Clinical practise in the ageing population is changing from organ-specific specialty care to holistic care. This is done through comprehensive geriatric assessment and multi-disciplinary team management. Hence, we adopted an approach consisting of multi-professional teachers teaching a Healthcare of Elderly Course (HEC), in a public university in Malaysia. We aimed to analyze the students' attitude, self-perceived competency and interest in geriatric medicine as a career before and after the course. We also investigated variables that might influence this interest among these students. All 96 students in the course were invited to participate in the survey. Sixty-eight (70.8%) completed both pre and post-course questionnaires. Although most students (93%) have a positive attitude (University of California at Los Angeles Geriatric Attitude Scale >3) toward older adults at baseline, it did not significantly increase post-course. We found that the mean scores for self-perceived competency increased from 3.62 (±0.76) to 3.81 (±0.56) post-course (p < 0.01). However, the students remained neutral with no significant change in the mean interest in pursuing a geriatric medicine career after the course. Students with higher self-perceived competency post-course were found to be more interested in geriatric medicine (β = 0.56, p < 0.001). In conclusion, the HEC in our centre could sustain a positive attitude and increase self-perceived competency in students. It is important to increase the preparedness of our graduates in managing older adults with frailty and multimorbidity. Future studies may involve inter-professional education of students from multiple disciplines undergoing the same course to nurture real-life collaborations in managing the ageing population.

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Early mobilisation must follow on from early hip fracture surgery as delayed ambulation leads to poor post-operative outcomes. Early mobilisation post-operatively was associated with better mobility and more discharges from hospital. Embedding it into routine clinical practice will require involvement of the orthogeriatric multidisciplinary team.

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Objective To examine the effectiveness and safety of non-pharmacological interventions to reduce bone loss among post-stroke adult patients. Data sources Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database for Systematic Reviews, MEDLINE, CINAHL, ScienceDirect, Scopus, PubMed and PeDRO databases were searched from inception up to 31st August 2021. Methods A systematic review of randomized controlled trials, experimental studies without randomization and prospective cohort studies with concurrent control of non-pharmacological interventions for adult stroke patients compared with placebo or other stroke care. The review outcomes were bone loss, fall and fracture. The Cochrane Risk of Bias Tools were used to assess methodological quality, and Grading of Recommendations, Assessment, Development and Evaluations Framework to assess outcome quality. Synthesis Without Meta-Analysis (SWiM) was used for result synthesis. Results Seven studies (n = 453) were included. The methodological and outcome qualities varied from low to moderate. There were statistically significant changes between the intervention and parallel/placebo group in bone mineral density, bone mineral content, cortical thickness and bone turnover markers with specific physical and vibration therapies (p<0.05). Falls were higher in the intervention group, but no fracture was reported. Conclusion There was low to moderate evidence that physical and vibration therapies significantly reduced bone loss in post-stroke patients at the expense of a higher falls rate. The sample size was small, and the interventions were highly heterogeneous with different duration, intensities and frequencies. Despite osteoporosis occurring with ageing and accelerated by stroke, there were no studies on vitamin D or protein supplementation to curb the ongoing loss. Effective, high-quality non-pharmacological intervention to improve post-stroke bone health is required.