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All Outputs (26)

Proactive integrated consultation-liaison psychiatry and time spent in hospital by older medical inpatients in England (The HOME Study): a multicentre, parallel-group, randomised controlled trial (2024)
Journal Article
Sharpe, M., Walker, J., van Niekerk, M., Toynbee, M., Magill, N., Frost, C., White, I. R., Walker, S., Duarte, A., Owens, C., Dickens, C., Price, A., Sharpe, M., Walker, J., van Niekerk, M., Toynbee, M., Magill, N., Frost, C., White, I. R., Walker, S., …Yousif, M. (online). Proactive integrated consultation-liaison psychiatry and time spent in hospital by older medical inpatients in England (The HOME Study): a multicentre, parallel-group, randomised controlled trial. Lancet Psychiatry, https://doi.org/10.1016/s2215-0366%2824%2900188-3

Summary Background Older people admitted to hospital in an emergency often have prolonged inpatient stays that worsen their outcomes, increase health-care costs, and reduce bed availability. Growing evidence suggests that the biopsychosocial complex... Read More about Proactive integrated consultation-liaison psychiatry and time spent in hospital by older medical inpatients in England (The HOME Study): a multicentre, parallel-group, randomised controlled trial.

New horizons in clinical practice guidelines for use with older people (2024)
Journal Article
Martin, F. C., Quinn, T. J., Straus, S. E., Anand, S., van der Velde, N., & Harwood, R. H. (2024). New horizons in clinical practice guidelines for use with older people. Age and Ageing, 53(7), Article afae158. https://doi.org/10.1093/ageing/afae158

Globally, more people are living into advanced old age, with age-associated frailty, disability and multimorbidity. Achieving equity for all ages necessitates adapting healthcare systems. Clinical practice guidelines (CPGs) have an important place in... Read More about New horizons in clinical practice guidelines for use with older people.

Social participation in the promoting activity, independence and stability in early dementia (PrAISED), a home-based therapy intervention for people living with dementia: a realist evaluation (2024)
Journal Article
Lorito, C. D., Pollock, K., Booth, V., Howe, L., Goldberg, S., Godfrey, M., Dunlop, M., Harwood, R. H., Van Der Wardt, V., & Lorito, C. D. (2024). Social participation in the promoting activity, independence and stability in early dementia (PrAISED), a home-based therapy intervention for people living with dementia: a realist evaluation. BMC Geriatrics, 24(1), Article 615. https://doi.org/10.1186/s12877-024-05086-y

Background: Interventions promoting social activity may reduce behavioural psychological symptoms and improve quality of life in people living with dementia. This study aimed to identify social benefits for participants living with dementia in the co... Read More about Social participation in the promoting activity, independence and stability in early dementia (PrAISED), a home-based therapy intervention for people living with dementia: a realist evaluation.

Establishing a research partnership to investigate functional loss and rehabilitation towards the end of life (2024)
Journal Article
Maddocks, M., Brighton, L. J., Connell, L., Cowley, A., Laird, B., Peryer, G., …Harwood, R. (2024). Establishing a research partnership to investigate functional loss and rehabilitation towards the end of life. Health Technology Assessment, 1-12. https://doi.org/10.3310/pthc7598

Background Functional loss, the inability to perform necessary or desired tasks, is a common consequence of life-limiting illnesses and associated symptoms (pain, fatigue, breathlessness, etc.) and causes suffering for patients and families. Rehabil... Read More about Establishing a research partnership to investigate functional loss and rehabilitation towards the end of life.

Adapted problem adaptation therapy for depression in mild to moderate Alzheimer's disease dementia: A randomized controlled trial (2024)
Journal Article
Howard, R., Cort, E., Rawlinson, C., Wiegand, M., Downey, A., Lawrence, V., …Gould, R. (2024). Adapted problem adaptation therapy for depression in mild to moderate Alzheimer's disease dementia: A randomized controlled trial. Alzheimer's & Dementia: The Journal of the Alzheimer's Association, 20(4), 2990-2999. https://doi.org/10.1002/alz.13766

INTRODUCTION: Trials of effectiveness of treatment options for depression in dementia are an important priority. METHODS: Randomized controlled trial to assess adapted Problem Adaptation Therapy (PATH) for depression in mild/moderate dementia caused... Read More about Adapted problem adaptation therapy for depression in mild to moderate Alzheimer's disease dementia: A randomized controlled trial.

Whether from a position of strength or weakness, geriatric medicine has work to do to drive up standards in health care for older people (2023)
Journal Article
Gordon, A. L., Martin, F., Mistry, S., Harwood, R. H., & Dhesi, J. (2023). Whether from a position of strength or weakness, geriatric medicine has work to do to drive up standards in health care for older people. Age and Ageing, 52(11), Article afad208. https://doi.org/10.1093/ageing/afad208

• Geriatric medicine is the largest physicianly specialty in the UK, with high levels of competition for available training posts. • Improving care of older people has been the focus of multiple national policy initiatives in the UK over the past dec... Read More about Whether from a position of strength or weakness, geriatric medicine has work to do to drive up standards in health care for older people.

A rehabilitation intervention to improve recovery after an episode of delirium in adults over 65 years (RecoverED): study protocol for a multi-centre, single-arm feasibility study (2023)
Journal Article
Allan, L., O'Connell, A., Raghuraman, S., Bingham, A., Laverick, A., Chandler, K., …Clare, L. (2023). A rehabilitation intervention to improve recovery after an episode of delirium in adults over 65 years (RecoverED): study protocol for a multi-centre, single-arm feasibility study. Pilot and Feasibility Studies, 9, Article 162. https://doi.org/10.1186/s40814-023-01387-y

BackgroundDelirium affects over 20% of all hospitalised older adults. Delirium is associated with a number of adverse outcomes following hospital admission including cognitive decline, anxiety and depression, increased mortality and care needs. Previ... Read More about A rehabilitation intervention to improve recovery after an episode of delirium in adults over 65 years (RecoverED): study protocol for a multi-centre, single-arm feasibility study.

Promoting Activity, Independence and Stability in early dementia and mild cognitive impairment (PrAISED): randomised controlled trial (2023)
Journal Article
Harwood, R. H., Goldberg, S. E., Brand, A., van Der Wardt, V., Booth, V., Di Lorito, C., …Adams, E. (2023). Promoting Activity, Independence and Stability in early dementia and mild cognitive impairment (PrAISED): randomised controlled trial. BMJ, 382, Article e074787. https://doi.org/10.1136/bmj-2023-074787

Objective: To determine the effectiveness of an exercise and functional activity therapy intervention in adults with early dementia or mild cognitive impairment compared with usual care. Design: Randomised controlled trial. Setting: Participant... Read More about Promoting Activity, Independence and Stability in early dementia and mild cognitive impairment (PrAISED): randomised controlled trial.

Promoting Activity, Independence, and Stability in Early Dementia and mild cognitive impairment (PrAISED): randomised controlled trial (2023)
Journal Article
Harwood, R. H., Goldberg, S. E., Brand, A., van Der Wardt, V., Booth, V., Di Lorito, C., Hoare, Z., Hancox, J., Bajwa, R., Burgon, C., Howe, L., Cowley, A., Bramley, T., Long, A., Lock, J., Tucker, R., Adams, E. J., O’Brien, R., Kearney, F., Kowalewska, K., …Masud, T. (2023). Promoting Activity, Independence, and Stability in Early Dementia and mild cognitive impairment (PrAISED): randomised controlled trial. BMJ, 382, Article e074787. https://doi.org/10.1136/bmj-2023-074787

Objective To determine the effectiveness of an exercise and functional activity therapy intervention in adults with early dementia or mild cognitive impairment compared with usual care. Design Randomised controlled trial. Setting Participants’... Read More about Promoting Activity, Independence, and Stability in Early Dementia and mild cognitive impairment (PrAISED): randomised controlled trial.

Incidence of cognitive impairment and dementia after hospitalisation for pneumonia: a UK population-based matched cohort study (2023)
Journal Article
Chalitsios, C. V., Baskaran, V., Harwood, R. H., Lim, W. S., & McKeever, T. M. (2023). Incidence of cognitive impairment and dementia after hospitalisation for pneumonia: a UK population-based matched cohort study. ERJ Open Research, 9(3), Article 00328-2022. https://doi.org/10.1183/23120541.00328-2022

Background Survivors of common infections may develop cognitive impairment or dementia; however, the risk of these conditions in people hospitalised with pneumonia is not well established. Methods A matched cohort study was conducted using Hospit... Read More about Incidence of cognitive impairment and dementia after hospitalisation for pneumonia: a UK population-based matched cohort study.

Promoting continence in older people (2022)
Journal Article
Schlögl, M., Umbehr, M. H., Habib, M. H., Wagg, A., Gordon, A. L., & Harwood, R. (2022). Promoting continence in older people. Age and Ageing, 51(9), Article afac199. https://doi.org/10.1093/ageing/afac199

The prevalence of urinary incontinence (UI) is strongly associated with increasing age. Twenty five percent of women over 80 years of age have clinically significant symptoms in population surveys, but prevalence is as high as 70% in older hospital i... Read More about Promoting continence in older people.

Impact of COVID-19 lockdown on physical exercise among participants receiving the Promoting Activity, Independence and Stability in Early Dementia (PrAISED) intervention: a repeated measure study (2022)
Journal Article
Di Lorito, C., van der Wardt, V., O'Brien, R., Gladman, J., Tahir, M., & Harwood, R. (2022). Impact of COVID-19 lockdown on physical exercise among participants receiving the Promoting Activity, Independence and Stability in Early Dementia (PrAISED) intervention: a repeated measure study. BMC Geriatrics, 22, Article 605. https://doi.org/10.1186/s12877-022-03239-5

Background The potential decrease in daily physical activity associated with the COVID-19 pandemic lockdowns may have a negative impact on people living with dementia. Given the limited literature around the effects of home confinement in people liv... Read More about Impact of COVID-19 lockdown on physical exercise among participants receiving the Promoting Activity, Independence and Stability in Early Dementia (PrAISED) intervention: a repeated measure study.

The geriatrician’s role in end-of-life care (2020)
Journal Article
Ahmed, N., Ahmedzai, S. H., & Harwood, R. H. (2021). The geriatrician’s role in end-of-life care. Age and Ageing, 50(2), 366-369. https://doi.org/10.1093/ageing/afaa266

Healthcare aims to help older people to live well, but ultimately must also support them to die well. Most people die in old age, but predicting death in both short- and long-term is impossible for many, although not all, older people. Frail older pe... Read More about The geriatrician’s role in end-of-life care.

Association of frailty with mortality in older inpatients with Covid-19: a cohort study (2020)
Journal Article
Aw, D., Woodrow, L., Ogliari, G., & Harwood, R. (2020). Association of frailty with mortality in older inpatients with Covid-19: a cohort study. Age and Ageing, 49(6), 915-922. https://doi.org/10.1093/ageing/afaa184

Background: COVID-19 has disproportionately affected older people. Objective: to investigate whether frailty is associated with all-cause mortality in older hospital inpatients, with COVID-19. Design: cohort study Setting: secondary care acute hos... Read More about Association of frailty with mortality in older inpatients with Covid-19: a cohort study.

Atypical presentation of COVID-19 in a frail older person (2020)
Journal Article
Tay, H. S., & Harwood, R. (2020). Atypical presentation of COVID-19 in a frail older person. Age and Ageing, 49(4), 523-524. https://doi.org/10.1093/ageing/afaa068

Common symptoms of pandemic coronavirus disease (COVID-19) include fever and cough.We describe a 94-year-old man with well-controlled schizoaffective disorder, who presented with non-specific and atypical symptoms: delirium, low-grade pyrexia and a... Read More about Atypical presentation of COVID-19 in a frail older person.

End-of-life care for frail older people (2019)
Journal Article
Harwood, R. H., & Enguell, H. (2019). End-of-life care for frail older people. BMJ Supportive and Palliative Care, https://doi.org/10.1136/bmjspcare-2019-001953

Most people die when they are old, but predicting exactly when this will occur is unavoidably uncertain. The health of older people is challenged by multimorbidity, disability and frailty. Frailty is the tendency to crises or episodes of rapid deteri... Read More about End-of-life care for frail older people.

What palliative care can learn from geriatric medicine (2019)
Journal Article
Enguell, H., & Harwood, R. H. (2019). What palliative care can learn from geriatric medicine. British Journal of Hospital Medicine, 80(2), 86-90. https://doi.org/10.12968/hmed.2019.80.2.86

Most people die when they are old, with multiple pathologies, and while living with frailty or dementia. These circumstances need the specialist skills of geriatric medicine. Death may not be unexpected, but survival and restoration of function are u... Read More about What palliative care can learn from geriatric medicine.