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Professor Rowan Harwood's Outputs (115)

Psychiatry and the geriatric syndromes - Creating constructive interfaces (2017)
Journal Article
Thacker, S., Skelton, M., & Harwood, R. (2017). Psychiatry and the geriatric syndromes - Creating constructive interfaces. BJPsych Bulletin, 41(2), 71-75. https://doi.org/10.1192/pb.bp.115.051649

Integrating mental and physical healthcare is difficult to achieve because of professional and organisational barriers. Psychiatrists recognise the problems resulting from fragmentation of services and want continuity of care for patients, but commis... Read More about Psychiatry and the geriatric syndromes - Creating constructive interfaces.

Challenges and opportunities in understanding dementia and delirium in the acute hospital (2017)
Journal Article
Jackson, T. A., Gladman, J. R., Harwood, R. H., MacLullich, A. M., Sampson, E. L., Sheehan, B., & Davis, D. H. (2017). Challenges and opportunities in understanding dementia and delirium in the acute hospital. PLoS Medicine, 14(3), Article e1002247. https://doi.org/10.1371/journal.pmed.1002247

What is the problem?

Dementia in general hospitals

Dementia is very common in patients admitted to acute hospitals, affecting one in four patients, with 6% of people living with dementia being inpatients in acute hospitals at any given time [1,... Read More about Challenges and opportunities in understanding dementia and delirium in the acute hospital.

Where next for delirium research? (2017)
Journal Article
Harwood, R. H., & Teale, E. (2018). Where next for delirium research?. International Journal of Geriatric Psychiatry, 33(11), 1512-1520. https://doi.org/10.1002/gps.4696

Clinicians who manage delirium must do so without key information required for evidence‐based practice, not least lack of any clearly effective treatment for established delirium. Both the nature of delirium and the methods used to research it contri... Read More about Where next for delirium research?.

New horizons: the management of hypertension in people with dementia (2016)
Journal Article
Harrison, J. K., Van Der Wardt, V., Conroy, S. P., Stott, D. J., Dening, T., Gordon, A. L., Logan, P., Welsh, T. J., Taggar, J., Harwood, R., & Gladman, J. R. (2016). New horizons: the management of hypertension in people with dementia. Age and Ageing, 45(6), 740-746. https://doi.org/10.1093/ageing/afw155

The optimal management of hypertension in people with dementia is uncertain. This review explores if people with dementia experience greater adverse effects from antihypertensive medications, if cognitive function is protected or worsened by controll... Read More about New horizons: the management of hypertension in people with dementia.

Ambulatory blood pressure monitoring in older people with dementia: a systematic review of tolerability (2016)
Journal Article
Conroy, S. P., Harrison, J. K., van der Wardt, V., Harwood, R. H., Logan, P., Welsh, T., & Gladman, J. R. (2016). Ambulatory blood pressure monitoring in older people with dementia: a systematic review of tolerability. Age and Ageing, 45(4), 456-462. https://doi.org/10.1093/ageing/afw050

BACKGROUND:
Ambulatory blood pressure monitoring (ABPM) may be helpful for the management of hypertension, but little is known about its tolerability in people with dementia.

OBJECTIVE:
To review the published evidence to determine the tolerabil... Read More about Ambulatory blood pressure monitoring in older people with dementia: a systematic review of tolerability.

Economic Evaluation of a General Hospital Unit for Older People with Delirium and Dementia (TEAM Randomised Controlled Trial) (2015)
Journal Article
Bradshaw, L. E., Tanajewski, L., Franklin, M., Gkountouras, G., Berdunov, V., Harwood, R. H., Goldberg, S. E., Bradshaw, L., Gladman, J. R. F., & Elliott, R. A. (2015). Economic Evaluation of a General Hospital Unit for Older People with Delirium and Dementia (TEAM Randomised Controlled Trial). PLoS ONE, 10(12), e0140662. https://doi.org/10.1371/journal.pone.0140662

Background

One in three hospital acute medical admissions is of an older person with cognitive impairment. Their outcomes are poor and the quality of their care in hospital has been criticised. A specialist unit to care for older people with delir... Read More about Economic Evaluation of a General Hospital Unit for Older People with Delirium and Dementia (TEAM Randomised Controlled Trial).

The Balance and the Mind study: baseline data (2015)
Journal Article
van der Wardt, V., Logan, P., Booth, V., Hood, V., Masud, T., & Harwood, R. H. (2015). The Balance and the Mind study: baseline data. European Geriatric Medicine, 6(1), Article S55. https://doi.org/10.1016/S1878-7649%2815%2930190-X

OBJECTIVES: The purpose of the study was to establish falls risk factors for people with mild cognitive impairment and mild dementia.
METHODS: Survey of 76 people recruited from Memory Clinics (n=56), Falls Services (n=12), Community Geriatricians (... Read More about The Balance and the Mind study: baseline data.

Communication between family carers and health professionals about end-of-life care for older people in the acute hospital setting: a qualitative study (2015)
Journal Article
Caswell, G., Pollock, K., Harwood, R., & Porock, D. (in press). Communication between family carers and health professionals about end-of-life care for older people in the acute hospital setting: a qualitative study. BMC Palliative Care, 14(1), Article 35. https://doi.org/10.1186/s12904-015-0032-0

Background: This paper focuses on communication between hospital staff and family carers of patients dying on acute hospital wards, with an emphasis on the family carers’ perspective. The age at which people in the UK die is increasing and many conti... Read More about Communication between family carers and health professionals about end-of-life care for older people in the acute hospital setting: a qualitative study.

The Association of Specific Executive Functions and Falls Risk in People with Mild Cognitive Impairment and Early-Stage Dementia (2015)
Journal Article
Harwood, R., Logan, P., van der Wardt, V., Logan, P. A., Hood, V., Booth, V., Masud, T., & Harwood, R. H. (2015). The Association of Specific Executive Functions and Falls Risk in People with Mild Cognitive Impairment and Early-Stage Dementia. Dementia and Geriatric Cognitive Disorders, 40(3-4), 178-185. https://doi.org/10.1159/000433523

Background/Aims:

Impairment in executive function is associated with a heightened risk for falls in people with mild cognitive impairment (MCI) and dementia. The purpose of this study was to determine which aspects of executive function are assoc... Read More about The Association of Specific Executive Functions and Falls Risk in People with Mild Cognitive Impairment and Early-Stage Dementia.

Reducing and managing faecal incontinence in people with advanced dementia who are resident in care homes: protocol for a realist synthesis (2015)
Journal Article
Goodman, C., Rycroft Malone, J., Norton, C., Harari, D., Harwood, R., Roe, B., Russell, B., Fader, M., Buswell, M., Drennan, V. M., & Bunn, F. (2015). Reducing and managing faecal incontinence in people with advanced dementia who are resident in care homes: protocol for a realist synthesis. BMJ Open, 5(7), Article e007728. https://doi.org/10.1136/bmjopen-2015-007728

Introduction Faecal incontinence (FI) is the involuntary loss of liquid or solid stool that is a social or hygienic problem. The prevalence of FI in residents of care homes is high, but it is not an inevitable consequence of old age or dementia. Ther... Read More about Reducing and managing faecal incontinence in people with advanced dementia who are resident in care homes: protocol for a realist synthesis.

Falls prevention interventions in older adults with cognitive impairment: A systematic review of reviews (2015)
Journal Article
Harwood, R., Booth, V., Booth, V., Logan, P., Harwood, R. H., & Hood, V. (2015). Falls prevention interventions in older adults with cognitive impairment: A systematic review of reviews. International Journal of Therapy and Rehabilitation, 22(6), 289-296. https://doi.org/10.12968/ijtr.2015.22.6.289

Aim: This critical review explores the review material on falls prevention interventions in older adults with a cognitive impairment such as dementia.

Method: A critical, systematic, review of review method was used. Five large electronic databas... Read More about Falls prevention interventions in older adults with cognitive impairment: A systematic review of reviews.

Medical Crises in Older People: cohort study of older people attending acute medical units, developmental work and randomised controlled trial of a specialist geriatric medical intervention for high-risk older people; cohort study of older people with mental health problems admitted to hospital, developmental work and randomised controlled trial of a specialist medical and mental health unit for general hospital patients with delirium and dementia; and cohort study of residents of care homes and interview study of health-care provision to residents of care homes (2015)
Journal Article
Gladman, J., Harwood, R., Conroy, S., Logan, P., Elliott, R., Jones, R., Lewis, S., Dyas, J., Schneider, J., Porock, D., Pollock, K., Goldberg, S., Edmans, J., Gordon, A., Bradshaw, L., Franklin, M., Whittamore, K., Robbins, I., Dunphy, A., Spencer, K., …Frowd, N. (2015). Medical Crises in Older People: cohort study of older people attending acute medical units, developmental work and randomised controlled trial of a specialist geriatric medical intervention for high-risk older people; cohort study of older people with mental health problems admitted to hospital, developmental work and randomised controlled trial of a specialist medical and mental health unit for general hospital patients with delirium and dementia; and cohort study of residents of care homes and interview study of health-care provision to residents of care homes. Programme Grants for Applied Research, 3(4), 1-410. https://doi.org/10.3310/pgfar03040

Background
This programme of research addressed shortcomings in the care of three groups of older patients: patients discharged from acute medical units (AMUs), patients with dementia and delirium admitted to general hospitals, and care home residen... Read More about Medical Crises in Older People: cohort study of older people attending acute medical units, developmental work and randomised controlled trial of a specialist geriatric medical intervention for high-risk older people; cohort study of older people with mental health problems admitted to hospital, developmental work and randomised controlled trial of a specialist medical and mental health unit for general hospital patients with delirium and dementia; and cohort study of residents of care homes and interview study of health-care provision to residents of care homes.

Factors associated with family caregiver dissatisfaction with acute hospital care of older cognitively impaired relatives (2014)
Journal Article
the Medical Crises in Older People Study Group, Whittamore, K. H., Goldberg, S. E., Bradshaw, L. E., & Harwood, R. H. (2014). Factors associated with family caregiver dissatisfaction with acute hospital care of older cognitively impaired relatives. Journal of the American Geriatrics Society, 62(12), 2252-2260. https://doi.org/10.1111/jgs.13147

© 2014, The American Geriatrics Society. Objectives To identify patient and caregiver characteristics associated with caregiver dissatisfaction with hospital care of cognitively impaired elderly adults.Design Secondary analysis of data from a randomi... Read More about Factors associated with family caregiver dissatisfaction with acute hospital care of older cognitively impaired relatives.

P488: The effects of cognitive and exercise interventions for people with mild cognitive impairment and dementia on carers: a systematic review (2014)
Journal Article
Gondek, D., Patel, D. R. K., Pollock, K., das Nair, R., Harwood, R. H., & van der Wardt, V. (in press). P488: The effects of cognitive and exercise interventions for people with mild cognitive impairment and dementia on carers: a systematic review. European Geriatric Medicine, 5(S1), Article S237. https://doi.org/10.1016/S1878-7649%2814%2970653-9

Systematic review into motivational strategies that support adherence to exercise for people with mild cognitive impairment (MCI) or dementia (2014)
Journal Article
Van der Wardt, V., Patel, D. R. K., Gondek, D., Pollock, K., Logan, P., das Nair, R., & Harwood, R. H. (2014). Systematic review into motivational strategies that support adherence to exercise for people with mild cognitive impairment (MCI) or dementia. European Geriatric Medicine, 5(Supp.1), S238. https://doi.org/10.1016/s1878-7649%2814%2970657-6

Introduction: Physical exercise has a positive effect on cognitive functioning, mobility and activities of daily living in people with dementia (Forbes & al., 2013; Pitkälä & al., 2013). Most exercise studies employ motivational strategies to support... Read More about Systematic review into motivational strategies that support adherence to exercise for people with mild cognitive impairment (MCI) or dementia.

A qualitative study into the attitudes of people with mild cognitive impairment and early stages of dementia, and their carers, about falls interventions and risk (2014)
Journal Article
Peach, M., Pollock, K., Harwood, R., Van Der Wardt, V., & Masud, T. (2014). A qualitative study into the attitudes of people with mild cognitive impairment and early stages of dementia, and their carers, about falls interventions and risk. European Geriatric Medicine, 5(S1), S169. https://doi.org/10.1016/S1878-7649%2814%2970440-1

Introduction: Falls are a common and serious problem for older people with cognitive impairment. Successful intervention to reduce falls risk could result in great benefit to patients and their families, and reduce costs. This study examines patients... Read More about A qualitative study into the attitudes of people with mild cognitive impairment and early stages of dementia, and their carers, about falls interventions and risk.

Antihypertensive treatment in people with dementia (2014)
Journal Article
van der Wardt, V., Logan, P. A., Conroy, S., Harwood, R. H., & Gladman, J. R. (2014). Antihypertensive treatment in people with dementia. Journal of the American Medical Directors Association, 15(9), https://doi.org/10.1016/j.jamda.2014.03.005

Introduction
The range and magnitude of potential benefits and harms of antihypertensive treatment in people with dementia has not been previously established.
Method
A scoping review to identify potential domains of benefits and harms of antihyp... Read More about Antihypertensive treatment in people with dementia.

Diagnoses, problems and healthcare interventions amongst older people with an unscheduled hospital admission who have concurrent mental health problems: a prevalence study (2014)
Journal Article
Glover, A., Bradshaw, L., Watson, N., Laithwaite, E., Goldberg, S. E., Whittamore, K. H., & Harwood, R. H. (2014). Diagnoses, problems and healthcare interventions amongst older people with an unscheduled hospital admission who have concurrent mental health problems: a prevalence study. BMC Geriatrics, 14, Article 43. https://doi.org/10.1186/1471-2318-14-43

Background
Frail older people with mental health problems including delirium, dementia and depression are often admitted to general hospitals. However, hospital admission may cause distress, and can be associated with complications. Some commentator... Read More about Diagnoses, problems and healthcare interventions amongst older people with an unscheduled hospital admission who have concurrent mental health problems: a prevalence study.