Dawn A Skelton

Glasgow Caledonian University | GCU · School of Health and Life Sciences

Introduction: The COVID-19 pandemic lockdowns have reduced physical activity (PA) among home-dwelling older adults. The main aim of this study was to investigate how real-life PA in home-dwelling older adults changed over a year with gradual eases in COVID-19 restrictions. Methods: Community-dwelling older adults (≥65 years) were recruited from loc...

Background Urinary and bowel incontinence are more common in adults with intellectual disability (ID), compared to the general population. Little is known about their incontinence experiences and toileting issues. The aim was to learn about their experiences and toileting issues. Method Incontinence and toileting issues assessment was conducted wi...

Background Between 26% and 52% of adults with intellectual disability experience urinary incontinence (UI). Little is known about the implications of urinary tract infections (UTIs) for this group. The aim was to screen for UTIs in a sample of adults with intellectual disability and UI. Method Twenty adults with intellectual disability and UI recr...

Background: The Otago Exercise Programme is an effective intervention for falls prevention. However, there is limited evidence in relation to studies that compare efficacy for falls prevention when delivered Otago Exercise Programme in a group or individual format in a primary care context. Objective: To compare the Otago Exercise Programme deli...

Purpose FaME, a group based multi-component exercise programme, was developed by researchers to reduce the risk of falls and help participants regain confidence and self-efficacy to increase physical activity, as fallers often avoid activity through concern about falls. Uniquely, FaME includes retraining the ability to get up from the floor, reduci...

Purpose: Whilst trials have shown that FaME can reduce falls and increase physical activity, it is still not routinely available across the UK. Where it is available, it is often adapted, though the impact of adaptations has not been described. The conditions necessary for FaME’s spread are not well understood. We undertook two studies that examine...

Purpose: The Irish Longitudinal Study on Ageing (TILDA) reports that 19% of people aged >50 fall annually. In 2021, the population of > 65s reached 742,300, and is set to reach 1 million within 10 years, with the associated cost of falls se to exceed €2 billion. In 2022, a population health-improvement project, AFFINITY supported the training of Ph...

Aims: The study aimed to synthesize evidence of daily physical activity (PA) following Behavior-change technique (BCT)-based interventions compared to any control in individuals with peripheral arterial disease/intermittent claudication (PAD/IC); and examine the relationship between BCTs and daily PA. Methods: Systematic search of 11 databases fro...

Purpose The aim of this study is to explore the feasibility of using machine learning approaches to objectively differentiate the mobilization patterns, measured via accelerometer sensors, of patients pre- and post-intervention. Methods The intervention tested the implementation of a Frailty Care Bundle to improve mobilization, nutrition and cogni...

Background The Falls Management Exercise (FaME) Programme is a group-based, face-to-face and home-based, six-month multi-component exercise intervention for older adults. It reduces falls and fear of falling, increases physical activity and improves confidence and balance. FaME is also cost effective. Despite this evidence, it is not widely availab...

Background and Purpose The COVID-19 pandemic has raised concerns about nursing home (NH) residents’ well-being, with recent studies indicating a significant increase in functional decline rate during this critical period. However, a comprehensive exploration of functional capacity trajectories in NH residents during the pandemic remains unexplored....

Background Falls among older adults represent a major health hazard across the world. In 2022, the World Falls Guidelines was published, summarising research evidence and expert recommendations on how to prevent falls, but we need more knowledge on how the evidence can be successfully implemented into routine practice. In this study we used an impl...

In 2021, a ‘call to action’ was published to highlight the need for professional regulation of clinical exercise physiologists to be established within UK healthcare systems to ensure patient safety and align training and regulation with other health professions. This manuscript provides a progress report on the actions that Clinical Exercise Physi...

Objectives 1) Map FaME delivery across the UK, 2) explore and understand delivery of the FaME programme in practice. Methods Sequential exploratory mixed methods. 1) survey of n=247 Postural Stability Instructor (PSIs) across the UK, 2) purposively sampled n=23 PSIs to take part in interviews. Quantitative data was described descriptively due to l...

Background Age, multimorbidity, immunodeficiency and frailty of older people living in nursing homes make them vulnerable to COVID-19 and overall mortality. Objective To estimate overall and COVID-19 mortality parameters and analyse their predictive factors in older people living in nursing homes over a 2-year period. Method Design : A 2-year pro...

Objectives The Benchmarking Exercise Programme for Older People (BEPOP) service improvement project seeks to determine and promote the exercise training characteristics associated with positive outcomes for resistance exercise for older people living with, or at risk of, sarcopenia or physical frailty. Methods Mixed-methods service improvement pro...

Objective To implement and evaluate a Frailty Care Bundle (FCB) targeting mobilisation, nutrition, and cognition in older trauma patients to reduce hospital associated decline. Methods We used a two group, pretest-posttest design. The FCB intervention was delivered on two orthopaedic wards and two rehabilitation wards, guided by behaviour change t...

Background Urinary incontinence (UI) is a common geriatric syndrome with high health and socio-economic impacts in nursing home (NH) residents. Objectives To estimate the prevalence and types of UI and its associated factors in older people living in NHs in Central Catalonia (Spain). We also determined the proportion of residents who were receivin...

Background Despite substantial research evidence indicating the effectiveness of a range of interventions to prevent falls, uptake into routine clinical practice has been limited by several implementation challenges. The complexity of fall prevention in municipality health care underlines the importance of flexible implementation strategies tailore...

This chapter focuses on the prevalence and amount of sedentary behaviour in older adults with a range of functional limitations, distinguishing the differences between those who live independently with those who live in residential settings or who are subject to enforced sedentary behaviour, such as those in hospital. The associations of prolonged...

This study aims to evaluate the inter-rater reliability of the Tool for assessing determinants of health in public space, a methodology developed to assess the potential health impact of public space improvement actions. The study involved a participatory evaluation conducted during an urban design co-creation process with older adults and research...

Background Limited mobility in older adults consistently predicts both morbidity and mortality. As individuals age, the rates of mobility disability increase from 1.0% in people aged 15–24 to 20.6% in adults over 65 years of age. Physical activity can effectively improve mobility in older adults, yet many older adults do not engage in sufficient ph...

Introduction Scarce evidence is available about the minimum number of valid days wearing the activPAL3 to obtain a precise estimate of sedentary behaviour (SB) and awake-time movement behaviours (ATMB) in nursing home (NH) residents. The study aimed to determine the minimum number of valid days required for accurately estimate SB and ATMB using the...

Background Limited mobility in older adults consistently predicts both morbidity and mortality. As individuals age, the rates of mobility disability increase from 1.0% in people aged 15–24 to 20.6% in adults over 65 years of age. Physical activity can effectively improve mobility in older adults, yet many older adults do not engage in sufficient ph...

Loneliness, little studied in Nursing Homes (NHs), can affect physical and mental health. We aimed to analyze the factors associated with overall, social, and emotional loneliness in 65 residents of 5 NHs from Central Catalonia (Spain), and to verify its prevalence. The sample consisted of 81.5% women with a mean age of 84±7.13 years. The cross-sec...

The objective of this review was to determine the effects of exercise on high-resolution peripheral quantitative computed tomography (HR-pQCT) derived trabecular microarchitecture parameters in older adults. Five electronic databases were systematically searched by two independent reviewers. Inclusion criteria were adults age ≥ 50, any type of exer...

Kyphosis can lead to back pain, poor posture, and increased falls risk. This systematic review aimed to synthesize research on stretching alone, or in combination with strengthening, as a management for hyperkyphosis in the adult population (≥18 years old). An electronic database search was conducted from February to March 2022. The author and an i...

The provision of inclusive indoor and outdoor spaces is essential for achieving age-friendly cities and addressing complex health inequalities. Older adults, especially care home residents, are the least active and most sedentary segment of the population, and are more likely to be isolated and experience loneliness. They also present more difficul...

Objectives: To identify which risk factors were associated with developing Coronavirus Disease-19 (COVID-19) infection, with symptoms, in institutionalized older people. Methods: A 1-year longitudinal multi-center study was conducted in 5 nursing homes (NHs) over the period December 2019 to March 2021. Inclusion criteria included being a permane...

Exercise is an important intervention to maintain bone health in women with osteopenia and osteoporosis. This systematic review aims to gain insight into the experiences or perceptions females have toward bone health interventions, to promote uptake and adherence. Four electronic databases were searched: MEDLINE, CINAHL, PubMed and PsycInfo. Inclus...

Background Urinary incontinence (UI) is a common geriatric syndrome with high health and socio-economic impacts in nursing home (NH) residents. Objectives To verify the prevalence and types of UI and its associated factors in older people living in NHs in Central Catalonia (Spain). We also determined the proportion of residents who were receiving...

Background The age, multimorbidity, immunodeficiency and frailty of older people living in nursing homes make them vulnerable to COVID-19 and to mortality in general. For this reason, our objective is to verify the incidence of general and COVID-19 mortality and to analyse its predictive factors in older people living in nursing homes over a 2-year...

Introduction: Understanding daily movement patterns (i.e., the relative proportion of time spent on Sedentary behaviour (SB), light physical activity (LPA), moderate-vigorous physical activity (MVPA) and sleep) to establish links with chronic diseases is a contemporary topic. Little research has looked at the effects of 24-hour movement behaviour o...

Background our aim was to assess the effectiveness of medication review and deprescribing interventions as a single intervention in falls prevention. Methods Design systematic review and meta-analysis. Data sources Medline, Embase, Cochrane CENTRAL, PsycINFO until 28 March 2022. Eligibility criteria randomised controlled trials of older partici...

Background: falls and fall-related injuries are common in older adults, have negative effects on functional independence and quality of life and are associated with increased morbidity, mortality and health related costs. Current guidelines are inconsistent, with no up-to-date, globally applicable ones present. Objectives: to create a set of evi...

Background To have an impact on the population's health, preventive interventions have to reach a large proportion of the intended population. Digital solutions show potential for providing wider access to fall preventive exercise. However, there is a lack of knowledge about how to reach the target group. The aim of this study was to describe the r...

Background: Care to Move (CTM) provides a series of consistent ‘movement prompts’ to embed into existing movements of daily living. We explored the feasibility of incorporating CTM approaches in home care settings. Methods: Feasibility study of the CTM approach in older adults receiving home care. Recruitment, retention and attrition (three time po...

Place-based creative programmes can help alleviate the structural and place-related problems that affect older adults' health. However, it is unclear why these programmes achieve positive outcomes, and how these may vary across contexts. This critical realist review aimed to address these gaps. We were able to evidence why these programmes may work...

Place-based creative programmes can help alleviate the structural and place-related problems that affect older adults' health. However, it is unclear why these programmes achieve positive outcomes, and how these may vary across contexts. This critical realist review aimed to address these gaps. We were able to evidence why these programmes may work...

Background: In 2018, the European Working Group on Sarcopenia in Older People (EWGSOP2) updated the original definition of sarcopenia, establishing new criteria to be used globally. Early diagnosis of sarcopenia in nursing home residents and the identification of contributing factors would target interventions to reduce the incidence of malnutritio...

Background Frailty is clinically associated with multiple adverse outcomes, including reduced quality of life and functioning, falls, hospitalisations, moves to long-term care and mortality. Health services commonly focus on the frailest, with highest levels of need. However, evidence suggests that frailty is likely to be more reversible in people...

Objectives To review the evidence on incidence and predictive factors of functional decline (FD) in nursing home (NH) residents. Design A systematic review of the literature. Setting and Participants Longitudinal studies involving individuals age 60 years and older living in a NH and with at least 2 functional capacity assessments were eligible....

Background and purpose: Foot-related falls risk factors and specific foot and ankle exercise interventions are within the scope of Physiotherapy, yet little is known about United Kingdom (UK) and Portugal-based (PT) physiotherapists' self-perceived knowledge, confidence and practice of such interventions, or perceptions of patients' falls preventi...

Purpose Physical activity has been shown to improve older adults’ functional capacity, independence, and quality of life. In a feasibility study, we embedded a movement approach within older adults existing home care services through “Care to Move” (CTM). The aim of this qualitative study is to explore older adults’ experiences of CTM within their...

Background In 2018, the European Working Group on Sarcopenia in Older People (EWGSOP2) updated the original definition of sarcopenia, establishing new criteria to be used globally. Early diagnosis of sarcopenia in nursing home residents and the identification of contributing factors would target interventions to reduce the incidence of malnutrition...

Exercise and physical activity can improve bone strength and fall risk, which may offer benefits in the prevention and management of osteoporosis. However, uncertainty about the types of exercise that are safe and effective instigates lack of confidence in people with osteoporosis and health professionals. Existing guidelines leave some questions u...

Objective To formatively evaluate the Make Movement Your Mission (MMYM) digital health initiative to promote physical activity (PA) levels and help avert the negative consequences of sedentary behaviours in older adults during the SARS-CoV2 pandemic. Methods Mixed-method study to explore activity levels, changes in physical function and Activities...

Introduction In Ireland, over 55,000 older adults are supported in their community by formal home support, amounting to an estimated 23 million care hours annually. There is a growing need to move beyond care, to more proactive approaches to maintain physical function. In a feasibility study, we delivered the “Care to Move” (CTM) program through ex...

Background Little is known about associations between performance-based measurements and self-reported scales, nor about ceiling effects or sensitivity to change to evaluate effects in the target population for self-managed exercise interventions. This study aimed to explore the feasibility of using performance-based outcomes for gait speed, functi...

Sarcopenia is a generalised skeletal muscle disorder characterised by reduced muscle strength and mass and associated with a range of negative health outcomes. Currently, resistance exercise (RE) is recommended as the first-line treatment for counteracting the deleterious consequences of sarcopenia in older adults. However, whilst there is consider...

Background Older adults are at increased risk of falls due to ageing, decreased muscle strength and impaired balance. Clinical trials have demonstrated the efficacy and effectiveness of the Falls Management Exercise (FaME) programme in improving functioning and preventing falls. However, programme completion is often low, impacting the potential be...

1) Background: Loneliness, little studied in Nursing Homes (NHs), can affect physical and mental health. We aimed to verify the prevalence of loneliness in 5 NHs and its associated factors. (2) Methods: Cross-sectional study. Older adults aged 65 or over with preserved cognitive status were included. The De Jong Gierveld Loneliness Scale was used t...

Background COVID-19 pandemic has had a major impact on society, including on residents of nursing homes (NH), who have a higher risk of complications and mortality due their physical and intellectual disabilities. Aim To identify which risk factors associated with developing COVID-19 infection with symptoms in institutionalized older people. Meth...

Background: Older people are among the most vulnerable patients in acute care hospitals. The hospitalisation process can result in newly acquired functional or cognitive deficits termed hospital associated decline (HAD). Prioritising fundamental care including mobilisation, nutrition, and cognitive engagement can reduce HAD risk. Aim: The Frailty C...

Embedding Care To Move into every day life for improving physical activity and frailty outcomes for people receiving care at home - barriers and facilitators

How do older people receiving care view Care To Move and whether it is acceptable and feasible to embed Care To Move into their care provision at home

Background In Ireland, over 53,000 older adults are supported in their community by formal home support, amounting to an estimated 19 million care hours annually. There is a growing need to move beyond care, to more proactive approaches to maintain physical function. In a feasibility study, we delivered the ‘Care to Move’ (CTM) programme through ex...

Background Physical activity programmes have been shown to improve older adults’ functional capacity, independence and quality of life. Research around structured exercise programmes has been completed in different groups of community-dwelling older people, however few studies have focused on the older population receiving formal home care. In a fe...

Amidst public health campaigns urging people to sit less as well as being more physically active, this paper investigates how older adults make sense of their sedentary behaviour. Using an accounts framework focusing on how people rationalise their sitting practices, we analysed data from 44 qualitative interviews with older adults. All interviewee...

Background: In 2018, the European Working Group on Sarcopenia in Older People (EWGSOP2) updated the original definition of sarcopenia, establishing new criteria to be used globally. To our knowledge, this is the first study considering it for the diagnosis of sarcopenia in older people living in Nursing Homes. Aim: Verify the prevalence and the deg...

The objective of this study was to evaluate physical function and health-related quality of life 4 months after the cessation of a 4-month exercise intervention in 89 older adults after discharge from hospital. Linear mixed regression models were used to evaluate between-group differences. Data were analyzed according to the intention-to-treat prin...