in at home elderly care.
maybe briefly in some weeks ~+25% in no care in 70+ years, this one is difficult to estimate from chart due to low baseline number.
Continuing our #KidneyWk virtual e-poster tour! Check out this thread for some interesting research on #exercise, #PhysicalActivity, & #PhysicalFunction in CKD and ESKD!
A comparison of #frailty measures among individuals referred for #KidneyTransplant in Canada (PO1704). #KidneyWk @FilteredDoc @tennankore @CNTN_RCEN
A pilot RCT to embed technology-enabled group-based #Exercise programming in the clinic: The Exercise Is Medicine in Chronic Kidney Disease Trial (PO2057). #KidneyWk @felipelobelo @ahadbootwala @Shuchi_Anand @JasonCobbMD
@DukePallCare SUCCESS! Journal Club Time Machine: Speed Dating with the Classics. Format - everyone in attendance (MS2-Attending) teaches a classic article for 4 minutes, it is put in context by someone old for 1-2 min, and we move on. Here's the list! A #HPC thread:
No 1 - SUPPORT Trial: pubmed.ncbi.nlm.nih.gov/7474243/. 5 AMCs. Docs don't know pt's CPR preference, many DNRs within 2d of death, lots of ICU time and pain. RN led intervention gives docs data. Centers around communication. NO CHANGE IN KEY METRICS.
No 2 - Prognostication: pubmed.ncbi.nlm.nih.gov/10678857/. Docs of pts referred to #hospice asked for assessment of prognosis. Only 20% accurate (+/- 33%) with most over-optimistic. Average miss factor of 5.3! Longer pt/doc relationship = worse prognostication accuracy (#LoveThemTooMuch)
Cool #Senescence paper #2, in @JCI_insight: insight.jci.org/articles/view/….
@marissa_schafer, Xu Zhang, @NKLeBRASSEUR & team dive into the details of SASP, the Senescence Associated Secretory Phenotype first discovered in the Campisi lab @BuckInstitute.
@marissa_schafer, Xu Zhang, @NKLeBRASSEUR & team dive into the details of SASP, the Senescence Associated Secretory Phenotype first discovered in the Campisi lab @BuckInstitute.
SASP is a prime suspect for how #Senescent cells cause #Inflammation, #Cancer and #Fibrosis. But SASP is a mix of many secreted proteins, so the @MayoClinic looked closely at 24 factors.
1st, they show which factors are secreted by different cell types (in culture).
1st, they show which factors are secreted by different cell types (in culture).
Next, and more exciting, they measured which SASP factors increase with age in human blood. #ChronicInflammation is an important mechanism of aging, but really defining #ChronicInflammation is hard and often not even attempted. So this detailed analysis is great.
Our new meta analysis led by @SylvieAucoin now out in @_Anesthesiology. Seems like a good time for a thread on choosing a frailty instrument for #periop care 1/
2/ There are dozens of frailty instruments (big problem) but in reality 4 are commonly used: Frailty Index, Frailty Phenotype, Clinical Frailty Scale, Edmonton Frail Scale
3/ All 4 Frailty instruments predict/are associated with bad outcomes. Effective sizes vary but are not substantively different. Discrimination generally moderate, calibration WAY under-reported
So grateful to @TheFangGroupUiO and impressed with @NoAge100. Months ago, I told Evandro that @HorizonsHK invited me to beautiful #Norway. He responded with a request to keynote noage100.com/2019/08/17/nad…
At this conf, there were presentations on clinical testing of #nicotinamideriboside in #ataxiatelangiectasia, #Parkinsonsdisease, #frailty, #chemotherapyinducedcardiomyopathy & #amyotrophiclateralsclerosis, all premised on sound preclinical data and all based in beautiful Norway
Beyond that, they have strong interest/plans in #alcoholicliverdisease, #mildcognitiveimpairment & more. So impressed with the scientists, physicians & institutions in Norway that make this possible @Ahus_no @oslouniversity @ChromaDex #NR #NAD #Bergen #Tromsø #thebestisyettocome
Hoy en el CAP Sagrada Familia (Barcelona) @consorcsanitari, empezamos con las pruebas funcionales del programa @vivifrail (Programa Multicomponente de ejercicio físico para prevención de la #fragilidad y el riesgo de caídas) 🏃🏻♀️🏃🏻♂️
Organiza: Fundacio Salut i envelliment @fsie_uab
Organiza: Fundacio Salut i envelliment @fsie_uab
La actividad se realizará en el @caprogerflor como parte del proyecto de prescripción social del barrio Sagrada Familia #prescripciosocialSF #placomunitari @silviasimo72 @AlbaGili1 @gelesmm @BlancafortSergi gracias por vuestra confianza!
Test VIVIFRAIL 2.0, mucho más fácil de aplicar con los nuevos recursos del Folleto Programa de Entrenamiento Físico vivifrail.com/resources #vivifrail #frailty
Animo a todos los profesionales sanitarios a aplicarlo! 👩🏻⚕️👨🏻⚕️🏃🏻♂️🏃🏻♀️💪🏻👴🏻👵🏼
Animo a todos los profesionales sanitarios a aplicarlo! 👩🏻⚕️👨🏻⚕️🏃🏻♂️🏃🏻♀️💪🏻👴🏻👵🏼
On the cover—#Frailty as an emerging global health burden
With prevalence of this complex age-related clinical condition expected to rise alongside a rapidly ageing population, a new Series calls for evidence-based, feasible & cost-effective interventions hubs.ly/H0lc7Mh0
With prevalence of this complex age-related clinical condition expected to rise alongside a rapidly ageing population, a new Series calls for evidence-based, feasible & cost-effective interventions hubs.ly/H0lc7Mh0
@EmielHoogendijk @ElsaDent Burden of #frailty: global prevalence is not yet known, partly because research has mainly been done in high-income countries. Some studies have observed that prevalence is higher in women than in men and rises with age hubs.ly/H0ldMDc0
@EmielHoogendijk @ElsaDent #Frailty in daily practice: By considering a patient’s degree of frailty, clinicians can deliver more patient-centred care, leading to better outcomes & avoidance of harm in primary, secondary & tertiary prevention of disease, but more research is needed hubs.ly/H0ldMDc0
Thread: Decreasing muscle mass in aging: The harmful effects and how to counteract ––
Tags: #sarcopenia #aging #ageing #HealthyAging #MSKover50 #resistance training, #weights #physicalmobility #muscle, #protein
#osteoporosis #bone #fracture #falls
Image: iofbonehealth.org/what-sarcopenia
Tags: #sarcopenia #aging #ageing #HealthyAging #MSKover50 #resistance training, #weights #physicalmobility #muscle, #protein
#osteoporosis #bone #fracture #falls
Image: iofbonehealth.org/what-sarcopenia
Thread: 🔽muscle in #aging ––#Sarcopenia RX, prevention –––
#MSKover50 #resistance #physicalmobility #osteoporosis #bone #fracture #falls
Lifespan vs. Healthspan: Why We Need Muscle for #HealthyAging.
runnersworld.com/health-injurie…
+
Live Strong and Prosper...
link.springer.com/article/10.100…
#MSKover50 #resistance #physicalmobility #osteoporosis #bone #fracture #falls
Lifespan vs. Healthspan: Why We Need Muscle for #HealthyAging.
runnersworld.com/health-injurie…
+
Live Strong and Prosper...
link.springer.com/article/10.100…
Thread: Sarcopenia in #Aging: RX, prevention –––
🔽
Biochemical Pathways of #Sarcopenia &Their Modulation by Physical #Exercise: A Narrative Review
frontiersin.org/articles/10.33… …
H/T @MathewPiasecki Tags: #MSKover50
LT: Key RE: onset & progress
RT: Rec. of @ACSMNews & @American_Heart
🔽
Biochemical Pathways of #Sarcopenia &Their Modulation by Physical #Exercise: A Narrative Review
frontiersin.org/articles/10.33… …
H/T @MathewPiasecki Tags: #MSKover50
LT: Key RE: onset & progress
RT: Rec. of @ACSMNews & @American_Heart
Had a chance to take a deep dive into a recent paper on #frailty in #TAVR by @glen_martin1 @mmamas1973 et al so I figured I'd share some thoughts tweetorial-style
🅿️ Patients: 2,624 TAVRs from the population-based UK registry... lucky them - 95 prospectively collected variables on all TAVRs in the land
ℹ️ Independent var: F-R-A-I-L-T-Y as measured by 3 scales - CSHA Clinical Frailty Scale, Katz activities of daily living scale, poor mobility per MD's impression... I personally like all of these but *caveat* they reflect disability > frailty
In Hong Kong at Hospital Authority conf, speaking on frailty & illness acuity. As with work from @CamGeris the frailer someone is, the more lethal is illness acuity. And the longer the recovery time. It’s almost as if frailty degree estimates resilience. Or intrinsic capacity.
Of course there’s more to it than that. Social vulnerability (in relation to education, occupation, safe environment, supportive community) and personal health practices (exercise, not smoking, etc.) explain variability in the relationship between FI and mortality.
And more yet. Where do biomarkers come in? (As predictors, likely as a package.) And as @dr_shibley warns, how do we put all this together in ways that do not stigmatize, but still allow the complexity of #frailty to be taken seriously? (vs common sense? or harmful stereotype?)
