Alcohol related Korsakoffs disease is most likely non-progressive. Of those who do, there is probably an additional underlying disease process. #ANZSGM2021 Assoc. Professor Dr Steven Macfarlane #geriatrics #medtwitter
Discussing people with dementia who have Brodaty Tier 5-6+ behaviours and the role of Specialist Dementia Care Units. More info here: health.gov.au/initiatives-an…
#ANZSGM2021 Assoc. Professor Dr Steven Macfarlane #geriatrics #medtwitter
SDCP: behaviours need to be refractory to management by a specialist or specialist service. Behaviours might flare but if they are addressed by a geriatrician/psychogeriatrician or other specialist service and allowed to settle, then they will not meet criteria. #ANZSGM2021
Great modification of Brodaty's tiered model of service delivery and how it relates to services available. #ANZSGM2021 Assoc. Professor Dr Steven Macfarlane #geriatrics #medtwitter
Dementia Support Australia referral has doubled from roughly 6000 since 2017 to over 12,000 in 2020. #ANZSGM2021 Assoc. Professor Dr Steven Macfarlane #geriatrics #medtwitter
Average clients - females more likely to need DBMAS (Dementia Behaviour Management Advisory Service level input, males: SBRT (Severe Behaviour Response Team). #ANZSGM2021 Assoc. Professor Dr Steven Macfarlane #geriatrics #medtwitter
What happens when you give individualised multimodal nonpharmacological measures to people with severe BPSD? Outcomes on NPIs were between 60 and 75% reduction on BPSD which dwarfs effect sizes of antipsychotics. VERY exciting!! #ANZSGM2021 Assoc. Professor Dr Steven Macfarlane

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More from @DrKate_Miller

21 May
Alright, a tweet series on what I currently think about the AZ vaccine. This is NOT medical advice, I am not an expert by any means, I don't have the same access to data that the public health guys do, I'm just a geriatrician trying to figure this out too in an info vacuum.
So before you get stuck into me about being a murderer/playing god/being Bill Gates drone...just don't. I'm not here to shame anyone, I'm here to discuss. Whatever you choose, based on your own personal circumstances, is just fine.
In 800 AD smallpox had wiped out millions. Chinese doctors discovered that by taking scrapings of smallpox and pipetting it up peoples noses, they could prevent smallpox. The fatality rate of this was a whopping 1%. People still took it; the smallpox death rate was 35%.
Read 25 tweets
21 May
Roots of geriatric medicine stretch back 5000 years ago, in the Nile Valley, Egypt. Demonstrating a hieroglyph for the world 'old'. It's a bent over person with a gait aid! #ANZSGM2021 Dr William Browne - The Unexpected History of Geriatric Medicine Image
(I am loving this talk SICK). Ptah-Hotel 2000 BCE - "Old age makes a man miserable". #ANZSGM2021 Dr William Browne
Ancient Greek depiction of 'Geras' the god of old age - the root of the word geriatric. #ANZSGM2021 Dr William Browne Image
Read 24 tweets
20 May
Up now at #ANZSGM2021: Vaccination considerations in the elderly. Professor Michael Woodward. Disclosure: Sponsored by GSK #geriatrics
Possible modulators of age-related decline in immunity
- mediteranean diet preferred: vegetable and fish sources of protein in preference over animal protein
- caloric restriction
#ANZSGM2021 Professor Michael Woodward #geriatrics
Shingles: VZV specific t-cells decline with age (starts around 50), drop below the threshold to develop shingles. 15% of people will suffer a neurological event ie stroke in those who have zoster opthalmicus.
#ANZSGM2021 Professor Michael Woodward #geriatrics
Read 10 tweets
19 May
The very excellent Dr Clare White (and my former boss!) from Western Health up now on the COVID-19 response in aged care last year. #ANZSGM2021 Dr Clare White
Early: Lack of agreed on protocols across the country with onus placed on providers to be prepared. This overestimated the level of expertise in aged care to manage this especially with RC going on! Not enough focus on aged care, more on ED/ICU. #ANZSGM2021 Dr Clare White
Western Health and Melbourne Health carried the whole cluster due to the structure of regional hubs (as opposed to a single hub) 👏👏👏👏 #ANZSGM2021 Dr Clare White
Read 10 tweets
19 May
What went wrong in residential aged care last year in Victoria? Broadly: Governance, leadership and communication. Furloughing large swathes of staff caused critical failures. - no one available to provide primary care. #ANZSGM2021 Professor Michael Murray
Inreach geriatricians saved people by providing basic care in residential aged care as a result. 👏👏👏👏👏 Hospitals were focus of all thankyou gifts etc - nothing given to residential aged care staff looking after their covid residents. #ANZSGM2021 Professor Michael Murray
"We will never get some of these people back into this industry. We never demonstrated that we gave a toss". Some facilities received death threats. Hospitals? Nothing. #ANZSGM2021 Professor Michael Murray
Read 5 tweets
18 May
Professor Sharon Lewin @ #ANZSGM2021 (paraphrased): Clotting syndrome of AZ now less concerning now that we know how to rapidly identify and treat it, in addition to the point that it is very very rare.
Rationale for giving it to older Australians is that it's even more rare in their age group. We are NOT safe to avoid vaccination because of current low community transmission. If we have an outbreak (and highly possible we will), no one is protected. #ANZSGM2021
On variants: Calling variants by country name ie UK variant, Indian variant etc is unfair, as this is simply where the variant was first identified, not where it originated. #ANZSGM2021
Read 5 tweets

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