Walking can be distinguished from other activities by upper and lower cutoffs. The RT3 accelerometer should be used on the same side of the body. Different walking aids do not appear to affect RT3 counts in older people.

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Introduction With advancing age, frailty, multi-morbidity and need for care, elderly patients are some of the most vulnerable to Covid-19 disease. In NHS Tayside, a dedicated Covid-19 Medicine for the Elderly (MFE) Team was formed to care for patients identified as frail and likely to benefit from comprehensive geriatric assessment. Methods All Covid-19 patients meeting frailty criteria1, cared for by the Covid-19 MFE Team were identified. Data on outcomes and clinical characteristics for all (140) patients admitted during the first pandemic wave (March–July 2020) was collected using electronic patient records and analysed. Results Patients were predominantly male (58.6%). Ages ranged from 65–99 years, with 43.6% aged ≥85 years. 82.1% had one or more of cough, fever and anosmia on admission fitting Covid-19 case definition 2. Lymphopenia was present in 92.1%. Of note, 26.5% of patients had a normal or unchanged chest x-ray report, with only 10.2% showing bilateral peripheral infiltrates. 28-day mortality was 37.1% with Covid-19 Disease listed as primary cause of death in 90.4%. Conclusion(s) Entering further “waves” of infection, it is vital that we understand the clinical presentation and course of Covid-19 disease in elderly patients. Our data highlights that any Covid-19 symptom, even in isolation, should raise suspicion of disease. Chest x-rays should not be used alone as a diagnostic tool. The presence of lymphopenia should raise suspicion of Covid-19 infection. In developing an understanding of how elderly patients with Covid-19 present, we can ensure early identification and initiation of appropriate infection control measures. References 1. Healthcare Improvement Scotland. Think Frailty. 2014. http://www.healthcareimprovementscotland.org/his/idoc.ashx?docid=8abd8530-48f3-4152-bbfb-d0918b870ec9&version=-1 2. Scottish Government. Update to Coronavirus Symptoms 2020. https://www.gov.scot/news/update-to-coronavirus-symptoms

Diuretics are commonly prescribed in older people and are often used for prolonged periods. Indications for their use include heart failure and hypertension. They are also used to empirically treat complaints such as swollen ankles and shortness of breath. The aging body is particularly susceptible to the adverse effects of diuretic therapy. Many of the problems are a result of intravascular and extravascular fluid imbalance. It is therefore important that diuretics are prescribed rationally and with good reason. Most major clinical trials do not include older people with multiple co-morbidities. This review will consider whether trials involving diuretics are any different, through an evaluation of what evidence there is to support diuretic use in older people. We will also evaluate the evidence which implicates diuretics as a cause of common clinical problems such as falls, postural hypotension and incontinence. Finally, a rational approach to the use of diuretics in older people will be suggested so that the benefits of diuretic therapy can be maximized and potential adverse effects minimized.