Associate Professor Ruth Hubbard

Head, PA-Southside Clinic

Princess Alexandra Hospital Southside Clinical Unit
Faculty of Medicine

Affiliate Associate Professor

Centre for Health Services Research
Faculty of Medicine
r.hubbard1@uq.edu.au
+61 7 344 38043

Overview

Dr Ruth E. Hubbard is a Senior Lecturer in Geriatric Medicine at the University of Queensland, Centre for Research in Geriatric Medicine (CRGM) and Consultant Geriatrician at the Princess Alexandra Hospital. This position was made possible by a Queensland Health Office for Health and Medical Research Fellowship awarded jointly to PAH and UQ.

Dr Hubbard qualified from St Mary’s Hospital Medical School in London and trained in general internal medicine and geriatric medicine in Cardiff, Wales. She previously worked as a Consultant Geriatrician and Physician at University Hospital Llandough and Barry Community Hospital. She has always combined clinical practice with an interest in teaching and research, completing an MSc in Medical Education in 2005 and an MD on pathophysiological changes in frail older people in 2009. Following her doctoral work, she was awarded a travel fellowship by the Peel Medical Research Trust to pursue her frailty studies at Dalhousie University, Nova Scotia with Professors Ken Rockwood and Arnold Mitnitski. Here, she was able to test hypotheses regarding determinants and manifestations of frailty, the difficulties of measuring frailty in clinical practice and the relationships between frailty and obesity, smoking, SES, and exercise. Dr Hubbard has an international reputation for her work on frailty in older people. Based on the number and nature of her publications, she is currently ranked number 5 in a list of the world’s leading experts in this field (http://expertscape.com/leaders/frail-elderly). She has been invited to give keynote lectures at several major medical conferences including the RACP Congress on Future Directions in Health and the ANZSGM Annual Scientific Meeting in New Zealand. She has made a significant impact on policy and practice having co-written the ANZSGM position statement on frailty in older people as well as presenting to the 2013 European Commission in Brussels (Frailty in old age, a public health concern at EU level).

She is an external reviewer for governmental funding bodies in Europe and Australia, an Associate Editor of 3 geriatric medicine journals and has supervised RhD students originating from a variety of multidisciplinary backgrounds as well as medical students and advanced trainees in geriatric medicine.

Research Interests

  • Measurement of Frailty in Clinical Practice
    Older people in hospital are at high risk of adverse outcomes, a vulnerability commonly referred to as frailty. In community-dwelling older people, frailty status can be measured precisely with a Frailty Index score. We are currently leading a research programme to develop a Frailty Index from the interRAI instrument, a standardised comprehensive geriatric assessment tool used in the routine care of many patients in hospital. This would assist clinicians to identify vulnerable older inpatients, improving their care in the acute setting.
  • Optimisation of Medication Prescribing in Older Inpatients
    Polypharmacy is strongly associated with increased mortality, frailty, disability, and falls, and is the most significant risk factor for adverse drug reactions. Medications can also improve quality of life through symptom control and maintenance of function. Individualisation of therapy should therefore underpin prescribing, weighing up the potential benefits and risks of medication with reference to the patient’s own goals of care. Our research is interrogating large datasets to explore associations between inpatient prescribing and functional outcomes as well as prospective evaluation relating prescribing to frailty status.
  • Telehealth for Older People in Residential Aged Care Facilities
    This study is examining the effectiveness of telehealth to reduce utilization of external health services by residents in long-term care. These services include visits to emergency departments, hospital admissions and visits to specialists in ambulatory clinic settings. It will also evaluate effects on quality of care, appropriateness of medication use and costs. The design is a pragmatic randomised control trial, which will recruit 880 residents in 10 residential care facilities (5 intervention facilities) and monitor outcomes over 6 months.
  • Sex differences in frailty
  • Education in geriatric medicine
  • Using balance and mobility to track disease progression in older inpatients

Qualifications

  • Bachelor of Medicine and Bachelor of Surgery, Impperial Coll.
  • Doctor of Medicine, Cardiff University
  • Bachelor of Science, The Imperial College of Science, Technology and Medicine
  • Master of Science, Cardiff University

Publications

View all Publications

Supervision

  • Doctor Philosophy

  • Master Philosophy

  • Master Philosophy

View all Supervision

Publications

Book Chapter

  • Hubbard, R.E. (2015). Sex differences in frailty. In Frailty in Aging: Biological, Clinical and Social Implications (pp. 42-53) Basel, Switzerland: S. Karger AG. doi:10.1159/000381161

Journal Article

Conference Publication

  • Lin, H-S, Peel, N. M. and Hubbard, R. E. (2016). Baseline vulnerability and inpatient frailty in relation to adverse outcomes in a surgical cohort. In: The Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2016, “The AGEnder Paradox”, Cairns, Queensland, Australia, (41-41). 1–3 June, 2016. doi:10.1111/ajag.12337

  • Peel, N. M., Watts, J. N., Hubbard, R. E. and Gray, L. C. (2016). Clinical characteristics of older people referred for specialist geriatric consultation. In: The Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2016, “The AGEnder Paradox”, Cairns, Queensland, Australia, (75-75). 1–3 June, 2016. doi:10.1111/ajag.12339

  • Gray, L. C., Peel, N. M., Hornby-Turner, Y., Pimm, B., Wood, S. and Hubbard, R. E. (2016). Development and testing of a rapid functional and psychosocial assessment system for adult inpatients of acute hospitals. In: The Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2016, “The AGEnder Paradox”, Cairns, Queensland, Australia, (64-65). 1–3 June, 2016. doi:10.1111/ajag.12339

  • Chowdhury, R., Peel, N. M., Saweirs, W., Johnson, D., Krosch, M., Senff, S., Basev, A. and Hubbard, R. E. (2016). Frailty index in chronic kidney disease (FI-CKD) study. In: The Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2016, “The AGEnder Paradox”, Cairns, Queensland, Australia, (62-62). 1–3 June, 2016. doi:10.1111/ajag.12339

  • Arjunan, A., Hubbard, R. E. and Peel, N. M. (2016). Gait speed and frailty status in relation to adverse outcomes in geriatric rehabilitation: A prospective cohort study. In: The Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2016, “The AGEnder Paradox”, Cairns, Queensland, Australia, (42-42). 1–3 June, 2016. doi:10.1111/ajag.12338

  • Gregorevic, K., Peel, N. M., Lim, W. K. and Hubbard, R. E. (2016). Health assets improve outcomes for hospitalised older adults. In: The Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2016, “The AGEnder Paradox”, Cairns, Queensland, Australia, (65-65). 1–3 June, 2016. doi:10.1111/ajag.12339

  • Wong, D. L-Y, Peel, N. M., Watts, J. N. and Hubbard, R. E. (2016). Impact of inpatient rehabilitation on frailty and various health domains. In: The Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2016, “The AGEnder Paradox”, Cairns, Queensland, Australia, (59-59). 1–3 June, 2016. doi:10.1111/ajag.12338

  • Bukkapatnam, S., Hubbard, R. E. and Peel, N. M. (2016). Morbidity and mortality among older people with fractures of the humerus: a systematic review. In: The Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2016, “The AGEnder Paradox”, Cairns, Queensland, Australia, (43-43). 1–3 June, 2016. doi:10.1111/ajag.12338

  • Gordon, E., Peel, N. M., Samanta, M. and Hubbard, R. E. (2016). Sex differences in frailty: a systematic review and meta-analysis. In: The Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2016, “The AGEnder Paradox”, Cairns, Queensland, Australia, (25-25). 1–3 June, 2016. doi:10.1111/ajag.12337

  • Khatry, K., Peel, N. M., Gray, L. C. and Hubbard, R. E. (2016). The utility of the frailty index in clinical decision making. In: The Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2016, “The AGEnder Paradox”, Cairns, Queensland, Australia, (25-25). 1–3 June, 2016. doi:10.1111/ajag.12337

  • Kewalram, G., Peel, N. M. and Hubbard, R. E. (2016). Validation of the interRAI Acute Care assessment tool for recording medical diagnoses against the recorded diagnoses in the medical records. In: The Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2016, “The AGEnder Paradox”, Cairns, Queensland, Australia, (48-48). 1–3 June, 2016. doi:10.1111/ajag.12338

  • Bak, Melissa, Peel, Nancye, Lynch, Angelica and Hubbard, Ruth E. (2014). Enhancing dignity for older inpatients: the photograph next to the bed study. In: Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting, Melbourne Australia, (55-55). 28–30 May 2014. doi:10.1111/ajag.12179

  • Smith, Morgan, Peel, Nancye, Dawson, Blake, Lambat, Zahed, Bak, Melissa, Johnson, David W. and Hubbard, Ruth E. (2014). Feasibility and construct validity of a frailty index for patients with chronic kidney disease. In: Special Issue: Abstracts of the Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting. Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting, Melbourne, VIC, Australia, (18-18). 28–30 May 2014. doi:10.1111/ajag.12177

  • Macdonald, James, Peel, Nancye and Hubbard, Ruth (2014). Physical independence in centenarians - better or worse than expected? A systematic review. In: Special Issue: Abstracts of the Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting. Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting, Melbourne, VIC, Australia, (34-34). 28–30 May 2014. doi:10.1111/ajag.12177

  • Runganga, Maureen, Peel, Nancye and Hubbard, Ruth E. (2014). Polypharmacy in older patients discharged from hospital: a descriptive analysis. In: Special Issue: Abstracts of the Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting. Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting, Melbourne, VIC, Australia, (24-24). 28–30 May 2014. doi:10.1111/ajag.12177

  • Poudel, A., Nissen, L., Mitchell, C., Peel, N. M., Gray, L. C. and Hubbard, R. E. (2014). Potentially inappropriate prescribing in older patients admitted to acute care hospitals and discharged to residential aged care facilities. In: Special Issue: 2014 Annual Scientific Meeting Abstract Book. Annual Scientific Meeting of the American Geriatrics Society, Orlando Fl, (S264-S264). 15-17 May 2014. doi:10.1111/jgs.12870

  • Hubbard, Ruth E., Peel, Nancye, Gray, Len, Mitnitski, Arnold and Rockwood, Kenneth (2014). Risk stratification of older inpatients using a Frailty Index. In: Special Issue: Abstracts of the Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting. Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting, Melbourne, VIC, Australia, (16-17). 28–30 May 2014. doi:10.1111/ajag.12177

  • Poudel, A., Peel, N. M., Nissen, L., Mitchell, C., Gray, L. C. and Hubbard, R. E. (2014). The impact of frailty and polypharmacy on adverse outcomes in older inpatients. In: Special Issue: 2014 Annual Scientific Meeting Abstract Book. Annual Scientific Meeting of the American Geriatrics Society, Orlando Fl, (S264-S264). 15-17 May 2014. doi:10.1111/jgs.12870

  • Chan, K. W., Peel, N. M. and Hubbard, R. E. (2013). Attitudes of medical students towards ageing - a systematic review. In: Special Issue: Abstracts of The Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting. The Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting, Adelaide, SA, Australia, (30-30). 17-19 June 2013. doi:10.1111/ajag.12078

  • Eeles, E. M. P., Peel, N. M., White, S., V, O'Mahony, M. S., Bayer, A. J., Bhat, R. and Hubbard, R. E. (2013). Frailty and illness severity in relation to delirium in older inpatients. In: Special Issue: Abstracts of The Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting. The Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting, Adelaide, SA, Australia, (28-28). 17-19 June 2013. doi:10.1111/ajag.12078

  • Peel, N. M., Kuys, S. S., Slater, A., Klein, K., Paul, S. and Hubbard, R. E. (2013). Gait speed in nursing home residents: a systematic review. In: Special Issue: Abstracts of The Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting. The Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting, Adelaide, SA, Australia, (14-14). 17-19 June 2013. doi:10.1111/ajag.12078

  • Hubbard, R. E., Peel, N. M., Scott, I. A., Martin, J. H., Pillans, P., I and Gray, L. C. (2013). Polypharmacy among older inpatients in Australia. In: Special Issue: Abstracts of The Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting. The Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting, Adelaide, SA, Australia, (24-24). 17-19 June 2013. doi:10.1111/ajag.12078

  • Krishnan, M., Beck, S., Cowen, O., Hughes, M., Havelock, W., Eeles, E., Hubbard, R. and Johansen, A. (2013). Predicting outcome after hip fracture: using frailty index to integrate comprehensive geriatric assessment results. In: British Geriatrics Society Communications to the Spring Meeting. British Geriatrics Society, Belfast, Ireland, (iii16-iii17). 17-19 April 2013. doi:10.1093/ageing/aft101

  • French, A., Peel, N., Smith, A., Gray, L. and Hubbard, R. (2013). The Drug Burden Index and its association with frailty, function and prescribing patterns in Australian hospital inpatients. In: Special Issue: Abstracts of The Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting. The Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting, Adelaide, SA, Australia, (45-45). 17-19 June 2013. doi:10.1111/ajag.12080

  • Ballokova, A., Fialova, D., Peel, N., Gray, L. C. and Hubbard, R. E. (2013). Use of benzodiazepines and Z-durgs in older nursing home residents in Europe and their association with adverse outcomes: results from the EU SHELTER project. In: 42nd ESCP symposium on clinical pharmacy: implementation of pharmacy practice, Prague Czech Republic, (1334-1335). 16-18 October 2013. doi:10.1007/s11096-013-9886-5

  • Ballokova, A., Peel, N., Fialova, D., Scott, I. A., Gray, L. C. and Hubbard, R. E. (2013). Use of benzodiazepines and history of falls in older people admitted to acute care settings in Australia. In: 42nd ESCP symposium on clinical pharmacy: implementation of pharmacy practice, Prague, Czech Republic, (1334-1334). 16-18 October 2013. doi:10.1007/s11096-013-9886-5

  • Goodwin, V. A., Hubbard, R. E., Llewellyn, D. J. and Lang, I. A. (2012). Changes in health status amongst the oldest old: trends over two decades in the English population aged 85+. In: Abstracts of the Communications to the British Geriatrics Society Spring Meeting. Communications to the British Geriatrics Society Spring Meeting, Llandudno, Wales, (ii52-ii52). 16-18 May 2012. doi:10.1093/ageing/afs112

  • Goodwin, V. A., Hubbard, R. E., Llewellyn, D. and Lang, I. (2012). Changes in health status amongst the oldest-old: Trends over two decades in the English population aged 85+. In: Communications to the British Geriatrics Society Spring Meeting. British Geriatrics Society Spring Meeting, Llandudno, Wales, (52-52). 16-18 May 2012.

  • Hubbard, R. E., Goodwin, V., Llewellyn, D. J. and Lang, I. A. (2012). Changes in medication prescribing for the oldest old. In: The Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2012. Dementia: Managing Not to Forget. ANZSGM Annual Scientific Meeting 2012 Dementia: Managing not to Forget, Sydney, Australia, (28-28). 2-4 May 2012. doi:10.1111/j.1741-6612.2012.00603.x

  • Hubbard, R. E., Lang, I. A., Goodwin, V. and Llewellyn, D. J. (2012). Changes in medication prescribing for the oldest old. In: Abstracts of the Communications to the British Geriatrics Society Spring Meeting. Communications to the British Geriatrics Society Spring Meeting, Llandudno, Wales, (ii79-ii79). 16-18 May 2012.

  • Hubbard, R. E., Goodwin, V., Llewellyn, D. J. and Lang, I. A. (2012). Frailty and obesity in later life. In: Abstracts of the Communications to the British Geriatrics Society Spring Meeting. Communications to the British Geriatrics Society Spring Meeting, Llandudno, Wales, (ii50-ii50). 16-18 May 2012. doi:10.1093/ageing/afs112

  • Hubbard, R. E., Lang, I. A., Goodwin, V. and Llewellyn, D. J. (2012). Frailty and obesity in later life. In: Communications to the British Geriatrics Society Spring Meeting. British Geriatrics Society Spring Meeting, Llandudno, Wales, (50-50). 16-18 May 2012. doi:10.1093/ageing/afs112

  • Hubbard, R. (2012). Frailty in older people: Measurement, management and prevention. In: Abstracts for the RACP Future Directions in Health Congress 2012. RACP Future Directions in Health Congress 2012, Brisbane, QLD, Australia, (7-7). 6-9 May 2012. doi:10.1111/j.1445-5994.2012.02779.x

  • Navanathan, S., Peel, N. and Hubbard, R. E. (2012). Gait speed at usual pace as a predictor of outcomes in transitional care program (TCP) recipients. In: The Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2012. Dementia: Managing Not to Forget. ANZSGM Annual Scientific Meeting 2012 Dementia: Managing not to Forget, Sydney, Australia, (19-19). 2-4 May 2012.

  • Goodwin, V. A., Hubbard, R. E., Llewellyn, D. J. and Lang, I. A. (2012). Health, Wealth and Well-Being in Older People. In: Abstracts of the Communications to the British Geriatrics Society Spring Meeting. Communications to the British Geriatrics Society Spring Meeting, Llandudno, Wales, (ii57-ii57). 16-18 May 2012.

  • Goodwin, V., Hubbard, R. E., Llewellyn, D. J. and Lang, I. A. (2012). Health, wealth and well-being in older people. In: Abstracts of the Communications to the British Geriatrics Society Spring Meeting. Communications to the British Geriatrics Society Spring Meeting, Llandudno, Wales, (ii90-ii90). 16-18 May 2012. doi:10.1093/ageing/afs112

  • Hubbard, R. E., Goodwin, V., Llewellyn, D. J. and Lang, I. A. (2012). Health, wealth and well-being in older people. In: The Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2012. Dementia: Managing Not to Forget. ANZSGM Annual Scientific Meeting 2012 Dementia: Managing not to Forget, Sydney, Australia, (17-17). 2-4 May 2012. doi:10.1111/j.1741-6612.2012.00603.x

  • Lang, I. A., Goodwin, V., Hubbard, R. and Llewellyn, D. J. (2012). Healthy Behaviours in Middle Age and Long-Term Consequences for Mortality, Physical and Cognitive Function, and Mental Health. In: Abstracts of the Society for Social Medicine 56th Annual Scientific Meeting. 56th Annual Scientific Meeting of the Society for Social Medicine, London, England, (A34-A34). 12-14 September 2012. doi:10.1136/jech-2012-201753.087

  • Lang, I. A., Goodwin, V., Hubbard, R. E. and Llewellyn, D. (2012). Healthy behaviours in middle age: Long-term consequences for functioning and mortality. In: Communications to the British Geriatrics Society Spring Meeting. British Geriatrics Society Spring Meeting, Llandudno, Wales, (49-49). 16-18 May 2012.

  • Eeles, E. M., Morse, R. E., Lazarus, G., Murison, J., Heade, S., Wiltshire, H. and Hubbard, R. E. (2012). Impact of Geriatrician-Led Care On An Intermediate Care Unit. In: Abstracts of the Communications to the British Geriatrics Society Spring Meeting. Communications to the British Geriatrics Society Spring Meeting, Llandudno, Wales, (ii31-ii31). 16-18 May 2012.

  • Eeles, E. M., Morse, R. E., Lazarus, G., Murison, J., Heade, S., Wiltshire, H. and Hubbard, R. E. (2012). Impact of geriatrician-led care on an intermediate care unit. In: Abstracts of the Communications to the British Geriatrics Society Spring Meeting. Communications to the British Geriatrics Society Spring Meeting, Llandudno, Wales, (ii31-ii31). 16-18 May 2012. doi:10.1093/ageing/afs112

  • Krishnan, Manju, Beck, Sue, Havelock, William, Eeles, Eamonn, Hubbard, Ruth and Johansen, Antony (2012). Total hip replacement after hip fracture - implications of the new nice guidance. In: Abstracts of the Osteoporosis and Bone Conference 2012. Osteoporosis and Bone Conference, Manchester, United kingdom, (S581-S581). 1-4 July 2012. doi:10.1007/s00198-012-2005-y

  • Rockwood, M. R. H., Hubbard, R. E., Eeles, E., Mitnitski, A. and Rockwood, K. (2012). Use of a Frailty Index based on a comprehensive geriatric assessment in an acute care setting. In: Communications to the British Geriatrics Society Spring Meeting. British Geriatrics Society Spring Meeting, Llandudno, Wales, (73-73). 16-18 May 2012.

PhD and MPhil Supervision

Current Supervision

  • Doctor Philosophy — Principal Advisor

    Other advisors:

  • Master Philosophy — Principal Advisor

    Other advisors:

  • Master Philosophy — Principal Advisor

    Other advisors:

  • Doctor Philosophy — Principal Advisor

    Other advisors:

  • Master Philosophy — Principal Advisor

Completed Supervision