ObjectivesIn this paper we provide revised estimates of the prevalence of dementia in Ireland, the number of new cases per year and the severity mix. These estimates are a necessary input for any assessment of the potential demand for services and supports for people with dementia across all care settings in Ireland.MethodsThe prevalence, incidence and severity stage of dementia are calculated by applying rates from prominent international studies to population data from the 2016 census.ResultsWe show that the total number of people with dementia in Ireland ranges between 39 272 and 55 266, depending on the international rates used to measure prevalence. The incidence of dementia in Ireland has increased as the population has aged, to at least 7752 new cases per year. We estimate that there are at least 11 175 people living at home in the community in Ireland with dementia who have a serious functional impairment, based on an Activities of Daily Living measurement, of which an estimated 1876 are chair or bedbound.ConclusionsWithout a national prevalence study it is not possible to be precise about the estimates of the number of people with dementia in Ireland. However, having credible upper and lower bound estimates for the number of people with dementia, the potential number of new cases per year and severity rates is useful for planners and those charged with the responsibility of making resource allocation decisions in dementia.
BackgroundThis study aimed to explore older adults' and healthcare professionals' (HCPs) perceptions of dietary influences and food preferences in older age.MethodsThe research design was phenomenological qualitative description. Semistructured one‐to‐one interviews and focus groups were held separately with community‐dwelling older adults and HCPs involved in care of the older person in Ireland. Data were analysed using inductive thematic analysis.ResultsA total of 47 adults aged 55+ years were recruited (50% male; 49% aged 60–69 years; 28% aged above 70 years), and 26 HCPs were involved, comprising dietitians (n = 8); geriatricians (n = 6); clinical therapists (n = 4); and nurses, pharmacists, catering managers and meal delivery service coordinators (n = 2 each). There are strong desires for ‘good, honest food’ within the diet for an older person; however, gaps in current nutrition priorities, dietary guidance and health promotion were perceived. There were differences in the perspectives held by HCPs and adults aged 55+ years, as some HCPs centred their discussion around nutrition for preventing sarcopenia, frailty or cognitive decline, whereas many adults aged 55+ years desired foods which promote cardiometabolic health and reflect wider personal health and environmental values. Other themes included the impact of health and lifestyle changes accompanying ageing on dietary priorities, the importance of personal and psychosocial values in determining food choice and the impact of the external food environment on accessibility and shopping experiences.ConclusionsInfluences on dietary choice for the older person are multifactorial, driven by a range of health, psychological, sociocultural and environmental perspectives. Future nutrition priorities for older adults should encourage health‐promoting approaches and not just disease‐mitigating efforts.
Introduction Despite the growing prevalence of Parkinson’s disease (PD), and the need to plan for future health service provision, very little is known in the Irish context about PD patients’ experiences of health service access and use. Method A cross-sectional survey design, with multiple formats, i.e. online, pen-and-paper, and telephone. Data were collected from May 2020–July 2021 using a multipronged recruitment strategy. It could be completed by a person with PD, or a support person on behalf of/with the person. Survey development was informed through literature review, and in consultation with the Parkinson’s Association of Ireland, and a patient advisory group (N = 10). Results A total of 1,504 individuals accessed the survey, with 1,402 meeting the eligibility criteria. Over half (53%) were male. Approx. 9% were diagnosed with young-onset PD. A minority (6%) reported attending only their GP to manage their PD, with the rest attending a specialist outpatient clinic. The mean distance travelled each-way to outpatient clinics was 45.6 km (SD = 49.4, min 1 km, max. 300kms). Most were diagnosed by Neurologists (84%), followed by GPs (8%), and Geriatricians (7%); 1% indicated ‘other’. Of those diagnosed by a Neurologist or Geriatrician, most were diagnosed privately (68%); though 37% of these patients subsequently switched to the public system for ongoing management. The majority (97%) reported currently taking PD medications, but just 52% believed these were working effectively. Just over one-fifth (22%) had access to a PD nurse specialist. Access to the range of other health and social care professionals is also reported, and is universally poor for this patient group. Conclusion A number of significant gaps in PD care have been identified, which require urgent attention. A reconfigured model of PD care is necessary to accommodate the growing need for specialist, integrated care at the population level.
Malnutrition is common in older adults, and is associated with high healthcare costs and adverse outcomes, particularly in hospital settings (1,2) . The prevalence and correlates of malnutrition in hospitalised older adults are currently not clear; much of the existing research in this area is limited methodologically; studies are typically based on small samples and/or narrow populations (3,4) , exclude people with dementia (3,4) , are uni-centre (5) , and/or use tools not designed for use with older adults (5) . The present study addresses this gap, investigating the prevalence, correlates and outcomes of malnutrition in older adults on admission to hospital.In total, 606 (70+ years) older adults were included in a prospective cohort study across six hospitals in the Republic of Ireland. All elective and acute admissions to any speciality were eligible. Day-case admissions and those moribund on admission were excluded. All participants were clinically assessed for dementia on admission (see Timmons et al. (6) ). Socio-demographic and clinical data, including nutritional status (Mini-Nutritional Assessment -short form (7) , was collected within 36 hours of admission. Outcome data was collected prospectively on length of stay, in-hospital mortality and institutionalisation.The mean age was 79·7; 51 % were female; 29 % were elective admissions; 67 % were admitted to a medical specialty. Nutrition scores were available for 602/606; 37 % had a 'normal' status, 45 % were 'at-risk', and 18 % were 'malnourished'. Malnutrition was more common in females, acute admissions, older patients and those who were widowed/ separated. Dementia, functional dependency, comorbidity and frailty independently predicted a) malnutrition and b) being at-risk of malnutrition (p < ·001). Malnutrition was also associated with an increased length of stay (p < ·001), institutionalisation (p < 0·001) and in-hospital mortality (p < ·001).These findings support the prioritisation of nutritional screening in clinical practice and public health policy, for all ≥70 on admission to hospital, and in particular for people with dementia, increased functional dependency and/or multi-morbidity, and those who are frail.
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