John Cullen

Improving Vision to Prevent Falls in Frail Older People: A Randomized Trial

OBJECTIVES: To determine the efficacy of vision and eye examinations, with subsequent treatment of vision problems, for preventing falls and fractures in frail older people.

Effect of Helicobacter pylori infection and low‐dose aspirin use on iron stores in the elderly

Background and Aims:u2002 Helicobacter pylori infection has been associated with lower ferritin levels in some adult populations, but subsets of potentially higher risk subjects, such as the elderly have not been examined. The aim of the present study was to determine the impact of H. pylori infection and low‐dose aspirin use on iron stores in a well elderly population.

Vision screening for frail older people: a randomised trial

Aim: To assess the effects of vision screening, and subsequent management of visual impairment, on visual acuity and vision-related quality of life among frail older people. Design: Randomised controlled trial. Setting: Community in Sydney, Australia. Participants: 616 men and women aged 70 years and over (mean age 81 years) recruited mainly from people attending outpatient aged care services. Control: No vision assessment or intervention Interventions: Comprehensive vision and eye examinations conducted by an optometrist. Three hundred subjects were seen by the study optometrist, with 146 judged to need treatment for a vision or eye problem. The optometrist arranged new glasses for 92 subjects; 24 were referred for a home visit by an occupational therapist; 17 were referred for glaucoma management; and 15 were referred for cataract surgery. Main outcome measure: Distance and near visual acuity (logMAR) and composite scores on the 25-item version of the National Eye Institute Visual Function Questionnaire, both assessed at a 12-month follow-up home visit. Results: After 12 months’ follow-up, the mean (logMAR) distance visual acuity was 0.27 in the intervention group and 0.25 in the control group (pu200a=u200a0.32). The mean (logMAR) near visual acuities were −0.01 in the intervention group and −0.03 in the control group (pu200a=u200a0.26). The mean composite score on the National Eye Institute Visual Function Questionnaire was 84.3 in the intervention group and 86.4 in the control group (pu200a=u200a0.49). Conclusions: Vision screening by an optometrist for frail older people living in the community in Australia does not lead to improvements in vision or vision-related quality of life after 1 year’s follow-up.

Residential age care and domiciliary oral health services: Reach‐OHT—The development of a metropolitan oral health programme in Sydney, Australia

OBJECTIVEnTo describe an oral health care programme for older people in Residential Aged Care Facilities (RACFs) to improve access to care and support facilities.nnnINTRODUCTIONnDifferent models of residential care have been proposed, but few have been comprehensive (providing on-site health promotion and service delivery) or sustainable.nnnMETHODSnA partnership model of oral health care, with dental services plus oral health education, was integrated into the community outreach services of a metropolitan hospital department of aged care. The programme provided annual oral health education and training to staff, and on-site dental care to 10 (RACFs).nnnRESULTSnNone of the RACFs had received organised education or on-site dental service care prior to the programme. At the completion of the third year of the programme, 607 residents (75% of the total bed capacity for the 10 RACFs) had received an annual oral health assessment, and 271 (46.5%) had received on-site dental care. More than 120 nursing and allied health staff had received education and training in oral health support to residents. Oral cleanliness, the proportion not experiencing dental pain and referral for additional care decreased significantly over the period, but dental caries experience and periodontal conditions remained a concern.nnnCONCLUSIONSnSustainable domiciliary oral health services and oral health education are feasible and practical using a partnership model within the Australian health system. Adaptability, continuity and the use of oral health therapists/dental hygienists in the coordination and management of the programme further contribute to viability.