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Department of Rehabilitation & Elderly Medicine, Allied Health Professionals and MARS Service DREAMS)
Woodend Hospital
Eday Road
Aberdeen AB15 6XS
Telephone No: 01224 556789

Department of Medicine for the Elderly

Head of Academic Department

Professor Arduino A. Mangoni (commencing January 2010)

Head of Clinical Department

Dr Donald M Newnham
donald.newnham@nhs.net

Regional Specialty Adviser

Dr William R Primrose
wprimrose@nhs.net

DEPARTMENTAL AIMS

To promote health, well-being and independence amongst older people living in Grampian through exemplary multi-disciplinary clinical practice, effective systems of care and nurturing an environment of quality teaching, research and academic leadership in Geriatric Medicine .

TEACHING

The department actively undertakes teaching of undergraduates throughout their five year programme from introductory visits in first year to final year attachments. The department also welcomes both local and visiting elective students wanting to have a more experience in Medicine for the Elderly. Formal teaching of junior doctors also occurs on a regular basis by senior members of staff in preparation for postgraduate exams.

Postgraduate medical education in the department aims to ensure that all staff working in the department from Foundation Year doctors to Specialist Trainees have a myriad range of experience in the principles and practice of Geriatric Medicine. Training days amongst the various levels range from weekly teaching sessions to monthly educational sessions ensuring that all are kept up to date with the latest developments in the treatment and management of elderly people.

GERIATRIC MEDICINE / GENERAL INTERNAL MEDICINE TRAINING

We currently have a total of 11 Specialist / Specialty Registrars at various stages of training. The training in Aberdeen is structured such that trainees have distinct “junior” and “senior” Geriatric and General Internal Medicine years enabling trainees to complete essential requirements of the JRCPTB curriculum as detailed below. Regular reviews with Educational and Academic supervisors are held every 4 months to ensure steady progression of trainees. A monthly teaching session based on a two-year rolling curriculum largely trainee led prepares trainees for the annual Specialty Certificate Examination (SCE).

RESEARCH

It is envisaged that the Department will be highly proactive in encouraging undergraduate medical and science students to undertake ad-hoc research projects in different areas related to ageing. This might lead to an intercalated BSc, with the aim to attract students for a higher research degree at a later stage (MPhil/MD/PhD).

Similarly, trainees in Geriatric Medicine will be strongly encouraged to undertake research projects which may range from clinical audits in appropriate areas to basic and experimental research in Geriatric Medicine, Gerontology, or related specialties. Active engagement in research at this early stage will benefit trainees for a number of reasons:

develop research methodology, data collection, analysis, and interpretation skills
provide the opportunity to present at either local or national meetings and to publish in peer-reviewed scientific journals (communication and writing skills)
enhance the learning portfolio and maximize the chances of employment, whether in clinical or academic medicine, at the end of the training period
form the basis for a higher research degree for those interested in an academic career pathway

Current strengths:

The Department is strongly involved in research on the Aberdeen Birth Cohorts from 1921 (ABC1921) and 1936 (ABC1936). All Scottish schoolchildren born in 1921 and 1936 underwent IQ testing at the age of 11, although little was done with the information at the time. Since 1997, beginning with the 1921 cohort, Professor Lawrence Whalley (Professor of Psychiatry at Aberdeen) and colleagues have painstakingly traced surviving individuals in Grampian and established two cohort studies namely the ABC1921 and ABC1936. In recent years, individuals in the ABC1921 and, more recently the ABC1936, have been evaluated in a number of “waves” of investigation using a battery of psychometric, physiological, genetic, clinical and neuro-imaging tests. Formal research links from Medicine for the Elderly were established for the 5th Wave of the ABC1921, with particular emphasis on examining determinants of Quality of Life and “successful aging” in octogenarians, while a more recent ongoing collaboration with the ABC1936 cohort has focused on associations between endothelial function, cognitive function and neuro-imaging. There is considerable scope for further collaborative research, particularly in the ABC1936 individuals who are now in early old age. The existing datasets also provide many opportunities for further statistical evaluation.
Availability of state-of-the art techniques for the assessment of vascular function (endothelial function and arterial stiffness) in humans.
Wide catchment area (440,000 people) for community and epidemiological studies.
Strong links with other academic departments (Clinical Pharmacology, Radiology and Cardiology).

Research in the Department of Medicine for the Elderly in Aberdeen divides roughly into the following groups:

I. Applied clinical and translational research

• The role of methylated arginines, endogenous inhibitors of nitric oxide, as novel biomarkers of cardiovascular risk, cognitive impairment, and renal function in human ageing.

• Cardiovascular adaptation to orthostatic stress and regulation of cardiovascular homeostasis in ageing.

• Regulation of vascular tone and endothelial function in health and disease.

• Musculoskeletal and hormonal effects of whole body vibration in older patients

• Hyponatraemia as an independent predictor of poor short- and long-term outcomes and identification of novel therapeutic strategies to manage hyponatraemia in the acute and chronic setting.

• EXCELL - Exercising with Computers in Later Life - A pilot study investigating if the use of the Nintendo WiiFit © is an acceptable intervention in the community dwelling falling population. The aim is to undertake a randomised control trial to see whether exercise with the WiiFit is comparable to standard falls group therapy.

• Nutrition - Physical and cognitive effects of vitamins and multivitamins in older people.

• Effect of Hearing Augmentation on Cognitive Assessment.

II. Population Research

• Identification of determinants and predictors of cardiovascular remodeling, ischaemic brain changes, and cognitive impairment (ABC cohorts)

• Use of non-steroidal anti-inflammatory drugs and cardiovascular outcomes in elderly patients

III. Evaluation of Quality of Life (QoL) in Older Patients

• The impact of anti-cholinergic drugs on functional status in elderly hospitalised patients.

• Clinical service utilisation pattern & outcome in the oldest old in collaboration with colleagues in Norwich.

IV. Educational Research (Specialist Registrars' Group)

The department has a strong interest in educational research. Our aim is to improve teaching in Geriatric Medicine and effect change in medical students' attitudes towards the elderly.

V. Parkinsonism

There are local epidemiological studies of incidence [Parkinsonism Incidence in the North East (PINE) led by Dr C Counsell, Senior Lecturer in Neurology] and local / European survey of environmental influences on Parkinsonism. One of our Specialist Registrars is in the process of completing his PhD in this field.

Consultants

Dr Steven J C Hamilton stevenhamilton@nhs.net

Dr Aamir M Qureshi aamir.qureshi@nhs.net

Dr Stuart R Rochow stuart.rochow@nhs.net

Dr S P Wilkinson steve.wilkinson@arh.grampian.scot.nhs.uk

Dr Roy L Soiza roy.soiza@nhs.net

Dr. Graeme E Hoyle graeme.hoyle@nhs.net

Associate Specialist

Dr C J M Chithila cchithila@nhs.net

Specialist Registrars

Dr. Yaqoob Bhat mbhat@nhs.net (CCT Jan 2010)

Dr. Melvin Chua melchua@nhs.net (CCT Aug 2010)