The edition · Geriatrics
Hospital disability hits one in four older inpatients, and an app that steadies balance
Plus sarcopenia as a stroke-prognosis marker, a negative trial of pilocarpine for dry mouth in frailty, and a reminder to review the medication list.
The edition in brief
Today's geriatrics edition opens on a syndrome that is common and preventable. A meta-analysis of 439,406 older inpatients found a pooled 27% prevalence of hospitalisation-associated disability, higher in those aged 75 to 89 and with respiratory infection — a case for early identification and keeping older patients mobile in hospital. A meta-analysis of 36 cohorts found sarcopenia roughly doubled the odds of a poor functional outcome after stroke and tracked with worse motor and cognitive recovery, supporting sarcopenia screening in stroke care. A double-blind trial found pilocarpine drops did not significantly beat placebo for dry mouth in frailty or life-limiting illness, though it was underpowered and well tolerated. A clinic pearl reaffirms structured medication review and deprescribing. The practice-changer: a randomised trial of the NHS-approved Keep-On-Keep-Up digital exercise programme improved balance in community-dwelling older adults, with preliminary cost-effectiveness, supporting digital falls prevention as a scalable complement to usual care.
Hospitalisation-associated disability affects about one in four older inpatients
Treat functional loss as a core inpatient outcome in older people: record a pre-admission baseline, flag high-risk patients, and mobilise early to prevent hospitalisation-associated disability.
Sarcopenia marks worse recovery after stroke
Screen stroke patients for sarcopenia and address it in rehabilitation with resistance exercise and adequate protein, recognising it as a prognostic marker rather than a proven treatment target.
Pilocarpine drops did not clearly beat placebo for dry mouth in frailty
Pilocarpine drops are not proven for dry mouth in frailty; rely on non-drug measures and medication review, with pilocarpine an option where tolerated.
Make a structured medication review part of every older-adult visit
Build a structured, recurring medication review into older-adult care and deprescribe fall-risk and anticholinergic drugs one at a time.
A digital exercise programme improved balance in older adults
Consider an evidence-based digital exercise programme to improve balance and extend falls prevention to older adults who cannot attend in-person classes.
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