Research interests
Recent and current research studies on ageing.
Southampton Mealtime Assistance Roll Out Trial (SMART) 2014 - 16
The Southampton Mealtime Assistance Study, funded by the Southampton Biomedical Research Centre and the MRC Lifecourse Epidemiology Unit, evaluated the introduction of trained volunteer mealtime assistants to help older patients on Medicine for Older People wards at lunchtime. We showed that it was feasible to recruit and train volunteers to assist patients safely including help with eating. Patients, relatives, ward staff and the volunteers reported that the quality of mealtime care was improved by the introduction of the volunteers. We then studied the implementation of mealtime volunteers more widely in four different clinical areas within University Hospital Southampton, supported by the NIHR CLAHRC: Wessex. This study demonstrated that volunteers provided high quality mealtime care, were highly regarded by patients, relatives and staff, and released nurses for clinical tasks. This programme has now been adopted by the hospital and recognised as a national exemplar by HelpForce (www.HelpForce.community) which campaigns for more volunteers in the NHS.
See Howson F et al. BMJOPEN 2018; 8:e022285
Southampton Mobility Volunteers Study (SoMoVe) 2015 - 18
Older people often have very low levels of physical activity in hospital, which can lead to a loss of independence. Building on our experience of the impact of volunteers helping older people at mealtimes, we studied the feasibility and acceptability of volunteers helping older patients in hospital maintain and improve their physical activity. This work was supported by the NIHR CLAHRC: Wessex. We have produced recommendations on how to measure physical activity of older people in hospital; exercise and training programmes that are safe and practical; and shown that the volunteers were appreciated by the patients. This programme is also adopted by University Hospital Southampton and is an exemplar for HelpForce.
See Lim SER et al. Age Ageing 2019; Sep 30 [epub ahead of print]
Grip Strength Measurement Implementation Study (GRImP) 2015 - 17
Low grip strength is central to the diagnosis of sarcopenia (loss of muscle strength, function and mass with older age), and is a recognised marker of poor current and future health. Grip strength is often measured in research studies but is not used in clinical practice. This study evaluated the implementation of routine grip strength measurement on Medicine for Older People wards, supported by the NIHR CLAHRC: Wessex. We found that grip strength was simple to measure and could be adopted into routine ward assessments, to identify those patients who would benefit from increased attention to their diet and physical activity. This finding is highly relevant as low grip strength was recommended in 2018 to be the main diagnostic feature of sarcopenia in clinical settings.
See Ibrahim K et al. BMC Geriatrics 2018;18:79
Hertfordshire Sarcopenia Study 2012 - 17
This study aimed to determine the lifecourse nutrition and lifestyle influences on sarcopenia in community dwelling older people and to identify the epigenetic, cellular and molecular mechanisms that underlie the observed associations between nutrition, lifestyle and sarcopenia. The study is funded by the Southampton Biomedical Research Centre and the MRC Lifecourse Epidemiology Unit, and research continues into biomolecular markers of sarcopenia.
See Westbury LD et al. Calcif Tissue Int 2018; 103(3): 237
Acute Hospital Care for Frail Older People (HOW-CGA) 2014 - 17
This multicentre study funded by the NIHR HS&DR programme aimed to identify markers of frailty in older people admitted to acute care and which models of care are effective and cost effective. Research partners were the Universities of Leicester, Newcastle, Sheffield and the Nuffield Trust. The study team developed a Hospital Frailty Risk Score derived from routine data. Other outputs include a national survey of Comprehensive Geriatric Assessment (CGA) and toolkits to develop CGA practice in a wide range of hospital departments. Details are available at the BGS website.
See Gilbert T et al. Lancet 2018; 391(10132):1775
Screen and Treat for Malnutrition (STREAM) Programme 2016 - 21
I am a co-applicant on this study funded by NIHR PGfAR and led by Professor Paul Little which aims to establish the role of oral nutritional supplements for malnourished community dwelling older people.
See Harris PS et al. BMC Fam Pract 2019; 20:100
Fortified foods for older people 2017 - 18
This study aimed to evaluate the use of fortified foods for older patients in hospital in collaboration with colleagues at the University of Reading. It was funded by the Southampton Biomedical Research Centre.
See Mills SR et al. J Hum Nutr Diet 2018;31:379
Anorexia of Ageing 2018 - 2022
This research programme aims to understand the mechanisms underlying this condition and how clinicians can recognise and manage it. We have demonstrated that poor appetite in hospital is associated with increased mortality at 6 months
See Cox N et al. JNHA 2020 [in press]
Nutriom Research Collaboration 2019-2022
This collaboration is supported by an MRC NRP award and aims to develop effective nutritional targeting of age-related immune decline and intestinal microbial dysbiosis. The collaboration involves researchers from the universities of Southampton, Birmingham, Nottingham and the Quadram Institute.
Southampton Arm Fracture Frailty and Sarcopenia Study 2019 – 2021
This study will test the best way to measure frailty and sarcopenia among older people attending fracture clinics with an arm fracture. We will estimate how common these conditions are and how best to manage them in this group. This study is supported by NIHR Research for Patient Benefit and will report in 2021.It is led by Dr Kinda Ibrahim and myself.
See Ibrahim K et al. BMJOPEN 2019; 9: e031275
Impact study 2020 - 2021
This study builds on the SoMoVe study and will evaluate training community volunteers to help increase the physical activity of older people attending social clubs. This is supported by the NIHR ARC Wessex and led by Dr Steve Lim and myself.
Recent and current research in Parkinson’s
PDSAFE 2013 - 17
This multi-centre randomised controlled trial compared a novel personalised physiotherapy treatment with usual care, and was funded by the NIHR HTA programme. The intervention did not reduce falling overall but did show reduced falls rate and improved physical function among those with moderate rather than advanced disease severity.
See Chivers Seymour KC et al. JNNP 2019;90:774
Implementing a self-management guide for people with Parkinson’s who fall and their carer. 2016 - 20
This study is developing and evaluating a self- management guide in partnership with people with Parkinsons’s and their carers. This work is supported by the NIHR CLAHRC: Wessex.
See Owen C et al. J Parkinson’s Disease 2019; 9:282
First Steps. 2017 - 19
This study evaluated a programme for people newly diagnosed with Parkinson’s, in partnership with people with Parkinson’s and the Universities of Oxford and Oxford Brookes. The programme was designed and delivered by people with Parkinson’s. This work was funded by Parkinson’s UK.
See Soundy A et al. Behav Sci 2019;9:107
Optim park 2019 – 2022
Optimization of community resources and systems of support to enhance the process of living with Parkinson´s Disease: a multi-sectoral intervention (funded by EU Joint Programme – Neurodegenerative disease research).
This study is a partnership between Universities and national Parkinson’s organisations in Spain, Norway, Denmark and Cyprus, led by Southampton. This project aims is to enhance the process of living with Parkinson’s Disease (PD) for the person with PD and the family-carer by building multi-sectoral care pathways, with a special focus on how to optimize the use of resources and systems of support in the community.
Visit OPTIM-PARK international research group
Recently completed postgraduate student supervision:
4 PhD students
2 DM students
2 MSc students
2 MPhil students
1 Parkinson’s UK Career Development Fellow
Current postgraduate student supervision:
Charlotte Owen DM
Esther Clift DClinP
Veena Agarwal PhD
Milly Heelan PhD
Natalie Cox PhD
Qian Tan PhD
Department(s)
Human Development and Health
Affiliate Department(s)
Human Development and Physiology, NIHR ARC: Wessex , OPTIM-PARK international research group
