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BACKGROUND Community physiotherapy is often prescribed for stroke patients with long-term mobility problems. We aimed to assess the effectiveness of this treatment in patients who had mobility problems 1 year after stroke. METHODS We screened 359 patients older than 50 years for a single-masked, randomised controlled trial to assess the effects of(More)
Frailty is the most problematic expression of population ageing. It is a state of vulnerability to poor resolution of homoeostasis after a stressor event and is a consequence of cumulative decline in many physiological systems during a lifetime. This cumulative decline depletes homoeostatic reserves until minor stressor events trigger disproportionate(More)
Few ill health situations are more degrading to people of any age than loss of reasoning, faculties, and per-sonhood. These are the unpleasant consequences of delirium—a common condition affecting ill older people, particularly those with some degree of dementia. It is characterised by recent onset of fluctuating inattention and confusion, linked to one or(More)
OBJECTIVES To investigate the predictive validity and reliability of the STRATIFY falls risk assessment tool as applied to patients recovering from acute stroke. DESIGN Prospective cohort study. SETTING Six stroke rehabilitation units in the North of England. SUBJECTS All patients with a diagnosis of acute stroke admitted to the participating stroke(More)
BACKGROUND Most patients who have had a stroke are dependent on informal caregivers for activities of daily living. The TRACS trial investigated a training programme for caregivers (the London Stroke Carers Training Course, LSCTC) on physical and psychological outcomes, including cost-effectiveness, for patients and caregivers after a disabling stroke. (More)
BACKGROUND Delirium is a common complication for older people in hospital. Evidence suggests that delirium incidence in hospital may be reduced by about a third through a multi-component intervention targeted at known modifiable risk factors. We describe the research design and conceptual framework underpinning it that informed the development of a novel(More)
BACKGROUND frailty is an especially problematic expression of population ageing. International guidelines recommend routine identification of frailty to provide evidence-based treatment, but currently available tools require additional resource. OBJECTIVES to develop and validate an electronic frailty index (eFI) using routinely available primary care(More)
OBJECTIVE This study aimed to design a multicomponent intervention to improve delirium care in long-term care facilities for older people in the UK and to identify the levers and barriers to its implementation in practice. METHODS The research incorporated the theoretical phase and Phase 1 of the Medical Research Council's framework. We designed a(More)
BACKGROUND Frailty is common in older age, and is associated with important adverse health outcomes including increased risk of disability and admission to hospital or long-term care. Exercise interventions for frail older people have the potential to reduce the risk of these adverse outcomes by increasing muscle strength and improving mobility. (More)
Delirium is a common complication of acute illness in older people. Earlier and more reliable detection could be achieved by greater routine cognitive testing in older people. Research evidence suggests that episodes of delirium and duration of delirium could be reduced by about one third if systems of care that prioritized delirium risk factor amelioration(More)