Round-the-clock paracetamol did not ease pain in care-home residents with dementia

The edition in brief

Today's geriatrics edition opens on hip fracture. A prospective cohort of 430 adults aged 70 and over found that the five-item SARC-F questionnaire, unlike handgrip strength or calf circumference, consistently predicted slower mobilisation after surgery (OR 7.56 for impaired mobilisation on day 3) and greater functional decline at four months. A phase 3 trial of 1,112 adults aged 60 and over found that giving an adjuvanted RSV prefusion F vaccine and a 20-valent pneumococcal conjugate vaccine at the same visit produced immune responses non-inferior to giving them a month apart, with similar safety. A US study linked corrected vision impairment, compared with uncorrected, to a lower risk of progressing from mild cognitive impairment to dementia; only a summary was available, without effect sizes. The pearl covers assessing pain in people who cannot report it. The edition closes on a meta-analysis of four randomised trials in 482 long-term care residents with moderate to severe dementia and mild to moderate pain: paracetamol 2.5 to 3 g a day on a fixed schedule did not reduce pain compared with placebo or usual care (SMD −0.14, 95% CI −0.39 to 0.11; moderate certainty), which argues for reviewing standing prescriptions rather than continuing them by default.