Introduction: Increasing attention is being paid to interventions for cognitive impairment (CI) post-stroke, including for CI that does not meet dementia criteria. The aim of this paper was to conduct a systematic review and meta-analysis of the prevalence of cognitive impairment no dementia (CIND) within one year post-stroke. Patients and methods: Pubmed, EMBASE and PsychInfo were searched for papers published in English in 1995-2017. Included studies were population or hospital-based cohort studies for first-ever/recurrent stroke, assessing CIND using standardised criteria at 1-12 months post-stroke. Abstracts were screened, followed by full text review of potentially relevant articles. Data were extracted using a standard form, and study quality was appraised using the Crowe Critical Appraisal Tool. A pooled prevalence of CIND with 95% confidence intervals (CI) was estimated using random-effects meta-analysis. Heterogeneity was measured using the I 2 statistic. Results: A total of 7000 abstracts were screened, followed by 1028 full text articles. Twenty-three articles were included in the systematic review, and 21 in the meta-analysis. The pooled CIND prevalence was 38% [95% CI ¼ 32-43%] (I 2 ¼92.5%, p < 0.01). Study quality emerged as one source of heterogeneity. The five studies with the highest quality scores had no heterogeneity (I 2 ¼0%, p ¼ 0.99), with a similar pooled prevalence (39%, 95%CI ¼ 35-42%). Other sources of heterogeneity were stroke type, inclusion of pre-stroke CI, and age at assessment time. Discussion and conclusion: Meta-analysis of available studies indicates that in the first year post-stroke, 4 in 10 patients display a level of cognitive impairment that does not meet the criteria for dementia.

IntroductionTo examine the impact of frailty on medical and social care utilisation among the Irish community-dwelling older population to inform strategies of integrated care for older people with complex needs.MethodsParticipants aged ≥65 years from the Irish Longitudinal Study on Ageing (TILDA) representative of the Irish community-dwelling older population were analysed (n = 3507). The frailty index was used to examine patterns of utilisation across medical and social care services. Multivariate logistic and negative binomial regression models were employed to examine the impact of frailty on service utilisation outcomes after controlling for other factors.ResultsThe prevalence of frailty and pre-frailty was 24% (95% CI: 23, 26%) and 45% (95% CI: 43, 47%) respectively. Frailty was a significant predictor of utilisation of most social care and medical care services after controlling for the main correlates of frailty and observed individual effects.ConclusionsFrailty predicts utilisation of many different types of healthcare services rendering it a useful risk stratification tool for targeting strategies of integrated care. The pattern of care is predominantly medical as few of the frail older population use social care prompting questions about sub-groups of the frail older population with unmet care needs.Electronic supplementary materialThe online version of this article (doi:10.1186/s12877-017-0579-0) contains supplementary material, which is available to authorized users.

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How many beds? Capacity implications of hospital care demand projections in the Irish hospital system, 2015-2030 1 *Conor Keegan (ESRI), Aoife Brick (ESRI), Brendan Walsh (ESRI), Adele Bergin (ESRI), James Eighan (Indecon), Maev-Ann Wren (ESRI) ESRI Research Bulletins provide short summaries of work published by ESRI researchers and overviews of thematic areas covered by ESRI programmes of research. Bulletins are designed to be easily accessible to a wide readership.

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