Older Adults In Ireland Research Articles

Integrated Care in Action: A Case Study of Collaborative Multidisciplinary Approach for Older Adults in Ireland

Abstract Background In Ireland, the healthcare landscape is evolving with frameworks which emphasize community-based care, such as Enhanced Community Care and the National Integrated Care Programme for Older Persons. Our Integrated Care Team for Older Persons (ICPOP) service exemplifies this shift by providing intensive, immediate multidisciplinary care to frail adults, aiming to maintain their independence in their homes and communities. Methods In the case study we describe service users journey with ICPOP. The case study illustrates the transition from fragmented care to a collaborative, patient-centred approach. ICPOP employs a structured process involving comprehensive assessment, goal setting, weekly multidisciplinary team meetings, stakeholder liaison, and detailed discharge reports. This approach focuses on early supported discharge and close coordination with local MDT teams, fostering effective communication and shared decision-making. Results This case study demonstrates the effectiveness of ICPOP's multidisciplinary model. Key factors contributing to this success include physical co-location, shared goals and vision, mutual trust, and established relationships among professionals. Furthermore, the integration of Allied Health Professionals (AHPs) within community teams enriches the care continuum and enhances outcomes for older adults. Conclusion To further enhance integrated care delivery, digital solutions are crucial. Implementing shared electronic health records and facilitating access to medical findings can streamline communication and improve care coordination. Additionally, prioritizing written discharge summaries for clients can ensure continuity of care and empower patients and their families in the post-discharge phase. This patient journey underscores the importance of collaborative, patient-centred care models in achieving the objectives of Sláintecare leading to better outcomes for older adults in Ireland.

Advancing Loneliness as a National Health Priority: Results of a Multisectoral Roundtable

Abstract Background Ireland has the highest rates of loneliness of all EU countries. Those in the older old category (aged 80+) are at increased risk of developing loneliness, which is in turn a risk factor for many adverse health outcomes. Ireland has a strong tradition of Irish gerontological loneliness research, and it is critical to now know how best to focus research efforts to mitigate the impact of loneliness on older adults. Methods We held a roundtable discussion on priorities in Irish loneliness research at the Loneliness Taskforce Research Network inaugural event on 16th April 2024. 75 attendees were present, including those from non-governmental organisations, health and social care professionals, experts by lived experience, academic experts, researchers, and representatives from the private sector and governmental agencies. Of seven tables discussing loneliness research priorities, two tables were devoted to the discussion of priorities in research on loneliness in older people (with 18 participants in total). The priorities were noted, then amalgamated and organised. Results There was considerable heterogeneity in priorities raised, with little overlap across the two roundtable outputs. Of particular note was the need to evaluate the many services being delivered across Ireland to reduce loneliness, which operate without an evidence base. Other priorities included: Conclusion Results are informative for those planning future research on loneliness among older adults in Ireland and will form the basis for a report from the Loneliness Taskforce to the Irish Government, who have pledged funding for alleviation of loneliness.

Don't Forget About Your Memory...Exploring Need And Impact Of A Cognitive Strategies Group On Older Adults Following Comprehensive Geriatric Assessment

Abstract Background The increasing prevalence of mild cognitive impairment (MCI) and dementia in older adults in Ireland, with projections of up to 20% of over 80-year-olds affected, is widely documented (TILDA 2023). Due attention is required in service planning to provide tailored non-pharmacological and lifestyle interventions to this growing cohort. This review aims to analyse the need for and impact of a cognitive strategies and brain health intervention group on older adults attending the Integrated Day Hospital (IDH) as part of an ICPOP service. Methods Retrospective analysis of the health care record was complete on older adults over 70 years with recent deterioration in cognitive or functional status. Cognitive screening scores and diagnoses received at the IDH were gathered to inform presence of MCI or dementia. Permission was sought from the authors of a cognitive strategies and brain health intervention group which was delivered to a sample of older adults and evaluated as part of the Jog Your Memory Program (HSE 2020). Results Preliminary results indicate a cohort of 355 older adults. Analysis of cognitive screening scores reflect prevalence of MCI at 15% and dementia at 35%. The Jog Your Memory program is implemented over 4 sessions. 2 programs were complete in October 2023 and April 2024 with 16 participants. Evaluation was complete with 100% of participants reporting benefits including acquisition of memory strategies, improved confidence and increased knowledge of MCI. Implementing this program optimises therapist time indicating cost saving. Final findings will be available for the purpose of this poster presentation. Conclusion The prevalence of cognitive impairment is broadly in keeping with previous audit (2023). The intervention group implementation and evaluation are ongoing. Participant feedback suggests the intervention is meeting the needs of this cohort. Future work will focus on scaling up the intervention group and integrating with other local services.

Long-Term Outcomes of Older Adults in Ireland after Geriatric Rehabilitation for COVID-19: A Prospective Cohort Study

Abstract Background COVID-19 is a contagious disease caused by the Sars-CoV-2 virus. Disease presentation and severity has evolved since its emergence in 2019. In May 2023, the World Health Organization declared the end of the COVID-19 pandemic but described it as an established and ongoing health issue. Studies to date have focused on disease presentation, prevalence and evolution and the immediate rehabilitation outcomes for older adults. There is a paucity of research reporting the long-term outcomes of older adults who have completed geriatric rehabilitation. The primary aim of this study was to describe the long-term functional outcomes of a cohort of older adults with acute COVID-19 who have completed inpatient geriatric rehabilitation. Methods This is a subgroup analysis of Irish data gathered as part of a pan-European prospective cohort study. Patients were recruited from two acute hospitals in the Republic of Ireland: Beaumont Hospital and University Hospital Limerick. Patients with a confirmed case of COVID-19 infection and accepted for geriatric rehabilitation in the hospital setting were eligible for recruitment. Functional ability, patient reported symptoms and quality of life were measured using the Barthel Index, the COVID-19 Yorkshire Rehabilitation Screen and the EQ-5D-5L respectively. Results Thirty patients were included in the subgroup analysis. The rate of mortality was 23.3% at six months after discharge from rehabilitation. Patients achieved a return to pre-admission functional ability but reported a significant increase in patient reported symptoms and their quality of life did not return to pre-admission levels when assessed at six months after discharge from rehabilitation. Conclusion Multidisciplinary rehabilitation for older adults with acute COVID-19 infection can assist patients to return to their premorbid functional ability. On discharge from rehabilitation, ongoing follow up of older adults is recommended to assist them to negotiate and manage ongoing symptomatology such as breathlessness or fatigue.

A qualitative exploration of the lives lived by Irish centenarians

Centenarians are of particular importance to aging research as they represent the living architype of exceptional longevity and as such studying their attributes is expected to contribute to one's understanding of survivorship. While much centenarian research to date recognizes the biological and genetic determinants in achieving advanced age, there is a lack of understanding regarding the influence of social factors and their role in aging. As centenarian populations continue to grow at an unprecedented rate, the heterogeneity among centenarian cohorts together with current aging trends highlights the intrinsic need to better understand centenarian aging from a biopsychosocial perspective. A key challenge for research concerning centenarians is understanding their personal experiences of reaching this momentous age as such information could help to identify the sociodemographic and psychosocial factors that enable people to live such extraordinarily long lives. To address this, this study focused on the lived experience of Irish centenarians and explored their understanding of their aging in a rapidly modernized sociocultural Ireland. Documenting the psychosocial profiles of centenarians will assist key stakeholders including researchers, practitioners, and policymakers in the development of policies and strategies to support the growing population of older adults in Ireland. Furthermore, this research will also map Irish centenarians who have not previously been explored onto the international nexus of centenarian research.

Healthcare practitioners' views of self-harm management practices in older adults in Ireland: A qualitative study.

To explore healthcare practitioners' views on management practices of self-harm in older adults. Semi-structured interviews were conducted with healthcare practitioners, including consultant psychiatrists, general practitioners, clinical psychologists, psychotherapists, clinical nurse specialists and social workers. Purposeful sampling was used to recruit participants in the Republic of Ireland ensuring diverse perspectives of healthcare practitioners were included. Healthcare practitioners were recruited advertising via professional and clinical research networks, social media, and snowballing methods. Interviews were audio-recorded, transcribed verbatim, and analysed using reflexive thematic analysis. We conducted interviews with 20 healthcare practitioners from April to July 2023. Three main themes were generated: first, a perceived greater risk of suicide, and increased awareness of complexity in older adults' self-harm presentations. Second, integrated care as an avenue for improving the management of self-harm in older adults. Third, the importance of safety planning in risk assessments of older adults. Healthcare practitioners viewed self-harm in older adults as complex, challenging, and associated with high suicide risk, approaching patients with care and caution. The need for integrated support and improved collaboration between relevant healthcare practitioners was identified. Suggestions were made for primary care having a lead role in identifying and managing older adults after self-harm. Increased mental health promotion and awareness of mental health and self-harm in this age group would help address current stigma and shame.

Keeping up with the times in Ireland: Older adults bridging the age-based digital divide together?

In 2021, data on Internet usage for those aged 75 years and older in Ireland indicated that almost half of this cohort (46%) had never accessed the Internet. This study examines the role of informal peer learning in the digital lives of older adults in Ireland. A mixed methods case study methodology was employed. Data were collected from 100 participants by means of an online survey, followed by interviews with 12 participants who opted in from the survey. Interview data were collected and analysed using a constructivist grounded theory approach. My findings indicate that questions surrounding digital technologies were best addressed on an individual level, often from a same generation peer, whether household member, family or other relative, friend or member of one’s social environment. There was evidence of indirect reciprocity from these learning exchanges to a participant’s peers. Research into peer learning in informal social and community environments for older adults has been scarcely addressed heretofore. This research highlights that it is here that much later-life learning relating to digital skills takes place. The principles of intergenerational learning: learning with one another, learning from one another, learning about one another, offer a useful lens for future consideration of informal peer learning related to digital skills development amongst older adults.

Factors linked to future care conversations with others in Ireland: Age and gender differences

Abstract Background Ireland needs evidence-based strategies for meaningful engagement in ACP activities. This study aimed to identify factors associated with conversations with trusted others among older adults in Ireland. Methods Data from the Irish Longitudinal Study on Ageing (TILDA), a nationally representative study of community-dwellers (≥50 years old), was used. Participants who consistently reported ACP conversations with trusted others at Waves 4 and 6 (n = 2764) were included. Binary logistic regression was carried out using these conversations as a dependent variable (categorised as engagement/non-engagement). The results of a mixed-research synthesis informed selection of explanatory variables; including age, gender, education, health literacy, pain, making a will, religiosity, wish to die, and marital status. Data were stratified by gender and aged groups. Results Although men (n = 1242) were 58% less likely to engage in conversations with trusted others, there was a 4% increase in odds of their engagement per year older. Younger participants (≤64) who made a will were 99% more likely to report ACP conversations. Those who were ≤74 years old and reported pain were 42% more likely to engage. Men and younger participants (50-64) who ever experienced a wish to die were over twice as likely to report ACP. Similarly, men and those >74 years old with a third level education were twice as likely to engage. For every additional score on the health literacy scale, women were 56% more likely to report ACP. Younger participants (50-64) for whom religion was somewhat important were 36% less likely to engage. While single women were 49% less likely to engage, separated, divorced, or widowed women were 43% more likely to report ACP. Conclusions This study identified theoretically important factors associated with ACP conversations with loved ones in Ireland and highlighted gender and age groups differentials. These findings will inform policy and ACP intervention development. Key messages • Increasing age, female gender, third level education, health literacy, having a will, pain, and a wish to die facilitate ACP conversations. Religiosity and being single impede these conversations. • The findings should inform the design of local ACP interventions. They suggest the need to tailor future ACP strategies to the requirements of specific gender and age groups.

Hospital-presenting self-harm among older adults living in Ireland: a 13-year trend analysis from the National Self-Harm Registry Ireland.

To examine trends in rates of self-harm among emergency department (ED) presenting older adults in Ireland over a 13-year period. Population-based study using data from the National Self-Harm Registry Ireland. National hospital EDs. Older adults aged 60 years and over presenting with self-harm to hospital EDs in Ireland between January 1, 2007 and December 31, 2019. ED self-harm presentations. Between 2007 and 2019, there were 6931 presentations of self-harm in older adults. The average annual self-harm rate was 57.8 per 100,000 among older adults aged 60 years and over. Female rates were 1.1 times higher compared to their male counterparts (61.4 vs 53.9 per 100,000). Throughout the study time frame, females aged 60-69 years had the highest rates (88.1 per 100,000), while females aged 80 years and over had the lowest rates (18.7 per 100,000). Intentional drug overdose was the most commonly used method (75.5%), and alcohol was involved in 30.3% of presentations. Between the austerity and recession years (2007-2012), self-harm presentations were 7% higher compared to 2013-2019 (incidence rate ratio (IRR): 1.07 95% CI 1.02-1.13, p = 0.01). Findings indicate that self-harm in older adults remains a concern with approximately 533 presentations per year in Ireland. While in younger age groups, females report higher rates of self-harm, this gender difference was reversed in the oldest age group (80 years and over), with higher rates of self-harm among males. Austerity/recession years (2007-2012) had significantly higher rates of self-harm compared to subsequent years.

O.1.2-6 Music and Movement for Health: an arts-based Intervention to promote health and wellbeing of community dwelling older adults in Ireland

Abstract Purpose The Music and Movement for Health study is a pragmatic cluster-randomised controlled feasibility trial that aims to assess the feasibility of an innovative music and dance intervention that was developed to promote health and wellbeing of community dwelling older adults in Ireland. This study also aims to obtain preliminary data on the effect of the arts-based intervention on health and wellbeing in older adults. Methods One hundred community-dwelling adults aged 65 years or older were recruited across seven clusters in the Mid-West region of Ireland. The seven clusters were randomly allocated to either the intervention group (n = 56, 4 clusters) or the control group (n = 44, 3 clusters). The intervention group participated in the Music and Movement for Health intervention which consisted of a 1.5-hour session and a 1-hour home-based programme weekly for 12-weeks. Music and Movement for Health is a complex intervention developed following the Medical Research Council Framework, co-designed with stakeholders using research evidence and theories to optimise engagement. Participants completed assessments at baseline and after 12 weeks and participated in focus group or interview after their participation. Results The targeted feasibility outcomes including the recruitment rates, the retention rates, attendance, and participation rates were achieved. Randomisation was completed according to the protocol and no safety issues were identified. The outcome measures used were acceptable and feasible for this population. The results on secondary outcomes and process evaluation of this trial are awaited. Conclusion This research strives to strengthen collaborative efforts to implement effective, sustainable and cost-effective programmes for older adults to support community connection, enhancing health and wellbeing, in turn reducing demands on the healthcare system. To our knowledge, Music and Movement for Health is the first evidence-based arts intervention that has incorporated music therapy with dance to improve health and wellbeing of community dwelling older adults. Feasibility results demonstrate that Music and Movement for Health is feasible, acceptable and safe for community dwelling older adults in the Mid-West region of Ireland.

Caries and the older patient

Population ageing is global and pervasive and in Ireland, we can expect to see the proportion of the population aged over 65 grow to nearly 30% in the next thirty years. Along with this we have seen a reduction in tooth loss. Therefore we will be managing increasing numbers of partially and fully dentate older adults in dental practice. Older adults in Ireland have high levels of past caries experience and, in particular, root caries is almost exclusively a disease seen in this cohort. Preventing and managing caries in older adults with heavily restored dentitions will bring both treatment planning and operative challenges to the dental profession.

Prevalence and determinants of sarcopenia in community-dwelling older adults in Ireland.

Data on the prevalence of sarcopenia among older adults in Ireland are lacking. To assess the prevalence and determinants of sarcopenia among community-dwelling older adults in Ireland. This cross-sectional analysis involved n = 308 community-dwelling adults aged ≥ 65 y living in Ireland. Participants were recruited via recreational clubs and primary healthcare services. Sarcopenia was defined according to the 2019 European Working Group on Sarcopenia in Older People (EWGSOP2) criteria. Skeletal muscle mass was estimated using bioelectrical impedance analysis, strength was measured via handgrip dynamometry, and physical performance was assessed using the Short Physical Performance Battery. Detailed information was collected on demographics, health, and lifestyle. Dietary macronutrient intake was measured via a single 24h recall. Binary logistic regression was used to examine potential demographic, health, lifestyle, and dietary determinants of sarcopenia (where both probable and confirmed sarcopenia were combined). The prevalence of EWGSOP2-defined probable sarcopenia was 20.8% and confirmed sarcopenia was 8.1% (5.8% had severe sarcopenia). Polypharmacy (OR 2.60, 95% confidence interval [CI] 1.3, 5.23), height (OR 0.95, 95% CI 0.91, 0.98), and Instrumental Activities Of Daily Living (IADL) score (OR 0.71, 95% CI 0.59, 0.86) were independently associated with sarcopenia (probable and confirmed combined). There were no independent associations between energy-adjusted macronutrient intakes, as determined by 24h recall, and sarcopenia. Sarcopenia prevalence within this sample of community-dwelling older adults in Ireland is broadly similar to other European cohorts. Polypharmacy, lower height, and lower IADL score were independently associated with EWGSOP2-defined sarcopenia.

Cost-Effectiveness of the Use of Adjuvanted Quadrivalent Seasonal Influenza Vaccine in Older Adults in Ireland.

Enhanced vaccines (e.g., containing adjuvants) have shown increased immunogenicity and effectiveness in older adults, who often respond sub-optimally to conventional influenza vaccines. In this study, we evaluated the cost-effectiveness of an inactivated, seasonal, MF59-adjuvanted quadrivalent influenza vaccine (aQIV) for use in adults ≥ 65 years in Ireland. A published dynamic influenza model incorporating social contact, population immunity, and epidemiological data was used to assess the cost-effectiveness of aQIV in adults ≥ 65 years of age compared with a non-adjuvanted QIV. Sensitivity analysis was performed for influenza incidence, relative vaccine effectiveness, excess mortality, and the impact on bed occupancy from co-circulating influenza and COVID-19. The use of aQIV resulted in discounted incremental cost-effectiveness ratios (ICERs) of EUR 2420/quality-adjusted life years (QALYs) and EUR 12,970/QALY from societal and payer perspectives, respectively, both of which are below the cost-effectiveness threshold of EUR 45,000/QALY. Sensitivity analysis showed that aQIV was effective in most scenarios, except when relative vaccine effectiveness compared to QIV was below 3%, and resulted in a modest reduction in excess bed occupancy. The use of aQIV for adults ≥ 65 years old in Ireland was shown to be highly cost-effective from both payer and societal perspectives.

Dynapenic Abdominal Obesity Increases Risk for Falls Among Adults Aged ≥50 Years: A Prospective Analysis of the Irish Longitudinal Study on Ageing.

There is a scarcity of studies examining the longitudinal relationship between dynapenic abdominal obesity (DAO; ie, impairment in muscle strength and high waist circumference) and future fall risk. Therefore, we aimed to investigate the prospective association between DAO at baseline and falls occurring during 2 years of follow-up in a nationally representative sample of middle-aged and older individuals from Ireland. Data from 2 consecutive waves of the Irish Longitudinal Study on Ageing survey were analyzed. Dynapenia was defined as handgrip strength of <26 kg for men and <16 kg for women. Abdominal obesity was defined as a waist circumference of >88 cm for women and >102 cm for men. DAO was assessed at Wave 1 (2009-2011) and was defined as having both dynapenia and abdominal obesity. Falls occurring between Wave 1 and Wave 2 (2012-2013) were self-reported. Multivariable logistic regression analysis was conducted. Data on 5 275 individuals aged ≥50 years were analyzed (mean [standard deviation {SD}] age 63.2 [8.9] years; 48.8% males). After adjustment for potential confounders, compared to no dynapenia and no abdominal obesity at baseline, DAO was significantly associated with 1.47 (95% confidence interval [CI]: 1.14-1.89) times higher odds for falls at 2-year follow-up. Dynapenia alone (odds ratio [OR] = 1.08; 95% CI: 0.84-1.40) and abdominal obesity alone (OR = 1.09; 95% CI: 0.91-1.29) were not significantly associated with falls at follow-up. DAO increased the risk for falls among middle-aged and older adults in Ireland. Interventions to prevent or reverse DAO may be beneficial for fall reduction.

Association of adverse childhood experiences with lipid profiles and atherogenic risk indices in a middle-to-older aged population

BackgroundAdverse childhood experiences (ACE) have been associated with poor later life health outcomes, including cardiovascular disease (CVD). Limited research investigating potential underlying biological mechanisms linking ACE to CVD exists, particularly regarding lipid biomarkers. ObjectivesThe aim of this study was to examine the associations between childhood adversity and unfavourable lipid profiles and derived atherogenic risk indices in a middle-to-older aged population. MethodsThis cross-sectional study includes 1820 participants from the Mitchelstown cohort (49% male) in Ireland. Participants' self-reported history of childhood adversity (overall and by subtypes household dysfunction, abuse and neglect) were assessed through a validated 10-item ACE questionnaire. Lipid profiles were determined and atherogenic risk indices including Castelli's Risk Index 1 and 2 (CRI-I and CRI-II), Atherogenic Coefficient (AC) and Atherogenic Index Plasma (AIP) were generated. Logistic regression analysed ACE associations with unfavourable lipid outcomes, controlling for potential confounders. ResultsACE history (reported by 23% of sample), in particular childhood exposure to household dysfunction, was associated with later-life non-optimal TG and HDL-C concentrations and atherogenic risk indices CRI-II and AC in age and sex-adjusted models (all p < 0.05). In fully adjusted models, adults reporting ACE or exposure to household dysfunction were approximately twice as likely to have pro-atherogenic CRI-II relative to adults with no ACE (OR = 1.86, 95% CI: 1.19–2.92, p = 0.006 and OR = 2.19, 95% CI: 1.33–3.61, p = 0.002, respectively). Sex-stratified analysis demonstrated sex-specific associations. ConclusionsThis study provides evidence that ACEs are common among older adults in Ireland and are associated with unfavourable lipid profiles and derived atherogenic risk indices.

114 THE EFFECTIVENESS OF A 26-WEEK CLASS AND HOME-BASED OTAGO EXERCISE PROGRAMME ON BALANCE CONFIDENCE AND PHYSICAL PERFORMANCE IN OLDER ADULTS

Abstract Background Falls have a substantial burden on the Irish economy and on the individual. The Otago Exercise Programme (OEP) is a cost-effective falls prevention programme that can prevent 35% of falls. This study aims to evaluate the effectiveness of a 26-week modified OEP using a combined delivery approach of physiotherapists and Exercise Therapists (ET) on balance confidence and physical performance in older adults in rural Ireland. Methods Study-design: A prospective pre-post single arm intervention study. Older adults (≥60 years) were recruited from HSE waiting lists for the OEP which consisted of a group-class (1x/week) and a home OEP (3x/week). Participants were assessed at baseline, 6, 16 and 26 weeks. Outcome measures (OMs) were compared pre and post intervention using Paired T-Tests and Wilcoxon Signed Ranks tests. A repeated-measures ANOVA compared OMs across the time points. Results Improvements were detected in the CONFbal scale (diff = 2.12, 95% CI=1.353-2.803, p&amp;lt;0.01), 30-second sit-to-stand (diff = 3.49, CI= 2.361-4.201, p&amp;lt;0.01), timed-up and go (diff = 2.38, CI=8.08-12.0, p&amp;lt;0.01), functional reach (diff = 9.158, CI=6.758-11.294, p&amp;lt;0.01), 180° turn (diff = 1.04, CI=3-5, p&amp;lt;0.01), and the four-test balance scale (diff = 0.61, CI=1.0-3.0, p&amp;lt;0.01). Significant changes are noted for each measure (p&amp;lt;0.05) with small-moderate positive effects (ηp2=0.32-0.512). The most significant changes in the 180° turn are seen between week-0 (4.92 ±1.784) and week-6 (4.44 ±1.258) followed by a plateau in results. Conclusion Confidence and physical performance improved significantly pre and post intervention, suggesting the physiotherapist and ET combined delivery of the programme is effective. Static and dynamic balance improvements may plateau after 6-weeks of the OEP suggesting the participants may not have been adequately challenged. Lower limb strength and mobility continued to improve throughout suggesting the modified OEP is an effective intervention for older adults in Ireland.

6 OLDER ADULTS’ DECISION-MAKING CAPACITY FOR INDEPENDENT LIVING: OCCUPATIONAL THERAPY CONTRIBUTIONS TO COLLABORATIVE MULTIDISCIPLINARY ASSESSMENT

Abstract Background Increasing age and life expectancy, alongside the growing prevalence of dementia-related diseases, indicate more older adults are likely to experience challenges regarding their decision-making capacity (DMC). The Assisted Decision Making (Capacity) Act 2015 provides a statuary framework for adults who are experiencing difficulties with decision-making and has implications for all healthcare professionals. Occupational therapists frequently contribute to multidisciplinary assessments of older adults’ DMC for independent living (IL). Methods Focus groups were conducted among occupational therapists working with older adults in Ireland to explore assessment practices of DMC for IL. Results Fifty-two occupational therapists, from a range of hospital and community settings, participated in nine focus groups. Therapists reported using enablement strategies and occupation-based approaches when assessing DMC to address the person’s values and preferences, cognitive-functional abilities and environmental needs for IL. However, resource issues and lack of shared understanding of DMC among the multidisciplinary team constrain DMC assessment practices. Furthermore, older people are often excluded from care-planning, and IL options are determined by availability of services rather than will and preference. Multidisciplinary education on DMC is essential in shaping a cohesive approach to assessment and to enhance older adults’ participation in decision-making. Conclusion Multidisciplinary collaboration and commitment to person-centred approaches may lead to enhanced outcomes for maximising and supporting older adult’s DMC regarding IL. A potential leadership role for occupational therapy in assessing DMC for IL is also highlighted.

36 WHAT DO OLDER ADULTS AND HEALTH CARE PROFESSIONALS LOOK FOR IN A FOOD PRODUCT?

Abstract Background The Mediterranean diet (Medi-diet) has proven benefits for healthy ageing but isn’t the habitual diet of most middle-aged or older adults in Ireland; there can be accessibility and tolerability issues with high amounts of fresh fruit and vegetables. Providing key Medi-diet nutrients in a food product is a novel approach to this challenge. This research aims to explore what ‘younger-old’ adults and healthcare professionals (HCPs) would value in such a novel food product. Methods Semi-structured 1:1 interviews and Focus Groups (FGs) were conducted remotely from July 2021 to January 2022. Older adults, defined as over 55’s, were recruited through relevant social, retirement and disease-support groups. Purposive sampling recruited a gender balance and a range of ages and disease profiles. HCPs were recruited through researcher networks and professional associations. Interviews/FGs were recorded, transcribed, and subsequently examined using inductive thematic analysis. Results Older adults (n=47; 50% male) were mostly aged 60-69 years (48.9%). Recruited HCPs (n=26) included dieticians (n=8); geriatricians (n=5); therapists (n=4); and nurses, pharmacists, catering managers (community; residential), and meal delivery service coordinators (n=2 each). Participants supported a food product for older adults requiring a nutrient-dense “boost”, or supplementary fibre or protein, but generally preferred a “food-first” approach, as opposed to a “silver bullet” product. Older adults largely associated functional foods with probiotic products “to repair the gut”, something to have “every now and then”. Product texture and portion size should consider changing dentition and appetite, and consider packaging (dexterity) and preparation ease, but should not stigmatize older adults through targeted branding. Participants felt pre-made soups or cake-type bars would be appealing, but not drinks. Conclusion A novel food product could supplement a balanced diet for older adults, providing high-protein content, and high-fibre for gut health, complimenting an overall lifestyle approach to health improvement and disease prevention.

220 RELATIONSHIP BETWEEN HEIGHT AND SYSTOLIC BLOOD PRESSURE IN OLDER ADULTS

Abstract Background Hypertension is common amongst older adults in Ireland and is a major risk factor for both ischaemic and haemorrhagic stroke. Several studies have investigated the relationship between height and hypertension, however results have been inconsistent. In our Irish tertiary hospital patients undergoing tilt table testing have resting blood pressure measured prior to the test, and height recorded. Our aim was to assess whether there is a relationship between height and resting Systolic Blood Pressure (SBP) in patients aged over 60 years. Methods All tilt table test results between 2000 and 2021 in a single centre were reviewed retrospectively, collecting data on age, height and resting SBP. Any incomplete records were excluded, as were those from patients under 60 years old. Linear regression modelling was used to assess relationship between height and resting SBP. Results A total of 4,729 complete records were included for patients over 60 years old. 2630 (61.5%) of the patients were female. Mean age was 77 ± 7.8 years. 57.7% patients had either an elevated resting systolic and/or diastolic BP ≥130/80 and 28.4% ≥140/90. The linear regression model established that while height could be used to predict resting systolic blood pressure (beta=-0.166, 95% CI: –0.219 to –0.113, p&amp;lt;0.001), height only accounted for 0.8% of variability in resting SBP (R2 = 0.008). Conclusion Our large dataset establishes an association but no meaningful causation between height and resting systolic blood pressure. Current antihypertensive treatment was not recorded, which may have affected the results. Future studies will include further multivariate analysis accounting for antihypertensive use and other factors that may impact hypertension such as age, weight and gender.

The Effects of Social Support on ACEs and Mental Health in Ireland

The aim of this study is to determine the moderating effect of perceived social support on the relationships between ACEs and depression/anxiety, and CPTSD symptoms in older adults in Ireland. Moderated regression analysis was used to evaluate these relationships in a sample of 535 residents of Ireland, aged 50 or above. The results show statistically significant predictive relationships between ACEs and mental health outcomes as well as a significant moderating effect of perceived social support. These findings suggest that ACEs in Ireland should be considered and measures to increase perceived social support should be implemented.