Southampton Academy of Research

Dr Stephen Lim is a Consultant Geriatrician at University Hospital Southampton (UHS) and holder of a Research Leaders Programme (RLP) award.

His research interests are firstly physical activity in older people, nutrition and deconditioning – a deterioration in a person’s physical abilities due to prolonged bedrest and malnutrition in hospital.

Helping older adults get active

People aged over 65 spend 10 hours or more each day sitting or lying down, making them the most inactive age group. Sedentary behaviour contributes to weight gain and obesity. It also increases the risk of developing many chronic diseases, such as heart disease, stroke and type 2 diabetes.

In addition, 30-60% of older people are estimated to be at risk of deconditioning due to hospitalisation. This can cause them to become weak and frail, making them more at risk of falls. Doing more physical activity could help to prevent this.

“People who suffer from deconditioning are more likely to have prolonged hospitalisation,” Stephen explains. “They are also more likely to be admitted to care homes, and have a higher mortality risk.”

To tackle this, the Frail2Fit study will provide older patients with physical activity, nutrition and behavioural change support after they are discharged from UHS. This will support older adults in maintaining an active and healthy lifestyle following their hospital stay.

Stephen worked closely with professors Mike Grocott and Sandy Jack from the NIHR Southampton Biomedical Research Centre to set up the study, combining their expertise to achieve this.

“The multimodal intervention came from them, and my expertise was using volunteers,” he explains, “so we’re combining our learning to deliver this new trial for older people.”

He is also working with the NIHR Applied Research Collaboration (ARC) Wessex and the NIHR Wessex Academic Health Sciences Network (AHSN) on the Implementation of Digital Activity (IDA) study. This is trialling an online physical activity tool, known as Active Lives, for people over the age of 65. Working with Brendoncare, Stephen led and delivered the ImPACt study which explored an online group exercise intervention for older adults attending social clubs.

“We know that physical activity and nutrition is important, and we know that older people who are in hospital are at risk of deconditioning. Any intervention to try to better that effect or to try to improve physical activity levels is crucial,” he says.

Becoming a research leader

Stephen is looking to use the dedicated time the fellowship provides to not only deliver these existing research projects, but also to secure a future NIHR research grant or fellowship.

“The Research Leaders Programme ensures I have time to carry out and conduct the research that I’m currently involved in. It a prestigious award, and it helps me in my development to become a clinical academic,” he says.

“The fellowship allows me to develop my research portfolio, and also establish collaboration with researchers within the Southampton infrastructure, but also nationally and internationally.”

He believes his fellowship will offer various benefits for patients. He will be able to be part of more studies, meaning older patients at UHS will have more opportunities to take part. But even older patients at UHS who decide not to take part will benefit, as he plans to apply his research findings to improve the care they receive.

“The primary aim is to develop my research skills,” he says. “The ultimate goal is to be a leader in applied health research, to translate known research evidence into patient benefit.”