Article type
Abstract
"BACKGROUND
In the UK, the number of people aged 80 years or more is set to double to 6.4 million by 2045 and treble by 2070. Aging not only affects health but also impacts social support and wellbeing, with over half of all people in the UK aged 75 and over living alone. The evidence underpinning the treatments and interventions for the majority of health and social care issues has been derived from younger populations. The effectiveness and suitability of established treatments may not be either suitable or effective for this population, termed the ‘oldest old’.
OBJECTIVE
We undertook an evidence and gap map (EGM) of health and social care interventions in the ‘oldest old’, with the aim of identifying areas where systematic reviews are needed and where further primary research is needed. Here we present the unexpected challenges we experienced.
METHODS
We included systematic reviews, randomised controlled trials and qualitative studies related to relevant interventions. Our protocol was published in the Campbell Library in July 2023.
RESULTS
We encountered methodological challenges with respect to framework development for the EGM and identifying relevant evidence. Despite being recognised as a growing population sub-group, concepts and theories related to aging have been developed with a younger ‘elderly’ in mind. Furthermore the definition of the ‘oldest old’ has been shifting upwards in age across the decades. Locating the evidence base has been challenging due to the broad indexing terms within Medline and authors not reporting ages in the abstracts. Furthermore, reference to frail elderly, older people or very old, with no reported age, resulted in a lot of additional full text retrieval. Our first searches in May 2023, retrieved 17,306 hits. After two reviewers screened these independently, we included 153 articles, but were aware we were missing relevant articles. Revised searches with specific MeSH terms combined with free text terms returned a further 7179 to screen and resulted in an additional 473 includes.
CONCLUSION
In presenting these challenges and the solutions we developed along the way we hope to help others interested in evidence synthesis in this population.
"
In the UK, the number of people aged 80 years or more is set to double to 6.4 million by 2045 and treble by 2070. Aging not only affects health but also impacts social support and wellbeing, with over half of all people in the UK aged 75 and over living alone. The evidence underpinning the treatments and interventions for the majority of health and social care issues has been derived from younger populations. The effectiveness and suitability of established treatments may not be either suitable or effective for this population, termed the ‘oldest old’.
OBJECTIVE
We undertook an evidence and gap map (EGM) of health and social care interventions in the ‘oldest old’, with the aim of identifying areas where systematic reviews are needed and where further primary research is needed. Here we present the unexpected challenges we experienced.
METHODS
We included systematic reviews, randomised controlled trials and qualitative studies related to relevant interventions. Our protocol was published in the Campbell Library in July 2023.
RESULTS
We encountered methodological challenges with respect to framework development for the EGM and identifying relevant evidence. Despite being recognised as a growing population sub-group, concepts and theories related to aging have been developed with a younger ‘elderly’ in mind. Furthermore the definition of the ‘oldest old’ has been shifting upwards in age across the decades. Locating the evidence base has been challenging due to the broad indexing terms within Medline and authors not reporting ages in the abstracts. Furthermore, reference to frail elderly, older people or very old, with no reported age, resulted in a lot of additional full text retrieval. Our first searches in May 2023, retrieved 17,306 hits. After two reviewers screened these independently, we included 153 articles, but were aware we were missing relevant articles. Revised searches with specific MeSH terms combined with free text terms returned a further 7179 to screen and resulted in an additional 473 includes.
CONCLUSION
In presenting these challenges and the solutions we developed along the way we hope to help others interested in evidence synthesis in this population.
"