Input of multidimensional phenotyping in the metabolic
syndrome stratification
Estelle Pujos-Guillot, Stéphanie Monnerie, E Thévenot, C Junot, J Morais, H
Payette, P Gaudreau, Blandine Comte

To cite this version:
Estelle Pujos-Guillot, Stéphanie Monnerie, E Thévenot, C Junot, J Morais, et al.. Input of multidimensional phenotyping in the metabolic syndrome stratification. 13th Congress of the European Union
Geriatric Medicine Society (EUGMS), Sep 2017, Nice, France. European Geriatric Medicine, 8, 276
p., 2017, 13th International Congress of the European Union Geriatric Medicine Society –Developing
Preventive Actions in Geriatrics. �hal-02735920�

HAL Id: hal-02735920
https://hal.inrae.fr/hal-02735920
Submitted on 2 Jun 2020

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Distributed under a Creative Commons Attribution - ShareAlike 4.0 International LicenseAbstracts of the

13th International Congress of theEuropean Union Geriatric Medicine Society –Developing Preventive Actions in Geriatrics
20–22 September 2017, Nice, France

Authors are responsible for content and language quality of abstracts

Published as Supplement 1 toEuropean Geriatric Medicine, Volume 8, 2017

EDITOR-IN-CHIEF
J.-P. Michel, Emeritus professor of geriatric medicine, Geneva University, Switzerland, Past EUGMS president, WHO expert aging and life course program,
Member of the French Academy of Medicine.
jean-pierre.michel@unige.ch
ASSOCIATE EDITORS
M. Barbagallo, Full professor, Università degli Studi di Palermo, Palermo, Italy. International Association of Gerontology and Geriatrics, Clinical Director European
sectionA. Benetos, Full professor of geriatric medicine, University of Nancy, France, Academic director of the EUGMS (2014-2017)
J. Bousquet, Emeritus professor of medicine University of Montpellier, France, Ofﬁcial representative of the European Innovative Partnership, Active Healthy
Ageing, European Community, Brussels
A.J. Cruz-Jentoft, Head of the geriatric department, University Hospital Ramón y Cajal, Madrid, Spain, Past EUGMS president
S. Maggi, Research Director, Institute of Neuroscience, Aging Branch-Padua, Italy, President EUGMS, 2016-2017
F. Martin, Professor of Medical Gerontology, King’s college, London; elect-EUGMS President 2018-2019
T. Strandberg, Full professor of geriatric medicine, University of Helsinki, Finland, EUGMS immediate past president 2014-2015
N. Van Den Noorgate, Professor of Geriatric Medicine, Head of the geriatric department, Ghent University, Ghent, Belgium; President of the European Academy
for Medicine of Ageing (EAMA).
EDITORIAL BOARD
J.-P. Baeyens (University of Luxembourg Kirchberg, Luxembourg), H. Blain (University of Montpellier, France), C. Bollheimer (University of Aix-la-Chapelle,
Germany), M. Bonnefoy (University of Lyon-Sud, Lyon, France), M. Cankurtaran (University of Ankara, Turkey), T. Chevalley (University of Geneva, Switzerland),A. Cherubini (Instituto Nazionale di Riposo e Cura per Anziani, Ancona, Italy, EUGMS academic board member), S. Conroy (University of Leicester, UK),
P. Crome (University College London, UK), A.W. Ekdahl (University of Linköping, Linköping, Sweden, EUGMS executive board member), J. Flamaing (Universityof Leuven, Leuven, Belgium), M. Gogol (Lindenbrunn, Germany), T. Grodzicki (Jagiellonian University, Krakow, Poland. EUGMS academic board member),
K. Kinugawa-Bourron (Pierre & Marie University, Sorbonne-Paris-Cité Universities, EUGMS academic board member), T. Kostka (University of Łódź, Poland),F. Muller (University of Geneva, Switzerland), D. O’Neill (EUGMS past president, Dublin, Ireland), J. Petermans (University of Liège, EUGMS executive board
member), M. Petrovic (University of Ghent, EUGMS academic board member), K. Pitkälä (University of Helsinki, Helsinki, Finland, EUGMS academic board
member), A.A. Sayer (University of Newcastle upon Tyne, UK, EUGMS academic board member), G. Sergi (University of Padova, Italy), C. Sieber (University
Friedrich-Alexander d’Erlangen-Nuremberg-Germany, EUGMS academic board member), E. Topinkova (Charles University in Prague, Czech Republic, pastclinical director of the IAGG-ER), A. Ungar (University of Florence, Italy), M. Verny (Pierre & Marie University, Sorbonne-Paris-Cité Universities, Paris, France),
A. Vilches-Moraga (Salford Royal NHS Foundation Trust Ageing and Complex Medicine Directorate, Salford, UK, EUGMS executive board member)
INTERNATIONAL EDITORIAL BOARD
H. Arai (Director of the National Center of Gerontology and Geriatrics, Nagoya, Japan), O. Beauchet (MacGill University, Montréal, Quebec, Canada),
C.A. Cano-Gutierrez (Pontiﬁcia Universidad Javeriana, Santa Fe de Bogotá, Colombia), P. Chan (Capital University of Medical Sciences, Beijing, China),
L.-K. Chen (National Yang Ming University, Taiwan), B. Dong (University of Sichuan, China), C. Kyung-Hwan (Korea University College of Medicine, Seoul,
Korea), T. Fulop (University of Sherbrook, Sherbrook, QC, Canada), L.M. Gutierrez Robledo (Director of the National Institute of Aging of Mexico, Mexico),
J. Li (Director of the National Institute of Gerontology, Beijing, China), P.P. Marin Larrain (Past IAGG president, Central and South America, Santiago, Chile),
X. Li (General Hospital of Chinese People’s Liberation Army, China), F. Morales Martinez (University of Costa Rica, San Jose, Costa Rica), J.E. Morley (SaintLouis University School of Medicine St. Louis, Missouri, USA), J. Ouslander (Florida Atlantic University, Boca Raton, Florida, USA), M.P. Paixo Junior (Federal
University of Rio de Janeiro, Rio de Janeiro, Brazil), J. Tao (Sun Yat-Sen University, Guangzhou, China)
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European Geriatric Medicine 8S1 (2017) v–vi

Abstracts of the 13th International Congress of the European Union Geriatric Medicine Society –Developing Preventive Actions in Geriatrics
20–22 September 2017, Nice, France
For the Congress Program, please refer to http://www.eugms.org/2017.html

Contents
Oral presentations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S1

Area: Comprehensive geriatric assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S1

Area: Cognition and dementia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S6

Area: Frailty and sarcopenia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S8

Area: Geriatric rehabilitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S9

Area: Frailty and sarcopenia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S10

Area: Geriatric rehabilitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S10

Area: Comorbidity and multimorbidity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S10

Area: Comprehensive geriatric assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S13

Area: Psychiatric symptoms and illnesses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S14

Area: Comprehensive geriatric assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S15

Area: Pharmacology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S15

Area: Biogerontology and genetics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S17

Area: Cognition and dementia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S18

Area: Pharmacology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S19

Area: Ethics and end of life care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S20

Area: Pharmacology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S20

Area: Ethics and end of life care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S21

Area: Pre and post operative care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S22

Area: Cognition and dementia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S24

Area: Acute care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S26

Area: Longevity and prevention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S27

Area: Metabolism and nutrition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S27

Area: Acute care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S28

Area: Metabolism and nutrition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S28

Area: Acute care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S28

Area: Comorbidity and multimorbidity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S29

Area: Organisation of care and gerotechnology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S30

Area: Longevity and prevention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S32

Area: Oral and dental health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S33

1878-7649 / © 2017 Elsevier Masson SAS and European Union Geriatric Medecine Society. All rights reserved.

viContents / European Geriatric Medicine 8S1 (2017) v–vi

Area: Infectious diseases and vaccines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S33

Area: Pre and post operative care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S34

Area: Infectious diseases and vaccines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S34

Area: Pre and post operative care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S35

Area: Geriatrics in organ disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S36

Area: Urology and continence management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S37

Late Breaking Abstracts – Oral presentations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S38

Poster presentations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S40

Area: Biogerontology and genetics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S40

Area: Cognition and dementia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S42

Area: Comorbidity and multimorbidity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S60

Area: Comprehensive geriatric assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S72

Area: Delirium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S85

Area: Ethics and end of life care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S91

Area: Frailty and sarcopenia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S96

Area: Geriatric education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S115

Area: Metabolism and nutrition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S121

Area: Organisation of care and gerotechnology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S133

Area: Acute care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S143

Area: Geriatric rehabilitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S164

Area: Geriatrics in organ disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S176

Area: Infectious diseases and vaccines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S186

Area: Longevity and prevention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S194

Area: Oral and dental health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S209

Area: Pharmacology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S211

Area: Pre and post operative care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S224

Area: Psychiatric symptoms and illnesses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S236

Area: Urology and continence management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S240

Area: Geriatrics in organ disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S243

Late Breaking Abstracts – Poster presentations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S243

Author Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . S249

European Geriatric Medicine 8S1 (2017) S1–S39

Oral presentations
Area: Comprehensive geriatric assessment

O-001
Multidimensional Prognostic Index (MPI) predicts postdischarge health-care outcomes in hospitalized older patients:
an international, multicentre, one-year follow-up study.
The MPI_AGE European Project
C. Musacchio 1 , J. Daragjati 2 , E. Topinkova 3 , A. Cruz-Jentoft 4 ,M.C. Polidori 5 , M. Paccalin 6 , A. Greco 7 , F. Mattace-Raso 8 ,A.A. Mangoni 9 , M. Puntoni 10 , T. Brunet 6 , R. Custureri 1 , A. Egbert 8 ,A. Mangiacotti 7 , H. Michalkova 3 , C. Miret 4 , K. Ruxton 9 ,M. Simonato 2 , A. Pilotto 11 , on behalf of the MPI_AGE Project
Investigators. 1 Geriatrics Unit, Dept. of Geriatric Care, OrthoGeriatrics& Rehabilitation, Frailty Area, E.O. Galliera Hospital, Genova, Italy;
2 Geriatrics Unit, AULSS 6 Euganea, S Antonio Hospital, Padova, Italy;
3 Dept. of Geriatrics, First Faculty of Medicine, Charles University,
Prague, Czech Republic; 4 Hospital Universitario Ramón y Cajal,
Madrid, Spain; 5 Ageing Clinical Research, Dept. of Medicine II,
University Hospital of Cologne, Germany; 6 Geriatrics Department
University Hospital La Milétrie, Poitiers, France; 7 IRCCS Casa Sollievodella Sofferenza, San Giovanni Rotondo (FG), Italy; 8 Section of GeriatricMedicine, Dept. of Internal Medicine, Erasmus University Medical
Center, Rotterdam, The Netherlands; 9 Dept. of Clinical Pharmacology,
Flinders University, Adelaide, Australia; 10 Clinical Trial Unit, Scientiﬁc
Directorate, E.O. Galliera Hospital, Genoa, Italy; 11 Geriatrics Unit, Dept.
of Geriatric Care, OrthoGeriatrics & Rehabilitation, Frailty Area, E.O.
Galliera Hospital, Genova, Italy and Geriatrics Unit, AULSS 6 Euganea,
S Antonio Hospital, Padova, Italy
Background: The MPI_AGE is a European project aimed to identify the most cost-effective health interventions according to theindividual prognostic mortality-risk proﬁle by using Comprehensive Geriatric Assessment (CGA) to calculate Multidimensional
Prognostic Index (MPI).
Aim: To evaluate the usefulness of MPI in predicting post-discharge
outcomes, i.e. one-year mortality and access to Home-Care Services
and/or Nursing Homes.
Methods: Older patients consecutively admitted to nine Geriatric Units across Europe and Australia underwent CGA-based MPI
assessment, including functional (ADL,IADL), cognitive (SPMSQ),
nutrition (MNA-SF), risk of pressure sores (Exton-Smith Scale), Comorbidity (CIRS), drugs and cohabitation. Patients were divided in
MPI-1-low-risk, MPI-2-moderate-risk and MPI-3-high-risk of mortality. Time-to-event (Kaplan-Meier and Cox regression) and logistic
analyses were performed adjusting data for age, gender, diagnosis
and hospital center. Area under receiving-operating-characteristic(ROC) curve was also calculated.
Results: 1,069 hospitalized patients were recruited (mean age
84.1±7.4 years, females = 60.8%) and classiﬁed according to the

MPI at admission as MPI-1 = 167 patients (15.6%), MPI-2 = 482
patients (45.0%) and MPI-3 = 413 patients (38.6%). MPI signiﬁcantly
predicted one-year all-cause mortality (MPI-1 = Hazard Ratio 1.0
reference; MPI-2 = HR 2.79, 95% CI: 1.56–4.97, MPI-3 = HR 6.49,
95% CI: 3.69–11.4, p-for-trend <0.0001) with good accuracy (ROC
curve = 0.75, p<0.001). Moreover, MPI grade was signiﬁcantly
associated with access to Home-Care Services (MPI-1 = Odds Ratio
1.0 reference; MPI-2 = OR 2.47, 95% CI: 1.5–4.0, MPI-3 = OR 1.82,
95% CI: 1.1–3.0, p=0.002) and to Nursing Home (MPI-1 = OR 1.0
reference; MPI-2 = OR 2.2, 95% CI: 1.3–3.8, MPI-3 = OR 1.7, 95% CI:
0.9–2.9, p=0.002) during the one-year follow-up period.
Conclusion: MPI predicts long-term mortality with high-grade of
accuracy. Moreover, MPI stratiﬁcation may identify older patients
who need access in Home-Care Services and Nursing Homes after
hospital discharge.
O-002
Self-rated health as a predictor of mid-term and long-term
mortality in older Afro-Caribbeans hospitalised via theemergency department
L. Godaert 1 , C. Godard-Sebillotte 2 , L. Allard Saint-Albin 1 ,I. Bourdel-Marchasson 3 , M. Dramé 4 , J.-L. Fanon 1 . 1 University
Hospital of Martinique; 2 MacGill University Montreal; 3 University
Hospital of Bordeaux; 4 University Hospital of Reims
Aim: To determine whether self-rated health (SRH) is an independent prognostic factor for mid- and long-term mortality in older
Afro-Caribbean patients hospitalised for an acute condition.
Methods: This study was a prospective cohort that recruited patients from the University Hospitals of Martinique Acute Care forElders (ACE) unit (French West Indies) from January to June 2012.
Patients aged 75 or older and hospitalized for an acute condition
were eligible. The primary outcome was time to death within the
36-week follow-up. SRH was the explanatory variable of interest.
Demographic and clinical characteristics were recorded. Cox’s Proportional Hazards model was used to estimate the relationshipbetween SRH and mortality.
Results: In total, 223 patients were included; average age 85.1±5.5
years, mainly women (61.4%). In total, 123 patients reported "verygood to good" health, and 100 "medium to very poor" health. Crude
mortality rates at six months, 1, 2 and 3 years were 30.5%, 34.8%,
48.4%, and 57.0%, respectively. SRH reached signiﬁcant relationshipfor all mortality endpoints, after adjustment for baseline demographic and clinical characteristics. The adjusted hazard ratios for
subjects who perceived their health as medium, poor or very poor
was 1.6 to 2.7 times greater than that of subjects who reported
good or very good health.
Conclusion: The association between self-rated health and midto long-term mortality in elderly subjects could have implications
for clinical practice, particularly in helping practitioners to better
estimate prognosis in the acute care setting.

1878-7649 / © 2017 Elsevier Masson SAS and European Union Geriatric Medecine Society. All rights reserved.

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Oral presentations / European Geriatric Medicine 8S1 (2017) S1–S39

O-003
Effect of geriatrician-performed comprehensive geriatric careon health care utilization in older persons referred to acommunity rehabilitation unit
D. Zintchouk 1 , M. Gregersen 1 , T. Lauritzen 2 , E.M. Damsgaard 1 .
1 Department of Geriatrics, Aarhus University Hospital, Denmark;2 Department of Public Health, Section of General Medical Practice,
Aarhus University, Denmark
Introduction: Persons with geriatric conditions account for a large
share of health care utilization. The aim of this study was to investigate the effect of a geriatrician-performed comprehensive geriatriccare (CGC) on secondary and primary health care utilization inolder persons referred to community rehabilitation.
Methods: The study was a randomized, controlled trial conductedin two Danish community rehabilitation units. Inclusion: persons
aged 65 or older from home or hospital. Exclusion: persons receiving palliative care or assessed by a geriatrician during the pastmonth. Intervention group (IG): CGC including medical history,
physical examination, blood tests, medication adjustment, and related treatment performed by a geriatrician. Control group (CG):standard care with the GPs as back-up. Outcomes were measured
within 90 days of follow-up. Primary outcome: inpatient contacts(hospital admissions or emergency department visits). Secondary
outcomes: days spent in hospital, outpatient contacts, and GPs’contacts. Results: 368 persons were randomized (185 to IG/183 to
CG). No signiﬁcant differences in number of inpatient and outpatient contacts, days spent in hospital or number of out of hourGP-visits or phone calls were found between the groups. Incidence
rate ratios for number of daytime GPs’ consultations and visits (0.7,
95% CI: 0.6–0.9), daytime phone and email consultations (0.6, 95%
CI: 0.5–0.7), or other GPs’ services (0.5, 95% CI: 0.4–0.7) were all
signiﬁcantly lower in the IG (p<0.001).
Conclusions: Geriatrician-performed CGC reduces the primary
health care utilization, but has no impact on secondary health careutilization in older persons referred to community rehabilitation
unit during 90 days’ follow-up.
O-004
Anemia, even mild, is associated with early death and altered
geriatric domains, in elderly patients with cancer
E. Liuu, A. Jamet, M.-L. Bureau, A. Caupenne, S. Valéro, M. Paccalin.
CHU de Poitiers, 2 rue de la Milétrie, Poitiers, France
Introduction: Anemia is frequent in elderly patients with cancer, due to many physio-pathological mechanisms (inﬂammation,
bleeding, iron and vitamin deﬁciency, bone marrow failure, defaultof hematopoiesis). The aim of this study was to determine theprevalence of anemia and its severity, in geriatric oncology population, and its association with mortality and geriatric domains
alterations.
Methods: Prospective cohort ANCRAGE (ANalyse Cancer et Sujet
AGE) including cancer patients aged ≥75 years, referred to geriatric oncology clinic between 2009 and 2015. Anemia severity
was graded according to World Health Organization criteria: mild[women: 110–119g/L; men: 110–12.9g/L], moderate [80–109], severe[<80]. Geriatric assessment explored functional domain (assessedwith Activities of Daily Livings); fall risk (Timed Get Up and Go
Test, One-Leg Standing Balance Test, and ﬁve-repetition sit-to-standtest); nutritional status (Mini-Nutritional Assessment and serum
albumin); mood (Geriatric Depression Scale) and cognitive impairment (Mini-Mental State Examination, MMSE). Early mortality wasconsidered at three, six and 12 months.
Results: Of 884 patients with available data, 392 had anemia (44%):
mild in 237 patients (60%), moderate in 151 (39%) and severe in four.
Anemia was associated with mortality (p<0.0001) and alterationof all explored geriatric domains, except MMSE. Mild anemia wasassociated with functional alteration (p=0.01), risk of falls (p=0.03),
malnutrition (p<0.0001) and early death (p<0.0004).
Conclusions: Hemoglobin appeared to be an interesting biomarker,
as its value was associated with mortality and altered geriatricdomains in elderly cancer patients. This association remained withmild anemia, with consequences frequently underestimated bypractitioners.
O-005
Oropharyngeal dysphagia and fragility: Can it be related?
G. Bahat 1 , O. Yilmaz 1 , S. Durmazoglu 1 , C. Kılıç 1 , B. Aykent 2 ,M.A. Karan 1 . 1 Istanbul Medical School; 2 Marmara Medical School
Objective: Oropharyngeal dysphagia (OD) and fragility are geriatricsyndromes those are effecting the prognosis. Literature has beensuggested OD may be present in fragile elderly without neurodegenerative diseases. We aimed to investigate the association of OD
with fragility in the community dwelling elderly.
Methods: Patients admitted prospectively. Participants’ demographic datas were recorded. OD screening was done by scanning
the EAT-10 questionnaire which has two thresholds (≥3 and ≥15).
FRAIL Scale was applied to determine the fragility. We performed
the measurements of BMI, hand grip strength, time and go test
(TUG), usual walking speed, activities of daily living (ADL), instrumental ADL, MNA-SF.
Results: 1138 patients ≥60 years old were enrolled. The mean
age was 74.1±7.3. EAT 10 score correlated with age, number ofillnesses, number of medications, fragility, BMI, hand grip strength,
TUG, usual walking speed, ADL, IADL and MNA SF according to thetwo thresholds of EAT-10 groups. There were higher incidence offemale gender, number of neurodegenerative diseases in the two
thresholds of EAT-10 groups. In the linear regression analysis, EAT
10 score ≥3 (n=65, 7.6%, p<0.012) and EAT 10 score ≥15 (n=33, 3.8%,
p<0.001) were found to be correlated with fragility irrespectivelyof all causes.
Conclusion: OD is a common public health problem and can bediﬃcult to recognize. We have shown that OD increases withfragility. To our knowledge, this is the largest serie in the literatureproviding data on independent association of OD with frailty.
O-006
Malnutrition and comorbidities predict early mortality inelderly patients with cancer
A. Jamet 1 , T. Fauchier 2 , M. Paccalin 3 , P. Bouchaert 4 , V. Migeot 5 ,J.-M. Tourani 4 , S. Valéro 6 , E. Liuu 3 . 1 Pôle de Gériatrie de Poitiers,
CHU de Poitiers, France; 2 Pôle Biologie, Pharmacie et Santé Publique,Centre Hospitalier Universitaire de Poitiers, Poitiers, France; 3 Pôle deGériatrie, Centre Hospitalier Universitaire de Poitiers, Université dePoitiers, Poitiers, France, INSERM, CHU de Poitiers, Université dePoitiers, centre d’investigation clinique CIC1402, Poitiers, France; 4 Pôle
Régional de Cancérologie, Centre Hospitalier Universitaire de Poitiers,
Université de Poitiers, Poitiers, France; 5 Pôle Biologie, Pharmacie etSanté Publique, Centre Hospitalier Universitaire de Poitiers, Poitiers,
France, INSERM, CHU de Poitiers, Université de Poitiers, centred’investigation clinique CIC1402, Poitiers, France; 6 Pôle de Gériatrie,
Centre Hospitalier Universitaire de Poitiers, Université de Poitiers,
Poitiers, France
Introduction: Few data address the prognoses of elderly patientswith cancer. Assessment of prognostic factors might allow speciﬁc
treatment and personalized medical care. We sought to identify
factors predictive of early mortality (<three months) in this patient
population.
Methods: Prospective cohort included patients aged 75 years andolder with solid tumors or hematologic malignancies followed inOral presentations / European Geriatric Medicine 8S1 (2017) S1–S39

oncology geriatric consultations. A comprehensive geriatric assessment including sociodemographic data, social status, autonomy,
cognitive status (Mini-Mental Status Evaluation, MMSE), nutrition(Mini-Nutritional Assessment, MNA), depression scale, risk of falls,
and comorbidities (Cumulative Illness Rating Scale for Geriatrics[CIRS-G] score) was performed. Multivariate models were createdwith logistic regression at three months, Cox models at six and12 months. Sensitivity analyses were performed using multiple
inputation and the maximum bias hypothesis.
Results: A total of 824 patients (mean age, 81.8 years; 48% men)were included; 28% had metastatic cancer. The mortality rates
were 13%, 22%, and 37% at three, six, and 12 months, respectively.
At three months, a MNA score <17 (odds ratio [OR], 8.16, 95%
conﬁdence interval [CI], 3.47–19.20), CIRS-G score >8 (OR, 2.66,
95% CI, 1.32–5.33), metastasis status (OR, 2.20, 95% CI, 1.27–3.81)
were associated with mortality and a higher serum albumin levelappeared protective (OR, 0.90; 95% CI, 0.85–0.94). Nutritional status
was associated with the prognoses throughout follow-up. Cognitive impairment (MMSE) <24/30 was speciﬁcally associated withmortality at 12 months (p<0.01).
Conclusions: Personalized geriatric assessment can improve shortterm treatment strategies and management of elderly patients withcancer.
O-007
Older People Short Stay Unit (OPSSU) team working acrossemergency areas reduces length of stay (LOS) in the over 75s
R. Lisk, K. Stevenson, P. Watts, R. O’Sullivan, C. Spencer,
M. Pagkalinawan, K. Reyes, C. Chikusu. Elderly Care Department,
Ashford & St. Peter’s NHS Foundation Trust
Objectives: It is recognised that the older person, once admitted tohospital, frequently have a longer length of stay and occupy more
bed days than other patients, so we focused on reducing the lengthof stay (LOS) for the over 75s.
Methods: Introduction of Older People Assessment and Liaison
Service (OPAL) in October 2013 based in MAU improved the qualityof care provided in hospital for over 75s, with limited success in
reducing LOS.We set out to reduce LOS for over 75s using PDSA
cycles which involved amalgamating the existing OPAL team withthe acute therapy team; senior therapy presence in emergency
areas; created OPSSU (Dec 2015) with 13 beds expanding to 29
beds, patient information leaﬂets emphasizing the ethos of theimportance of getting patients home and developed a culture in theunit "Time to Move" with posters on the ward.
Results: Before the full implementation in Dec 2015, there were
10,040 over 75 admissions with LOS 8.85 days (Dec 2014–Nov
2015) and after full implementation, there were 10,292 over 75
admissions with LOS 7.66 days (Dec 2015–Nov 2016) – 13.4% reduction in LOS saving 10,017 bed days. Using under 75 as control,
the LOS reduced from 3.79 (Dec 2014–Nov 2015) to 3.54 days (Dec
2015–Nov 2016) – only 6.6% reduction in LOS.98.6% (74 patients)
mentioned that they were extremely likely/likely to recommend
the service.
Conclusions: OPSSU team working across all emergency areas
reduces the LOS for the over 75s with signiﬁcant cost savings.
O-008
Effect of an assessment in a Balance and Fall Prevention Centeron falls rate, and falls and injurious falls incidence in older
fallers: a before/after study
S. Mekhinini 1 , M.-C. Picot 2 , A. Jaussent 3 , J. Rambaud 4 ,L.P. Bernard 5 , C. Boubakri 6 , H. Blain 7 . 1 Department of Internal
Medicine and Geriatrics, University hospital and University ofMontpellier; 2 Département de l’information médicale, CHU

S3Montpellier; 3 Département de l’information médicale, Centred’Investigation clinique, CHU Montpellier; 4 Département de Médecine
Générale, Faculté de Médecine de Montpellier; 5 UFR STAPS, Euromov,
Montpellier University; 6 Pôle gérontologie, Montpellier University
hospital; 7 Dept. of internal medicine and geriatrics, University hospitalof Montpellier, Montpellier University, Euromov, Macvia France
Falls represent a major cause of burden and death in older adults.
Patients visiting the Montpellier Balance and Fall Prevention Center(BFPC) (EIP on AHA reference site) beneﬁt from a plan for falls andfracture prevention based on a 3-hour multidimensional assessment by a geriatrician, a physiotherapist, an occupational therapist,and a podiatrist. 134 consecutive patients (mean age, 82 years; 69%
women) referred by their GP to the BFPC between Sept. 2014 and
Sept. 2015 for balance disturbances and with at least one fall in
the previous 6 months were followed for 6 months after assessment. Falls number per patient, 3 and 6 months after vs 3 and 6
months before assessment, was signiﬁcantly reduced [−2.9 ± −10.3,
p<0.0001; −5.2 ± −20.6; p<0.0001, respectively]. A signiﬁcant decrease was found for falls rate [25% vs 88% (p<0.0001), and 32%
vs 100% (p<0.0001), respectively]. Severe and minor injuries werelower 6 months after vs 6 months before assessment [6% vs 31%,p<0.0001; 8% vs 14%, p<0.05, respectively]. The same trend wasobserved for major injuries in the subgroup of patients with atleast a fall during the follow-up (17% vs 37%, p=0.1). Fear of falling
was signiﬁcantly reduced after 6 months (p=0.001). Satisfaction ofpatients or caregivers was high at M6 (90%). Recommendations
made to patients were well followed (80%). Walking ability waspreserved at M6. Present results show that referral by their GP ofolder persons who fall to a fall clinic reduces falls incidence, fallsrate, and injurious falls.
O-009
Geriatric factors associated with one year mortality after cardiac
surgery
G. Chapelet 1 , M. Paille 1 , J.N. Trochu 2 , J.C. Roussel 3 , G. Berrut 1 ,L. De Decker 1 . 1 Department of Geriatrics, EA 1156–12, Nantes
University Hospital, Nantes, France; 2 Inserm, UMR 1087, Departmentof Cardiology and Vascular diseases, Institut du Thorax, Nantes
University Hospital, France; 3 Department of Thoracic andCardiovascular Surgery, Institut du Thorax, Nantes University Hospital,
Translink European Network, Nantes, France
Objective: Surgical aortic valve replacement has been shown to
improve survival and quality of life in patients with severe aortic
stenosis. However, cardiologic variables are known to be associatedwith an increased mortality. As speciﬁc geriatric factors are predominant in this older population, the aim of this study was todetermine geriatric factors associated with one year mortality after
a surgical aortic valve replacement for older patients with severe
symptomatic aortic stenosis.
Methods: Between January 2012 and September 2014, all patients≥75 years referred for a surgical aortic valve replacement after acomplete pre-operative evaluation in a university-aﬃliated center
were retrospectively included in this observational study. Association between one year mortality surgical aortic valve replacement
and baseline characteristics including cardiac and geriatric factors
was analysed by Cox models.
Results: Mean age of the 197 patients studied was 81.3 years
and 48.2% were men. At one year of the intervention, 19 patients(9.6%) were dead. On multivariate analysis, previous cardiac surgery(Hazard ratio [HR] =10.47, p=0.03), undergoing concomitant cardiac
surgery (HR=6.22, p=0.03), pulmonary hypertension (HR=3.73, 0.04)
were still associated with one year mortality. Moreover, cognitive
impairment deﬁned by mini-mental state examination <24 wasalso associated with one year mortality (HR=4.67, p=0.04).

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Oral presentations / European Geriatric Medicine 8S1 (2017) S1–S39

Conclusion: The present study shows that among geriatric factors,
cognitive impairment was the only predictor of one year mortality
after a surgical aortic valve replacement in patients aged 75 years
old and older, independently of cardiac factors and other geriatric factors. This study highlights the importance of preoperative
cognitive assessment.
O-010
The combination of cognitive function test score and Japanese
Fall Risk Index effectively identiﬁes the fall-prone older
inpatients
S. Harada, K. Shibasaki, A. Sampei, Y. Yoshioka, M. Yakabe,
A. Yonenaga, K. Toyoshima, T. Kojima, M. Ishii, Y. Kameyama,
T. Urano, Y. Yamaguchi, S. Ogawa, M. Akishita. Department ofGeriatric Medicine, Graduate School of Medicine, The University ofTokyo
Introduction: Falls are critical turning points for older people
because of postfall morbidity and mortality. As a screening tool,
the Japanese fall prevention guideline proposed Fall Risk Index(FRI) consisting of 21 simple yes/no questions regarding physicaland environmental factors. Since cognitive deﬁcit is also a risk, toidentify the fall-prone population more accurately, we combined
Mini Mental State Examination (MMSE) score with FRI.
Methods: We utilized the geriatric ward database of 253 inpatientsin the University of Tokyo Hospital, discharged from April 2016 to
March 2017, mainly hospitalized for cognitive impairment or acuteillness such as pneumonia. The database includes patients’ characteristics, a history of falls in the past year, FRI and MMSE.Logistic
regressions and receiver operating characteristic (ROC) curves wereanalyzed to assess MMSE and FRI as screening tools for falls.
Results: Forty-six point one percent (88/191) were identiﬁed ascognitively impaired by low MMSE scores (≤23/30 points). The
FRI ranged from 0 to 20 (mean 11±4) in 135 patients.Adjusted forage, sex, skeletal muscle mass index (SMI) and cognitive function,
1 point-increase of FRI demonstrated fall odds of 1.16 (95% CI:
1.02–1.31).Adjusted for age, sex, SMI and FRI, cognitively impaired
patients showed fall odds of 2.78 (95% CI: 1.07–7.22). The area
under the ROC curve of FRI in the cognitively impaired population
was 0.72, the largest area of all variables, increased from 0.66 forthe whole population.
Conclusions: The combination of low cognitive function and highfall risk index improved the identiﬁcation of the fall-prone inpatients.
O-011
Prognostic impact of frailty domain trajectories on 5-year
mortality in very old adults: Results from the PARTAGE cohort
study
M.-L. Erpelding 1 , C. Labat 2 , S. Gautier 3 , F. Guillemin 4 , A. Benetos 5 .
1 Inserm, Université de Lorraine, CHRU Nancy, CIC-1433 Epidémiologie
Clinique, Nancy, F-54000, France; 2 Inserm U1116, Nancy, F-54000,
France; Universite de Lorraine, Nancy, F-54000, France; 3 CHRU Nancy,
Department of Geriatrics, University Hospital of Nancy, F-54000,
Nancy, France; 4 Inserm, Université de Lorraine, CHRU Nancy, CIC-1433
Epidémiologie Clinique; Université de Lorraine, EA 4360 Apemac;
F-54000 Nancy, France; 5 Department of Geriatrics, University Hospitalof Nancy; Inserm U1116; Universite de Lorraine, Nancy, F-54000,
FranceIntroduction: The prognostic value of longitudinal monitoring offrailty remains unknown in very-old adults. The objective was to
identify trajectories of nutritional, cognitive functions and autonomy over time in very-old adults and to assess their association
with long-term all-cause mortality.
Methods: The PARTAGE cohort study was used. Individuals aged

≥80 years, institutionalized, and who signed informed consent,
were included in 2007 and followed-up for 5 years. Socio demographics and comorbidities were collected at baseline. Body massindex (BMI), Mini mental status examination (MMSE), and Index ofactivities of daily living (ADL) were assessed at baseline, 1, 2, and 5
years. Vital status was collected during the follow-up.
Results: In the 710 very-old adults recruited, mean±SD age was
88.0±0.8 years, and 78.9% were female. Seven composite trajectories
were identiﬁed according to the initial level and the evolution of
the nutritional, cognitive and autonomy status. As compared to thereference group (T7-stable overweight, preserved cognitive functions and autonomy), two trajectories presented a higher relativerisk of dying: T1 - stable overweight, moderately impaired thendeclining cognitive function and autonomy, (adjusted HR=1.79, 95%
CI [1.26–2.55], p=0.001) and T6 - stable normal BMI, slight cognitive
decline, and moderate then amplifying loss of autonomy (adjusted
HR=1.67, 95% CI [1.15–2.44], p=0.008).
Conclusions: Weight and height scales, MMSE and ADL questionnaires reﬂecting nutritional, cognitive frailty and loss of autonomy
are reliable and simple instruments requiring insigniﬁcant time tocomplete. Their repeated monitoring in very-old adults provides
trajectories holding prognostic information potentially warning
clinicians to adjust care efforts.
O-012
Goal attainment scaling in a person-centered care setting – areolder adults able to attain their goals?
J.R. Uittenbroek 1 , D.L. Gerritsen 2 , J.P.J. Slaets 3 , S.U. Zuidema 4 ,K. Wynia 1 , W. Rietkerk 4 . 1 Department of Health Sciences,
Community and Occupational Medicine, University of Groningen,
UMCG, Groningen, The Netherlands; 2 Department of Primary andCommunity Care, Center for Family Medicine, Geriatric Care andPublic Health, Radboud University Nijmegen, Medical Centre, theNetherlands; Nijmegen Alzheimer Centre, Radboud University
Nijmegen, Medical Centre, the Netherlands; 3 Leyden Academy on
Vitality and Ageing, Leiden; 4 Department of General Practice andElderly Care Medicine, University of Groningen, UMCG, Groningen, The
Netherlands
Introduction: Goal planning and goal attainment scaling is amethod to facilitate the delivery of person-centered care. Little is
known about the process of care delivery in person-centered careprojects and the additional value of goal planning within theseprojects.
Methods: Community-dwelling older adults (75 years and older)received a person-centered integrated care intervention programwith collaborative goal setting, the Embrace intervention. Goals
were set with a case manager within a care plan. The goal of thecare plan was to encourage the older adult to carry out actions
autonomously, with support of the general practitioner and casemanager. Older adults rated their health-problems with a severity
score at start and a desirable severity score after one year of casemanagement (goal score). After the intervention year, the goal was
evaluated and an end score was measured. Characteristics of goalplans were described. The proportion of attained goals and impactof patient and goal characteristics were calculated.
Results: Among 233 older adults, 836 goal plans were formulated.
Of these, 74% was attained. Goals about physical health and personal care were more likely to be attained, in contrast to goals
about mobility and pain.
Conclusion: Older adults are capable of determining goals in consequence of their needs and preferences and to quantify these.
With goal planning person-centered care can be facilitated andquantiﬁed.

Oral presentations / European Geriatric Medicine 8S1 (2017) S1–S39

O-013
DIALOG task force for deﬁnition of a geriatric minimum data set
for clinical oncology research
E. Paillaud 1 , P. Caillet 1 , T. Cudennec 2 , F. Pamoukdjian 3 ,V. Fossey-Diaz 4 , G. Albrand 5 , R. Boulahssass 6 , A.-L. Couderc 7 ,F. Retornaz 8 , C. Mertens 9 , L. Balardy 10 , F. Rollod-Trad 11 , L. De
Decker 12 , T. Aparicio 13 , L. Mourey 14 , E. Brain 15 , S. MathoulinPélissier 16 , P. Soubeyran 17 . 1 Henri Mondor Hospital, Creteil, France;
2 Ambroise Paré Hospital, Boulogne Billancourt, France; 3 Avicenne
Hospital, Bobigny, France; 4 Bretonneau Hospital, Paris, France;
5 Antoine Charial Hospital, Francheville, France; 6 Cimiez Hospital, Nice,
France; 7 Sainte Marguerite Hospital (CHU), Marseille, France; 8 Centre
gérontologique départemental, Marseille, France; 9 Bordeaux
Universitary Hospital (CHU), Bordeaux, France; 10 Centre Hospitalier
Universitaire Purpan-Casselardit, Toulouse, France; 11 Institut Curie,
Paris, France; 12 Nantes University Hospital, Nantes, France; 13 SaintLouis Hospital, Paris, France; 14 Institut Claudius Regaud, Toulouse,
France; 15 Institut Curie, Saint-Cloud, France; 16 Institut Bergonié,Comprehensive Cancer Centre, Bordeaux, France; 17 Mathoulin Pelissier
Introduction: A minimum set of geriatric data at baseline would
allow comparing results across reports. The aim is to deﬁne aminimum set of geriatric parameters called the Geriatric Mini Data
Set (GMDS) that allows to describe the elderly cancer population inclinical trials.
Methods: The GMDS has been deﬁned by an adapted DELPHI-type
consensus method with four groups: a steering group, a scoringgroup of 14 French geriatrician experts and two validation groupsof national and international panels of experts. The consensus
process proceeded in 6 steps: 1) initial literature search of available
measuring tools; 2) individual scoring (by e-mail) of the relevanceof the selected tools using a graduated (1 to 9) visual analogue scalein 3 rounds; 3) feedback between rounds of the results for eachmeasuring tool; 5) appropriation by national panel of experts.
Results: After 3-round, tools chosen for each domain were: 1)social assessment: using two questions “Are you living alone” and“Would you have a person or caregiver able to help you”; 2) functional autonomy: Activities of Daily Living (ADL) and short-IADL;3) mobility: timed get up and go test; 4) nutrition: unintentional
weight loss in last 6 months and Body Mass Index; 5) cognitive
assessment: Mini-Cog; 6) thymic status: mini-Geriatric Depression
Scale; 7) comorbidity: updated Charlson.
Conclusions: DIALOG intergroup reached an agreement for a shortgeriatric MDS to be incorporated in future clinical trials for theelderly. This initiative still needs to be evaluated for appropriation
by an international panel of experts.
O-014
Functional decline in older nursing home residents in Europe:
The SHELTER study
M. Fedecostante 1 , G. Dell’Aquila 1 , P. Eusebi 2 , G. Onder 3 ,R. Bernabei 3 , A. Cherubini 1 . 1 IRCCS-INRCA, Ancona; 2 Osservatorio
per la Salute degli Anziani, Regione Umbria, Italia; 3 Università
Cattolica del Sacro Cuore, RomaIntroduction: Disability is an important outcome for older nursing
home (NH) residents, closely linked to their quality of life andto higher health care costs. The aim of our study was to identify
independent predictors of functional decline in older NH residents,
taking into account both resident and facility characteristics.
Methods: We evaluated 1760 older (>65 years) NH residents participating in the SHELTER* study (57 NH among 8 countries). A
decline in functional status was deﬁned as an increase of at least
one point in the MDS Long Form ADL scale during a one year
follow-up. Country effect was taken into account.
Results: During the study period 891 (50,6%) NH residents expe-

S5

rienced an ADL decline. Residents experiencing ADL decline wereolder (85.2 vs 84.8 ys; p=0.053), had a lower level of disability(median ADL score 9 vs 12; p=0.003), were more frequently affected by severe cognitive decline (23.2% vs 18.8%; p<0.001) andby urinary incontinence (70.4 vs 63.9, p=0.004) and used more
antipsychotics (31.8 vs 26.1%; p=0.009). In the mixed effect logistic
regression model factors independently associated with a higher
risk of functional decline were cognitive decline and urinary incontinence, whereas the presence of a geriatrician and the nurse
availability during night were protective.
Conclusions: Facility characteristics could be a target of intervention to prevent functional decline in NH: the presence of ageriatrician, associated with an adequate amount of nursing care,seem to be important to achieve this goal.
*funded by the EU FP7th CN:223115
O-015
The GCCM Home Assessment Program: survival analysis of timeto institutionalization of an elderly population followed since2006 in Monaco
P. Migliasso 1 , P. Porasso 1 , S. Louchart de la Chapelle 2 , S. Hesse 2 ,A. Pesce 2 . 1 Gerontologic Coordination Center of Monaco; 2 Rainier III
Gerontologic Center, Princess Grace Hospital, Monaco
Introduction: Since 2006, the Gerontologic Coordination Centerof Monaco (GCCM) takes care of disable elderly living at home.
The GCCM team performs a Comprehensive Geriatric Assessment(CGA) at home, annually or in case of disability progression, as
long as elderly live safety at home. Aims of this retrospective study
are to estimate the time to institutionalization and to investigate
predictive factors.
Methods: In April 2017, time to institutionalization was studied
for 1872 patients followed by the GCCM since 2006. 574 patients
had been institutionalized and 699 others died without previous institutionalization. A Kaplan-Meier analysis was performed
to estimate the time to institutionalization given covariates, anda Cox model was ﬁtted to determine the predictors of time toinstitutionalization.
Results: The median, mean and maximum time from the ﬁrst CGA
to institutionalization were 1.9, 2.4 and 10.2 years, respectively.
The mean age at institutionalization was 86.9 (range: 56–104).
Institutionalization-free survival at 2, 5 and 8 years were 80% (95%
CI: 78 to 82%), 56% (95% CI: 53 to 59%) and 43% (95% CI: 39 to48%), respectively. The following signiﬁcant risks factors for timeto institutionalization were obtained by a multivariate Cox model:age (HR: 1.03), MMS-E 20–24 (HR: 0.45), the French disability score(GIR: Groupe Iso-Ressources) 5–6 (HR: 0.62).
Conclusions: Our study gives relevant epidemiological data andconﬁrms some well-known predictors of institutionalization such asage, disability, presence of cognitive impairment.Its originality lieson the analysis of 1872 patients followed at home, until their deathor institutionalization. We emphasize the pertinence of our original
program initiated 11 years ago, especially the repeated practice of
CGA by a medical doctor and nurses, not in an institutional context
but at home.
O-016
Assessment of clinical practices for crushing medication in
geriatric units
D. Nghiem 1 , M. Fodil 2 , M. Colas 2 , S. Bourry 2 ,A.-S. Poisson-Salomon 2 , H. Rezigue 2 , C. Trivalle 2 . 1 Hôpital CharlesFoix; 2 Hôpitaux universitaires Paris-Sud (AP-HP), Hôpital Paul Brousse
Objectives: To assess the modiﬁcation of the form of medicationand evaluate staff observance of good clinical practices. Setting:Elderly in-patients with diﬃculties swallowing medications within

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17 geriatrics units in the 3 Teaching Hospitals of Paris-Sud. Measurements: One-day assessment of target-patient prescriptions anddirect observation of nurses’ rounds.
Results: 155/526 in-patients (29.5%) were unable to swallow tablets
or capsules: 98 (40.3%) in long-term care, 46 patients (23.8%) in
the rehabilitation unit and 11 (12.2%) in acute care (p=0.005). In
thirty-nine (27.3%) of the 143 prescriptions studied, all tablets were
safe to crush and all capsules were safe to open. In 104 cases,
at least one medication could not be safely modiﬁed, including
26 cases (18.2%) in which none of the prescribed drugs were
safe to crush or open. In 48.2% of the 110 medications that werecrushed, crushing was forbidden, and presented a potential threat
in 12.7% of cases or a reduced eﬃcacy in 8.2% of cases. Crushingmethods were rarely appropriate: speciﬁc protective equipment not
used (81.8%), crushing equipment shared between patients withoutcleaning (95.1%), medications spilled or lost (69.9%). The method ofadministration was appropriate (water, jelliﬁed water) in 25% of thecases, questionable (soup, coffee, juice, cream) in 55% of the cases
and unacceptable (laxative) in 21% of the cases.
Conclusion: Management of drug prescriptions in patients withswallowing diﬃculties is not optimal, and may even have iatrogenic
effects. Doctors, pharmacists and nurses need to reevaluate theirpractices.

Area: Cognition and dementia

O-017
Impact of opioid initiation on antipsychotic and benzodiazepine
and related drug use among persons with Alzheimer’s disease –An interrupted time series analysis
A. Hamina 1 , P. Lavikainen 1 , A. Tanskanen 2 , J. Tiihonen 2 ,S. Hartikainen 3 , A.-M. Tolppanen 3 , H. Taipale 3 . 1 University ofEastern Finland,UEF, Kuopio, Finland; 2 Karolinska Insitutet, KI,
Stockholm, Sweden; 3 University of Easter Finland, UEF, Kuopio, Finland
Introduction: Analgesia use may reduce behavioral and psychological symptoms of dementia and symptomatic drug use of persons
with Alzheimer’s disease (AD). We aimed to analyze the impact of
opioid initiation on the prevalence of antipsychotic and benzodiazepine and related drug (BZDR) use among community-dwellingpersons with AD.
Methods: Utilizing register-based Medication use and Alzheimer’s
disease (MEDALZ) cohort, we collected all community-dwellingpersons diagnosed with AD during 2010–2011 in Finland initiating
opioid use and a matched cohort of non-initiators. Prevalences ofantipsychotic and BZDR use in 30-day time periods six months
pre-opioid initiation were compared with time periods six months
after with interrupted time series analyses.
Results: We included 3,327 opioid initiators and 3,325 noninitiators with AD. Six months before opioid initiation, 13.3% and27.1% of opioid initiators used antipsychotics and BZDRs, respectively; 18.3% and 28.9% at opioid initiation and 17.3% and 26.9%
six months later. Accounting for the pre-opioid rate, prevalenceof antipsychotic use decreased 0.3 percentage points (pps, 95%
conﬁdence interval 0.1–0.5) and BZDR use 0.3 pps (0.3–0.4) per
month after opioid initiation. Compared to non-initiators, opioid
initiation immediately resulted in an increase of 1.9 pps (1.4–2.3)
for antipsychotics and of 1.6 pps (1.3–1.9) for BZDR use. Post-opioid
initiation, there was a decrease of 0.5 pps per month (0.4–0.7) for
antipsychotics and of 0.4pps (0.3–0.5) for BZDR use until the end of
the follow-up.
Conclusions: Opioid use initiation slightly decreased antipsychotic
and BZDR use compared to pre-opioid initiation and to noninitiators.

O-018
Associated risk factors of restraint use in older adults with homecare: A cross-sectional study
K. Scheepmans 1 , K. Milisen 2 , K. Vanbrabant 3 , L. Paquay 4 , H. Van
Gansbeke 4 , B. Dierckx de Casterlé 5 . 1 Wit-Gele Kruis van Vlaanderen;
Dept. of Public Health and Primary Care, Academic Centre for Nursing
and Midwifery, KU Leuven, Leuven, Belgium; 2 Dept. of Public Healthand Primary Care, Academic Centre for Nursing and Midwifery, KU
Leuven; Division of Geriatric Medicine, Department of Internal
Medicine, Leuven University Hospitals, Leuven, Belgium; 3 KU Leuven University of Leuven & Universiteit Hasselt, Interuniversity Institutefor Biostatistics and Statistical Bioinformatics, Leuven, Belgium;
4 Wit-Gele Kruis van Vlaanderen, Nursing Department, Brussels,
Belgium; 5 Dept. of Public Health and Primary Care, Academic Centre
for Nursing and Midwifery, KU Leuven, Leuven, Belgium
Introduction: Although there is evidence that restraint use in homecare is increasing, research into the factors associated with restraint
use in this setting is scarce. The aim of the study was to gain
insight into the factors associated with restraint use on older adults
receiving home care.
Methods: A cross-sectional survey was completed by the patients’
primary care nurses (June 2013). A binary logistic regression modelwith generalised estimating equations was used to evaluate factors
associated with use of restraints. Eight thousand subjects wererandomly selected from a total of 45,700 older adults.
Results: The mean age of the sample (n=6397) was 80.6 years, 66.8%
were women and 46.4% lived alone. 24.7% of the patients were
subject to restraint. Multivariate logistic regression indicated that
restraint use was associated with supervision [OR=2.433, 95% CI:
1.948 3.038]; dependency in ADL-activities (i.e. eating [OR=2.181,
95% CI: 1.212–3.925], diﬃculties in transfer [OR=2.131, 95% CI: 1.191
3.812] and continence [OR=1.436, 95% CI: 0.925–2.231]; perceived
risk of falling in the nurses’ clinical judgement [OR=1.994, 95% CI:
1.710–2.324], daily behavioural problems [OR=1.935, 95% CI: 1.316
2.846] and less than daily behavioural problems [OR=1.446, 95%
CI: 1.048 1.995]; decreased well-being of the informal caregiver[OR=1.472, 95% CI: 1.126 1.925], the informal caregiver’s dissatisfaction with family support [OR=1.339, 95% CI: 1.003 1.788];
patient’s cognitive impairment [OR=1.398, 95% CI: 1.290 1.515];
polypharmacy [OR=1.415, 95% CI: 1.219 1.641].
Conclusions: The study results provide insight into new and context speciﬁc factors associated with use of restraints in home care(e.g. supervision, informal caregiver’s decreased well-being anddissatisfaction with family support). These insights could support
the development of interventions to reduce use of restraints inhome care.
O-019
The risk of Alzheimer’s disease associated with benzodiazepinesand related drugs: A nationwide nested case-control study
V. Tapiainen 1 , H. Taipale 2 , A. Tanskanen 3 , J. Tiihonen 3 ,S. Hartikainen 4 , A.-M. Tolppanen 1 . 1 School of Pharmacy, Universityof Eastern Finland, Kuopio, Finland; Research Centre for Comparative
Effectiveness and Patient Safety (RECEPS), University of Eastern
Finland, Kuopio, Finland; 2 School of Pharmacy, University of Eastern
Finland, Kuopio, Finland; Research Centre for Comparative
Effectiveness and Patient Safety (RECEPS), University of Eastern
Finland, Kuopio, Finland; Kuopio Research Centre of Geriatric Care,
University of Eastern Finland, Kuopio, Finland Karolinska Institutet,
Department of Clinical Neuroscience, Stockholm, Sweden; 3 Karolinska
Institutet, Department of Clinical Neuroscience, Stockholm, Sweden;
National Institute for Health and Welfare, Helsinki, Finland; Universityof Eastern Finland, Department of Forensic Psychiatry, Niuvanniemi
Hospital, Kuopio, Finland; 4 School of Pharmacy, University of EasternOral presentations / European Geriatric Medicine 8S1 (2017) S1–S39

Finland, Kuopio, Finland; Kuopio Research Centre of Geriatric Care,
University of Eastern Finland, Kuopio, Finland; Karolinska Institutet,
Department of Clinical Neuroscience, Stockholm, Sweden; Departmentof Psychiatry, Kuopio University Hospital, Kuopio, FinlandObjective: To assess the association between benzodiazepine andrelated drug (BZDR) use and risk of Alzheimer’s disease (AD) withcumulative consumption and duration of use based models with
5-year lag time between exposure and outcome.
Methods: A nationwide nested case-control study of all Finnish
community dwelling persons who had clinically veriﬁed AD diagnosis in 2005–2011 (N=70,719) and their age, sex and region ofresidence matched controls (N=282,862). AD diagnosis was basedon DSM-IV and NINCDS-ADRDA criteria. BZDR purchase data in
Deﬁned Daily Doses, were extracted from the Prescription register
since 1995. BZDR use periods, i.e. when continuous use started andended, were calculated using validated PRE2DUP-method. The association between BZDR use and AD was assessed using conditional
logistic regression.
Results: Use of BZDRs were associated with somewhat increased
risk of AD (adjusted OR 1.05, 95% CI 1.03–1.07). A dose-response
relationship was observed with both cumulative consumption andduration when accounting for occupational social class and comorbidities. The association between BZDR use in general and AD
was evident also after additional adjustment for other psychotropic
use. However, adjustment for other psychotropics removed thecumulative dose-response relationship by attenuating the ORs in
the highest dose category.
Conclusions: BZDR use in general was associated with somewhat
increased risk of AD with no major differences were observed
between different subcategories of BZDRs (i.e. benzodiazepines,
Z drugs, short/medium acting or long acting BZDRs). Cumulative
dose-response relationship was abolished after adjustment forother psychotropics, indicating that the association may partially be
due to confounding by indication.
O-020
2-Hour interactive workshop for family caregivers followed by
weekly instruction with postcard for 12 weeks reduced burdenof caregivers and improved behavioral psychological symptoms
of dementia (BPSD) of care receivers
M. Honda 1 , M. Ito 2 , R. Marescotti 3 , Y. Gineste 3 . 1 National Hospital
Organization Tokyo Medical Center; 2 Tokyo Metropolitan Institute ofGerontology; 3 Institut Gineste-Marescotti
Background: Family caregivers for people with dementia are in
distress and feel severe burden. Objective: The aim of this study
is to evaluate the effectiveness of 2-hour interactive workshop ofmultimodal comprehensive care methodology for family caregivers
who are taking care of people with dementia at home. behavioral
psychological symptoms of dementia (BPSD) of their care receivers
were measured as secondary outcome.
Methods: Family caregivers participated 2-hour interactive workshop of multimodal comprehensive care methodology: Humanitude. The participants performed this care methodology at hometo their cognitive impaired care receivers. 12 postcards were sent
to the participants weekly to teach the care techniques of theweek. The burden of caregivers was measured by Zarit BurdenInterview (ZBI) and BPSD of care receivers was scored by Behavioral
Pathology in Alzheimer’s Disease (BEHAVE-AD) rating scale. They
were evaluated before the workshop (month 0), at month 1 andmonth 3 after the workshop.
Results: 148 family caregivers enrolled the study and 118 completed 3-month follow up. ZBI of family caregivers was signiﬁcantly
reduced from 13.1 at month 0, then 10.7 at month 1 (p<0.001)
and 10.5 at month 3 (p<0.001). BPSD was also signiﬁcantly reduced

S7

from 12.9 at month 0, then 10.7 at month 1 (p<0.01) and 11.2 atmonth 3 (p<0.05).
Conclusion: 2-hour interactive workshop of multimodal comprehensive care methodology: Humanitude followed by 12 weekly
postcard instructions is effective to reduce the burden of family
caregivers and to improve BPSD of care receivers.
O-021
Is proton pump inhibitor use associated with an increased riskof Alzheimer’s disease?
H. Taipale 1 , A.-M. Tolppanen 1 , M. Tiihonen 1 , A. Tanskanen 2 ,J. Tiihonen 2 , S. Hartikainen 1 . 1 University of Easter Finland, UEF,
Kuopio, Finland; 2 Karolinska Institutet, KI, Stockholm, Sweden
Introduction: Objective was to investigate whether PPI use isassociated with an increased risk of clinically veriﬁed Alzheimer’s
disease (AD).
Methods: A Finnish nationwide nested case-control study MEDALZ
includes all community-dwelling persons with newly diagnosed
AD during 2005–2011 (N=70,719), and up to four age-, sex- andregion of residence matched comparison persons for each case
(N=282,862). Data were extracted from Finnish nationwide healthcare registers. Proton pump inhibitor (PPI) use was derived frompurchases recorded in the Prescription register data since 1995 andmodelled to drug use periods with PRE2DUP method. AD was theoutcome measure.
Results: PPI use was not associated with risk of AD with 3 year
lag window applied between exposure and outcome (adjusted OR
1.03, 95% CI 1.00–1.05). Similarly, longer duration of use was not
associated with risk of AD (1–3 years of use, adjusted OR 1.01 [95%CI 0.97–1.06], ≥3 years of use adjusted OR 0.99 [95% CI 0.94–1.04]).
Higher dose use was not associated with an increased risk (≥1.5
deﬁned daily doses per day, adjusted OR 1.03 [95% CI 0.92–1.14]).
Conclusion: In conclusion, we found no clinically meaningful association between PPI use and risk of Alzheimer’s disease. The results
for longer duration of cumulative use or use with higher doses did
not indicate dose-response relationship.
O-022
Association between potentially inappropriate medication andmild cognitive impairment in patients attending memory
clinics, Memento cohort
C. Mouchoux 1 , V. Bouteloup 2 , H. Savarieau 2 , C. Favary 2 ,B. Dubois 3 , B. Vellas 4 , F. Pasquier 5 , F. Blanc 6 , O. Hanon 7 ,P. Krolak-Salmon 8 , V. Dauphinot 8 , G. Chêne 2 , C. Dufouil 9 , theMemento Study Group, France. 1 Lyon University Hospital, Lyon,
France; 2 Bordeaux University Hospital, Bordeaux, France; 3 AP-HP La
Salpétrière, Paris, France; 4 INSERM UMR1027, Paul Sabatier University,
Toulouse, France; 5 Lille University, INSERM U1171, CHU, Memory
Center, Lille, France; 6 Strasbourg University Hospital, Haute Pierre,
Strasbourg, France; 7 AP-HP Brocca, Paris, France; 8 Lyon University
Hospital, Memory Center, Lyon; 9 INSERM U897, Bordeaux, France
The use of potentially inappropriate medication (PIM) is common inolder adults and may be associated with adverse health events suchas falls. In a large nationwide cohort of persons with either isolated
cognitive complaints (ICC) or mild cognitive impairment (MCI), theMemento cohort, we assessed the adjusted association between
the PIM use and MCI at baseline. A total of 2323 outpatients wererecruited with either ICC or MCI from 28 French research memory
clinics. PIM were identiﬁed using the Beers 2015 criteria andthe EU(7)-PIM list. A multivariate logistic regression analysis was
conducted to assess the association between PIM use and MCI (vs.
ICC).A total of 1780 patients aged 65 years and over were selected
for the purpose of this analysis among whom 1500 had MCI. A
total of 945 (53.1%) patients received at least one PIM. The most

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common class of PIM were peptic ulcer drugs (70.2%), anxiolytics(30.7%), anti-thyroid synthesis (23.9%), antidepressant (20.1%) andsedative-hypnotics (19.8%). After adjusting for sociodemographic
characteristics, MMSE score, number of drugs, NPI depression andanxiety scores, PIM use was more frequent in patients with MCI
than ICC (Odds Ratio 1.44, 95% Conﬁdence Interval 1.03 to 1.99).
More than half of elderly included in the Memento cohort are
exposed at baseline to PIM, most of them are observed among
participants with MCI. Medication use needs to be improved inolder adults. The Memento cohort will allow to assessing the impact
of PIM on further evolution of cognitive proﬁle of the participants.
O-023
The Short Physical Performance Battery (SPPB) relates toneuroimaging biomarkers of Alzheimer’s disease in cognitively
normal elderly subjects
A. Mendes 1 , S. Tezenas du Montcel 2 , A. Bertrand 2 , M. Levy 2 ,M.-O. Habert 2 , H. Bertin 2 , B. Dubois 2 . 1 Department of Internal
Medicine, Rehabilitation and Geriatrics, Geneva University Hospitals,
Geneva, Switzerland; 2 Institute of Memory and Alzheimer’s Disease(Im2A), Department of Neurology, AP-HP, Pitié-Salpêtrière University
Hospital, and Brain and Spine Institute (ICM) UMR S 1127 Aramis Lab,
Sorbonne Universities, Pierre et Marie Curie University, Paris 06, France
Introduction: Gait speed begins to slow a decade before the diagnosis of Mild Cognitive Impairment (MCI), suggesting that gait
abnormalities could be markers for preclinical states of dementia.
The SPPB tool evaluates locomotion by gait speed, balance andstrength. Poor performances are associated with functional decline,
hospitalization and mortality. We aim to examine the association
between SPPB and neuroimaging biomarkers of Alzheimer’s disease(AD) in cognitively normal elderly subjects.
Methods: Cross-sectional design of 318 cognitively normal elderly
subjects participating to the INSIGHT PreAD study. A trained nurse
assessed SPPB and participants underwent multimodal neuroimaging and automated methods measured hippocampal volumes in
MRI, FDG-PET standardized uptake values (SUV) in AD signature regions and amyloid PET SUV ratio (SUVr). Linear regression methods
were used for statistical analysis.
Results: Higher PET FDG SUV was associated to higher performances in SPPB total scores (Coef = 0.7, r=0.02, p=0.019), as wellas with faster gait speed (Coef = 0.09, r=0.01, p=0.049) and lower
time needed to realize 5-chair stands (Coef = −1.4, r=0.01, p=0.038).
Similarly, we observed a trend for an association of SPPB scoreswith hippocampal volumes (Coef = 0.465, r=0.012, p=0.05). After
adjustments for potential confounding variables, the association of
FDG PET SUV values and SPPB total score (Coef = 0.73, r=0.047,
p=0.0207) and gait speed (Coef = 0.12, r=0.0998, p=0.0141) remained
statistically signiﬁcant. There was no association between SPPB andamyloid SUVr.
Conclusion: SPPB total score, gait speed and 5 chair stands areassociated with neurodegeneration in cognitively normal elderly
people, demonstrating that gait disturbances, assessed with thistest, may be a potential marker of preclinical AD.
O-024
Effect of a program for family caregivers with close relatives ininstitutions
S. Damnee 1 , C. Bayle 1 , E. Masanet 1 , J. Piot 1 , H. Kerherve 1 ,R. Lasserre 2 , J.-M. Nguyen 3 , C. Monnet 1 , A.-S. Rigaud 1 . 1 Hôpital
Broca, AP-HP, Paris, and EA 4468, University Paris Descartes, Faculty of
medicine, Paris, France; 2 Acppa, EHPAD Pean, Paris, France; 3 MonsieurVincent Association, EHPAD Antoine Portal, Paris, France
Introduction: In order to meet the speciﬁc needs of the family
caregivers with close relatives in institutions, we created a program

called “EHPAD Aidant” (Nursing home caregivers) focusing on theirdiﬃculties, identiﬁed beforehand during focus groups of families
and professionals. These diﬃculties are based on the ignorance ofthe potential and limitations of a nursing home, and on their own
limitations. The objective was to evaluate the impact of the "EHPAD
Aidant" program on obstacles, management strategies, satisfactionlevels and anxiety-depressive symptomatology among a group of
caregivers.
Methods: Eighty caregivers aged 67 (±10) received multidisciplinary
support ((psychologists, geriatric physicians, speech therapists, coordinating nurses, nursing home directors) in 2-hour weekly
sessions during 6 weeks. Topics included institution management,
dementia, psychic stakes of entering an institution, diet and endof-life support. Pre-and post-intervention evaluations focused on
anxiety, depression, caregiver task, situational management strategies, and satisfaction. Focus groups were ﬁlmed and analyzed.
Results: Results showed a great satisfaction of caregivers, a better
understanding of the functioning of the nursing home and of theprofessionals’ missions, an improved communication with the staffof the institution, an improvement of the relationship with theclose in institution, a redeﬁnition of the role and place of the caregiver within the institution, with close relatives in institutions anddecreased feelings of guilt among caregivers related with feelingsof failure and abandonment.
Conclusion: Providing caregivers with a pathway, changing theirperception of the disease and the care relationship resulted in a
redeﬁnition of their caregiving role within the institution.

Area: Frailty and sarcopenia

O-025
Tracking changes in frailty throughout later life: Results from a
17-year longitudinal study in the Netherlands
E.O. Hoogendijk 1 , K. Rockwood 2 , O. Theou 2 , J.J. Armstrong 3 ,B.D. Onwuteaka-Philipsen 4 , D.J.H. Deeg 1 , M. Huisman 1 . 1 Dept. of
Epidemiology & Biostatistics, Amsterdam Public Health ResearchInstitute, VU Medical Center, Amsterdam, the Netherlands; 2 Division ofGeriatric Medicine, Department of Medicine, Dalhousie University,
Halifax, Nova Scotia, Canada; 3 Dept. of Health Sciences, Lakehead
University, Thunder Bay, Ontario, Canada; 4 Dept. of Public andOccupational Health, Amsterdam Public Health Research Institute, VU
Medical Center, Amsterdam, the Netherlands
Introduction: Few studies have investigated changes in frailty
throughout later life, and variability in change between subgroups.
Our aim was to investigate changes in the degree of frailty
with aging, and the extent to which changes are determined bysocio-demographic characteristics.
Methods: Six waves of the Longitudinal Aging Study Amsterdam(LASA) across atime period of 17 years were used to study changes
in frailty among a sample of 1660 Dutch older adults aged 65 andover at baseline. The degree of frailty was measured at each wave
with a 32-item frailty index (FI), based on the deﬁcit accumulation approach. Socio-demographic characteristics included age, sex,
educational level and partner status. Generalized Estimating Equation (GEE) analyses were performed to study longitudinal frailty
trajectories over a period of 17 years.
Results: The overall mean FI score at baseline was 0.15, and increased to 0.36 after 17 years of follow-up. The average doublingtime in the number of deﬁcits was 12.5 years, and this was similarin those aged 65–74 years compared to those aged 75+. Higher
baseline FI scores were observed in people with a higher age,females, lower educated and people without a partner. The rate ofincrease in FI score was only associated with partner status.

Oral presentations / European Geriatric Medicine 8S1 (2017) S1–S39

Conclusions: The degree of frailty increased with aging, but therate of deﬁcit accumulation was relatively stable during later life.
O-026
Integrated geriatric and primary care management of frail older
adults in the community
L.M. Perez 1 , P. Burbano 1 , N. Gual 1 , G. Liesa 1 , L. Soto 1 , L. Tobella 2 ,M.B. Enfedaque 2 , M. Hernandez 1 , E. Martin 3 , M. Inzitari 1 . 1 Parc
Sanitari Pere Virgili; 2 Institut Català de la Salut; 3 EAP Bordeta, Institut
Català de la Salut
Introduction: Frailty is a reversible state of vulnerability towards
disability and other outcomes in older adults. We are implementing
an integrated programme between geriatrics and primary care,based on screening, comprehensive geriatric assessment and tailored intervention. We assessed its impact on physical performanceand frailty.
Methods: After screening in primary care (Gerontopôle FST), subjects are referred to geriatrician and physiotherapist, who perform
comprehensive geriatric assessment and implement a tailored plan,shared with primary care and based on physical activity (PA, 10
group sessions, 1hour/week of functional, endurance, ﬂexibility andaerobics exercises), plus nutritional education and optimization of
medications. We assessed the impact on physical performance in a
3-months follow-up.
Results: In the ﬁrst 6 months of the program, we included 81 older
community-dwellers (mean age±SD=81.8±5.4 years, 72.3% female).
Despite good functional capacity (Barthel = 95, IQR = 90–100,
Lawton = 6, IQR = 3–7.5, 41% living alone), 36,1% were at least “vulnerable” according to the Clinical Frailty Scale, and had impaired
physical function (SPPB±SD = 6.2±2.8, gait speed ± SD = 0.77±0.15m/s, 36,1% with falls last year). Comorbidity was low (Charlson =2, IQR = 1–4), but 85.5% had polypharmacy (mean ± SD = 8.2±3.7
drugs). Intervention: 92,7% participated in PA, 97,6% received healtheducation and 60,2% treatment modiﬁcations. At 3 months (N=39),
adherence to PA was high (57.4% ≥7.5 sessions), with improved
physical function: mean ± SD SPPB = 8.6±2 (mean improvement =1.6, 95% CI: 1.6–1.8, p<0.001), gait speed = 0.77±0.15 m/s (meanimprovement = 0.09 m/s, 95% CI: 0.09–0.11, p<0.001).
Conclusions: According to our results, a multidisciplinary and comprehensive geriatric intervention in frail older community-dwellers
improved physical function and almost reversed frailty at 3 months,
according to established physical performance scales’ cut-offs.
O-027
How clinical practitioners assess frailty in their daily practice:
An international survey
O. Bruyère 1 , F. Buckinx 2 , C. Beaudart 2 , J.-Y. Reginster 2 , J. Bauer 3 ,T. Cederholm 4 , A. Cherubini 5 , C. Cooper 6 , A.J. Cruz-Jentoft 7 ,F. Landi 8 , S. Maggi 9 , R. Rizzoli 10 , A.A. Sayer 11 , C. Sieber 12 ,B. Vellas 13 , M. Cesari 13 , on behalf of ESCEO and the EUGMS Frailty
Working Group. 1 Department of Public Health, Epidemiology andhealth Economics, University of Liège, Liège, Belgium; 2 Department of
Public Health, Epidemiology and Health Economics, University of Liège,
Liège, Belgium; 3 Center for Geriatric Medicine, University of
Heidelberg; Agaplesion Bethanien Hospital Heidelberg, Germany;
4 Department of Public Health and Caring Sciences, Clinical Nutrition
and Metabolism, Uppsala University, Uppsala, Sweden; 5 Geriatrics andGeriatric Emergency Care, IRCCS-INRCA, Ancona, Italy; 6 MRC
Lifecourse Epidemiology Unit, University of Southampton,
Southampton, England, UK; 7 Servicio de Geriatría. Hospital
Universitario Ramón y Cajal (IRYCIS), Madrid, Spain; 8 Department ofGeriatrics, Neurosciences and Orthopedics, Catholic University of the
Sacred Heart School of Medicine, Rome, Italy; 9 National ResearchCouncil, Neuroscience Institute, Padua, Italy; 10 Rehabilitation and

S9Geriatrics, Geneva University Hospitals, Geneva, Switzerland; 11 NIHR
Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals
NHS Foundation Trust and Faculty of Medical Sciences, Newcastle
University, England, UK; 12 Friedrich-Alexander-Universität
Erlangen-Nürnberg, Germany; 13 Gérontopôle de Toulouse,
Département de Médecine Interne et Gérontologie Clinique, Centre
Hospitalo-Universitaire de Toulouse, Toulouse, France
Introduction: Various operational deﬁnitions have been proposed
to assess the frailty condition among older individuals. Understanding the strengths and limits of such deﬁnitions is important inorder to better identify frail individuals in need of specialized careand is thus crucial for the standardization of clinical practice. Our
objective was to assess how practitioners measure the geriatricsyndrome of frailty in their daily routine.
Methods: An online survey was sent to through the European Union
Geriatric Medicine Society (EUGMS) and the European Society for
Clinical and Economic Aspects of Osteoporosis, Osteoarthritis andMusculoskeletal Diseases (ESCEO).
Results: A total of 380 clinicians from 44 countries answered tothe survey. Most of them were medical doctors (93%), and theirprimary ﬁeld of practice was geriatrics (83%). Fifty-one clinicians
always assessed frailty in their daily practice, and 41.5% reported
to "sometimes" measure it. The most widely used tool was thegait speed test, adopted by 43.8% of the clinicians, followed by
the Clinical Frailty Scale (34.3%), the SPPB test (30.2%), the frailty
phenotype (26.8%) and the Frailty Index (16.8%). The functional
status, the Short Physical Performance Battery, the gait speed, andthe handgrip strength were also assessed by 84.8%, 74.5%, 55.9%
and 40.7% of the clinicians, respectively. The cognitive domain wasassessed by 90.9% of the respondents, mainly by means of the Mini
Mental State Examination (76.5%).
Conclusion: A huge variety of tools is used to assess frailty inclinical practice, highlighting the absence of standardisations andguidelines.

Area: Geriatric rehabilitation

O-028
Emergency department use in post-acute rehabilitation facilities
A. Chandra, P.A. Rahman, C.B. Storlie, P.Y. Takahashi. Mayo Clinic
Rochester MN, USA
Introduction: Discharge of elderly patients from hospitals to skilled
nursing facilities (SNF) for post-acute care is a transition when
patients are at risk for adverse outcomes. Emergency department(ED) visits in this period indicate unplanned healthcare utilization
and are often considered a quality measure by Centers for Medicare& Medicaid Services [1]. We sought to describe the patterns of ED
use within 30 days of discharge to a SNF.
Methods: This was a retrospective analysis of 30-day ED use among
patients discharged from the hospital to ten area SNFs from January
1, 2009 to June 30, 2014. Demographics and 30- day ED visitsobtained from the electronic health record and administrative data
were analyzed to determine the frequency and distribution of ED
use after discharge to a SNF.
Results: There were 8616 discharges from Mayo Clinic Rochester
hospitals to ten area SNFs served by its Division of Employee
and Community Health between January 2009 and June 2014. The
average age was 79 years (±9.8 years) and 62% of the patients werefemale. 1671 (19.4%) needed ED visits within 30 days. Of these ED
visits, 40.8% occurred within 7 days and 63.2% occurred within 14
days of discharge to the SNF.
Conclusion: A substantial proportion of patients discharged toS10Oral presentations / European Geriatric Medicine 8S1 (2017) S1–S39

SNFs for post-acute care needed unplanned care in EDs within
30 days. Majority of these visits occurred within the initial two
weeks of hospital discharge indicating a need for better transition
management in this population.
References:[1] https://www.cms.gov/newsroom/mediareleasedatabase/pressreleases/2016-press-releases-items/2016–04–27.html

Area: Frailty and sarcopenia

O-029
Comparison of the performance of different screening methods
for sarcopenia within the SarcoPhAge study
M. Locquet 1 , C. Beaudart 1 , J. Petermans 2 , J.-Y. Reginster 1 ,O. Bruyère 1 . 1 University of Liège; 2 CHU of Liège
Introduction: Our aim was to compare the performance of 5
screening strategies for identifying elders at risk of sarcopenia.
Methods: We gathered cross-sectional data of elders from theSarcoPhAge (Sarcopenia and Physical Impairment with Advancing
Age) study. Following screening approaches were put into perspective: the 2-stage algorithm of the EWGSOP (2010), the SARC-F
questionnaire by Malmstrom and Morley (2013), the screening gridby Goodman et al. (2013), the screening test by Ishii et al. (2014)
and the prediction equation by Yu et al. (2015). Performance of thescreening method was described using sensitivity, speciﬁcity, PPV,NPV and AUC, according to 4 deﬁnitions of sarcopenia: Cruz-Jentoft
et al. (2010); Fielding et al. (2011); Morley et al. (2011) and Studenski et al. (2014). In the SarcoPhAge study, lean mass was measured
with DEXA, muscle strength with a handheld dynamometer andphysical performance with the SPPB test.
Results: 306 subjects (74.8±5.9 years, 59.5% women) had complete
data for statistical analyses. The prevalence of sarcopenia varied
from 5.88% (Morley et al.) to 16.7% (Cruz-Jentoft et al.) dependingon the deﬁnition. The best sensitivity (up to 100%) and the best
NPV (up to 99.1%) has been shown by the screening test of Ishii etal., regardless of the deﬁnition tested. The highest AUC (0.841 to
0.891) has also been demonstrated by the tool of Ishii et al. The
most speciﬁc tool was the 2-stage algorithm of the EWGSOP (88.5%
to 91.1%). All NPV were superior to 87.0%, whatever the screening
tool used. However, all PPV were below 51.0%.
Conclusions: The screening test of Ishii et al. showed better properties in terms of distinguish those at risk of sarcopenia from those
who were not at risk. All screening tools identify with a high degreeof reliability individuals who do not suffer from sarcopenia.

Area: Geriatric rehabilitation

O-030
Factors associated with Activity of Daily Living (ADL) decrease ingeriatric rehabilitation unit
M. Laurent 1,2 , N. Oubaya 2,3 , E. Audureau 2,3 , F. Canouï-Poitrine 2,3 ,J.P. David 2,4 , S. Bastuji-Garin 2,3, *, E. Paillaud 1,2, *. 1 AP-HP, Hôpitaux
universitaires Henri Mondor, Département de médecine interne etgériatrie, France; 2 UPEC, DHU A-TVB, IMRB, EA 7376 CEpiA (Clinical
Epidemiology And Ageing Unit), Créteil, F-94000, France; 3 AP-HP,
Hôpital Henri-Mondor, Service de Santé Publique, Créteil, France;
4 AP-HP, Hôpital Henri-Mondor/Emile Roux, Département de gériatrie*These authors contributed equally to this work
Introduction: The ﬁrst aim of geriatric rehabilitation units is torestore functional independence to elderly patients in terms ofActivities of Daily Living (ADL). We know that some patients will
suffer ADL decrease in this unit, however factors associated withfunctional decline are debated.
Objective: To assess frequency of functional decline during rehabilitation unit stay and factors associated with ADL decrease.
Methods: Between July 2006 and December 2008, 252 consecutive patients aged ≥75 years admitted in geriatric rehabilitation
unit in a university hospital in Créteil, France were included in thisprospective cohort study. During follow up, Hospital Acquired Infection (HAI) and ADL at rehabilitation unit discharge were recorded.
Multivariable logistic regression and mediation analyses were used
to identify factors associated with ADL decrease.
Results: Among 165 patients with baseline and discharge ADL
available, median age was 85 IQR [81–90] years, Cumulative Illness
Rating Scale for Geriatrics (CIRS-G) 11 [9–13] baseline ADL 7 [4–10]). Thirty patients (18.2%) suffered ADL decrease and 24 (14.5%)
experienced pulmonary HAI. Factors independently associated with
ADL decrease were albumin<35g/l (p=0.02), CIRS G index (p=0.02)
or CIRS G ≥2 for Respiratory (p=0.03) (CIRSG-R) and psychiatricdiseases (p=0.02) (CIRSG-P). Pulmonary HAI could be a mediator in
the association between CIRSG-R and ADL decrease (p for mediation
test = 0.07).
Conclusion: Baseline elderly characteristics such as comorbidities
are associated with ADL decrease in geriatric rehabilitation unit.
Some mediators such as pulmonary HAI could take part in thisassociation, thus, improving prevention of HAI could enhance theeffects of a stay in geriatric rehabilitation unit.

Area: Comorbidity and multimorbidity

O-031
Activities of daily living at admission to acute geriatric wards as
predictor of mortality: A Danish nationwide population-based
cohort study
J. Ryg 1 , H. Engberg 2 , P. Mariadas 2 , S.G. Henneberg Pedersen 3 ,M. Jørgensen 4 , K.L. Vinding 5 , K. Andersen-Ranberg 1 . 1 GeriatricDepartment, Odense University Hospital, Denmark; 2 Center For
Clinical Epidemiology, Odense University Hospital, Denmark; 3 Medical
Department, Holbæk Hospital, Denmark; 4 Geriatric Department,
Aalborg University Hospital, Denmark; 5 Medical Department, Kolding
Hospital, Denmark
Introduction: The Barthel Index (BI) is used to measure geriatricpatients’ activities of daily living. Our study examines whether
routine BI assessment at the time of hospital admission predicts
mortality.
Materials and methods: This nationwide population-based cohort
study included all patients aged ≥65 years admitted to a Danish
geriatric ward during 2005–2014. BI-100 was assessed at admission
and data linked at the individual level to Danish national healthregisters. BI-score was reported numeric and categorized in fourstandard sub-categories. All individuals were followed-up until
death or the end of study (December 31st 2015). Multivariate Cox
regression was used to analyze associations adjusting for relevant confounders (age, admission year, civil status, BMI, Charlson
Comorbidity Index, polypharmacy, hospital admissions).
Results: Totally 74,603 patients were included. Women (63%) weresigniﬁcantly older with higher BI than men ((median [IQR]) age
84 [79–89] vs. 81 [76–86] years, and BI score 55 [(30–77] vs. 52[26–77], respectively). Median survival (years, 95% CI) according toBI sub-category was 4.9 (4.7–5.0) and 3.6 (3.4–3.7) in BI=80–100,
3.5 (3.4–3.6) and 2.3 (2.2–2.4) in BI=50–79, 2.7 (2.6–2.8) and 1.7(1.6–1.8) in BI=25–49, and 1.3 (1.2–1.4) and 0.9 (0.8–0.9) in BI=0–24,

Oral presentations / European Geriatric Medicine 8S1 (2017) S1–S39

women and men, respectively. Adjusted hazard ratio for mortality(95% CI) for BI=0–24 was 2.42 (2.32–2.52) in women and 2.07 (1.97–
2.18) in men (reference BI=80–100). The adjusted model with BI asa continuous variable revealed a signiﬁcantly increased mortality
risk by 1.1% in women and 0.9% in men for each single point scoredbelow 100 on the BI.
Conclusion: BI at hospital admission is a strong and independent
predictor of mortality in geriatric patients.
O-032
The impact of the community Transitional Care (TC) program on
hospital utilisation, mortality and cost
M.L. Ginting 1 , C.W. Tew 2 , Y.H. Ang 3 , J.K.C. Khoo 4 , C. Liu 5 ,D.B. Matchar 6 , N.R. Sivapragasam 6 , C.H. Wong 1 . 1 Program in HealthServices & Policy Research, Geriatric Education & Research Institute(GERI), Singapore; 2 All Saints Home, Singapore; 3 Department ofGeriatric Medicine, Khoo Teck Puat Hospital (KTPH), Singapore; 4 Khoo
Teck Puat Hospital (KTPH), Singapore; 5 ACCESS Health International,
Inc; 6 Program in Health Services and Systems Research, Duke-NUS
Graduate Medical School, Singapore
Introduction: Aging population is a growing challenge in Asia andSingapore. Older adults with multiple comorbidities and disability
have high hospital utilisation, and are vulnerable to poor outcomes
during care transition from hospital to home. Addressing posthospitalisation needs of these complex and frail older adults inthe community is vital in improving care. Objectives: To evaluate
the impact of a 3-month post-hospitalisation nurse-led Transitional
Care (TC) on hospital utilisation, mortality and cost among patientswith complex medical, social and functional needs in northern
Singapore.
Methods: We analysed a retrospective cohort of patients eligible for TC between April 2012 and March 2014 using hospitaladministrative data. Outcome measures were number of hospitalisations, emergency department visits, hospital length of stay,
cost, rehospitalisation and mortality at 30, 90 and 180 days postindex hospitalisation discharge. A quasi-experimental study withdifference-in-difference analyses was done to compare outcomes
between eligible patients who accepted TC (intervention) and those
who rejected (control).
Results: Mean age was 81.5±10.5; and 64.9% were female. Participants had mean disability and disease severity index of 2.2±1.7
Activities of Daily Living (ADL) limitation and Charlson Comorbidity Index (CCI) of 6.2±2.3, respectively. At 180 days, intervention
group had 4.2 less hospital bed-days/patient (95% CI: −8.25, −0.14;
p<0.05) and lower cost (mean savings of €836/patient*). They
tend to have lower re-admission with similar condition that precipitated the index hospitalisation (AOR=0.82; 95% CI: 0.44–1.54)
and mortality (AOR=0.69; 95% CI: 0.45–1.07) during the follow-up
period, compared to controls; although these were not statisticallysigniﬁcant.
Conclusion: TC is effective in reducing hospital bed-days and costamong older patients with complex care needs.
*Converted using yearly exchange rate from Singapore Dollar toEuro as of 31st December 2014.
O-033
The effect of 2 year intervention of diet, physical exercise,cognitive training and monitoring of vascular risk versus control
on chronic morbidity – the FINGER trial
A. Marengoni 1 , D. Rizzuto 2 , L. Fratiglioni 3 , R. Antikainen 4 ,T. Laatikainen 5 , J. Lehtisalo 6 , M. Peltone 7 , H. Soininen 8 ,T. Strandberg 9 , J. Tuomilehto 10 , M. Kivipelto 11 , T. Ngandu 12 .
1 Department of Clinical and Experimental Sciences, University of
Brescia, Italy; 2 Aging Research Center, Department of Neurobiology,

S11

Care Sciences and Society, Karolinska Institutet, and Stockholm
University, Sweden; 3 Aging Research Center, Department of
Neurobiology, Care Sciences and Society, Karolinska Institutet, andStockholm University and Stockholm Gerontology Research Center,
Sweden; 4 Center for Life Course Health Research/Geriatrics, Universityof Oulu and Medical Research Center Oulu, Oulu University Hospitaland Oulu City Hospital, Oulu, Finland; 5 Department of Public Health
Solutions, Chronic Disease Prevention Unit, National Institute for
Health and Welfare, Helsinki, Finland and Institute of Public Healthand Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
and Joint Municipal Authority for North Karelia Social and HealthServices, Joensuu, Finland; 6 Department of Public Health Solutions,
Chronic Disease Prevention Unit, National Institute for Health andWelfare, Helsinki, Finland and Department of Public Health, University
of Helsinki, Helsinki, Finland; 7 Department of Public Health Solutions,
Chronic Disease Prevention Unit, National Institute for Health andWelfare, Helsinki, Finland; 8 Institute of Clinical Medicine/Neurology,
University of Eastern Finland, Kuopio, Finland; 9 Center for Life Course
Health Research/Geriatrics, University of Oulu and Medical ResearchCenter Oulu, Oulu University Hospital and University of Helsinki,
Helsinki University Hospital, Helsinki, Finland; 10 Department of Public
Health Solutions, Chronic Disease Prevention Unit, National Institutefor Health and Welfare, Helsinki, and Department of Public Health,
University of Helsinki, Helsinki, and South Ostrobothnia Central
Hospital, Seinäjoki, Finland; 11 Aging Research Center, Department of
Neurobiology, Care Sciences and Society, Karolinska Institutet, andStockholm University, Sweden, and Department of Public Health
Solutions, Chronic Disease Prevention Unit, National Institute for
Health and Welfare, Helsinki, and Institute of Clinical Medicine/
Neurology, University of Eastern Finland, Kuopio, Finlad and Divisionof Clinical Geriatrics, Center for Alzheimer Research, NVS, Karolinska
Institutet, Stockholm, Sweden; 12 Department of Public Health
Solutions, Chronic Disease Prevention Unit, National Institute for
Health and Welfare, Helsinki, Finland and Division of Clinical
Geriatrics, Center for Alzheimer Research, NVS, Karolinska Institutet,
Stockholm, Sweden
Objective: We evaluated the effect of a multidomain intervention
on the development of chronic diseases in older adults.
Methods: Multicenter, randomized clinical trial of 1260 persons
aged 60–77 years enrolled in the Finnish Geriatric Intervention
Study to Prevent Cognitive Impairment and Disability (FINGER).
Seventeen diseases were assessed at baseline and at 24-monthfollow-up. Complete-case analyses were performed including 532(84.3% of the original sample) participants in the intervention groupand 527 (83.8%) in the control group. The two-year multidomainintervention consisted of: nutritional guidance; exercise; cognitive
training and social activity; and management of metabolic andvascular risk factors.
Results: After 24-month follow-up the average number of newchronic diseases was 0.47 (SD 0.7) in the intervention group and
0.58 (SD 0.8) in the control group (p≤0.01). After adjustment forage, sex, education, current smoking, alcohol intake, baseline number of chronic diseases, being in the intervention group showed a
HR ranging from 0.81 (0.66–0.98) for developing 1+ new chronic
diseases to 0.39 (0.17–0.88) for developing 3+ new chronic diseases
compared to the control group. The absolute risk reduction ofdeveloping 3+ new chronic diseases was 2.1 per cent, meaning that
2 out of 100 have been prevented related to the intervention. After
stratiﬁcation for the presence at baseline of zero or 1+ chronic
diseases, ﬁndings were signiﬁcant only in those already affected bybaseline morbidity.
Conclusion: A multidomain intervention could reduce the riskof chronic diseases in older persons, especially in those alreadyaffected by morbidity.

S12

Oral presentations / European Geriatric Medicine 8S1 (2017) S1–S39

O-034
HOMR model accurately predicts 1-year mortality in older
hospitalized patients

O-036
The assessment of functional status and health-related qualityof life in elderly patients with peripheral artery disease

D. Curtin, D. O’Donnell, P. Gallagher, D. O’Mahony. Cork University
Hospital

B. Gryglewska 1 , D. Studzińska 2 , M. Wojnarowska 2 , J. Paleń 2 ,B. Rudel 2 , T. Grodzicki 1 . 1 Dept. of Internal Medicine and Gerontology,
Faculty of Medicine, Jagiellonian University, Medical College, Kraków,
Poland; 2 Dept. of Internal Medicine and Angiology, Hospital of theOrder of Brothers Hospitalers, Kraków, Poland

An important principle in caring for older people with frailty andmulti-morbidity is to align interventions and treatments to thepatient’s condition, preferences, and prognosis. Making accurate
prognostic assessments is a major challenge however. Recently, theHospital patient One-year Mortality Risk (HOMR) model was shownto accurately predict risk of death 1 year after hospital admission.
This model was validated in a large cohort of adult hospitalized
patients in North America and signiﬁcantly exceeds the predictive
performance of other published validated prognostic tools. External
independent validation has not been performed to date. In addition,
the HOMR model has not been tested in an exclusively older patient
cohort. We applied the HOMR model to patients aged 65 and over
who were discharged from the geriatric service in our institution
from January 1st 2013 to March 6th 2015. Patients who died during
the index hospital admission were excluded. Overall 1409 patientswere included in the analysis. Of these, 476 (33.4%) were frail. In total, 259 (18.4%) died within one year of hospitalization. The HOMR
model was very discriminative with an area under the receiver
operating characteristic curve (c-statistic) of 0.79 (95% conﬁdence
interval of 0.754 to 0.82). In conclusion, the HOMR model is robust
and accurately predicts risk of death in older hospitalized patientsand could potentially motivate discussions about values, priorities
and goals of care between physicians and their patients. Its performance compares favorably to other published prognostic models.
O-035
Genetic and cardiovascular risk factors in relation to physicallimitation in older adults – a population-based study
E.G. Heiland, L. Fratiglioni, A.-K. Welmer, D. Rizzuto, R. Wang,
C. Qiu. Aging Research Center, Karolinska Institutet
Introduction: Behavioral (i.e., smoking, physical inactivity, heavy
alcohol consumption) and metabolic (e.g., hypertension, diabetes)
cardiovascular risk factors (CRFs) may increase the risk of physicallimitation, however, the role of APOE ε4 on potentially heightening
this risk remains unknown. The association between APOE andits interactions with CRFs on limitation in balance, walking speed,
chair stand, and their composite was examined.
Methods: Data were from the longitudinal Swedish National study
on Aging and Care in Kungsholmen, including adults aged 60+
at baseline (2001–2004) without cardiovascular disease (CVD),
grouped into 4 limitation-free sub-populations: balance (n=1542),
walking speed (n=1748), chair stand (n=1811), and composite(n=1401). Limitation was deﬁned as balance stand <5 seconds,
walking speed <0.8m/s, unable to stand from a chair, and limitation
in at least 1 test. Cox proportional models, over 9 years, wasutilized, with age as time-scale. Covariates included sex, mutual
CRFs, prevalent and incident cognitive impairment, and incident
CVDs.
Results: During follow-up 268 (22%), 263 (19%), 323 (22%), and 357(30%) persons developed limitation in balance, walking speed, chairstand, and composite, respectively. APOE was signiﬁcantly associated with limitation in chair stand (HR 1.29, 95% CI: 1.00–1.67) andcomposite (HR 1.28, 95% CI: 1.01–1.62), adjusting for all covariates.
No signiﬁcant interactions were found between individual CRFs
and APOE. The risk of limitation for chair stand (HR 1.89, 95% CI:
1.23–2.89) and composite (HR 1.75, 95% CI: 1.19–2.57) was highest
for the combination of aggregated behavioral CRFs and APOE.
Conclusions: Presence of ε4 allele may modify CRFs conferring asubstantial risk of limitation.

Introduction: The objective of the study was the assessment of
the functional status and quality of life of the elderly patientswith symptomatic peripheral arterial disease (PAD) admitted to theangiology department.
Methods: Results from basic and instrumental activities of dailyliving scales (bADL, IADL) and Quality of Life (EQ-5D-3L) werecompared in PAD patients of different groups of ages: 55–64 years– Group I, 65–74 years – Group II and 75 years and over – Group III.
The degree of PAD was evaluated using Rutherford’s classiﬁcation.
Results: The study enrolled 151 patients (I – 54 subjects, mean age
60.4±2.5 years, II – 54, 69±3.1, III – 43, 79.7±3.6), 66.9% were malegender. The degree of PAD was comparable in all groups. Patients
had similar score in bADL scale, but score of IADL signiﬁcantly decreased with age (22.5±3 vs. 21.5±4.5 vs. 20.6±3.4 points, p=0.001).
Patients lost their independence most frequently in transportation.
Index of EQ-5D-3L signiﬁcantly decreased with age, (0.712±0.23 vs.
0.676±0.26 vs. 0.594±0.29, p=0.04). In the EQ-5D-3L questionnaire,the groups did not differ signiﬁcantly in frequency of reported
problems with movement, pain, anxiety and/or depression. However, older patients reported more diﬃculty in self-care (13.0 vs.
14.8 vs. 39.5, p=0.008).
Conclusions: Age may signiﬁcantly inﬂuence on the quality of life
and the loss of independence in instrumental activities daily livingin patients with PAD.
O-037
What do nursing home patients with mental-physicalmultimorbidity need and who knows best?
A. van den Brink 1 , D. Gerritsen 2 , M. de Valk 3 , R. Oude Voshaar 4 ,R. Koopmans 2 . 1 De Waalboog, ’Joachim & Anna’ Center forSpecialized Geriatric Care, Nijmegen, The Netherlands; 2 Radboud
University Medical Center, Radboud Institute for Health Sciences,
Department of Primary and Community Care, Nijmegen, The
Netherlands; 3 De Waalboog, ’Joachim & Anna’, Center for Specialized
Geriatric Care, Nijmegen, The Netherlands; 4 University Medical Center
Groningen, University of Groningen, University Center for Psychiatry
and Interdisciplinary Center for Psychopathology of Emotion
regulation, Groningen, The Netherlands
Introduction: Aging societies will bring an increase in the numberof long-term care patients with mental-physical multimorbidity(MPM). To optimize care for patients with MPM, it is important
to know their care needs, since unmet needs lower quality of life.
To date, knowledge about (un)met care needs of these patients
is limited. Therefore, the aim of this study was to explore their(un)met care needs and determinants of unmet needs.
Methods: Cross-sectional cohort study among 141 patients with
MPM without dementia living in 17 geronto-psychiatric nursing
home units across the Netherlands. Data collection consisted ofchart review and semi-structured interviews. The Camberwell Assessment of Need for the Elderly (CANE) was used to rate (un)met
care needs from patients’ and staff’s perceptions. Descriptive analyses and multivariate regression analyses were conducted.
Results: Patients rated a lower total number of needs, but a higher
number of unmet needs than the staff. The highest numbers of met
needs were reported in the physical and environmental domains.
Most unmet needs were found in the social domain according to theOral presentations / European Geriatric Medicine 8S1 (2017) S1–S39

patients and in the psychological domain as reported by the staff.
Disagreement between patient and staff regarding unmet needs
was most common in the areas accommodation, company, anddaytime activities. Depression, anxiety and less care dependency
were the most important determinants of unmet needs.
Conclusions: Systematic assessment of care needs showed discrepancies between the perspectives of patient and staff. This should be
the starting point of the dialogue between them about needs andexpectations regarding care. This dialogue will lead towards themost optimal individually tailored care plan.
O-038
Health inequalities during dementia: A nation-wide 3-year
longitudinal study of diabetes monitoring and complications
among older adults
M. Wargny 1 , A. Gallini 1 , H. Hanaire 2 , F. Nourhashemi 3 ,S. Andrieu 1 , V. Gardette 1 . 1 Department of Epidemiology and Public
Health, University Hospital of Toulouse, Toulouse, France; 2 Department
of Diabetology, Metabolic Disease and Nutrition, University Hospital of
Toulouse-Rangueil, Toulouse, France; 3 Gérontopole, University Hospitalof Toulouse, Toulouse, France
Introduction: The association of Alzheimer’s Disease and Related
Syndromes (ADRS) and diabetes mellitus is increasing. Based ona nationwide healthcare reimbursement database, we compareddiabetes care and the incidence of diabetes-related hospitalizations
between patients with or without incident ADRS.
Methods: Reimbursement data from the French insurance healthsystem database was used to identify subjects aged 65 years ormore with incident ADRS between 2010 and 2012. Each subject
was matched to a pair free of ADRS. 87 816 subjects with known
diabetes were included. Diabetes monitoring and complications(HbA1c, lipid proﬁle, microalbuminuria tests; eye examination;
diabetes-related hospitalization) were studied between the year
preceding ADRS identiﬁcation (Y-1) and the subsequent two years(Y0 and Y1). We calculated Standardized Incidences Ratios (SIR)
between ADRS and non ADRS group.
Results: HbA1c test was less frequent in ADRS group: 82.6% vs88.5% had at least one HbA1c testing during Y-1 (SIR=0.94, 95% CI
0.93–0.95), 73.4% vs 89.0% during Y0 (SIR=0.83, 95% CI 0.82–0.84),
and 75.4% vs 89.3% during Y1 (SIR=0.85, 95% CI 0.83–0.86). Subjects
with ADRS were at higher risk of diabetes-related hospitalizations(SIR Y-1: 2.04, Y0: 3.14, Y1: 1.67), hospitalizations for diabetic coma
(SIR Y-1: 3.84, Y0: 9.30, Y1: 3.06) and hypoglycemia (SIR Y-1: 4.20,
Y0: 5.25, Y1: 2.27).
Conclusions: Incident ADRS is associated with a lower receipt of
diabetes monitoring and an increased risk of diabetes complications. Further investigations of the mechanisms underlying theseresults are required, in order to propose actions limiting such healthinequalities.

Area: Comprehensive geriatric assessment

O-039
At-home orthostatic hypotension among non-demented elderly
subjects: Prevalence and determinants by self-measured home
blood pressure monitoring
A. Cohen, E. Duron, J.-S. Vidal, H. Rananja, I. Hernandorena,
H. Jailany, S. Chauvelier, M.-L. Seux, A.-S. Rigaud, O. Hanon. AP-HP,
Groupe Hospitalier Paris-Centre. Broca Hospital, Department ofGeriatrics, Paris – 75013; EA 4468, Université Paris Descartes,
Sorbonne Paris Cité, Paris, France
Objective: To evaluate prevalence and determinants of ortho-

S13

static hypotension detected by self-measured home blood pressure
monitoring (SMOH) among non-demented elderly subjects.
Patients and methods: Subjects attending a memory clinic, comprehensively evaluated in day care hospital (including detectionof OH), 65 years or older, able to stand for ≥3 minutes and with
Mini Mental State Examination >25/30were consecutively included
In this observational study, OH was deﬁned by a fall of at least
20mmHg in systolic blood pressure (BP) and/or at least 10mmHg
in diastolic blood pressure. Subjects were instructed on SMOH
detection protocol and lent validated devices. BP was to be measured three consecutive times, after 10 minutes of seated rest withreadings taken one minute apart and after one and three minutes ofstanding, in the morning and in the evening for three consecutive
days and BP results written down on a standardized data sheet.
OH prevalence was evaluated according to OH occurrence at 3
minutes compared with the last BP in sitting position. Successful
SMOH was deﬁned by the ability to properly ﬁll in at least four BP
measurements in the data sheet.
Results: Mean age of the 151 included patients was 75.7 (8.4) years
old (60.3% of women). One hundred twenty seven patients (84%)
provided SMOH. There was no signiﬁcant difference between thegroup "success" and "failure". Over the 3 days, 40.9% of patients
had at least 1 occurrence of SMOH. Patients had 1, 2, 3 and4 SMOH occurences in 26.8%, 7.9%, 4.7% and 1.6% respectively.
SMOH determinants were low albumin level (p=0.03), high depression risk according to the Geriatric Depression Scale (p=0.03),
benzodiazepine use (p=0.004) and ≥4 medications (p=0.04). In
multivariate ordinal logistic regression SMOH was associated withbenzodiazepine use (p=0.03).
Conclusion: SMOH appeared feasible to detect OH among subjects
with preserved cognitive function. OH’s prevalence increases withrepetition of measurements. The determinants found are in accordance with the literature review. No association was disclosed
between hypertension and antihypertensive treatments numbers
probably due to a selection bias Predicative value of this SMOH for
unfavorable outcome ought to be in investigated in a prospective
study.
O-040
Qualitative gait abnormalities of neurologic type, clinicalcharacteristics and disability in older community-dwellers
without neurological diseases
M. Inzitari 1 , A. Metti 2 , A.L. Rosso 2 , C. Udina 1 , L.M. Perez 1 ,J. Verghese 3 , A.B. Newman 2 , S. Studenski 4 , G. Carrizo 1 , C. Rosano 2 .
1 Parc Sanitari Pere Virgili, Barcelona, Spain; 2 University of Pittsburgh,
PA, USA; 3 Albert Einstein College of Medicine, NY, USA; 4 National
Institute on Aging, MD, USA
Introduction: Gait abnormalities are common even in wellfunctioning older adults, and are associated with falls, dementia and death. We evaluated the cross-sectional association ofneurologic-type qualitative gait abnormalities (NGA) with clinicalcharacteristics and disability in older community-dwellers.
Methods: The Healthy Brain Project enrolled a sub-sample of older
community-dwellers of the Health ABC study without previous
psychological or neurological illnesses. We detected NGA using
standardized and validated readings of video-records (adapted from
Verghese et al). Non-neurological abnormalities were not considered NGA. We also assessed demographics, vascular risk factors andcomorbidities, cognitive function (3MSE and Digit-Symbol Substitution Test), brain MRI (cerebral volumes and connectivity), anddisability in seven activities of daily living (ADL).
Results: Of 177 participants (mean age = 82, IQR = 4 years, 55%
women, 58% Caucasian), 49 (27,7%) had NGA. In a multivariablelogistic regression model, adjusted for different covariates, diabetes
was associated with prevalent NGA (OR=3.24, 95% CI: 1.38–7.59),

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Oral presentations / European Geriatric Medicine 8S1 (2017) S1–S39

whereas higher physical activity (OR=0.89, 95% CI: 0.80–0.99) andgait speed (OR=0.04, 95% CI: 0.005–0.27) were protective. NGAs
were associated with disability in at least 1 ADL, adjusting forconfounders (OR=3.95, 95% CI: 1.64–9.52), but this association was
attenuated after adjusting for gait speed.
Conclusions: In our sample of community-dwelling older adults
without clinical neurological diseases, NGA, assessed through standard visual classiﬁcation, were associated with risk factors, suchas diabetes and physical activity, which might have a “systemic”
action (on cardiovascular, central and peripheral nervous systems,etc.). Gait speed could mediate their impact on disability. These
results, if conﬁrmed by longitudinal studies, might add information
for preventing and managing mobility disability.
O-041
Postoperative delirium after aortic valve replacement:
incidence, risk factors and cognitive outcomes
M. Humbert. Services de Cardiologie et de Gériatrie & Rédaptation
gériatrique, CHUVIntroduction: Older patients undergoing transcatheter (TAVR) or
surgical (SAVR) aortic valve replacement can develop postoperativedelirium (POD). This prospective study aims to determine: 1) POD
incidence; 2) patients’ characteristics associated with POD; 3) the
relationship between POD and cognition at 3-month follow-up.
Methods: Patients aged = 70 years who underwent TAVR or SAVR
in an academic hospital were assessed before and 3 months after
the intervention. Data were collected on health, functional status(including instrumental (IADL) activities of daily living), mood,and cognition (MMSE). POD was assessed using the Confusion
Assessment Method (CAM) at postoperative days 1, 2, 3, and 7.
Results: Among patients (N=84, mean age 81.5±6.5 years, 42.9%
women) who underwent TAVR (N=57, 67.9%) or SAVR (N=27, 32.1%),
POD incidence was 19.1% (N=16), not different in TAVR and SAVR
(19.3% vs 18.5% respectively, P=0.932). Patients with POD had signiﬁcantly baseline lower IADL (6.3±1.8 vs 7.2±1.2, P=0.034), lower
MMSE (24.4±5.7 vs 27.4±2.4, P=0.017), and higher Society of Thoracic Surgeons (STS) score (6.2±5.4 vs 4.5±4.7, P=0.035). Only MMSE
score remained associated with POD (AdjOR 0.79; 95% CI: 0.68–0.91,
P=0.001) when adjusting for STS score. At 3-month (N=63), patientswith POD (N=12, 19.0%) tended to have higher odds of cognitive impairment (AdjOR 4.61; 95% CI:0.87–24.36, P=0.072) once adjustingfor baseline cognition.
Conclusions: About one out of ﬁve older patient had POD after aortic valve replacement. Worse baseline cognition was most strongly
associated with POD incidence. Even when controlling for baseline
cognitive performance, POD tended to further increase the odds ofcognitive impairment at 3-month.

Area: Psychiatric symptoms and illnesses

O-042
Restraint use in older adults in home care: a systematic review
K. Scheepmans 1,2 , B. Dierckx de Casterlé ( 2), L. Paquay 1 ,K. Milisen 1,2 . 1 Wit-Gele Kruis van Vlaanderen, Nursing Department,
Brussels, Belgium; 2 Department of Public Health and Primary Care, KU
Leuven, Belgium; 3 Department of Geriatrics, University Hospitals
Leuven, Belgium
Objectives: To get insight into restraint use in older adults receiving
home care and, more speciﬁcally, into the deﬁnition, prevalence
and types of restraint, as well as the reasons for restraint use andthe people involved in the decision-making process.
Design: Systematic review, registered in PROSPERO (CRD42016036745).

Data sources: Four databases (i.e. Pubmed, CINAHL, Embase,
Cochrane Library) were systematically searched from inception
to end of April 2017.
Review methods: The study encompassed all empirical researchon restraint use in older adults receiving home care that reported
deﬁnitions of restraint, prevalence of use, types of restraint, reasonsfor use or the people involved. We considered publications written
in English, French, Dutch and German. One reviewer performed thesearch and made the initial selection based on titles and abstracts.
The ﬁnal selection was made by two reviewers working independently; they also assessed study quality. We used an integrated
design to synthesize the ﬁndings.
Results: Eight studies were reviewed (one qualitative, seven quantitative) ranging in quality from moderate to high. The review
indicated there was no single, clear deﬁnition of restraint. The
prevalence of restraint use ranged from 5% to 24.7%, with various
types of restraint being used. Families played an important role inthe decision-making process and application of restraints; generalpractitioners were less involved. Speciﬁc reasons, other than safety
for using restraints in home care were noted (e.g. delay to nursing
home admission; to provide respite for an informal caregiver).
Conclusions: Restraint use is common in home care and is inﬂuenced by the speciﬁcs of the home care setting. This implies
that the wealth of knowledge about restraint use in residential
settings cannot simply be transferred to the home care setting andso further research is urgently needed.
O-043
Risk of head and traumatic brain injuries associated withantidepressant use among community-dwelling persons with
Alzheimer’s disease, a nationwide matched cohort study
H. Taipale 1 , M. Koponen 2 , A. Tanskanen 3 , P. Lavikainen 4 , R. Sund 5 ,J. Tiihonen 3 , S. Hartikainen 2 , A.-M. Tolppanen 2 . 1 University ofEastern Finland, UEF, Kuopio, Finland; 2 University of Easter Finland,
UEF, Kuopio, Finland; 3 Karolinska Institutet, KI, Stockholm, Sweden;
4 University of Turku, Turku, Finland; 5 University of Helsinki, Helsinki,
FinlandBackground: Antidepressant use has been associated with an increased risk of falls and fractures among older persons. However,risk of head and brain injuries has not been investigated.
Objectives: To investigate the risk of head injuries and traumaticbrain injuries (TBI) associated with antidepressant use among
persons with and without Alzheimer’s disease (AD).
Methods: A matched cohort study compared new antidepressant
users (N=10,910) with two nonusers (N=21,820) within the MEDALZ
study cohort which includes all community-dwelling persons newly
diagnosed with AD during 2005–2011 in Finland. Incident users
were identiﬁed based on Prescription register data with a one-year
washout period for antidepressant use. Nonusers were matchedwith users based on age, gender and time since AD diagnoses.
Head injuries and TBIs were identiﬁed from Hospital Discharge
and Causes of Death registers. Propensity score adjusted Cox proportional hazard models were utilized. Sensitivity analyses withcase-crossover design were conducted.
Results: Antidepressant use was associated with an increased riskof head injuries (adjusted HR 1.35, 95% CI 1.20–1.52) and TBIs (HR1.26, 95% CI 1.06–1.50). The risk was highest during the ﬁrst 30 daysof use (head injuries HR 1.71, 95% CI 1.10–2.66, TBIs HR 2.06, 95% CI
1.12–3.82) and remained on elevated level for head injuries for over
2 years of use. In case-crossover analyses, antidepressant use wasconsistently associated with higher risk of head injuries.
Conclusions: Antidepressant use was associated with an increased
risk of the most severe outcomes, head and brain injuries in persons
with Alzheimer’s disease.

Oral presentations / European Geriatric Medicine 8S1 (2017) S1–S39

Area: Comprehensive geriatric assessment

O-044
Cancer related fatigue (CRF) before oncologic treatments:
Fatigue related factors and analyses of early death associated tofatigue — AST-ELD study, a prospective cohort study with 979
elderly cancer patients
R. Boulahssass 1 , S. Gonfrier 2 , M. Sanchez 2 , C. Rambaud 2 , D. Saja 2 ,J.M. Turpin 2 , I. Bereder 3 , G. Sacco 2 , C. Arlaud 2 , F.H. Brunschwing 2 ,E. Clais 2 , F. Leborgne 2 , E. Ferrer 2 , J. Guigay 4 , E. François 5 ,O. Guérin 1 . 1 UCOG PACA EST CHU de Nice, FHU; 2 UCOG PACA ESTCHU de Nice; 3 EMG CHU de Nice; 4 Centre Antoine Lacassagne, FHU;
5 UCOG PACA EST CHU de Nice, Centre Antoine Lacassagne
Introduction: CRF is a common symptom, misunderstood andunder-manage which can greatly affect the quality of life (QoL).The
aims of this study were: Identify potential reversible factors associated with fatigue and analyze the relation between fatigue andearly death in older patients.
Methods: This is a multicentric, prospective cohort study approvedby an ethics committee. Patients over 70y have been enrolled.
At the baseline and before the speciﬁc treatments we collected:
MMSE, MNA,ADL, IADL, CIRSg, Gait speed, Charlson, G8, PS, Balducciscore, fatigue and intensity (QLQC30), need to rest and intensity,
medication review, Haemoglobin, clearance of creatinine,stage andcancers types; presence of: weakness, sleep disorders, anxiety,polypharmacy, isolation, conﬁned patients. Events (deaths) havebeen collected during the follow up of 100 days.
Results: 979 patients were enrolled with median age:of 82y [70–100]. Fatigue was observed in 69% (In 21% and 25% respectively
mild and high intensity). Patients who have expressed fatigue atthe baseline before treatments were signiﬁcantly more linked todeath HR 1.9 [1.3–2.7]. Factors signiﬁcantly associated with fatigue
in multivariate analyses were polypharmacy >5 OR: 1.6 [1.1–2.1],
anxiety OR 2.3 [1.7–3.2],GDS >5 OR: 2.2 [1.5–3.3], PS >2 OR
1.6 [1.1–2.5], lung cancers OR 4.1 [1.3–11.9], Hb <10g/dl OR 1.8[1.2–2.8],homebound OR 1.5 [1.1–2.5], MNA <17 OR 1.8 [1.1–3.2]
and MNA≤23.5 and >17 OR1.4 [1.1–2.1]. Among patients presenting
fatigue at baseline (n=681) factors linked to death in multivariate
analyses were: MNA <17 OR 12.1 [4.1–35.1] and MNA≤23.5 and >17
OR 6.7 [2.3–19.5], MMSE <24 OR1.5 [1.1–2.4],male gender OR1.8[1.1–2.7], stage 4 OR2.7 [1.7–4.1], gait speed <0,8m/s OR3.1 [1.9–5.3]
and weakness OR 2.5 [1.2–4.9].
Conclusions: Some of these factors are potentially reversible andcan lead to guided interventions to improve QoL and possibly
survival.The originality of this study is the relation between fatigue
and geriatric assessment, biological factors, and early survival in ahuge cohort of a real geriatric population.

Area: Pharmacology

O-045
Differences between drug related problems in aged andmiddle-aged patients: analysis of pharmacists medication orderreview during 8 years
F. Gervais, T. Novais, C. Pivot, C. Mouchoux. Pharmacie, Hospices
Civils de Lyon, Lyon, France
Introduction: Involvement of clinical pharmacists to prevent Drugs
Related Problems (DRP) through pharmaceutical interventions (PI)is supported by literature, underlying positive patient outcomes and

S15

improvement of care. Identifying speciﬁc DRPs and PIs occurringin aged patients compared to middle-aged patients should help tobetter manage at-risk patients and prioritize PIs. This study aimed
to analyses differences in DRPs during daily medication orderreview between patients aged ≥75 and patients aged 18–75.
Methods: A retrospective study on DRPs documented at the French
university hospital of Lyon - 8 hospitals - into a dedicated moduleof the French Society of Clinical Pharmacy website (Act-IP® ), wasconducted from beginning of 2008 to end of 2015.
Results: A total of 56241 DRPs were registered: 19071 among
aged patient and 37170 among patient aged 18–75. Compared to
middle-aged patients, aged patients were, in particular, signiﬁcantly associated with 1) interventions: Non Conformity of the drug
choice to guidelines (OR=1.693, 95% CI [1.520–1.887]), adverse drug
reaction (OR=1.532, 95% CI [1.408–1.667]), 2) drug class: Cardiac
therapy (OR=5.257, 95% CI [3.404–8.119]), Antithrombotic agents(OR=3.059, 95% CI [2.003–4.671]). A supratherapeutic dosage ofbenzodiazepines (4.03%) was the most frequent DRP in aged people
compared to middle-aged.
Conclusion: The medication review by pharmacists allows detecting DRPs effectively. This study highlights some directions that
could be taken to improve prevention of DRP among aged patients:
speciﬁc training to medical team, targeted information on safe drug
use and a closer collaboration between physicians and pharmacists.
O-046
Trend analysis: prescription changes during geriatric care
episodesM. Reimers, M. Eriksdotter, Å. Seiger, J. Fastbom. Karolinska
Institutet
Background: The number of prescribed drugs among old people
has been rising in recent decades. With increasing age and many
medications, risk of complications and drug prescription complexity increases. Many changes in prescriptions could be a factor that
improves treatment quality. Aim: to investigate drug-prescription
trends and factors that contribute to prescription changes. Speciﬁc objectives were to ﬁnd out if high numbers of prescriptionchanges are signiﬁcantly correlated with age, gender, comorbidity,care-episode length, and number of drugs.
Methods: Data were extracted from geriatric clinic records inStockholm during 2005, 2010, and 2015. Indicators for good drug
therapy were used to assess the effects of prescription changes
on quality, using an inappropriate drug use index, IDU index. Data
were analyzed with Student’s t-test; PR test, Wilcoxon’s rank sum
test, and linear regression.
Results: The patients had more comorbidities and more drugs, but
shorter hospital stays and signiﬁcantly fewer prescription changes
in 2015 compared to 2005. There were signiﬁcant associations
between care-episode length and the prevalence of prescriptionchanges. Our model showed that the prescription changes decreased with 8% for each day of shortening of the care episode. The
number of prescription changes was negatively correlated to the
IDU index.
Conclusions: The study showed that more prescription changes
were associated with longer care episodes and improved drugprescribing quality as per the IDU index. Given prescription changes
are regarded as a quality factor in geriatric care, quality may havedecreased along with reduction of care-episode lengths, during the
2005–2015 period.

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O-047
Discontinuing Inappropriate Medication In Nursing Home
Residents (DIM-NHR study): A cluster randomized controlled
trial
H. Wouters 1 , J. Scheper 1 , H. Koning 1 , C. Brouwer 1 , J. Twisk 2 ,H. Van Der Meer 1 , F. Boersma 3 , S. Zuidema 3 , K. Taxis 1 .
1 Department of Pharmacotherapy, Epidemiology & Economics,
University of Groningen, Groningen, The Netherlands; 2 Depepartmentof Epidemiology And Biostatistics, VU University Medical Center,
Amsterdam, The Netherlands; 3 Department of General Practice And
Elderly Care Medicine, University Medical Center Groningen,
Groningen, The Netherlands
Introduction: Inappropriate prescribing is a prevalent problem
in nursing home residents that is associated with cognitive andphysical impairment. Few interventions have been shown to reduce inappropriate prescribing. The aim was therefore to examine
successful discontinuation of inappropriate medication.
Methods: A cluster randomized controlled trial was conducted.
Fifty-nine wards were randomly assigned to the intervention or
to “care as usual”. The intervention was a Multidisciplinary Multistep Medication Review (3MR), consisting of an assessment of thepatient perspective, a medical history, a critical appraisal of medication, a meeting between the elderly care physician and a pharmacist,and the execution of medication changes. The primary outcome
was successful discontinuation of ≥1 inappropriate drug(s), without
relapse or severe withdrawal symptoms. Secondary outcomes included neuropsychiatric symptoms, cognitive function and qualityof life. Nursing home residents with a life expectancy of >4 weeks
who did not refuse treatment with medication were included. Data
were collected at baseline and at an average follow-up of 144 days.
Results: A total of 426 nursing home residents participated (intervention group: N=233 and control group: N=193). Generalized
linear mixed models (logit link function) showed that for 91 (39.1%)of the residents in the intervention group ≥1 inappropriate drugs
could be successfully discontinued vs. 57 (29.5%) of residents in thecontrol group (adjusted odds-ratio: 1.57, 95% CI: 1.03 to 2.39). There
was no deterioration on secondary outcomes.
Conclusions: The 3MR is effective in discontinuing inappropriate medication in nursing home residents whilst probably notcompromising their wellbeing.
O-048
Acetyl-L-carnitine supplementation and the treatment for
depressive symptoms: A systematic review and meta-analysis
B. Stubbs 1 , M. Solmi 2 , A. Carvalho 3 , S. Maggi 4 . 1 King’s College
London; 2 University of Padova; 3 Federal University of Ceará, Fortaleza;
4 CNR Padova
Introduction: Deﬁciency of acetyl-L-carnitine (ALC) appears to playa role in the risk of developing depression, but the data regarding
its supplementation in humans are limited. We thus conducted asystematic review and meta-analysis investigating the effect of ALC
on depressive symptoms across randomized controlled trials (RCTs).
Methods: A literature search in major databases, without language
restriction, was undertaken from inception until 30 December
2016. Eligible studies were RCTs of ALC alone or in combination with antidepressant medications with a control group taking
placebo/no intervention or antidepressants. Standardized mean differences (SMD) and 95% conﬁdence intervals (CIs) were used forsummarizing outcomes with a random-effect model.
Results: Twelve RCTs (11 of which were ALC monotherapy) witha total of 791 participants (mean age 54 years, % females = 65%),
were included. Pooled data across nine RCTs (231 treated with
ALC vs. 216 treated with placebo and 20 no intervention) showedthat ALC signiﬁcantly reduces depressive symptoms (SMD=−1.10;

95% CI: −1.65 to −3.99; I2=86%). In three RCTs comparing ALC vs.
antidepressants (162 for each group), ALC demonstrated similareffectiveness compared toestablished antidepressants in reducing
depressive symptoms (SMD=0.06; 95% CI: −0.22 to 0.34; p=0.69;
I2=31%). In these latter RCTs, the incidence of side effects was
signiﬁcantly lower in ALCthan the antidepressant group.
Conclusions: ALC supplementation signiﬁcantly decreases depressive symptoms compared to placebo/no intervention, whilst
offering a comparable effect to established anti-depressant agentswith fewer side effects. Future large scale trials are required to
conﬁrm/refute these ﬁndings.
O-049
Concurrent use of alcohol interactive medications and alcohol in
older adults: A systematic review of prevalence and associatedadverse outcomes
A. Holton 1 , P. Gallagher 1 , T. Fahey 2 , G. Cousins 1 . 1 RCSI School of
Pharmacy; 2 The HRB Centre for Primary Care Research
Objectives: The quantity of alcohol consumed declines with age
however, older adults drink more frequently. [1] Alcohol interactive(AI) medicines have the potential to interact with alcohol. [2] The
aim of this review was to investigate the prevalence of concurrent
alcohol and AI medicines use among older adults and associatedadverse outcomes.
Methods: We conducted a search of PubMed, Embase, Scopus andWeb of Science databases from January 1990-June 2016. Included
studies reported: the quantity/frequency of alcohol consumption
and concomitant use of alcohol & AI medicines in the same oroverlapping recall periods in older adults. Data was extracted andthe risk of bias was evaluated, using an adapted form of the
Newcastle Ottawa cohort scale (NOS).
Results: From 546 records identiﬁed, 20 studies were included inthis review. Nine reported a wide range of AI medicines; three
investigated any medicine use and eight focused on psychotropics.
Alcohol consumption was more prevalent among older men; while
psychotropic use was higher among older women. Concurrent alcohol consumption with a wide range of AI medicines ranged between
18–39%, whilst concurrent use of psychotropics and alcohol ranged
from 2–15.7%. Four studies reported the occurrence of adverse
outcomes, with mixed evidence for falls and adverse outcomes.
Conclusions: This review highlights the prevalence of concurrent
use of alcohol and AI medicines among older adults. With considerable heterogeneity in the inclusion of AI medicines, research is
required to identify a comprehensive list of AI medicines in the
future. Further research is required to investigate adverse outcomesdue to concurrent use among older adults.
References:[1] Britton A, Ben-Shlomo Y, Benzeval M, Kuh D, Bell S. Life course
trajectories of alcohol consumption in the United Kingdom
using longitudinal data from nine cohort studies. BMC Med.
2015;13:47.
[2] Weathermon R, Crabb DW. Alcohol and medication interactions.
Alcohol Res Health. 1999;23(1):40–54.
O-050
Association between psychotropic and cardiovascular iatrogenic
alerts and risk of hospitalizations in elderly people treated for
dementia
L. Zerah 1 , J. Boddaert 2 , A. Leperre-Desplanques 3 ,D. Bonnet-Zamponi 4 , M. Verny 2 , J. Deligne 5 , P.-Y. Boelle 6 .
1 Sorbonne université, Université Pierre et Marie Curie - Paris 06,“Institut Pierre Louis d’Epidémiologie et de Santé Publique”, INSERM,
UMR 1136, Paris; Sorbonne université, Université Pierre et Marie Curie– Paris 06, “Biological adaptation and ageing”, INSERM, UMR 8256,

Oral presentations / European Geriatric Medicine 8S1 (2017) S1–S39

Paris, France 3 APHP, Pitié-Salpêtrière Hospital, Geriatric department,
Paris, France 4 University Hospital Department Fight Aging and Stress(DHU FAST), APHP, Paris, France; 2 Sorbonne université, Université
Pierre et Marie Curie - Paris 06, “Biological adaptation and ageing”,
INSERM, UMR 8256, Paris; APHP, Pitié-Salpêtrière Hospital, GeriatricDepartment, Paris, France 4 University Hospital Department Fight
Aging and Stress (DHU FAST), APHP, Paris, France; 3 Haute Autorité deSanté (French National Authority For Health), Saint Denis La Plaine,France; 4 OMEDIT - Ile de France (Observatory of Drugs, Medical
Devices and Therapeutic Innovations), Paris; Centre de Pharmacoépidémiologie de l’APHP, Paris, France; 5 Régime Social desIndépendants (RSI). Saint Denis La Plaine, France; 6 Sorbonne
université, Université Pierre et Marie Curie - Paris 06, “Institut Pierre
Louis d’Epidémiologie et de Santé Publique”, INSERM, UMR 1136, Paris;
APHP, Saint-Antoine Hospital, Public Health department, Paris, France
Introduction: Elderly people are at risk of repeated hospitalizations, some being drug-related and preventable. In 2011, French
experts selected 5 “iatrogenic alerts” (IAs), from the existing setsof explicit criteria, to assess the appropriateness of medicationin elderly patients. Our objective was to examine the association
between hospitalizations and IAs in elderly patients treated for
dementia.
Methods: A two-year longitudinal national database study using
an approach similar to the “self-controlled case series” between
January 1, 2011 and December 31, 2012 was set up to analyze
data on drug prescriptions and hospital stays. IAs were deﬁned
as: (1) long half-life benzodiazepine; (2) antipsychotic drug; (3)co-prescription of 3 psychotropic drugs or more, (4) co-prescriptionof 2 diuretics or more and (5) co-prescription of 4 antihypertensive
drugs or more. Data were obtained from the matching of two French
National Health Insurance Databases. All aﬃliates, aged 75 or more,in treatment for dementia, still alive on January 1st, 2011 were
included. The analysis was performed over a period of 6 months.
Results: 10,754 patients were included. During the IA periods,
compared to others periods, hospitalization incidence increasedby (0.23/year vs. 0.36/year) and the number of hospitalizations
doubled (Proportional Fold Change PFC=1.9, 95% CI [1.8, 2.1]). We
calculated that 22% (95% CI [20%, 23%]) of all hospitalizations wereassociated with IAs, 80% of which were due to psychotropic IAs.
Conclusion: IAs seem to be a simple and clinically relevant tool thatenables the prescribing physicians to assess the appropriateness ofthe prescription in elderly patients treated for dementia.
O-051
The change in psychotropic drug use in Norwegian nursing
homes (between 2004 and 2011)
G. Selbaek 1 , S. Janus 2 , S. Bergh 3 , K. Engedal 4 , A.S. Helvik 3 ,J. Šaltytė Benth 1 , S. Zuidema 2 , S. Ruths 5 . 1 University of Oslo;
2 University Medical Centre Groningen; 3 Norwegian National Advisory
Unit on Ageing and Health; 4 Oslo University Hospital; 5 University ofBergen, Norway
Objectives: We aimed to assess whether there were any changes in
the use of psychotropic drugs in Norwegian nursing homes between
2004 and 2011. Also, we investigated whether the predictors of useof speciﬁc psychotropic drug groups have changed.
Methods: We conducted a secondary analysis of two cohort studiesof two Norwegian nursing home samples (2004/05 and 2010/11).
Multivariate models were applied.
Results: We found a signiﬁcant decrease in the prescription of
antipsychotic drugs between 2004 and 2011 (0.63 OR, 95% CI:
0.49–0.82, p<0.001) even after adjusting for relevant demographic
and clinical variables. There are only minor changes for the otherpsychotropic drugs. We found that (1) the use of speciﬁc psychotropic drug groups as well as the number of psychotropic drugs

S17

used were associated with more affective symptoms and (2) theuse of speciﬁc psychotropic drug groups as well as the number ofpsychotropic drugs used were associated with lower scores on the
Physical Self-Maintenance scale.
Conclusions: This is the ﬁrst study to show a robust decrease in
antipsychotic drug use in nursing home patients with dementia
unrelated to possible changes in case mix. The change might be
explained by treatment recommendations against its use except
in the most severe conditions of aggression or psychosis. Ourﬁndings indicate that it takes several years to implement scientiﬁcknowledge in clinical practice in nursing homes.
O-052
Preventability of serious adverse drug reactions in the elderly:
analysis of the spontaneous reports to a French
pharmacovigilance center over 10 years
P. Gibert 1 , S. Chanoine 1 , Y. Rebillard 2 , M. Mallaret 2 , G. Gavazzi 3 .
1 Pharmacie clinique, CHU Grenoble-Alpes; 2 Centre Régional de
Pharmacovigilance, CHU Grenoble-Alpes; 3 Gériatrie, CHU
Grenoble-Alpes
Introduction: Adverse drug reactions (ADR) are a major healthissue, especially in the elderly, due to frailty and polymorbidity
requiring polypharmacy. The risk of ADR and ADR-related hospitalizations increases with age. One to 2 thirds of ADR are predictableand preventable.The aim of this study was to identify characteristics
of preventable and non-preventable ADR in the elderly.
Material and methods: We performed a retrospective analysis ofserious ADR that occurred in the elderly over 75 years and were
spontaneously reported to the Grenoble pharmacovigilance centerfrom 2005 to 2015.
Results: Overall, 966 notiﬁcations of serious ADR were analyzed.
Patients were 82.1±5.2 years old and 56.5% were women. Amongthese ADR, 27.7% (n=268) were preventable and 319 errors occurred, mostly during prescription (68.7%) and drug dispensation(29.9%). Patients suffering from preventable ADR were signiﬁcantly
older than those with no preventable ADR (p=0.008).Vasculardisorders (ie. hemorrhages and hematomas), renal disorders (ie.
acute kidney injury) and disorders of hemostasis were signiﬁcantly more frequent in case of preventable ADR. Preventable ADR
were signiﬁcantly more related to antithrombotics, drugs acting on
the renin-angiotensin system (RAS), analgesics, antigout and antiinﬂammatory. A drug-drug interaction was much more frequent inpreventable ADR (21.6%) than in not preventable ADR (1.9%).
Discussion/Conclusion: A quarter of ADR were preventable in theelderly, as it has been previously reported. Precautions have to focus
on prescription and medical monitoring of antithrombotic agentsand drugs acting on the RAS. Collaboration between pharmacovigilance, clinical pharmacist and practitioner could easily help toreduce occurrence of preventable ADR.

Area: Biogerontology and genetics

O-053
Estimating the association of 5HTTLPR polymorphism withdelusions in Alzheimer’s disease
G. D’Onofrio, D. Sancarlo, F. Panza, A. Mangiacotti, C. Gravina,
M. Urbano, C. Garcia Fernandez, F. Addante, L. Cascavilla, A. Greco,
D. Seripa. Complex Structure of Geriatrics, Department of Medical
Sciences, IRCCS “Casa Sollievo della Sofferenza”, San Giovanni Rotondo,
Foggia, Italy
Introduction: Mechanisms underlying delusions in Alzheimer’s
disease (AD) patients have not been fully clariﬁed. 5HTTLPR isS18

Oral presentations / European Geriatric Medicine 8S1 (2017) S1–S39

a 44-bp deletion polymorphism in promoter region of serotonintransporter gene SLC6A4, with 2 alleles: 1 termed long (L) and1 short (S). Aim of this study was to determine whether the
5HTTLPR serotonin transporter gene polymorphism is associatedwith delusions in patients with AD.
Methods: A total of 257 consecutive AD patients were included.
Of these, 171 AD patients with delusions (AD-D) and 86 AD
patients without delusions (AD-noD). All participants underwent
a comprehensive evaluation with standardized CGA, Mini-Mental
State Examination (MMSE), and Neuropsychiatric Inventory (NPI).
Individuals were genotyped for 5HTTLPR polymorphism in blindedfashion.
Results: No signiﬁcant differences were shown between two groups
on gender, mean age, educational level, in disease duration and inage at onset. AD-D showed signiﬁcantly an higher cognitive impairment in MMSE (p=0.047), a major impairment in NPI (p<0.0001)
and in NPI-Distress (p<0.0001), and a worsening in several CGA
domains. Homozygosis for L/L genotype was associated with alower MMSE in all (p=0.002) and AD-D (p=0.024) patients, andan increased risk for delusions in all AD-D (p<0.0001), moderate
AD-D (p<0.0001) and severe AD-D (p=0.006) patients. L/L genotype
seems to be associated to cognitive deterioration (p<0.0001) anddelusion severity (p=0.005) after 5-years follow-up.
Conclusions: This study showed that 5HTTLPR polymorphism is
associated with delusions in AD, with important implications regarding mechanisms underlying this symptom. Because of this, it
could be possible to implement a personalized therapy for AD-D
patients.

Area: Cognition and dementia

O-054
How do community-dwelling persons with Alzheimer’s disease
fall? Falls in the FINALEX study
N. Perttila, H. Öhman, T. Strandberg, H. Kautiainen, M. Raivio,
M.-L. Laakkonen, N. Savikko, R. Tilvis, K.H. Pitkälä. University of
Helsinki, Helsinki, Finland
Introduction: People with dementia are at high risk for falls.
However, little is known of the features causing falls in Alzheimer’s
disease. The aim of this study was to investigate how participants
with Alzheimer’s disease fall.
Methods: In the FINALEX exercise trial, participants’ (N=194) falls
were followed up for one year by diaries kept by their spouses. We
investigated various features and risk factors behind the falls.
Results: Altogether 355 falls occurred during follow-up. The mostcommon reason for a fall was stumbling (N=61). Of the falls, 123 led
to injuries, 50 to emergency department visits, and 13 to fractures.
The participants having no falls (N=103) were younger and had
milder dementia than those with one (N=34) or two or more
falls (N=57). Participants scoring around ten points on the Mini
Mental State Examination were most prone to fall. In age-, sex-, andintervention-adjusted regression models, good nutritional status,
good physical functioning according to Functional Independence
Measure, timed “Up & Go” test, and Short Physical Performance
Battery, and use of antihypertensive medication (Incident Rate
Ratio (IRR) 0.68, 95% Conﬁdence Interval (CI) 0.54 to 0.85) protectedagainst falls, whereas fall history (IRR 2.71, 95% CI: 2.13 to 3.44),
osteoarthritis, diabetes mellitus, COPD, higher number of drugs,
drugs with anticholinergic properties, psychotropics, and opioids(IRR 4.27, 95% CI: 2.92 to 6.24) were risk factors for falls.
Conclusions: Our study provides a detailed account on how andwhy people with Alzheimer’s disease fall, suggesting several risk
and protective factors.

O-055
Trauma resurgence and impact on a dementia process
N. Delrue, A. Plagnol. Paris 8 University, Neuropsychology andPsychopathology Laboratory
Introduction: Links may exist between Alzheimer’s disease (AD)and Post-Traumatic Stress Disorder (PTSD). No existing study seems
to have veriﬁed if a PTSD treatment in AD patients can improve
episodic memory and dementia stage. We verify if a PTSD treatment
can improve memory in early or a moderate dementia subjects,
with a positive impact on the AD evolution.
Method: 40 patients are studied with 20 subjects for the target
group with AD and PTSD, and 20 subjects for the control group withAD but without PTSD. Our longitudinal study compares the twogroups evolution over a 12-month period: before PTSD treatment(T0), after PTSD treatment (T2) and after an additional 6 months offollow-up. During the 3 periods, the episodic memory and the autobiographical episodic memory are examined with the Alzheimer’s
Disease Assessment Scale, the Memory Impairment Screen and thefrench version of the Autobiographical Memory Interview. The dementia stage is calculated with the Mini Mental State Examination.
PTSD symptoms (with the Clinician Administered PTSD Scale) andquality of life (with the Alzheimer’s Disease-Related Quality of Life)are examined.
Results: PTSD treatment in AD patients improve capacities in: (1)word recall, (2) word recognition, (3) immediate recall, (4) delayedrecall, (5) recall of personal childhood events, (6) recall of personal
young adult events, (7) recall of personal adult events, (8) recall of
personal events of the 5 past years, (9) recall of personal events of
the 12 past months, (10) general cognitive abilities and (11) qualityof life.
Conclusion: PTSD identiﬁcation and PTSD treatment in AD patients
can increase, for more than 6 months, cognitive performance, verbal
and autobiographical episodic memory eﬃciency, can stabilise thedementia process and signiﬁcantly improve the quality of life.
O-056
Long-term effects of prediabetes and diabetes on cognitive
trajectories in a population-based cohort
A. Marseglia 1 , A. Dahl 2 , L. Fratiglioni 1 , N. Pedersen 2 , W. Xu 1 .
1 Karolinska Institutet, Aging Research Center; 2 Karolinska Institutet,
Department of Medical Epidemiology and Biostatistics
Introduction: Diabetes has been linked to dementia risk. However,the cognitive trajectories in older adults with diabetes remain unclear. We aimed to investigate the effect of prediabetes and diabetes
on cognitive trajectories among cognitively intact older adults in along-term follow-up study.
Methods: Within the Swedish Adoption/Twin Study of Aging, 793
cognitively intact older adults aged ≥50 were identiﬁed at baseline
and followed for up to 23 years. Cognitive domains (verbal, spatial/ﬂuid, memory, speed) were assessed at baseline and up to sevenfollow–ups. Prediabetes was deﬁned according to blood glucose levels in diabetes–free participants. Diabetes was ascertained based on
self–report, hypoglycemic medication use and blood glucose levels.
Data were analyzed with linear mixed–effect models adjusting forpotential confounders.
Results: At baseline, 68 participants (8.6%) had prediabetes and 45(5.7%) had diabetes. Compared to diabetes–free individuals, people
with diabetes had lower performance in spatial/ﬂuid abilities (β−2.63; 95% CI: −5.36, 0.05; p=0.058), and an accelerated linear
decline over time in verbal abilities (β −0.15; 95% CI: −0.29, −0.01;
p=0.041). Prediabetes was associated with an accelerated decline
in processing speed (β −0.01; 95% CI: −0.02, −0.004; p=0.041), butwith a better maintenance of memory (β 0.23; 95% CI: 0.05, 0.42;
p=0.013) over the follow-up.

Oral presentations / European Geriatric Medicine 8S1 (2017) S1–S39

Conclusions: Prediabetes may accelerate processing speed decline,
and diabetes is associated with the verbal ability decline, suggestingthat diabetes and even prediabetes affect especially the cognitive
domains of ﬂuid intelligence at the early stages of cognitive
impairment.
O-057
The association between clinical symptoms of dementia with
Lewy bodies and functional image ﬁndings using SPECT for
dopamine transporter and cerebral blood ﬂow
M. Imai, K. Mori, H. Maruno, Y. Igeta, Y. Ouchi. Toranomon Hospital,
Japan
Introduction: I-123 ioﬂupane SPECT is a relatively new imaging
tool to assess the integrity of the nigrostriatal dopaminergic neuron.
I-123 ioﬂupane is the radioligand for the presynaptic dopaminetransporter (DaT), which improves the accuracy of clinical diagnosis
for dementia with Lewy bodies (DLB). Additionally, cerebral blood
ﬂow (CBF) in DLB is well-known to decline in the primary visualcortex using I-123 iodoamphetamine (IMP) SPECT which is possible
to analyze regional CBF with the 3D stereotactic surface projection
method. Few reports to compare the clinical symptoms and the
SPECT ﬁndings are present.
Methods: Patients with memory loss, visiting our department ofGeneral Geriatric Medicine from May to December in 2016 werereviewed. We reviewed their clinical symptoms including tremor,
rigidity, gait, visual hallucination, REM sleep behavior disorder,
depression, and cognitive disorders. In DaT SPECT, average speciﬁc
binding ratio (SBR) was calculated. In IMP SPECT, indexed regional
CBFs were calculated. Biserial/Polyserial correlation between eachclinical symptom and the imaging "marker" from scintigraphy wasevaluated.
Results: There were high correlation between the below; tremor
and SBR (rho=0.67), time orientation and CBF in parahippocampus
gyrus (rho=0.52), pentagon drawing and CBF in parietal cortex(rho=0.65), and pentagon drawing and CBF in primary visual cortex(rho=0.78).
Conclusions: Some of clinical symptoms are associated with thefunctional imaging markers using clinically available radioisotopes.
Our results will be helpful to interpret functional image ﬁndings
linked the clinical symptoms.
O-058
Long-term exposure to anticholinergic and sedative drugs andcognitive and physical function in later life
H. Wouters 1 , S. Hilmer 2 , D. Gnjidic 3 , J. Van Campen 4 , M. Teichert 5 ,H. Van Der Meer 1 , L. Schaap 6 , M. Huisman 7 , P. Denig 8 , C. Lamoth 9 ,K. Taxis 1 . 1 Department of Pharmacotherapy, Epidemiology &Economics, University of Groningen, Groningen, The Netherlands;
2 Department of Clinical Pharmacology And Aged Care, Kolling
Institute, Royal North Shore Hospital, Sydney, Australia; 3 Faculty of
Pharmacy, University of Sydney, Sydney, Australia; 4 Department ofGeriatric Medicine, Slotervaart Hospital, Amsterdam, The Netherlands;
5 Department of Clinical Pharmacy and Toxicology, Leiden University
Medical Center, Leiden, The Netherlands; 6 Department of Health
Sciences, Amsterdam Public Health Research Institute, VU University,
Amsterdam, The Netherlands; 7 Department of Epidemiology &Biostatistics, Amsterdam Public Health Research Institute, VU
University, Amsterdam, The Netherlands; 8 Department of ClinicalPharmacy and Pharmacology, University Medical Center Groningen,
Groningen, The Netherlands; 9 Center of Human Movement Science,
University Medical Center Groningen, Groningen, The Netherlands
Introduction: Anticholinergic and sedative drugs from various
therapeutic classes are frequently prescribed to older people. These
drugs are known to impair cognitive and physical function in the

S19

short-term. However, long-term exposure to these drugs remains
less examined.
Methods: Data from the Longitudinal Aging Study Amsterdam, aDutch nationally representative cohort study, collected over twenty
years (1992–2012) at seven occasions, were analyzed. On each occasion, cumulative exposure to anticholinergic and sedative drugs
was quantiﬁed with the Drug Burden Index (DBI), a linear additive
pharmacological dose-response model. The relationships between
the DBI and outcomes of cognitive function (MMSE, Alphabet Coding Task, 15-Words Test) and physical function (Walking Test, Chair
Stands Test, Cardigan Test, and Functional Independence Scale)were examined using linear mixed models adjusted for sex, marital
status, age, education, smoking status, drugs not included in DBI,
body mass index, depression, and co-morbidities.
Results: At baseline, there were 2896 individuals (52% women;mean age 70±9 years). Of them, 62% had no exposure to anticholinergic and sedative drugs (DBI=0), 24% moderate exposure (DBI
=0–1), and 14% high exposure (DBI >1). Signiﬁcant independentassociations were found between the DBI and physical function(Walking Test log transformed: B=0.02 [95% CI: 0.01; 0.03], Cardigan
Test log transformed: B=0.02 [95% CI: 0.01; 0.03], Chair Stands Test
B=0.48 [95% CI: 0.20; 0.76], and Functional Independence: B= -0.89[95% CI: −1.22; −0.55]). No associations were found between the
DBI and cognitive function.
Conclusions: Over 20 years, higher anticholinergic and sedative
exposure is associated with poorer physical but not poorer cognitive
function.

Area: Pharmacology

O-059
Potential drug interactions in older patients with cancer:
the ELCAPA cohort survey (ELCAPA-15)
P. Caillet 1 , G. Beinse 1 , D. Reitter 2 , M. Carvahlo-Verlinde 2 ,C. Tournigand 3 , E. Paillaud 1 , F. Canouï-Poitrine 4 . 1 AP-HP, HenriMondor Hospital, Department of Internal and Geriatric Medicine and
Sud-Val-de-Marne Geriatric Oncology Unit, Créteil, France; 2 AP-HP,
Henri-Mondor Hospital, Department of Pharmacy, Créteil, France;
3 AP-HP, Henri-Mondor Hospital, Department of Medical Oncology,
Créteil, France; 4 AP-HP, Henri-Mondor Hospital, Department of Public
Health and Clinical Research Unit (URC-Mondor), Créteil, France
Introduction: Because of the increasing number of comorbidities with age leading to polypharmacy, older cancer patients areat higher risk of adverse events related to drug-interactions in
the daily medications, but also between daily medications andchemotherapy drugs.Objectives: To identify Potential Drugs Interactions (PDI) in the daily medications, PDI between daily medications
and chemotherapy, Potential Clinical Outcomes (PCO) related tomajor PDI.
Method: From 2007 to 2014, all consecutive cancer patients aged
70 years or older, referred for geriatric assessment were includedin the prospective ELCAPA cohort survey. For the present study
patients receiving chemotherapy were analyzed. PDI were analyzed
using Lexicomp Online® (Lexi-Comp, Inc., Hudson, USA) softwareand completed with the Theriaque® website for French medications. Collected PCO were those relevant in geriatrics. PDI and PCO
were classiﬁed according to importance (A: no interactions known,
B: no action needed; C: monitor therapy; D: consider therapy
modiﬁcation; X: avoid combination). Factors associated with PDI ofgrades C, D or X were analyzed using ordered multivariate logistic
regression dependent variable being the PDI in three categories, PDI
of grade A or B (reference), versus C, versus D or X.
Results: The study included 442 patients (median age: 77 years;

S20

Oral presentations / European Geriatric Medicine 8S1 (2017) S1–S39

Q1: 74.5 - Q3: 81; 48.7% of women). Most frequently tumor sitewere colorectal (20.9%), followed by urological tracts (19%), breast(12.4%); 22.9% had metastasis. The median number of drugs per
patients per day was 6 [3–8], the median comorbidities index
CIRS-G was 12 [9–16]. At least 1 PDI per patient was identiﬁedin the daily medications in 70.6% of patients (median 4 [2–7]),
and between daily medications and chemotherapy drugs in 33.9%(median 2 [1–3]). Overall, 171 patients had PDI of grade C (38.7%)
and 166 of grade D or X (37.6%); 1918 grade C, D or X PDI
were identiﬁed (83.8% of C and 16.2% of D or X), 1578 (71.5%)in the daily medications and 340 (28.5%) between daily medications and chemotherapy. Considering drug-interaction in daily
medications, main PCO were hypotensive risk (31.7% of all PDI),
psychotropic effects (16.4%), glycemic disorders (11%), hemostasis
deregulation (7.9%), ﬂuid disorders (7.4%), and QT prolongation(3.6%). Considering drug-interaction between daily medications
and chemotherapy, main PCO were risk of renal, cardiovascular, hemostasis deregulation, or neurogenic impairment (17.6%),
over-exposition of chemotherapy (11.7%) or under-exposition (8%).
After adjustment for age, tumor site and metastasis, factors independently associated with PDI were increase number of daily
medications (adjusted OR (ORa)1-medication increase = 1.74; 95%
CI [1.43–2.11] for grade C; ORa=1.95; 95% CI [1.56–2.43] for gradeDX), hypertension (ORa=4.10; 95% CI [1.84–9.17] for grade C) andoverweight/obesity (ORa=2.55; 95% CI [1.12–5.82] for grade C).
Conclusion: PDI were frequent in older cancer patients. This highlights the need of monitoring the iatrogenic risk, especially forhypotension risk, psychotropic side-effects, glycemic and hemostatis regulation mainly in patients with polypharmacy, hypertension, and overweight, with integrated team involving geriatricians,
pharmacists, and oncologists.

Area: Ethics and end of life care

O-060
The use of opioids in the dying geriatric patient: comparison
between the acute geriatric ward and the palliative care unit
W. Janssens, N. Vandennoortgate, R. Piers. University Hospital,
Ghent, Belgium
Introduction: Palliative care for the older person is often limited,resulting in poor quality of dying. Using opioids can be one of
the cornerstones to achieve better symptom control. However, little
data concerning the use and dosage of opioids are available.
Methods: In this multicentric retrospective study, we included
patients 75 years and older who died on the acute geriatric unit
(AGU) and the palliative care unit (PCU) in 3 hospitals (during a
2-years period). Sudden deaths were excluded. Demographic andclinical variables, and data concerning use and dosage of opioids inthe last 72 hours before death were collected. Underlying pathology
was divided into several groups: cancer, organ failure, dementia,
others.
Results: Data from 556 patients were collected (38.5% from PCU,
61.5% from AGU). On the PCU, cancer was the most frequent
underlying pathology, compared to organ failure on the AGU. After adjusting for the variables age, gender, underlying pathology,
opioids seemed to be given more frequently (OR 1.2; 95% CI:
1.1–1.3; P<0.001) and in a higher dosage (B 34.2; 95% CI: 15.0–53.4;
P=0.001) on the PCU compared to the AGU.
Conclusions: Organ failure is more frequently considered as theunderlying pathology in elderly dying on an AGU, compared tocancer on a PCU. After adjusting for these variables, opioids are
more often used and in a higher dosage in the terminal phase inpatients on the PCU compared to the AGU.

O-061
Use of opioids at the end of life in adults with advanced
dementia in Finland
D. Jakovljević 1 , H. Finne-Soveri 1 , M. Mäkelä 2 . 1 Helsinki HealthCenter, Home Care Services, Helsinki; 2 National Institute for Healthand Welfare, Helsinki
Introduction: Alzheimer’s disease as well other types of dementias are inevitably progressive. Recognizing their terminal stage istherefore a basis in the adequate palliative care planning. Pain isbelieved to be under-treated in elderly, especially in patients withdementia.
Methods: Data from long-term care facilities was extracted fromthe Resident Assessment Instrument (RAI) database of Finnish
National Institute for Health and Welfare during the 3-year study
period. Study was descriptive and cross-sectional. Relationships
were performed as chi-squares and logistic multivariation tests.
Results: The total number of assessments was 23454. Mean age was
84 years and it was almost equally distributed across the country.
The number of residents over 90 years was signiﬁcantly higher in
Helsinki (27%) compared to the rest of Finland (22%). Two-thirds ofresidents were female. Opioids were used in more than a third of
all observations. Buprenorphine was the most common. Phentanyl(OR 0.35, 95% CI: 0.26–0.47) and buprenorphine (OR 0.73, 95% CI:
0.58–0.90) were signiﬁcantly less used in Helsinki. Opioids weresigniﬁcantly more used among patients over 90 years (OR 1.30,
95% CI: 1.05–1.62). Despite observed more pain, patients withdementia were more likely to receive lower doses of opioids in
Helsinki compared to those in other parts of Finland. However,the lowest percentage of use was found among nursing homeresidents.
Conclusion: Our results show that there are clear differences intreatment of patients with dementia at the end of life in Helsinkicompared to other parts of Finland, especially among nursing homeresidents.

Area: Pharmacology

O-062
Effect of the Mebrobamate removal on psychotropic drugs
consumption in patients with dementia (PACAL-Alz cohort)
L. Lagarde 1 , Q. Boucherie 1 , E. Ronﬂe 2 , J. Micallef 1 ,S. Bonin-Guillaume 1 . 1 APHM-AMU; 2 DRSM
Introduction: Describe the consumption of psychotropic drugs 6months after the withdrawal of Meprobamate (usually prescribedfor behavioral symptoms of dementia in France) in the PACA-Alz
cohort with the hypothesis of a switch to other psychotropic drugs.
Methods: Retrospective observational pharmacoepidemiologicalstudy from 10/01/2011 to 07/01/2012 based on Provence Alpes Côted’Azur region (PACA)-ALZ cohort including patients with the chronic
condition “Alzheimer disease or related disease” and/or had at least
one delivery of Alzheimer’s speciﬁc treatment, registered in the
General Health Care System. Four subgroups were analyzed according to the moment of the meprobamate removal announcement(October 2011) and the removal (10/01/2012). Chronic exposuredeﬁned as 3 consecutive deliveries.
Results: Among the 36442 subjects of the cohort, 11.1% had atleast a delivery of mebrobamate in 2011; out of which 44.6%(n=1814) were still consumers after the removal announcement.
Those who were the latest to stop meprobamate were more likely
to be on a chronic consumption (86.5%). In all groups, meprobamate
withdrawal was associated with an important increase of benzodiazepines (+15.3%, p<0.001) and antipsychotics consumption (+5.6%,

Oral presentations / European Geriatric Medicine 8S1 (2017) S1–S39

p<0.001), in particular in the subgroup who stopped in January
2012 (+25.1% and +10.0% respectively).
Conclusions: The removal of a psychotropic drug is associated tothe switch to others psychotropic classes. This should be taken into
account when speciﬁc warnings are published with pharmacoepidemiological studies to follow consumption modiﬁcations.
O-064
Trajectories of long-term exposure to anticholinergic andsedative drugs: A latent class growth analysis
H. Wouters 1 , S. Hilmer 2 , J. Van Campen 3 , H. Van Der Meer 1 ,H. Gardarsdottir 4 , L. Schaap 5 , M. Huisman 6 , P. Denig 7 , K. Taxis 1 ,D. Rhebergen 8 . 1 Dept. of Pharmacotherapy, Epidemiology &Economics, University of Groningen, Groningen, The Netherlands;
2 Dept. of Clinical Pharmacology and Aged Care, Kolling Institute, RoyalNorth Shore Hospital, Sydney, Australia; 3 Dept. of Geriatric Medicine,
Slotervaart Hospital, Amsterdam, The Netherlands; 4 Division of
Pharmacoepidemiology and Clinical Pharmacology, Utrecht University,
Utrecht, The Netherlands; 5 Dept. of Health Sciences, Amsterdam Public
Health Research Institute, VU University, Amsterdam, The Netherlands;
6 Dept. of Epidemiology & Biostatistics, Amsterdam Public HealthResearch Institute, VU University, Amsterdam, The Netherlands; 7 Dept.
of Clinical Pharmacy and Pharmacology, University Medical Center
Groningen, Groningen, The Netherlands; 8 Dept. of Psychiatry, VU
University Medical Center Amsterdam, Amsterdam, The Netherlands
Introduction: A variety of drugs, which are frequently prescribed toolder people, have anticholinergic and sedative effects whereby they
may impair cognitive and physical function. Although substantial
inter-individual variation in anticholinergic and sedative exposure
has been documented, little is known about subpopulations with
distinct trajectories of exposure.
Methods: Data from the Longitudinal Aging Study Amsterdam(LASA), an ongoing Dutch population-based cohort study, collected
over 20 years (1992–2012) at seven occasions, were analyzed. On
each occasion, cumulative anticholinergic and sedative exposure
was quantiﬁed with the Drug Burden Index, a linear additive
pharmacological dose-response model. The most likely numberof trajectories were empirically derived with Latent Class Growth
Analysis using “Goodness of ﬁt” statistics. Trajectories were thencompared on physical and cognitive function.
Results: A total of 763 participants completed all follow-ups (61%women; mean age 83, ±6). “Goodness of ﬁt” statistics (Bayesian Information Criterion = 22916, Bootstrapped Likelihood Ratio Test of 3
vs. 2 classes = 514.12 p<0.01, Entropy = 0.87) indicated the presenceof 3 distinct trajectories: “Gradual Increase” (67%), “Stable High”(8%), and “Steep Increase” (25%). Linear mixed models adjusted forco-morbidities and other covariates demonstrated poorer physicalfunction but not poorer cognitive function for “Stable High” and“Steep Increase” trajectories compared to the “Gradual Increase”
trajectory.
Conclusions: Three trajectories of long-term anticholinergic andsedative exposure were identiﬁed. The present ﬁndings need corroboration by examining whether more adverse trajectories areassociated with poorer outcomes on other measures of physical andcognitive function.
O-065
Implementing medication reconciliation for elderly hospitalized
in an orthopedic unit raised surgeons’ awareness to therapeutic
recommendations and led to decrease the cumulative exposure
to sedative and anticholinergic drugs
H. Capelle 1 , G. Hache 1 , P. Caunes 2 , D.A. Kerebel-Bucovaz 2 ,P. Bertault-Peres 1 , P. Villani 2 , A. Daumas 3 , S. Honoré 1 . 1 Service dePharmacie, Centre Hospitalier Universitaire de la Timone, Assistance

S21

Publique Hôpitaux de Marseille, France; 2 Service de médecine interne,
gériatrie et thérapeutique, Assistance Publique Hôpitaux de Marseille,
France; 3 Service de médecine interne, gériatrie et thérapeutique,
Assistance Hôpitaux de Marseille, France
Introduction: Sedative and anticholinergic medications are widelyused in older adults. They are associated with adverse clinicaloutcomes, especially falls that can lead to hospitalization. In the orthopedic unit, the mobile geriatric multidisciplinary team (MGMT)
is consulted to assess clinics of patients over 75. Recently, we haveintegrated systematic medication reconciliation and medication
review to therapeutic recommendations. The aim of our study wasto evaluate the impact of this process on in-hospital prescriptions,and exposure to sedative and anticholinergic drugs.
Methods: We recruited patients over 75 hospitalized in the orthopedic unit of a 1200-bed University Hospital. After a clinical assessment, medication reconciliation was performed and medication
review was implemented to provide therapeutic recommendations.
Cumulative exposure to anticholinergic and sedative drugs within
the chronic treatment was measured by the drug burden index(DBI). We retrospectively compared recommendations provided by
the MGMT, before and after implementation.
Results: 58 and 56 patients were recruited before and after implementation, respectively. Demographics and DBI at admission,
were comparable for both groups. After implementation: (i) the
number of therapeutic recommendations signiﬁcantly increased(1.7±2.0 vs 3.4±2.2 p<0.05), such as their acceptance rate (10±6% vs
67±35%; p<0.05); (ii) the DBI of chronic treatment was signiﬁcantly
decreased at discharge (1.09±0.72 vs 0.81±0.58, p<0.01).
Conclusion: Medication reconciliation ensured the process of medication history and provided a solid basis for medication review. We
had a signiﬁcant impact on cumulative exposure to anticholinergicand sedative drugs at discharge. Further studies are required toevaluate the long-term clinical impact.

Area: Ethics and end of life care

O-066
A high sense of coherence in old spousal caregivers protectsfrom burden
M. de Saint-Hubert 1 , J.-M. Degryse 2 , G. Aubouy 3 , S. Henrard 4 ,F. Potier 1 . 1 Dept. of Geriatrics, CHU Université catholique de Louvain,
Namur, and Institute of Health and Society (IRSS), Université
catholique de Louvain, Brussels, Belgium; 2 Institute of Health andSociety (IRSS), Université catholique de Louvain, Brussels, and Depts. of
Public Health and Primary Care, Katholieke Universiteit Leuven,
Leuven, Belgium; 3 Dept. of Geriatrics, CHU Université catholique deLouvain, Namur, Belgium; 4 Institute of Health and Society (IRSS),
Université catholique de Louvain, Brussels, and Clinical Pharmacy
Research Group, Louvain Drug Research Institute, Université catholiquede Louvain, Brussels, Belgium
Introduction: Studies about caregiving focus often on the “burden”
of the caregiver but few have looked at caregiver’s potential resources like the sense of coherence (SOC). SOC has 3 components(comprehensibility, manageability and meaningfulness) and has
been positively associated to perceived health and quality of life.
Our research question was: Has SOC an inﬂuence on the burden inolder caregivers?
Methods: Seventy-nine spousal caregivers of frail older patientswere recruited through the geriatric outpatient clinic. Data collected: Zarit Burden Inventory, SOC, Geriatric Depression Scale(GDS-15), sleep, time of supervision. Among care-receiver: Katz
Index, Global Deterioration Scale and Neuropsychiatric Index. A

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Oral presentations / European Geriatric Medicine 8S1 (2017) S1–S39

multivariable logistic regression was performed to identify thevariables which best predict caregivers’ burden. Results are presented as mean ± SD, median ± P25–P75, odd ratios (OR) and 95%
conﬁdence intervals (CI).
Results: Mean age was 79.4±5.3; 53% were women. Among carereceiver (mean age 81.6±5.3) 82% had cognitive impairment and the
median (P25-P75) Katz Index was 14 out of 24 (8–17). Caregivers’
burden mean score was 32 out of 88 representing a “mild to moderate burden” according to Zarit. Caregivers with a high SOC andcaregivers older than 80 years old showed a lower burden (OR=0.2;
0.05–0.68 & OR=0.88; 0.78–0.99, respectively). A higher burden was
associated with more ADL-dependency among the care-receiver(OR=9.31; 2.1–53.7).
Conclusions: Having a high sense of coherence seems to be aprotective factor against the burden. To support caregivers, healthproviders should recognize their expertise and the meaning of thiscare situation in order to enhance their positive reactions.

Area: Pre and post operative care

O-067
Pre-operative Geriatric Medicine Surgical Liaison Clinic:
A service evaluation
D. Scholes, N. Carroll, A. Gatignol, M. Johnston, J. Timperley. Royal
Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool,
United Kingdom
Introduction: We set up a pre-operative geriatric medicine clinic
for the frailest patients undergoing elective surgery. The nurse-led
pre-operative assessment clinic was asked to identify patients using
a validated frailty score.
Methods: The Edmonton Frail Scale (EFS) has been shown to bevalid for use by non-geriatricians [1]. Patients aged ≥65 with
EFS score ≥10 (orthopaedic surgery) or ≥7 (vascular or colorectal
surgery) were referred to a geriatrician pre-operatively.
Results: 47 patients (69–94 years, mean age 80.4) were reviewed.
43% did not meet referral criteria. This was disproportionately seen
with increasing age; 70% of patients aged <76 being appropriately
referred and 54% of patients aged ≥76. Only 35% of orthopaedicreferrals met the EFS criterion.Geriatricians recommended speciﬁc
interventions in 66% of patients. This did not correlate with EFS
and geriatric review was at least as likely to prompt a change
in management in patients with low EFS scores as in those withhigher scores.
Conclusions: Our results suggest limitations to the reproducibilityof EFS scoring and to its value in this setting. Bias towards referralto geriatric clinic may be introduced because of older patient age, orthe nature of the intended surgery. EFS served as a poor predictor
as to whether geriatrician review could drive medical optimisation
pre-operatively.Local practice has evolved, with referrals now basedon clinical concern from surgical or anaesthetic colleagues rather
than EFS.
References:[1] Rolfson DB et al. Validity and Reliability of the Edmonton Frail
Scale. Age and Ageing 2006 35(5) 526–9.
O-068
Isolated cardiac troponin rise does not modify the prognosis inelderly patients with hip fracture
H. Vallet 1 , A. Breining 2 , Y. Le Manach 3 , J. Cohen-Bittan 4 ,A. Mézière 2 , M. Raux 5 , M. Verny 6 , B. Riou 7 , F. Khiami 8 ,J. Boddaert 6 . 1 Geriatric Department and Unit of Peri-Operative
Geriatric care, Groupe Hospitalier (GH) Pitié-Salpêtrière, Assistance

Publique-Hôpitaux de Paris (APHP). Sorbonne University, University
Pierre and Marie Curie (UPMC) Paris 06, University Hospital
Department Fight Aging and Stress (DHU FAST), Paris, France;
2 Geriatric Department, Groupe Hospitalier (GH) Pitié-SalpêtrièreCharles Foix, Assistance Publique-Hôpitaux de Paris (APHP), Paris,
France; 3 Depts. of Anesthesia & Clinical Epidemiology andBiostatistics, Michael DeGroote School of Medicine, Population HealthResearch Institute, Perioperative Medicine and Surgical Research Unit,
Faculty of Health Sciences, McMaster University, Hamilton, Canada;
4 Geriatric Department and Unit of Peri-Operative Geriatric care,Groupe Hospitalier (GH) Pitié-Salpêtrière, Assistance PubliqueHôpitaux de Paris (APHP), Paris, France; 5 Dept. of Anesthesiology andCritical Care, Groupe Hospitalier (GH) Pitié-Salpêtrière, Assistance
Publique-Hôpitaux de Paris (APHP), Paris, France; 6 GeriatricDepartment and Unit of Peri-Operative Geriatric care, Groupe
Hospitalier (GH) Pitié-Salpêtrière, Assistance Publique-Hôpitaux deParis (APHP), Sorbonne University, University Pierre and Marie Curie(UPMC) Paris 06, University Hospital Department Fight Aging andStress (DHU FAST), Paris, France; 7 Dept. of Anesthesiology and Critical
Care (M.R.), Department of Emergency Medicine and Surgery, Groupe
Hospitalier (GH) Pitié-Salpêtrière, Assistance Publique-Hôpitaux deParis (APHP), Paris, France; 8 Dept. of Orthopedic Surgery and Trauma(F.K.) Groupe Hospitalier (GH) Pitié-Salpêtrière, Assistance PubliqueHôpitaux de Paris (APHP), Paris, France
Introduction: Perioperative myocardial infarction remains a lifethreatening complication in non-cardiac surgery and even an
isolated troponin rise (ITR) is associated with signiﬁcant mortality.
Our aim was to assess the prognostic value of ITR in elderly patientswith hip fracture.
Methods: In this cohort study, all patients admitted between 2009
and 2013 in our dedicated geriatric post-operative unit after hip
fracture surgery with a cardiac troponin I determination were
included divided into Control, ITR and acute coronary syndrome(ACS) groups. The primary end point was a composite criteriadeﬁned as 6 month mortality and/or re-hospitalization. Secondary
end points included 30-day mortality, 6 month mortality, and 6
month functional outcome.
Results: 312 patients were (age 85±7 years) divided into Control(n=217), ITR (n=50) and ACS (n=45) groups. There was no signiﬁcantdifference for any post-operative complications between ITR andControl groups. In contrast, atrial ﬁbrillation, acute heart failure,
hemorrhage, and ICU admission were signiﬁcantly more frequent in
the ACS group. Compared to the Control group, 6-month mortality
and/or rehospitalization was not signiﬁcantly modiﬁed in the ITRgroup (26 vs 28%, P=0.84, 95% CI of the difference -13 to 14%)
whereas it was increased in the ACS group (44 vs 28%, P=0.02, 95%
CI of the difference 2 to 32%). ITR was not associated with a higher
risk of new institutionalization or impaired walking ability at 6
month, in contrast to ACS group.
Conclusion: In elderly patients with hip fracture, ITR was not associated with a signiﬁcant increase in death and/or rehospitalization
within 6 months.
O-069
Clinical and functional differences at 1-year follow-up between
nursing home and community dwelling hip fracture patients
P. Rios German 1 , R. Menendez Colino 2 , R. Ramirez Martin 2 ,R. Velasco Guzman de Lazaro 2 , R. Queipo 3 , T. Alarcón 2 , A. Otero
Puime 3 , J.I. González Montalvo 2 . 1 Geriatrics Department, Hospital
Universitario La Paz, Madrid, Spain; 2 Geriatrics Department, Hospital
Universitario La Paz, Madrid, Spain; IdiPAZ, Spain; 3 IdiPAZ, Spain;
Preventive Medicine Department, Universidad Autónoma de Madrid,
Spain
Introduction: The aim of this study was to know if there are dif-

Oral presentations / European Geriatric Medicine 8S1 (2017) S1–S39

ferences in clinical and functional outcomes at 1-year of follow-up
between nursing home (NH) and community dwelling (CD) hip
fracture (HF) patients.
Methods: All patients admitted with HF from January 2013 throughFebruary 2014 to a co-managed orthogeriatric unit in a 1,100-bed
university hospital were included. A geriatric assessment protocol
was applied and patients were treated with a speciﬁc protocol
aimed to improve function, nutrition, bone metabolism, pain andanaemia. They were classiﬁed in function of their previous place ofresidence. One year after HF, patients or relatives were contacted
by telephone and requested about vital and functional status andreadmissions. The impairment of the gait was moderate/severe if
the patient had ≥2/5 points decline in the Functional Ambulatory
Category Scale.
Results: Five hundred and nine patients were included, 116 (22.8%)of them were admitted from NH. At 1 year follow-up NH patients
had a similar mortality rate than CD patients (27.6% vs 21.9%,
p=0.201), they had similar hospital readmissions (27.6% vs. 23.6%,
p=0.479), they reached their baseline gait ability less frequently(38.5% vs 56.2%, p<0.001). The impairment of gait was moderate/severe more frequently (41.0% vs 18.8%, p<0.001) in NH than in
CD patients.
Conclusions: HF patients admitted from NH and treated by meansof a speciﬁc orthogeriatric assessment and management protocol
did not die or were readmitted more frequently at 1-year follow-up
but they had more functional decline than CD patients.
O-070
Preoperative geriatric assessment and tailored interventions infrail older patients with colorectal cancer. A randomised
controlled trial
N. Ommundsen 1 , T.B. Wyller 1 , A. Nesbakken 2 , A.O. Bakka 3 ,M.S. Jordhøy 4 , E. Skovlund 5 , S. Rostoft 1 . 1 Dept. of Geriatric Medicine,
Oslo University Hospital, Norway; 2 Dept. of Gastrointestinal Surgery,
Oslo University Hospital, Norway; 3 Dept. of Digestive Surgery, Akershus University Hospital, Norway; 4 Cancer Unit, Innlandet Hospital
Trust, Norway; 5 Dept. of Public Health and Nursing, NTNU, Norway
Background: Colorectal cancer (CRC) is prevalent in the older
population, and surgery is the mainstay in curative treatment.
A preoperative geriatric assessment (GA) can identify frail older
patients at risk for developing postoperative complications. In thisrandomised controlled trial we wanted to investigate whether
tailored interventions based on a preoperative GA could reduce thefrequency of postoperative complications.
Methods: Patients >65 years scheduled for elective CRC surgery
and fulﬁlling predeﬁned criteria for frailty were randomised toeither a preoperative GA followed by a tailored intervention, or careas usual. Primary endpoint was severe postoperative complications.
Secondary endpoints included any complication and survival.
Results: 122 patients with a mean age of 78.6 years were randomised. Time from inclusion to surgery was median 6 days. We
found no statistically signiﬁcant differences between the intervention group and the control group for severe complications (68% vs75%, p=0.43) or 30-day survival (4% vs 5%, p=0.79). Any complication
occurred in 76% of intervention group patients compared to 87%
in the control group (p=0.10). In secondary analyses adjusting forprespeciﬁed prognostic factors, there was a statistically signiﬁcantdifference in favour of the intervention for reducing the total
number of complications (p=0.05).
Conclusion: A preoperative GA and tailored interventions did not
reduce the rate of severe complications in frail older patients
electively operated for CRC. Secondary analyses showed an effectof the intervention for reducing the total number of complications.
This effect was due to a reduction of less severe complications in
the intervention group.

S23

O-071
Prognostic value of the Erasmus Frailty Score on post-operativedelirium after transcatheter aortic valve implantation in older
patients. The TAVI Care & Cure study
J. Goudzwaard, M. de Ronde-Tillmans, N. El Faquir, F. Acar, N. vanMieghem, M. Lenzen, P. de Jaegere, F. Mattace-Raso. Erasmus
University Medical Center
Introduction: Post-operative delirium (POD) is a frequent and severe complication in older patients undergoing TAVI. However, little
is known about the prognostic value of frailty on POD. This study
investigated the potential independent value of a novel, self-developed frailty score in predicting delirium after TAVI in older patients.
Methods: TAVI Care & Cure is an observational ongoing study
including consecutive patients undergoing TAVI at the Erasmus University Medical Centre. Prior to TAVI, a frailty status was assessed.
The Erasmus Frailty Score was deﬁned as follows: 1 point assigned
when: MMSE was <27 points, MUST <2 points, grip strength <20
kg for females, <30 kg for males, KATZ index ≥1 limited activity,
Lawton and Brody index ≥2 limited activities. Maximum score
was 5. Patients were classiﬁed as frail when the score was ≥3.
Presence of delirium was evaluated by daily clinical assessment by ageriatrician pre- and post TAVI. Primary outcome was to investigate
the predictive value of frailty on delirium in TAVI patients. Logistic
regression was used.
Results: 213 patients were included for analysis. Incidence of POD
was 19.5% (n=50). A frailty score of ≥3 was signiﬁcantly morepresent in the group of patients developing a delirium (OR 2,9(95% CI 1,30–6,6], p=0.009). Other independent predictors of POD
included: age (OR 1.10 [95% CI 1.01–1.19], p=0.021), previous stroke(OR 6.36 [95% CI 2.2018.40], p=0.001), MUST-score ≥2 (OR 2.8 [95%CI 1.03–7.44], p=0.043), and cognitive disorder (p=0.015).
Conclusion: The Erasmus Frailty Score is an independent predictorof POD in the elderly.
O-072
Impact of anticoagulants and antiplatelet agents on long-term
mortality after hip fracture
K.L. Quiñones Huayna, L. Del Rosario Evangelista Cabrera, P. Cabezas
Alfonso, J. Mora Fernández. Hospital Clínico San Carlos, Madrid, Spain
Objectives: To evaluate the impact of preoperative anticoagulant
and antiplatelet therapy on the long-term mortality of hip fracture
patients.
Methods: One-year follow-up study including patients aged >65
admitted with hip fracture. Variables: demographic, functional(Barthel Index – BI, Functional ambulation classiﬁcation – FAC,
Lawton index – LI), comorbidity (Charlson’s Index – CCI), time tosurgery (T-Surg), length of stay (L-stay), use and type of Anticoagulant and antiplatelet agents, admission haemoglobin (Hb-a), lowest
haemoglobin level (Hb-L), blood transfusion, complications andmortality at 1-year follow-up. Statistical analysis: Chi-square andMann-Whitney U test, Kaplan-Meier survival curves, Cox regression
model. SPSS 23.0.
Results: n=418, mean age 84.9 (SD: 7.2), women 79.9%, BI 85 (IQR =65–95), FAC 4 (IQR = 3–5), CCI 6.4 (SD: 2.0), cognitive impairment
43.5%. T-Surg 3.8 (IQR = 2.1–5.5); L-stay 9.3 (IQR = 6.4–14.7). Anticoagulants 15.8% (acenocumarol 86.2%). Antiplatelet agents 34.4%(Acetylsalicylic acid 100mg/day 76.9%, 300mg/day 9.0%, Clopidogrel
9.0%). Hb-a 12.5; Hb-L 8.9; preoperative blood transfusion 24.7%.
Complications: delirium 45.6%, heart failure 16.5%, kidney injury
25.9%. In-hospital mortality 3.3%, one-year mortality 15.2% (anticoagulant therapy 18.3%, antiplatelet therapy 17.1%, and other 9.8%;
with no differences between groups). There was statistical association between death and sex, age, functional status, comorbidity,
Hb-a, length of stay and complications (p<0.05). Predictors ofS24

Oral presentations / European Geriatric Medicine 8S1 (2017) S1–S39

one-year mortality in multivariate analysis: men HR 2.18 (p=0.010),
age HR 1.04 (p=0.054), CCI HR 1.28 (p<0.001), kidney injury HR 2.62
(p=0.001), and delirium HR 2.07 (p=0.025).
Conclusions: There was no association between use of anticoagulant and antiplatelet agents and mortality 1-year follow-up in our
sample; being demographic, comorbidity, and certain complications
the main predictive factors.
O-073
Consultants of the week model in orthogeriatric care
R. Lisk, K. Yeong. Orthogeriatrics Department, Ashford & St. Peter’s
NHS Foundation Trust
Objectives: There are various models of orthogeriatric care. This
includes older models such as the traditional model of orthopaediccare and post-operative geriatric care. Newer models include orthopaedic patients having routine orthogeriatric review, admitted
under geriatricians and shared care (patients are managed throughout their stay by a named orthopaedic surgeon and a named
orthogeriatrician within a deﬁned orthogeriatric team).
Methods: We use the shared care model but noted that the orthogeriatrician focused on the hip fracture patients (NoFs) whereas
the orthopaedic surgeon focused on the other trauma patients. The
medical needs of the trauma patients were not addressed early andat times the orthopaedic needs of the hip fracture patients were
delayed.In November 2016, we implemented the CoW, whereby thesame orthopaedic surgeon and orthogeriatrician saw every patienton the ward round.
Results: 6 months before the CoW model (July – Oct 2016), theLength of Stay (LOS) for NoFs was 13.13 days and 4 months after
the CoW model (Nov–Feb 2017), the LOS was 13.33 days.For othertrauma patients, before CoW, LOS was 7.77 days and after CoW 6.49
days.We receive 400 NoFs and 1291 other traumas annually. Witha 1.28 day reduction for other trauma; the cost savings (£275/bed)
is approximately £454,432 for other trauma with total net savingof £432,432. Midnight bed occupancy: 26.77 before CoW and 24.44
after COW.Readmissions: 16.0% before CoW and 13.1% after CoW.
Conclusion: The CoW model reduced the LOS for trauma patientswith signiﬁcant cost-savings.
O-074
Association between actigraphy sleep parameters and recovery
of walking ability after hip fracture
R. Haddad 1 , J. Cohen Bittan 2 , C. Chalﬁne 2 , L. Dourthe 2 , H. Vallet 3 ,L. Zerah 3 , A. Gioanni 3 , M. Verny 3 , A. Mézière 4 , K. Kinugawa 5 ,J. Boddaert 3 . 1 Sorbonne University, UPMC University Paris 06, GRC 02,
Group of Clinical Research in Neuro-Urology (GREEN), Rothschild
Hospital, Neuro-rehabilitation Department, Assistance Publique
Hôpitaux de Paris (APHP), Paris, France; 2 Unit of Peri-Operative
Geriatric Care, Geriatric Department, Hôpitaux universitaires PitiéSalpêtrière-Charles Foix. DHU FAST, Assistance Publique Hôpitaux deParis (APHP), Paris, France; 3 Sorbonne University, University Pierre
and Marie Curie Paris 06, University Hospital, Paris; Unit of PeriOperative Geriatric Care, Geriatric Department, Hôpitaux
universitaires Pitié-Salpêtrière-Charles Foix. DHU FAST, Assistance
Publique Hôpitaux de Paris (APHP), Paris, France; 4 Rehabiliation
Geriatric Department, Hôpitaux Universitaires Pitié Salpêtrière-Charles
Foix, AP-HP, Paris, France; 5 Sorbonne University, University Pierre andMarie Curie Paris 06, University Hospital, Paris; Functional Exploration
Unit, Hôpitaux universitaires Pitié-Salpêtrière-Charles Foix. DHU FAST,
Assistance Publique Hôpitaux de Paris (APHP), Paris, France
Introduction: Several studies had shown an association between
sleep disorders and sarcopenia, cognitive function, mood and mortality, especially among elderly with osteoporotic fracture. The
main objective of this study is to examine the association between

objective sleep parameters and recovery of walking ability in acutecare after hip fracture.
Methods: All patients admitted within 3 days after hip fracture
surgery (HFS) into a dedicated unit of peri-operative geriatric(UPOG) care and who completed wrist actigraphy were included.
Actigraphy was used to record sleep parameters including total
sleep time, daytime and nighttime sleep duration and a sleep-wakeparameter, the circadian rhythm, which refers to the relationshipbetween daytime and nighttime activity. Demographic and medical
data were also prospectively collected and especially if patient hador not a walking disability prior to the fracture.
Results: From 06/2015 to 03/2017, 133 patients were included (age87±6 years; men 17.3%, dementia 39%, CIRS 10±4, previous walking
disability 65%). After discharge, 68% patients recovered previous
ambulation status (95.4% with previous walking disability, 15.2%
without). In patients with previous walking disability, recovery
was inversely associated with daytime sleep duration (p=0.047),
and positively associated with circadian rhythm (p=0.002) andnighttime activity (p<0.001). No association was found in patients
without walking disability.
Conclusion: In elderly patients with hip fracture surgery managed
in UPOG care pathway, recovery of previous ambulation status atdischarge is associated with daytime sleep duration and physicalactivity assessed by actigraphy at admission.

Area: Cognition and dementia

O-075
Relationship of brain amyloid deposition to daily functioning inolder adults without dementia: A longitudinal study from the
MAPT trial
M. Cesari 1 , P. Payoux 2 , S. Andrieu 1 , B. Vellas 1 . 1 Gerontopole,
Toulouse, France; 2 Department of Nuclear Medicine, Toulouse, France
Objectives: Amyloid plaques are pathologic features of Alzheimer’s
disease and negatively impact the longitudinal course of cognitive
function in older adults. However, the longitudinal evolution ofdaily limitations in amyloid positive individuals remains largely
unknown so far. Here we aimed at examining the evolution of
instrumental activities of daily living (IADL) performance according
to the presence of brain amyloid deposition. Design: Observational longitudinal analysis. Setting: Amyloid Positon Emission
Tomography (PET) ancillary study from the Multidomain Alzheimer
Prevention Trial. Participants: 269 community dwelling elders aged
70 and over without dementia. Measurements: Linear mixed models were performed to assess the 36-month modiﬁcation of ADL-PI
performance according to the presence of amyloid deposition(Standardized Uptake Value ≥1.17). Additional analyses were also
performed to examine the changes in speciﬁc domains of dailyfunctioning. Analyses were also performed with adjustments forage, gender, ApoE and randomization group.
Results: Among our participants (women = 60%, age = 75±4
years), 102 (37.9%) were amyloid positive. Amyloid negative subjects showed a statistically signiﬁcant improvement in ADL-PI total
score (p=0.04 after 36 months). The difference in change between
the amyloid positive and negative participants was not signiﬁcant(β=−0.95±0.53 after 36 months, p=0.08). These changes in IADL
performance after 3 years were consistent in adjusted models(β=−1.04±0.53, p=0.07). Amyloid positive subjects were also likely
to present more diﬃculties in memory tasks (β=−0.45±0.24, p=0.06)
than their amyloid negative counterparts.
Conclusion: Amyloid positive elders showed poorer IADL performance after 3 years. Future research is needed to better understandthe relationship of amyloid plaques to functional limitations.

Oral presentations / European Geriatric Medicine 8S1 (2017) S1–S39

O-076
Corneal Confocal Microscopy a potential surrogate end point for
mild cognitive impairment and dementia
H. Al Hamad 1 , E. Al Sulaiti 2 , G. Ponirakis 3 , A. Khan 3 , M. Ramadan 4 ,A. Shuaib 5 , R.A. Malik 3 , M. Al Obaidili 2 , S. Osman 2 . 1 Rumailah
Hospital, Hamad Medical Corporation; 2 Geriatric Dept., Rumailah
Hospital; 3 Weill Cornell Medicine-Qatar; 4 Geriatric Clinic, Rumailah
Hospital; 5 Neuroscience Institute, Hamad General Hospital
Background: There are no validated biomarkers to diagnose mild
cognitive impairment (MCI) or dementia. Corneal confocal microscopy (CCM) is a non-invasive ophthalmic device which candetect neuronal loss, characterised by a reduction in corneal nerve
ﬁbre density (CNFD), branch density (CNBD) and length (CNFL).
We have pioneered CCM as a surrogate marker of neuronal loss
in a range of peripheral neuropathies and more recently in central
neurodegenerative conditions like Parkinson’s disease and Multiple
Sclerosis.
Aims: To evaluate the association between cognitive impairment
and corneal axonal loss in individuals with MCI and dementia.
Methods: 56 subjects (20 with MCI, 14 with dementia and 22
controls) underwent assessment of cognitive impairment (MoCA)
and CCM.
Results: Comparing dementia vs MCI vs controls, CNFD (24.33±1.9
vs 25.68±2 vs 32.53±1.8, p=0.008), CNBD (78.1±12.5 vs 92.76±10.1 vs120.51±10.7, p=0.02) and CNFL (19.92±1.8 vs 21.28±1.4 vs 26.09±1.3,
p=0.01) were signiﬁcantly reduced. Age (74.2±2.4 vs 69.1±1.7 vs67.9±1.8) p=0.09 and HbA1c (6.49±0.4 vs 6.94±0.4 vs 7.27±0.34%)
p=0.4 were comparable between subjects with dementia, MCI andcontrols, respectively. Furthermore, in a multiple linear regression
model adjusted for age and HbA1c, there was a signiﬁcant association between loss of cognitive ability and CNFD (R2=30.5%, F=6.44,
p=0.001), CNBD (R2=28.26%, F=5.78, p=0.002) and CNFL (R2=29.55%,
F=6.15, p=0.001).
Conclusion: CCM detects axonal loss and may therefore act as a
viable surrogate end point for clinical trials in patients with MCI ordementia.
O-077
Reperfusion therapy and long-term outcomes in patients with
ST-elevation myocardial infarction and pre-existing dementia
C.-L. Liu 1 , C.-L. Lai 2 , R.N.-C. Kuo 3 , Y.-Y. Yang 4 , K.A. Chan 5 ,M.-S. Lai 6 . 1 Dept. of Internal Medicine, Taipei City Hospital
Heping-Fuyou Branch, Taipei, Taiwan; 2 Dept. of Internal Medicine andCenter for Critical Care Medicine, National Taiwan University Hospital
Hsin-Chu Branch, Hsin-Chu, Taiwan; 3 Institute of Health Policy andManagement, College of Public Health, National Taiwan University,
Taipei, Taiwan; 4 Center for Comparative Effectiveness Research,
National Center of Excellence for Clinical Trial and Research, National
Taiwan University Hospital, Taipei, Taiwan; 5 Dept. of Medical
Research, National Taiwan University Hospital, Taipei, Taiwan;
6 Institute of Epidemiology and Preventive Medicine, College of Public
Health, National Taiwan University, Taipei, Taiwan
Introduction: ST-elevation myocardial infarction (STEMI) patientswith dementia were less likely to receive reperfusion procedures
than those without mental disorders but the long-term outcomes
were inconclusive. In this study, we examined the long-term
outcomes of patient with dementia between the groups of withreperfusion and without reperfusion in an incident STEMI cohortfrom a population-based database.
Methods: Using the data claimed by Taiwan National Health Insurance between 2003 and 2009, incident cases of STEMI with age
over 65 years with dementia were identiﬁed. We identiﬁed 759
eligible patients, 402 with and 357 without reperfusion therapies in
the course of hospitalization for STEMI until 2012. Adjusting for age,

S25

gender and comorbidities, we used survival analysis for all-cause,
cardiovascular (CV), non-CV mortality and hospitalization due toheart failure and analyzed the risk of mortality by stratiﬁed thedifferent hospital levels.
Results: Participants had a mean age of 80.3 years (47.8% female).
The group without reperfusion was associated with increased riskof long-term all-cause mortality rate (Hazard Ratio (HR) 1.69, pvalue <0.001) and CV mortality rate (HR 2.32, p-value <0.001). The
risk of CV mortality between without and with reperfusion therapy
group was higher in medical center (HR 4.41, 95% CI: 2.21 to 8.77)
than regional hospital (HR 3.06, 95% CI: 1.70 to 5.52) and local
hospital (HR 1.34, 95% CI: 0.37 to 4.85).
Conclusions: STEMI older patients with dementia who didn’t receive reperfusion therapy showed higher mortality risk. In higher
hospital level, the beneﬁt of reperfusion therapy was more signiﬁcant.
O-078
Hippocampal calciﬁcations: Risk factors and association withcognitive functioning
E. de Brouwer. UMC Utrecht, the Netherlands
Background: Hippocampal calciﬁcation (HCC) is commonly seen
on computed tomography (CT) in people above 50 years old. The
etiology and possible association with cognitive functioning ispoorly understood. Our aim was to identify risk factors for HCC and
to investigate the association of HCC with cognitive functioning.
Methods: Consecutive patients visiting a memory clinic of a Dutch
general hospital between April 2009 and April 2015 were identiﬁed.
All individuals underwent a standard routine diagnostic work up
including cognitive tests and a CT scan of the head. Vascular risk
factors as hypertension, diabetes mellitus (DM), hyperlipidemia andsmoking were assessed. Cognitive screening consisted of the Cambridge Cognitive Examination (CAMCOG), Visual Association Test
(VAT) and the Clock Drawing Task (CDT). CT scans were analyzed bypresence and severity (absent, mild, moderate or severe) of HCC.
Results: A total of 1991 patients (median age 80 years, inter quartile
range 73; 85) were included, of whom 380 (19.1%) had HCC. Increasing age (odds ratio [OR] per year 1.05, 95% conﬁdence interval[CI] 1.03–1.07), DM (OR 1.49, 95% CI 1.12–2.00) and current smoking(OR 1.50, 95% CI 1.05–2.14) were associated with the presence of
HCC. No associations were found between presence and severity of
HCC and cognitive functioning.
Conclusions: Increasing age, DM and current smoking appear to
be associated with an increased risk of HCC. However, there is noevidence from this study that HCC has a role in the multicausal
etiology of dementia.
O-080
The relationship between stress, carotenoids and cognitive
function in The Irish Longitudinal Study on Ageing (TILDA)
J. Feeney-Beckett 1 , R.A. Kenny 2 . 1 Centre for Public Health Queen’s
University Belfast, United Kingdom and The Irish Longitudinal Studyon Ageing, Trinity College Dublin, Ireland; 2 The Irish Longitudinal
Study on Ageing, Trinity College Dublin, Ireland
Introduction: It is well established that psychological stress canadversely affect cognition. Dietary antioxidants have long been
associated with health beneﬁts, via a putative reduction in cellularstress. Recently the antioxidant carotenoids lutein and zeaxanthinhave been associated with better cognition. Therefore, the study
aim was to investigate whether these carotenoids can buffer thenegative impact of psychological stress on cognition.
Methods: The sample comprised 3,577 older adults, who were partof The Irish Longitudinal Study on Ageing. Cognitive function wascomprehensively assessed at baseline and 4 years later. Stress was

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Oral presentations / European Geriatric Medicine 8S1 (2017) S1–S39

measured using the 4-item Perceived Stress Scale. Blood levels of
the carotenoids lutein and zeaxanthin were measured at baseline.
Covariates included demographics, education, health conditions,and health behaviours. The effect of stress, carotenoids and theirinteraction on cognitive function was analysed using mixed-effects
regression.
Results: Stress was negatively associated with global and memory
scores. There was a positive main effect of zeaxanthin on memory(b=−1.12, p<0.05, 95% CI: −2.24, −0.006). There was also a signiﬁcanteffect of the interaction between zeaxanthin and stress on memory
scores such that, among individuals with higher stress, those withhigher levels of zeaxanthin showed better memory than those withlower zeaxanthin (b=0.32, p<0.01, 95% CI: 0.08, 0.55). There was no
signiﬁcant effect of the interaction on the other cognitive domains.
Conclusions: There is limited evidence that antioxidant compounds
such as lutein and zeaxanthin may have a protective role in stressrelated cognitive dysfunction. More detailed study is warranted.
O-081
The effect of a cognitive stimulation program on
institutionalized elderly: a randomized controlled trial
V. Parola 1 , A. Coelho 1 , H. Neves 1 , A. Mouro 2 , M. Almeida 3 ,S. Duarte 3 , A. Cavaleiro 3 , D. Cardoso 1 , J. Apóstolo 1 . 1 Health Sciences
Research Unit: Nursing, Nursing School of Coimbra, Portugal; Centre
for Evidence-Based Practice: a Joanna Briggs Institute Centre of
Excellence, Portugal; 2 Santo Antonio Nursing Home, Portugal; 3 Health
Sciences Research Unit: Nursing, Nursing School of Coimbra, Portugal
Introduction: Cognitive stimulation therapy (CST) offers a rangeof activities, which provide general stimulation for thinking, concentration, and memory, commonly in a social setting. This paper
describes the effectiveness of CST on cognition and depressive
symptoms in older adults in nursing homes (NHs).
Methods: A randomized controlled trial, carried out in 2016,
included 100 residents from ﬁve NHs, 75 women and 25 men(randomized into experimental (n=49) and control groups (n=51)).
Six participants dropped out (intention to treat (ITT) analysis andper protocol (PP) analysis were performed). During 7 weeks, participants of the experimental group underwent 14 CST sessions,and participants of the control group received usual care. The
Mini-Mental State Examination, the Geriatric Depression Scale-15,
were administered at baseline and postintervention.
Results: Inferential statistics revealed that CST increased cognitionin the experimental group (p<0.01; R2 (%) =58.82), although evidence of differences between groups in depressive symptoms was
not found (p>0.05; R2 (%) =43.4). However, from a clinical pointof view, in the experimental group there was evidence of depressive symptoms reduction (p<0.05), while there was no evidence
reduction in the control group (p>0.05).
Conclusions: CST had signiﬁcantly improved cognition, with amoderate signiﬁcant correlation, but there was no statistical evidence of its effectiveness on depressive symptoms. These results
support the implementation of CST in NHs. Additionally CST may
also have an important economic impact by reducing the costs of
the impact of elders’ cognitive frailty.
O-082
Optimization of antipsychotic drug’s prescription through aneﬃcient personalized awareness campaign towards nursing
home residents suffering from dementia
A.S. Philippe 1 , D. Braunstein 1 , S. Tessier 2 , B. Roch 3 , J. Micallef 1 ,S. Bonin-Guillaume 1 . 1 Assistance Publique Hôpitaux de Marseille, Aix
Marseille Université; 2 EHPAD La bastide des Oliviers, ORPEA, Vitrolles;
3 COS Saint Maur, Marseille
Introduction: Antipsychotics drugs (AP) are commonly used totreat behavioral and psychological symptoms in dementia (BPSD)
although their non-negligible adverse effects. Despite several warnings, the prevalence of AP use remains high, particularly in nursing
homes (NH).
Aim: Optimizing the AP’s prescription of NH residents sufferingfrom dementia, with a personalized awareness campaign to theresident’s general practitioner (GP) by the NH practitioner. Study
design: Observational prospective multicentric study.
Methods: All permanent NH residents suffering from dementia or
cognitive impairment that are treated with AP were included in
the study. Each related NH’s practitioners were asked to ﬁll up aquestionnaire for every resident, based on her/his medical record.
Then, the practitioner asked the resident’s general practitioner(GP) to reevaluate the need of the AP’s prescription after giving
information about the beneﬁce/risk of AP in these indications andreminding national warnings about AP’s prescriptions in NH.
Results: 30 NH volunteered to participate for a total of 2344 residents. Out of those residents, 24% were under AP regimen, 15% werediagnosed demented and had AP’s prescriptions. 317 residents’ ﬁlewere retained; 80,1% of which had an atypical AP’s prescription.
Most of the residents had a psychotropic drugs coprescription(anxiolytic Benzodiazépines and BZD-like: 43.2%; Antidepressants:
33.1%; Hypnotics: 16.1%). Only 187 ﬁles (60%) were completed by
the GPs. After the campaign, 44.8% of the AP’s prescriptions were
modiﬁed by the GP (15.5% withdrawal, 19.3% dose modiﬁcation).
Conclusion: The number of AP’s prescription is high in NH residents with dementia and is often associated to other psychotropic
drugs prescription. Personalized awareness campaign showed an
improvement in optimizing AP’s prescription in this population.
This has to be conﬁrmed with the follow up of this cohort.

Area: Acute careO-083
Acute heart failure management and treatment in the elderly:
adherence to current guidelines in the real world. Data from the
ATHENA Registry
A. Pratesi 1 , F. Orso 2 , A.C. Baroncini 2 , A. Lo Forte 2 , C. Ghiara 2 ,S. Parlapiano 3 , A. Herbst 3 , G. Biagioni 3 , F. Fedeli 3 , M.L. Di Meo 2 ,E. Carrassi 3 , N. Marchionni 4 , M. Di Bari 2 , L. Gabbani 5 , A. Ungar 2 ,S. Baldasseroni 2 . 1 Geriatric Intensive Care Unit, Careggi University
Hospital, Florence; University of Florence, Florence, Italy; 2 GeriatricIntensive Care Unit, Careggi University Hospital, Florence, Italy;
3 University of Florence, Florence, Italy; 4 Division of General Cardiology,
Careggi University Hospital, Florence, Italy; 5 Department of Medicine
and Geriatrics, Florence, Italy
Introduction: Heart failure (HF) has a high prevalence in the elderly. Aim of our study was to compare adherence to current clinicalguidelines in the management of elderly patients hospitalised for
acute HF in the settings of care of most frequent management:
cardiology, internal medicine and geriatrics.
Methods: Data derived from the ATHENA retrospective observational study which included elderly patients (≥65 years) admitted
for acute HF to the emergency department of a tertiary University
teaching-hospital and transferred to the above described settings ofcare in the period 01.12.2014–12.01.2015.
Results: 342 patients composed the study population; 17.8% were
hospitalised in cardiology, 17.3% in geriatrics and 64.9% in internal
medicine. Mean age was 83.7 years, females were 54.1%. 28.1% of
the patients had not performed any echocardiographic evaluation
during hospitalization. In 44% of patients, no information regarding
body weight measurement was collected during hospitalisation. In
patients with HF with reduced ejection fraction prescription rates

Oral presentations / European Geriatric Medicine 8S1 (2017) S1–S39

for beta-blockers, ACE-inhibitors/angiotensin receptor blockers andmineralocorticoid receptor antagonists were 77.3%, 58.6% and 49.3%
respectively, without signiﬁcant differences across the consideredsettings of care. A clinical FU at the discharge was scheduled onlyin 16.0% of the total study population, 70.0% in cardiology, 7.0% in
geriatrics and 5.0% in internal medicine; p=0.001).
Conclusions: In elderly patients hospitalised for acute HF a low
adherence to current international guidelines recommendations
regarding HF management could be observed. This was particularly evident for non-pharmacological strategies that are known to
reduce the risk of rehospitalisation.
O-084
Screening for frailty in the Emergency Department: The utility of
The SHARE-FI in predicting outcomes in a cohort of older
patients
A. Fallon, L. Kilbane, R. Briggs, T. Coughlan, R. Collins, D. O’Neill,
S. Kennelly. Department of Age-Related Healthcare, Tallaght Hospital,
Dublin 24
Introduction: Greater numbers of older patients are accessing hospital services. Specialist geriatric input at presentation may improveoutcomes for high risk patients. The Survey of Health, Ageing andRetirement in Europe Frailty Instrument (SHARE-FI) was developedfor use in the community but has been shown to be useful in theemergency department (ED). To measure frailty, review its prevalence in older patients presenting to ED and compare characteristics
and outcomes of frail patients with their non-frail counterparts.
Methods: Prospective cohort study was carried out with prespeciﬁed convenience sampling of those aged ≥70 years presenting
to ED on a 24/7 basis, from January-August 2014. Patient characteristics were recorded using symphony® electronic data systems;
SHARE-FI assessed frailty. Cognition, delirium and six and twelve
month outcomes were reviewed.
Results: Older patients were more likely to die (OR2.34, 95%
CI1.30–4.21, p=0.004) and less likely to be alive and at home attwelve months (OR=0.49, 95% CI: 0.23–0.83, p=0.009). Patients withdementia (OR=0.24, p=0.005) and on ≥5 medications (OR=0.37,
95% CI: 0.16–0.87, p=0.022) had a lower likelihood of being alive
and at home at twelve months. Frailty was not associated with asigniﬁcant difference in mortality rates (OR=0.89, 95% CI:0.58–1.38,
p=0.614) or being alive and at home at twelve months (OR=1.07,
95% CI: 0.72–1.57, p=0.745).
Conclusions: This study suggests SHARE-FI was an inappropriate
screening instrument in ED. It may be more useful to treat all older
patients as being at risk of adverse outcomes. New screening tools
to assess older patients presenting to hospital are required.

Area: Longevity and prevention

O-085
The obesity paradox: A result of mismeasurement?
K. Bowman 1 , D. Melzer 2 . 1 University of Exeter; 2 University of Exeter& University of Connecticut Health Center
Introduction: In middle aged cohorts, being overweight (BMI
25–29.9) or moderately obese (BMI 30–34.9) is clearly associatedwith increased mortality, but in later life reduced mortality has
been reported. This opposing mortality risk is termed the obesity
paradox in older people. We aimed to examine this paradox byassessing the impact of smoking, conditions associated with weight
loss, and measurement errors associated with BMI, in very large
cohorts.
Methods: We used electronic medical records (from Clinical Prac-

S27

tice Research Datalink) for nearly 1 million primary care patients
aged ≥60 years, with 14.9 years of follow-up. We also used UK
Biobank data, including 500,000 volunteers aged 40 to 69 years,
with 8 years of follow-up.
Results: Mean BMI declines progressively for 14 years before death,potentially biasing risk estimates. Mortality is increased for moderately obese patients aged ≥60 years after properly accounting
for smoking and conditions associated with weight loss. The risk
paradox is explained further by central adiposity not being measured by BMI. Measures combining BMI and waist-to-hip ratio
classiﬁed patients more accurately: there were major excess risks
for mortality and incident cardiovascular disease in overweight ormoderately obese but otherwise healthy 60 to 69 year olds.
Conclusions: In later life, people within BMI deﬁned overweight orobesity are at substantially increased risk for mortality and incident
cardiovascular disease after accounting for confounding conditions.
Calls to amend policies for obesity prevention and to promotehealthy ageing are unwarranted.

Area: Metabolism and nutrition

O-086
Associations between dietary intake and resistance exercise withchange in body composition and physical function among
elderly
O.G. Geirsdottir 1 , A. Ramel 1 , M. Chang 2 , K. Briem 3 , P.V. Jonsson 4 ,I. Thorsdottir 1 . 1 Unit for Nutrition Research, The National University
Hospital of Iceland & Faculty of Food Science and Nutrition, Universityof Iceland, Reykjavik, Iceland; The Icelandic Gerontological ResearchInstitute; 2 The Icelandic Gerontological Research Institute;
3 Department of Physical Therapy, University of Iceland; 4 School of
Medicine, University of Iceland, Reykjavík, Iceland; The Icelandic
Gerontological Research Institute
Background: Age related changes in body composition and physicalfunction are important factors in healthy aging. Dietary intake andphysical resistance exercise (RE) can affect these changes. The aimof this study was to investigate the associations between dietaryintake and resistance exercise with change in body compositionand physical function (PF) among elderly Icelanders.
Method: Intervention study with RE for 12 weeks. Participants
were community dwelling, aged 65 years and older (60% females).
Body composition was measured using DXA. Quadriceps- and grip
strength was measured. PF was measured as timed up and go test
(TUG) and the 6 minute walk for distance (6MWD). Three day
weighed food records were analysed.
Results: On average, all outcome parameters improved signiﬁcantly
after the RE intervention. However, 19% lost lean mass (LM) after
the intervention. Where those who lost LM had lower protein
intake compared with those who gained LM (80±25 vs. 69±21 g/day,
P=0.012 or 0.98±0.27 vs. 0.84±0.24 g/kg body weight, P=0.001), nodifference in age, gender, medication or physical activity was foundbetween those who gained LM or lost LM. Participants who did
not improved PF had lower energy intake (1656±502 vs. 1870±515
kcal/day, P=0.060)
Conclusion: A many studies have demonstrated the beneﬁcial
effect of progressive RE on LM, strength and PF among older adults.
However, few studies have looked at association with dietary intake
among non-respondents participants. Our study underlines the importance of suﬃcient energy and protein intake in the maintenanceof LM, strength and PF in elderly.

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Area: Acute care
O-087
Which are the main precipitating causes of heart failure inelderly patients? Real world evidence from the ATHENA
registry
A.C. Baroncini 1 , F. Orso 1 , A. Pratesi 1 , S. Parlapiano 2 , A. Herbst 2 ,A. Lo Forte 1 , C. Ghiara 1 , E. Carrassi 2 , G. Biagioni 2 , M.L. Di Meo 1 ,N. Marchionni 1 , L. Gabbani 1 , M. Di Bari 1 , A. Ungar 1 ,S. Baldasseroni 1 . 1 Geriatric Intensive Care Unit, Careggi University
Hospital, Florence; 2 University of Florence
Introduction: Whilst clinical trials and cardiological clinical registries identify cardiovascular pathologies as the main precipitating
cause leading to hospitalisations for Acute Heart Failure (AHF), "realworld" administrative data suggest that precipitating causes may bemainly non-cardiovascular. Our purpose was to compare precipitating causes of Heart Failure (HF) in elderly patients hospitalised for
AHF in three different, common care settings: cardiology, internal
medicine and geriatrics.
Methods: Data derived from ATHENA retrospective observational
study which included elderly patients (≥65 years) presenting witha diagnosis of AHF to the emergency department of a tertiary
University teaching-hospital and subsequently transferred to thecardiology, internal medicine and geriatric wards in the period
01.12.2014–01.12.2015.
Results: Study population was formed by 342 patients; 17.8% ofthem were hospitalised on the cardiology ward, 17.3% on thegeriatrics ward and 64.9% on internal medicine. Mean age was 83.7
years old, females were 54.1%. Pneumonia was found in 39.7% of
the cases and was more prevalent on geriatrics (52.1%) and internal
medicine (42.6%) settings compared to the cardiology one (20.0%),
P=0.001. Sepsis also had a greater focus in geriatrics (4.2%) andinternal medicine (8.1%) than in cardiology (no cases), P=0.001.
Acute Coronary Syndrome (ACS) caused hospitalization in 6.2% of
individuals, reaching a signiﬁcantly higher prevalence in cardiology(21.7%) compared to geriatrics (2.1%) and in internal medicine(2.5%), P=0.001.
Conclusions: Precipitating causes of HF in the elderly population
hospitalised for AHF are mainly non-cardiovascular, as pneumonia
and sepsis, and they seem to be criteria for admission onto different
care setting.

Area: Metabolism and nutrition

O-088
Tailored nutritional guidance has positive effect on energy andprotein intake of geriatric patients after discharge:
a randomized controlled trial
J. Verho, T. Puranen, M. Suominen. Department of General Practiceand Primary Health Care, University of Helsinki, Finland
Introduction: Malnutrition is common among hospitalized older
adults and nutritional status may deteriorate during hospital stay.
Recovering from acute disease requires good nutritional status andadequate energy and protein intake.
Methods: 24-week randomized, controlled trial was used to investigate effectiveness of tailored nutritional guidance on nutrient
intake after discharge among independently living older adults
with normal cognition. MNA was used to assess nutritional status
and three-day food diaries collected after discharge to assess nutrient intake. Nutritional guidance included at least one home visit

with registered dietitian, personalized nutritional care plan, writtenmaterial and ONSs when needed.
Results: 41 (73% women) older adults, age 76 y (SD 6) wererecruited. 61% of all participants were at risk for malnutrition andonly 17% reached the recommended protein intake of 1.2g/kg. Mean
energy intake increased in the intervention group (I) from 1210 kcal
(SD 359) to 1655 kcal (SD 468) and decreased in the control group(C) from 1532 kcal (SD 477) to 1425 kcal (SD 412) (P<0.05). Mean
protein intake increased from 57 g (SD 19) to 76 g (SD 20) in I and
decreased from 75 g (SD 25) to 65 g (SD 22) in C (P<0.001).
Conclusions: The risk of malnutrition, poor energy and protein intake are common among geriatric patients after discharge. Tailorednutritional guidance and use of ONSs improve energy and protein
intake which are essential when recovering from acute disease.
O-089
Agreement between ESPEN criteria and MNA in the diagnosis ofmalnutrition in elderly patients with hip fracture
L. Del Rosario Evangelista Cabrera 1 , L. Fernández Arana 1 , V. Garay
Airaghi 1 , E. Lueje Alonso 1 , P. Matía Martín 2 , F. Cuesta Triana 1 .
1 Department of Geriactrics, Hospital Clinico San Carlos, Madrid, Spain;
2 Department of Endocrinology and Nutrition, Hospital Clínico San
Carlos, Madrid, Spain
Introduction: Recently, new malnutrition diagnosis criteria havebeen proposed by ESPEN (European Society of Clinical Nutrition
and Metabolism) in patients with positive nutritional screening.
Validation is still advocated. The objective of this study was todescribe the agreement of two methods of nutritional assessment:
Mini Nutritional Assessment (MNA) and the new ESPEN criteria.
Methods: Patients admitted to the Orthogeriatric Unit above 65
years. During the ﬁrst 48 hours from admission, a nutritional
assessment was carried out: MNA-SF as a screening tool, and when
positive, complete version of the MNA and the ESPEN criteria
method were applied. A monofrequency Akern® bioimpedance wasused to measure the fat free mass index (FFMI). The agreement wasdetermined by Kappa index.
Results: 213 patients were evaluated. 42.7% (91) were at risk ofmalnutrition. The complete version of the MNA in this subsample
showed a malnutrition prevalence of 14.3% – n=13 – (score <17) and
84.6% – n=77 – (when a score <24 was considered). The prevalenceof malnutrition with ESPEN criteria was 30.8% – n=28; 14 patientswith lost values of FFMI and those from the estimation of weightloss 3 months earlier. Considering a MNA score <17, the kappa
index for malnutrition diagnose was 0.207 (p=0.038). When a MNA
score <24 was used, the kappa index for malnutrition diagnose was
0.043 (p=0.498).
Conclusions: The two methods evaluating the nutritional statusshow a poor or very poor agreement in elderly hip fracture patients.
To test the value of each method it is mandatory to assess theirrelationship with disability and clinical events (mortality, length ofstay and complications).

Area: Acute care

O-090
HFmrEF in elderly patients: the pathogenetic role of ischemia.
Real world data from the ATHENA registry
A. Lo Forte 1 , F. Orso 1 , A. Pratesi 1 , C. Ghiara 1 , A. Baroncini 1 , M.L. Di
Meo 1 , L. Gabbani 2 , M. Di Bari 1 , A. Ungar 1 , S. Baldasseroni 1 ,N. Marchionni 3 , S. Parlapiano 4 , A. Herbst 4 , G. Biagioni 4 , F. Fedeli 4 .
1 Geriatric Intensive Care Unit, Careggi, University Hospital, Florence;
2 Department of medicine and geriatrics, Careggi, Florence; 3 Division of

Oral presentations / European Geriatric Medicine 8S1 (2017) S1–S39

General Cardiology, Careggi, University Hospital, Florence; 4 University
of Florence
Introduction: Recently, the ESC has recognized the presence ofan "area" of patients with ejection fraction between 40 and 49%
deﬁned as "mid-range" Heart Failure (HFmrEF).
Methods: Data derived from ATHENA retrospective observational
study (patients ≥65 years) admitted with diagnosis of AHF (worsening or de novo) to the Emergency department in the period
01.12.2014–01.12.2015.
Results: 246 patients were included: (HFmrEF 19.5%, HFrEF 30.5%,
HFpEF 50.0%). HFmrEF and HFpEF shared similar characteristics:
mean age 83.8–84.5 versus 79.9 in HFrEF, p<0.001, prevalence offemales 41.7%, 67.5% versus 32.0%, p<0.001. History of coronary disease was more frequent in HFmrEF (41.7%) and HFrEF (36.0%) than
HFpEF (19.5%), p=0.004, as well as the prevalence of previous PCI(27.1%, 25.3% and 11.5% respectively, p=0.014). Ischemic aetiology
was prevalent in HFmrEF (47.9%) and HFrEF (40.0%), while in HFpEF
was only 28.5%, p=0.038. Acute coronary syndromes represented(in HFmrEF), was the most frequent precipitating cause (11.6%)
and coronary angiography was the procedure most frequently performed in elderly with HFmrEF (12.5%) and in those with HFrEF(22.7%), higher than those reported for patients with HFpEF (6.5%),
p=0.004.
Conclusions: These data suggest that ischemia plays a role in thepathogenesis of HFmrEF. Patients with HFmrEF could be a groupconsisting of a subgroup of patients with HFpEF that have experienced a reduction of ejection fraction and a subgroup of patientswith HFrEF that improved part of the LVEF: (HFrecEF, Recovered
Ejection Fraction).

S29

Institutet, Department of Neurobiology, Care Sciences and Society,
Center for Alzheimer research, Division of Clinical Geriatrics,
Huddinge; Södersjukhuset, Department of Internal Medicine. Section
for Neurology, Stockholm, Sweden
Stroke is a common cause of morbidity and mortality in patientswith dementia. Pre-stroke dementia is associated with worse outcomes, including a higher rate of disability and mortality. Baseline
mobility is an important predictor of functioning and mortality
after stroke.
Objectives: To assess the role of mobility and dementia as predictors of level of residential assistance, dependency for mobility
and mortality in older patients with stroke. Methods: This is alongitudinal cohort study based on SveDem, the Swedish Dementia
Registry and Riksstroke, the Swedish Stroke Registry. 1689 patients>65 years old with dementia registered in SveDem and suffering
a ﬁrst stroke between 2007 and 2014 were matched with 7973
non-dementia controls with stroke.
Results: Pre-stroke dependency in activities of daily living andmobility was worse in dementia patients than non-dementia controls. Patients with dementia were more likely to be discharged
to nursing homes after a stroke than non-dementia controls (51vs 20% p<0.001). After the stroke, mortality at three months washigher in dementia patients (31 vs 23% p<0.001) and fewer were
living at home without help (21 vs 55%; p<0.001). Patients who
moved independently before stroke were more often discharged
home (60% vs 28%) and had lower mortality. In adjusted analyses,
pre-stroke mobility limitations was associated with higher odds forpoorer mobility, needing more residential assistance, and death.
Conclusion: Patients with mobility impairments and/or dementia
present a high burden of disability after a stroke. There is a need forresearch on stroke interventions among these populations.

Area: Comorbidity and multimorbidity

O-091
Pre-stroke mobility associated with worse outcomes indementia patients with stroke – data from the Swedish
Dementia (SveDem) and Stroke registries
M. Eriksdotter 1 , B. Contreras Escamez 2 , E. Zupanic 3 , D. Religa 4 ,L. von Koch 5 , K. Johnell 6 , M. von Euler 7 , I. Kåreholt 8 ,S. Garcia-Ptacek 9 . 1 Karolinska Institutet, Department of Neurobiology,
Care Sciences and Society, Center for Alzheimer Research, Division ofClinical Geriatrics, Huddinge; Karolinska University Hospital,
Department of Geriatric Medicine, Stockholm, Sweden; 2 Karolinska
Institutet, Department of Neurobiology, Care Sciences and Society,
Center for Alzheimer Research, Division of Clinical Geriatrics,
Huddinge; Department of Geriatrics, Hospital Universitario de Getafe,
Getafe Madrid, Spain; 3 Karolinska Institutet, Department of
Neurobiology, Care Sciences and Society, Center for Alzheimer
Research, Division of Neurogeriatrics, Huddinge; Department of
Neurology, University Medical Centre, Ljubljana, Slovenia; 4 Karolinska
Institutet, Department of Neurobiology, Care Sciences and Society,
Center for Alzheimer Research, Division of Neurogeriatrics, Huddinge;
Karolinska University Hospital, Department of Geriatric Medicine,
Stockholm, Sweden; 5 Karolinska Institutet, Department of
Neurobiology, Care Sciences and Society, Division of Occupational
Therapy, Huddinge, Sweden; 6 Karolinska Institutet and Stockholm
University, Aging Research Center (ARC), Stockholm, Sweden;
7 Karolinska Institutet, Department of Clinical Science and Education,
Södersjukhuset and Department of Medicine, Solna, Stockholm;
Karolinska University Hospital, Department of Clinical Pharmacology,
Stockholm, Sweden; 8 Karolinska Institutet and Stockholm University,
Aging Research Center (ARC), Stockholm; Jönköping University,
Institute of Gerontology, School of Health and Welfare, Aging Research
network – Jönköping (ARN-J), Jönköping, Sweden; 9 Karolinska

O-092
Risks of longer term proton pump inhibitor exposure in 228,752
older adults
J. Zirk-Sadowski 1,2 , J.A. Masoli 1,3 , J. Delgado 1 , W.D. Strain 3,4 ,W. Hamilton 6 , W. Henley 5 , D. Melzer 1 , A. Ble 1 . 1 Epidemiology andPublic Health, University of Exeter Medical School, Barrack Road
Exeter, EX2 5DW, UK; 2 Medicines Policy Research Unit, Centre for Big
Data Research in Health, University of New South Wales, Sydney, NSW
2052, AU; 3 Department of Healthcare for Older People, Royal Devonand Exeter National Health Service Foundation Trust, Barrack Rd,
Exeter, EX2 5DW, UK; 4 Department of Diabetes and Vascular Medicine,
University of Exeter Medical School, Exeter, Barrack Road, EX2 5AX, UK;
5 Health Statistics Group, University of Exeter Medical School, St Luke’s
Campus, Exeter, EX1 2LU, UK; 6 Primary Care Diagnostics, University of
Exeter Medical School, St Luke’s Campus, Exeter, EX1 2LU, UK
Introduction: Proton Pump Inhibitors (PPIs) are commonly prescribed and often continued in older adults, with limited understanding of longer term risks. We aimed to estimate the risk offragility fractures (FFs), late community acquired pneumonia (CAP),
and cardiovascular disease (CVD) in older adults exposed to PPIs for≥1 year.
Methods: We conducted retrospective cohort analyses in adults
over 60 years old using primary care records (CPRD) linked to hospital records (HES). We analysed: i) 86469 patients to estimate the4-year FF risk; ii) 150100 to estimate the second-year CAP incidence
after PPI start; iii) 228752 clopidogrel-free patients to estimate
the 4-year CVD (myocardial infarction [MI] and ischaemic stroke[stroke]) risk; and relevant 1:1 age- and gender-matched controls.
We used a statistical difference-in-difference methodology (the“Prior Event Rate Ratio” [PERR]) to adjust for measured and unmeasured confounding, as well as traditional propensity-score-adjusted
Cox’s models.

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Results: PPI patients were at greater longer-term risk of: i) Fragility
fracture (PERR-adjusted Hazard Ratio [HR]: 1.27, 95% CI: 1.16 to1.34); ii) Community Acquired Pneumonia (HR=1.82, 1.27 to 2.54);
iii) MI (HR=2.11, 1.79 to 2.54) and stroke in aspirin treated patients(HR=1.43, 1.12 to 1.94), with no increased stroke risk without aspirin
exposure (HR=1.01, 0.83 to 1.17). Several sensitivity analyses conducted in relevant sub-groups and/or using alternative statisticalmethods provided consistent results.
Conclusions: These results raise questions about the safety ofcurrent widespread prescribing practices of PPIs in older patients.

Area: Organisation of care and gerotechnology

O-093
Benchmarking European Community care delivery on costs andquality of care, a novel approach
H. van der Roest 1 , L. van Lier 1 , L. van Eenoo 2 , A. Declercq 2 ,G. Onder 3 , V. Garms-Homolová 4 , H. Finne-Soveri 5 , P.V. Jónsson 6 ,J. Smit 7 , J. Bosmans 8 , H. van Hout 1 . 1 VU University medical center;
2 KU Leuven; 3 Università Cattolica del Sacro Cuore; 4 Hochschule fürTechnik und Wirtschaft; 5 National Institute for Health and Welfare;
6 Landspitali National University; 7 GGZ inGeest; 8 VU University
To deliver adequate care in the future to the rapidly ageing population and avoid excessive costs, reform of healthcare systems isnecessary. Evidence-based restructuring of systems should build
on reliable benchmarks of quality and costs of care, which arelacking. A novel benchmark method on organizational eﬃciency incommunity care was developed with the IBenC project.Longitudinal
data collection was performed among 2884 community care clients(six countries, 38 organizations) by means of the comprehensive geriatric assessment instrument interRAI-HC. Baseline and six
month follow-up assessments were used. The 11-point Independence Quality scale (IQS) and Clinical Balance Quality scale (CBQS)
expressed quality, respectively reﬂecting quality of care aimed atfunctional independence and engagement, and at functional improvement. Higher scores indicate better quality. Six month costof care were estimated by valuing resource utilization with Dutch
standard costs. Case-mix adjustments were applied.Organizational
quality varied between poor to good: IQS scores varied between
2 and 7, CBQS between 4 and 8. Mean adjusted costs were€21.004 (range €14,300-€24,209). Quality and cost outcomes were
integrated in the IQS-index and CBQS-index. Index values of 1
indicate average quality against average costs, higher values reﬂect
better organizational eﬃciency. IQs-index ranged between 0.49
to 1.74 and CBQS-index between 1.00 and 1.66. The indexes hadhigh face-validity compared to the plotted costs and quality anddiscriminated organizations based on their eﬃciency. The indexes
permit for a novel benchmark approach, opening up possibilities
for unexplored areas of research and knowledge in organizational
performance and restructuring care systems.
O-094
City4Age: unobtrusive detection of mild cognitive impairment
and frailty by harnessing sensor technology and big data sets insmart-cities
G. Ricevuti 1 , S. Copelli 2 , L. Venturini 1 , F. Guerriero 3 , F. Mercalli 2 .
1 University of Pavia, Italy, CITY4AGE Project; 2 MultiMed Engineers

SRLS, Parma, Italy, CITY4AGE Project; 3 ASP S.Margherita Hospital,
Pavia, Italy
City4Age aims to demonstrate the potential of large datasets obtained from sensing technologies in smart-cities’ contexts, to adopt
preventing actions for older people [1]. In particular, the challenge isto demonstrate that such datasets can be harnessed to early detect
the onset of Mild Cognitive Impairment (MCI) and frailty – ideally
before signs and symptoms become evident – and to consequently
enact more effective interventions [2]. A fundamental assumption
is that current technology allows “unobtrusive” detection, without
the need to place signiﬁcant burden on the monitored person or
on her carers [3]. To achieve this goal, City4Age is applying thefollowing approach:- review of established scales, commonly usedin geriatrics to measure MCI and frailty onset (e.g. such as the
Lawton IADL scale or the Fried Frailty Index) [4] – identiﬁcationof relevant behaviours implied in such scales (e.g. communication,
shopping, use of transportation, cultural/social activities, engagement in physical activities, gait/motility progression, etc.) – review
and classiﬁcation of data types that can be collected throughsensors and from smart-cities’ datasets, and used to reconstruct theabove behaviours and to discover relevant changes that may havepredictive value in relation to the inception of MCI/frailty Currently,
the Project has successfully completed the above actions and deﬁned a risk model that is, at the same time, easy to understand by
geriatricians and technically feasible. Since April 2017 such modelis under testing at 6 different Pilot cities (Athens, Birmingham,
Lecce, Madrid, Montpellier and Singapore), involving 200 elderly
participants, monitored for 6–12 months.
Acknowledgement: The City4Age project has received funding
from the European Union’s Horizon 2020 research and innovation
programme under grant agreement No 689731.
References:[1] Paolini P et al, City4Age: Smart Cities for Health Prevention,
IEEE Second International Smart Cities Conference, Trento,
September 2016.
[2] Lathia N et al, Smartphones for Large-Scale Behavior ChangeInterventions, IEEE Pervasive Computing, July 2013.
[3] Rantz MJ et al, Using Sensor Networks to Detect Urinary Tract
Infections in Older Adults, IEEE 13th International Conferenceon e-Health Networking, Applications and Services, June 2011.
[4] Memory Training e Ginnastica Mentale per l’anziano, Monica
Bacci, CESI, Roma, 2000.
O-095
Functional status and social support network as risk factors for
hospital readmission in Heart Failure
S. Duarte, R. Amaral, J.J. Eira, P. Vaz Marques. Centro Hospitalar deTrás os Montes e Alto Douro - Hospital de Vila Real, Internal Medicina
Department
Introduction: Hospital readmission in chronic heart failure (CHF)
is widely recognized as a quality indicator of health care. Sociodemographic factors that supplant the power of medical action, aresometimes neglected in assessing the risk of readmission. The setof social disadvantages surrounding the patient have important
implications and should be considered at hospital discharge.
Aim: The aim is to examine the impact of demographic characteristics, functional status and social support network on hospital
readmissions for CHF.
Methods: Retrospective study of total admissions at an Internal
Medicine Department of a Portuguese hospital, with the main
diagnosis of CHF. Data was obtained through the SClinico systemand processed by SPSS 24.0® software. The demographic characterization was according to gender and age; functional status according
to Katz Scale; social and hospital support network by type of residence, type of support (family/institutional/none) and destination
after discharge (with or without referral for external consultation).
For hospital readmission were considered hospitalizations with thesame diagnosis in the following 12 months.
Results: During one year, 336 admissions with the main diagnosis of CHF were reported, 9.3% of the total hospitalizations.

Oral presentations / European Geriatric Medicine 8S1 (2017) S1–S39

The readmission rate within 12 months was 49.7%. Among thepatients 61.3% were female, with a mean age of 79.9±10 years. The
functional status was associated with hospital readmission (X2 (4)=32.3, p≤0.05), unlike gender, age and the social support network.
Contrary to expectations, the referral for external consultation was
associated with more readmissions (OR=2.47, [1.55–3.94], IC 95%).
Conclusion: Functional status appears to be a major risk factor
for hospital readmission in CHF. The recognition of patients’ sociodemographic disadvantages allows better continuity of care after
discharge. Future research is needed to deﬁne sociodemographic
indicators and to measure their role on readmission risk.
O-096
Comparing the quality of discharge documentation between
specialist elderly care wards and acute medical or surgical wards
A. Howe, S. Akbar, H. Ashraﬁ, W. Chmiel, H. Choonara, L. Kent,
K. Yip, O. Gaillemin, A. Vilches-Moraga. Salford Royal NHS
Foundation Trust, Salford, UK
Objectives: We wanted to identify if there were differences in thequality of documentation if a patient was discharged from specialist
ageing and complex medicine (ACM) wards in comparison to acutemedical or surgical wards (non-ACM).
Methods: Using established national and local guidance, we reviewed the discharge documentation of three ACM wards and three
non-ACM wards; a medical admissions unit, a general surgical ward
and an orthopaedic ward. Patients aged ≥74 years were included.
Results: 321 records were reviewed. Regarding authorship, 95% ofrecords were written by a team member involved in a patient’s
care when from an ACM ward in comparison to 84% from generalwards. ACM wards performed more highly in documenting the
key elements of an inpatient stay; visit summary (98% ACM wards
vs. 93% non-ACM wards), investigations (96% vs. 93%), clear listof new diagnoses (69% vs. 57%) and an up-to-date past medical
history (65% vs. 38%). If a patient was from a care facility this was
documented in 82% of ACM ward summaries compared to 47% ofsummaries from non-ACM wards. In contrast, discharge documentsfrom non-ACM wards recorded changes to medication regimes withgreater accuracy (84%) than those from ACM wards (79%).
Conclusions: Across most domains, discharge summaries from
ACM wards were of higher quality when compared to those from
non-ACM wards. Standardising the approach to discharge documentation across a variety of inpatient wards will improve continuity ofcare for our elderly population.
O-097
Robots in care for older people: Opinions of potential end-users
S. Tobis 1 , C. Salatino 2 , A. Tapus 3 , A. Suwalska 1 . 1 Poznan Universityof Medical Sciences, Poland; 2 Fondazione Don Carlo Gnocchi, Italy;
3 Robotics and Computer Vision Lab, France
Introduction: The ENRICHME project - Enabling Robot and assisted
living environment for Independent Care and Health Monitoring of
the Elderly (Horizon 2020 Programme, No: 643691C), uses a mobile
social robot for long-term interaction and monitoring of an older
person with MCI, with the aim to optimise their independence.
We used focus group discussions to collect opinions about the
robot-related requirements of older people, as well as their formal
and informal caregivers.
Methods: Six focus groups discussions were analysed: one organised in Italy (composed of older subjects attending a day centre,
and health workers of a day centre), four in Poland (two witholder volunteers, one with professional, and one with informal
caregivers), one in Greece (with older participants); all participants
were willing to discuss the issues related to the introduction of arobot.

S31

Results: Six areas of interest were identiﬁed:• overall attitudes towards the robot,• ethical issues,• the scope of the robot’s functions,• safety issues,• doubts about the preparedness of older persons for the robot,• issues related to the introduction of robots into the lives of theelderly.
In general, the expectations towards the introduction of a social
robot were positive.
Conclusions: The use of robots by community-dwelling older persons is generally accepted by all participating groups, especially if
the robots’ introduction is preceded by eﬃcient pre-training. Ethicaland practical issues should be taken into account.
O-098
Predicting hospitalisations and emergence visits: Comparing
nine risk scores in care dependent elderly from 6 countries:
IBenC Study
H. Finne-Soveri 1 , G. Onder 2 , V. Garms-Homolová 3 , A. Declercq 4 ,P. Jónsson 5 , J. Bosmans 6 , S. Draisma 7 , K. Joling 8 . 1 National InstituteFor Health and Welfare Finland (THL); 2 Department of GeriatricMedicine USCS Roma; 3 University of Applied Sciences Berlin (HTW);
4 Lucas Institute, University of Leuven; 5 National University Hospital of
Iceland; 6 VU University Amsterdam, Health Technology Section;
7 GGZInGeest, Mental Health Organisation; 8 VU University Medical
Center Amsterdam
Introduction: We compared the accuracy of nine existing risk
scores to predict hospitalisations or emergency department visitsamong older care dependent home dwelling adults.
Methods: We assessed 2884 persons aged 65 or older, who received professional homecare in six different countries in Europe.
Main outcome was the occurrence of hospitalisations or Emergency
Department visits within 6 months. Nine existing index risk scores
were computed using baseline data: (1) The Changes in Health, Endstage Disease, Signs, and Symptoms Scale (CHESS); (2) Detection ofIndicators and Vulnerabilities for Emergency Room Trips (DIVERT);(3) Method of Assigning Priority Levels (MAPLe); (4) Identiﬁcation
Seniors At Risk Primary Care (ISAR PC); (5) Emergency admission
risk likelihood index (EARLI); (6) Sherbrooke Postal Questionnaire(SPQ); (7) the Elders Risk Assessment (ERA), (8) Community Assessment Risk Screen (CARS), ad (9) Rockwood’s Frailty Index. Theiraccuracy to predict was expressed in the area under the ROC curve(AUC).
Results: 194 older adults were admitted at the ED and/or hospitalward during the six-month study period. The highest AUC value wasfound for the DIVERT (AUC=0.70) and CARS (AUC=0.69), followed
by EARLI (AUC=0.60), CHESS (AUC=0.58), ERA (AUC=0.63), Frailty
Index (AUC=0.54), MAPLE (AUC=0.52), ISAR-PC (AUC=0.49) and SPQ(AUC=0.46). Signiﬁcantly better AUC values were found in persons
without a recent admission at baseline for DIVERT, EARLI and CARS
risk scores.
Conclusion: DIVERT and CARS were the most promising risk scores:
These may help to target preventive interventions in high-risk
groups.

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Area: Longevity and prevention

O-099
Long-term effects of the LUCAS health promotion andpreventive care intervention (RCT) for senior citizens in thecommunity (LUCAS IV/MINDMAP: HORIZON 2020, research andinnovation action 667661)
U. Dapp, L. Neumann, W. von Renteln-Kruse. Albertinen-Haus,
Centre of Geriatrics and Gerontology, Scientiﬁc Department at the
University of Hamburg, Germany
Introduction: A health-promotion and preventive-care RCT was
performed in initially community-dwelling older people without
need of nursing-care between 2001–2002 as part of the Longitudinal Urban Cohort Ageing Study (LUCAS). The Intervention-group(IG) participants had the opportunity to choose between the programmes “small-group-session” at a geriatric centre performed byan interdisciplinary geriatric team giving information on healthy
ageing, physical activity, healthy nutrition and social participation[1]; “preventive home visit (PHV)” performed by a nurse trainedin geriatrics [2] or no programme. The 1-year (y) follow-up (FU)results showed signiﬁcantly higher use of preventive-services andbetter health-behaviour in the IG (n=878) than the control-group(CG; n=1,702). After completion of the 1-y FU, the CG had theopportunity to participate in the small-group-session, too.
Methods: Long-term survival-analyses were performed 12y after
1-y FU. ITT-analyses and in addition, for the subgroup of smallgroup-session participants On-Treatment-analyses were performed.
Results: ITT-Analysis: In the 1y RCT 503 (62.5%) participants of
the IG chose small-group-session, 77 (9.6%) persons chose PHV and
224 (27.9%) persons did not choose any. Mean observation-time
accounted 10.3y. 313/878 (35.7%) IG-participants and 674/1,702(39.6%) of the CG died; HR=0.89 [3]. On-Treatment-Analysis:
768 (IG: 503; CG: 265) small-group-session participants wereanalysed against 1,335 (IG: 224; CG: 1,111) non-participants.
Mean observation-time was 10.9y. 194/768 (25.3%) small-groupsession participants and 531/1,335 (39.8%) non-participants died;
HR<0.001. The results were conﬁrmed after adjustments.
Conclusions: The small-group-session addresses ROBUST older
persons (ca.18.4% of the European population >65y), to strengthenfunctional competence and reserves to proactively prevent/postpone
frailty and/or need of nursing-care.
References:[1] Dapp etal. J Public Health 2005;13:122–7.
[2] vonRenteln-Kruse etal. Z Gerontol Geriatr 2003;36:378–91.
[3] Neumann et al. J Nutr Health Ageing 2017; inprint.
O-100
Reducing physical restraints in a care home company
D. Curto 1 , P. Cano 1 , C. García 1 , J.F. Tomas 2 . 1 Sanitas Mayores Sanitas
ELA-Bupa; 2 Sanitas ELA-Bupa
Introduction: Half of Spanish Alzheimer patients have suffered, atsome point, the use of physical restraints, especially with people
with behavioral symptoms and cognitive impairment, especiallythose that have symptoms of dementia. Prevalence of restraints for
elderly residents with dementia has been reported between 21.5
and 41.2% in different Spanish regionsThe main issue of the study
was to demonstrate that the use of physical restraints provides no
beneﬁts in the care of people with dementia.
Methods: In 2011 Sanitas Mayores started an ambitious program
to reduce physical restraints in all of its 41 care homes. After
implementing an All Staff training programme and analyzing asample of more of 7,657 subjects from care homes showed that thefrequency of residents having at least one restraint was reduced
from 18.1% to 1.0%.
Results: Beside the use of benzodiacepines was reduced, with nosigniﬁcant changes in mortality. The rate of total falls increased
from 13.1% to 16.1% with no signiﬁcant increase in injurious falls.
The group of residents most restrained before the program werepeople with dementia (29%). There was no signiﬁcant differencein use of bed rails at both study waves when the total samples
were compared (43.5% vs. 41.7%). A global decrease in psychotropic
medication prescription was recorded in people who had dementia.
Conclusions: It is safe to reduce physical restraints after a training programme delivered to all staff. The reductions of physicalrestraints was not accompanied by an increase of psychotropic
medications prescription
O-101
Predictors of attrition in a large, long-term exercise randomized
controlled trial – The Generation 100 study
H. Viken 1 , J. Nauman 1 , N. Zisko 1 , N.P. Aspvik 2 , J.E. Ingebrigtsen 2 ,U. Wisløff 1 , D. Stensvold 1 . 1 K.G. Jebsen Center of Exercise in Medicine
at Department of Circulation and Medical Imaging, Faculty of Medicine
and Health Sciences, Norwegian University of Science and Technology
Trondheim (NTNU), Norway; 2 Department of Sociology and Political
Science, Faculty of Social and Educational Sciences, NTNU, Norway
Introduction: Dropout from exercise programs both in the realworld and in research is a challenge, but few have examined predictors of attrition in exercise randomized controlled trials (RCTs)
conducted in the real world, in the general population and over alonger time period – among older adults. The aim of the present
study was to examine attrition prevalence rates and predictors,
from baseline to 3-years, in a long-term exercise RCT with older
adults.
Methods: Generation 100 is the world’s largest RCT (n=1567) ina general older population, examining the effect of exercise on
mortality in older adults (70–77 years at baseline). All study participants were randomized to either exercise- or control group for 5
years. Self-reported demographics (e.g. education), general health,speciﬁc health conditions (e.g. heart disease, memory loss, psychological distress), smoking and physical activity (PA) were examinedat baseline. Cardiorespiratory ﬁtness (CRF) and grip strength weredirectly measured. Multivariate logistic regression analysis wasused to identify predictors of attrition.
Results: The total attrition rate was 14.4% (n=225) after 3-years.
Signiﬁcant predictors of attrition in the exercise group were CRF,
level of education (p<0.01), memory status and PA level (p<0.05),
and in the control group CRF (p<0.01) and memory status (p<0.05).
Conclusions: This is the largest study of predictors of attrition in along-term exercise RCT on older adults. Our ﬁndings provide new
and important knowledge about older adults potentially at risk of
attrition in long-term exercise RCTs.
O-102
Dietary consumption and self-reported health status in older
adults. A cross-sectional study
K. Shibasaki 1 , S. Yamada 2 , S. Ogawa 1 , M. Akishita 1 . 1 Department ofGeriatric Medicine, Graduate School of Medicine, The University ofTokyo; 2 Komagane Kogen Ladies Clinic
Introduction: Little is known about the association between dietaryconsumption and health status in older adults. We investigated therelationship between them.
Methods: We recruited 1394 community-dwelling older adults in
Nagano (highest life expectancy in Japan). Food frequency questionnaire and self-reported health condition (physical condition anddepressive mood) were asked all participants. Dietary data coveredOral presentations / European Geriatric Medicine 8S1 (2017) S1–S39

13 major food groups: ﬁsh, meat, eggs, milk, soybeans products,
vegetables, seaweeds, potatoes, fruits, fat or oil, snakes, salty foods,
and alcohol. Physical condition contains 5 questionnaires, fall, walking distance, one-leg stand, usage of cane and decline of walking
speed. Depressive mood also contains 5 questionnaires such as
fulﬁlment in your daily life, a lack of joy, diﬃculty in doing what
you could do easily before, and tiredness. Chi-square tests and regression analysis were done to investigate the relationship between
dietary consumption and health status.
Results: Participants’ mean age was 76.3±5.5 years, female were778 (55.8%). Women consumed meat, soy beans products, potatoes,
fruits and snakes frequently compared with men. On the other
hand, male consumed salty food and drink alcohol frequently.
In men, higher meat consumption was related to long walking
distance and less depressive mood. In women, higher soybeans
products and vegetable consumption were related to long walking
distance and less depressive mood. Logistic regression analysis
revealed vegetable consumption was signiﬁcantly connected tofavorable effect on both physical conditions and depressive mood.
Conclusion: In older adults, health status might be improvedby daily dietary intake such as meat, soy beans products andvegetables.
O-103
Variation in falling and fall risk among community-dwellingolder citizens in 12 European countries
C. Franse 1 , J. Rietjens 1 , A. Burdorf 1 , A. van Grieken 1 , I. Korfage 1 ,A. van der Heide 1 , F. Mattace-Raso 2 , E. van Beeck 1 , H. Raat 1 .
1 Erasmus MC, department of Public Health; 2 Erasmus MC, section ofGeriatric Medicine, department of Internal Medicine
Introduction: The rate of falling among older citizens appears tovary across different countries, but the underlying aspects causing
this variation are unexplained. We aim to describe between-country
variation in falling and explore whether intrinsic fall risk factors
can explain possible variation.
Methods: This was a prospective study of Survey of Health, Ageing and Retirement in Europe (SHARE) data in twelve European
countries among community-dwelling persons aged ≥65 years(N=18,596). Socio-demographic factors (age, gender, education level
and living situation) and intrinsic fall risk factors (less than good
self-rated health (SRH), mobility limitations, limitations with activities of daily living (ADL), dizziness, impaired vision, depression andimpaired cognition) were assessed in a baseline interview. Falling
was assessed 2-years later by asking whether the participant had
fallen within the 6 months prior to the follow-up interview.
Results: There was between-country variation in the rate of falling.
The prevalence of intrinsic fall risk factors varied 2–4 fold between
countries. Associations between factors age ≥80 years, less than
good SRH, mobility limitations, ADL limitations, dizziness and depression, and falling were different between countries (p<0.05).
Between-country differences in falling largely persisted after adjusting for socio-demographic differences but strongly attenuatedafter adjusting for differences in intrinsic fall risk factors.
Conclusion: There is considerable variation in the rate of falling
between European countries, which can largely be explained by
between-country variation in the prevalence of intrinsic fall risk
factors. These ﬁndings emphasize the importance of addressing
intrinsic fall risk in (inter)national fall-prevention strategies, while
highlighting country-speciﬁc priorities.

S33

Area: Oral and dental health

O-104
Oral pain and discomfort in community-dwelling older people –a randomised 2-year intervention study
K. Komulainen, A. Nihtilä, I. Nykänen, S. Hartikainen. University ofEastern Finland, Finland
Introduction: Oral pain or discomfort can cause problems in eating,speaking and swallowing affecting the quality of everyday life.
The aim of this study was to examine the effect of oral healthintervention on the self-reported oral pain or discomfort amongcommunity-dwelling people aged 75 years or older over a 2-year
period.
Methods: The study was based on subpopulation in GeriatricMultidisciplinary Strategy for Good Care of Elderly People (GeMS)
study (2004–2007). In this 2-year randomised intervention study,
279 community-dwelling old people completed the study, 145
person in the intervention group and 134 in the control group. Oral
health intervention included individually tailored instructions fororal and/or denture hygiene and healthy oral habits. Oral pain anddiscomfort were asked by the dentist at the baseline and after one
year and two years. Both groups also had the possibility to get basic
dental treatment during the study.
Results: In the intervention group, at the baseline 31% (n=45) and at
the end 21% (n=30) reported oral pain or discomfort. In the control
group, the corresponding ﬁgures were 22% (n=30) and 18% (n=24).
In the intervention group the main reasons at the beginning of thestudy were problems with removable dentures (n=16), teeth (n=13)
or mucosa/tongue (n=13) and after two years problems with teeth(n=11), removable dentures (n=9) or mucosa (n=5).
Conclusions: Despite the preventive intervention and dental treatment, every ﬁfth of the participants had oral pain or discomfort.
The management of oral pain in old people is challenging, amultifactorial treatment approach is often needed.

Area: Infectious diseases and vaccines

O-105
Procalcitonin to individualize antibiotic therapy duration in
hospitalized pneumonia in very old population
B. de Wazieres 1 , M. Paccalin 2 , M. Debray 3 , R. Gonthier 4 ,M. Bonnefoy 5 , S. Drevet 6 . 1 University Hospital of Nimes; 2 University
Hospital of Poitiers; 3 Hospital of Annecy; 4 University Hospital of Saint
Etienne; 5 University Hospital of Lyon; 6 University Hospital of
Grenoble-Alpes
Background: Procalcitonin (PCT) may help Physician to reduce duration of antibiotic therapy (ATBt) in pneumonia in adult. However,there was no speciﬁc study older population. We performed a Randomized Clinical Trial assessing if PCT serial measurements reduces
antibiotic duration in pneumonia (community or nosocomial) in
older patients.
Methods: Inclusion criteria were: >80 years old, ATbt <3 days
for pneumonia, and had a PCT measurement. After inclusion, PCT
was measured every 2 days in both groups (from Day 2 to theend of treatment or discharge). In the PCT group, physician could
use PCT levels to stop ATBt according a PCT algorithm, (stop ATBt
if PCT <0.25 ng/l and pursues if PCT >0.25 ng/l). Demographic,clinical and geriatric characteristics, and, severity of pneumonia(pneumonia severity index (PSI), CURB 65) at baseline and every 2days were collected. Diagnosis was conﬁrmed by reviewed Chest

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Oral presentations / European Geriatric Medicine 8S1 (2017) S1–S39

X ray or/and CT Scan. ATBt duration without outcome differences(Day 45) was the ﬁrst end point.
Results: Final analysis includes 107 pneumonia (57 in control
group, 50 in PCT group). All characteristics of patients and severityof pneumonia weren’t signiﬁcantly different; In control group, 86%
had a CURB 65 of 2 or 3 and 84% had PSI class IV or V; in PCT group
86% had a CURB 65 of 2 or 3 and 78% had PSI was class IV or V;
PCT levels were not signiﬁcantly different in between both group;
Antibiotic duration was signiﬁcantly shorter in PCT group (8. 4 days
±3.1) than in control group (10.7 days ±3.6) (p<0.001). with a goodoutcome in both groups (>85%). Algorithm was followed for only
52% of PCT group.
Conclusion: PCT algorithm is useful to individualize the duration of
ATBt for pneumonia in very old without any impact on outcome andleads to decrease ATBt duration. Further studies need to measure
the impact of the limitation of antibiotic use at individual andcollective level in this special population.

Area: Pre and post operative care

O-106
Baseline characteristics and clinical outcomes of older surgicalpersons admitted to a tertiary hospital. Proactive care of older
people admitted to General surgery-Salford General Surgery(POPS-GS)
A. Vilches-Moraga, J. Fox, A. Gomez-Quintanilla, M. Tan, A. Paracha,
M. Moatari, L. Miguel-Alhambra, M. Rowles, A. Price. Ageing andComplex Medicine Directorate, Salford Royal NHS Foundation Trust
Introduction: We describe the characteristics of older people
admitted to general surgical wards reviewed by an elderly carein-reach service.
Methods: Prospective non-randomised study of consecutive patients >74 years of age requiring admission to general surgery.
Results: Between 08/09/2014 and 28/02/2017 we reviewed 719
consecutive patients, age 81.4±4.6, 55.2% females, 577 emergency(Em) and 142 elective (El). 36% underwent surgery (Em 135- 23.3%
El 124- 87.3%), 15.4% non-surgical procedure (Em 102- 17.7% El 96.3%) and 48.5% medical management (Em 340- 58.9% El 9- 6.3%).
Most common diagnoses: biliary disease in emergency (22.4%) andcancer in elective admissions (70.4%). There were differences inemergency vs elective regarding independence for basic (78.6% vs98.6%) and instrumental (52.8% vs 88%) ADLs, mobility with noaids/cane (69.2% vs 92.3%), absence of cognitive impairment (81.3%
vs 95.8%), ASA I-II (35.7% vs 51.4%), average medications (8.4 vs 6.2)
and comorbidities (5.5 vs 4.6). No differences in individual comorbidities except in emergency patients who suffered more ischemic
heart disease (30.2 vs 19), stroke (15.9 vs 7.7) and dementia (12 vs0.7). Median length of stay was 9 days (8 Em, 10 El); in hospitalmortality 5.9% 43/719 (2.1% Em, 6.9% El), 30-day mortality fromadmission 7.3% 53/719 (Em 8.8%, El 1.4) and 30-day readmission
rate 8.8% 60/676 (Em 9.9%, 4.3% El).
Conclusions: Older persons admitted to surgery are multimorbid
and take multiple medications. Biliary disease and cancer are thecommonest diagnoses. 50% are managed non-invasively. Individuals
admitted electively are signiﬁcantly less complex and experiencesigniﬁcantly better clinical outcomes.

Area: Infectious diseases and vaccines

O-107
Elderly patients (>75yo) with infective endocarditis: geriatric,
therapeutic and prognostic characteristics before, through and3 months after the infection course. (Elderl-IE)
C. Roubaud-Baudron 1 , E. Forestier 2 , G. Gavazzi 3 , C. Schambach 4 ,J. Zirnhelt 5 , C. Patry 6 , E. Averty 7 , T. Basileu 8 , M. Chuzeville 9 ,M.-C. Laurain 10 , J.L. Novella 11 , R. Guiard 12 , M. Paccalin 13 , G. Sost 14 ,J. Naturel 15 , B. Chokry 16 , C. Ernst 16 , F. Alla 17 , M.-L. Erpelding 18 ,W. Ngueyon Sime 18 , C. Selton Sulty 19 . 1 Geriatrics Department,
Bordeaux University Hospital, Bordeaux, France; 2 Infectious Disease
Dot, Ch Metropole Savoie, Chambéry, France; 3 Geriatrics Department,
Grenoble University Hospital, Grenoble, France; 4 CH Alès, Alès, France;
5 CH Annecy, Annecy, France; 6 Geriatrics Department, Bichat-Claude
Bernard University Hospital, Paris, France; 7 Geriatrics Department, CH
Métropole Savoie, Chambéry, France; 8 Geriatrics Department, Pointe àPitre University Hospital, Guadeloupe, France; 9 Geriatrics Department,
Lyon University Hospital, Lyon, France; 10 Geriatrics Department,
Nancy University Hospital, Nancy, France; 11 Geriatrics Department,
Reims University Hospital, Reims France; 12 Geriatrics Department,
Polyclinique Les Bleuets, Reims, France; 13 Geriatrics Department,
Poitiers University Hospital, Poitiers, France; 14 Geriatrics Department,
Rennes University Hospital, Rennes, France; 15 CH Villeneuve SaintGeorges, Villeneuve Saint Georges, France; 16 Geriatrics Department,
Montpellier University Hospital, Montpellier, France; 17 Nancy
University Hospital, Nancy, France; 18 Public Health Department, Nancy
University Hospital, Nancy, France; 19 Cardiology Department, Nancy
University Hospital, Nancy, France
Introduction: 1/3 patient with infective endocarditis (IE) is >75
yo in Western countries with speciﬁc features and prognosis, but
geriatric characteristics are poorly known. Our aim was to describe
geriatric assessment through the infective endocarditis (IE) course
and its impact on 3-month prognosis.
Methods: Comprehensive geriatric assessment was performed during the ﬁrst week after diagnosis of IE (D0) and at 3 months
follow-up (M3) over one year in 14 French hospitals.
Results: Prior IE, among the 111 pts (83.1±5.1 yrs, 53% men)
included, most patiens lived at home (88%) with a low CIRS-G
score (14.1±6.9) and subnormal ADLs (5.1±1.7). At diagnosis (D0),functional status decreased (ADLs 3.2±2.1) with a cognitive (MMSE
20.2±7.2) and nutritional (MNA<17 in 40%) impairment. Intracardiac devices were frequent (valvular prosthesis 31%, PM 22%).
Digestive bacteria and Staphylococcus aureus were the most prevalent pathogens. Surgery was indicated in 36 patients (32%) but
performed only in 18. Operated patients were more ﬁt: CIRS-G
9.2±4.3 vs 15.2±7, p<0.001 and MNA 20.9±4.8 vs 17.4±5.9, p=0.03
than others. At M3, 29 patients were dead (27%) and 27 did notattend the visit (24%). The 55 assessed patients recovered andautonomy was almost back at the initial level (ADLs 4.7±1.8), 80%
were back at home. Low ADLs (HR 0.7 (0.5–0.9), p=0.002) and MNA
score (HR 0.9 (0.8–1.0), p=0.006) at D0 were associated with apoorer prognosis.
Conclusions: Nutritional and functional impairment are frequentat admission in elderly patients with IE. They are associated with aless aggressive management and a poorer prognosis.
O-108
Management of elderly patients with Clostridium diﬃcile
infections: Observational data of the French survey CLOdi
A. Caupenne 1 , I. Ingrand 2 , M. Lauda 1 , M. Priner 1 , P. Ingrand 2 ,G. Gavazzi 3 , M. Paccalin 1 . 1 Pôle de gériatrie, CHU de Poitiers, 2 rue deOral presentations / European Geriatric Medicine 8S1 (2017) S1–S39

la Milétrie, Poitiers, France; 2 Epidémiologie et biostatistique, Pôle
Biologie, Pharmacie et Santé Publique, Centre Hospitalier Universitairede Poitiers, Université de Poitiers, Poitiers, France; 3 Pôle
Pluridisciplinaire de Médecine et de Gérontologie Clinique, CHU deGrenoble Alpes, Avenue Maquis du Grésivaudan, La Tronche, France
Introduction: Incidence of Clostridium diﬃcile infections (CDI) is
high in hospitalized elderly patients, estimated at 2.28 cases/10,000
day-patients. Risk of recurrence is reported between 10 and 30%
at 3 months, and CDI-related mortality varies from 5 to 40%. The
main objective of the French survey CLOdi, is to assess prognosis ofelderly patients with CDI. We report observational data collectedduring hospitalization and therapeutic regimen regarding to theEuropean recommendations, published in 2013.
Methods: Prospective observational multicentric study, supportedby the French Societies of Geriatrics and Infectious Diseases. Frommarch 2016 to march 2017, patients aged ≥75 presenting with
CDI were included in 31 french hospital centers. An online survey
focused on clinical criteria of severity, and CDI therapeutic support.
A systematic follow-up was performed to report recurrences.
Results: One hundred and eighty-two patients were included with
74% of CDI cases that were nosocomial. Overall 144 (79%) patients
presented with at least one severity criteria. CDI episods weretreated with metronidazole, vancomycin and ﬁdaxomicin, respectively in 55%, 30% and 15% of patients. Less than half of the patientswere treated with the appropriate regimen according to the European recommendations. Thirty-one patients (17%) died during theacute infectious episode and the rate of CDI recurrence was up to
11%.
Discussion: This is the ﬁrst national survey focusing on CDI invery elderly patients. Rate of recurrence and mortality are close toliterature data. Still our results highlight the lacks of knowledge orof adequacy of therapeutic regimen to the guidelines.
O-109
Pertussis incidence in older individuals: Results from the French
EPICOQSEN study
G. Gavazzi 1 , D. Pinquier 2 , J. Gaillat 3 , J.-L. Gallais 4 , N. Guiso 5 .

S35

cough may be severe in the older population, booster dose of
vaccine in 50+ should be discussed. Similar studies are required toelaborate adapted vaccine programs in adult.
O-110
Antibiotic resistance of Escherichia coli in 312 non-hospitalised
nursing home acquired urinary tract infection
G. Gavazzi 1 , F. Guerber 2 , J. Chouteau 3 , B. Boussat 4 , D. Dye 3 .
1 University clinic of Geriatric Medicine University Grenoble

Alpes/GREPI, EA 7408, Grenoble, France; 2 Groupe Oriade-Noviale,
Grenoble France; 3 Groupe Oriade-Noviale, Grenoble, France; 4 Public
Health Department, University of Grenoble-Alpes
Introduction: Urinary tract infection is one the major infection in
Nursing home (NH) leading to overuse of antibiotic. The risk ofemerging resistance leads to use inappropriate empirical therapy
in a high-risk population. E coli is the main bacteria responsiblefor UTI and bacteraemia and takes part of Intestinal ﬂora in older
population. Yet we believe that antibiotic susceptibility of E coli
may represent an overview of ATBic susceptibility in NH. The aim of
this study was then to analyse ATBic resistance of Escherichia coli
in urine culture collected in 14 NH of the same French area.
Methods: Between 2014 and 2015, we retrospectively selected froma community private laboratory all positive urine cultures for E. coli
performed in 14 NH because of UTI suspicion. All usual antibiotics
were tested.
Results: 312 Positive urines cultures were analysed. Antibiotic resistances were as follow: amoxicillin 52%, amoxicillin+ clavulanate
34%, ciproﬂoxacine 18%, ceftriaxone 11,8%, cefexime 14,1% and below 5% for penems, gentmamycin, Furan and fosfomycin; there wasno difference in between NH.
Discussion and conclusion: Regarding the high level of resistance
Amoxcicllin, coamoxiclav can no longer be used as empiricaltreatment; of concern, resistance to 3rd cephalosporin generation,
becoming higher than at the university Hospital of the area. Thissuggests that NH may act as a reservoir of multidrug resistancebacteria; Yet, the surveillance of the resistance is critical in NH tobetter guide the empirical therapy.

1 University of Grenoble-Alpes; 2 CHU de Rouen; 3 CH Annecy Genevois;
4 Société française de médecine générale; 5 Institut Pasteur de Paris,

Paris, France
Introduction: In France, vaccination against Bordetella pertussis is
recommended in children and young adult (cocooning strategy) but
not for people aged 50 years and over (50+). As the duration ofprotection is limited following vaccination, the 50+ may be infected
and participate in the spread of the disease. The aim of this survey
was to assess the incidence of B. pertussis (whooping cough) in 50+
in France.
Methods: Between June 2013 and August 2014, participating general practitioners (GPs) using management software Axisanté®
were to include all volunteer 50+ patients suffering from a coughlasting 7 to 21 days. Final diagnosis of whooping cough was basedon polymerase chain reaction (PCR) (nasopharyngal samples) or on
clinical or epidemiological deﬁnition. Crude incidence rates were
calculated and then extrapolated to France.
Results: 42 GPs included 129 patients (large towns: 38; mediumsized towns; 57, rural areas: 34); 106 samples were collected
for analysis. Overall, 30 pertussis cases were diagnosed; 10 wereconﬁrmed by PCR and 20 based on clinical and/or epidemiologicaldeﬁnitions. Crude incidence rate was 103.6 [95% conﬁdence interval(CI): 69.9–147.9]/100’000 patients (50+) and extrapolated incidence
rate was 187.1 [126.2–267.1]; the lowest incidences (77.1 and 131.1,
respectively) were observed in large towns.
Conclusions: According to these results, older individuals (50+)
may play a role in B. pertussis circulation in France. As whooping

Area: Pre and post operative care

O-111
Total transfusion requirements in hip fracture patients fromemergency department to geriatrics: retrospective validation ofa restrictive regimen. The UPOG-TRF1 study
L. Dourthe 1 , J. Cohen-Bittan 1 , L. Zerah 1 , H. Vallet 1 , A. Gioanni 1 ,C. Villain 1 , R. Haddad 1 , M. Verny 1 , M. Raux 1 , A. Mézière 2 ,B. Riou 1 , F. Khiami 1 , J. Boddaert 1 . 1 Pitié Salpêtrière, Paris, France;
2 Charles Foix, Paris, France
Introduction: In the elderly, management of anaemia and bloodtransfusion is still a matter of debate in hip fracture (HF). According
to the FOCUS study (2011), we evaluated the association between
restrictive transfusion strategy and cardiovascular complications
during hospitalizations for hip fracture in a dedicated unit ofperioperative geriatric care (UPOG).
Material and methods: All patients >70 years old admitted for HF
to our emergency department were included in our time series
analysis study. Patients with multiple, metastatic or periprosthetic
fractures were excluded. We used a liberal strategy (LS) (Goal:
hb level ≥10 g.dL-1) from July 2009 (the opening of UPOG) until
December 2011 and a restrictive strategy (RS) (Goal Hb level ≥8g.dL-1 or transfusions according to symptoms) from January 2012
until June 2016. The primary endpoint was in-hospital acute cardio-

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Oral presentations / European Geriatric Medicine 8S1 (2017) S1–S39

vascular complications (acute heart failure (AHF), acute coronary
syndrome (ACS), acute atrial ﬁbrillation (AF) or stroke). Secondary
endpoints were in-hospital 6-month mortality rate, transfusions
and infections.
Results: 667 patients were included: 193 in the LS group, 474 in the
RS group. The change of transfusion regimen for a RS was associatedwith a reduction in acute cardiovascular complications (21 vs 34%,
p<0.01), including AHF (10 vs 19%, p<0.01) and ACS (8 vs 17%,p<0.01), and a UPOG transfusion reduction (31 vs 50%, p<0.01).
Conclusion: In elderly patients with consecutive hip fracture, achange to restrictive strategy of transfusion is associated with fewer
cardiovascular complications and transfusion with no effect on
in-hospital and long-term mortality

Area: Geriatrics in organ disease

O-112
Analysis of a national dataset: Single kidney transplant
outcomes in recipients over 65
I. Chappelow 1 , A. Arshad 1 , J. Hodson 2 , J. Nath 2 , A. Sharif 2 .
1 University of Birmingham, Birmingham, United Kindom; 2 Queen
Elizabeth Hospital, Birmingham, United Kingdom
Introduction and aims: It is well established that patients with
end-stage kidney failure that receive kidney transplants have huge
improvements in life expectancy compared with the alternative
treatment of dialysis. However, the risks versus beneﬁts of kidneytransplantation become less clear with increasing age. With our
aging population and many patients in their 70’s and 80’s arereceiving transplants yet they are often excluded from clinicalresearch trials. Therefore, I intend to look at the current practice oftransplantation in elderly patients in the UK and determine how
recipient age affects clinical outcomes in the contemporary eraof transplantation practise. Results from this study will hopefully
aid decision making into the optimal allocation of these precious
resources.
Method: This nationwide population cohort analysis used the NHS
Blood and Transplant Registry dataset for all deceased donor single
kidney transplants to adults aged 18 and over performed in the UK
between 2003 to 2015. We originally stratiﬁed cases into recipients
aged 18–40, 41–59, and 60 and older and then undertook further
subgroup analysis focusing on patients over 60, using the following
age bands (1≤59, 2=60–65, 3=66–70, 4=71–75, 5=76>). Patient andgraft survival outcomes were assessed using Kaplan Meier curves
and Cox regression models, while delayed graft function (DGF) was
assessed using binary logistic regression.
Results: There were 18,769 transplants in our study cohort, withthe median age for recipients 48, and age groups were as follows;
40 and under (n=4712), 41–59 (n=8968), and 60 and over (n=5055).
In unadjusted analyses, graft survival differed signiﬁcantly acrossthe age groups (p<0.001). Cox regression analysis showed graft
survival was signiﬁcantly better for the age group 41–59 years(Hazard Ratio [HR]: 0.793, p<0.001) compared with the over 60’s
group. However, there was no signiﬁcant difference between graft
survival of the over 60’s compared to the under 40’s [HR=0.984,
p=0.755]. Patient survival between the three groups conﬁrmed
reduced patient survival with HR 0.143 (p<0.001) and HR 0.353(p<0.001) for the ages under 40’s and 41–59 respectively. Delayed
graft function varied signiﬁcantly between the age groups (40 andunder, 23.4%; 41–59, 28.1%; 60 and over, 33.1%, p<0.001). Mean
creatinine among surviving kidneys was higher in the 60 and overgroups (142 mmol/l) versus the 41–59 group (139 mmol/l) and
40 and under (138 mmol/l) (p<0.001). Further stratiﬁcation ofage groups 60–65 (n=2396), 66–70 (n=1496), 71–75 (n=679), and>75 (n=148) showed worse outcomes for creatinine, delayed graftfunction, graft and patient survival for the over 75 groups comparedto other “older” adults.
Conclusion: Even in the contemporary era, increasing recipient
age remains a predictor of inferior clinical outcomes graft survival,
adding a layer of complexity into the decision of how best to
allocate such scarce resources. In the literature, there is muchheterogeneity in deﬁning at the elderly and therefore we lack clear
guidelines on risk of kidney transplantation stratiﬁed by recipient age. In our analysis, we highlight this diﬃculty by showing
the gradual stepwise decrease in graft survival and the unusual
pattern of delayed graft function amongst the 60 and over group.
Therefore, we recommend further research into clinical outcomesamong the 60 and over group and consideration should be given fortargeted research for age-adapted immunosuppression to optimise
outcomes for older kidney transplant recipients.
O-113
IGF-1 pathway in the regulation of Nox4 ROS production inchondrocytes: Osteoarthritis physiopathology
S. Drevet, G. Gavazzi, B. Lardy. Grenoble University Hospital
Introduction: Osteoarthritis (OA) is characterized by a cartilage
dysregulation, a degenerescence of the chondrocytes with oxidative stress (OS) involvement. Nox 4 isoform dependent reactive
oxygen species (ROS) production is one of the triggers for thematrix metalloproteases (MMPs) synthesis and extracellular matrix(ECM) degradation. IL-1β could induce OA conditions. Insulin-like
Growth Factor-1 (IGF-1) is another key regulator in human articularchondrocytes. The main objective of the study was to assess IGF-1
stimulation on MMPs synthesis in chondrocytes immortalized cellline C-20/A4.
Methods: We used human C-20/A4 chondrocyte cell line. Nox4
overexpression was performed with retrovirus (RV) Nox4. Rv Nox4
C-20/A4 stimulation was performed using IL1-b 20ng/ml or IGF-1
200ng/ml. Quantitative RT-PCR was used to assess MMP 1, 9, 13,
Nox 4 expression level.
Results: Human IL-1β stimulation induced MMP-1 -13 and -9mRNA rate elevation. IGF-1 cell stimulation induced MMP-9 peakat 4 hours and an increase of MMP-13 mRNA level sevenfold at 24hours. The effect seemed to be Nox4 dependent.
Conclusions: We showed for the ﬁrst time that IL-1β induced
MMP-9 by a Nox 4 dependent pathway. High concentrations
IGF-1 induced MMP-9 and MMP-13 mRNA synthesis, trigger ofcatabolism. IGF-1 pathway is interesting since Klotho anti-ageing
protein has at least two ways to participate in OA pathway. Klotho
is known to inhibit Insulin/IGF-1 pathway and to enhance cellular
protection against OS by inducing transcription of anti oxidant
enzyme as Mn Superoxide dismutase. Klotho could be a protein ofinterest for future OA treatment.
O-114
Analyzing kidney impairment in the elderly
V. Guerrero, R. Quílez, R. Sander, A. Narvión, A. Sanjoaquín,
J. Galindo. H. Sagrado Corazón Jesús, Huesca, Spain
Introduction: Chronic Kidney Disease (CKD) is a disease with a highprevalence in people over 65 years old. It’s 23.6% in Spain, 35.7%
in Canada, 35.8% in Finland and 23.4% in the USA [1,2]. The mostwidely accepted method for measuring renal function is glomerular
ﬁltration (GFR), for which different formulas have been developed(MDRW, CKD-EPI, Cockroft Gault (C-G), BIS1), although none havebeen validated in a population older than 70 years or overestimate
the true glomerular ﬁltration rate in subjects over 65 years. In 2011
was created a new formula, called HUGE formula (hematocrit, urea
and gender). It will help to assure if the GFR is reduced below 60

Oral presentations / European Geriatric Medicine 8S1 (2017) S1–S39

ml/min, is due to a physiological process associated with aging or
due true CKD [3].
Objectives: To evaluate the sensitivity (S) and speciﬁcity (E) of thedifferent formulas (MDRW, CKD-EPI, CG, BIS1) to diagnose CKD.
Evaluate if the HUGE formula has predictive value in people over 90
years.
Methods: Prospective longitudinal cohort study. Study the characteristics of patients over 90 years seen in the out patient
clinic between 2015 and 2016 in Huesca. Also Socio-demographic
data, comorbidity, analytical results and drugs were recorded. All
collected data was analyzed with Statistical analysis SPSS 23.
Results: A total: 288 patients with age: 94.5±2.4 years, 69.8% werefemale, survival in ﬁrst year of 81.3%. Comorbidities: HTA 78.5%, DM
29.2%, dyslipidemia 45%, anemia 35.7%. We evaluated (S) and (E) of
each formula twice during the study: At the beginning of the study,
comparing all the formulas against the CKD-EPI obtaining: MDRW4:
S: 77.3% and E: 100%. C- G: S: 100% and E: 10.7%. BIS1: S: 100% andE: 20.4%. Throughout the follow-up year, comparing all the formulas
against the CKD-EPI from the beginning of the study obtaining;
MDRW4: S: 82.9% and E: 93.5% and CKD-EPI: S: 95.9% and E: 74.2%.
According to the HUGE formula of patients with GF below <60
ml/min (48.6%) had a physiological deterioration associated withaging. CKD identiﬁed by HUGE formula was associated with higher
mortality at one year (p=0.003).
Conclusions: It is conﬁrmed that despite different and new formulas for estimating glomerular ﬁltration rate, CKD-EPI continues tobe the most sensitive and speciﬁc even in older patients.Current
available formulas can overestimate the diagnosis of CKD, so it isadvisable to apply the HUGE formula in a complementary way,
which also gives us prognostic value.
References:[1] Otero A, Francisco ALM De, Gayoso P, García F, Study E. Prevalence of chronic renal disease in Spain: Results of the EPIRCE
study. Rev Soc Española Nefrol. 2010;30(1):78–86.
[2] Martín De Francisco A., Piñera C, Gago M, Ruiz J, Robledo C, Arias
M. Epidemiología de la enfermedad renal crónica en pacientes
no nefrológicos. SEN. 2009;29:101–5.
[3] Heras M, Fernández-Reyesa M. Nuevas herramientas para abordar la función renal en ancianos: la ecuación Berlin Initiative
Study y la fórmula hematocrito, urea y género. Med Clin (Barc).
SEGO; 2016;146(10):450–4.
O-116
Low diastolic blood pressure increases risk of cardiovascular
events in the vascular frail
L. Wijsman 1 , A. De Craen 1 , W. Jukema 1 , R. Westendorp 2 ,S. Mooijaart 1 . 1 Leiden University Medical Center; 2 University of
Copenhagen
Background: In older age, a low diastolic blood pressure (DBP)
has been associated with increased risk of cardiovascular events,
especially in frail older people. A potential mechanism might bethat low DBP leads to inadequate perfusion of vital organs due to a’frail’ vascular system. Here, we tested the hypothesis that low DBP
is associated with a high risk of cardiovascular events in people
with a previous history of cardiovascular disease, as a proxy ofvascular frailty.
Methods: 5,804 participants (mean age 75 years) from the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER) who aspart of the trial were intensively monitored for an average period of
3.2 years. Baseline DBP was categorized in low (<70 mmHg), normal (70–90 mmHg) or high (>90 mmHg). Cox proportional hazards
analyses were used to estimate hazard ratio (HR) with 95% conﬁdence intervals (CI) for the association of DBP with cardiovascular
events. Analyses were stratiﬁed for cardiovascular history.
Results: Participants with low DBP had an 1.24-fold (1.04; 1.49)

S37

increased risk of cardiovascular events compared to those withnormal DBP. After further adjusting for cardiovascular factors, thisassociation attenuated to 1.05 (0.86; 1.28). A previous history of
cardiovascular disease signiﬁcantly modiﬁed the relation between
DBP and risk of cardiovascular events (p-interaction = 0.042). In
participants without a history of cardiovascular disease, DBP was
marginally signiﬁcant associated with a increased event risk (HR(95%) per 10 mmHg increase in DBP 1.08 (0.99; 1.18), p-value = 0.07),
whereas in participants with a history of cardiovascular disease
higher DBP was associated with a decreased risk of cardiovascular
events (HR (95%) per 10 mmHg increase in DBP 0.92 (0.85; 0.99,
p-value = 0.018). These risk estimates were independent of potential
confounders, including classical cardiovascular risk factors.
Conclusion: The association of DBP with cardiovascular eventsin older people varies upon their previous history, showing thatin participants who are vascular frail (pre-existing cardiovasculardiseases) lower DBP associates with an increased risk of futurecardiovascular events.

Area: Urology and continence management

O-117
Recurrent urinary retention: 6 months follow-up of elderly
patients who beneﬁted an alternative treatment to theindwelling catheter after a multidisciplinary team board
C. Rambaud 1 , M. Durand 2 , S. Gonfrier 1 , C. Arlaud 1 , M. Sanchez 1 ,J. Fallot 3 , G. Sacco 1 , O. Guérin 4 . 1 Geriatrics Department, University
Hospital of Nice, France; 2 Department of Urology, University Hospitalof Nice, INSERM, U1189, ONCO-THAI, Lille, France; 3 Department ofUrology, University Hospital of Nice, France; 4 Geriatrics Department,
IRCAN - University of Nice - Sophia-Antipolis INSERM U1081 - CNRSUMR 7284
Introduction: The indwelling urinary catheter (IUC) is over usedon the elderly. The aim is to analyze the success rate of alternative
treatments (AT) to the IUC at 6 months follow up.
Methods: A standardized multidisciplinary team board was established to screen patients, over 70y, who can beneﬁt from analternative treatment option to IUC, using comprehensive geriatricassessment. We evaluated success of AT (deﬁned by the lack ofurinary retention at 7 days, 1, 3 and 6 months) and overall death
rates.
Results: Sixty-one patients were enrolled with a mean age of 87y(women: 42.6%). Alternative technics were offered to 62% (n=38),
including 23 catheter withdrawals, 7 thermo-expandable intraprostatic stents, 8 prostatic photovaporizations. Overall, the successrate was 92.1% at 7 days and raised up to 100% at 1, 3 and 6-monthfollow-up. The IUC group patients were signiﬁcantly older (89.3 vs
85.3y, p=0.021), very dependent (ADL <2, 78.3% vs 39.5%, p=0.03)
and with neurologic comorbidities (78.3% vs 52.6%, p=0.045). The
global rate of death of the cohort were at 1, 3 and 6 months: 6.6%(n=4), 21.3% (n=13), 36% (n=22). At 6 months, the rate of deathin the IUC group was higher (65% vs 18.4%, p=0.01). In univariate
analyzes, predictive factors of a 6-months death were neurologic
comorbidities (HR: 4,3 [1.2–14.9], p=0.023), a dependence (ADL<2)(HR: 4.9 [1.5–16]) and the IUC (HR: 5.5 [1.8–17], p=0.003). In
multivariate analyzes, the factors were a dependence (ADL<2) (HR:
3.9 [1.1–13.4], p=0.034) and the IUC (HR: 4.4 [1.4–14.5], p=0.014).
Conclusion: The multidisciplinary analysis may offer a betterchance to deal with IUC in elderly people with a steady global
success rate of 62% catheter withdrawals at 6 months. The elevatedrate of death in IUC group highlight the frailty of dependent patientsand data is needed to report the relation with IUC.

S38

Oral presentations / European Geriatric Medicine 8S1 (2017) S1–S39

Late Breaking Abstracts – Oral presentations

LB-001
Genetic variants associated with physical performance andanthropometry in old age: a genome-wide association study inthe ilSIRENTE cohort
E. Marzetti 1 , D. Heckerman 2 , B.J. Traynor 3 , A. Picca 1 , R. Calvani 1 ,D. Hernandez 4 , M. Nalls 5 , S. Arepali 4 , L. Ferrucci 6 , F. Landi 1 ,R. Bernabei 1 . 1 Center for Geriatric Medicine (CEMI), Department ofGeriatrics, Neurosciences and Orthopedics, Catholic University of
Sacred Heart, Rome, Italy; 2 Microsoft Research, Los Angeles, California,
USA; 3 Neuromuscular Diseases Research Section, Laboratory of
Neurogenetics, National Institute on Aging, 35 Convent Drive, Room
1A-1000, Bethesda, MD, USA; 4 Genomics Technology Group,
Laboratory of Neurogenetics, National Institute on Aging, 35 Convent
Drive, Room 1A-1000, Bethesda, MD, USA; 5 Molecular Genetics Unit,
Laboratory of Neurogenetics, National Institute on Aging, 35 Convent
Drive, Room 1A-1000, Bethesda, MD, USA; 6 Longitudinal Studies
Section, Clinical Research Branch, National Institute on Aging, 251
Bayview Blvd., Room BRC/04C225, Baltimore, MD, USA
Background: Unraveling the complexity of aging is crucial forunderstanding its mechanisms and why aging is the risk factor for
most chronic conditions. The advancements marked by genomewide association studies (GWASs) have sparked interest in genecataloguing in the context of aging and age-related conditions.
Here, we used GWAS to explore whether single nucleotide polymorphisms (SNPs) were associated with functional and anthropometricparameters in a cohort of old community-dwellers enrolled in theilSIRENTE aging study.
Methods: Analyses were carried out in men and women aged 80+
years enrolled in the ilSIRENTE Study (n=286) and replicated in
the inCHIANTI Study (n=1055). Genotyping was accomplished on
Inﬁnium Human610-QUAD version 1.
Results: In the ilSIRENTE population, genetic variants in ZNF295 andC2CD2 (rs928874 and rs1788355) on chromosome 21q22.3, weresigniﬁcantly associated with the 4-meter gait speed (rs928874,
p=5.61×10–8 ; rs1788355, p=5.73×10–8 ). This association was not
replicated in the inCHIANTI population.
Conclusions: Our ﬁndings suggest that speciﬁc SNPs may be associated with a key measure of physical performance in older
adults. GWASs using larger samples are needed to conﬁrm thesepreliminary results to enhance our comprehension of complex
age-associated phenomena.
LB-002
MtDNA content and MtDNA deletion mutation abundance inskeletal muscle of sedentary high- and low-functioning elderly
individuals
A. Picca 1 , A. Gordillo Villegas 2 , R. Mankowski 2 , A.M.S. Lezza 3 ,R. Calvani 1 , E. Marzetti 1 , C. Leeuwenburgh 2 , R. Bernabei 4 .
1 Department of Geriatrics, Neurosciences and Orthopedics, Catholic
University of the Sacred Heart School of Medicine, Teaching Hospital“Agostino Gemelli”, Rome, Italy; 2 Department of Aging and GeriatricResearch, Institute on Aging, Division of Biology of Aging, University of
Florida, Gainesville, FL, USA; 3 Department of Biosciences,
Biotechnology and Biopharmaceutics, University of Bari, Bari, Italy;
4 Department of Geriatrics, Neurosciences and Orthopedics, Catholic
University of the Sacred Heart, Rome, Italy
Introduction: Mitochondrial dysfunction in skeletal myocytes has
been proposed as a major factor contributing to the development
and progression of sarcopenia. Hence, the quantitation of mitochondrial DNA (mtDNA) abundance and mtDNA deletion mutationload may help clarify the role of mtDNA instability in muscle
aging.
Methods: We applied real-time PCR-based approaches to total DNA
puriﬁed in muscle samples obtained from young adults, sedentary
older adults, classiﬁed as high- and low-functioning based on the
Short Physical Performance Battery (SPPB), in order to examine theeffect of aging on key quantitative alterations of mtDNA and how
this relates to physical performance.
Results: Muscle volume, as quantiﬁed via 3D-NMR, was decreased
by 38% and 30% in low- (LFE) and high-functioning elderly (LFE)
participants, respectively when compared to young and highfunctioning elderly participants, respectively, and positively correlated with physical performance. The content of mtDNA was foundto be signiﬁcantly reduced in both groups of elderly participants,
regardless of the SPPB score, relative to their younger counterparts.
The age-associated decrease in mtDNA abundance was paralleled byan increase in the mtDNA deletion in HFE and LFE participants, withno differences between the two groups. Further investigations willprobe alterations in mtDNA encoding genes: NADH dehydrogenase
1 (ND1/Complex 1), Cytochrome b (Complex III), and cytochrome coxidase (COI/Complex IV).
Conclusion: This study shows altered mitochondrial homeostasis inmuscles of aged human. The decline in myocyte mitochondrial massand the accumulation of mtDNA deletions may therefore represent
critical steps to muscle aging and possible targets for interventions
against sarcopenia.
LB-003A study of executive function (EF) and prospective fall risk incommunity-dwelling older adults
C. Smith 1,2,4 , C. Bula 1,2 , H. Krief 2 , L. Seematter-Bagnoud 3 ,B. Santos-Eggimann 3 . 1 University of Lausanne, Lausanne, Vaud,
Switzerland; 2 University of Lausanne Medical Center, Lausanne, Vaud,
Switzerland; 3 IUMSP, Lausanne, Vaud, Switzerland; 4 Rehabilitation
Clinic Bois-Bougy
Background: Recent ﬁndings suggest that older people with executive function (EF) impairment have an increased fall risk.
Prospective evidence with prolonged follow-up is however lacking.
Objective: To examine 1) whether EF impairment at baseline predicts falls at 6-year follow-up; and 2) whether a dose-response
relationship exists between EF impairment and falls at 6-year
follow-up.
Methods: Community-dwelling older adults (N=906, mean age
69±1.4, women 59.8%) were followed between 2005 and 2011. Measures of EF at baseline: clock drawing test (CDT), verbal ﬂuency (VF),TMT-A, -B, and ratio (TMT B-A/A). Falls were collected prospectively
in 2011using monthly calendars.
Results: At baseline, 5.5% were cognitively impaired (MMSE≤24),
17.9% had abnormal CDT (score≤7). In 2011, 13% fell one time
without injury and an additional 20.2% had multiple or injurious falls. Baseline cognitive proﬁles of non-fallers and multiple/injurious fallers were similar. In multivariable analysis, poor
EF at baseline was signiﬁcantly associated with reporting one
non-injurious fall (RRworst quintile TMTB = 0.38, 95% CI: 0.19–0.77,
p=0.007; RRworst quintile ratio TMT B-A/A = 0.33, 95% CI: 0.16–0.67,
p=0.002). There was no signiﬁcant association between poor
EF and multiple/injurious falls, showing no dose-response relationship. In subgroup analysis among fallers, poor EF was associatedwith recurrent or injurious falls (ORworst quintile of TMT B = 1.86, 95%
CI: 0.98–3.53, p=0.059; (ORworst quintile ratio TMT B-A/A = 1.84, 95% CI:
0.98–3.43, p=0.057).
Conclusions: Among fallers, EF impairment at baseline predictedrecurrent or injurious falls. Further investigations will examine
whether decline in EF increases fall risk during follow-up.

Oral presentations / European Geriatric Medicine 8S1 (2017) S1–S39

LB-004
Incidence and cost of medication-related harm in older adults
following hospital discharge in the UK: Results from the PRIME
study
N. Parekh 1 , K. Ali 1 , J.M. Stevenson 2 , J.G. Davies 2 , R. Schiff 3 ,J. Harchowal 4 , J. Raftery 5 , C. Rajkumar 1 , on behalf of the PRIME
Study Group. 1 Department of Elderly Medicine, Brighton And Sussex
Medical School, Brighton UK; 2 Institute of Pharmaceutical Science,King’s College London, London UK; 3 Department of Ageing And Health,
Guy’s and St. Thomas’ NHS Foundation Trust, London UK;
4 Department of Pharmacy, The Royal Marsden NHS Foundation Trust,
London UK; 5 Department of Medicine, University of Southampton,
Southampton, UK
Introduction: Medication-related harm (MRH) is the most common adverse event following hospital discharge [1]. We sought todetermine the incidence of MRH post-discharge in a populationof older adults in the UK and associated cost of National HealthService (NHS) utilisation.
Methods: The study methods have been published [2]. Patients
65 years and above were recruited at the point of discharge
following an acute admission from 5 teaching hospitals in SouthEngland between September 2013 and November 2015. Patientswere followed-up by research pharmacists for 8 weeks to determine
whether they experienced MRH through 3 sources; hospital readmission, patient/carer telephone interview and GP records. MRH
was deﬁned as harm from adverse drug reactions or non-adherence.
National Health Service (NHS) utilisation associated with MRH wasrecorded and costed using national NHS tariffs, and extrapolatedusing national hospital admissions data.
Results: Data from 1116 patients were analysed, median age 81.9
years (IQR, 75.5–86.9), and 58.4% female. The median discharge
medicines per patient was 9 (IQR, 7–12). Four hundred and thirteen(37.0%) patients experienced MRH in the 8-weeks follow-up period, of which 51.9% was potentially avoidable. The most common
MRH events were gastrointestinal (25.4%), neurological (17.9%),
cardiovascular (11.0%) and musculoskeletal (10.5%). Four patients
experienced fatal MRH (0.4%). Medicine classes associated withthe highest risk of MRH (adverse events per 1000 discharge prescriptions) were opiates (399), antibiotics (189), benzodiazepines(180) and diuretics (153). Of 413 patients that experienced MRH,
328 (79.4%) sought NHS care. The incidence of MRH-associatedpatient readmission was 78 per 1000 discharges. We estimate
post-discharge MRH in older adults to cost the NHS £ 395.5 million
annually, of which £ 243.4 million is potentially avoidable.
Conclusions: MRH is common in older adults following hospitaldischarge, and results in substantial use of NHS resources. Interventions to prevent avoidable MRH could lead to considerable savings
for NHS.

S39

References:[1] Forster AJ, Murff HJ, Peterson JF, Gandhi TK, Bates DW. The
incidence and severity of adverse events affecting patients after
discharge from the hospital. Ann Intern Med 2003;138:161–7.
[2] Stevenson J, Parekh N, Ali K, Timeyin J, Bremner S, Van Der
Cammen T, et al. Protocol for a Prospective (P) study to develop
a model to stratify the risk (RI) of medication (M) related harmin hospitalized elderly (E) patients in the UK (The PRIME study).
BMC Geriatr 2016;16:22. doi:10.1186/s12877–016–0191–8.
LB-005Caregivers’ tailored nutritional counseling increases protein
intake among male caregivers and patients receiving care athome
S. Kunvik 1,2 , R. Valve 2 , M. Salonoja 1 , M.H. Suominen 3 . 1 The Social
Services and Healthcare Centre of Pori, Finland; 2 Department of Foodand Environmental Sciences, University of Helsinki, Finland; 3 Unit ofPrimary Health Care, Helsinki University Central Hospital, Finland
Introduction: Older caregivers (CG) and care recipients (CR) arevulnerable to nutritional problems. Low intake of protein is common and can affect to their nutrition and health. Tailored nutrition
counseling is needed to improve caregivers’ and care recipients’nutrition.
Methods: In this RCT, we investigated the effectiveness of tailorednutrition counseling on nutrient intake among CG aged ≥65 years
with normal cognition and CR aged ≥50 years. Nutrient intake
was assessed with three-day food diary. Six-month intervention
included tailored nutritional counseling with home visits, groupmeetings and written material in intervention group (I). Writtenmaterial was offered to control group (C). Main outcome measure
was change in protein intake (g/kg bodyweight (BW)/d) and it
was analyzed among participants with protein intake under 1.2
g/kgBW/d (intervention target) at baseline.
Results: Total of 55 CG (n=28 I, n=27 C) and 40 CR (n=25 I, n=15 C),
who had protein intake under 1.2 g/kgBW/d at baseline (79.7% CG
and 88.8% CR), completed the study. Mean protein intake was 0.86
g/kgBW/d in the CG and 0.90 g/kgBW/d in the CR. Protein intake
increased in CG male intervention group (n=12) 0.11 g/kgBW/d
and decreased in male control group (n=13) −0.07 g/kgBW/d),
p=0.007. Among CR intervention group protein intake increased
0.07 g/kgBW/d, p=0.033, but did not change in controls. There wereno signiﬁcant differences between other groups.
Conclusions: Tailored nutritional counseling improve protein intake among elderly male caregivers. Offering nutritional counselingto caregivers can affect to care recipient’s nutrition at the sametime.

European Geriatric Medicine 8S1 (2017) S40–S247

Poster presentations
Area: Biogerontology and genetics

P-001
Accelerated attrition early in life can explain short telomeres inpatients with atherosclerotic cardio-vascular disease
A. Benetos 1 , S. Toupance 2 , S. Gautier 3 , C. Labat 2 , M. Kimura 4 ,P.M. Rossi 5 , N. Settembre 6 , J. Hubert 7 , L. Frimat 8 , B. Bertrand 9 ,M. Bouﬁ 10 , X. Flecher 11 , N. Sadoul 12 , P. Eschwege 7 , M. Kessler 8 ,J.D. Kark 13 , S. Malikov 6 , S. Verhulst 14 , A. Aviv 4 . 1 INSERM UMRS
1116, Université de Lorraine, Nancy, France; Department of GeriatricMedicine, CHRU de Nancy, Université de Lorraine, Nancy, France;
2 INSERM UMRS 1116, Université de Lorraine, Nancy, France;
3 Department of Geriatric Medicine, CHRU de Nancy, Université deLorraine, Nancy, France; 4 Center of Human Development and Aging,Rutgers, The State University of New Jersey, New Jersey Medical School,
Newark, NJ 07103, USA; 5 Department of Vascular Surgery, North
hospital, APHM, Marseille of Internal Medicine, North hospital, APHM,
Marseille, France; 6 Department of Vascular Surgery, CHRU de Nancy,
Université de Lorraine, Nancy, France; 7 Department of Urology, CHRU
de Nancy, Université de Lorraine, Nancy, France; 8 Department ofNephrology, CHRU de Nancy, Université de Lorraine, Nancy, France;
9 Department of Plastic Surgery, Conception Hospital, APHM and
UMR-S1076, Aix-Marseille University, France; 10 Department of
Vascular Surgery, North hospital, APHM, Marseille, France;
11 Department of Orthopedic Surgery, North hospital, APHM, France;
12 Department of Cardiology, CHRU de Nancy, Université de Lorraine,
Nancy, France; 13 Hebrew University-Hadassah School of Public Healthand Community Medicine, Jerusalem 29107, Israel; 14 Groningen
Institute for Evolutionary Life Sciences, University of Groningen,
Groningen, the Netherlands
Short telomere length (TL) in leukocytes is associated withatherosclerotic cardiovascular disease (ACVD). It is unknown
whether this relationship stems from having inherently shortleukocyte TL (LTL) at birth, a faster LTL attrition thereafter, before or
during the clinical manifestation of ACVD, or both. To understandthe temporal relation of LTL with ACVD, we built on the following
ﬁndings: TL attrition during extra-uterine life varies in proportion to the replicative activities of tissues. Consequently, skeletal
muscle (M), a minimally proliferative tissue, displays a longer TL
than LTL, which represents the highly proliferative hematopoietic
system. We applied this blood-and-muscle to study the relation
between TL and ACVD. We studied 259 individuals (82 women)
aged 63±1 years (mean±SEM), undergoing surgery with (n=131) orwithout (n=128) clinical manifestation of ACVD. TL in leukocytes
and in muscle biopsies was measured by Southern blots. In all
subjects, MTLA (MTL adjusted for muscle biopsy site) was longer
than LTL and LTL-MTLA difference became wider with age similarly in ACVD patients and controls. Age- and sex-adjusted LTL,

but not MTLA, was shorter in patients with ACVD than controls(6.52±0.06 vs 6.80±0.06, P=0.005). LTL-MTLA was wider in ACVD
than in controls (−2.01±0.05 vs −.74±0.05 respectively, P=0.0003).
This ﬁrst study, applying the “blood-and-muscle” TL model, shows
more pronounced LTL attrition in ACVD patients than controls.
The difference in attrition rates was not modiﬁed by age during
adulthood indicating that accelerated attrition in early life is likely
to be a major explanation of the shorter LTL in ACVD patients.
P-002
Activation of SKN-1 response in Caenorhabditis elegans by
dietary protein-bound Nε-carboxymethyllysine
R. Litke, T. Leycuras, I. Bin-Saïd, E. Boulanger, C. Fradin.
LIRIC-UMR995
Introduction: Caenorhabditis elegans is one of the major modelorganisms for studying aging. We investigated the impact of dietary protein bound Nε-carboxyméthyllysine (CML) on C. elegans
lifespan. We also studied the inﬂuence of CML on activation of
three transcription factors controlling C. elegans longevity: DAF-16,
SKN-1 and PHA-4 which are orthologs of human FOXO, NRF1/2 and
FOXA, respectively.
Methods: Bovine serum albumin (BSA) was incubated with glyoxylic acid to produce CML-modiﬁed BSA (CML-BSA). Non-modiﬁed
BSA (Ctrl-BSA) was used as control. C. elegans lifespan was measured in presence of CML-BSA and Ctrl-BSA. Activation of DAF-16,
SKN-1 and PHA-4 transcription factors was monitored by using
strains which express GFP fusion protein. Nuclear translocationof GFP fusion transcription factors was visualized by ﬂuorescencemicroscopy. Expression of SKN-1 target genes (HSP-4, ATF-5 andGST-14) was analysed by RT-qPCR.
Results: CML-BSA had a transient but signiﬁcant effect on C. elegans
median lifespan. This effect was dependent on the concentrationof CML. Activation of DAF-16 and PHA-4 was not controlled by
CML-BSA. Nuclear translocation of SKN-1 was observed in proximal
intestinal cells of worms incubated with CML-BSA. Time-course
expression of SKN-1 target genes is in progress to conﬁrm SKN-1
response induced by CML-BSA.
Conclusions: Our preliminary data show that dietary BSA-bound
CML transiently inﬂuences C. elegans lifespan. SKN-1 activation,
which typically results in recovery of homeostatic functions, could
be responsible for CML detoxiﬁcation, then worms’ recovery. Additional analysis will be necessary to uncover mechanisms andmolecules involved in SKN-1 activation by CML.
P-003
Assessing the role of APOE polymorphism on the executive
dysfunctions in Alzheimer’s disease
G. D’Onofrio, D. Sancarlo, F. Panza, A. Mangiacotti, P. Bisceglia,
C. Gravina, M. Urbano, M. Lauriola, M. D’Agostino, L. Cascavilla,

1878-7649 / © 2017 Elsevier Masson SAS and European Union Geriatric Medecine Society. All rights reserved.

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

D. Seripa, A. Greco. Complex Structure of Geriatrics, Department ofMedical Sciences, IRCCS “Casa Sollievo della Sofferenza”, San Giovanni
Rotondo, Foggia, Italy

P-005
BMP-2 and BMP-4 plays a positive role in articular cartilage
maintaining in mice

Introduction: To determine the role of the apolipoprotein E (APOE)
ε4 allele on executive dysfunctions in Alzheimer’s disease (AD)patients.
Methods: A total of 182 AD patients attending Alzheimer’s Evaluation Unit of Geriatrics, IRCCS “Casa Sollievo della Sofferenza” were
included in the study. Of these patients, 132 were with executive
dysfunctions (AD-ED) and 50 were without executive dysfunctions(AD-noED). All patients underwent APOE genotyping, Comprehensive Geriatric Assessment (CGA), Mini Mental State Examination(MMSE), Clinical Dementia Rating (CDR), Clock Drawing Test (CDT),
and Frontal Assessment Battery (FAB).
Results: Percentage of females with AD-ED were signiﬁcantly higher(p=0.044). AD-ED showed signiﬁcantly higher cognitive impairment
in MMSE (p<0.0001) and CDT (p=0.002), a more severe stage of
dementia (CDR, p=0.008), and a worsening in several CGA domains(ADL, p=0.048; IADL, p=0.015; ESS, p=0.035). A higher frequencyof APOE ε4/ε4, ε3/ε4 and ε2/ε4 genotypes was observed in patientswith AD-ED (82.4%, 97.6%, and 66.7% respectively; p<0.0001). Conversely, a lower frequency of APOE ε3/ε3 and ε2/ε2 genotypes wasobserved in patients with AD-ED (45.1% and 28.6% respectively;
p<0.0001).
Conclusions: If conﬁrmed in wider samples of subjects, the observed differences suggested that the presence of ED in AD might
identify two clinically and diagnostically distinct groups of patients.
The observed results may have important clinical implications
regarding mechanisms underlying these symptoms that may implicate a different treatment of these patients.

J. Li 1 , A. Zhu 1 , H. Zheng 1 , D. Chen 2 . 1 Liaoning Traditional Chinese
Medicine University; 2 Rush University Medical Center

P-004
Association of mitochondrial DNA copy number and self-rated
health status: A cross-sectional study
J. Cerhan, J. Olson, S. Thibodeau, M. Cicek, B. Welkie, S. McDonnell,
J. Evans, E. Ryu. Mayo Clinic, Rochester, MN
Introduction: Mitochondria DNA (mtDNA) has received attention
in aging and human health. We evaluated the association of mtDNA
copy number with self-rated health status, independent of age.
Methods: This is a cross-sectional study of patients enrolled within
the Mayo Clinic Biobank. We used 956 MCB patients with a completed health questionnaire and whole genome sequencing. The
primary outcome was mtDNA copy number. The primary predictor
was self-rated health status with 3 collapsed categories (excellent/very good, good, and fair/poor). A quantile regression model
was used to test the association between self-rated health status
and mtDNA copy number, adjusting for age and sex.
Results: The median age at enrollment was 61 years (range: 20 to96), and 63% reported excellent or very good health with 31% good;and 6% with fair/poor health. The median mtDNA copy number was
89.3 (25th – 75th: 77.6–101.3). Higher copy number was observedwith younger age (median of 96.0 for those ≤30 years vs 84.8
for subjects >65), and excellent or very good self-rated healthstatus (median of 91.1, compared to 86.1 for good health and 83.0
for fair/poor health status). The association of self-rated healthstatus with mtDNA copy number remained signiﬁcant, even after
adjusting for age and sex (2.2 [95% CI: 0.4–4.2] greater median
mtDNA copies for those reporting excellent or very good health,compared to those with “good” health).
Conclusions: We found higher mtDNA copy number is associatedwith better self -rated health status independent of age and sex.

S41

BMPs, speciﬁcally BMP-2 and -4, have been shown to play a majorrole in mesenchymal cell differentiation and chondrocyte hypertrophy. The graded genetic expressions of BMP-2 and -4 within thefour major growth plate zones represent an important molecularcomponent of long bone formation after birth. However, the roleof BMP-2 and -4 in mature articular cartilage remains limited. In
this study, we investigate the signiﬁcance of the BMP2While BMP
signaling plays an important role in chondrocyte metabolism, and
BMP2 and BM and BMP 4 gene in articular cartilage maintaining at
postnatal stage in mice vivo.
Objective: To observe the phenotype of deleting BMP-2 and BMP-4
gene in chondrocytes in the development and maintaining of articular cartilage in mice. Try to demonstrate the molecular mechanismof articular cartilage development and degradation through BMP 2
and BMP 4 gene related signaling.
Material and method: Bmp-2, Bmp-4 conditional knockout mice,(Bmp-2 Bmp-4)Col 2 ER mice were generated by breeding (Bmp2,Bmp-4)fx/fx mice with Col2-CreER transgenic mice. Knee joints
were harvested from 3 months and 6 months old mice for histology
to compare the difference in morphology of AC. Immunohistochemical were performed to analyze the OA-related proteins expression,
which involves mmp13, adamts 4, and adamts 5.
Results: 1. The silence of BMP2 and BMP4 induced articular cartilage degradation phenotype, such as narrowed AC area, shortened
AC depth, and massive subchondral bone, and the osteometric dataof calculated AC area is consistent to the dramatically morphology
changes in both 3- and 6- month old mice. (P<0.05) 2. The protein
expression of MMP 13, Adamts4 and Adamts5 in superfacial zone ofarticular cartilage tissue is signiﬁcnt increased in (BMP2, BMP4)Col
2 ER Group in 3-month old mice. (P<0.05) While in the 6-month
old mice there showed the same tendency but the data is notstatistical
Conclusion: Bmp2 and Bmp4 are not only involved in the formationof articular cartilage but also the mature cartilage metabolism andplay a positive role in cartilage maintaining.
P-006
Mechanism of secretion of ribosomal protein S3 (rpS3) fromcancer cells: a potential serological marker for cancer
Y. Kwon 1 , Y. Kim 2 , K.-H. Cho 1 , J. Kim 2 . 1 Korea University College ofMedicine, Seoul, Republic of Korea; 2 Laboratory of Biochemistry, Korea
University, Seoul, Republic of Korea
Introduction: Our previous study reported the secretion of ribosomal protein S3 (rpS3) into the extracellular space in conjunction
with tumor malignancy. However, the secretion pathway andmechanism have not been fully elucidated.
Methods: Human ﬁbrosarcoma (HT1080) cells were cultured in
Dulbecco’s modiﬁed Eagle’s media. To conﬁrm whether the secretion of rpS3 was regulated by an endoplasmic reticulum (ER)to Golgi or Golgi to ER pathway, HT1080 cells were treated with
brefeldin A or monensin. To determine whether glycosylation wasnecessary for the secretion of rpS3, HT1080 cells were treated withtunicamycin, and an immunoblot assay and ELISA were performed.
The presence of glycans in rpS3 was determined using peptideN-glycosidase F (PNGase F) and concanavalin A. To identify thesites of glycosylation in rpS3, liquid chromatography-tandem mass
spectrometry was performed.
Results: Secretion of rpS3 was inhibited by brefeldin A and tunicamycin. RpS3 bound to concanavalin A, whereas the band

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Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

for the secreted rpS3 shifted to lower-molecular-weight after thetreatment with PNGase F, indicating that the secreted rpS3 was
N-glycosylated. Mass spectrometry analysis showed that rpS3 is
glycosylated at the Asn165 residue.
Conclusions: N-linked glycosylation is needed for rpS3 to be secreted into culture media, in which ER-Golgi-dependent pathway is
involved. Moreover, we proved that the Asn165 residue of rpS3 had
an important role for N-linked glycosylation. Additional studies areneeded to deﬁne the role of the N-linked glycosylation of rpS3 incancer pathophysiology and to assess its potential as a new targetof cancer therapy.
P-007
Ribosomal protein S3 (rpS3) is secreted by various cancer celllines: a potential biomarker for cancer
Y. Kwon 1 , Y. Kim 2 , S. Park 1 , K.-H. Cho 1 , J. Kim 2 . 1 Korea University
College of Medicine, Seoul, Republic of Korea; 2 Laboratory ofBiochemistry, Korea University, Seoul, Republic of Korea
Introduction: Ribosomal protein S3 (rpS3) is known to be secreted
only by cancer cell lines and cells from cancer patients. We compared the secretion level of rpS3 among various cancer cell lines,
cells from healthy adults, and normal cell lines. We then evaluatedits possibility as a novel general biomarker for cancer.
Methods: HT1080 and MPC-11 (mouse plasmacytoma) cells were
cultured in serum-depleted media for 24 h. Thereafter, the culture
media were collected and precipitated to assess rpS3 protein secretion into the cell culture media. To clarify whether the secretionof rpS3 is associated with tumor malignancy, we used a seriesof tumor cell lines derived from a single immortalized humannormal bronchial epithelial cell line (BEAS-2B). Their malignancy
is classiﬁed as follows: non-transformed (1799), transformed but
non-tumorigenic (1198), and tumorigenic (1170-I). A doxorubicinresistant MPC-11 cell line was generated to examine the relationshipbetween secreted rpS3 and tumor malignancy.
Results: The rpS3 protein was only detected in the culture mediaof HT1080 and MPC-11 cells. The secretion of rpS3 was dramaticallyhigher in 1170-I cells compared to that in other cells. Additionally,
1198 and 1799 cells showed a moderately higher secretion of rpS3
compared to BEAS-2B. The level of rpS3 secreted by doxorubicinresistant MPC-11 cells was signiﬁcantly higher than that secretedby the MPC-11 parental cells.
Conclusions: We demonstrated that malignant cells release rpS3
protein. Based on our ﬁndings, secreted rpS3 can be a useful cancer
biomarker, and the rpS3 level might indicate the aggressiveness oftumor cells.
P-008
Role of epigenetics as a novel therapeutic approach to
Parkinson’s disease
A. Shueb. Glan Clwyd Hospital (BCU- North Wales)
Parkinson’s disease (PD) is a complex multifactorial disease with anelusive aetiology, in which genetic and environmental factors are
intricately associated. In recent years, epigenetic mechanisms such
as DNA methylation, histone modiﬁcations and non-coding RNAs
have been recognised as potential mediators in the pathogenesis of
PD. Epigenetics refers to the heritable changes in gene expressionthat do not involve changes to the underlying DNA sequence.
These modiﬁcations exist throughout our lifetime, commencing
in the prenatal phase, and are inﬂuenced by the summation of
one’s genome and the environmental factors we are subjected to,rendering epigenetics as the missing link between the risk factors
for PD and its development. Current pharmacological agents only
provide symptomatic relief, of which levodopa still remains thegold standard. However, drugs that halt or delay progression of PD

are still lacking. The increasing amount of papers aimed at understanding the epigenetics of PD has led to a better understanding of
the molecular pathways involved in dopaminergic neuron degeneration, and several researchers are now working to understand thetherapeutic potentials of epigenetic molecules to counteract agerelated neurodegenerative diseases. Research revealed that DNA
methylation, histone modiﬁcation, and alterations in non-coding
RNA proﬁles often precede disease pathology, which might prove
useful as early disease biomarkers. Over the past few years, there
has been a substantial progression in the development of epigenetic
drugs, particularly the histone deacetylase (HDAC) inhibitors andDNA methyltransferase (DNMT) inhibitors, as a novel therapeuticmodality in the management of PD. Cell replacement therapy is apromising avenue for the treatment of PD with scientiﬁc research
making great progress in the development of induced pluripotent
stem cells (iPSCs) to produce midbrain dopamine phenotypes. With
direct access to the neurons that are affected in PD, the pace of
discovery should speed up and the cure for PD should become
an attainable goal. This comprehensive critical appraisal will shedlight on the emerging role of epigenetics in the pathogenesis andtherapeutic modulation of PD.

Area: Cognition and dementia

P-009
A project improving identiﬁcation and assessment of elderly
oncology patients with suspected dementia
N. Rajcoomar, Z. Ali, S. Holikova, S. Tahir. Broomﬁeld Hospital Mid
Essex Hospitals NHS Trust, Chelmsford, UK
Introduction: In the UK 1 in 14 people aged over 65 have Dementia
and over 600,000 live with Dementia. On average 48% of thesehave no formal diagnosis, nor have access to specialist services[1]. Oncology patients with suspected Dementia have a poorer
prognosis and are more likely to be unsuitable candidates for
surgical management [2]. Our project aim was to improve practiceidentifying and assessing elderly oncology inpatients suspected of
Dementia.
Methods: 30 oncology patients over 65 years with AbbreviatedMental Test Score of 8 or less were audited. In line with NICE
guidance we reviewed appropriate history, examination, and investigations, as well as a discharge recommendation for memory
clinic. Interventions implemented include feeding back audit results, teaching and printed summary NICE Dementia guidance as anaide memoire. A re-audit was performed to assess improvement.
Results: A n initial audit showed that 15 (50%) patients had appropriate investigations, and 20 (66%) patients had recommendations
for memory clinic. Post intervention an audit showed improved
compliance with NICE recommended investigations to 26 (87%)
patients and memory clinic recommendations in 28 (93%) patients.
Discussion: Following simple intervention our project showed thatcurrent practice of identifying and assessing elderly oncology patients with suspected cognitive impairment, improved from 50–66%
to 87–93% compliance in line with NICE Dementia Guidance. Future
recommendations include teaching, signposting Doctors and making summary NICE guidance widely available; with re-audit in 1
year to ensure continued compliance.
References:[1] National Institute for Health and Clinical Excellence (NICE)(2016) Dementia: supporting people with dementia and theircarers in health and social careAvailable at: https://www.nice.
org.uk/guidance/cg42?unlid=725106828201715152953 [Last accessed 29/01/2017]

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247[2] Solomons et al. Dementia and Cancer. Ageing Health. 2013;9(3):307–319
P-010
A randomized controlled trial on the effect of physical andcombined physical and cognitive dual-task training on frailty inearly stage dementia patients
E.G.A. Karssemeijer, M.G.M. Olde Rikkert. Department of GeriatricMedicine, Radboud university medical center, Nijmegen, The
Netherlands
Background: Reducing frailty could have large positive effects on
health status and reduce future healthcare costs, speciﬁcally in frail
older adults suffering from dementia. This study aims to assess
the eﬃcacy of an aerobic training with and without a cognitivedual-task on the level of frailty in older adults with mild dementia.
Methods: A three-arm randomized controlled trial compared single aerobic training, combined cognitive-aerobic training, and an
active control group (i.e. stretching and toning). Frailty was measured by the Evaluative Frailty Index for Physical activity (EFIP), a
questionnaire that assesses patient-related outcomes on multiple
domains (e.g. physical, psychological and social). Older adults withmild dementia (N=56, age = 79.4±5.2 years) were randomized andindividually trained three times a week during 12 weeks.
Results: This abstract concerns preliminary results. At baseline, themean frailty index was 0.25 (95% CI: 0.22–0.28) and after 12 weeks
the index declined signiﬁcantly to 0.21 (0.18–0.25) in the total
study population. Post intervention group means for single training,combined training and active control were 0.20 (0.14–0.26), 0.21
(0.15–0.28) and 0.23 (0.17–0.29) respectively. These between groupdifferences were not signiﬁcant (ANCOVA p=0.535).
Conclusions: A 12-week training successfully reduces the levelof frailty in older adults with mild dementia. Since a signiﬁcant
contrast between the intervention groups was not found, the effectiveness of the different components of the intervention could
not be identiﬁed. This may be due to a lack of power at thisinterim stage of the trial and should be re-examined following
future inclusions.
P-011
Administering continuous palliative sedation to patients withdementia and extreme neuropsychiatric symptoms
R.T.C.M. Koopmans 1 , A.E. Veldwijk-Rouwenhorst 1 , D.L. Gerritsen 1 ,S.A.J. Hanssen 1 , M. Smalbrugge 2 , H. Bor 1 , S.U. Zuidema 3 .
1 Department of Primary and Community Care, Radboudumc
Alzheimer Centre, Radboud University Medical Center, Nijmegen;2 Department of General Practice and Elderly Care Medicine/EMGO+
Institute, VU University medical center, Amsterdam; 3 Department ofGeneral Practice and elderly care medicine, University of Groningen,
University Medical Center, Groningen
Introduction: Less than one percent of the patients with dementia
living in nursing homes exhibit very severe neuropsychiatric symptoms (NPS). Within this group, there are patients with so-called“refractory” NPS. In these patients the treating physician sometimes
decides to administer continuous palliative sedation (CPS).
Methods: To explore the process of decision-making leading to CPS,
this study retrospectively describes 3 cases where CPS was administered because of refractory NPS. We performed in-depth interviewsof involved physicians, nurses and relatives. All interviews weretranscribed ad verbatim and qualitative analyzed using Atlas.ti.
Results: Preliminary results show a range of themes relevant in
the process leading to the decision to administer CPS. The NPS
are extremely burdensome and considered refractory after a long
period of trying various interventions; stakeholders mention tohave tried everything, but with no effect. At a certain moment,

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they seem to lose hope, leading to a point dictated by feelingsof powerlessness. These feelings appear especially when the resident explicitly suffers, showing an intensive internal struggle andsometimes verbally expressing a death wish. At that point, thephysicians face the dilemma whether or not to make the decision
to administer CPS, knowing that the Dutch guideline only permits
CPS when life expectancy is less than two weeks.
Conclusions: CPS for NPS in residents with dementia is an undiscovered area. These preliminary results offer highly important
insights into the process of stakeholders surrounding a resident
with dementia and extreme NPS in their search for providing thebest care that they possibly can.
P-012
Age differences in reaction time during an inhibitory choice
stepping task challenged by a proprioceptive perturbation
G. Berrut 1 , C. Couturier 2 , C. Cornu 3 , T. Deschamps 3 . 1 Lab“Movement, Interactions, Performance” (E.A. 4334) (University of
Nantes, France), Clinical Centre of Gerontology Department (Nantes
University Hospital, France); 2 Clinical Centre of Gerontology
Department (Nantes University Hospital, France); 3 Lab “Movement,Interactions, Performance” (E.A. 4334) (University of Nantes, France)
Introduction: We aimed to explore the effects of a proprioceptive
perturbation from Achilles’ tendon vibrations on an inhibitory
stepping reaction time (RT) in young and older adults.
Methods: Twenty-six older adults (65–77 years, Mini-Mental State
Examination >26, non-fallers) and twenty-six young adults (20–30
years) performed quiet standing trials with and without vibrations
to record postural sway. Then, they executed an inhibitory stepping
RT task, with and without Achilles tendon vibration. They had tostep as quickly as possible in response to the direction of visual
arrows that manipulated speciﬁc inhibition processes (congruent“no inhibition” vs. incongruent “inhibitory” trials).
Results: During quiet standing, postural instability was higher inyoung adults as compared with older adults while challenging thevibratory perturbation. Concerning the stepping performance, older
adults had higher RTs than younger adults (p<0.01, +30%). Incongruent trials had larger effects on performances than congruence(p<0.01, +16%). Interestingly, only the young adults showed anincrease in RTs in presence of vibrations (p<0.05, +8%).
Conclusions: The vibrations did not affect the stepping RT performance in older adults, unlike young adults. The attentional
cost associated with the postural regulation might be alreadyhigh enough to be affected by vibrations and/or their well-known
age-affected sensory system may have not perceived the vibratory perturbation. Current investigations are conducted to knowwhether this composite assessment of inhibition and reactive
stepping can strongly discriminate fallers from non-fallers.
P-013
Ageism and dementia stigma among healthcare professionals
S. Schroyen 1 , S. Adam 2 , P. Missotten 2 . 1 University of Bordeaux,Bordeaux, France; 2 University of Liège, Liège, Belgium
Introduction: Attitudes of staff working in nursing homes (NH) areof great importance when it comes to the quality of life of residents.
The purpose of this research is to determine which parameters areassociated to more aging and dementia stigmas among different
types of professionals working in NH.
Methods: Our sample was constituted of 1276 professionals (Mage =39.21 years old), recruited from 32 NH belonging to the FIH
ASBL (Belgium). They were classiﬁed in nine groups: administrative(N=48); cooking staff (N=56); cleaning staff (N=150); activities(N=37); ergotherapists (N=39); assistant nurses (N=546); nurses(N=258); physiotherapists (N=76); and managers (N=64). Ageism

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Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

was evaluated by using the French version of the FSA-R [1] and theattitudes towards dementia were assesses by the DAS [2].
Results: Regression analyses show that the more people have experience, the more they have aging stigmas (p=0.001). Differences arealso observed according to their profession: assistant nurses, cooking and cleaning staff have a more negative aging view than nurses(all p<0.001). Concerning dementia stigmas, being a man, a lower
study level, working at partial time (vs full time) is associated withmore negative attitudes toward dementia (respectively, p=0.24,
0.002 and 0.005). Moreover, cooking, cleaning and administrative
staff have more stigmas toward dementia in comparison to nurses(all p<0.001).
Conclusion: Experience and profession seems to inﬂuence aging
stigma. Concerning dementia stigmas, they are associated withprofession, gender, level of education and working time.
P-014
Alzheimer and Helicobacter pylori infection: inﬂammation fromstomach to brain? Preliminary results
G. Albaret 1 , E. Sifré 1 , P. Floch 1 , S. Layé 2 , A. Aubert 2 , N. Salles 3 ,F. Mégraud 1 , P. Lehours 1 , C. Roubaud-Baudron 1 . 1 INSERM 1053;
2 INRA 1286; 3 Pôle gérontologie CHU BordeauxAlzheimer’s disease (AD) is the leading cause of dementia worldwide. Its neuropahtology is well described; still its origin is
unknown. Besides amyloid hypothesis, the role of infections has
emerged. Recent studies concluded that Helicobacter pylori (Hp)infection increased AD incidence in humans and amyloïd plaquesin the brain of AD-predisposed mice [1]. We hypothesized that
Hp-induced gastritis was associated with an increased systemic
and cerebral inﬂammation worsening AD lesions. C57BL6 mousewere infected with H. pylori (Hp, n=15) or H. felis (Hf, n=13) orleft uninfected (NI, n=9). Stomach, brain and serum were collected
after 18 months. Gastritis was scored after H&E staining. Brain
specimens were processed to detect astroglial cells (immunochemistry anti-GFAP). Systemic and cerebral cytokines (IL1β, TNFα, IL-6,
INFy, IL17a, IL-4, IL-10) were evaluated by ELISA and semi quantitative protein array test, respectively. After 18 months, infection
induced a severe gastric inﬂammation (Hf>Hp) and an increase ofastroglial cell area (8.0±2.2% (Hf), 6.0±1.2% (Hp) versus 5.6±2.4%(NI), p=0.02). Inﬂammatory cytokines were enhanced in the brain
of infected mice (Hf>Hp) compared to NI mice. Systemic cytokines
measurements are pending.
These preliminary results showed that long lasting gastritis induced
by Helicobacter is associated with an increased neuroinﬂammation.
To document the stomach-brain axis, systemic inﬂammation will
be investigated soon.
References:[1] Roubaud Baudron C, Letenneur L, Langlais A, Buissonnière A,
Mégraud F, Dartigues J-F, et al. Does Helicobacter pylori infection increase incidence of dementia? The Personnes Agées QUID
Study. J Am Geriatr Soc. 2013 Jan;61(1):74–8.
P-015
Are we aware of dementia?
O. Yilmaz 1 , S. Gurkas 2 , G. Bahat 1 , M.A. Karan 1 . 1 Istanbul University
Istanbul Medical School, Department of Internal Medicine, Division ofGeriatrics; 2 Istanbul University Istanbul Medical School
Objective: Dementia is increasingly prevalent in our community,
but its awareness is relatively less. We aimed to reveal theknowledge, attitudes and opinions of our country about dementia.
Method: Anyone ≥18 years who agreed to complete the online
questionnaire were included. There were 36 general questions about
the characteristics of dementia, factors associated with dementia,
the dementia courses and attitudes about dementia. Further ques-

tions were asked to subgroups (doctors, medical students, nurses,
physiotherapists, dietitians, relatives of patients with dementia)
about attitudes and disease knowledge.
Results: 2808 subjects ≥18 years were enrolled in to the study
so far (male 895, female 1908). 2277 subjects were in the age
range 18–44. The vast majority of participants were at least college
graduates. Participants thought that dementia is a natural aging
process (n=2088, %75), dementia isn’t a killing disease (n=1406,%50), early diagnosis is important (n=1745, %62), patients withdementia are not living dead (n=1106, %39) and it is an unashamed
illness (n=1906, %67).
Conclusion: According to the results that the early recognition ofdementia is important, but the participants do not have enoughinformation about the dementia. And on the other hand attitudes
regarding patients with dementia is quite humane. We aim to becompleted the survey by 10,000 people and the trial is ongoing now.
The data at the end of the study would give the opportunity to havean opinion on the general disease perspective of our community. So
it can be a guide to what can be done for awareness.
P-016
Associations between plasmatic poly-unsaturated fatty acids
concentrations and cognitive status and decline in Alzheimer’s
diseaseM. Haution-Bitker, T. Gilbert, A. Vignoles, C. Lecardonnel,
S. Watelet, C. Falandry, M. Bonnefoy. Service de Gériatrie du Pr
Bonnefoy, Centre hospitalier Lyon Sud, France
Introduction: Despite an indisputably role of Omega-3 polyunsaturated fatty acids (n3-PUFA) in neuronal protection andprevention of dementia, the associations between PUFA blood concentrations and both cognitive status and decline, remain to betested. In addition, the impact of nutrition seems more signiﬁcant
on erythrocytes linked PUFA than circulating plasma PUFA.
Methods: A prospective cohort was performed in Lyon Sud memory center, France, in order to correlate PUFA biomarkers andCognitive function in a longitudinal way: Mini Mental Status Examination (MMSE) was assessed at baseline and every 6 months.
Concentration of n-3 PUFA (linoleic: AAL, eicosapentaenoic: EPA
and docosahexaenoic: DHA) and n-6 PUFA (arachidonic: AA), were
measured at baseline in plasma and erythrocytes membranes by gas
chromatography-mass spectrometry extraction. Statistical analysis
included Student’s t-test and linear regression.
Results: From March 2010 and February 2014, 140 patients aged
over 65 years were included. Compared to participants with mild or
normal cognition (MMS ≥24), participants with advanced dementia
had lower plasmatic concentrations of EPA and DHA (p<0.05).
Cognitive decline (deﬁned as ≥2 points loss on MMSE/year) was not
associated with PUFA plasma concentrations but with DHA and AA
levels in erythrocytes fractions (p<0.05).
Conclusions: Our study conﬁrms n-3 PUFA concentrations (mainly
EPA and DHA) are associated with cognitive status in the elderly.
Moreover, in this exploratory study, lower erythrocyte PUFA concentrations (AA and DHA) were associated with accelerated decline
and could be proposed as a surrogate marker for prediction of
cognitive decline.
P-017
Attitude of General Practitioners face to Alzheimer’s diseases’s
drugs prescriptions
O. Maigre 1 , A. Corvol 2 . 1 CHU Rennes; 2 Gériatrie CHU Rennes
The goal of this study is to describe the attitude of General Practitioners (GP) in front of drugs which are initiated by a consultant,here the Alzheimer’s disease (AD) drugs, and to analyze the consequences on the relationship between GP and consultants. The

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

method used a survey sentby email to the GP of the region Brittany
between december 2016 and february 2017.
Results: 233 completes replies out of 1380 respondents. 13% had acessation attitude without delay, 50% temporize with an prospective attitude of cessation and 36% continue these treatments. The
evaluation of the beneﬁt-risks ratio was negative regardless of theattitude.
Discussion: The relational determinants were predominating in
the medical decision process, with attitude frequently paternalistic.
The prescription of AD drugs can create a mistrust felling to the“memory consulting” or feeling sick among those who continue
treatments despite of a negative evaluation.
Conclusion: Because of divergences between GP and consultants,
the ﬁrst prescription of ADdrugs reserved for consultants seems tocause destructuring consequences on accompanying patients.
P-018
Can the principle of Occam’s Razor be applied to the elderly?
L.L.B. Wong, S.E. Ng, R.A. Merchant. National Univerisity Hospital
An 87-year-old woman with Alzheimer’s dementia presented witha two-day history of lethargy, altered mental status and fever of
38.6°C. She had deteriorated from being able to walk with assistance to being bedridden within two days. Her family also reported
signiﬁcant weight loss of eight kilograms over one year but declined
further investigations. On admission she was delirious, clinicallydehydrated and uncooperative with neurological examination. Investigations revealed haemoglobin of 8.6 g/dL (11.4–14.7g/L) withnormocytic hypochromic picture, total white blood cell of 9.4×109 /L(3.84–10.01×109 /L) and c-reactive protein within the normal range.
Urine microscopy was unremarkable although urine culture grew
Escherichia coli and Klebsiella pneumonia. A non-contrasted CT
brain showed lobulated hypodensities with hyperdense rims in theright occipital lobe, associated with perilesional oedema which was
initially attributed to malignancy but MRI conﬁrmed it to be abrain abscess with a diameter of 40mm. Her family declined biopsy
and patient was commenced on six weeks of intravenous ceftriaxone and metronidazole. Transthoracic echocardiogram revealed anaortic valve vegetation. Three sets of blood cultures were negative
for bacterial growth. CT thorax abdomen pelvis was unremarkable.
She was discharged to community hospital for rehabilitation andimproved signiﬁcantly back to baseline. Functional decline, delirium
and atypical presentations (which may cause a delay in diagnosis)
are not uncommon in patients with dementia. Our patient had
normal inﬂammatory markers. There is no substitute for a goodhistory, physical examination and constant revision of diagnosis.
Occam’s Razor does not apply to elderly.
P-019
Co-conception of a robot-assisted intervention for the
management of care-induced pain in major neurocognitive
disordersM. Demange 1,2 , M. Pino 1,2 , H. Kerhervé 1,2 , A.-S. Rigaud 1,2 ,I. Cantegreil-Kallen 1,2 . 1 Department of Geriatrics, Assistance
Publique-Hôpitaux de Paris, Hôpital Broca, Paris, France; 2 Unit EA
4468. Alzheimer’s disease: risk factors, treatment and support forpatients and their families, Paris Descartes University, Paris, France
Introduction: Health care professionals lack tools to deal with acutepain in patients with moderate to severe dementia during daily
nursing situations. The present study determined a framework andexamined the feasibility of an innovative intervention using the Parorobot for the management of nursing-induced pain in dementia.
Methods: A mixed-method research design combining qualitative(4 focus groups) and quantitative (questionnaire survey) approaches
was used to deﬁned the intervention framework. We recruited 51

S45

health care professionals from various medical and paramedical
specialties (e.g., nursing auxiliaries, nurses, physicians, psychologists) and with expertise in gerontology.
Results: Four main issues regarding the intervention framework
were addressed: (1) identiﬁcation of a core group of situations
associated with nursing-induced pain (washing, dressing/change,transfer/mobilization), currently considered as ineﬃciently managed, (2) the selection of an appropriate assessment methodology
including criteria and tools for pain evaluation, (3) the deﬁnitionof professionals training needs and organizational requirements for
its implementation and, (4) the perceived usefulness of a robotassisted intervention for the management of pain in dementia.
Conclusion: A consensual and feasible intervention framework
for the management of nursing-induced pain in dementia using the Paro robot was deﬁned. Understanding of professionals’
needs, opinions and perceived obstacles regarding the intervention
was necessary to implement effectively the assessment of theintervention clinical effects.
P-020
Cognitive decline and functional status in elderly cancer
survivors from non Hodgkin lymphoma
D. La Carpia 1 , B. Di Capua 2 , R. Liperoti 2 , M. Guglielmo 3 ,G. Colloca 2 , D. Fusco 2 , M.C. Cipriani 2 , P. Matteucci 3 , L. Farina 3 ,L. Devizzi 3 , P. Di Pede 3 , C.I. Ripamonti 3 , R. Bernabei 2 . 1 Università
Cattolica Del Sacro Cuore (Roma, Italy), Fondazione IRCCS Istituto
Nazionale Dei Tumori (Milano, Italy); 2 Università Cattolica Del Sacro
Cuore (Roma, Italy), Fondazione Policlinico Agostino Gemelli (Roma,
Italy); 3 Fondazione IRCCS Istituto Nazionale dei Tumori (Milano, Italy)
Introduction: Cancer and oncological treatments have been shownto cause cognitive impairment in cancer survivors. Data on elderly
haematological patients are laking.
Methods: This is a multicentric observational study. Long-term
outpatient survivors from Non Hodgkin Lymphoma aged 65 ormore (N: 52) and a corresponding group of non-cancer controls(N: 51) have been enrolled since November 15th 2016 at Istituto
Nazionale dei Tumori (Milano, IT) and Policlinico Agostino Gemelli(Rome, IT). Enrollement will end in July 2017. All study subjects havebeen assessed with a battery of neuropsychological tests; ADL, IADL
and Karnofsky Performance Status scales were used for functional
status. Data are presented using descriptive statistics and compared using T-test for unpaired samples with unequal variance forcontinuous variables and Chi squared test for categorical variables.
Results: Mean age was 74 years in both groups. Survivors scoredlower in IADLs (6.9±2.5 vs 7.8±0.9) while no difference was observedin ADLs. As for cognition, survivors showed poorer performances inall tests for executive functions (Stroop Time 23.4" vs 15.6"; Trail
Making Test A 34.3" vs 36.9", part B 84.1" vs 71.1", part B-A 48.7
vs 36.0) as well as in attention and visuospatial tasks (Multiple
Features Target Cancellations time 48.3" vs 39.2"). No signiﬁcantdifference was observed in verbal learning and immediate recall.
Conclusions: Similarly to previous evidence, we observed a frontal
subcortical proﬁle with a relative sparing for episodic memory.
The impairment in IADL is remarkable because it can be of criticalimportance for functional autonomy in elderly patients.
P-021
Cognitive proﬁle of nonagenarian patients hospitalized in anintermediate care unit
N. Leiva, C. Roqueta, S. Ubero, M.I. Martínez-Fernández, R. Miralles,
O. Vázquez. Geriatric Medicine Department, Centre Fòrum, Parc de
Salut Mar, Barcelona, Spain
Aim: To assess the cognitive status of nonagenarian patients in anintermediate care unit.

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Patients and method: Prospective study of nonagenarian patients
admitted to an intermediate care unit. The following demographic
variables (age, sex) and the presence of previous cognitive impairment were recorded (through anamnesis and review of clinicaldocumentation). The cognitive status at admission was evaluatedby Mini-mental Examination of Folstein (MMSE) and the presenceof delirium by the Confusion Assessment Method (CAM) duringadmission. MMSE scores were categorized as: Normal (MMSE:
21–30), moderate cognitive impairment (MMSE: 15–20), and severe
cognitive impairment (MMSE <15).
Results: Two-hundred and twelve patients (75.9% women) wereregistered. Eighty (37.73%) had cognitive impairment prior to admission. The mean of MMSE at admission was 15±9.82 points.
At admission, 71 (34.80%) patients had not cognitive impairment(MMSE ≥21 points), 55 (26.96%) had moderate cognitive impairment (MMSE: 15–20 points) and 78 (38.24%) severe cognitive
impairment (MMSE <15 points). The test was not applied to 8
patients because of aphasia, severe cognitive deterioration or deterioration of the state of consciousness. Ninety (42.45%) presenteddelirium during admission and 75 (35.37%) met dementia criteria.
Conclusions: The prevalence of cognitive impairment in the sampleof patients evaluated was high. More than one-third of the nonagenarians had cognitive impairment prior to admission and haddelirium during admission.
P-022
Course of neuropsychiatric symptoms in institutionalized
patients with young onset dementia
R.T.C.M. Koopmans 1 , R. Bauhuis 1 , A. Mulders 2 . 1 Department ofPrimary and Community Care, Radboudumc Alzheimer Centre,
Radboud University Medical Center, Nijmegen; 2 Archipel Care Group,
Landrijt, Centre for Specialized Care, Eindhoven, The Netherlands
Introduction: Young onset dementia (YOD) often comes with neuropsychiatric symptoms (NPS) that are burdening for patients andcaregivers and are predictors for institutionalization. The course of
NPS in institutionalized patients with YOD is unknown. This study
aims to ﬁll this gap.
Methods: This study is part of the BEYOND-study, a descriptive
cohort study of patients in Dutch YOD special care units. Eightynine patients were included in a two-year follow-up study, of
which 50 patients completed follow up. NPS were assessed using
the Neuropsychiatric Inventory Nursing Home version. Prevalence,incidence, resolution and persistence of NPS were calculated fromall patients alive at the moment of a given assessment. Cumulative
prevalence was calculated in patients with complete follow up.
Results: 82–94% of the residents had at least one NPS at any of
the ﬁve assessments. Over the two year course 94% of the patientsdeveloped at least one new symptom of which 58% developed
irritability, 52% agitation, 44% disinhibition, 44% eating change, and
42% apathy or aberrant motor behaviour. Apathy had the highest
overall prevalence rate and was the most persistent symptom over
the two-year course, followed by eating changes and aberrant
motor behaviour. Most symptoms had a variable course with noclear patterns of increase or decrease.
Conclusions: NPS in institutionalized YOD patients vary during thecourse of the disease. More research into the course and predictorsof NPS in institutionalized YOD patients is necessary in orderto develop interventions tailored to the speciﬁc needs of thesepatients.

P-023
Depression in the elderly: the impact of comorbidities andsociodemographic factors
S. Hammami 1 , I. Chabéne 1 , A. Mhalla 2 , L. Gaha 2 . 1 CHU F Bourguiba,
Department of Internal Medicine Faculty of Medicine, University ofMonastir, Tunisia; 2 CHU F Bourguiba, Department of Psychiatry
Faculty of Medicine, University of Monastir, Tunisia
Introduction: The depression in the elderly is the most common
psychiatric disorder. In current practice, it represents a diagnostic
and therapeutic challenge because of the atypical forms, screening
diﬃculties and the presence of potentially serious forms.
Objective: The aim of our work is to determine the impact of co
morbidities and the socio-demographic factors on the depression inelderly.
Methodology: This was a retrospective, descriptive study, interesting patients aged 65 years and more, who where consulting, in both
Geriatric and psychiatric unit in the Fattouma Bourguiba Hospitalin Monastir, from 1 January to 31 December 2015, for a major
depressive disorder.
Results: In all, we collected 38 cases. Our population was predominantly female (sex-ratio=0,72). The mean age was 71 years. 68,4%of our patients were not married, 60,5% were illiterate and 60%
were unemployed. Over three-quarters of our patients (86,8%) had
a personal history of somatic disease dominated by the cardiovascular one. A major depressive disorder, type of single episodewas diagnosed in 25 patients (65,8%) and recurrent one in 31
cases (34,2%). The SSRI antidepressants were the most frequently
prescribed drugs (81,5%) followed by the benzodiazepines (31,5%)
and the tricyclic ones (18,5%). The Factors which was correlatedwith a severe disorder are: the social status, a high stress factors
score and co morbidities. An academic instruction was considered
as a protective one.
Conclusion: According to this study, the high frequency of somaticco morbidities and the low level of education were predictive of
a severe and atypical forms of depressive disorders in the elderly
population
P-024
Description of a cognitive-behavioral unit: management of
behavior disorders in dementia
C. Marinho, R. Razou, V. D’Ouince, O. Saint Jean. Hôpital Corentin
Celton - Hôpitaux Universitaire Paris Ouest
Behavior disorders found in dementia are a source of caregiver
fatigue and hospitalization. The Cognitive Behavioral Units (UCC)
for the management of its symptoms was created within theframework of measure 17 of the Alzheimer plan in 2008/2012.
The objective of this study is to characterize the patients hospitalized in our CCU as well as to evaluate the pharmacological vs.
non-pharmacological therapeutic practices implemented to reducebehavioral symptoms.
Results: 145 patients were enrolled in the study with an averageage of 80.35 years (±8.0). An improvement in behavioral disorders
was obtained in 65% (n=95) of patients. Symptoms of aggressiveness, anxiety and hallucination were the most frequent reasons foradmission. Patients had severe deterioration (mean MMS at 14).
The duration of hospitalization was 56.57 days. A decrease in thenumber of psychotropic drugs is conﬁrmed by non-drug therapies.
Discussion: The use of UCCs appears to be fundamental to manage
behavioral disorders; nevertheless there is still room for improvement in the management of non-drug therapies. This study
demonstrates that UCC fulﬁlls the speciﬁcations of the UCCs.

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

P-025
Diagnosis of neurodegenerative diseases: interest of a second
FDG-PET
A. Pesce 1 , C. Vincent 1 , S. Louchart de la Chapelle 1 , B. Paulmier 2 ,A. Morisot 1 , S. Hesse 1 , K. Polet 1 , B. Kullmann 1 . 1 Rainier III
Gerontologic Center - Princess Grace Hospital; 2 Nuclear Medicine
Department - Princess Grace Hospital
Introduction: The diagnosis of cognitive disorders requires clinical,
neuropsychological/orthophonic examination, brain MRI, functional
imaging, proteomic study, amyloid-PET. However, the evolutionof these disorders often conducts to correction of prior hypothesis. Lack of investigation on this topic, conducted us to evaluate
the interest of a second 18F-ﬂurodeoxyglucose positon emission
tomography (FDG-PET).
Methods: Retrospective study of patients followed in our primaryclinic. 66 patients were enrolled: 27 men (41%), 39 women (59%);
mean age 74.7 (44–87); mean MMS-E at ﬁrst assessment 24 (12–29); mean time between ﬁrst and second FDG-PET was 18 months(6.4–56.5). Primary diagnosis were compared with a second clinicaland neuropsychological assessment, and all cases were discussed todetermine ﬁnal diagnosis and usefulness of second FDG-PET.
Results: Among second FDG-PET, 46 (69.7%) were considered as
useful. In 22 (48%) patients from this group, second FDG-PET led
to correct previous diagnosis, in 12 (26%) conducted to eliminate asecond hypothesis, in 12 (26%) conﬁrmed the ﬁrst hypothesis. Secondary FDG-PET is more useful when performed after 12 months.
Furthermore, in patients presenting initially with a psychiatricproﬁle, second FDG-PET was useful in 85.7% of cases.
Conclusions: A second FDG-PET performed at least 12 months afterﬁrst complete assessment is of high interest to deﬁne diagnosisof neurodegenerative diseases, and can correct initial diagnosis,
especially in patients with initial psychiatric presentation.
P-026
Differential association between BP level and cognitive functionin the elderly and very elderly treated hypertensive subjects
N. Sharashkina 1 , V. Ostapenko 1 , O. Tkacheva 1 , N. Runikhina 1 ,Y. Kotovskaya 2 , E. Mkhitaryan 1 . 1 Pirogov Russian National Research
Medical University of the Ministry of Health of the Russian Federation,
Russian Gerontology Clinical Research Center, Moscow; 2 RUDNUniversity, Moscow
Aim: To evaluate relationship between blood pressure and theseverity of cognitive impairment in elderly and very elderly patients was studied.
Material and methods: The study included 356 patients, the mean
age was 74.9±6.1 years, 80.4% were women All patients underwent clinical-neurological examination. Cognitive functions wereassessed by Mini Mental State Examination (MMSE). All statisticalanalyses were performed using “IBM SPSS Statistics version 20” and“Microsoft Excel 2010”. Univariate analysis and regression analysis
using Pearson’s product-moment and Spearman’s rank correlationcoeﬃcients were undertaken to evaluate data.
Results: Average BP level among 65–79 y.o. patients with 28–30
points on the MMSE reveal 141,7±22,93/80,7±9,12 mmHg; among
65–79 y.o. patients with less than 27 points on the MMSE reveal 152,0±23,94/91,0±8,21 mmHg. However the results of BP
level among ≥80 y.o. was 144,1±22,44/78,5±8,55 and 145,7±27,04/
77,9±8,23. In the group of patients under the age of 80, a signiﬁcant
inverse relationship between the total score of MMSE and thelevel of blood pressure found: for systolic blood pressure (r=−0.22,
p=0.0003), for diastolic blood pressure (r=−0.13, p=0.03). That is, inpatients with higher blood pressure, low scores on the cognitive status assessment scale were obtained from the Spearman correlation
analysis. In those aged 80 years and, correlations were insigniﬁcant,

S47

for systolic blood pressure (r=−0.05 , P=0.64), for diastolic bloodpressure (r=−0.13, p=0.25).
Conclusion: The results suggest differential association between
BP and cognitive function in the elderly and very elderly patients.
Diminishing of inverse correlation between SBP and MMSE may befound in the very elderly treated hypertensive subjects
P-027
Distinguishing Alzheimer disease and other forms of dementia:
the role of amyloid positron emission tomography imaging
G. Ricevuti 1 , G. Triﬁro’ 2 , C. Vellani 2 , I. Bossert 2 , G. Cuzzoni 1 ,L. Venturini 1 , C. Alfano 3 , F. Guerriero 1 . 1 Dept. of Internal Medicine
and Therapeutics, Section of Geriatrics, University of Pavia, Italy;
Azienda Servizi alla Persona, S. Margherita Institute, Pavia; 2 Nuclear
Medicine Unit, ICS Maugeri, Pavia; 3 Dept. of Internal Medicine andTherapeutics, Section of Geriatrics, University of Pavia, Italy
Background: Diagnosing Alzheimer Disease (AD) is complex. Withno single test currently available, diagnosis is based on an individual’s history, physical examination, and cognitive testing. Oneof the main features of AD is the presence of amyloid beta deposits, which accumulate in the brain years before the onset ofsymptoms. Positron emission tomography (PET) imaging assessing
amyloid burden represents a potential advance in the assessment ofneurocognitive disorders. PET scanning has been reported to play apivotal role in helping the clinician distinguishing between AD andother dementia disorders.
Aim: This study aimed at exploring the ability and eﬃcacy of
Amyloid PET-CT to diagnose AD in patients with a suspicion of AD.
Methods: 66 subjects (mean age 75.2 y, SD ±5.2 y) suffering from
cognitive impairment suspicious for AD underwent amyloid PET.
Laboratory and neuropsychological assessment and brain CT/MRI
scan were also performed for differential diagnosis. AD diagnosis was made according to 2011 Alzheimer Association/National
Institute of Aging (AA/NIA) diagnostic criteria and guidelines for AD.
Results: Concordance with AD diagnosis – according to AA/NIA
criteria – and PET-CT visual reads was estimated at 96.9% in ourstudy population. Statistical analysis has demonstrated that amyloid
PET-CT has a 98.4% sensitivity and 91.9% speciﬁcity to distinguish
AD from other forms of dementia.
Conclusion: Amyloid PET has improved the non-invasive assessment of the pathological hallmarks of AD, It should be used as
an additional diagnostic tool when evaluating individuals who may
have AD, in conjunction with cognitive tests and patient history
gathering.
P-028
Economic impact of the intervention of geriatric specialized
teams (EAR) in the assessment of patients with dementia in
nursing homes in two catalan counties (Vallès Occidental andVallès Oriental)
J. Mandujano Valencia. EAR (Nursing home care team) - Mutuam
Introduction: There is worldwide concern about healthcare economic impact of population aging and the exponential increase ofprevalence of elderly people with dementia. Until 2016, 98,800 people were diagnosed with Alzheimer’s desease in Spain, assuming anannual pharmacological cost of €23,354 and a direct medical costof €10,291 per person in a year. Dementia directed treatment (DDT)
cost is €1,000 per patient/year while hospital specialised assessment cost is 200€ per visit. Every patient is usually assessed twice ayear at the hospital. In 2016, EAR teams began monitoring patientswith dementia in Vallès Occidental (VOC) and Vallès Oriental (VOR)
nursing homes.
Method: Prospective and descriptive study of assessment, performed on dementia patients admitted in VOC and VOR nursing homes.

S48

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

Objective: EAR teams are cost-efective in monitoring patients ondementia directed treatment in VOC and VOR nursing homes.
Results: 105 patients (81 women and 24 men) were assessed by
EAR at their nursing home. Mean age was 85 years old and 42%
had severe dependence (Barthel index below 20). Only 20 patientswere identiﬁed as MACA (chronic advanced disease); 7 out of
20 had severe cognitive impairment as assessed with a Global
Deterioration Scale (GDS) of 7. 40 were not identiﬁed neither MACA
nor PCC (chronic complex patient); 22 out of 40 had a GDS of 7.
After EAR assessment DDT was withdrawn in 53 patients, renewedin 37 patients, started in 1 patient and partially renewed in another.
Conclusion: EAR intervention had a reduction of direct costs tohealthcare system of 101,500€ in 2016. For this reason, we conclude
that speacilized geriatric provided at the nursing home is probably the most suitable and eﬃcient device to assess and monitor
resident nursing home patients with dementia.
P-029
Effects of multisensory stimulation in a snoezelen room on the
behavior of elderly people with dementia
D. Curto 1 , P. Cano 1 , C. Garcia 1 , J.F. Tomas 2 , C. Resano 1 . 1 Sanitas
Mayores Sanitas ELA-Bupa; 2 Sanitas ELA-Bupa
Introduction: Snoezelen rooms (multisensory stimulation) areavailable in day centers and care homes, but there is little researchon the impact of these on the behavior of people with dementia.
The main objective of this study is to investigate the beneﬁts ofmultisensory stimulation on the affective-behavioral level in elderly
people with mild, moderate or severe dementia.
Method: Mixed methodology: quantitative and qualitative data.
Design: Quasi experimental, pre and post test with control group.
Subjects: 18 people with dementia. Instruments: Standard tests
combined with video footage are combined. Tests applied: Blessed(dementia); Cornell (depression). Hamilton (Anxiety) Cohen (agitation). Record of relaxation. Procedure: Participants were randomly
assigned to the snoezelen room or reminiscence sessions (control
group). They have participated in two weekly sessions of 30 minutes
for 3 weeks in a group of three people. The tests and videotaped
sessions 1, 3 and 6. The therapist of the multisensory classroom hascompleted two questionnaires designed ad hoc for each participant:a) Register of the different materials that have used. b) Perceptionof the professional about the general condition of the patient.
Results: Presented for each study group as well as comparative
between groups. Regarding the behavior in general there are no
signiﬁcant differences between the pre and post test, but it isnoteworthy that regarding relaxation there are remarkable changes.
The group with mild dementia presents notable improvements inparticipation.
Conclusions: Multisensory therapy favors relaxation and interpersonal relationships in the individuals studied. Implications forclinical practice of snoezelen rooms are discussed.
P-030
Evidence of RedOx homeostasis disruption on red blood cells ofpatients with dementia
A. Zarrouk 1 , S. Hammami 2 , M. Dabbabi 1 , M. Frih 3 , G. Lizard 4 ,M. Hammami 1 . 1 University of Monastir, Faculty of Medicine,
Department of Biochemistry -UR “Nutrition Humaine et Désordre
Métabolique”, Monastir, Tunisie; 2 CHU F Bourguiba, Department ofInternal Medicine, University of Monastir, Faculty of Medicine, UR“Nutrition Humaine et Désordre Métabolique”, Monastir, Tunisie;
3 CHU F Bourguiba, Department of Neurology, University of Monastir,
Tunisia; 4 (EA 7270)/University of Bourgogne/INSERM, Dijon, France
Introduction: The pivotal role of oxidative stress in brain degeneration is widely accepted, and its increase may cause adverse effects

in the cell membranes. The present study realized on 64 demented
patients vs 79 healthy non-demented controls was undertaken toprecise the relationships between the different types and stages ofdementia and oxidative stress.
Methods: All the participants (age>60) were classiﬁed according
to the DSM-IV diagnostic criteria for dementia. Demented patientswere stratiﬁed into 3 groups; Alzheimer disease (AD), vasculardementia (VD) and others dementia group (OD). We measured
malondialdehyde (MDA) and conjugated dienes (CD) levels, superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase(GPx) activities and reduced glutathione (GSH) in RBCs from allparticipants.
Results: A signiﬁcant increase in catalase and SOD activity was
revealed in all demented patients compared with controls. Besides,
a signiﬁcant decrease of the GPx activity was revealed associatedwith a signiﬁcant increase of GSH level compared to controls.
Highly signiﬁcant differences were observed with GPx activityof each group comparatively to controls. An increase in catalase
activity was also observed in the different groups of patients.
Furthermore, mean values of MDA increase in AD, VD and OD.
Also, raised levels of CD were observed in demented patients. In
conclusion, on the population of demented patients considered,
our investigation suggests that the occurrence of oxidative stress atthe peripheric level is not counteracted by enhanced activities ofanti-oxidative defenses.
P-031
Factors associated with adherence to multidomain lifestyleinterventions for the prevention of dementia: data from the
MAPT and FINGER trials
N. Coley 1 , T. Ngandu 2 , C. Cantet 3 , J. Lehtisalo 2 , B. Vellas 3 ,M. Kivipelto 4 , S. Andrieu 5 . 1 INSERM UMR1027/CHU Toulouse,
Toulouse, France; 2 Chronic Disease Prevention Unit, National Institutefor Health and Welfare, Helsinki, Finland; 3 INSERM-Toulouse
University UMR1027/CHU Toulouse, Toulouse, France; 4 Aging ResearchCenter, Karolinska Institutet/Stockholm University, Stockholm, Sweden;
Chronic Disease Prevention Unit, National Institute for Health andWelfare, Helsinki, Finland; Institute of Clinical Medicine/Neurology,
University of Eastern Finland, Kuopio, Finland; Center for Alzheimer
Research, Karolinska Institutet, Stockholm, Sweden; 5 INSERMUniversity of Toulouse UMR1027/CHU Toulouse, Toulouse, France
Introduction: Multidomain lifestyle interventions have been advocated for dementia prevention, but can be burdensome. The
content, intensity and method of delivery of interventions could
affect adherence, which in turn could affect eﬃcacy. Our aim was tostudy factors associated with adherence in two multidomain trials
aiming to prevent cognitive decline.
Methods: The 2-year FINGER trial included 1260 Finnish individuals aged 60–77 years with an increased dementia risk score,
and the 3-year MAPT trial included 1680 French individuals aged
≥70 with a subjective memory complaint, IADL limitation and/or
slow walking speed. The FINGER intervention involved separate
group and individual sessions of computer-based cognitive training, physical exercise, nutritional counselling and cardiovascularmonitoring. The MAPT multidomain intervention involved groupsessions simultaneously covering pen and paper-based cognitive
training, and advice/education on physical activity and diet. We
examined factors associated with adherence to the MAPT groupsessions, and simultaneous adherence to all components of the
FINGER intervention.
Results: In unadjusted analyses, only poor physical status and low
income were signiﬁcantly associated with poorer adherence in both
trials. In addition, in FINGER, older age, lower education, lack ofphysical exercise and being single were associated with poorer
adherence, while in MAPT, lower cognition and cardiovascular risk

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

factors (BMI, diabetes, high blood pressure) were associated withpoorer adherence. Multivariate analyses will be presented.
Conclusions: Dementia risk factors were associated with poorer
adherence to multidomain lifestyle interventions, although results
varied across trials, probably due in particular to differences instudy populations, and intervention design.
P-032
Factors associated with caregiver burden in caregivers ofpatients with dementia admitted to psychiatric hospitals forbehavioral and psychological symptoms of dementia in Japan
T. Ishii 1 , K. Fuchino 2 , H. Okamura 3 . 1 Medical Corporation Tijinkai,
Maple Hill Hospital, Otake, Japan; 2 Medical Corporation Fuchinokai,
Green-Hill Health Hospital, Oita, Japan; 3 Institute of Biomedical &Health Sciences, Hiroshima University, Hiroshima, Japan
Background: We have reported that caregiver burden may impede
early discharge of patients with dementia admitted to psychiatrichospitals for the management of the behavioral and psychologicalsymptoms of dementia (BPSD) in Japan. We analyzed the data of anationwide prospective cohort study to identify factors associatedwith caregiver burden.
Methods: A total of 138 psychiatric hospitals with dementia units(31.5% of such hospitals in Japan) participated in the cohort study.
The subjects were patients with dementia admitted to psychiatric hospitals for BPSD and their caregivers and their data at
admission were analyzed. Caregiver burden was assessed using the
Zarit Caregiver Burden scale (ZCB). Measures of patients included
Barthel index (activities of daily living), cognitive function (Mini
Mental State Examination), agitation (Cohen-Mansﬁeld Agitation
Inventory), BPSD severity and burden (Neuropsychiatric InventoryQuestionnaire). The association with caregiver burden was assessedusing multiple linear regression.
Results: Of 361 caregivers included in the analysis, the mean of
ZCB was 43.8 with standard deviation of 20.4. In multiple linear
regression analysis, patient’s marital status, experience of caregivers
quitting or changing their job for caregiving, time for caregiving
more than 8 hours per day, caregiver’s self-rated health, BPSD
severity were associated with caregiver burden.
Conclusion: Multiple factors may contribute to caregiver burden.
Our results may enable medical staff to identify caregivers at highrisk for caregiver burden, which would be a prime target for theintervention to alleviate caregiver burden.
P-033
Frailty indicates study dropouts in a randomized drug trial
among mild to moderate Alzheimer’s disease patients
A.M.M. Santoso, G.J. van Spijker, M.G.M. Olde Rikkert. Donders
Institute for Brain, Cognition and Behavior; Radboud Alzheimer Centre;
Department of Geriatric Medicine; Radboud University Medical Center,
Nijmegen, The Netherlands
Introduction: While frailty has been widely reported in observational studies as an important predictor for adverse healthoutcomes, its contribution to dropouts and adverse events in trials
has not been reported. We examined whether frailty is linked withthese relevant events in a drug trial among patients with mild tomoderate Alzheimer’s Disease (AD).
Methods: 469 participants (73±8 years, female 61.6%) were included in the NILVAD-frailty substudy [1]. A Frailty Index (FI) with arange of 0 (ﬁttest) to 1 (frailest) was derived based on a previously
deﬁned approach [2] from 26 deﬁcits across seven domains (i.e.
daily functioning, cognition, morbidity, physical performance, social
network, polypharmacy, and body mass index) assessed at baseline
and at 78±1 week follow up. Using Mann-Whitney test, differencesof baseline FI were examined among participants who dropped

S49

out versus those who adhered to the study. Spearman’s correlation coeﬃcient was examined between baseline FI and number ofrecorded adverse events.
Results: 408 participants had available FI at both time points,
with positive-skewed distribution at baseline (median=0.18), whichbecame signiﬁcantly higher (p<0.001) and normalized at follow up(median=0.29). Median baseline FI was 0.06 higher (p<0.05) for
participants who dropped out than for those who adhered to study.
We did not ﬁnd an association between baseline FI and number ofrecorded adverse events (Spearman’s r=0.55).
Conclusions: Our ﬁndings suggest that the frailty status of participants in AD drug trials will signiﬁcantly increase over 1.5 year study
period, and it may assist researchers to anticipate dropouts among
these patients.
References:[1] Meulenbroek, O., et al., European multicentre double-blind
placebo-controlled trial of Nilvadipine in mild-to-moderate
Alzheimer’s disease – the substudy protocols: NILVAD frailty;
NILVAD blood and genetic biomarkers; NILVAD cerebrospinal
ﬂuid biomarkers; NILVAD cerebral blood ﬂow. BMJ Open, 2016.
6(7).
[2] Searle, S.D., et al., A standard procedure for creating a frailty
index. BMC Geriatrics, 2008. 8(1): p. 24.
P-034
How to support people with dementia to take part in activities
R. Granbo. Boulton,L (UK), Saltvedt, I. (Norway), Helbostad, J.L.
(Norway), Taraldsen, K. (Norway
Introduction: Participation in activities outside home can be achallenge for people with dementia. In this qualitative study wewanted to explore the experiences and perspectives of caregivers
related to participation in physical activities, in order to understandbarriers and facilitators to participating in activities for older adults
with dementia. The study represents a ﬁrst step in describing
challenges, in order to be able to design new activities adapted tothis particular group of older adults.
Methods: We recruited eight caregivers of home-dwelling people
with a dementia diagnosis from a local centre for people withdementia and their families in a Norwegian municipality. We performed two focus groups, and qualitative data were analysed by
Systematic Text Condensation method.
Results: The ﬁndings indicate that current health care services forpeople with dementia do not meet the needs of either the people
with dementia or their caregivers. The services offered are characterised by passivity and lack of individual and personalised care.
Rather than focus on the dementia diagnosis, caregivers suggestthat services consider individual resources, interests, and physicalfunction.
Conclusions: To improve the health care services for people withdementia participation and involvement from both people withdementia and their caregivers is necessary. Design and organisationof services for people with dementia should take their total situation into account, in order to provide activities that people withdementia can use, and also to support and decrease caregivers’
burden.
P-035
Hypertension and cognitive function in the elderly: preliminary
results of a screening study
G. Rivasi, M. Bulgaresi, L. Menozzi, F. Sgrilli, A. Giordano, L. Martella,
C. Lorenzi, A. Ungar. Department of Geriatrics, Careggi Hospital andUniversity of Florence, Florence, Italy
Introduction: Hypertension is a risk factor for cognitive decline,
therefore cognitive evaluation should be included in the clinicalS50

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

assessment of elder hypertensive patients. Nonetheless, there is
still controversy over which screening test is more appropriate. Our
study evaluates the Mini-Cog test as ﬁrst-line screening, to assess
cognitive function in old hypertensive patients without a previous
diagnosis of cognitive impairment.
Methods: Patients aged ≥65 years consecutively referred to ourCentre were enrolled. All patients underwent a ﬁrst-line evaluation
with the Mini-Cog test (three-item repetition and recall and clock
drawing). If the Mini-Cog result was abnormal, the Mini Mental
State Examination (MMSE) was administered. In case of a MMSE
score ≤27, a Neuropsychological Evaluation (NPE) was performed.
Results: 80 patients were enrolled; the mean age was 75.7±5.5
years, 27.5% of patients was octogenarian. All patients had bothclinic and out-of-oﬃce blood pressure (BP) values in the target
range; mean BP values were similar in patients with normal andabnormal Mini-Cog Test results. A Mini-Cog Test suggestive forcognitive impairment was observed in 16 patients (20%); of these, 5
had a MMSE score ≤27. At the NPE, a diagnosis of cognitive decline
was conﬁrmed in 2 patients (2.5% of our population). Clock Drawing
Test was incorrect in 39.1% of patients with a normal Mini-Cog test;
the 51.3% of the overall population had a deﬁcit in clock drawing.
Conclusions: The Mini-Cog test cannot be suggested as a screening
test for the evaluation of cognitive function in old hypertensive
patients.
P-036
Improvement of behavioral and psychological symptoms ofdementia (BPSD) by teaching basic comprehensive standardizedcare methodology to family caregivers
M. Honda, C. Shimada. National Hospital Organization Tokyo Medical
CenterIn Japan, the population with dementia is estimated over 7 million
in 2025. Although it is recommended to support person with dementia to live in familiar community as long as possible, it can cause
caregivers’ burden. Especially BPSD brings enormous care burden
and interferes the health of family caregivers, which results tohasten timing of long-term care institutionalization. A multimodal
comprehensive French care methodology; Humanitude, focuses on
their perception, emotion and verbal-nonverbal communication
between vulnerable elderlies and their caregivers. The effectivenessof this methodology has been reported in professional caregivers,
however, no study was conducted among family caregivers. The
objective of this study is to evaluate reduction of BPSD by teaching
Humanitude to family caregivers. This pilot study was designed as
pre-post comparison of teaching the care methodology to family
caregivers. It conducted in two regions in Japan, and 9 caregivers
participated. Family caregivers learned this methodology, and used
the techniques at home. The BPSD of the care-receivers was evaluated by Behavioral Pathology in Alzheimer’s Disease (BEHAVE-AD)
before the training, at month 1 and month 3 after the training.
The average age of caregivers was 65.1 (±12.7) and care-receivers
was 81.5 (±8.0). The score of BEHAVE-AD at baseline was 9.0 anddecreased to 6.4 at month 1 (t-test, p=0.088), 5.9 at months 3 (t-test,n.s.). There was no difference in Burden score. A comprehensive
multimodal care methodology for family caregivers was effective
for improvement BPSD of people with dementia at home.
P-037
Improving personalised care for inpatients with dementia in
Wales: quality improvement initiative using the “This is me”
booklet
S. Wright, L. Linley-Adams, N. Moss, O. Daly, G. Jones, L. Rozier. Careof the Elderly Department, Royal Glamorgan Hospital, Cwm Taf
University Health Board, Wales

Introduction: Personalised care can alleviate psychological distressfor inpatients with dementia. The “This is Me” booklet contains
questions which patients and families can ﬁll in together: thesequestions explore important life events, preferences and causes foranxiety. The UK National Audit for Dementia aims for all inpatientsto have access to a “This is Me” or alternative care booklet.
Methods: We are undertaking a quality improvement initiative
within the Royal Glamorgan Hospital (RGH) to ensure that “This isme” booklets are completed for all inpatients with dementia. We
have undertaken a primary audit of their use, followed by focusedinterviews and questionnaires for relatives (n=16) and clinical staff(n=36) to assess the perception of the quality of personalised caredelivered on the wards.
Results: 18% of patients with dementia had a “This is me” or alternative personal care booklet completed (n=32). Focused interviews
highlighted concerns that staff didn’t know their relatives preferred
name, food/drink preferences or communication requirements. 37%
of family members felt that staff were aware of what makes theirrelative anxious.
Conclusions: RGH is currently providing inadequate personalisedcare to patients with dementia. We have therefore provided ward
based multi-disciplinary education sessions, emphasising the beneﬁts of providing personalised care. We have also created dementia
packs for relatives, which include “This is me” booklets in addition
to information about dementia/delerium. Improvements in staff
and patient satisfaction have already been noted following thisintervention and will be re-audited throughout Summer 2017.
P-038
Leisure activity, social interactions and the risk of cognitive
decline in old people
H. Hansdóttir 1 , G. Eiríksdóttir 2 , M.K. Jónsdóttir 1 , D. Fisher 2 ,P.V. Jónsson 1 , V. Guðnason 2 . 1 Landspitali University Hospital;
2 Icelandic Heart Association
Introduction: Participation in leisure activities as well as extensivesocial networks have been associated with a lower risk of incident
dementia. While cognitive activity, such as solving puzzles, readingor playing board games have been shown to reduce the likelihoodof incident dementia, the role of group, social, creative or physicalactivity is less clear.
Methods: We examined the relationship between leisure activities
and social relations and the risk of MCI (mild cognitive impairment)
and dementia in a cohort of 4409 elderly individuals who participated in the Ages-Reykjavik Study. The cohort was cognitively
intact at baseline and was followed for 5 years. Logistic regression
analysis was used to evaluate the risk of cognitive decline withadjustment for age, sex, education, occupation, physical function,
health and vascular risk factors.
Results: There were 351 (8%) individuals who were cognitively
impaired at AGES II follow up, 243 were diagnosed with MCI and
108 with dementia. Frequent engaging in solitary or group cognitiveor creative activity, was associated with reduced risk of cognitive
decline Odds Ration (OR): 0,49 (95% conﬁcence interval (CI):0,38–0,64), OR: 0,50 (95% CI:(0,30–0,82) and OR:0,53 (95% CI:0,35–0,83)
respectively. Frequency of interaction with friends and relatives
was associated with reduced risk of cognitive decline (OR:0,49(95% CI:0,31–0,75). The associations were generally stronger for
women, except for the frequency of interactions with friends orrelatives.
Conclusion: Cognitive, either solitary or group, and creative leisureactivities and frequent social interactions was associated with
reduced risk of cognitive decline by half over 5 years of follow-up

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

P-039
Refusal and acceptance of Paro-based therapy: a pilot study inpatients with major neurocognitive disorders
M. Demange 1,2 , H. Lenoir 1,2 , M. Pino 1,2 , I. Cantegreil-Kallen 1,2 ,A.-S. Rigaud 1,2 , V. Cristancho-Lacroix 1,2 . 1 Department of Geriatrics,
Assistance Publique-Hôpitaux de Paris, Hôpital Broca, Paris, France;
2 Unit EA 4468. Alzheimer’s disease: risk factors, treatment and support
for patients and their families, Paris Descartes University, Paris, France
Introduction: Social robot therapy is a promising psychosocial
intervention for patients displaying behavioral and psychological symptoms of dementia (BPSD). While the acceptability ofrobot-based interventions plays a crucial role in the therapeutic observance, studies on refusal causes and the inﬂuence of
acceptability on intervention’s eﬃcacy remains little explored.
Methods: A pilot study was conducted among 17 patients with
BPSD in order to measure the impact of an exposition to PARO robot
without simultaneous human presence. Intervention consisted offour 15-minutes individual sessions. Participants were assessed on
their perceived emotional well-being and the acceptability of theintervention.
Results: Of the 24 pre-selected patients for the study, seven refused
to participate (29,2%). Reasons for refusals were classiﬁed into three
categories: (1) “no interest in robots” (57,2%), (2) “It is childlike”(28,6%), and (3) “refuse consent to any care” (14,3%). However,included participants reported good robot acceptability. No statistical differences were found between patients who accepted andrefused the intervention regarding socio-demographic characteristics, cognitive status or BPSD proﬁle. Higher acceptability level
was positively associated with positive affects improvement in thewell-being scale (r =0.56; p<0.05).
Conclusion: In spite of Paro’s impact in patients’ with BPSD, its use
would be limited by the preconceptions, which seems change after
real experiences. Thus, producing strategies to democratize the useof social robots in these populations seems warranted.
P-040
Motor performance of older subjects with mild cognitive
impairment and early Alzheimer’s disease: Is dual task test
really useful?
M. Mengoni 1 , M. Baccini 2 , L. Vicarelli 1 , E. Latini 1 , M. Betti 1 ,G. Rubbieri 1 , M. Paoli 1 , L. Sati 1 , A.M. Mello 2 , D. Simoni 1 ,C. Baroncini 1 , M.C. Cavallini 1 , M. Di Bari 1 , E. Mossello 1 .
1 Department of Experimental and Clinical Medicine, University of
Florence and AOU Careggi, Florence, Italy; 2 Azienda USL Toscana
Centro, Florence, Italy
Introduction: Motor impairment has been observed in Alzheimer’s
disease (AD), since early stages, and Mild Cognitive Impairment(MCI), with dual task (DT) measures being considered as speciﬁc
correlates of cognitive decline. The purpose of this study is tocompare motor performance (including DT performance) of older
subjects with and without cognitive impairment.
Methods: Subject 65+ with mild AD or MCI (D+) and peers without
cognitive impairment (D-) underwent Short Physical Performance
Battery (SPPB) and quantitative gait analysis with GAITRite, bothas single task (ST) and as dual task (DT, with concurrent verbal
ﬂuency test). DT cost was calculated as percentage change of motor
performance in DT compared with ST.
Results: 32 D- and 35 D+ were enrolled. In comparison with D-,
D+ had a similar age (78) but greater cognitive (Mini Mental State
Examination 25.0 vs. 28.6) and functional impairment, comorbidity
and polypharmacy. D+ showed a poorer motor performance thanD-, both as SPPB score (10 vs. 11, p=0.02) and as walking speed (1.10
vs. 1.24 m/sec, p=0.02) and cadence. DT cost was similar between
the two groups. These differences were lost after adjustment for

S51

comorbidity and polypharmacy. In the whole sample, both MMSE
score and polypharmacy independently predicted SPPB score.
Conclusion: Older subjects with MCI and mild AD showed a worse
motor performance compared to cognitively intact peers, but thisdifference was at least partly explained by greater comorbidity/polypharmacy. Contrary to previous literature, dual task cost
was not associated with cognitive impairment.
P-041
My life story
E. Borizovski 1 , M. Sambuchi 2 , C. Farjon 1 , J. Dodart 2 , A. De Chassey
Parzy 1 . 1 EHPAD Frédéric Mistral, CH Vaison la Romaine, France;
2 EHPAD Albert Artilland, Bedoin, France
Introduction: “My Life Story” is a concept which involves making
a book of one’s life, which allows seniors in nursing homes toreappropriate and revisit their history and memories. This booklet
contains the life course of resident and has for the purpose along-term study of behavioral and moods disorders, in the practicalapplication of non-drug treatments.
Methods: Each book is created during a weekly session. The resident
himself or one of his relatives, (if the resident presents demential
disabilities or psychiatric disorders), evoke his life based on speciﬁc
events illustrated by personal photos that he has preselected. Thisbooklet is established two months after arrival in nursing homewhile residents get their benchmarks. This study analyses threegroups of residents: – “Placebo”, – “Demented” – “Psychiatric”;
Under three different conditions: – With booklet and an houra week personal accompaniment, – With booklet and withoutaccompaniment, – Without booklet and without accompaniment.
Results: The qualitative results, verbalized or observed data, willallow working on the resident’s representations and interpretations
on some aspects of their lives, but also how they lived them. The
quantitative results, which study the decrease in medical prescriptions, as well as mood and behavioral disorders will demonstrate
the positive effect or not of this booklet.
Conclusions: Improvements will be made in multidisciplinarygroup such as recording interviews by video to investigate objectively the exchange time and the different expressions between theresident and his family or nursing team.
P-042
Negative perceptions of Alzheimer disease and memory
problems: factor to beginning a diagnosis process?
A. Besozzi 1 , C. Perret-Guillaume 1 , E. Spitz 2 , P. Balassa 2 . 1 CHRU
Nancy; 2 Equipe APEMAC - Université de Lorraine
Illness perceptions are well known to inﬂuence how people livewith chronic disease and deal with bad news such as diagnosis
disclosure. Assessment of illness perceptions is used for preventive
approach too. In this study, the Common Sense Model of Leventhal
helps us to assess memory problems perceptions of people withmemory complaints. These people were split in two groups: 54
persons with help seeking behavior recruited at a memory centerand 46 persons without help seeking behavior met in their homes.
The aim of the study was to identify: the main causes of memory
problems reported by people with memory complaints, perceptions
and factors of help seeking. For that purpose, we developed aFrench version of Illness Perceptions Questionnaire-Memory.
Results: Memory problems are embarrassing for the majority of
respondents in the two groups. Nevertheless, memory problems are
considered controllable with external support. Besides aging, themain causes of memory problems reported are lack of attention andlack of brain stimulation. Memory problems perceptions are linked
to quality of life and are more predictive of help seeking behavior
than aging or effective cognitive decline.

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Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

Conclusion: Assessment of memory problems perceptions could
be interesting when memory complaints appear to determine thedegree of global understanding and the need for medical care. In
the diagnosis process and after the diagnosis disclosure, memory
problems perceptions could help health professionals to adjust their
care.
P-043
Neuropsychiatric symptoms in people with Korsakoff syndrome
and other alcohol-related cognitive disorders living in specialist
long-term care facilities: the prevalence, severity and associatedcaregiver distress
I. Gerridzen 1,2 , C. Hertogh 1 , M. Depla 1 , R. Veenhuizen 1 ,E. Verschuur 2,3 , K. Joling 1 . 1 Department of General Practice andElderly Care Medicine, Amsterdam Public Health research institute, VU
University Medical Center, Amsterdam, the Netherlands; 2 Nursing
Home Markenhof, Atlant, Beekbergen, the Netherlands; 3 HAN
University of Applied Sciences, Nijmegen, the Netherlands
Introduction: Caring for people with Korsakoff syndrome (KS)residing in specialist long-term care facilities (LTCFs) can be distressing due to challenging neuropsychiatric symptoms (NPS) andmay lead to inappropriate prescription of psychotropic drugs.
However, good quality studies on NPS in this under-researched
population are lacking. This study examined the prevalence andseverity of NPS in residents with KS living in specialist LTCFs andthe associated distress on care staff.
Methods: A cross-sectional, observational study was conductedamong 281 residents with KS living in nine specialist LTCFs in the
Netherlands. Data were obtained using structured interviews withcare staff, elderly care physicians, and residents. The prevalenceand severity of NPS were measured with the NeuropsychiatricInventory–Questionnaire (NPI-Q). The associated caregiver distress
was assessed with the NPI Distress Scale (NPI-D) according to thenurse or nursing assistant.
Results: Almost all residents (96.4%) showed at least one NPS and45.8% showed ﬁve or more symptoms. Irritability/lability (68.3%),
agitation/aggression (58.7%) and disinhibition (52.7%) were mostprevalent. While NPS scored overall low on severity, half of theresidents (49.1%) had at least one severe NPS. Care staff experienced
low levels of distress associated with NPS.
Conclusions: This study demonstrates that NPS are highly prevalent
in residents with KS, but manageable for care staff. Acquiring moreinsight in NPS and its associations among residents with KS isimportant to better understand and reduce these symptoms. This
may improve the quality of care of these residents.
P-044
NEVIP, a new test assessing visual perception in elderly
C. Sagot 1 , B. Dieudonné 2 , S. Greffard 2 , L. Mora 3 , M. Daeschner 2 ,J.-L. Golmard 4 , V. de La Sayette 5 , M.J. Firbank 6 , M. Verny 2 . 1 Service
de gériatrie et médecine polyvalente, Centre hospitalier Sud Francilien,
Corbeil, France; 2 Sorbonne Universités, UPMC Univ Paris 06 (DHU
FAST), Groupe Hospitalier Pitié Salpêtrière - Charles Foix (AP-HP),
Centre de Gériatrie, Paris, France; 3 Service de médecine gériatrique,Centre Hospitalier Charles Foix, Ivry-sur-Seine, France; 4 Départment
de Biostatistiques, Groupe Hospitalier Pitié Salpêtrière - Charles Foix
(AP-HP), Paris, France; 5 Service de Neurologie, Centre Hospitalier
Universitaire, Université Caen-Normandie, Caen, France; 6 Institute of
Neuroscience, Campus for Ageing and Vitality, Newcastle University,
Newcastle, United Kingdom
Objective: Visuoperceptual deﬁcits are common in neurodegenerative diseases, especially in dementia with Lewy Body, with highimpact on diagnosis and prognosis. In the geriatric population,
testing visuoperception is rare because of decline in other cognitive

domains and motor diﬃculties. The NEVIP is a new, easy to use,and quick computer based battery, which evaluates visuoperceptual
deﬁcits. We aimed to study, in routine care, the feasibility of the
NEVIP, and its performance compared to paper-and-pencil tests, inthe geriatric population.
Methods: We conducted a prospective study in a French geriatric medical center. During 3 months, we recruited patients withmemory complaint, MMSE ≥18 and without signiﬁcant visual impairment. Visuoperception was examined with usual tests (Benton
Judgment of line orientation, Incomplete Letters of VOSP, PEGV’s
overlapping ﬁgures and Rey-Osterrieth ﬁgure complex copy) andNEVIP, which was composed of 4 subtests (angle, color, form andmotion perceptions). Memory and executive functions were also
evaluated and compared with NEVIP.
Results: Thirty patients were included with an average age of
81.9±5.3 and an average MMSE of 24.8±2.8. Global NEVIP score andangle perception score were correlated with visuoperception scoreeven after controlling for executive functions. Motion perception
score was speciﬁcally correlated with both visuoperception andexecutive scores. Color perception score was only correlated withexecutive score.
Conclusions: We highlighted multiple correlations between NEVIP
and standard paper-and-pencil tests assessing visuoperception. Ourﬁnding suggests that the NEVIP battery could be a quick and easyalternative to explore visuoperception deﬁcits, including in thegeriatric population.
P-045
Optimising falls risk assessment in memory services: sharing
best practice across geriatric and psychiatric services in England
A.K. Buttery 1 , A. Hopper 2 , C. Ballard 3 , M. Kinirons 2 , J. Sauer 4 ,R.M. Lawrence 5 , A.B. Saiz 6 , F.C. Martin 2 . 1 Faculty of Life Sciences
and Medicine, King’s College London, UK; 2 Guy’s and St Thomas’ NHS
Foundation Trust, London, UK; 3 University of Exeter Medical School,
Exeter, UK; 4 South London and Maudsley NHS Foundation Trust,
London, UK; 5 South West London and St George’s Mental Health NHS
Trust, London, UK; 6 Oxleas NHS Foundation Trust, London, UK
Background: In the UK, a variety of medical specialists are involved
in delivering memory services and diagnosing dementia. As people
with dementia have an increased risk of falling, understanding
variation in falls risk assessment in memory services will clarify the
implementation approach needed to improve effective assessments.
Methods: Comparative case study design of four large regional National Health Service (NHS) memory services in England involving
geriatricians or psychiatrists.
Methods: Included: i) document analysis of local falls policies
including assessment and referral arrangements for those at risk;ii) observation of falls risk assessment procedures in memory services (total=17.5 hours); iii) semi-structured qualitative interviews(n=30) with multi-disciplinary memory and falls service providers.
Interviews were audio-recorded, transcribed and analysed using
thematic analysis and NVivo software.
Results: Three key themes emerged: i) identifying people at risk offalling is regarded as a high priority among memory services, ii)
memory service providers varied in conﬁdence and knowledge inperforming falls risk assessment and, iii) standardised assessments
and electronic prompts for assessment and referral to falls prevention services are underutilised. Falls risk assessment was conductedby all memory services, but assessment methods varied. Most usedpatient self-report, asking recommended questions about the frequency of falls in the previous 12 months, problems with mobility,
gait and balance and occasionally fear of falling. Brief observationof gait was performed, but objective measures (e.g. Timed Up and
Go test) were not routinely performed.
Conclusions: Improving case ﬁnding of people at risk of falling inPoster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

memory services requires embedded standardised assessments andsimpliﬁed care pathways.
P-046
Physical activity, physical function, and gait in persons withdementia
K. Taraldsen 1 , P. Thingstad 1 , J.L. Helbostad 1 , S. Bergh 2 , G. Selbæk 3 ,C. Becker 4 , I. Saltvedt 1 . 1 NTNU, Norway; 2 IHT, Norway; 3 Ageing and
Health, Norway; 4 RBK, Germany
Introduction: For persons with dementia, PA may inﬂuence physical function and ability to perform activities of daily living. The
aim was to investigate differences in PA, physical function, andgait function between older adults with normal cognition/mild
cognitive impairment (MCI), mild, and moderate/severe dementia.
Methods: This cross-sectional study included 100 home-dwellingolder adults from an outpatient geriatric clinic. Cognitive impairment was categorised by using clinical dementia rating scale (CDR),
CDR 0 was normal, CDR 0.5 was MCI, CDR 1 mild, CDR 2 moderate
and CDR 3 severe dementia. We used accelerometers to measure
PA, the Short Physical Performance Battery (SPPB) and gait speed tomeasure physical function, and an electronic gait mat to evaluate
gait characteristics. Statistical analyses included one-way ANOVA.
Results: Participants (mean age 78.9 years, SD 6.7, 57% women)
average upright time was 301 min/day and gait speed was 0.93
m/sec. Upright time, SPPB, gait speed, step length, and walk ratio
differed between groups. Post hoc tests revealed signiﬁcant differences between CDR 0/0.5 and CDR 1 for upright time (345.7 vs.
265.7 min/day, p=0.011), SPPB (10.4 vs. 8.3 points, p=0.001), andstep length (0.6 vs. 0.5 metres, p=0.003), and CDR 0/0.5 and CDR
2/3 for SPPB (10.4 vs. 8.1 points, p=0.004), gait speed (1.1 vs. 0.8
m/sec, p=0.001), and step length (0.6 vs. 0.5 metres, p=0.002).
Conclusions: Results indicate that PA, physical function, and gait
differ depending on the severity of cognitive impairment and highlight the need for including such measures in the evaluation ofgeriatric patients.
P-048
Physical ﬁtness in older people recently diagnosed withcognitive impairment compared to older people recently
discharged from hospital
K. Hesseberg 1 , A. Bergland 2 , E. Rydwik 3 , T. Brovold 2 .
1 Diakonhjemmet Hospital, Norway; 2 HIOA, Norway; 3 KI, Sweden
Introduction: There is evidence of an association between cognitive function and physical ﬁtness. The aim of this study was tocompare physical ﬁtness in patients with cognitive impairmentwith a group of older people recently discharged from hospital.
By comparing two groups of older persons with different healthproblems, we wanted to highlight how affected physical ﬁtness
can be in older people with cognitive impairment. Early detection
is essential in order to prevent further decline through physicalactivity interventions and rehabilitation strategies.
Methods: The sample includes baseline data from two study
settings and has a cross-sectional design. 98 patients recently
diagnosed with cognitive impairment and 115 patients recently
discharged from hospital participated. Associations between the
study group variable and different components in the Senior ﬁtness test were examined, controlling for demographic factors andcomorbidity.
Results: The main ﬁndings showed that the group recently diagnosed with cognitive impairment indicated poorer results on threeof six physical ﬁtness Components, Chair sit and reach-test, Up&go
test and 6-min walk (p<0.05) compared to older people recently
discharged from hospital.
Conclusion: This study shows that the level of physical ﬁtness was

S53

low among older adults with cognitive impairments compared toolder people discharged from hospital. Thus, this study supportsthat public health initiatives should be designed to reduce passive
sedentary behavior in older adults with cognitive impairment.
Older adults with cognitive impairment are in need of individually
tailored physical activity programs to increase the level of physicalﬁtness.
P-049
Predictors of functional decline among Portuguese hospitalized
older adults
J. Tavares, J. Grácio, L. Veiga Nunes. Centro Hospitalar e Universitário
de Coimbra, Coimbra, Portugal
Introduction: Functional decline (FD) represents the most frequent
adverse event among hospitalized older adults, about 30–60%. Thisdecline during hospitalization is associated with poor outcomes
including death both during and following hospitalization. This
study aim to estimate the incidence of FD and to examine thepredictors of FD in hospitalized older adults.
Methods: A Cohort study was perfomed. Funcional status was measured at three moments: two weeks before admission (baseline),
discharge and three months after discharge. A demographic andclinical survey was conduct at admission moment and Katz scale
administered in three moments. Logistic regression analyses were
employed to examine the predictive fators. SPSS software, version
20, was used for the statistical analysis.
Results: Of the 117 older patients, 55% experienced FD at discharge
and 35.5% at three months after discharge. Of the 117 older patients,
55% experienced FD at discharge and 35.5% at three months after
discharge. Logistic regression revealed delirium, not having a partner, prior social support, previous hospitalization, cognitive decline
and restraint use were signiﬁcant predictors of FD between baselineand discharge. The advance age, delirium and risk assessment of
FD at baseline were signiﬁcant predictors of FD three months after
discharge.
Conclusions: The higher prevalence of DF highlights the importance of prevention in Portuguese hospitals. Some of predictors
occur in the health-disease process, but others may be associatedwith hospital practice. Thus, implementing interventions directedat some of these predictors, such as restraint and delirium, may
contribute to preventing the decline.
P-050
Predictors of institutionalization for Alzheimer’s patient living
at home with a family caregiver
C. Lecardonnel 1 , B. Fantino 2 , F. Fantino 1 , M. Rabilloud 3 ,C. Falandry 1 , M. Valero 1 , E. Nahornyj 4 , M. Haution-Bitker 1 ,M. Bonnefoy 1 . 1 Geriatric Unit, Lyon Sud University Hospital, Hospices
Civils de Lyon, Pierre-Bénite, France; 2 Department of Neuroscience,
Division of Geriatric Medicine, Angers University Hospital, Angers,
France; 3 Department of Biostatitics, Hospices Civils de Lyon, Lyon,
France; 4 Geriatric Unit, Pierre Garraud Hospital, Hospices Civils de
Lyon, Lyon, France
Introduction: Determining the predictive factors for institutionalization of Alzheimer’s disease patients is a priority to prevent
care pathway breakdowns. If the role of patient’s related covariates
is well described, few studies evaluated the impact of caregivers’
characteristics.
Purpose: To identify predictors of institutionalization at one year
by a simultaneous evaluation of the patient-caregiver dyad. The primary endpoint of this prospective study was the institutionalizationof the Alzheimer disease patient at 1 year follow-up.
Methods: Between mars 2012 and December 2013, 97 dyads wererecruited through a Memory Resources & Research Centre: theS54

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

patient and his unformal caregiver living with him at home. Afterinformation and consent, patients and caregivers were evaluatedevery six months according a standardized assessment including medical, psychological, behavioral, economic, environmental
and formal aids. Statistical analyses included correlations analysis,
univariate and multivariate logistic regressions.
Results: At one year, 22 patients (22,7%) were institutionalized.
In univariate, characteristics signiﬁcantly correlated with institutionalization were: (i) patient-related: age, severity of cognitive
impairment (MMSE score), taking antipsychotic treatment, functional disability (IADL) and (ii) caregiver-related: moderate to highburden (Zarit). In multivariate, patient’s age and antipsychotic
treatment were the only signiﬁcant independent predictors of
institutionalization (respectively p=0,007 and p=0,010). A modelwith patient’s characteristics only could classify correctly 81,6% of
the institutionalizations. Adding caregiver’s characteristics did not
improve the model.
Conclusions: Risk factors for institutionalization of patients living at home with a family caregiver are mainly patient-related.
Taking an antipsychotic treatment is a strong predictive factor of
institution.
P-051
Prevalence of cognitive impairment in patients with type 2
diabetes: a systematic review and meta-analysis
Y. Kwon 1 , Y.-J. Kwon 1 , H.J. Kim 1 , Y.-K. Roh 2 , Y.-G. Park 3 ,K.-H. Cho 1 . 1 Korea University College of Medicine, Seoul, Republic ofKorea; 2 Hallym University College of Medicine, Chuncheon, Republic ofKorea; 3 The Catholic University of Korea, Seoul, Republic of Korea
Introduction: Mild cognitive impairment (MCI) and dementia arecommon in patients with type 2 diabetes (T2DM), but publishedresults vary and lack precision. We performed a systematic review
and meta-analysis to provide a precise MCI and dementia prevalence estimates in patients with T2DM and clarify the heterogeneity
in reported results.
Methods: The MEDLINE and EMBASE databases and the CochraneCentral Register of Controlled Trials were searched for studies using
a list of keywords. Articles were included if they (1) reported
patients with T2DM as a primary study group, (2) reported MCI
or dementia using a validated instrument, (3) reported MCI or dementia prevalence in patients with T2DM, and (4) were performed
prospectively in a population-based setting. Data were pooled usinga random-effects model, and heterogeneity was explored using
stratiﬁcation and random-effects meta-regression.
Results: Of the 596 potentially relevant studies, 32 were included in
the meta-analysis. The overall pooled MCI and dementia prevalencein patients with T2DM were 25% (95% CI, 12–39; I2 =90.2%) and 4%(95% CI, 3–5; I2 =88.2%), respectively. Studies with older patientsand longer T2DM durations reported signiﬁcantly higher prevalence
estimates, whereas glucose control, insulin usage, disease subtype,and diagnosis method did not signiﬁcantly inﬂuence the pooledprevalence.
Conclusions: The MCI and dementia prevalence in patients with
T2DM are high, and older patients with longer diabetes duration
have a greater burden of MCI and dementia. MCI and dementia
prevalence estimates for patients with T2DM can guide both clinicaldecisions and public health policy.
P-052
Preventive medicine: physical activity and cognitive disorders
J. Duhautois 1 , L. Bonnel 1 , D. Huvent 2 , H. Idiri 1 , F. Puisieux 2 ,F. Pasquier 2 . 1 CHI Wasquehal, Wasquehal, France; 2 CHRU Lille, Lille,
FranceIntroduction: Various dementia-related pathologies currently rep-resent a major public health issue and it’s considered as a signiﬁcant
medical activity especially related to the population’s aging. The
practice of regular physical activity already represents a protective
factor known and recognized in several ﬁelds such as cardiovasculardiseases, cancer, diabetes or even osteoporosis. The current recommendations yield merely a few prevention and drug treatmentsthat only allow for partial control of the disease. As a matter offact, as physical inactivity prevails in industrialized countries, it has
become a public health issue. A part from the prevention of cardiovascular risk factors, no preventive link has so far been establishedbetween the practice of regular physical activity and the advent ofcognitive impairment later on. However, some assumptions seemto highlight the possibility that a protective factor link might exist.
Faced with an increasing prevalence, approaching these pathologies
on the preventive level could be a new element in the context of apreventive activity in primary care.
Method: The present study establishes a global description of thecharacteristics of a population who consult a memory consulting
center for a memory troubles, and compares the different physicalactivity groups with each other in order to observe the possible
inﬂuence of physical activity on the dementia process.
Results and Conclusion: This is to provide an additional argument infavor of the practice of regular physical activity so as to establish an
early preventive management of dementia pathologies in primary
care.
P-053
Prognostic impact of “syncopal-like falls” in elderly patientswith dementia: Preliminary results of the follow-up of the“Syncope and Dementia” Study
F. Tesi 1 , A. Ceccoﬁglio 1 , M. Rafanelli 1 , G. Rivasi 1 , C. Mussi 2 ,G. Bellelli 3 , F. Nicosia 4 , M. Bo 5 , D. Riccio 6 , A.M. Martone 7 ,A. Langellotto 8 , E. Tonon 9 , G. Noro 10 , A. Ungar 1 . 1 Syncope Unit,
Department of Medicine and Geriatrics, Azienda Ospedaliero
Universitaria Careggi and University of Florence, Florence, Italy;
2 Centro di Valutazione e Ricerca Gerontologica, Chair of Geriatrics,
University of Modena and Reggio Emilia, Modena, Italy; 3 Department
of Health Sciences, University of Milano Bicocca and Acute Geriatric
Unit, San Gerardo Hospital, Monza, Italy; 4 Medicine and Geriatric Unit
- Spedali Civili of Brescia, Brescia, Italy; 5 SCDU Geriatria e Malattie
Metaboliche dell’Osso, Azienda Ospedaliero-Universitaria Città della
Salute e della Scienza di Torino, Torino, Italy; 6 Geriatric Department,
SS. Trinità Hospital, Cagliari, Italy; 7 Department of Geriatrics,
Neurosciences and Orthopedics, Catholic University of the Sacred
Heart, Rome, Italy; 8 S. Maria di Ca’ Foncello Hospital, Treviso, Italy; 9 S.
Jacopo Hospital, Azienda USL 3, Pistoia, Italy; 10 Geriatric Unit, Santa
Chiara Hospital, Trento, Italy
Objectives: Syncope and falls are one of the main causes of
hospitalization in elderly patients with dementia. Aim of the observational, multicenter “Syncope and Dementia” (SYD) study was toinvestigate the etiology of transient loss of consciousness suspected
for syncope and unexplained falls in elderly adults with dementia.
The present follow-up study was aimed at identifying predictors ofmortality.
Methods: Of 532 patients enrolled in the SYD study (mean [SD] age
83.5±6.2 years) from February 2012 to December 2016, preliminary
follow-up data were available in 355 patients (66.7%). Mortality
were investigated during a mean follow up of 197.4±128.5days.
Unexplained fall with a ﬁnal diagnosis of syncope was deﬁned“syncopal fall”, unexplained fall was considered “non-syncopal fall”
when a syncopal origin was excluded.
Results: 87 patients died (24.5%) during the follow-up. In thissubgroup, pathological electrocardiographic ﬁndings were morecommon (p=0.042), particularly persistent or permanent atrial ﬁbrillation (p=0.041), they had a higher heart rate (p<0.001) and aPoster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

longer QT interval (p=0.002). A higher mortality rate was observedin patients with non-syncopal falls compared with patients withsyncopal falls or conﬁrmed syncope (36.9% vs 24.7% and 16.9%,
p<0.002). At logistic regression, a diagnosis of non-syncopal falls(OR 2.753 [1.595, 4.750], p=0.001), male gender (OR 1.448 [1.226,
1.889], p=0.001) and functional status (OR 1.135 [1.001, 1.287],
p=0.048) were predictors of mortality.
Conclusion: Non-syncopal falls are predictive of short-term mortality in elderly patients with dementia. It is necessary to pay
attention to patients with non-syncopal fall that required greatersupervision and should be followed over time.
P-054
Ranking barriers, motivators and facilitators to promote
physical activity participation in dementia patients: an
explorative study
F.H. de Klijn 1 , E.G.A. Karssemeijer 2 , W.J. Bossers 1 , M.G.M. Olde
Rikkert 2 , M.J.G. van Heuvelen 1 . 1 Center for Human Movement
Sciences, University Medical Center Groningen, Groningen, The
Netherlands; 2 Radboud University Medical Center, Radboudumc
Alzheimer Center, PO 9101 (hp 925), Nijmegen, The Netherlands
Introduction: Community-dwelling dementia patients are inactive
most of the day. The purpose of this study was to explore whichbarriers, motivators and facilitators play a role in promoting physical activity (PA) participation in dementia patients. Results can beused to design effective interventions to promote dementia patientsto be physically active.
Methods: Twenty community-dwelling dementia patients (79±5.3
years, 25% female, X MMSE = 23±3.5), their (family) caregivers(70±11.5 years, 85% female) and an expert group of physiotherapists(n=15, 41±12.3 years, 73% female) ranked preselected barriers, motivators and facilitators for PA participation in dementia patients.
Fifty-ﬁve statements were included and ranked by family caregivers
and experts on a continuum from − (not important) to +5 (veryimportant). Dementia patients used a ranking method with seriesof two-choice questions ranging from 0 to 1. Statements wereclassiﬁed by the socio-ecological model, including the intrapersonallevel, interpersonal level and community level.
Results: In both caregivers and dementia patients, the motivator “beneﬁcial health effects” scored highest (X=3.00±1.41 and
X=0.91 ±0.19) for engagement in physical activity. Physiotherapists
scored highest on the barrier “loss of initiative” (X=3.15±1.56).
Intrapersonal level factors scores highest compared to factors frominterpersonal level and community level.
Conclusions: Experts focus strongly on barriers to engage in physical activity participation, whereas caregivers and dementia patients
focus more on motivators and facilitators. The current study suggests that intrapersonal factors are most important to promote PA
in dementia patients, for example by communicating the beneﬁts
of PA.
P-055
Relationship between white matter hypointensities and daily
life activity tests in Alzheimer’s patients
E.A. Karakulak 1 , E. Bulut 2 , B.V. Salancı 3 , K.K. Oğuz 2 , B. Erbaş 3 ,E.L. Ergun 3 , B.B. Yavuz 1 , M. Cankurtaran 1 , M. Halil 1 . 1 Hacettepe
University Faculty of Medicine Department of Geriatric, Ankara,
Turkey; 2 Hacettepe University Faculty of Medicine Department ofRadiology, Ankara, Turkey; 3 Hacettepe University Faculty of Medicine
Department of Nuclear Medicine, Ankara, Turkey
Objective: Cerebral white matter hyperintensity is frequently seenin patients with Alzheimer Diseases (AD) and evaluated by using
hypointensity in T1 imaging sequence and fazekas scaling in T2
imaging sequence. The aim of this study is to demonstrate the rela-

S55

tionship between fazekas scale, T1 hypointensity and instrumental
and basic daily living activities in AD patients.
Methods: Thirty-seven patients with AD were included. T1 hypointensity and fazekas scale of patients were performed by
two radiologists using FLAIR sequence images on the transverse
plane and by visual analysis. Daily life activities were assessed byquestionnaire.
Results: Fazekas scale was found to be signiﬁcantly correlated with
instrumental (r=0.553, p=0.001) and baseline daily life activity score(r=0.378, p=0.021). The cortical white matter T1 hypointensity was
found to be signiﬁcantly and negatively correlated with instrumental (r=−0.628, p=0.009) and baseline daily life activity score(r=−0.488, p=0.050).
Conclusion: Control of vascular risk factors provides an increase
in daily living activities in alzheimer patients and reducing theworkload of caregivers. Fazekas scale and T1 hypointensity areuseful tool to assess and monitor vascular risk factor in alzheimer
disease.
P-056
Renal Function and Cognitive Decline in in the frail elderly. The
ReFiCI (Chronic Renal Failure in Cognitive Impairment) study
A. Castagna 1 , G. Coppolino 2 , C. Ruberto 1 , G. Ruotolo 3 , P. Gareri 1 .
1 Azienda Sanitaria Provinciale di Catanzaro (ITALY); 2 AO Pugliese
Ciaccio di Catanzaro; 3 SOC di Geriatria, AO Pugliese Ciaccio di
Catanzaro (ITALY)
Introduction: Frailty is associated both with an increased risk ofcognitive decline, and the development of Chronic Kidney disease.
In primary care units Frailty Ambulatory is dedicated to elderly
people and is an example of health innovation. The aim of thepresent study was to investigate the relationship between renal andcognitive functions in the frail elderly.
Methods: Frailty Ambulatories have to facilitate the “art” of caring
complex elderly patients’ needs through geriatricians and out-ofhospital network services. We analyzed data from 271 consecutive
patients visited in our ambulatories. The starting point is caring
patients and their needs. The ﬁrst step is represented by over-65
year-old patients’ selection according to prefrailty and frailty Fried’s
criteria. We performed multidimensional assessment and kidney
function assessment in all the patients.
Results: Of 271 patients, 109 (40,22%) were men, mean age
82,74±6,77 years old; BMI was 22,65±2,21 kg/m2 ; CKD-EPI eGFR
was 64,25±25,04 ml/min/1,73 m2 . After performing multidimensional assessment we found the following scores: MMSE 12,18±3,65;
ADL 0,90±2,02; IADL 0,04±0,189. In the 271 patients analyzed we
detected a positive correlation between cognitive function andthe estimated glomerular ﬁltration rates (eGFR). After multivariate
analysis the relationship was conﬁrmed (beta=0,474; p=0,000).
Conclusions: Experimental activity in Frailty Ambulatories could
offer a tool able to recognize conditions of prefrailty/frailty. Frailty,
assessed through Renal function and cognitive functions are signiﬁcanty related in the frail elderly.
P-057
Sensory gating in the elderly with subjective memory
complaints: An MEG study
C.-H. Cheng 1 , P.-N. Wang 2 . 1 Department of Occupational Therapy,
Chang Gung University, Taiwan; 2 Department of Neurology, Taipei
Veterans General Hospital, Taiwan
Introduction: Subjective memory complaint (SMC) has been associated with an increased risk of dementia. Although SMC can hardly
to be determined by neuropsychological assessments, functional
neuroimaging offers an alternative method to probe this symptom.
Sensory gating (SG), an attenuation of the neural response to theS56

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

second identical stimulus, is considered as an automatic process ofthe brain to inhibit redundant sensory inputs. Accumulating evidence showed that patients with Alzheimer’s disease demonstrated
a deﬁcit in SG function. However, there has been no study of SG
in the elderly with SMC. Thus, we aimed to use a whole-headmagnetoencephalography (MEG) to address this issue.
Methods: We recruited 15 healthy older adults and 15 elderly seeking help for their SMC at an out-patient memory clinic. Participants
were cognitively normal as evaluated by Cognitive Ability Screening
Instrument (CASI), with no between-group differences. An auditory
paired-stimulus (S1-S2) paradigm was delivered to each subject
during MEG recordings. SG ratio was calculated as S2/S1, and alower value indicates a better function.
Results: SG ratio was obtained from superior and middle temporalgyrus (STG, MTG), inferior frontal gyrus (IFG) and orbitofrontal
cortex (OFC) of each hemisphere. Compared to the controls, elderlywith SMC exhibited signiﬁcantly decreased S2/S1 ratios in the left
STG and MTG, suggesting an enhanced SG ability in SMC.
Conclusions: This is the ﬁrst study to show that increased SG
function is present in elderly with SMC. Our data also suggest that
self-reported SMC is a reﬂection of objective alterations in brain
function.
P-058
Stop Walking While Talking test: Is it related to cognitive
function?
N. Leiva, C. Roqueta, C. Farriols, M.I. Martínez-Fernández,
R. Miralles, O. Vázquez. Geriatric Medicine Department, Centro
Fórum, Parc de Salut Mar, Barcelona, Spain
Objective: To assess the relationship between cognitive function
and the Stop Walking While Talking (SWWT) test.
Patients and method: A prospective, observational and crosssectional study conducted on 108 patients (62% women), with amean age of 80.5±8.4 years. Twenty-three (21.3%) of them were
living at home, 24 (22.2%) in a nursing home and 61 (56.5%)
in an intermediate care unit. The SWWT test was performed on
all the patients. All patients were able to walk (with or without
walking aids). Based on the results of the SWWT test, patientswere divided in two groups: “stoppers” and “non-stoppers”. Minimental State Examination of Folstein (MMSE) was performed. The
cognitive status was categorized in absence of impairment (MMSE:
21–30 points) and moderate cognitive impairment (MMSE: 15–20).
Patients with severe cognitive impairment (MMSE <15 points) andthose with signiﬁcant auditory or visual deﬁcit were excluded.
Results: The stoppers group of patients had a mean of MMSE
21.6±5.1 and the non-stoppers 24.4±4.0, (p=0.004). Of the 50 nonstoppers patients, 9 (18%) had cognitive impairment and 41 (82%)
had not. Of the 58 stoppers patients, 27 (46.5%) had cognitive
impairment and 31 (53.5%) had not, (p=0.002).
Conclusions: The stoppers patients had greater cognitive impairment, suggesting a relationship between the presence of cognitive
impairment and less ability to perform double tasks.
P-059
The test of the watch drawing as a method of evaluation of
cognitive deterioration
M.I. Porras 1 , M.N. González 2 , T. Porras 3 , J.C. Verdejo 4 . 1 Geriatra
Complejo Asistencial Universitario de León; 2 Geriatría Complejo
Asistencial Universitario de León; 3 Profesora bilingüe. IES Tomás
Bretón Villamayor Salamanca; 4 Geriatra Hospital Clínico San Carlos
Madrid. España
The clock drawing test is widely used in clinical practice because it
is a fast and reliable method for assessing cognitive impairments.
Objective: To assess and compare the cognitive status of two groupsof patients attending the hospital day care center.
Material and methods: Observational, longitudinal, descriptive
study. The clock drawing test was carried out to assess the cognitive
status of two groups of patients attending the day care center
during the months of November and December 2014. One group
had functional recovery and the second had cognitive stimulation.
Variables: sex, age, domicile, pathological antecedents, reason to
go to day care center and in the second group, the prescribed
treatment for cognitive impairment. SPSS v.15 statistical treatment.
Results: n=30 36.7% males. 63.3% females. Group 1 (functional
recovery) 43.3%. Group 2 (cognitive stimulation) 56.4%. Averageage: 81.2 years. Domicile: alone 24.5%, with marriage 47.1%, withfamily 28.4%. Average pathology: 5.6. Hypertension, dyslipidemia,
depressive disorder and diabetes more frequent pathologies. Group
1: derived to Day center by: hip fracture 69%, vertebral fracture
7.7%, stroke 7.7%, discopathy 7.7%, fall syndrome 7.7%. Group 2:
derived by: Degenerative dementia: 64.7%, mixed dementia: 23.5%,
vascular Parkinsonism 5.9%, stroke sequels 5.9%. Test of the clock:
65.4% pathological. Group 1: pathological 50%; Group 2: 17.6%
pathological.
Conclusions: Increased cognitive impairment in women and in thefunctional recovery group. Worst functionality worst result of theclock drawing test. It is the pluripatology a protective factor for
dementia or, pluripathological patients are less concerned about
their memory?
P-060
The Cafe-multimedia: a promising psychosocial intervention forfrail older adults
S. Damnee 1 , L. Djabelkhir 2 , C. Ware 2 , J. Benovici 2 , Y.-H. Wu 2 ,H. Kerherve 2 , A.-S. Rigaud 2 . 1 Hopital Broca, AP-HP, Paris, France &EA4468, Faculty of medicine, University Paris Descartes, Paris, France;
2 Hôpital Broca, AP-HP, Paris, France & Equipe d’accueil 4468, Facultéde médecine, Université Paris Descartes, Paris, France
Objective: Psychosocial interventions using technologies could promote social ties in frail older adults at risk of isolation. The objectiveof this pilot study was to evaluate the effects of a psychosocial
intervention using ICT on social links and technology acceptanceparameters in frail older adults.
Methods: Participants (n=13) in group with mean age 75.9 (± 8.8)
were trained to use Tablets and Smartphones by two psychologists. The course encompassed two-hour sessions per week forthree months. Measures at baseline and after intervention included
assessment of the Montreal cognitive assessment (MoCA), Mini
Geriatric Depression Scale (GDS), loneliness scale (UCLA), perceived
social support (QSSP), and questionnaires of feeling of competency
in ICT and of acceptance of ICT. Opinions and perceptions of participants about the psychosocial intervention were collected at the endof the program by mean of a focus group and interviews.
Results: There was a signiﬁcant increase in the scores of acceptanceof ICT and feeling of competency in ICT, but no changes in MoCA,
GDS, UCLA and QSSP between baseline and the end of intervention.
Results showed that the intervention provided 1) cognitive stimulation and positive engagement with the outside world, 2) positivesocial contacts with other participants but frustration for making
real friendship, 3) engagement in technology learning and use
provided that technology is easy to use and services can facilitate
every day activities. This type of intervention can be an effective
tool in supporting older people at risk of isolation and helping toincrease technology adoption.

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

P-061
The effect of a cognitive stimulation program, with initial,
maintenance program and follow-up, on institutionalized
elderly: a randomized controlled trial (a research protocol)
V. Parola 1 , A. Coelho 1 , H. Neves 1 , M. Almeida 2 , S. Duarte 2 ,A. Cavaleiro 2 , D. Cardoso 1 , J. Apóstolo 1 . 1 Health Sciences Research
Unit: Nursing, Nursing School of Coimbra, Portugal; Centre forEvidence-Based Practice: a Joanna Briggs Institute Centre of Excellence,
Portugal; 2 Health Sciences Research Unit: Nursing, Nursing School of
Coimbra, Portugal
Introduction: Cognitive stimulation therapy (CST) offers a rangeof activities, which provide general stimulation. Evidence suggeststhat cognitive stimulation (CS) has a positive effect on cognitionand depressive symptomatology (DS). This research aims to analyse
the effectiveness of CST, on cognition and depressive symptoms inolder adults in nursing homes (NHs) in different periods of time.
Methods: A randomized controlled trial will be developed inresidents from ﬁve NHS. If required, “intention to treat” analysis
and per protocol analysis will be performed. During 7 weeks,participants of the experimental group will participate in 14 CST
sessions, and participants of the control group received usual care.
Then during another seven weeks, participants of the experimentalgroup will participate in 16 CST sessions (maintenance program),and participants of the control group still received usual care. The
Mini-Mental State Examination, the Geriatric Depression Scale-15,
will be administered at baseline, postintervention of the initial program, postintervention of the maintenance program and 3 months
after the end of the program.
Results: The present study will provide information on how
effective the CST is over time.
Conclusions: This study will bring evidence about CST’s relevancein elders in NHs, guiding recommendation of CST in this context.
P-062
The effect of cognitive stimulation in the elderly
V. Parola 1 , A. Coelho 1 , H. Neves 1 , A. Mouro 2 , M. Almeida 3 ,S. Duarte 3 , A. Cavaleiro 3 , D. Cardoso 1 , J. Apóstolo 1 . 1 Health Sciences
Research Unit: Nursing, Nursing School of Coimbra, Portugal; Centre
for Evidence-Based Practice: a Joanna Briggs Institute Centre of
Excellence, Portugal; 2 Santo Antonio Nursing Home, Portugal;
3 Health Sciences Research Unit: Nursing, Nursing School of Coimbra,
Portugal
Introduction: Evidence suggests that cognitive stimulation (CS) has
a positive effect on cognition and depressive symptomatology (DS).
This study aims to demonstrate that the implementation of the
CS program “Making a Difference” (MD) improves cognition anddepressive symptoms in elders in nursing homes (NHs).
Methods: This was a multicentre quasi-experimental study of 76
elders (59 women and 17 men), with a mean age of 84.28, from
5 nursing homes, in rural, semi-rural and urban environments in
Portugal. Participants attended 14 sessions twice a week over sevenweeks. The Mini-Mental State Exam and the Geriatric Depression
Scale-15 were administered at baseline and postintervention.
Results: T test for related samples revealed that, there is evidence ofimprovement in cognition (p<0.001), and in depressive symptoms(p<0.01) in the post-test scores compared with baseline. From theclinical point of view, 42 elders (55.3%) improved cognition and
25 elders (32.9%) maintained. Regarding depressive symptoms, 36
elders (47.4%) reduced while 21 elders (27.6%) maintained.
Conclusions: Our results showed improvement in elders’ cognitionand depressive symptoms after a seven weeks intervention. Therefore we recommend its implementation as a component of healthpromotion care plan for the elderly in nursing homes context. Further studies should include larger samples as well as maintenance

S57

program and follow-up in order to strengthen and clarify theseresults.
P-063
The effect of continuous positive airway pressure (CPAP) therapy
on cognitive functions in patients over 60 years old withmoderate to severe obstructive sleep apnea
A. Tufan 1 , G. Bahat 2 , D. Büyükgök 3 , Z. Bingol 4 , E. Kıyan 4 , R. İliaz 5 ,M.A. Karan 2 . 1 Marmara University Hospital, Dept. of Internal
Medicine, Division of Geriatrics; 2 Istanbul University Istanbul Medical
School, Dept. of Internal Medicine, Division of Geriatrics; 3 Istanbul
University Istanbul Medical School, Dept. of Psychiatry; 4 Istanbul
University Istanbul Medical School, Dept. of Pulmonary Medicine;
5 Istanbul University Istanbul Medical School, Dept. of Internal
Medicine
Introduction: Obstructive sleep apnea (OSA) characterizes apneas
and hypopneas during sleep. Daytime sleepiness and cognitive
dysfunction were reported in untreated OSA patients. However,theeffect of Continuous Positive Airway Pressure (CPAP) treatment
on cognitive functions, daily life activities, depression, anxiety andquality of life in elderly is unknown. The aim of our study was toinvestigate the effect of CPAP treatment on the parameters of the
OSA patients over 60 years of age.
Method: ESS (Epworth Sleepiness Score), AHI (apnea-hypopnea
index), ODI (oxygen desaturation index), sleeping SpO2 <90% of
patients >60 years old with moderate to severe OSA who applied to the pulmonary diseases outpatient clinic between May
2014-January 2015 were recorded. At least 5 days/week-at least 4
hours/day using CPAP, was accepted as compatible to treatment.
Neuropsychological assessment was performed before CPAP treatment and after 3-months of CPAP. Digit span forward-backward,
semantic-phonemic verbal ﬂuency, trail test, stroop test, visiospatial perception, instant-delayed story memory, instant memory andlearning score were determined. Functionality was evaluated using
Katz activities of daily living and Lawton instrumental activities ofdaily living scores, depression by geriatric depression scale, anxiety
by STAI anxiety scale, and quality of life by EQ5 test. Baseline values
were compared with values after 3 months of effective CPAP use.
Results: Thirty patients included to the the study. Analysis wascompleted on 16 patients due to device incompatibility and followup drop (Poster table 1). After 3-month CPAP result in signiﬁcant
improvements in clock drawing test, recognition, instant memory
and learning scores (Poster table 2).
Conclusion: In our study, 3-month CPAP treatment improved executive functions (attention and planning) in patients. The resultsof our study suggest that CPAP therapy is effective in preventing
cognitive impairments in older OSA patients.
P-064
The effect of implementation a program the physical activity inthe functionality and well-being in old people
L. Pedro 1 , J. Pais Ribeiro 2 , J.P. Pinheiro 3 . 1 Instituto Politecnico deLisboa - Escola Superio de Tecnologia da Saúde de Lisboa;
2 Universidade do Porto - FPCE; 3 Universidade de Coimbra - FM
Introduction: The increasing the number of old people with chronic
illness to live in the community, allows the involvement of publichealth, management of chronic disease, promoting well-being andfunctionality of these people. The Promoting physical activity in oldpeople has an important role for public health. The aim of this study
is implementation of a program of physical activity to improve thefunctionality and well being in old people.
Methods: This is a prospective study. The study includes 17 people,
aged between 66 and 83 years old, 75% female, 65% married, were
all retired and all had functional independence. The data collection

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Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

was performed on senior’s universities in Lisbon - Portugal. It wasapplied in the program of self-regulation the promotion of physicalactivity (IPPA), 90 minutes for a week, lasting seven weeks. We used
one question “Please classify your functionality?” with an answer innumerical scale between “0” and “11” and the Personal Wellbeing
Scale (PWS) before implementing the program (time A) and end
implementing the program (time B).
Results: The correlations between the functionality perception andwell-being, before application of IPPA (r=0.42, p<0.01), and the endof the implementation of IPPA (r=0.68, p<0.01). The results showthat the IPPA improves the correlation between functionality andwell-being.
Conclusions: We think this program promotion and awareness of
the importance of physical activity, using the conceptual modelof self-regulation, can be very beneﬁcial for Functionality andwell-being in old people.
P-065
The effects of cognitive impairment on health-related quality oflife in geriatric oncology patients
D. Matelot 1 , A. Martin 1 , B. de Wazieres 2 , V. Antoine 1 . 1 CHU Nîmes,France; 2 CHU Nîmes FRance
Background: Cancer incidence increases with age. Quality of life
(QOL) has become a major factor when considering treatment
approach and medical care in geriatric oncology. Various QOL measures have been recognized to help treatment decisions, prognostic
and survival assessment. The presence of cognitive disorders is apotential practical problem with QOL measurement. The objectiveof this study is to describe determinants and level of QOL in elderly
cancer patients with cognitive decline.
Methods: More than 100 consenting patients ≥74 years of age, witha progressive cancer (solid tumors or hemopathy, treated or not)were included from a geriatric oncology clinic in a French university
hospital. Determinants of their QOL were collected by open-ended
questions and the validated QOL questionnaire EORTC QLQ-C30(version 3.0). Socio-demographics (age, sex, lifestyle), cancer (typeof cancer, metastatic or not, curative treatment or not), comorbidities, G8 score and geriatric characteristics (cognitive and sensorial
functions, depression, nutrition, walking speed and perimeter, grip
strength, pain, hemoglobin, creatinine clearance, autonomy for
activities of daily living ADL/IADL) were also collected. Cognitive
function was measured by Montreal Cognitive Assessment (MoCA).
We compared the determinants and level of QOL in older cancer
patients with or without cognitive impairment.
Results: We present socio-demographical, medical and QOL dataassociated with the presence of cognitive decline in an elderly andfrail geriatric oncology population.
Conclusion: QOL and cognitive function should be integrated into
geriatric oncology evaluation in order to make the best treatment
decision.
P-066
The MINDMAP Consortium – Survey on mental healthpromotion and mental disorder prevention for older people incities (HORIZON 2020, research and innovation action 667661)
U. Dapp 1 , L. Neumann 1 , W. Jacobsen 1 , F. van Lenthe 2 , W. vonRenteln-Kruse 1 . 1 Albertinen-Haus Centre of Geriatrics andGerontology, Scientiﬁc Department at the University of Hamburg,
Hamburg, Germany; 2 Erasmus University, Department of Public
Health, Rotterdam, The Netherlands
Introduction: The MINDMAP consortium (2016–2019) aims toidentify opportunities offered by the urban environment for thepromotion of mental wellbeing and functioning of older individuals in Europe, by bringing together 10 European cities withurban longitudinal aging studies: GLOBE, HAPPIE (3 cities), HUNT,LASA, LUCAS, RECORD, Rotterdam study, Turin study. A survey on
mental health-care planning policies, strategies and programmes
addressing the heterogeneous group of older people covering healthpromotion to need of nursing care was performed for profound datainterpretation.
Methods: First, the MINDMAP partners identiﬁed experts in theircities, who had an overview of the current mental health sector.
Then, a structured telephone interview (1–2 h) with the expert was
performed always by the same person from the Albertinen-Haus.
All interviews were transcribed and analysed using an analysis
pattern based on the WHO Public-Health Framework for Healthy
Aging including the geriatric functioning continuum [1].
Results: Almost every city has developed speciﬁc mental healthcare planning policies and strategies with corresponding intervention programmes. However, it appears that the focus on older
citizens should be strengthened. Examples of good practices werebased on national guidelines and local strategies to strengthen both
physical and mental health. Promising intervention programmes forolder people made use of a target group identiﬁcation based on the
bio-psycho-social approach.
Conclusions: The ﬁndings will contribute to future-proof preventive strategies in urban settings favouring functional ability seen as
a combination of assessing physical and mental capacities.
References:[1] WHO. World Report On Ageing & Health. Geneve, 2015.
P-067
Towards a graduated detection and diagnosis strategy ofneuro-cognitive disorders in Europe
N. Vanacore 1 , G. Selbaek 2 , K. Rejdak 3 , T. Latchezar 4 , A. Politis 5 ,A. Leperre-Desplanques 6 . 1 National Center for Disease Preventionand Health Promotion, Institute of Health, Rome, Italy; 2 Norwegian
National Advisory Unit on Ageing and Health, Norway; 3 Medical
University of Lublin, Poland; 4 Clinic of Neurology, Medical University,
Soﬁa, Bulgaria; 5 Athens University, Greece; 6 Claude Bernard University(UCBL), Institute for the Elderly, University Hospital (HCL), Lyon,
FranceIn Europe, between 40% and 50% of demented persons are undiagnosed. When the etiological diagnosis is performed, it is mostly
done lately at a stage of advanced autonomy loss or behaviouraldisorders. One of the reasons of poor diagnosis relies on a lackof cognitive detection in primary care. Under the authority of
the European Commission, the new Joint Action “Act on dementia”
proposes a workpackage dedicated to “Diagnosis and post-diagnosis
supports” to enhance rates and quality of neurocognitive disorderdiagnosis. As the detection and diagnosis procedures are not always clear for primary care professionals, the workpackage groupproposes a consensual strategy to better understand the steps ofgraduated detection and diagnosis supports, as well as the links
between care pathways and research dynamics. With that aim, aconsensus has been adopted and discloses: 1 – a neurocognitive
disorder detection step in primary care, 2 – a ﬁrst step of etiological diagnosis dynamics of major neurocognitive disorders, 3 –a second step of etiological diagnosis that may be proposed forcomplex cases, 4 – a speciﬁc pathway dedicated to patients with aminor neurocognitive disorder, and patients who want to access toresearch. At each step, post-diagnosis supports, including research
dynamics, are tailored to the patient-caregiver dyad proﬁle andwills. This consensual European diagnosis strategy will help professionals to better explain to patients and caregivers the content ofclinical, neuropsychological, biological and neuro-imaging supportsthat may be proposed and adapted to the patient.

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

P-068
Trajectories of cognition among older patients from
hospitalization to three months post-discharge
L. Reichardt 1 , R. van Seben 1 , J. Aarden 2 , M. van der Schaaf 1 ,R. Engelbert 2 , J. Bosch 3 , B. Buurman 1 . 1 Academic Medical Center;2 Amsterdam University of Applied Sciences; 3 University of Amsterdam
Acute hospitalization often initiates events leading to changes incognitive functioning. The majority of studies that investigated cognitive trajectories over time focused on speciﬁc patient-populations
such as patients who suffered a hip fracture, stroke, or delirium.
Moreover, previous studies have had only long-term follow ups.
Trajectories of cognitive changes within the short critical threemonths post-discharge are hence unknown. Therefore, the aim of
this study was to identify distinct trajectories of cognitive functioning from acute hospitalization up to three months post-discharge
and to study the incidence of functional decline and mortality. We
conducted a multicenter prospective cohort study, the HospitalAssociated Disability and impact on daily Life (Hospital-ADL) study,
including 400 acutely hospitalized patients of 70 years and older,
who had a minimal MMSE-score of 15 at admission. Data werecollected in six hospitals in the Netherlands. We identiﬁed threecognitive trajectories: 1] consistently high level of cognitive functioning (69%), 2] moderate cognitive functioning and improvement(22%), and 3] consistently minimal cognitive functioning (9%). In
the group with a consistently high level of cognitive functioning,
14% had functional decline and the mortality rate was 11% at threemonths post-discharge. Of the participants with moderate cognitive
functioning and improvement, 24% experienced functional decline
and the mortality rate was 6.5%. Finally, of the participants withconsistently low cognitive functioning, 41% had functional decline
and 14% died within three months post-discharge. These distinct
trajectory groups of cognitive functioning provide information
about the possible prognosis of cognition and functional recovery
after an acute hospitalization.
P-069
Validation of the 7-point scoring system of the clock-drawing
test for the screening of cognitive disorders in elderly patients:
A pilot study
E. Thomas-Hermet 1 , C. Leissing-Desprez 2 , L. Segaux 3 ,A. Broussier 1 , F. Canouï-Poitrine 4 , J.P. David 2 . 1 AP-HP, Hôpital
Henri-Mondor/Emile-Roux, Department of Geriatrics, Créteil, France;
2 AP-HP, Hôpital Henri-Mondor/Emile-Roux, Department of Geriatrics;
Université Paris Est (UPEC), IMRB, A-TVB DHU, CepiA EA 7376 (Clinical
Epidemiology and Ageing Unit), Créteil, France; 3 AP-HP, Hôpital
Henri-Mondor, Department of Public Health, Créteil, France;
4 Université Paris Est (UPEC), IMRB, A-TVB DHU, CepiA EA 7376
(Clinical Epidemiology and Ageing Unit); Université Paris Est (UPEC),
Faculté de Médecine, Département Master; AP-HP, Hôpital
Henri-Mondor, Department of Public Health, Créteil, France
Goal: The main objective was to assess diagnosis performances of
the 7-point Clock-Drawing Test (CDT) using a pre-drawn circle forscreening of cognitive disorders in elderly patients and the interest
to integrate an additional task of copy.
Methods: The CDT was administered to 103 elderly patients divided
in 3 groups according to their score at the Clinical Dementia
Rating (CDR): 0: no cognitive impairment; 0.5: very mild cognitive
impairment; CDR1, 2, 3: mild, moderate and severe dementia. The
CDT and its copy were scored in 7 points according to the system
of Solomon [1]. All the patients had an initial cognitive assessment
using traditional screening tests.
Results: Patients with CDR0 were signiﬁcantly younger and of ahigher education level. The comparison of the CDT scores between
the three groups showed a signiﬁcant difference (p<0.0001). The

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cut-off score ≤6 gave a speciﬁcity of 71.4% and a sensitivity of
70.8% for CDR0.5, 93% for CDR≥1. In addition, 41.2% of patients with
CDR0.5 didn’t normalize their score in copy. The post-hoc subgroup
analysis showed a decrease of the sensitivity (55%) for the youngest
patients CDR0.5 (less than 82 years).
Conclusions: The study showed that the 7-point scoring system of
the CDT allows early identiﬁcation of cognitive decline, despite adecrease of the sensitivity for the youngest subjects. Furthermore,
the additional copy task showed that a large proportion of thepatients with very mild cognitive impairment present cognitive
disorders potentially associated with dysfunction in the parietal
region of the brain.
References:[1] Solomon PR, Hirschoff A, Kelly B, Relin M, Brush M, DeVeaux
RD, Pendlebury WW. A 7 minute neurocognitive screening battery highly sensitive to Alzheimer’s disease. Arch Neurol. 1998
Mar;55(3):349–55.
P-070
Visual [18F]Flutemetamol PET read and CSFs measures inroutine geriatric assessment of dementia
E. Fantoni. GE Healthcare, Life Sciences, Amersham, UK
Introduction: Amyloid PET imaging and CSF beta-amyloid (Aβ42)
measurement are two valid alternatives for determining the presence of pathological amyloid load. The accuracy of measurement by
the two diagnostic modalities was previously found by Palmqvist
et al., 2015 to be comparable. However, the CSF Aβ42 thresholdrequired to establish a “positive”diagnosis of beta-amyloid plaqueaccumulation is somewhat arbitrary and varies between sites.
This 60-patient cohort from routine clinical assessment comparedmatched pairs of CSF Aβ42 with [18F]ﬂutemetamol PET read results
to assess the concordance between PET and CSF measures. T and
P-tau measures were also collected.
Methods: During the course of 18 months, 60patientsreferred bytheir general practitioner to the Oslo University Memory Clinic withcognitive complaint (mean age 69; range 49 to 81)underwent lumbar CSF ﬂuid samplingand PET scanning following the intravenous
injection of approximately 185 MBq [18F]ﬂutemetamol. Aβ42, Ttau, and P-tau concentrations were determined in the NorwegianCentral CSF Laboratory in Akerhus University Hospital, Oslo using
INNOTEST enzyme-linked immunosorbent assays (Fujirebio, Ghent,
Belgium). PET [18F]ﬂutemetamol images were read and classiﬁed
by readers trained per the manufacturers instructions as either
positive or negative.
Results: [18F]Flutemetamol PET scanning resulted in 38 subjects
being amyloid-positive and 22 negative. 17/22 negative amyloid
scan had Aβ42 measures above 770 pg/mL.15 cases below 550
pg/mL had a positive PET read. The remainder of the 28 cases
had Aβ42 measures between 560–760 pg/ml with 23/28 reading
amyloid positive in the PET read and only 5/28 reading negative.
Conclusion: Results indicate that a threshold of over 720 pg/mL
captures approximately 78% of PET negatives (18/23), whilst below
720 pg/mL leads to a PET positivity rate of 89% (33/37 cases). This
cutoff is higher than regularly accepted in routine practise (550pg/mL). 17 cases out of 60 [28%) lie in the range 650–770 pg/mL
an area where there is not a consistent pattern of either positiveor negative PET scan reads. This data is compared with clinicaldiagnosis.
References:[1] Palmquist S, et al. Detailed comparison of amyloid PET and CSF
biomarkers for identifying early Alzheimers Disease. Neurology(2015) 85: 1–10.

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Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

P-071
Visual scan-path study of social cognition tasks inneurodegenerative diseases: A link between behavior disorders
and atypical gaze strategy in social situations
K. Polet, S. Hesse, B. Kullmann, A. Morisot, S. Louchart de laChapelle, A. Pesce. Centre Hospitalier Princesse Grace, Monaco
Introduction: Empathy, Theory of Mind (ToM) and facial emotion recognition impairments are associated with social behavior
disorders. This kind of disorders is observed in Fronto-Temporal
Dementia (FTD), Dementia of the Alzheimer’s Type (DTA) andParkinson’s Disease (PD). Our hypothesis is that patients apply
inappropriate visual exploration strategies to decode emotions
and intentions of others, explaining misinterpretation of others’
intentions, and then inappropriate social behaviors.
Methods: This study, conducted in the Rainier III Gerontologic Center (Monaco), compares eyes movements in social cognition tasks inpatients with FTD (n=5), DTA (n=13), PD (n=10) and normal elderly
people (n=12). We studied empathy using standardised observationof an artwork, ToM using the “Reading mind in the eyes” test, andrecognition of facial emotions using pictures from the Ekman faces
library. Behavior was assessed with the Neuropsychiatric Inventory.
Finaly, eyes movements were recorded with the EyeBrain Tracker®
T2.
Results: We highlighted a link between social cognition impairment, behavior disorder and atypical gaze strategy for decoding
facial emotions, with a speciﬁc proﬁle for each pathology.
Conclusions: These results open new perspectives for differential
diagnosis of dementia especially for an individualized rehabilitationof facial emotion recognition using explicits technics engaging patients to attend to the eye region of faces. This kind of rehabilitation
could be a way to prevent or delay behavioral disorders.

Area: Comorbidity and multimorbidity

P-072
A forgotten cause of falls; onychogryphosis
M. Atef. Russells Hall Hospital, Dudley, UK
An 89 years old lady presented with recurrent falls. She complainedof feet pain and no other symptoms. Examination was unremarkable apart from thickened curved hooked discoloured toenails. FBC,
kidney and liver functions, TSH and Calcium were all unremarkable.
The falls and feet’s pain were attributed to onychogryphosis. Onychogryphosis is hypertrophy of the nails resulting in long, curved
and thickened nails. It is common in older people; however patientsare often reluctant to seek professional advice. It is more common
in toenails than in ﬁngernails. Onychogryphosis is most commonly
caused by neglect or failure to cut the nails for long periods. It
may be also caused by injury or trauma to the toenails by ill-ﬁtting
shoes, peripheral vascular disease or diabetes. Damage to the ulnar
or median nerves can cause Onychogryphosis of the ﬁngernails.
Congenital onychogryphosis of all toenails and ﬁngernails is rare
however congenital onychogryphosis of the ﬁfth toe is not uncommon. Clinically, the nails may be so thickened and curved thatthey look like a ram’s horn. The thickened curved nails are diﬃcult
to cut especially if left for long periods. Pressure on an affected
toenail may cause severe pain and it may predispose to falls.
Onychogryphosis can be mistaken for fungal nail infection, becauseof the yellowish brown discolouration, and treated inappropriately.
Affected nails can have infection due to growth of the nails into theskin. The best treatment is prevention by regular trimming of thenails. Once onychogryphosis is established, treatment is by surgicalremoval of the nail and destruction of the nail bed. Foot and toenail

pathology can predispose to falls. Onychogryphosis is an overlooked
and under diagnosed contributing factor for falls. Feet inspection
should be a routine in assessment of older people especially thosewith falls.
P-073
Acute functional decline or Guillain-Barre Syndrome?
A. Grevy, P. Gibert, G. Gavazzi. CHU Grenoble Alpes
Introduction: A 75-year-old woman was hospitalized due to ahypovolemic shock caused by diarrhoea. She had a medical historyof hypertension, rheumatoid polyarthritis, thyroid hypofuntion andchronic renal failure. Her prescribed treatment included Léﬂunomide 20mg, Prednisone 5mg, Bisoprolol 10mg, Levothyroxine 75μg.
Activities of daily living at home was about 6/6.
Methods: Acute renal failure (161 μmol/L), hyperkaliemia (6,2mmol/L)
were reported. Based on favourable evolution of hypovolemic shock,etiology of diarrhea was not identiﬁed (negative CMV, EBV, VIH,
Campylobacter Jéjuni). After hospitalization, she had a thirteen days
period of functional decline that led to a geriatric rehabilitation.
His assessment at admission was ADL: 2,5/6. After 2 days, extreme
fatigue and a poor participation were reported.
Results: Clinical examination of lower limbs showed a loss ofstrength rating at 3/5, hyporeﬂexia. Upper limbs, pair of cranial
nerves were preserved. Saturation value was 98%. We suspected apolyradiculoneuritis that led us to considering an electromyography
which concluded a Guillain-Barre Syndrome (GBS). She died 10days after a septic shock on intestinal perforation.
Conclusions: Acute functional decline is a typical geriatric syndrom
based on post acute care complications. Nevertheless, we haveto think about others etiology and carry out a rigorous medical
examination. GBS’s prevalence increases with age and the mortality
rate ranges from 5 to 10%. Agent identiﬁcation was negative but
she was immunocompromised due to Léﬂunomide and Prednisone.
Physiopathological pathway is not clearly established but immune
reactions could be involved in the process. We made a declaration
to the pharmaco-vigilance department.
P-074
Adherence to treatment of patients with chronic pain andosteoarthritis
I. Sierra-Martinez 1 , L. Sierra-Martínez 2 , R. Martinez-Fuerte 2 ,L.A. Diez-Suarez 1 . 1 Traumatology Department, Hospital of Medina deCampo (Valladolid), Spain; 2 Valladolid Este Primary Assistance
Gerency, Valladolid, Spain
Objective: To know the Adherence to the Therapy of Patientswith Osteoarthritis and Chronic Pain (CPO), in order to promote
improvement interventions.
Methods: Cross-sectional study of a selection of patients (n=104, 52
males and 52 females (F)) selected by non-probabilistic sampling
treated in our clinic. With chronic pain and osteoarthritis. The
Morisky-Green-Levine trial was also included to assess adherence
to treatment. 1 – Have you ever forgotten to take the medication?
Yes/No. 2 – Do you take medications at the right time? Yes/No. 3 –If you feel well. Stop taking the medicines? Yes/No. 4 – If you everfeel bad. Stop taking the medicine? No Yes. The data is collected in
an Excel spreadsheet and analyzed with SPSS 9.0 for Windows.
Results: Therapeutic Adherence to Chronic Arthritic Pain: Therapeutic compliance, if adequately answered in order: No, Yes, No,
No, Therapeutic noncompliance, if the answer is incorrect. Malepatients: Therapeutic compliance: 83, 33%. Therapeutic noncompliance: 16.67%. Female patients: Therapeutic compliance: 41, 66%.
Therapeutic noncompliance; 58.34%.
Conclusions: Adherence was greater in males 83.33% than in females 41.66%. Taking into account these results, we propose accord-

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

ingly Interventions designed to improve adherence: 1 – Measures tosimplify treatment. 2 – Information and educational interventionsin primary care consultations and specialized consultations andin dynamic groups of health education. 3 – Family and social
support measures. 4 – Behavioral reinforcement interventions. 5 –Combination of Interventions.
P-075
Assessment of independency in activities of daily living of older
patients in nursing departments
J. Macijauskiene, A. Jakavonyte-Akstiniene. Lithuanian University of
Health Sciences, Department of Geriatrics, Kaunas, Lithuania
Introduction: Ageing of the population is one of the most urgent
health care concern. Long life doesn’t necessarily mean healthy life,
older patients more frequently experience vulnerability, morbidity,
disability, and mortality.
Methods: The study is part of the bigger project which was carriedout in 2015 from January to December in one of nursing hospitals
in Vilnius with the aim to assess older patients’ cognitive functionsand variables affecting them. Barthel Index (BI) scale [Mahoney &Barthel, 1965] was used to evaluate basic activities of daily living(ADL). The sumscore from 0 to 20 means total dependence, 21–60– severe dependence, 61–90 – moderate dependence, 91–99 – mild
dependence, 100 – independence. The authors received a permission from Vilnius Regional Biomedical Research Ethics Committee.
Results: The study included 177 patients, 106 women (59.9%) and71 men (40.1%). The youngest patient was 61 and the oldest 97
years old (mean age – 78.9±8.9). The mean sumscore of BI was
33.31±24.53. No signiﬁcant statistical differences were found between BI and age groups (p=0.241) and sex (p=0.538). Statisticallysigniﬁcant difference was found between BI sumscore and mortality during ﬁrst month in the hospital (p=0.004): four ﬁfths of thepatients who died during the ﬁrst month were totally dependent
on admission.
Conclusions: BI low sumscore is important prognostic factor for
negative outcomes in the nursing department.
P-076
Association between dipstick proteinuria and all-cause
mortality: a nationwide population-based study in Korea
Y. Kwon 1 , K. Han 2 , Y.H. Kim 1 , Y.-K. Roh 3 , Y.-G. Park 2 , K.-H. Cho 1 .
1 Korea University College of Medicine, Seoul, Republic of Korea; 2 The
Catholic University of Korea, Seoul, Republic of Korea; 3 Hallym
University College of Medicine, Chuncheon, Republic of Korea
Introduction: Proteinuria has been shown to be associated withmortality in various settings, and dipstick urinalysis is used as an
initial screening tool to assess proteinuria. We investigated theassociation between dipstick proteinuria and all-cause mortality ina general population.
Methods: The study population included 17,342,956 adults who
underwent health examinations between 2005 and 2008 under
the National Health Insurance System. Proteinuria was determinedusing a single dipstick semi-quantitative urinalysis, and the primary
outcome of this study was all-cause mortality. The prognostic
impact of proteinuria was assessed by constructing a multivariable
Cox model.
Results: The mean age of the study population (53.24% male) was
46.06 years; 724,681 deaths from all causes occurred over a medianfollow-up period of 9.34 years, and the maximum follow-up was
12.12 years. After full adjustment for covariates, a higher level ofdipstick proteinuria indicated a higher risk of all-cause death, andvarious subgroup analyses, including using age groups divided by
65 years, did not affect the main outcome for the total population.
Among older adults ≥65 years old, ≥1+ proteinuria in the group

S61

without metabolic diseases (hypertension, diabetes, dyslipidemia,
or obesity) resulted in higher hazard ratios than those in the groupwith metabolic diseases and negative or trace proteinuria.
Conclusions: Our study showed a strong association between
dipstick proteinuria and all-cause mortality in this nationwide
population-based cohort in South Korea. Dipstick proteinuria ismore effective for stratifying mortality in the older adult population
than metabolic diseases known to be cardiovascular risk factors.
P-077
Cardiometabolic risk modeling using a typical high risk adult
population of sub-Saharan settings
K. Leshabari 1,2 , B. Mphumuhila 3 , N. Mavura 4 , R. Bushiri 5 ,R. Kalikawe 6 . 1 Medical Director-Alshifa Polyclinics & Dial ysis Centre,
Dares Salaam, Tanzania; 2 Clinical Research Unit of H; 3 Institute, Dares
Salaam, Tanzania; 3 Te meke Municipal hospital, Dares Salaam,
Tanzania; 4 Mwananya Mala Hospital, Dares Salaam Tanzania;
5 Amana Municipal Hospital, Dares Salaam Tanzania; 6 Muhimbili
National Hospital, Dares Salaam, Tanzania
Introduction: Cardiometabolic risk syndrome is now an acceptableprevalent condition in Africa. There are potential evidence to suggest differences in therapeutic as well as pathogenesis in Africans
compared to other human races. Little is known of additional
beneﬁts of screening in African environment. The aim of the study
was to develop a simple, non-invasive cardiometabolic risk tool for
identiﬁcation of adults at risk of diabetes mellitus in sub-SaharanAfrica.
Method: A community based opportunistic screening was conducted among pre-deﬁned high risk population of Dar es Salaam,
Tanzania. Data were collected using a locally pre-validated questionnaire provided by Tanzania Diabetes Association after fastingblood glucose measurements. Analysis was done using SAS version
9.2 by ﬁtting linear models. A verbal informed consent was sought
to each participant before screening.
Results: We screened a total of 502 residents. A slight male preponderance was noted (male: female =1.8:1). A validated logistic
regression model (Adj. R2=0.714) revealed participant’s age >65
years (OR=1.6, 95% CI: 1.2–1.87), family history of diabetes (OR=2.0,
95% CI: 1.87–3.1), systolic BP (OR=1.01, 95% CI: 0.97–1.24) and BMI(OR=1.33, 95% CI: 1.00–4.1) to be useful in prediction of diabetes
risk. Statistical association was evident between family historyof diabetes and diabetes screening results (γ =0.7, p=0.002) No
statistical signiﬁcant effect was found between gender and positive
diabetes screening (χ2 =1.66, df=1).
Conclusion: Age of participants, family history of both diabetes
and hypertension, BMI as well as systolic measures of BP werepredictive of diabetes in this study population.
P-078
Characteristics of gastrointestinal symptoms in older adults
with diabetes mellitus
G.I. Prada 1 , R.M. Nacu 1 , I.D. Alexa 2 , A.G. Prada 3 , A. Kozma 4 ,A.M. Herghelegiu 1 . 1 N.I.G.G. “Ana Aslan” and U.M.F. “Carol Davila”,
Bucharest, Romania; 2 U.M.F. “Gr. T. Popa”, Iassi, Romania; 3 U.M.F.
“Carol Davila”, Bucharest, Romania; 4 Institute of Anthropology,
Bucharest, Romania
Introduction: Diabetes mellitus (DM), a frequent condition in elderly, has signiﬁcant and multiple consequences. Study objective
was to identify characteristics of gastrointestinal symptoms inelderly with diabetes mellitus.
Material and methods: A total of 731 subjects, age-range 50–91
years, were included. They were divided into two groups, both presenting DM: 359 adults (50–64 years) and 372 elderly (75–91 years).
Results: There was no signiﬁcant difference between the 2 groups

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Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

regarding obesity (p>0.05), but arterial hypertension and dyslipidemia were more prevalent in elderly (p<0.01). In elderly diabetes
mellitus was diagnosed more than 20 years before inclusion into
the study. In elderly diabetes was poorly controlled (higher HbA1c).
DM complications were more frequently encountered in elderly,
cardiovascular involvement and neuropathy having a leading position, followed by stroke. Gastrointestinal symptoms were: mostfrequently abdominal pain, followed by heartburn, constipation,
appetite loss, early satiety, bloating and nausea. Elderly had moreconcomitant symptoms than adults had (p<0.01), 5 and 6 symptoms, adults presenting mostly 3 symptoms in the same time.
Gastrointestinal symptoms increased in poorly controlled DM (increased HbA1c). Number of symptoms increased more signiﬁcantly
in elderly with longstanding DM, as compared to adults (p<0.01).
Presence of gastrointestinal symptoms was correlated with presence of neuropathy (r=0.79). In elderly these symptoms were more
evenly distributed amongst the 2 genders, except for constipationand loss of appetite that were more prevalent in women.
Conclusions: Gastrointestinal symptoms in older diabetics pose
special problems regarding differential diagnosis, including withcardiovascular diseases, this being complicated by silent presentation.
P-079
Chronic pain and post-traumatic stress disorder in elderly
N. Delrue, A. Plagnol. Université Paris 8/Laboratoire de
Psychopathologie et Neuropsychologie, Saint Denis, France
Introduction: Recent studies have highlighted the frequent cooccurrence of somatic complaints in Post-Traumatic Stress Disorders (PTSD). Moreover, PTSD symptoms are more severe duringassociated chronic pain. However, the data about the elderly arevery scarce. This study investigates the hypothesis that chronic
pains presented by elderly patients in nursing home may be a PTSD
manifestation. We argue that the two entities would tend to maintain each other but that a simultaneous treatment could be eﬃcient.
Method: We present ﬁve clinical cases of female patients (84, 88,
91, 92 and 97 years). Each patient has recently entered a nursing
home (less than one year) and was complaining about a chronic
pain that was unexplained by a medical factor. In each case, thepain was measured on Algoplus scale, a detailed physical check-up
was negative and a PTSD was diagnosed using a clinical interview
and the Clinician Administered PTSD Scale. After diagnosis, a shorttreatment protocol was proposed to decrease pain and PTSD symptoms. The Algoplus scale and the Clinician Administered PTSD Scale
were ﬁlled again after treatment and after 6 months of follow-up.
Results: For each patient the reactivation of a trauma has been
evidenced. The trauma was related to a war situation (several
decades before) or to a recent bereavement in the family. A ﬁveto thirteen weeks of speciﬁc treatment by cognitive-behaviouraltherapy (CBT) was eﬃcient with a complete disappearance of pain
and PTSD symptoms for more than 6 month.
Conclusion: Our data highlight some mechanisms involved in thepain maintenance in relation with a PTSD, in particular the hypervigilance and the avoidance, and indicate a non medical eﬃcient
treatment for PTSD and pain.
P-080
Comorbidity in an elderly cancer population; a cross-sectionalstudy
M. Ørum 1 , M. Gregersen 1 , K. Jensen 2 , P. Meldgaard 2 ,E.M. Damsgaard 1 . 1 Department of Geriatrics, Aarhus University
Hospital, Denmark; 2 Department of Oncology, Aarhus University
Hospital, Denmark
Introduction: Comorbidity is prevalent in elderly patients. Han-dling comorbidity is of paramount importance when treatingelderly cancer patients as it may complicate treatment of the cancer
disease. Assessment of comorbidity is part of a Comprehensive
Geriatric Assessment (CGA). Our aim is to quantify and classify
comorbidity in a cohort of elderly cancer patients.
Methods: We performed CGA in 70+-year-old patients with lungcancer (LC), cancer of the head and neck (HNC), colo-rectal cancer (CRC) or upper gastro-intestinal cancer (UGIC) who had beenreferred to the Oncology Department, Aarhus University Hospital,
Denmark for evaluation for cancer treatment. We registered comorbidity and its severity from the patient interview using the
Cummulative Indexed Rating Scale- Geriatrics (CIRS-G).
Results: From 8 January 2015 to 31 December 2015, we assessed 217
patients. The distribution of cancers was: 7% HNC, 43% LC, 15% UGIC
and 35% CRC. Median age was 75 yrs. (interquartile range (IQR))
72–80). Median number of comorbidities was 5 (IQR 3–6).46% had
vascular-hematopoietic (including anemia) comorbidity, 42% had
hypertension, 36% suffered from endocrine-metabolic comorbidity,
26% had a history of cardiac disease, 12% had another cancer disease
besides the index disease. 57% of patients had one or more grade-3
comorbidity and 9% had any grade-4 comorbidity. Further details
on the distribution of comorbidity will be presented.
Conclusions: Comorbidity is prevalent in elderly cancer patients.
Comorbidity in elderly affects a number of organ systems. Morethan half of patients had severe or extremely severe comorbidity
P-081
Comorbidity in nursing home residents with cognitive
impairment
J.M. Fernández Ibáñez 1 , M. del Carmen Morales Ballesteros 1 ,O. Redondo González 2 . 1 Section of Geriatrics, General Hospital La
Mancha Centro, Alcázar de San Juan, Spain; 2 Support Unit Research
General Hospital La Mancha Centro, Alcázar de San Juan, Spain
Introduction: In elderly patients with dementia there is a highlevel of multiple pathology associated. The objective was to assess
whether there are differences in comorbidity among nursing homeresidents with and without cognitive impairment (CI).
Methods: A retrospective cohort study of 277 residents over 65
years. The sociodemographic characteristics, Charlson index andtype of CI were collected. We compared the degree of comorbidity
between residents with and without CI by applying the chi2 test
using bivariate analysis.
Results: 75% (204) of the residents had CI. We did not ﬁnd signiﬁcant differences regarding age and sex between residents withand without CI. CI residents had a higher degree of comorbidity
than those without CI (Charlson 3.1 and 2.3 respectively, p=0.005).
The most frequent dementias were: Alzheimer’s disease (44.4%),
mixed dementia (19.3%) and vascular dementia (13.5%). We founddifferences between the residents with and without CI in the prevalence of cerebrovascular disease (CVD) (52% and 32.4% respectively,
p=0.005), osteoarticular disease (40.2% and 54.4%, p=0.041) andrespiratory failure (20.1% and 36.8%, p=0.005). The CVD was morecommon in the mixed and vascular dementia (p<0.001). We foundno signiﬁcant differences in the prevalence of Parkinson’s disease, epilepsy, depression, heart disease, renal failure and diabetes
mellitus.
Conclusions: Nursing home residents with CI have high comorbidity. CVD is more common in residents with mixed and vasculardementia. Osteoarticular disease and respiratory failure are morecommon in the residents without CI.

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

P-082
Comparison of different tools to detect frailty in nursing homes:
Feasability and interrelationship with disability andmultimorbidity
N. Martinez-Velilla 1 , A.C. Herrero 1 , M. Lopez Sáez De Asteasu 2 ,F. Zambon Ferraresi 2 , M. Gutiérrez-Valencia 1 , A. Sola Mateos 3 ,A.C. Zubillaga 4 , F.A. Amu Ruiz 2 , M. Izquierdo 2 . 1 Department Of
Geriatrics, Pamplona, Spain; 2 Universidad Publica De Navarra,
Pamplona, Spain; 3 Residencia El Vergel, Pamplona, Spain; 4 Residencia
La Vaguada, Pamplona, Spain
Introduction: Little is known about frailty among nursing homes,
and the evidence is scarce as only a limited number of studies havefocused on this topic. Few articles have analyzed the relationshipbetween the concept of different measures of frailty, disability andmultimorbidity.
Methods: This is a cross-sectional analysis of basal data of aconcurrent cohort study in subjects older than 65 years, residents
in two nursing homes. We used 4 Frailty measures: The Fried frailty
criteria, the Frailty Index (FI) de Rockwood, the FRAIL-NH, andan innovative approach trying to approach the limitations of theFried criteria: The Imputated Fried frailty criteria, usando la técnica
denominada MICE (multivariable imputation by chained equation).
Results: One hundred and ten individuals were included in the
study analyzed. Mean age: 86.3 (SD 7.3), 71.8% women. Most of theresidents had high rates of functional and cognitive impairment,
multimorbidity and malnutrition. According to the different frailty
scales, the prevalence was: Rockwood’s FI: 71.8%, Frail-NH: 42.7%,
Fried with MICE imputation 36.4%. There is an important heterogeneity between the interrelationship of the frailty scales and theconcepts of disability and multimorability
Conclusion: There is a signiﬁcant heterogeneity in the prevalence offrailty in nursing homes depending on the deﬁnition of frailty usedwhich signiﬁcantly affects the interrelationship with the conceptsof disability and multi-morbidity. This work is the ﬁrst to analyze
four different scales and to make an innovative approach to the useof the Fried index.
P-083
Comprehensive geriatric assessment in the older cancer patient:
A multidisciplinary approach to optimize management ofcomorbidities – a pilot study
C. Choukroun, G. Leguelinel-Blache, J.-M. Kinowski, H. Richard,
V. Antoine. CHU Nimes
Introduction: Older patients with cancer have increased risk for
multimorbidity, polypharmacy, inappropriate prescribing and adverse drug reaction (ADR). The objective of this study is to assess
the value of a clinical pharmacist-geriatrician teamwork on medication review (MR) to optimize management of comorbidities during
comprehensive geriatric assessment (CGA).
Methods: A prospective, monocentric and observational study was
conducted among older patients (≥75 years old) with cancer (alltypes), during 11 months in a French university hospital. We integrated a pharmacist consultation into CGA process in an acutegeriatric care. The pharmacist records medication story, risk of
ADR with Trivalle score and identiﬁes potentially inappropriate
medication (PIM) using STOPP/START (V2) and Laroche criteria.
The multidisciplinary teamwork then submits its proposals forprescription modiﬁcation to general practitioners (GP).
Results: We recruited 51 consenting patients. We present theirsocio-demographical and medical characteristics: age, sex, lifestyle,G8 score and geriatric rating scales (cognitive, depression, nutrition, autonomy), cancer types and stages, comorbidities, number ofdrugs, adherence, PIM and proposals for GP. We assessed the valueof MR on number of drugs, Trivalle score and PIM reduction.

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Conclusion: Multidisciplinary team seems to have a positive impact on iatrogeny and prevalence of PIM and underuse. The clinicalpharmacist can ﬁnd his place into CGA process to optimize management of comorbidities. This pilot study will lead to a larger
research project that will assess eﬃciency of this process, in a wider
town-hospital network.
P-084
Diabetes mellitus is associated with sleep disturbance in theoldest old
C. Balcı 1 , M. Esme 2 , B.B. Yavuz 1 , F. Sümer 1 , R.T. Dogrul 1 ,G.S. Aycicek 1 , C. Ozsurekci 1 , H. Çalışkan 1 , M. Halil 1 ,M. Cankurtaran 1 . 1 Hacettepe University Faculty of Medicine
Department of Internal Medicine Division Of Geriatrics, Ankara,
Turkey; 2 Hacettepe University Faculty of Medicine Department Of
Internal Medicine, Ankara, Turkey
Introduction: Sleep is an essential biological process and sleep
disturbance is a common health problem that has substantial
consequences like cognitive impairment, low quality of life and increased mortality in older people. The prevalence of sleep problems
increase with age and there are well known risk factors for sleep
disorders in older adults.
Methods: The aim of this study is to investigate whether thepresence of diabetes mellitus increases the sleep problems in oldest
old patients. A retrospective cohort analysis was performed using
health records of patients admitted to outpatient clinic of theDivision of Geriatric Medicine, Department of Internal Medicine, atHacettepe University Hospital. Demographic characteristics, comorbid conditions and presence of well known risk factors for sleep
disturbance were recorded.
Results: Ninety-nine patients over 85 years of age were includedin the study. Mean age was 88.45±4 and 44.4% (n=44) was female.
Twenty one percent of the patients had diabetes mellitus. Percentage of the patients that declared they had sleeping problem was
35.4% (n=35). 34% of the patients experiencing sleep disturbancehad diabetes mellitus while 14% of those not experiencing (p=0.02).
Also nocturia was higher among patients with sleep problem(p=0.02). There was no statisticaly signiﬁcant correlation between
sleep disturbance and gender (p=0.8), history of dementia (p=0.8),
depression (p=0.06), hypertension (p=0.2), heart failure (p=0.27),
chronic obstructive pulmonary disease (p=0.8) and Parkinson disease (p=0.55). The Odds Ratio (OR) of the signiﬁcant risk factors in
the logistic regression were: diabetes mellitus (OR [95% CI] = 3,4[1,2–9,7]), depression (OR [95% CI] = 3,3 [1,3–8,5]) and nocturia (OR[95% CI] = 3,4 [1,2–20,4]).
Conclusion: In addition to well known risk factors our ﬁndings
highlight the importance of diabetes mellitus in the developmentof the sleep disturbance in the oldest old.
P-085
Evaluation of quality indicators for patients with dyslipidemia
in Primary CareL. Sierra-Martínez 1 , R. Martinez-Fuerte 1 , N. Sanz-González 2 .
1 Valladolid Este Primary Assistance Gerency, Valladolid; 2 Parquesol
Senior Center, JCyL Social Services Gerency, Valladolid, Spain
Background and aim: Study on the quality of clinical care inpatients with dyslipidemia assigned to a family doctor.
Method/Design: Longitudinal evaluation: Palmer’s Quality CycleSetting: An urban health care center. Population and Sample:
Patients (total according to inclusion criteria, year 2015) with Dyslipidemia (n=406). Interventions:-Internal evaluation, dimensions:scientiﬁc-technica, quality, adequacy, accessibility, continuity ofcare; data related to the care process and intermediate results;
explicit, evidence-based procedural criteria. Subjects: analysis ofS64

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

coverage. Analysis on the evolution of treatment compliance. The Z
statistical test for comparing proportions, alpha 0,05.
Results: Compliance criteria (year 2015): Results Indicators inpatients with dyslipidemia associated with a Family Doctor (FD),in the Health Center (HC) and in the Health Area (HA). Patientsdiagnosed with dyslipidemia 14 years of age or older: FD 406
patients (30.27%), HC 3403 patients (22.39%), HA 56,355 patients(23.88%), Patients with dyslipidemia with registered cardiovascularrisk: (CVR): FD 204 patients (50.25%), HC 1687 patients (49.57%),
HA 25590 patients (45.43%), Patients with dyslipidemia with a registered CVR between 14 and 65 years: FD 88 (42%), HC 855 patients(45.50%), HA 13432 patients (44.52%), Patients with dyslipidemia
with CVR registered over 65 years: FD 116 (56.86%), HC 832 patients(44.37,45%), HA 12168 patients (47.54%).
Conclusions: The analysis of the records of care process indicators
for patients with Dyslipidemia makes us aware of the importanceof patient control. Registration allows us to evidence improvementsin the care process. To make a good registry of the controls, toadapt the interventions with the patient, adapting them to eachcase. After our analysis we say that we must improve the uptakeof patients with Dyslipidemia and the quality The analysis of therecords of care process indicators for patients with Dyslipidemia
makes us aware of the importance of patient control. Registration
allows us to evidence improvements in the care process. To makea good registry of the controls, to adapt the interventions with thepatient, adapting them to each case. After our analysis we say that
we must improve the uptake of patients with Dyslipidemia and thequality of the records of CVR of the care process.
P-086
Evaluation of quality indicators for patients with genderviolence in Primary CareL. Sierra-Martínez 1 , R. Martinez-Fuerte 1 , N. Sanz-González 2 .
1 Valladolid Este Primary Assistance Gerency, Valladolid; 2 JCyL Social
Services Gerency, Valladolid
Background and aim: Study of the quality of the registry of screening of gender violence patients assigned to a Primary Care Physician(PCP) and to compare them with patients with gender violence atthe Health Center (HC), with the Health Area (HA) and with thepatients of the Autonomous Community of Castilla and León (CyL)(during the period 2015).
Method/Design: Longitudinal evaluation: Palmer’s Quality CycleSetting: An urban health care center. Population and Sample:Female
patients ≥14 years: 753 (year 2015) (n=753). Interventions: Internal evaluation, dimensions: scientiﬁc-technica, quality, adequacy,
accessibility, continuity of care; data related to the care process andintermediate results; explicit, evidence-based procedural criteria.
Subjects: analysis of coverage. Analysis on the evolution of treatment compliance. The Z statistical test for comparing proportions,alpha 0,05.
Results: Compliance criteria (year 2015): Population of women≥14 years: PCP 754, HC 8.039, HA 121.649, CyL 1.088.855. Of theaforementioned, how many have been screened for gender violencein the last four years: PCP 44, HC 907, HA 23,697, CyL 152,246.
Screening Rate: PCP 5.84%, HC 11.28%, HA 19.48%, CyL 13.98%.
Conclusions: The analysis of the records of the screening indicators
for patients with gender violence makes us aware of the importanceof patient control. Registration allows us to evidence improvementsin the care process. To make a good registry of the controls, to adapt
the interventions with the patient, adapting them to each case.
After our analysis we say that we must improve the recruitment ofpatients with gender violence and the quality of the records of thecare process.

P-087
Evaluation of quality indicators for patients with heart failure inPrimary CareL. Sierra-Martínez 1 , R. Martínez-Fuerte 1 , N. Sanz-González 2 .
1 Valladolid Este Primary Assistance Gerency, Valladolid, Spain; 2 JCyL
Social Services Gerency, Valladolid, Spain
Background and aim: Study of the quality of the registry of screening of Heart Failure (HF) patients assigned to a Health Center (HC)and to compare them with HF patients with the Health Area (HA)
and with the patients of the Autonomous Community of Castillaand León (CyL) (during the period 2015).
Method/Design: Longitudinal evaluation: Palmer’s Quality CycleSetting: An urban health care center. Population and Sample: HF
patients ≥14 years: 116 (year 2015) (n=116). Interventions: Internal
evaluation, dimensions: scientiﬁc-technica, quality, adequacy, accessibility, continuity of care; data related to the care process andintermediate results; explicit, evidence-based procedural criteria.
Subjects: analysis of coverage. Analysis on the evolution of treatment compliance. The Z statistical test for comparing proportions,alpha 0,05.
Results: Compliance criteria (year 2015): Population ≥14 years: HC
17,122, HA 2,482, CyL 2,398,647. Number of patients with open
HF in the period: HC 116, HA 2,482, CyL 28,038. With the clinicaldata Fraction of Ejection (Fe) of the left ventricle (LV) recorded inElectronic Clinical History: HC 0, HA 4, CyL 48. Prevalence IC: HC
0.68%, HA 0.94%, CyL 1.17%. Percentage of patients with HF whohave LV, recorded in Electronic Clinical History: HC 0%, HA 0.16%,
CyL 0.17%. Patients with at least one prescription of ACE inhibitors
or ARAs in the period: HC 68, HA 1.663, CyL 16,928. Percentage ofpatients with at least one prescription of ACE inhibitors or ARAs in
the period: HC 58.62%, HA 67%, CyL 60.38%.
Conclusions: The analysis of the records of the screening indicators
for patients with HF makes us aware of the importance of patient
control. Registration allows us to evidence improvements in thecare process. To make a good registry of the controls, to adapt
the interventions with the patient, adapting them to each case.
After our analysis we say that we must improve the recruitment ofpatients with HF and the quality of the records of the care process.
P-088
Evaluation of quality indicators of physician follow-up after
hospital discharge in Primary Health CareL. Sierra-Martínez 1 , R. Martinez-Fuerte 1 , N. Sanz-González 2 .
1 Valladolid Este Primary Assistance Gerency, Valladolid, Spain; 2 JCyL

Social Services Gerency, Valladolid, Spain
Background and aim: Evaluation of the Quality Indicators of theMedical Follow-up after the discharge in Primary Health Care frompatients assigned to a Primary Care Physician (PCP) and comparethem with patients from the Health Center (HC), the Health Area
(HA) and the Autonomous Community of Castilla y León (CyL),
Spain. (During the period 2015).
Method/Design: Longitudinal evaluation: Palmer’s Quality CycleSetting: An urban health care center.
Population and sample: Patients (total according to inclusion criteria, year 2015) Medical Follow-up after the discharge in Primary
Health Care (n=119). Interventions: Internal evaluation, dimensions: scientiﬁc-technica, quality, adequacy, accessibility, continuityof care; data related to the care process and intermediate results;
explicit, evidence-based procedural criteria. Subjects: analysis ofcoverage. Analysis on the evolution of treatment compliance. The Z
statistical test for comparing proportions, alpha 0,05.
Results: Compliance criteria (year 2015): – Number of notiﬁcationsof Medical Follow-up after the discharge in Primary Health Care in
the period 2015: PCP 119, HC 1477, HA 26688, CyL 309573. – HowPoster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

many notiﬁcations of Medical Follow-up after the discharge, do you
have an accompanying hospital discharge report?: PCP 64 (53,78%),
HC 803 (54,37%), HA 16426 (61,55%), CyL 222483 (71,87%). – Howmany notiﬁcations of Medical Follow-up after discharge have an
appointment, a note on the electronic medical record, or medical
follow-up after discharge within 48 hours of the discharge date?:
PCP 71 (59,66%), HC 811 (54,91%), HA 17286 (64,77%), CyL 216574(69,96%).
Conclusions: The analysis of the records of care process indicators for patients with notiﬁcations of Medical Follow-up after thedischarge makes us aware of the importance of patient control. Registration allows us to evidence improvements in the care process.
To make a good registry of the controls, to adapt the interventions
with the patient, adapting them to each case. After our analysis we
say that we must improve the uptake of patients with notiﬁcationsof Medical Follow-up after the discharge and the quality of therecords of the care process.
P-089
Frequency and impact of medical complications in the patients
undergoing hip fracture
M.E. Baeza-Monedero, C. González-Villaumbrosía, C. Oñoro-Algar,
J. Martínez-Peromingo, V. Sendín-Martín, I. Navas-Clemente,
I. Robles-Barrena, R. Barba-Martín. Hospital Rey Juan Carlos, Madrid,
Spain
Objective: To study the incident of medical complications in patients undergoing hip fracture and the impact on mortality, hospitalstay, and functional deterioration.
Methods: Prospective and observational study, which includes all
patients admitted for hip fracture since 1st January 2016 to 15th
February 2017 in a secondary hospital in Madrid. We assessed
the presence of anaemia with transfusion requirement, acute renal failure, cardiovascular complications, stroke, thromboembolic,nosocomial infection, ulcers by pressure, delirium, malnutrition,
constipation with enema requirement and vitamin D deﬁciency.
We did a descriptive analysis of the population characteristics,
and a linear correlation (Pearson test) between the number ofcomplications and hospital stay and functional impairmet (Barthel).
We also did an univariate analysis between each complicationand mortality (χ2 test), and we studied the association between
each complication and hospital stay, functional impairment andmortality (T for independent samples).
Results: n:163 patients. The average number of complications was
3.39 (range 1–7). The most frequent was vitamin D deﬁciency(64.4%), malnutrition (60.7%), anaemi (59.5%), constipation (48.5%),
renal failure (30.7%), nosocomial infection (17.8%), cardiovascularcomplications (17.2%), ulcer (6.7%), strok (1.2%), and thromboembolis (0.6%). The number of complications was statistically signiﬁcantwith the stay (Pearson0.18, p=0.02) and functional decline (Pearson
0.16,p=0.04). The average of complications was signiﬁcantly higher
among the deceased patients against the living patient (5.5Vs3.39,
p=0.045). Complications associated signiﬁcantly with a higher
mortality were nosocomial infection (20.7Vs1.5%, p<0.001), cerebrovascular (100%Vs3.7%, p<0.001) and ulcer (27.3Vs3.3%, p=0.01)
and those related to a higher functional impairment were anaemi(loss of 21 points in BarthelVs15, p=0.025)and cardiovascular complications (25Vs17, p=0.018).
Conclusion: The coexistence of medical complications is a common problem in the patients undergoing hip fracture correlating
their number with increased mortality. Some complications areassociated with higher mortality and functional impairment.

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P-090
Geriatrician input into the care home signiﬁcantly reduces
anticholinergic burden (preliminary report)
S.-J. Bailey 1 , T.J. Welsh 1,2,3 . 1 Royal United Hospitals Bath NHSFoundation Trust, Bath, UK; 2 RICE (Research Institute for the Care ofOlder People), Bath, UK; 3 University of Bristol, Bristol, UK
Introduction: Many commonly used medications have mild anticholinergic effects of which practicing clinicians may not beroutinely aware. The cumulative effect of multiple such medications, known as anticholinergic burden, has been associated withadverse outcomes. Interventions that reduce anticholinergic burden may therefore be beneﬁcial. Review of care home residents’
medications is an intervention used by community geriatricians.
This quality improvement project aimed to evaluate the impact of acommunity geriatrician on care home residents by using change inanticholinergic burden as a proxy measure.
Methods: A joint review of care home residents’ medication was
carried out by a geriatrician in conjunction with the patient’s general practitioner and care home manager. Medication pre and post
review was documented. The anticholinergic cognitive burden scale
was retrospectively used to quantify and compare anticholinergic
burden before and after review.
Results: At the time of submission data was available from 25
residents: 76% female, mean age of 84 (8), taking a mean of
7.9 (3.8) medications at baseline. 22 (11%) out of a total of 198
medications were stopped or reduced following review. Both themedian anticholinergic burden (1 (0–3) to 0 (0–1) P=0.02) and themean number of medications (7.9 (3.8) to 7.2 (3.2) P=0.008) weresigniﬁcantly reduced.
Conclusions: Geriatrician input into the care home reduces anticholinergic burden and total medications. If the results were to be
replicated over a larger population this could have a potentially
important impact on health through a reduction in anticholinergic
burden and on cost through a reduction in medication expense.
P-091
GP-led locality hub for older people living with frailty in NorthWest Surrey
R. Lisk 1 , P. Wilkinson 2 , N. Selby 3 , J. Wagstaff 3 , L. Lawn 4 . 1 Elderly
Care Department, Ashford & St. Peter’s NHS Foundation Trust,
Chertsey, UK; 2 Cardiology Department, Ashford & St. Peter’s NHSFoundation Trust, Chertsey, UK; 3 North West Surrey CCG, Weybridge,
UK; 4 Medical Director, Bedser Locality Hub, Woking, UK
Introduction: At North West Surrey, (NWS) we faced a numberof challenges including an ageing population, people living withchronic conditions, overreliance on hospitals and disconnect between social and medicalised care. Our mission was to ﬁnd a way
to manage the challenges we face from a growing older population
within an integrated GP-led community service and in a mannerthat promotes independence, reduce social isolation, improve patient experience and safely delivers appropriate acute care in thecommunity.
Methods: The model delivers standardised, multidisciplinary careto patients focused on tasks and activities that maximise health,maintain independence and functioning, based on individual need.
These interventions are delivered in a co-located setting by a single
integrated team including carers and volunteers and we provide
transport to enable attendance. The 1st hub in Woking was opened
on 20th Dec 2015 and 2 other locality hubs are due to open towards
the end of 2017.
Results: From Dec 15–Sept 16, there has been a 3.6% reduction
in non-elective admissions across acute providers in NWS in theover 75s for Woking, compared with an increase in activity in theother localities. Friends & Family feedback (88 patients) showed

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Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

98.9% were likely/extremely likely to recommend service with 89%
extremely likely.
Conclusions: The locality hub has had an impact on admissions. It
is important that initiatives such as this, which focus on partnershipworking, are adopted more widely to enable older patients to betreated in the most appropriate environment for their social andmedical needs.
P-092
Hypotension in nursing home residents on antihypertensive
treatment: risk of mortality and hospitalization
G. Bahat 1 , B. İlhan 1 , A. Tufan 2 , S. Bovatekin 1 , H. Özkaya 3 ,H. Doğan 3 , C. Kılıç 1 , M.A. Karan 1 . 1 Istanbul University, Istanbul
Medical School, Division of Geriatrics, Istanbul, Turkey; 2 Marmara
University, Department of Internal Medicine, Division of Geriatrics,
Istanbul, Turkey; 3 Istanbul Kayışdağı Nursing Home, Istanbul, Turkey
Objective: Prevalence of hypertensio (HT) and use of antihypertensivemedications increase by-aging. Antihypertensive-medication is apotential risk-factor for hypotension for morbidity/mortality in elders. We aimed to assess prevalence of hypotension and orthostatic
hypotension (OHT) and their relationship between subsequent oneyear hospitalization and mortality in nursing home (NH) residents
receiving antihypertensive-medications.
Methods: A group of NH resident >60 years of age receiving
antihypertensive medications accepted to involved. Blood pressures(BPs) were measured sitting and 3–5 min after standing to assess
OHT. BPs were measured supine and 3–5 min after sitting to assess
OHT in bedridden residents. Also BP measures recorded in thelast year at NH have been studied retrospectively. Residents were
evaluated for both recorded and current BPs and comprehensive
geriatric assessment thoroughly.
Results: 175 were male (%66) and 89 were female (%34) from 264
subjects. Mean age was 75.7±8.7 years. Most of residents wereambulate (n=191, 72%). At one year, ratio of hospitalization fromany cause was 50.8% (n=134), mortality rate was 21.6% (n=57). 88
residents had mean SBP ≤110 mmhg (34.8%). 170 residents hadmean DBP≤70 mmhg (67,2%). 54 residents had OHT (21.6%). Lower
SBP (≤110 mmhg) was statistically signiﬁcant predictor of mortality(p=0,047) in cox regression analysis after adjusting for age, sex,
number of comorbidities and medications, and MNA-sf. Mortality
was signiﬁcantly higher in residents with mean DBP ≤70 mmhg
(p=0,031) in chi-square analysis. Hospitalization was higher in only
group with DBP≤65 mmhg with borderline statistical signiﬁcance(p=0,05) in regression analysis. OHT was not seen associated withmortality nor hospitalization.
Conclusion: Both supine hypotension and OHT are signiﬁcantly
prevalent in “hypertensive” NH residents on antihypertensivetreatment. Either lower SBP≤110 mmhg is independently associated with mortality in NH residents. Lower DBP ≤65 mmhg is also
associated with increased hospitalization in NH residents.
P-093
Hypoxic-ischemic brain injury related to dual disorder
C. García-Alonso 1 , D. Curto-Prieto 1 , B. Gonzalvo Cirac 2 . 1 Grupo
Residencial Valdeluz, Madrid, Spain; 2 CAS Benito Menni, CASM. Sant
Boi LLobregat (Barcelona), Spain
Objective: Observational and descriptive study of the N=21 outpatients in an addiction treatment center. There are cognitive andfunctional impairment (clinically detected and through The Montreal Cognitive Assessment – MoCA) that hinder the therapeutic
program of deshabituation.
Purpose of study: Show the reality (increasing) of outpatient addiction treatment centers and the diﬃculties of treatment of thesepatients.

Material and methods: Data are collected from N=21 patients, whoare being treated at a outpatient drug addiction center (CAS). All ofthem have mild cognitive and functional impairments.
Results: 89% of outpatients had alterations in neuroimaging evaluation (NMR). Two of them are women. Mean age were 61 ages
(44–72 years old). 61% had Dual Disorder (addiction and othermental illness). 83% had Alcohol Use Disorder. 72% had hypoxicischemic brain injury throughout life. MoCA were less than 24 in allof outpatients.
Conclusions: Chronic substances abuse and cognitive and functional impairments, should not be problem to the neurologicalassessment and rehabilitation of affected outpatients. Dysfunctionof patients makes it extremely diﬃcult to follow the speciﬁctherapies to recover from the addiction. Comprehensive cognitive/
neurological rehabilitation treatments and substance use disorders
would have to be started.
References:[1] Fernández-Serrano MJ, Pérez-García M, Verdejo-García A. What
are the speciﬁc vs. generalized effects of drugs of abuse on
neuropsychological performance? Neurosci Biobehav Rev 2011;35: 377–406.
[2] Verdejo-García A, Chong T-J, Stout J, Yücel M, London ED. Stagesof dysfunctional decisión-making in addiction. Pharmacology,
Biochemistry and Behavior. In press (2017).
P-094
Improving the management of osteoporosis in older men
R. Litke, E. Boulanger, F. Puisieux. Lille University Hospital, Lille,
FranceOsteoporosis in older men is common and causes signiﬁcant mortality and morbidity [Walsh et al. Nature Rev Endoc 2013]. Some
data suggest that osteoporosis is underidentiﬁed and undertreatedin men. Additionally, 50% of the causes of osteoporosis are secondary in men [Gielen et al. Best Pract. Res Clin Endoc Metab 2011].
The 2012 Endocrine Society recommend additional laboratory investigations in men with osteoporosis so as to treat them more
eﬃciently [Watts et al. JCEM 2012]. Our aim was to determine
whether men managed in our geriatrics centre, diagnosed withosteoporosis, underwent investigations to determine the aetiology
of osteoporosis and what the secondary causes were. We conducteda monocentric, retrospective study including all men seen at thegeriatric consult in 2016 diagnosed with osteoporosis. For eachpatient, we evaluated our clinical practice, whether common secondary causes were sought-after and what these aetiologies were.
Among the 121 men with a diagnosis of osteoporosis seen at thegeriatric consult at the Lille University Hospital in 2016 only 55
had undergone further investigations. Among the 3 major identiﬁed
secondary causes: 16% glucocorticoid induced, 12% hyperparathyroidism, 12% treatment induced hypogonadism. The investigations
conducted in elderly men to seek a secondary cause to osteoporosis
are insuﬃcient. The 2012 Endocrine Society guideline and Rheumatology societies provide a framework for evaluation and treatmentof osteoporosis in men. We should aim to more widely researchsecondary causes for osteoporosis in our patients so as to better
adapt the management.
P-095
Intervention program for caregivers of multimorbid patients
R. López-Liria 1 , F.A. Vega-Ramírez 2 , P. Rocamora-Pérez 1 ,M.I. Segura-Luján 3 . 1 Department of Nursing Science, Physiotherapy
and Medicine, University of Almería, Almería, Spain; 2 Torrecárdenas
Hospital, Almería. Spain; 3 Physiotherapist, Almería. Spain
Objective: To develop a practical guide for caregivers of multimorbid patients, which should be useful, providing information that

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

suits the demands and needs of both the patients and caregivers
themselves.
Methods: A cross-sectional descriptive study was carried out in
Almería Health District to describe the home care provided by
Mobile Rehabilitation and Physiotherapy Teams, the characteristics of its implementation, and its results on patients’ functional
independence and on their caregivers’ overload.
Results: Family and caregivers receive training to promote patient’s
functional independence, and are also given information about theintervention on the patient and its objectives, helping them incorporate these activities into their daily routine. Additionally, theyreceive information on health and community resources, in orderto help them look after their own physical and mental welfare.
Furthermore, they are encouraged to participate in support groups
for stress management, among other activities. There is supporting
evidence showing how the support from family, friends and bothpublic and private services and resources can diminish the overload
experienced by caregivers.
Conclusions: Access to information and the various domiciliary
resources available, both health and social, offer caregivers more
possibilities to provide their dependent patients with a more adequate intervention that will have an impact on their quality of life.
Caregivers themselves reach better physical and emotional welfare,so as to face the problems and diﬃculties of their daily lives.
Research Project PI 0354/2014 issued by the Ministry of Health of
the Government of Andalusia.
P-096
Invasive versus non invasive management of acute myocardial
infarction in patients with dementia: Data from SveDem, theSwedish Dementia Registry
D. Religa, P. Cermakova, K. Szummer, K. Johnell, J. Fastbom,
B. Winblad, M. Eriksdotter. Karolinska Institutet, Stockholm, Sweden
Background: Acute myocardial infarction (AMI) is one of the leading cause of death and is particularly prevalent and deadly after
80 years of age. We aimed to study factors that determine the useof invasive procedures in the management of AMI in patients withdementia and determine whether the use of invasive procedures
was associated with better survival.
Methods: The study was based on data from Swedish Dementia
Registry (SveDem), 2007–2012. We included 29 630 newly diagnosed dementia patients from specialist memory units (60) andprimary care units in Sweden (ca 880). During median follow-up
time 228 days 525 dementia patients got AMI (mean age 89 years,
54% women).
Results: 110 patients (21%) with dementia received invasive treatment for AMI. After multivariate adjustment, lower age and higher
global cognitive status were associated with the use of invasive procedures. The invasively managed patients survived longer (P=0.001).
Invasive treatment was associated with a lower risk of all-cause
mortality, adjusting for type of AMI and dementia disorder, age,gender, registration unit, history of AMI and comorbidity score (HR0.35, 95% CI: 0.21–0.59), or total number of drugs (HR 0.34, 95% CI:
0.20–0.58).
Conclusions: Age and cognitive status determine the use of invasive
procedures in patients with dementia. This study suggests that theinvasive management of AMI has a beneﬁt for survival of patientswith dementia.
P-097
Is multimorbidity a “Domino” phenomenon? The results of the
PolSenior study
A. Skalska 1 , K. Piotrowicz 1 , A. Pac 2 , T. Grodzicki 1 . 1 Department ofInternal Medicine and Gerontology, Jagiellonian University Medical

S67

College, Krakow, Poland; 2 Chair of Epidemiology and Preventive
Medicine, Jagiellonian University Medical College, Kraków, Poland
Introduction: Multimorbidity is a complex problem of the current
geriatric medicine. Patients with multimorbidity require more clinical concern, use healthcare resources more often, and experiencesigniﬁcantly worse short- and long-term outcomes. The aim of theanalysis was to determine the prevalence ﬁgures and conditionalcounts for the most frequent chronic diseases and mutimorbidity in
the Polish elderly.
Methods: Medical questionnaire, history taking and physical examination, and blood and urine collection were employed in orderto gather data on 17 chronic diseases in participant of nationwide
PolSenior Project. Multimorbidity was deﬁned as a co-occurrenceof 2 and more chronic diseases. All data was weighted with regard
to age and sex.
Results: Multimorbidity was diagnosed more often with advanced
age, in 88.4% of those 65–79, and in almost 94% of those aged
80 and older. Hypertension, metabolic diseases and obesity werethe most common chronic condition, however it was changing
with advanced age and in octogenarians and older hypertension,eye disorders and cognitive impairment were the most frequent
medical problems. The highest risk for multimorbidity was found in
the respondents aged 65–79 with stroke, and in the oldest olds who
had suffered from stroke or heart failure. Hypertension was mostoften diagnosed as a single disease, in 4.1% of those aged 65–79 andin 2% of those aged 80 years and more.
Conclusions: We showed that in the elderly chronic diseases wereusually diagnosed as multimorbidity patterns that might inﬂuence
the way how we diagnosed and treat the older patients.
P-098
Life with cancer in nursing homes. Can e-health technologies
improve the quality of care?
T. Delespierre 1 , P. Clot-Faybesse 2 , A. Letty 3 , L. Josseran 4 .
1 Paris-Saclay & Institut du Bien Vieillir Korian; 2 Korian SA; 3 Institut
du Bien Vieillir Korian & Korian SA; 4 Paris-Saclay
Introduction: Korian is a private group specialized in medical
accommodation for elderly and dependent people. A professional
data warehouse set up in 2010 hosts all residents’ data, the transmissions’ table containing key information about the residents’care fed on a daily basis. As cancerous residents require multiple interventions and hospitalizations, following them in nursing
homes (NH) in real time can be really challenging. The objective of
this study is then to show what e-health can bring to cancerous
residents’ quality of care.
Methods: Through nursing care narratives extraction, using deeplearning we built 26 syndromes including hospitalizations anddeaths, aﬄicting our residents: a ﬁrst layer shortened the characterﬁelds and cleaned up expressions, a second selected the syndromes,
and a third involved medical expertise and logical predicates. In thisstudy we chose to extract the life course of residents with at least
one recent cancer mention syndrome, staying in two NH where a GP
coordinating care was following them, from that transmission until
02/26/2017. A ﬁrst classiﬁcation using socio demographic variables
and care information, designed as a preliminary work, gave thefollowing results.
Results: Splitting the 57 residents between dead and alive, men andwomen, or by using a ﬁrst cancer mention delay in days’ threshold,shed light on the ever changing residents’ health and socio proﬁles
but also on the cancer treatment through time.
Conclusion: Including the residents’ past syndromic transmissions
information, especially cancer features, through textmining andmachine learning analyses will give new insight and improve GP’streatments.

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Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

P-099
Management of chronic insomnia in elderly
S. Hammami 1 , I. Chabéne 1 , A. Mhalla 2 , L. Gaha 2 . 1 CHU F Bourguiba,
Department of Internal Medicine, University of Monastir; 2 CHU F
Bourguiba, Department of Psychiatry University of Monastir, Tunisia
Introduction: Insomnia is the most common sleep disorder in theelderly. Its management must take into account the physiologicalchanges related to the age, the higher frequency of co morbidities
and the polymedication.
Objective: To evaluate the management of chronic insomnia in theelderly patients by general practitioners and to compare them withinternational recommendations.
Population and methods: We conducted a cross-sectional and descriptive study among general practitioners over a period of twomonths. We proposed to these doctors to participate in our study
by sending to them a questionnaire in their emails, which they ﬁllanonymously.
Results: A total of 32 doctors responded to the questionnaire.
Among them, 62.5% reported that they often or very often receive
elderly consulting for insomnia. Before prescribing hypnotic drugs,
65.6% of practitioners reported that they often advise lifestyle anddietary rules. The most prescribed hypnotic classes were: Benzodiazepine (BZD) and antihistamines in 59.37% of cases each one
and homeopathic treatments in 56.25% of patients. The treatment
period exceed 30 days in 18.75%. As for the prescription of BZD,
molecules with long half-life were used in 37.48% of cases, and theposology was identical to adults in 34.4% of cases.
Conclusion: The prescription of hypnotic treatment in the elderly
must be cautious, taking into account psychiatric and somatic comorbidities. Patients must be educated about environmental factorsthat affect sleep, such as avoiding caffeine late in the day, having
a regular sleep schedule, avoiding napping and the importance of
exercise.
P-100
Mortality risk factors among long-term care facility residents
A. Kantoch 1 , B. Gryglewska 1 , T. Grodzicki 1 , J. Wojkowska-Mach 2 ,P. Heczko 2 . 1 Department of Internal Medicine and Gerontology,
Faculty of Medicine, Jagiellonian University, Medical College, Kraków,
Poland; 2 Chair of Microbiology, Faculty of Medicine, Jagiellonian
University, Medical College, Kraków, Poland
Objective: The main aim of the study was to evaluate potential
mortality risk factors among long-term care residents during one
year of follow-up.
Material and methods: The study was performed among 172 elderly residents of three long-term care facilities in Poland. The study
population was divided into two groups: people who were alive[Group 1] and people who died [Group 2] during one year follow-up
period. Medical documentation, blood pressure (BP) measurements,
Body Mass Index (BMI) and selected tests including AbbreviatedMental Test Score (AMTS), physical dependence score, Mini Nutritional Assessment (MNA) and Barthel Index were performed in all
study participants at the beginning of the study. Statistical analysis:
Results obtained in two analyzed groups were compared using
U Mann-Whitney or Chi square tests. Univariate and multivariate
logistic regression models were used for investigating the risk
factors for mortality.
Results: The analyzed sample consisted of 172 long-term care
residents. Group 1 (N=148) and group 2 (N=24) revealed similarage, number of diagnosed diseases, number of used treatment, BMI
and BP values. However, group 2 showed signiﬁcantly lower scorein ADL (0 [0; 2,5] vs 3 [1; 6]), Barthel Index (5 [0; 37,5] vs 40 [15;95]), MNA (8 [6;10] vs 12 [9;13]), AMTS (4 [2;7] vs 8 [6;9]) andgreater physical dependence score (4 [3;5] vs 3 [1;3]) than group 1.

The statistical analysis showed that the potential risk factors that
increased the mortality among residents were: diagnosed diabetes(8,1 OR [95% CI; 3,00–21,86], p<0,001), dementia (3,0 OR [95%CI; 1,25–7,27], p=0,014) and physical dependence (2,13 OR [95%
CI: 1,47–3,07], p<0,001). The protection factor was diagnosis of
hypertension (0,28 OR [0,10 - 0,74], p=0,010).
Conclusion: Lower functional, nutritional, cognitive status, greater
dependence and diagnosis of diabetes or dementia were negatively
inﬂuenced on mortality outcomes. However, occurrence of hypertension may have positive impact on probability of survival among
institutionalized individuals.
P-101
Non-pulmonary symptoms and comorbidities in older people
with chronic obstructive pulmonary disease
G.I. Prada 1 , R.M. Nacu 1 , O.N. Penes 1 , I.D. Alexa 2 , A. Kozma 3 ,A.G. Prada 4 , A.M. Herghelegiu 1 . 1 N.I.G.G. “Ana Aslan” and U.M.F.
“Carol Davila”, Bucharest, Romania; 2 U.M.F. “Gr. T. Popa”, Iassi,
Romania; 3 Institute of Anthropology, Bucharest, Romania; 4 U.M.F.
“Carol Davila”, Bucharest, Romania
Introduction: Chronic Obstructive Pulmonary Disease (COPD) isfrequently seen in elderly, with important consequences on morbidity and mortality. We analyzed non-pulmonary symptoms andcomorbidities in elderly with COPD.
Material and methods: A retrospective study performed on 120
randomly selected patients previously diagnosed with COPD, divided into 2 equal groups: adults (50–64 years), elderly (≥75 years),with equal number of women and men.
Results: A lmost all subjects had no occupational risk. 2/3 ofpatients resided in urban area; 77.5% were current or previous
smokers, mainly males (58%). 16.7% had tachycardia and 2.5% had
bradycardia, more often encountered in elderly. Heart failure wasmore prevalent in elderly (p<0.05), 1 in 7 having ejection fraction≤40%. Pulmonary hypertension was more prevalent in adult womenchi-square test = 4.261 (p<0.05). C-reactive protein more prevalent
in elderly (p<0.01). Body Mass Index higher in adults, chi-square
test showed no gender difference. High prevalence of diabetes mellitus amongst elderly, no signiﬁcant difference from adults. Pearson
test showed no statistical correlation between COPD severity (GOLDcategory) and HbA1C levels. Osteoporosis more prevalent in elderly
women (chi square = 10.652, p<0.05). Regarding neurocognitive
status, only decreased orientation skills in elderly group and anxiety
in women in both age-groups. Comorbidities were highly prevalent in both groups (92%), elderly having more than 3 conditions
concomitantly. Most prevalent comorbidities in elderly, in order:
diabetes mellitus, heart failure, hypertension.
Conclusions: Comorbidities and non-pulmonary symptoms in elderly with COPD have a signiﬁcant impact on severity of disease
and survival in this category of patients and need special attention.
P-102
Potentially inappropriate medications in hospitalized elderly ina tertiary hospital in Singapore using the STOPP criteria
D. Chia 1 , P.S. Ong 2 , L. Chia 2 , C.P. Lee 3 , M.Q. Wan 1 . 1 Dept. of
Pharmacy, National University Health System, Singapore; 2 Dept. of
Pharmacy, National University of Singapore, Singapore; 3 Dept. of
Pharmacy, National Cancer Centre Singapore, Singapore
Background: Potentially inappropriate prescribing (PIP) in elderly
is prevalent and is associated with increased risk for adverse drug
events, morbidity and healthcare cost (Scott, 2015). Screening tools
such as Screening Tool of Older Persons (STOPP) assist to evaluate
PIP prescribing among elderly (Hill-Talyor, 2016). However, extent
of inappropriate prescribing among Singapore hospitalized elderlyis currently unknown.

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

Objectives: This study aims to investigate the prevalence of PIP in
elderly patients on hospital admission and at discharge as well as
to identify risk factors associated with PIP.
Methods: A retrospective cross-sectional study was conducted overa 2-month period in a cardiology ward in National University Hospital, Singapore. Patients 65-years and older who were taking at least
one medication were included. STOPP Version 2 criteria was used.
Results: A total of 115 patients were included with 52.2% having
more than 8 medications on admission. Admission PIP prevalence
was 51.3% (59 patients, 105 PIPs) which was decreased to 47.0%(54 patients, 78 PIPs) on discharge. Admission PIM index was
reduced from 0.110±0.150 to 0.0698±0.093 on discharge (p=0.007).
The two leading classes of PIPs were prescription of Vitamin B
supplementation without evidence-based clinical indication andmedications that increase the risk of falls including ﬁrst-generation
antihistamine. A signiﬁcant predictor of PIP on admission identiﬁed
was taking more than eight prescribed medications [OR 3.79; 95%
CI: (1.75, 8.21)].
Conclusion: Inappropriate prescribing was common among elderly
in Singapore and hospitalization resulted in a decrease in PIPs. The
number of medications prescribed was signiﬁcantly associated withnumber of PIP.
P-103
Predictors of cardiorenal damage in the elderly
D. Tasic, Z. Dimitrijevic, B. Mitic, K. Tasic. Serbia
Introduction: It is known that the incidence of heart failure
increases with age, and therefore, it is now characterized as ageriatric syndrome. Renal function is valorized as a marker of earlyor advanced stages of heart disease and is of much greater clinicalsigniﬁcance than the value of the ejection fraction. We are analyzing
the structural and functional markers of heart and kidney damage(BNP, troponin I, cTnhsT, cystatin C), inﬂammation markers (CRP,
IL-8, PAI-1) and oxidative stress markers (AOPP, MDA, XOD, XO, XD)
and determining their importance in different clinical modalities of
the cardiorenal syndrome.
Methods: The clinical group consisted of 79 patients, 40 of whomwere men (50.63%) and 39 of whom were women (49.37%), in
the average age of 70.72±9.26 years. Based on the current classiﬁcation of cardiorenal syndrome, the patients was divided into
ﬁve subgroups. The main criteria for the inclusion of subjects withassociated renal and heart failure in the study were the existence of a “de novo” or previously diagnosed, clinically manifested
cardiovascular disease.
Results: In the univariate logistic model, the age of the patients(p=0.002) and the elevated concentrations of CRP (p=0.001) wereidentiﬁed as risk factors for the development of chronic cardiorenal
syndrome. The multivariate model includes variables with the statistical signiﬁcance of p<0.010. The age of the patients (p=0.002),
the concentration of PAI-1 (p=0.032) and CRP (p<0.001) wereidentiﬁed as signiﬁcant risk factors.
Conclusions: The age of the respondents, as well as the high levelsof CRP were identiﬁed as independent risk factors for the development of chronic forms of cardiorenal syndrome. In the multivariate
model, the ages of respondents, as well as the high plasma levels of
CRP and PAI-1 have retained the importance as the risk factors.
P-104
Prevalence and pattern of use of oral antihyperglycemic drugs
and insulin in a population of diabetic patients in nursing
homes: Results from the SHELTER Study
F. Martini, D. Ronconi, G. Onder, R. Liperoti, R. Bernabei. Universita’
Cattolica del Sacro Cuore
Objectives: Describe prevalence and pattern of use of antidiabetic

S69

drugs in elderly people with diabetes mellitus residing in nursing homes (DMRs), and to identify individual socio-demographic
and clinical features associated with these drugs. Design: Crosssectional analysis of the Services and Health for Elderly in Long
TERm care (SHELTER) database. SHELTER is a 12-month prospective
cohort study, conducted between 2009 and 2011, to assess Nursing
home (NH) residents in 7 European countries and Israel.
Methods: The study included 4037 residents in 59 NH during
the 3-month enrollment period. The multidimensional InterRAI
instrument for Long-Term Care Facilities (InterRAI-LTCF) was used
to assess health and functional status. Descriptive statistics andlogistic regression models were used to perform the analyses.
Results: About 61.3% of DMRs were treated with antidiabetic drugs(33% with oral antihyperglycemic drugs (OAD), 22% with insulin(Ins) and 6% with combined therapy (OAD + Ins)). Among theOAD, Biguanides were the most prescribes drugs (53%). Non treatedresidents were more likely to be female, older, with a higher BMI
and with more severe cognitive decline. DMRs treated with Ins
presented more severe functional decline. Ins+OAD was associatedwith lower prevalence of cognitive impairment, depression, urinary
incontinence and pain.
Conclusion: Over 60% of DMRs receive pharmacological treatment with antidiabetic drugs. Advanced age is the main barrier
to treatment, while severity of cognitive and functional decline
may inﬂuence the prescribing choice. Further studies are needed to
conﬁrm these ﬁndings and evaluate the effectiveness of antidiabetic
treatment in frail elderly population.
P-105
Prevalence of benign paroxysmal positional vertigo, orthostatic
hypotension and polyneuropathy in patients referred to a
geriatric falls clinic – a cross-sectional study
L.H. Andersen, E.M. Damsgaard, M. Gregersen. Dept. of Geriatrics,
Aarhus University Hospital, Aarhus, Denmark
Introduction: Falls and vertigo are common in older persons. One
third falls at least once a year. The prevalence of vertigo is approximately 30%. Three common causes of vertigo and falling are: benign
paroxysmal positional vertigo (BPPV), orthostatic hypotension (OH),and polyneuropathy (PNP). Our aim was to ﬁnd the prevalence of
these diseases in older patients referred to a geriatric falls clinic.
Methods: We made a cross-sectional study of all patients aﬃliatedto a falls clinic on March 15th 2017. We calculated the prevalenceof BPPV, OH and PNP by chart review. BPPV had been diagnosedby physical therapists using the Dix-Hallpike method. OH had been
diagnosed using blood pressure measurements after having thepatient stand up for minimum three minutes and was conductedby a geriatric nurse. PNP had been diagnosed on the basis of distal
loss of sense, vibration and/or reﬂexes. This was performed by ageriatric doctor.
Results: The number of patients was 97. Mean age was 79.8 years(SD: 6.6), 67% were female. BPPV was found in 10% of the patients,
OH in 36%. PNP had been newly diagnosed in 40%. Twenty-six
percent of the patients had two diagnoses. Other common diagnoses were other vestibular disorders, polypharmacy and cardiac
arrhythmias.
Conclusions: BPPV, OH and PNP are common causes of vertigo andfalls in a geriatric falls clinic. BPPV, OH and PNP are potentially reversible. Further studies should be made to determine the outcomeof intervention of these diseases.

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Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

P-106
Risk factors and complications of arterial hypotension in older
peopleG.I. Prada 1 , O.N. Penes 1 , R.M. Nacu 1 , I.D. Alexa 2 , A. Kozma 3 ,A.G. Prada 4 , A.M. Herghelegiu 1 . 1 N.I.G.G. “Ana Aslan” and U.M.F.
“Carol Davila”, Bucharest, Romania; 2 U.M.F. “Gr.T. Popa”, Iassi,
Romania; 3 Institute of Anthropology “Fr. I. Rainer”, Bucharest,
Romania; 4 U.M.F. “Carol Davila”, Bucharest, Romania
Introduction: Arterial hypotension is a major problem in elderly
and has signiﬁcant consequences: syncope, falls, stroke, myocardial
infarction, even death. Study objective was to identify risk factors
and complication of this condition in elderly.
Material and methods: A total of 277 subjects, age-range 44–95
years, were included. They were divided into two groups, bothpresenting arterial hypotension: 136 adults (44–64 years) 136 and141 elderly (75–95 years).
Results: Three types of arterial hypotension have been identiﬁed
in elderly: orthostatic hypotension, post-prandial, post-exercise hypotension. In our sample, most cases had orthostatic hypotension,other variants had less than 4% prevalence. Parkinson disease
was more often seen in older patients (p<0.05). Type 2 diabetes
mellitus and chronic renal disease were also more prevalent in elderly (p<0.05). Smoking was more prevalent in adult males. Threegroups of medicines were involved: psychoactive, antiparkinsonian,vasodilator drugs. Age of menopause younger than 46 years wasmore prevalent in elderly women with arterial hypotension (chisquare=9.762, p<0.05). Anemia was signiﬁcantly more prevalent
in elderly (p<0.001). Stroke and myocardial infarction was significantly more prevalent in elderly patients (p<0.01). Vertigo andsyncope occurred as complications of arterial hypotension more
often in elderly (p<0.01), as well as falls, fractures and ischemic
heart disease. Orthostatic hypotension was identiﬁed in elderly
more than twice in adults. Headache and asthenia occurred more
often in elderly (p<0.05).
Conclusions: Identifying arterial hypotension, its forms and addressing some of its most important risk factors, could improvestanding and prevent falls and other complications in elderly.
P-107
Severity of vitamin D deﬁciency predicts mortality in stroke
patieNTS
J. Wajda 1 , M. Swiat 2 , A. Owczarek 3 , A. Brzozowska 4 ,M. Olszanecka-Glinianowicz 4 , J. Chudek 5 . 1 Department ofNephrology, Regional Specialist Hospital No. 3, Rybnik, Poland;
2 Department of Neurology with Stroke Unit, Regional Specialist
Hospital No. 3, Rybnik, Poland; 3 Department of Instrumental Analysis,
Faculty of Pharmacy and Laboratory Medicine in Sosnowiec, Medical
University of Silesia, Katowice, Poland; 4 Health Promotion and Obesity
Management Unit in Department of Pathophysiology, Medical Facultyin Katowice, Medical University of Silesia, Katowice, Poland;
5 Pathophysiology Unit in Department of Pathophysiology, Medical
Faculty in Katowice, Medical University of Silesia, Katowice, Poland
Introduction: Vitamin D (VD) deﬁciency is considered as a risk
factor for death due to cardiovascular events including stroke. In
the present study we assessed the hypothesis that decreased levelsof 25-hydroxyvitamin D (25-OH-D) and related calcium-phosphate
disturbances are associated with increased risk mortality in patientswith ischemic stroke.
Methods: Serum 25-OH-D, intact parathyroid hormone (iPTH),
intact ﬁbroblast growth factor 23 (iFGF23) levels were assessedin serum samples left after routine tests in a hospital laboratory
in 240 consecutive patients with acute ischemic stroke, admitted
within the 24 hours after the onset of symptoms to the Stroke Unit.
Mortality data were obtained from the local registry oﬃce.

Results: Only three subjects (1.3%) had optimal 25-OH-D level(30–80 ng/ml), 25 (10.4%) had mildly reduced (insuﬃcient) level, 61(25.4%) moderate deﬁciency and 151 (62.9%) a severe VD deﬁciency.
20% subjects had increased iPTH (>65 pg/mL). Of all patients, 79(32.9%) died during a follow-up observation (44.9 months). The
incidence rates of death (per year) were 4.81 and 1.89 in a groupwith and without severe VD deﬁciency, respectively (Incidence Rate
Ratio =2.52; 95% CI: 1.44–4.68). In multivariable stepwise backward
Cox proportional hazard regression age, 25-OH-D <10 ng/mL andfunctional status (assessed by the modiﬁed Rankin scale) weresigniﬁcant factors increasing the risk of death.
Conclusions: Severe VD deﬁciency is a strong and independent
from age and functional status negative predictor for survival instroke patients. VD supplementation in patients after stroke may beconsidered even without 25-OH-D assessment.
P-108
The gouty tophus
I. Sierra-Martinez 1 , L. Sierra-Martínez 2 , R. Martinez-Fuerte 2 ,L.A. Diez-Suarez 1 , N. Sanz-González 3 . 1 Traumatology Department,
Hospital of Medina de Campo (Valladolid), Spain; 2 Valladolid Este
Primary Assistance Gerency, Valladolid, Spain; 3 Parquesol SeniorCenter, JCyL Social Services Gerency, Valladolid, Spain
Background and aim: The incidence and prevalence of gout has
increased in recent decades, probably due to changing lifestyles andthe aging of the population. The objective of this clinical case is thereview of a case of patient with chronic gout and habit of alcoholabuse.
Method, results and case description: Patient of 70 years. Personal history: Arterial hypertension, Impaired glucose tolerance,
Hyperuricemia, Tendinitis aquilea left, Spondyloarthrosis, Hepatic
steatosis (drinker of 6 doses/day of wine), chronic gout. Surgicalinterventions: left hip prosthesis, right knee tibial osteotomy, rightthumb fracture. In study and follow up by Gouty Tophus: – Episodesof gouty tophus for 15 years, with ankle involvement; One or two
annual episodes of 8–10 days duration and recently episode inright thumb (where it has previous structural damage) swellingand drainage in the right wrist and 5th interphalangeal right hand.
– Tophus in left elbow for 2 years. – Structural damage in theright hand, knees, ankles and 1th metatarsophalangeal joints (MTP
joints) (hallux rigidus).
Conclusions: This type of patient needs a lot of support anda more continuous follow-up on the part of his family doctor,
emphasizing the importance of the dietary advice for the alcoholic
abstinence, since its consumption is a risk factor to present acuteepisodes of Gout more And more Frequent and severe, structurally
damaging more joints. In addition, liver damage may increase andtherefore diﬃcult to treat with Allopurinol. Remember to establish
allopurinol that we must make a check at 15 days and if Urico Acid
>6 mg, we increase at the dose of 300 mg/day. It is important
to clarify the basis of gouty tophus treatment: colchicine will be
used daily and nonsteroidal anti-inﬂammatory drugs (NSAIDs) ininﬂammatory outbreaks.
P-109
The impact of hospitalization on the number of administered
medications in consecutively admitted elderly patients
P. Voukelatou, I. Vrettos, A. Ragkou, A. Bitsikokou, A. Didaskalou,
D. Theotoka, A. Katsoras, A. Kalliakmanis. 2nd Department ofInternal Medicine, General Oncological Hospital of Kiﬁssia “TheAgioiAnargyroi”, Athens, Greece
Introduction: Previous studies concerning how hospitalization affects the number of medications administered to elderly patients,
before hospital admission and after discharge, have yielded mixedPoster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

results. The objective of this study was to assessthe impact of
hospitalization on drug prescriptions in consecutively admitted,
elderly patients.
Methods: In 262 patients, mean age 80,45±7,95 M±1SD, (53,4%
women) demographic characteristics, medical history, medications,Katz-index, Charlson-Comorbidity-Score (CCS) and reason of admission were recorded. The number of medications and CCS wererecorded both at admission and discharge. Parametric tests wereapplied to identify the variables that have signiﬁcant association
with the reduction of medications. The paired Wilcoxon test wasapplied to analyze both the difference between the number ofdrugs and CCS at the time of admission and discharge.
Results: The mean CCS before admission and after discharge was
5,50±1.80 M±1SD and 6,00±1,92 M±1SD respectively, while thenumber of medications was 5,22±3,06 M±1SD and 5,49±2,65 M±1SD
respectively. In 191 patients (72.9%) CCS remained stable while in 71
patients (27.1%) increased. The mean number of medications after
discharge increased, remained stable or decreased in 106 (40.5%),
104 (39.7%) and 52 (19.8%) respectively. While after hospitalization
the mean CCS increased (Z=−2.953, p=0.003)a statistically signiﬁcant change in the mean number of medications was not elicited(Z=−1.299, p=0.194). The only variable linked with the reduction of
medications was the unchanged CCS (p<0.001, χ2 =18.859).
Conclusions: Hospitalization seems to contribute in medications’
reduction. The effort to reduce the number of medications gets
more complicated when the CCS is increased.
P-110
The usability of the Supportive and Palliative Care Indicator’s
tool and the surprise question in Dutch nursing homes
L. Oosterbaan, K. Andringa, J. Harmer, P. Sonneveld, M. Smalbrugge,
J. van Berkel. VUmc/Gerion, Amsterdam, The Netherlands
Introduction: There are various tools available for indicating theneed for palliative care. However these tools have not been studied
for use in nursing homes. The aim of this study is to explore theusability of the Supportive & Palliative Care Indicators Tool (SPICT)
and to compare the SPICT with the Surprise Question (SQ) in
nursing homes.
Methods: Elderly care physicians used the SPICT and the SQ for
indicating the need for palliative care in 120 patients living in
Dutch nursing homes. This study features a quantitative data set
with a cross-sectional design in which the inter-rater agreement of
the SPICT and SQ for indicating palliative care was analysed. The
usefulness of the tools perceived by the physicians was studied
with a qualitative analysis based on a focus group.
Results: The SPICT indicated a need for palliative care in 71% ofincluded nursing home patients. The SQ indicated this need in
62,5%. A moderate agreement (kappa = 0,495) of the instruments
was found. The elderly care physicians regarded the SPICT unusable
for indicating a need for palliative care, but deemed it helpful forthe conversation concerning advanced care planning.
Conclusion: In indicating the need for palliative care, the SPICT and
the SQ are moderately comparable. However, according to elderly
care physicians the indicators used in the present form of the SPICT
are not appropriate for use in a nursing home.
P-111
The value of “p”: Novel risk factors for ischemic stroke?
J.J. Martínez Rivas, O. Duems Noriega. General Hospital Granollers,Barcelona, Spain
Introduction: The interatrial block (IAB) is a delay in atrial conduction deﬁned as a wide p-wave (WpW) on electrocardiogram(ECG) but has low speciﬁcity for supraventricular tachycardia (SVA)
and ischemic stroke (IS) prediction. New criteria for IAB appeared

S71

as the biphasic morphology of p wave in the inferior leads, which
has increased its predictive value. The objective of this study is
to ﬁnd relationship between new IAB’s criteria (NIAB) and IS ofundetermined cause (ISUC).
Method: Retrospective study of 188 cases admitted to hospitalfor ISUC (A group) without prior arrhythmias, compared to 180
controls admitted for other causes (B group). NIAB ﬁnding on the
ECG (biphasic p≥120ms in II, III and AVF) was assessed in bothgroups. Data analysis was made to ﬁnd NIAB differences between
groups in relation to age (<75; ≥75) and comorbidities.
Results: 368 patients (47% women; mean age 72,7±15,2; Barthel
index 79,5±24,9) were included. WpW and NIAB ﬁndings weresigniﬁcantly more prevalent in A group (p≤0.000), with no other
differences observed. Signiﬁcant differences were found considering age: stronger association WpW-IS vs NIAB-IS in the youngest
group (OR 24.1 (12.4–46.7) vs 20.5 (4.8–87.3) in contrast with astronger association NIAB-IS vs wpw-IS in the oldest group (OR 33.8
(4.3–264.7 vs 7.4 (2.1–26.8).
Conclusions: WpW and NIAB were signiﬁcantly related to ISUC.
Relevant differences were found considering age, being more prevalent the presence of WpW in younger with ISUC and NIAB in elder.
Although more studies are needed, these outcomes could justify
primary prophylaxis with anticoagulation before SVA appears.
P-112
Twenty year blood pressure trajectories in 46,634 older patients
J. Masoli 1,2 , J. Delgado 1 , K. Bowman 1 , A. Ble 1 , Y. Han 3 , W. Henley 3 ,S. Welsh 4 , G.A. Kuchel 4 , L. Ferrucci 5 , D. Melzer 1 . 1 Epidemiology andPublic Health, University of Exeter Medical School; 2 Royal Devon andExeter NHS Foundation Trust3Health Statistics Research Group,
University of Exeter Medical School; 4 UConn Center on Aging, UConn
Health, Farmington; 5 Longitudinal Studies Section, National instituteof Health, Baltimore
Introduction: We aimed to estimate trends in blood pressure (BP)for 20 years prior to death and test associations with multimorbidity
and cardiovascular diagnoses.
Methods: We used Clinical Practice Research Datalink primary andsecondary care records. We estimated BP in 46,634 participants
aged ≥60 who died 2010–2014 (including 10,957 aged 90+). We
investigated associations of comorbidity and cardiovascular diagnoses (hypertension, heart failure, AF, and stroke or TIA) with BP
trajectories. We compared BP slopes >2 years (to reduce end of life
effect) to 10 years prior to death for 28,241 participants who died,with 46,856 birth-year and gender matched controls surviving >9years.
Results: Peak systolic BPs occurred 14 years before death in ages
60–69 and 18 years in age ≥90 years. BP decline >2 to 10 years
prior to death was steeper compared to matched controls surviving>9 years across age-groups with interaction terms <0.001 in all
age groups: eg.60 to 69 years cases β coeﬃcient 0.88 (0.82:0.95)
controls 0.13 (0.0:0.15), 90+ years cases 1.88 (1.82:1.95) controls
0.37 (0.13:0.62).
Cardiovascular diagnoses increased the slope of SBP decline (interaction term: p-value <0.001 for all conditions). BP declines weremodestly larger in higher RFI comorbidity quintiles.
Conclusions: In this ﬁrst long-term individual patient analysis, we
showed that BP decline is not limited to the ﬁnal years of life, butfor ≥14 years. Declines were widespread and not simply due tobetter survival in those without hypertension or multimorbidity.
These ﬁndings may have implications for BP treatment monitoringin older adults.

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Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

Area: Comprehensive geriatric assessment

P-113
A prospective cohort study of 112 elderly patients with bladdercancer: predictive factors of early death after a Comprehensive
Geriatric Assessment
C. Rambaud 1 , M. Sanchez 1 , M. Durand 2 , S. Gonfrier 1 ,D. Borchiellini 3 , R. Boulahssass 1 , O. Guérin 4 . 1 Geriatrics
Department, University Hospital of Nice; 2 Department of Urology,
University Hospital of Nice, INSERM, U1189, ONCO-THAI, F-59037, Lille,
France; 3 Department of Oncology, CAL, Nice; 4 Geriatrics Department,
IRCAN - University of Nice, Sophia-Antipolis, INSERM U1081 - CNRSUMR 7284, OncoAge, Nice, France
Objectives: The management of bladder cancer (BCa) in the elderly
remains controversial. The aim of the study is to analyze predictive
factors of early death in a group of patients >70y, with Bca, at 100
days after a geriatric comprehensive assessment (CGA).
Methods: 112 patients with Bca were enrolled. This is a multicentricand prospective cohort study approved by an ethics committee. A
standardized CGA was done before the decision-making. Geriatricdata were collected: MMSE, MNA, BMI, Grip hand grip strength,
ADL, IADL, Gait speed, QLQC30, Charlson, G8 and Balducci classiﬁcation. Within 100 days follow up, events (death), oncologic andgeriatric data were collected.
Results: A total of 112 patients were enrolled, including 25.9% of
women and a mean age of 82y [70–96]. 26.8% (n=30) of patientsdied within the 100-days follow up. 34.8% (n=39) of patients had
metastatic cancers. The most common proposed treatments, by
the surgeon or the oncologist, were surgery (radical cystectomy)(44.6%, n=50) and chemotherapy (42, n=47). In 35.7% (n=40) ofcases, CGA modiﬁed the decision-making, in favor to palliative
care in 57.5%. In univariate analyzes, metastatic cancers (HR=2.7[1.3–5.5], p=0.008), cognitive impairments (MMSE<24) (HR=3.2[1.5–7], p=0.003), confusion (HR=2.2 [1.1–4.5], p=0.032), under nutrition (MNA<17) (HR=6.9 [2.1–22], p<0.001), gait speed<0.8m/sec(HR=5.6 [2.4–12.9], p<0.001), social isolation (HR=4.5 [2.1–9.6],
p<0.001), and dependence for ADL (<5.5) (HR=2.7 [1.1–6.2],
p=0.023) and IAD (>0) (HR=2.7 [1.1–6.5], p=0.032) have signiﬁcantly more risk of dying. Predictive factors of early death, in
multivariate analyzes, were metastatic cancers (HR=3.5 [1.6–7.5],
p=0.002), gait speed<0.8m/sec (HR=3.1 [1.2–7.7], p=0.015), social
isolation (HR=2.6 [1.2–5.9], p=0.02) and dependence (ADL<5.5)(HR=3.3 [1.2–9.2], p=0.022).
Conclusion: This study conﬁrms that some geriatric data could be
predictive of worse outcomes. These results can help in decisionmaking and encourage to propose targeted geriatric interventions
to improve the patient’s prognosis.
P-114
Applicability of comprehensive geriatric FLS: treatments of
FONDA protocol to recover the overall health status in fragility
hip fracture patients
D. Moral-Cuesta 1 , P. Matovelle 1 , T. Alarcón 1,2 , R. Velasco 1 ,R. Menéndez-Colino 1,2 , A. Otero 2,3 , J.I. González-Montalvo 1,2 .
1 Geriatrics Department, Hospital Universitario La Paz, Madrid, Spain;
2 Instituto de Investigación del Hospital La Paz IdiPAZ, Madrid, Spain;
3 Preventive Medicine Department, Universidad Autónoma, Madrid,
Spain
Introduction: Many patients die and others do not recover inthe follow-up after a Hip Fracture (HF). Orthogeriatric units are
considered the best option of treatment. There is not an agreed
protocol involving both secondary osteoporotic prophylaxis andoverall health status recovery of patients. The objective was toassess the applicability of an intervention program addressed toaccomplish these purposes.
Methods: HF patients admitted during one year in a university
Hospital were studied. Patients who could come to the outpatient
clinic were included. A protocol based on the speciﬁc needs of eachpatient (FONDA Protocol) was designed based on physical exercises,
correction of Vitamin D, nutritional assessment and treatment,scheduled analgesic prescription and iron deﬁciency correction.
Data were collected at admission and patients were followed-up at
3, 6 and 12 months.
Results: 134 HF patients were included. The patients with treatments prescribed by the FONDA Protocol at admission, discharge, 3,6, and 12 months were respectively: Ca + Vitamin D: 8%, 81%, 76%,
75%, 71%; Vitamin D: 72%, 91%, 71%, 74%, 82%; Nutritional Supplements: 95%, 70%, 11%, 6%, 4%; Minor Analgesics: 99%, 99%, 50%, 46%,39%; Opiates: 17%, 12%, 8%, 16%, 11% and Physical Exercises: 49%,85%, 94%, 96%, 97%. Parenteral Iron was prescribed in 51% duringadmission. Antiosteoporotic drugs were prescribed in 84%.
Conclusions: An individualized protocol addressed to solve theoverall speciﬁc needs of each HF patient besides to start secondary
osteoporosis prophylaxis is viable. Needs are different in the several
phases of the process.
P-115
Assessment clinic for the elderly at a university hospital in
Iceland
A. Björg Jónsdóttir 1 , I. Hjaltadóttir 2 , S. Bergmundsdóttir 1 .
1 Landspitali University Hospital of Iceland; 2 Landspitali University

Hospital of Iceland and University of Iceland
Introduction: The assessment clinic for the elderly was a productof a workshop at the Department of Geriatric Medicine. The idea
was to create a more direct pathway from the ED to the geriatricambulatorium for those frail older adults that needed a geriatricassessment. The aim of the assessment clinic is to reduce thenumber of revisits of the 75+ to the ED.
Methods: An individual got referred to the assessment clinic fromthe ED if he/she met one or more of the following criteria: a)a frail elderly, b) multimorbidity, c) had an internal medicine
health-problem, d) repeated falls, e) musculo-skeletal problems, f)pain problems. All came to the assessment clinic inside a week after
visiting the ED.
Results: In 2016 40 individuals got assessed, 28 (70%) were female
and 12 (30%) male. Mean age was 84,3 years (median 85,5). 30 days
before coming to the assessment clinic those 40 people had been to
the ED 51 times, the majority (26) came only once. After they had
been to the assessment clinic there were only 7 vistis to the ED, andof those 1 person came three times.
Conclusions: The conclusion is that the aim of the assessment clinic
to reduce revisits to the ED is met. The frail elderly got assessed toa more appropriate treatment and pathway.
P-116
Assessment of vision in people presenting with falls
O. D’Souza, L. Meadows, A. Andrusca, B. Ahmed, H. Ellis,
I. Bargaoanou. Scarborough Hospital, Scarborough, UK
Introduction: Falls are common in older people. Guidelines recommend that people who fall should undergo multifactorial assessment, including of visual impairment. Often this assessment
is neglected mainly due to lack of time and a validated Tool in aclinical setting. The Royal College of Physicians (UK) have devisedthe ‘Look out!’ bedside vision check tool for falls prevention. We
undertook this project to evaluate the ease of using this new tool.
Methods: We evaluated ﬁfty inpatients presenting with falls from

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

hospital wards, and twenty outpatients in the falls clinic, over 2
months from March – April 2017. An assessment of vision using
the vision assessment Tool was performed on each patient. Areas
addressed included date of last eye test, use and indication forglasses, ophthalmological conditions and medications, visual acuity, eye movements and visual ﬁelds. Subjective data was collectedfrom the doctors using the Tool regarding its ease and practicality.
Results: The Assessment tool, was found to be easy to use, by all
the doctors who trialled it. It took between 5 and 10 minutes tocomplete this Tool. In about 10% of patients, the Tool could not
be used due to dementia. In 3 patients eye sight was not tested
recently. One patient was found to have Progressive supranuclear
palsy.
Conclusions: This is an easy validated Tool, which can be applied inboth outpatient and inpatient settings. Dementia is the only factor
we found, which would prevent the full use of this Tool.
P-117
Attitude and practice patterns of geriatricians towards
discussing sexual function with their patients. A literature study
A.B.M. Elskamp, M.C. Faes. Amphia Hospital Breda
Introduction: Discussing patients’ sexual function by physicians isfundamental for addressing treatable causes of sexual dysfunction.
Aging and the associated morbidity and use of medication havea negative impact on sexual function of older persons. Physiciansconsider sexuality a diﬃcult topic to discuss. A literature study
was performed to explore the attitude and practice patterns ofgeriatricians in discussing sexual function with their patients, andwhich problems they might experience discussing this subject.
Method: A Pubmed, Medline and Medscape search was performed.
The search terms sexual behaviour, sexuality, aged, frail elderly
and communication were used. All publications were screened forrelevant information in title and abstract. The full text of relevant
articles was read.
Results: 437 publications were identiﬁed, after screening title andabstract, 17 articles were fully read. Only one study exploredpractice patterns of geriatricians, by using a limited questionnaire.
None of 120 geriatricians did routinely take a sexual history, eventhough 96.7% believed that patients with sexual problems should
be managed further. General practitioners do not routinely discuss
sexual function because of the stereotype that older patients areasexual. There is a low level of awareness of later life sexuality
among health care professionals. It is stated that more education
to increase awareness of sexual function of older persons and to
improve communication skills is needed.
Conclusion: At present there is limited information on practicepatterns and attitude of geriatricians towards discussing sexuality
with their patients. Such a study is planned among geriatricians in
the Netherlands.
P-118
Audit of the use of 24-72-hour ambulatory ECG’s as aninvestigation tool for older patients presenting with a fall
E.E. Ladikou, C. Jadawji, A. Mathur. University Hospitals of Leicester
NHS Trust, Leicester, United Kingdom
Introduction: Syncopal falls in older patients are often investigatedwith 24–72-hour ambulatory ECG’s. However, this investigation issometimes also requested as “routine”, to investigate the cause offalls. The aim of this audit was to assess the appropriateness of
ambulatory 24–72-hour ECG requests in patients aged over 65 years
who presented with a fall.
Methods: 24–72-hour ambulatory ECG’s requests for those aged 65
and above in one month were reviewed. 55 requests were identiﬁed
as planned investigations for falls. An audit data collection tool was

S73

created and used to retrospectively review case-notes to establish if
the investigative approach from NICE guidance was followed.
Results: In more than two-thirds of the requests, an alternative
diagnosis was more plausible than syncope and half of the tests
were not an appropriate choice of investigation. 52% of the tests
were abnormal when syncope was diagnosed clinically & inpatient
investigations deemed necessary. When done as outpatient after
discharge, or where there was a more plausible alternative diagnosis with a normal electrocardiogram, about 85% of the tests had noabnormalities.
Conclusions: Indiscriminate use of 24–72-hour ambulatory ECG’sfor older patients presenting with falls, without applying clinicalcriteria, in the presence of other plausible mechanisms of falls, orwhen syncopal episodes are infrequent leads to low diagnostic yield.
This delays identiﬁcation of mechanism(s) of falls and adds costs
due to inappropriate use of investigations. Our results suggest thatclinicians should be more aware of the indications for 24–72-hourambulatory ECG monitoring in older patients presenting with falls.
P-119
Centers of gerontology - institute of public health andgerontology centers in Croatia
S. Tomek-Roksandic, B. Kolaric, I. Popek, Z. Šostar, V. Fortuna,
S. Predavec, N. Tomasovic-Mrcela, M. Lukic, S. Mravak, M. Maltaric,
D. Sajko. Reference Centre for Health Care of the Elderly of the
Ministry of Health of the Republic of Croatia, Center of HealthGerontology, Andrija Štampar Teaching Institute of Public Health
The gerontologic-public health service provided at primary healthcare level by the Centers of Gerontology of the Public HealthInstitutes (PHI) in particular Croatian counties, City of Zagreb andRepublic of Croatia is based on the established gerontologic-publichealth parameters of health care needs and functional ability of theelderly in institutional and non-institutional health care. The measures of gerontologic-public health care have been legally deﬁned
by the Act on Amendments of the Act on Health Care, referringto the Plan and Program of Health Care Measures on National
Health Insurance for Gerontologic-Public Health Service provided
by gerontologic-public health care teams. Appropriate preventive
gerontologic program of primary prevention for the elderly has
also been performed by Gerontology Centers in local community,
providing immediate gerontologic non-institutional care for the elderly. A comprehensive approach in health care of the elderly, withfamily medicine playing the leading role, is ensured by due coordination at the level of primary health care for the elderly as part of
the gerontologic-public health service with a catchment populationof 30,000 people older than 65. Health care of the elderly cannot be
performed, upgraded or evaluated for eﬃciency and availability unless the respective gerontologic-public health parameters on healthcare needs and functional ability of the elderly in institutionaland non-institutional health care have been established. These very
parameters make the basis of the gerontologic-public health service
provided at primary health care level by the Centers of Gerontology
at Institutes of Public Health in Croatian counties, City of Zagreb andRepublic of Croatia. Appropriate programs of health care measuresand procedures in health care of the elderly, including primary,secondary and tertiary prevention for the elderly, could only be
developed based on monitoring and assessment of the health careneeds of the elderly. Such an appropriate preventive gerontologic
program of primary prevention for the elderly has also been implemented by Gerontology Centers in local community, by providing
immediate gerontologic non-institutional care for the elderly. The
aim is to enable the elderly to stay at home, with the family, as longas possible. In these efforts, coordination with primary health care
(PHC) professionals, i.e. selected family physicians providing carefor geriatric insurees, is necessary. Based on their recommendation

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Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247(PHC referral letter; Poster Fig. 1), geriatric insurees would be justiﬁably relieved of unnecessary and time-consuming waiting in lines
in waiting rooms for examination at PHC oﬃces. This is conﬁrmed
by frequent visits of elderly insurees to the selected PHC oﬃce forsome social indication.
P-120
Comprehensive geriatric assessment and intervention proposal
in an outpatient hematology ward
C. Palicio 1 , C. Boqué 2 , M. Antonio 2 , M. Bidó 1 . 1 Red Cross Central
Hospital; 2 Oncology Catalan Institute
Introduction: 60% of patients with malignant hemopathies areolder than 65 years and this proportion will continue to rise.
Methods: We evaluated thirty patients attending an outpatient
hematology ward, all of them older than 75 years. After the geriatric assessment, treatment changes were proposed. Comorbidities,functional status, mental status, depression, geriatric syndromes
and social situation were evaluated.
Results: Average age was 80 years old. Average functional scales
results: Barthel 84, Performance Status 0.8, Short Physical Performance Battery 7,9. Mental status scales: 36% failed the Pfeiffer test
(4.41 average mistakes). 76% had an altered Yesavage test. Charlson
Index average result was 2,1. All patients had at least one geriatricsyndrome, being 3.6 the average: 66% pain, 60% polypharmacy,
52% sensory disturbances, 42% constipation and 36% hyporexia. 93%
had no social assistance. After ﬁnding these problems, different
interventions were proposed by the geriatrician in 43% of them:
43% needed new painkillers, 23% needed psychotropic drugs to treat
insomnia or depression, 23% needed laxatives. 51 other outpatientreferrals to other specialists could have been avoided.
Conclusions: In order to properly identify modiﬁable frailty determinants and classify older patients with malignant hemopathies, amultidisciplinary approach and a comprehensive geriatric assessment are mandatory strategies. Old patients should beneﬁt froma consensuated decision to adapt the curative and/or supportive
approach, that should take into account the potential reversibilityof frailty and geriatric syndromes. Prehabilitation and prevention
strategies should be started in this vulnerable population, andpotential economic beneﬁts from a geriatric assessment should also
be considered.
P-121
Comprehensive geriatric assessment in elderly patients withsevere aortic stenosis referred for transcatheter aortic valve
implantation (TAVI)C. Roqueta 1 , N. Leiva 1 , M.I. Martínez-Fernández 1 , A. SánchezCarpintero 2 , B. Vaquerizo 2 , S. Burcet 1 , N. Farre 2 , M. Cladellas 2 ,R. Miralles 1 , O. Vázquez 1 . 1 Geriatric Medicine Department, Parc de
Salut Mar, Centre Fòrum, Hospital del Mar, Barcelona; 2 Department of
Cardiology, Parc de Salut Mar, Hospital del Mar, Barcelona
Aim: To assess patients with severe symptomatic aortic stenosis
with a comprehensive geriatric assessment.
Patients and methods: Prospective and descriptive study of patients with symptomatic severe aortic stenosis referred for TAVI,
were evaluated by a geriatrician from April 2016 to March 2017.
Socio-demographic variables (age, sex, cohabitation), functional
status [Barthel index (BI) and Lawton index (LI)], cognitive status[Mini-Mental State Examination of Folstein (MMSE)], emotional situation (GDS Yesavage), nutritional status [Mini-nutritional Assessment abbreviated (MNA)], comorbidity (Charlson index) and geriatric syndromes (immobility, pressure ulcers, dementia, delirium,
depression, falls, urinary incontinence, polypharmacy, constipation,
sensory impairment, malnutrition, insomnia) were registered.
Results: Forty-ﬁve patients were evaluated (62.22% women), mean

aged 82.62±6.09 years. Fifteen (33.33%) lived alone and the restwith the family. Mean of the parameters evaluated: LI: 5.02±2.05;
BI: 94±10.97; MMSE: 26.06±3.40; GDS Yesavage: 1.84±1.79; corrected Charlson index according to the age: 6.08±1.22. GeriatricSyndromes: 4 (8.89%) dementia, 5 (11.11%) depression, 1 (2.22%)
delirium, 10 (22.22%) previous falls, 5 (11.11%) urinary incontinence,
42 (93.33%) polypharmacy, 5 (11.11%) constipation, 24 (53.33%) sensory impairment, 2 (4.44%) malnutrition and 5 (11.11%) insomnia.
Conclusions: Patients with severe symptomatic aortic stenosis
evaluated by a geriatrician were old and predominantly female
patients. One-third of the patients lived alone. The patients had agood functional status of basic activities of daily living, involvementof instrumental activities, good cognitive, emotional and nutritional status and a high comorbidity. Polypharmacy was the mostprevalent geriatric syndrome in the sample of patients studied.
P-122
Comprehensive geriatric assessment of elderly patients withcancer living in nursing home
A.-L. Couderc 1 , G. Delalande 1 , M. Boucekine 2 , E. Cretel 1 , J. Berbis 2 ,E. Lechevallier 3 , L. Greillier 4 , F. Barlesi 4 , P. Villani 1 . 1 Division ofInternal Medicine, Geriatric and Therapeutic, Sainte Marguerite
Hospital, AP-HM, 270 Boulevard Sainte Marguerite 13009 Marseille,
France; 2 Department of Public Health, EA 3279 Self-perceveid Health
Assessment Research Unit, Medical School, Aix-Marseille University, 27
Boulevard Jean Moulin, 13385 Marseille Cedex 5, France; 3 Division of
Urological Surgery and Renal Transplantation, La Conception Hospital,
AP-HM, 147 Boulevard Baille 13005 Marseille, France; 4 Division ofMultidisciplinary Oncology and Therapeutic Innovations, Nord
Hospital, AP-HM, Chemin des Bourrely 13015 Marseille, France
Objectives: To compare elderly population with cancer living in
nursing home and those living at home, to identify frailty factors
and to adapt oncological treatment.
Design, setting and participants: Monocentric, prospective, descriptive and comparative study conducted in Assistance PubliqueHôpitaux de Marseille (AP-HM) Oncogeriatric Day Hospital. About
211 elderly patients with cancer were refered by Oncology Units
from September 2015 to October 2016.
Results: The mean age was 81.98±6.6 years. 57.8% patients weremen and 18/211 patients (8,5%) were nursing home residents.
The most common cancers in this population were prostatecancers (47/211 patients; 22.3%), lung cancers (35/211 patients;
16.6%), digestive cancers (23/211 patients; 10.9%) and breast
cancers (21/211 patients; 9.9%). 57/211 patients (27%) have presented a metastatic cancer. Nursing home residents have moreco-morbidities (p=0,001), cognitive disorders (p<0,001), dependency (p<0,001), nutritional disorders (p=0,026), grip strength
reduction (p<0,001) and have been hospitalized at the Emergency
Unit during 3 months (p=0,016) compared to those living at home.
Conclusion: Elderly patients with cancer living in nursing homehave more severe geriatric syndromes and frailties than those living
at home. Prevention of functional decline should be a priority forthis population. The personalized care plan should be tailored toeach patient, oncological treatments should not alter the qualityof life and medical staff should be trained to these speciﬁc cares.
Following this work, a course of personalized care for elderly
cancer patients living in nursing home is now offered in Marseille’s
Hospitals and its name is ONCO-EHPAD.
P-123
Determinants of quality of life in very old and frail geriatriconcology patients
V. Antoine, D. Matelot, A. Martin, B. de Wazieres. CHU Nîmes, France
Background: Quality of life (QOL) has become a major factor when

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

considering treatment approach and medical care in geriatric oncology. Various QOL measures have been recognized to help treatment
decisions, prognostic and survival assessment. The objective of thisstudy is to describe determinants of QOL in very old and frail
geriatric oncology patients.
Methods: Over 100 consenting subjects ≥74 years of age, witha progressive cancer (solid tumors or hemopathy, treated or not)were included from a geriatric oncology clinic in a French university hospital. Determinants of their QOL were collected by 3
open-ended questions: “What is the most important factor for you
to have the best QOL?”, “What could enhance your QOL?” and“What could reduce your QOL?”. Socio-demographics (age, sex,
lifestyle), cancer (type of cancer, metastatic or not, curative treatment or not), comorbidities, G8 score and geriatric characteristics(cognitive and sensorial functions, depression, nutrition, walking
speed and perimeter, grip strength), pain, hemoglobin, creatinine
clearance, autonomy for activities of daily living (ADL/IADL) werealso collected.
Results: We present the main areas of importance for QOL quoted
by an elderly and frail geriatric oncology population and compare
the quoted determinants for QOL with areas explored by the reference questionnaire used to measure QOL in elderly cancer patients(QLQ ELD 14).
Conclusion: Determinants of QOL in elderly cancer patients are
personal and multi-factorial.
P-124
Digital technologies in comprehensive geriatric assessment
A. Ilnitski, K. Prashchayeu, E. Korshun. Belarusian Republican
Gerontological Public Association, Minsk, Belarus
Effective introducing and spreading of diagnostic technologies ingeriatrics is possible on the base of ICT devices. Aim of the researchis to work out and introduce into geriatric practice the ICT based
comprehensive geriatric assessment.
Material and methods: On web-site www.gerontology.by we submitted the special original program for physicians for performing
comprehensive geriatric assessment which can be downloaded
into ICT device and allows to estimate automatically the risks offunctional decline, problematic geriatric syndromes and targets ofpersonalized coaching in rehabilitation process. In the same timesuch program gives possibility to perform the eLearning of physicians on better ways of rehabilitation and care of elders on the baseof syndromatic approach in geriatrics.
Results: 537 physicians experienced work with original computer
program. Using ICT for comprehensive geriatric assessment reduced
time of diagnostic procedure on 23,5%, increased the number ofcorrect prognosis of geriatric syndromes on 18,5%, decreased thenumber of mistakes in diagnosis and rehabilitation on 10,0%. Using
ICT for consultations and eLearning of physicians was most important factor of positive changes in quality of geriatric care. As a result
was observed the positive changes in occurring of acute functional
decline, decreasing of functional ability, quality of life was increased(p<0,05).
Conclusion: Introducing ICT technologies in comprehensive geriatric assessment improved quality of diagnostic process, geriatriccare and health status of elderly patients.
P-125
EASYCare Standard 2010 as an instrument for self-assessment ofolder people living at home
S. Tobis 1 , K. Jaracz 1 , D. Talarska 1 , S. Kropińska 1 , E. Zasadzka 1 ,M. Pawlaczyk 1 , I. Philp 2 , A. Suwalska 1 . 1 Poznan University of
Medical Sciences; 2 Warwick Business School, UK
Introduction: EASYCare Standard 2010 is a concise instrument to

S75

identify concerns in health, functional independence, and wellbeing of an older person. So far it has not been used for selfassessment. Our aim was to determine whether self-assessment(EC1) can give comparable results to an evaluation performed byprofessionals (EC2), for older people living at home.
Methods: The study included 100 older individuals (67 females), living in the community, without dementia (Abbreviated Mental Test
Score [AMTS] above 6). Two assessments (self and professional)
were performed, including summarising indexes: Independence
score [IS], Risk of breakdown in care [RBC], Risk of falls [RF],within a period between 1 and 2 weeks. Additionally, during EC1,
gold standard tests of physical and mental function (Barthel Index:
96.3±6.5, Lawton scale: 6.7±2.0, Geriatric Depression Scale: 3.0±2.7,
AMTS: 10.2±1.0) were applied to test for concurrent validity.
Results: Cohen Kappa values (self-assessment versus professional)
across all EASYCare domains were high (0.89–0.95). Results of allsummarising indexes derived from self-assessment correlated wellwith gold standard tests. No differences were found in IS and RBC
between EC1 and EC2 (8.6±12.0 vs. 9.0±12.7 and 1.0±1.1 vs. 1.2±1.4).
Results of RF were higher in EC2 (1.0±1.1 vs. 1.1±1.4; p=0.005), due
to a different response to the item “Do you feel safe outside yourhome?”.
Conclusions: Self-assessment with EASYCare Standard 2010 incommunity-dwelling older people can yield valid results, thus
providing an eﬃcient system for the assessment of relatively
independent individuals.
P-126
Elderly’s medication management ability: What are thepredictors?
A.M. Advinha 1 , C. Nunes 2 , M.J. Lopes 3 , S. Oliveira-Martins 1 .
1 University of Lisbon, Faculty of Pharmacy; 2 Universidade NOVA de

Lisboa, National School of Public Health, Public Health ResearchCentre; 3 University of Évora, Nursing School of S. João de Deus
Introduction: Medication management functional ability is deﬁned
as the cognitive and physical ability to self-administer medications
and to follow the prescribed regimen, when it is the patient desire[1]. This study aims to screen the predictors of elderly’s medication management ability assessed with Drug Regimen Unassisted
Grading Scale (DRUGS-PT) and Self-Medication Assessment Tool
(SMAT-PT) – Portuguese versions.
Methods: The study was carried out in a purposive sample of 207
Portuguese community-dwelling elders, using DRUGS-PT, SMAT-PT,
Medication Regimen Complexity Index (MRCI), Measure Treatment
Adherence (MTA), Mini-Mental State Examination (MMSE), ClockDrawing Test (CDT) and Instrumental Activities of Daily Living
scale (IADL). The associations were analysed with Wilcoxon-MannWhitney and Kruskal-Wallis. The logistic regression used Forward:
LR method. Analysis was conducted using SPSS (v22).
Results: Of the 207 participants, 156 (75.4%) were women, and themean age was 75.5, ±6.6 years. The elderly’s ability to manage their
medication was assessed with DRUGS-PT (80.7, ±25.7) and SMAT-PT(real regimen scales: medication recall 83.6 (±15.6) and adherence
self-report 97.2 (±10.9)). It was obtained signiﬁcant association
with scholarity (p≤0.01), MMSE (p≤0.03) and CDT (p≤0.003). The
binary model built according to maximum score demonstrated that
MMSE (p=0.002), CDT (p<0.001) and the number of medications(p<0.001) were signiﬁcant on the probability of the elderly have fullability to manage their medication. The ROC presented an excellent
power (89.9%).
Conclusions: The predictors of elderly’s medication management
ability were the cognitive measures and the medication daily consumption. This reﬂects the importance of early detection of thecognitive impairment and the inclusion of medication management
ability assessment in clinical practice.

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Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

References:[1] Maddigan SL, Farris KB, Keating N, Wiens CA, Johson JA. Predictors of older adults’ capacity for medication management in aself-medication program: a retrospective chart review. J Ageing
Health. 2033; 15(2):332–52.
P-127
Evaluation of the impact of comprehensive geriatric assessment(CGA) in older patients with kidney cancer
M. Sanchez 1 , R. Boulahssass 1 , S. Gonfrier 2 , D. Saja 1 , C. Rambaud 3 ,J.M. Turpin 4 , F. Leborgne 5 , E. Clais 3 , E. François 1 , O. Guérin 1 .
1 UCOG CHU Nice, France; 2 USLD CHU Nice, France; 3 SSR CHU Nice,
France; 4 CSG CHU Nice, France; 5 EMG CHU Nice, France
Introduction: In the future, life expectancy and incidence of cancer
will increase, and also incidence of kidney cancer will increasein patients over 75 years old. The treatment of kidney cancer issurgery. We observe in this population several comorbidities which
increase the risk of surgical morbidity and could lead to only best
supportive care.
Objective: The aim of this work is to determine the impact of CGA
in treatment decisions and also in guided geriatric interventions.
Methods: This is an observational and prospective cohort study
approved by an ethics committee. A complete CGA has been
done. Treatments made, ﬁnal therapeutic decisions and geriatricinterventions have been collected during the follow-up.
Results: The study included 58 patients, 31 men and 27 women.
The mean age was 83y. 39 patients were dependent for ADL. 38
patients were Balducci 3. 25 patients were metastatic. There were
13 patients with clear renal cell carcinoma; half of patients had
no histology. The most common predisposing factors were hypertension (n=39), and chronic kidney disease (n=24). 32 patients of
the 58 enrolled patients were symptomatic. The geriatric interventions the most often proposed were: the nutritional management(n=48), physiotherapy (n=34) and prevention of delirium (n=23). 25
patients approved the care plan, 22 opinions are not known. 21
patients undergo the standard treatment (33%), 37 patients have a
modiﬁcation of the care plan (67%). CGA inﬂuence the modiﬁcationof the therapeutic decision in over 43% (n=23) of cases, and forthe most of them it was best supportive care, active surveillance or ablative therapies. Of 22 operated patients, there were
16 extended radical nephrectomies, 4 partial nephrectomies and 2
radical nephrectomies. 4 arterial embolization and 1 radiofrequency
ablation were conducted. 4 patients received inhibitors of VEGF
receptors and 2 patients received mTOR inhibitors. The 3 factors
inﬂuencing the modiﬁcation treatment are geriatric factors fromthe CGA: decline of autonomy (p=0.016), a decreased gait speed(p=0.001), and a home conﬁnement (p=0.001).
Conclusion: There is a major selection of patients by urologists,
explaining why the effect of geriatric assessment is increasingly
important in the treatment of elderly patients with kidney cancer.
There is still a difference between the recommended standard
treatment and those applied after multidisciplinary consultation.
Reasons that lead to the modiﬁcation of treatment were the existence of geriatric syndromes and not the anesthetic evaluation. The
French Association of Urology recommends to have an early CGA
for patient over 70y.
P-128
Feasibility and validity of the InterRAI ED Screener
E.Þ Grétarsdóttir 1 , A. Björg Jónsdóttir 1 , G. Tomasson 2 ,E.E. Guðmundsdóttir 2 , I. Hjaltadóttir 1 , I. Sigurþórsdóttir 1 , I. Bjork
Jakobsdottir 2 , T. Thorsteinsdottir 1 . 1 Landspítali - The National
University Hospital of Iceland, University of Iceland; 2 University of
Iceland, Reykjavik, Iceland

Introduction: The InterRAI ED Screener (RAI-ED) is a novel risk
stratiﬁcation instrument incorporating functional and social aspects
intended to identify older adults at increased risk for adverse healthoutcomes. We assessed the feasibility of the instrument in an emergency department (ED) and its construct validity with establishedinstruments.
Methods: Data from a convenience sample of 67+ patients at the
ED were used. The items of the RAI-ED, Triage risk screening tool
(TRST) and Identiﬁcation of Seniors at risk (ISAR) were verballyadministered. Correlation coeﬃcients were calculated between RAIED with ISAR and TRST respectively. Linear regression was used
to determine the scores of the RAI-ED that best corresponded toaccepted cut-offs for the TRST and ISAR.
Results: Of 237 approached patients, 200 provided full consent forparticipation. The mean age was 78.5 years (range 67–97 years
and sd 7.4) and 44% were male. Majority of the participants (85%)
lived at home, 43% lived alone and 53% received home care. RAI-ED
and ISAR scores could be obtained for 187 participants (93%) and
TRST scores for 163 (81%). The mean scores were 3.19 (1.53), 2.22
(1.43) and 2.16 (1.36) for the RAI-ED, ISAR and TRST respectively.
The correlation of RAI-ED with ISAR and TRST was 0.56 and 0.41
respectively. Scores of 3.02 and 3.01 on RAI-ED corresponded tothe accepted cut-offs of 2 on the ISAR- and TRST instruments
respectively.
Conclusion: These data provide initial support for the utility of theRAI-ED instrument in the ED.
P-129
Functional and psychological impact of pain in elderly people
P. Carrillo Garcia, J. Marttini Abarca, M. Vigara Garcia, P. Gil
Gregorio. Hospital Clinico San Carlos, Madrid
Introduction: The purpose of this study was setting the relationship between pain relief and functional and psychological impact inelderly patient.
Methods: Descriptive study. Includes patients ≥75 years old withchronic pain at geriatric clinic in two separate one-month visits.
January - June 2016. Variables: demographic data, comorbidity(Charlson index), functional status (Barthel index), Geriatric syndromes: falls, insomnia, cognitive impairment: Mini Mental State
Examination (MMSE-30) and depression (Yesavage Test). Pain assessment: Visual analgesic scale (VAS), type, location and analgesic
treatment. Follow-up (a month later): Change of analgesic step,
VAS, Barthel index, depression and insomnia. Statistical analysis:
SPSS version 23.0
Results: 126 patients. Age 84,3 (SD:5), female 58.7%. Functional
evaluation Barthel Index 73.4 (SD 17.1). Charlson Index: 5 (SD 1.3).
Insomnia 48.4%, falls 16%, no cognitive impairment 25.4%, mild
cognitive impairment 60.3% and moderate 14.3%. Depression: 31.7%.
Type of pain: neuropathic pain 23%, nociceptive 33.3% and mixed
43.7%, location: Lower limbs: 37.3%, dorsolumbar column 35.7%.
Baseline VAS 6.7 (SD 1.4). Comparing results after pharmacologicalintervention about functionality (Barthel Index 80), depression (4%)
and insomnia (26.2%) we got signiﬁcant differences.
Conclusion: A correct evaluation of chronic pain, adjustment intreatment and subsequent medical follow-up, leads to an improvement in the pain relief and a positive impact on functional andemotional state. Every geriatric patient should receive a global
evaluation of chronic pain as a large geriatric syndrome.

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P-130
Functional status and demand for hospital care services in COPD
elderly survivors treated with NIV for acute respiratory failure:
one-year evolution
P. Kamienski. Department of Geriatrics, Duchenne General Hospital,
Boulogne sur Mer, France
Introduction: Non-invasive ventilation (NIV) has been shown to
reduce intubation and mortality in elderly patients with exacerbations of underlying chronic obstructive pulmonary disease(COPD) and acute hypercapnic respiratory failure (AHRF). Nevertheless, the effects of this therapeutic approach remains unclear interms of functional status, autonomy and demand for hospital careservices.
Methods: Prospective one-year study of 30 survivors of AHRF
undergoing NIV at the Pneumology Department, Duchenne General
Hospital, Boulogne sur Mer, France.
Results: 30 patients, mean age 83,4 years are included: average ADL(activities of daily living) score is 4,3, average IADL (instrumental
activities of daily living) score is 2,3. 22 patients are autonomous.
The average length of hospital stay is 11,8 days. At one year, morality
is 20%. The demand for hospital care services increases after discharge: number of hospital stays, average length of stay, emergency
department (ED) consultations. One year after discharge there is aloss of autonomy: average ADL score: 3,6, average IADL sore: 2,7.
8 patients have become dependent. Poor functional status, weak
degree of mobility, Charlson Comorbidity Index, polypharmacy,anaemia, hypoalbuminemia, length of hospital stay and hospitalisation in the previous year were correlated with readmission anddeath. These ﬁndings are not statistically signiﬁcant.
Conclusion: This is the ﬁrst study to show impairment of functional
status with a risk of loss of autonomy in elderly treated with NIV for
AHRF one year after discharge. Comprehensive geriatric assessment
should be applied in these patients.
P-131
How geriatric intervention helped to save a life
P. Marques, R. Martins, E. Haghighi. Hospital de Vila Franca de Xira,
Vila Franca de Xira, Portugal
Introduction: Only recently has Geriatrics been recognized in Portugal as a competence. Slowly the medical community begins tounderstand its necessity.
Methods: Complex clinical case where a geriatric approach was
performed as a life-saving strategy.
Results: 79 year old male patient, independent in daily activities,
with past history of atrial ﬁbrillation, on anticoagulation, wasreferred to a Geriatrics Consultation for repeated falls. Before theconsultation, he was admitted to the emergency department for
confusion and slurred speech. TC scan excluded brain hemorrhage
and laboratory results showed hyponatremia and anemia. During
the stay at the ward the patient developed multiple complications(immobility syndrome, urinary retentions, convulsion, nosocomial
pneumonia and dysphagia). Due to the rapid and apparently irreversible functional and neurological decline a do not intubateorder was declared. The patient survived and went home with aurinary catheter and a naso-gastric feeding tube. He then presented
at the previously booked consultation with apathy and mutism.
The comprehensive geriatric assessment revealed very severe functional dependence and malnutrition. After meticulous medication
adjustment, better social support, physical rehabilitation, nutritional advisements and close follow-up in consultations, he showedsigniﬁcant global improvement. His more recent major concern isto get back driving.
Discussion: This case allowed to show the major beneﬁts of acomprehensive geriatric assessment, important step in alerting the

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medical community to the need to include wards and geriatricconsultations in Portugal.
P-132
Impact of cognitive impairment and nutritional state on
mortality and length of hospitalization in acutely ill geriatricpatients
H. Yamamoto 1 , K. Ogawa 1 , T. Ishitake 2 , N. Kobayashi 3 . 1 Yamamoto
Memorial Hospital, Imari, Japan; 2 Kurume University School of
Medicine, Kurume, Japan; 3 Azuma-Dori Clinic, Fukushima, Japan
Introduction: It is well known that cognitive impairment andmalnutrition are prevalent conditions in the elderly. In a previous survey, we reported the usefulness of the Revised Simpliﬁed
Short-Term Memory Recall test (STMT-R) positively correlated with
MMS (r=0.65,p<0.001). The Short-Form Mini-Nutritional Assessment (MNA-SF) was also performed on these patients to evaluate
their nutritional state. We herein aim to appraise the impact of bothcognitive impairment and nutritional state on mortality and lengthof hospitalization in acutely ill geriatric patients.
Methods: Between December 2014 and September 2015, a totalof 976 patients 50yo were admitted in our hospital. STMT-R and
MNA-SF were performed for non-critical patients within one week
after admission. 770 subjects consented and were enrolled. 130
patients couldn’t complete the STMT-R due to delirium, severe
dementia, auditory disturbance, etc. (“uncomplete” group). STMT-R
 4 was considered as cognitive dysfunction by Kobayashi’s study[1].
Results: The mean age was 78.9 and 52.5% were female. Cognitive
dysfunction was found in 409 subjects. “Malnourished”, “at riskof malnutrition” and “well-nourished” status were found in 398,
310 and 62 patients respectively. Statistically, a signiﬁcant positive
correlation was found between STMT-R and MNA-SF points (r=0.50,
p<0.001). The relative risks for mortality in the “uncomplete”
and “malnourished” groups were 3.25 (OR; CI95%;1.53–7.23) and10.30 (OR; CI95%;2.09–186.6) respectively. The length of hospitalization was also signiﬁcantly longer in the cognitive dysfunction,“uncomplete” and “malnourished” groups (p<0.05).
Conclusion: Cognitive impairment and nutritional state at admission may inﬂuence mortality rates and length of hospitalization inacutely ill geriatric patients.
References:[1] Kobayashi N et al; Development of a simpliﬁed Short-Term
Memory recall Test (STMT) and its clinical evaluation; Aging
Clin Exp Res 2010, Vol. 22, No. 2 157
P-133
Impact of organizational culture in the elderly living in
long-term care by the elderly – A longitudinal study in Central
Portugal (a research protocol)
V. Parola 1 , A. Coelho 1 , E. Santos 1 , J. Tavares 2 , S. Pereira 3 ,M. Almeida 2 , S. Duarte 2 , A. Cavaleiro 2 , M. Cordeiro 2 , I. Gil 2 ,J. Apóstolo 1 , H. Neves 4 . 1 Health Sciences Research Unit: Nursing,Nursing School of Coimbra, Portugal; Centre for Evidence-Based
Practice: a Joanna Briggs Institute Centre of Excellence, Portugal;
2 Health Sciences Research Unit: Nursing, Nursing School of Coimbra,
Portugal; 3 Nursing School of Coimbra, Portugal; 4 Instituto de Ciências
da Saúde - Universidade Católica Portuguesa; Health Sciences Research
Unit: Nursing, Nursing School of Coimbra, Portugal Centre forEvidence-Based Practice: a Joanna Briggs Institute Centre of Excellence,
Portugal
Introduction: Long-Term Care Facilities (LTCF) provide care toelderly as an alternative when living at home is no longer an
option. Long-term effect of institutionalization in the elderly is
not yet understood, as cultural and organizational differences even

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between regions, may impact in overall outcomes. This leads tothe need of development of studies that provide insight of howorganizational cultures and strategies impact the elderlies’ healthin the long-term.
Methods: A longitudinal study, will be carried in ten LTCF in Central
Portugal. Evaluation of the risk of functional decline (Identifying
seniors at Risk Scale), presence of cognitive impairment (Six Item
Cognitive Impairment Test), activities of daily-living (Barthel Index),
fall risk (Timed Get Up and Go), fear of falling (Falls Eﬃcacy Scale),risk of pressure ulcer (Braden Scale), incidence of pressure ulcer,
geriatric depression (GDS-15), social isolation (UCLA-Loneliness
Scale), and quality of life (EQ-5D), will be evaluated three andsix months after the initial evaluation, and correlated with organizational aspects of the LTCF (ratio of healthcare providers/shift,presence of interventions targeting cognitive impairment and/or
functional decline).
Results: The development of this study will provide insight of
how organizational culture impacts elderly care, and which aspects
inﬂuence positively and negatively quality of life.
Conclusions: Elderly care is a concern of today, but also an emergent need in the future. This study aims to develop knowledgeof how to provide the best care. This will allow organizations toachieve higher levels of care thus improving the elderly’s quality of
life.
P-134
Implication of circulating immune complexes in atherosclerosis
G.I. Constantin, S. Opris. National Institute of Gerontology andGeriatrics “Ana Aslan”, Bucharest, Romania
Introduction: The atherogenicity of immune complexes containing
modiﬁed low-density lipoproteins (LDL-CIC) increases with age.
LDL-CIC induce cholesterol accumulation in vascular cells that
leads to foam cell formation, cellular proliferation, and extracellularmatrix production, therefore can play a signiﬁcant role in atherogenesis and are involved in the formation of early atherosclerotic
lesion.
Methods: In the present study, we determinated oxidatively modiﬁed lipoproteins of the circulating immune complexes in two study
groups of elderly patients (aged 72±4 years): a group of patientswith atherosclerosis and a control group of patients selected according to the SENIEUR protocol for immunogerontological studies.
The LDL content in circulating immune complexes was evaluatedby measuring total cholesterol levels in polyethylene glycol (PEG
8000) precipitates (immune cholesterol).
Results: Our results showed that the circulating immune complexes
containing LDL (LDL-IC) was increased in patients with atherosclerosis compared to the control group (21.34±7.94 vs. 9.41±5.36 μgcholesterol/ml serum).
Conclusions: This evidence indicates that the quantiﬁcation of
LDL-containing immune complexes has a predictive value superiorof that of traditional risk markers that are currently in use. In
conclusion, immune complexes involving low-density lipoprotein
induce profound changes on cholesterol metabolism at the cellularlevel.
P-135
Is hip pain affects quality of life in elderly women?
E. Baskan, N. Yağcı. Pamukkale University School of Physical Therapy
and Rehabilitation
Introduction: The incidence of hip joint pathologies increases withage. However the women are more affected than men. The mostimportant symptom of these pathologies is hip pain. The purposeof this study is to determine the effect of hip pain on quality of lifein elderly women.

Method: A total of 430 volunteer women aged 65–96 years were
included in the study. The severity of pain was assessed by the Visual Analogue Scale (VAS). The General Health Level CDC HRQOL-4
questionnaire was used yo evaluate health related quality of life.
Results: The average age of participants was 72.65±6.34 years.
Hip pain was detected in 36.7% of the participants (VAS mean:
4.86±1.98cm). 44.4% of the participants stated that their general
health status was moderate. Positive weak correlations were foundbetween hip pain and physical health (r =0,273, p=0,001), mental
health (r =0,218, p=0,006), activity limitation (r =0,246; p=0,002).
Conclusions: As a result, it has been observed that hip pain affects
all parts of quality of life including physical, emotional and daily
life activities in elderly women. Prevention or manage of hip pain
would improves all parameters related quality of life.
P-136
Low back pain risk among older Turkish adults
N. Yağcı, U. Cavlak, E. Baskan, M. Oztop. Pamukkale University Schoolof Physical Therapy and Rehabilitation
Introduction: Low back pain is well documented to be an extremelycommon health problem. The aim of this study was to evaluate thelow back pain risk among older Turkish adults.
Methods: Five hundred ﬁfty six elderly people (279 females; 277
males; mean age: 71.45±5.99 yr.) included the study. The pain
intensity was measured using by a Visual Analog Scale (VAS). The
risk of low back pain was evaluated with low back pain risk scale.
Results: The mean pain intensity was 4.43±1.98 cm. Low back pain
rate was found as 60.4% among the participants. While 36% of thesample was found as they have potential risk, the 34.2% of theparticipants were found as risky.
Conclusions: The ﬁndings indicate that mostly older Turkish adults
are at risk in terms of low back pain. That’s why older adults shouldbe evaluated about a chronic low back pain to improve their qualityof life.
P-137
Multidimensional Prognostic Index (MPI) predicts
re-hospitalization in frail older patients admitted to hospital:a multicentre, international, one-year follow-up study.
The MPI_AGE European Project
J. Daragjati 1 , E. Topinkova 2 , M. Puntoni 3 , A. Cruz-Jentoft 4 ,M.C. Polidori 5 , M. Paccalin 6 , A. Greco 7 , F. Mattace-Raso 8 ,A.A. Mangoni 9 , C. Musacchio 10 , H. Michalkova 2 , T. Brunet 6 ,A. Egberts 11 , C. Miret 4 , K. Ruxton 9 , A. Mangiacotti 7 ,M. Simonato 12 , A. Pilotto 10 . 1 Geriatrics Unit, AULSS 6 Padova, S
Antonio Hospital; 2 Department of Geriatrics, First Faculty of Medicine,Charles University, Prague, Czech Republic; 3 Clinical Trial Unit,
Scientiﬁc Directorate, E.O. Galliera Hospital, Genoa, Italy; 4 Hospital
Universitario Ramón y Cajal, Madrid, Spain; 5 Ageing Clinical Research,
Dpt. Medicine II, University Hospital of Cologne, Germany; 6 Geriatrics
Department University Hospital La Milétrie, Poitiers, France; 7 IRCCS
Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy;
8 Erasmus Universitair Medisch Centrum, Rotterdam, The Netherlands;
9 Department of Clinical Pharmacology, Flinders University, Adelaide,
Australia; 10 Department of Geriatric Care, OrthoGeriatrics &Rehabilitation, Frailty Area, E.O. Galliera Hospital, Genova, Italy;
11 Erasmus UniversitairMedisch Centrum, Rotterdam, The Netherlands;
12 Geriatrics Unit, AULSS 6 Padova, S Antonio Hospital, Padova, Italy
Background: The MPI_AGE is a European Commission co-funded
project aimed to identify the most cost-effective health interventions according to the individual prognostic mortality-risk proﬁleby using Multidimensional Prognostic Indices (MPI).
Aim: To evaluate the usefulness of the MPI in predicting one-year
re-hospitalization in older patients.

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

Methods: Patients admitted to nine Geriatric Units across Europe
and Australia underwent at hospital admission a Comprehensive
Geriatric Assessment (CGA), i.e. functional (ADL, IADL), cognitive(SPMSQ), nutrition (MNA-SF), risk of pressure sores (Exton-Smith
Scale), Comorbidity (CIRS), drugs and cohabitation status to calculate MPI. Patients were divided in MPI-1-low-risk, MPI-2-moderaterisk and MPI-3-high-risk of mortality. Time-to-event (Kaplan-Meierand Cox regression) and logistic analyses were performed adjustingdata for age, gender, discharge and hospital center.
Results: 1,140 hospitalized patients were included (mean age
84.1±7.4 years, females=60.8%) and classiﬁed according to MPI scoreas MPI-1=169 patients (14.8%), MPI-2=502 patients (44.0%) and MPI3=469 patients (41.1%). During the one-year follow-up 606/1,140
patients (53.1%) were re-hospitalized. A signiﬁcant association
between one-year re-hospitalization and all-cause mortality wasobserved (HR=1.79, 95% CI: 1.42–2.36,p<0.001). Multivariate logistic
regression analysis conﬁrmed that one-year re-hospitalization was
signiﬁcantly associated with higher MPI grade at baseline (MPI-1,
Odds Ratio:1.0 reference; MPI-2, OR: 1.69 95% CI: 1.15–2.48, MPI-3,
OR:1.60 95% CI: 1.07–2.38), lower age (OR=0.98, 95% CI: 0.96–0.99),
male sex (OR: 1.29, 95% CI: 1.0–1.65) and the centre (OR: 0.91, 95%
CI: 0.86–0.96).
Conclusion: Re-hospitalization is associated with all-cause mortality in hospitalized older patients. MPI performed at hospital admission identiﬁes frail older patients at high risk of re-hospitalization
during the one year follow-up period after hospital discharge.
P-138
Oropharyngeal dysphagia in a geriatric outpatient unit
S. Jiménez Mola 1 , J. Idoate Gil 1 , K. López López 2 , M. López Viñas 3 ,P. Sáez López 4 , E. Martín Pérez 5 . 1 Complejo Asistencial Universitario
de León, León. Spain; 2 Hospital San Juan de Dios, Burgos. Spain;
3 Centro de Mayores de Armunia, León. Spain; 4 Complejo Asistencial deÁvila, Ávila. Spain; 5 Hospital San Juan de Dios, León. Spain
Introduction: Oropharyngeal dysphagia, or inability to swallow
liquids and/or solids, is one of the less well known geriatric syndromes, despite its enormous impact on functional ability, qualityof life and health in affected individuals. The complications oforopharyngeal dysphagia are malnutrition, dehydration and aspiration, and can cause high morbidity and mortality. One therapeuticintervention is adaptation of the texture of the solid and theviscosity of the liquid.
Aim: The aim of this study was to determine the characteristic
pattern and the prevalence in our outpatient unit.
Methods: We performed a retrospective and descriptive study ofall patients with dysphagia seen in our oﬃce from December 2012
to May 2015. Underwent comprehensive geriatric assessment that
evaluates age, gender, comorbidities, medication use, ability toperform basic activities of daily living (Barthel Index) and place ofresidence.
Results: We enrolled 276 patients, 69% women. Mean age 87.4
years and 57% were living in a nursing home. 81% had a Barthel
Index <20 and only 7% a Barthel Index >60. Dementia was themost common diagnosis (70%) followed by Cerebrovascular Disease(16%) and Parkinson’s Disease. The swallowing inability of liquids
and or solids was the reason for consultation in 64% of patients, but
in the 36% were their complications as aspiration, malnutrition anddehydration.
Conclusions: Geriatric assessment may help in dysphagia detection
at outpatients units. Patients with neurodegenerative or cerebrovascular diseases and the frail elderly are the most vulnerable.
Oropharyngeal dysphagia should be identiﬁed early in risk groups.

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P-139
Polypharmacy based on the data of inpatient assessment for
elderly cancer patients in General Hospital
Y.-H. Park 1 , D.Y. Jung 2 . 1 Seoul National University, Seoul, South
Korea; 2 Seoul National University Hospital, Seoul, South Korea
Introduction: As old aged cancer patients have been increasing,
this study aims to understand the status of polypharmacy among
elderly cancer patients who have been in General hospital in orderto support the appropriate mediation and management for them.
Methods: This research has made retrospective survey researchstudy for 3 months starting from January 1, 2015. The data wascollected from 170 senior cancer patients over 65 years old at
the cancer ward in S university General Hospital. PI (Potentially
Inappropriate Medication) for elderly patient was veriﬁed by Beers
criteria and risky Drug-Drug interaction medication was referred tothe appropriate medication guideline for elders issued by Ministryof Food and Drug Safety.
Results: The average age of patient was 72.3 (±5.43) years oldamong 110 me (64.7%) and 60 wome (35.3%). 87.1% of patients had
more than 1 chronic disease and they had average 1.9 (±1.4) typesof chronic disease. The most of patients had colorectal cancer with22.9%, lung cancer with 11.8% and gastric cancer with 11.2% in order.
The patients were taking average 5.3 (±3.3) self-medications daily
and 55.9% were taking polypharmacy with over 5 and 10.0% were
overtaking polypharmacy with more than 10. It was veriﬁed by
Beers criteria that 30.0% showed PI (Potentially Inappropriate Medication) in 62 cases and 21.2% showed risky Drug-Drug interaction
medication in 50 cases among patients.
Conclusions: It is necessary to reduce the polypharmacy for elderly
cancer patients and build pharmacovigilance system to monitor
PIM and risky Drug-Drug interaction medication.
P-140
Potential impact of geriatric assessment on surgical treatment
decisions in the older cancer patient
K. Alexander 1,2 , A. Shahrokni 1,2 , S. Sarraf 1 , B. Korc-Grodzicki 1,2 .
1 Memorial Sloan Kettering Cancer Center, New York City, USA; 2 Weill
Cornell Medical Center, New York City, USA
Introduction: Older cancer patients are a heterogenous group. The
Geriatric Assessment (GA) is an important risk stratiﬁcation tool in
oncogeriatrics. This study aims to assess the impact of GA on thedecision to treat the cancer surgically, and the characteristics ofpatients that underwent surgery as opposed to those in whom theprocedure was cancelled.
Methods: This is a retrospective analysis of a cohort of 1767 patients≥75 years with diagnosis of cancer, scheduled for surgery, who presented to the Geriatrics clinic at Memorial Sloan Kettering Cancer
Center between 01/2015 and 12/2016 for a pre-operative assessment. Sociodemographic characteristics and GA parameters werecollected and analyzed. For continuous and categorical variables,
t-test and Chi-square test were applied respectively.
Results: Of the 1767 patients (median age 80) who were evaluatedwith preoperative GA, 114 (6.5%) did not proceed with surgery.
Signiﬁcant differences between the group of patients that did not
vs. the group that did proceed to surgery, include: median age (82.5,
80; p<0.05), KPS (70, 85; p<0.05), ADL (9.6, 12.3; p<0.05), iADL
(10.4, 13.7; p<0.05), MiniCog (3, 4; p<0.05), distress thermometer(5, 4.2; p<0.05), social activity limitation score (9.7, 8.2; p<0.05).
The differences were also signiﬁcant in their use of assistive devices for ambulation, history of falls in the past year and theirperformance on Timed Up and Go Test (p<0.05).
Conclusions: Preoperative GA helped identify a subset of frail older
cancer patients highlighting the need for this assessment. Thesepatients were then offered alternative treatment approaches.

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P-141
Predictors of lower respiratory tract infections (LRTIs) in elderly
patients requiring hospitalization
P. Voukelatou, I. Vrettos, A. Bitsikokou, A. Ragkou, D. Theotoka,
A. Katsoras, A. Kalliakmanis. 2nd Department of Internal Medicine,
General and OncologyHospital of Kiﬁssia “AgioiAnargyroi”, Athens,
GreeceBackground: Previous studies concerning risk factors for LRTI’s in
the elderly have shown conﬂicting results. Most frequently reported
risk factors include age, swallowing diﬃculties, comorbidities andstroke.
Objective: To assess the predictors of LRTI’sin consecutively admitted elderly patients.
Methods: In 310 patients (49,6% women), mean age 80.24 (95%
CI: 79.35–81.10) demographic characteristics, medical history, medications, Katz-index (KI), Charlson-Comorbidity-Score (CCS) andreason of admission were recorded. Chi-square test was used tocompare categorical data. Student’s t-test and Man-Whitney U
test were used to compare continuous data. Only variables being
statistically signiﬁcant were processed with multivariate analysis.
Age was both analyzed as a categorical and continuous variable.
Results: 52 patients (16.8%) mean age 82.52 (95% CI: 80.02–85.08)
suffered from LRTIs. Mean age was signiﬁcantly higher (t(308)=2.289, p=0,023) for patients with LRTIs. Mean number of diseases,
number of medications and CCSwere not signiﬁcantly different
between patients with or without LRTIs. Patients aged above 80
years old (χ2 =5.783, p=0.016) or with lower KI (χ2 =14.355, p=0.026)
were more likely to have been admitted due to LRTIs. Sex, useof PPI’s or SSRI’s, the presence of stroke, dementia, COPD, Parkinson disease and psychiatric disorders were not linked with LRTIs.
In multivariate analysis, the only independent predictor was KI(p=0.021, OR=0.867, 95% CI: 0.769–0.979).
Conclusion: Elderly unable to function independently in the everyday living activities are more prone to experience an LRTI. Thus,
it is of highly importance the education and the awareness of the
caregivers to take extra precautions to prevent LRTIs.
P-142
Prevalence and severity of vitamin B1- and -B6 deﬁciencies in alarge cohort study in The Netherlands
M. Newton-Boerjan, A.-K. Boer, C. van der Linden. Catharina
Hospital Eindhoven, The Netherlands
Introduction: A lthough multiple guidelines do not recommend
screening for vitamin-B1 deﬁciency (B1D) and vitamine-B6 deﬁcienc (B6D) in geriatric patients, it is not known how many (severe)
B1D and B6D remain undiagnosed. This study aims to answer thefollowing questions: what is the prevalence and severity of B1D and
B6D in geriatric patients?
Methods: This descriptive study investigates the prevalence of B1D
and B6D in a large cohort of patients referred to an inpatient or
outpatient geriatric department from February 2012 to May 2016.
Furthermore we made a subdivision for patients with malnutrition,
alcohol use or dialysis.
Results: Data of 4378 subjects were included in analysis. Mean age
was 82,2 years and 60,1% was female. B1D in the entire population
was 4,1% (3,6% moderate and 0,5% severe). In clinical and ambulant
patients B1D was 6,0% (5,0% moderate and 1,0% severe) and 2,6%
respectively. In the malnutrition and alcohol use group B1D was
7,7% (6,2% moderate and 1,5% severe) and 3,4% respectively. B6D inthe entire population was 5,0% (4,5% moderate and 0,5% severe). In
clinical and ambulant patients B6D was 10,4% (9,4% moderate and1,0% severe) and 2,4% respectively. In the malnutrition and alcohol
use group B6D was 8,5% (7,8% moderate and 0,7% severe) and 3,5%
respectively.

Conclusion: This large study shows that the prevalence of B1D
and B6D was twice as high compared with healthy subjects. Since
most patients suffer from moderate deﬁciency, one can defend thepolicy not to screen the entire geriatric population. However, we
do recommend screening for patients in the clinical setting andpatients who suffer from malnutrition.
P-143
Prevalence of abuse and neglect, and associated factors incommunity dwelling older adults
B. İlhan, F. Saka, G. Bahat, C. Kılıç, S. Bovatekin, Y. Topçu, O. Yilmaz,
P. Küçükdağlı, T. Erdoğan, M.A. Karan. Istanbul University, Istanbul
Medical School, Division of Geriatrics, Istanbul, Turkey
Objective: Elder abuse and neglect is a critical-health-care-issue
that-must-be-brought-to the-attention. Each year approximately
10% of adults 65 years and older are abused, and 4% experiencemoderate to severe abuse.
Aim: In this study, we aimed to assess the prevalence of elder abuse
and neglect, and associated factors.
Methods: Elders ≥60 years-of-age admitted to outpatient-clinic
were included. Patients with acute-clinical-conditions, disableto-cooperate, and absence-of-informed-consent were excluded.
Eligible individuals had face-to-face interview by social worker
in a room and alone. Components of comprehensive-geriatricassessment, The Hwalek-Sengstock Elder Abuse Screening Test
(HSEAST) scores have been recorded. Also a new-scale has beendeveloped by-our social-worker to assess elder’s self-neglect.
Results: 226 eligible individuals were included among 481 new admission.142 were femal (%63) and 84 were mal (%37). Mean age was
74±6.5 years. According to HSEAST-scores 81 (35,8%) respondents
met the criteria for elder abuse/neglect risk. This ratio were higher
in female-group than male-group (p=0,008;42%and25%, respectively). HSEAST-scores were positively-correlated with geriatricdepression-scale scores and EQ5D-self-report quality-of-life questionnair (p<0,0001 for both). The cut-off threshold for new selfneglect scale was 7 in ROC analysis. Scores ≤7 reﬂect self-neglectwith a ratio of 39.8%. Self-neglect were higher in female-groupthan male-grou (p=0,0017; 46% and 30%, respectively). The-newself-neglect-scale scores were negatively-correlated with HSEASTscores, geriatric-depression-scale-scores and EQ5D-scores (p=0,11,
p<0,0001, p=0,001 respectively).
Conclusion: We observed high rates of abuse/neglect. This study
showed females are at more abused risk than males. Abuse andneglect are correlated with lower quality of life and depression.
Also our new self-neglect scale was correlated with HSEAST scores,
depression, and lower quality of life. This cross-sectional study
conﬁrms that elder abuse is a considerable public health problem
warranting further longitudinal studies.
P-144
Prevalence of fallers and of subjects at risk of falling in the mostvisited French climatic health resort
N. Raffort 1 , L. Soriteau 1 , B. Aliaga 1 , H. Desfour 1 , P. Pech 1 ,L. Gamon 2 , M. Faunanie 2 , M.-C. Picot 2 , X. de la Tribonnière 3 ,H. Blain 4 . 1 Centre Thermal de Balaruc-Les-Bains; 2 Département del’Information Médicale, Centre d’Investigation Clinique, CHU
Montpellier; 3 Unité Transversale d’Education du Patient (UTEP) CHU
Montpellier; 4 Department of Internal Medicine, University Hospital ofMontpellier, Montpellier University, MACVIA France, EUROMOV
Balneotherapy has proven positive effects in various musculoskeletal diseases, conditions potentially associated with an increased
risk of falls. We determined the history of fall and the prevalenceof risk factors of falling in 1471 subjects aged 65 or older consecutively admitted between June and August 2016 in the climaticPoster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

health resort of Balaruc-les-Bains, the most frequently visited Spa
in France (over 46,000 medicalised persons welcomed per year).
A fall in the previous years was observed in 33% of the curists(29% in men and 34% in women) and at least two falls in theprevious fall in 20% of them (16% in men and 22% in women). A
timed-up and go test over 12 seconds was observed in 34% of men
and 39% of women and a one-leg stand test under 5 seconds in
42% of men and 46% of women. 16% of men and 24% of women
were unable to stand in tandem position for 10 sec and 63% of
men and 76% of women had a 4-m walking speed <1 m/s. The
5 sit-to-stand test was not possible in less than 12 sec in 73% of
men and 76% of women and the fear of falling was not reduced
during the stay. Performance in all the above functional tests was
signiﬁcantly lower in fallers than in non-fallers. Taken together,
the above results suggest that a systematic screening of curists at
risk of falling should be implemented in spas and that, in subjects
screened at risk of falling, a speciﬁc program should be initiatedduring the stay in order to prevent falls and fractures.
P-145
Proﬁle of results of a comprehensive geriatric FLS in thefollow-up of fragility hip fracture patients (FONDA protocol)
D. Moral-Cuesta 1 , P. Matovelle 1 , T. Alarcón 1,2 , R. Velasco 1 ,R. Menéndez-Colino 1,2 , R. Queipo 2,3 , J.I. González-Montalvo 1,2 .
1 Geriatrics Department, Hospital Universitario La Paz, Madrid, Spain;
2 Instituto de Investigación del Hospital La Paz IdiPAZ, Madrid, Spain;
3 Preventive Medicine Department, Universidad Autónoma, Madrid,
Spain
Introduction: Hip Fracture (HF) patients suffer an important decrease in their function and health status. Many patients die andothers do not recover after the HF. The objective was to assess
the results of an intervention program in the recovery of physicalfunction, bone health, nutrition and anemia since admission to
1-year of follow up.
Methods: HF patients admitted during one year in a university
Hospital were studied. An intervention (FONDA Protocol) based on
physical function (Barthel Index –BI-, Short Physical Performance
Battery –SPPB- and handgrip strength), bone health (vitamin D),
nutrition (serum protein, albumin levels and muscle mass index–MMI-) and anemia (hemoglobin level), was applied. In those who
could come to the outpatient clinic an assessment of the eﬃcacy ofthe protocol result was made. Data were collected at admission andat 3, 6 and 12 months.
Results: 134 HF patients were included. The assessment results at
admission, 3, 6, and 12 months were respectively: MMI (kg/m2 ): 8.6(±2.2), 8 (±1.6), 8 (±1.7), 8 (±1.4); handgrip strength (Kg): 16.1 (±7.3),
19.3 (±6.8), 20 (±8), 21.2 (±8.2); hemoglobin (g/dL): 12.9 (±1.6), 13.3(±1.3), 13.7 (±1.3), 13.6 (±1.4); total serum protein (g/dL): 6.8 (±0.8),
6.8 (±0.5), 6.9 (±0.5), 6.9 (±0.4); albumin (g/dL): 3.2 (±0.4), 4 (±0.4),
4.1 (±0.4), 4.1 (±0.3); vitamin D (ng/mL): 16.2 (±8), 56.4 (±37), 41.6(±19.8), 35.4 (±14.1). The results at 3, 6, and 12 months were for BI:
87.2 (±15.4), 89.2 (±13.2), 90.1 (±17.2) and for SPPB: 6.4 (±2.8), 7.2(±2.9), 7.75 (±2.9).
Conclusions: An individualized protocol aimed to solving the speciﬁc needs of each HF patient reach the overall health status
recovery, which improvement in the functional, nutritional, vitamin
D and hemoglobin status.
P-146
Proﬁle of re-hospitalization in Prevent Senior, a private healthprovider that caters exclusively geriatric patients, in 2016
S.A.D. Silveira Jr, P.B. Batista Jr, A.L.A. Nascimento, E.F. Parrilo.
Prevent Senior Brazil
Objective: To evaluate the proﬁle of readmissions in a particu-

S81

lar health care provider that caters exclusively geriatric patients(Prevent Senior) in Brazil during the year 2016.
Method: We conducted a prospective study between January 01 to
December 31, 2016, where evaluated all readmissions that occurred
during that period.
Results: Were analyzed in 3147 (8.44%) readmissions, of a total
population of 37.249 admissions. 40.0% of these re-admitted in up
to seven days post discharge; 43.0% readmitted for the same reason
discharge. 59% of readmissions were due to infectious aetiology,
15.4% from cardiovascular causes, 11.3% for palliative care, 7.8% forrenal insuﬁencia and 6.5% by other causes. The overall hospitalmortality was 7.50%, and the average length of stay was 4.3 days.
Conclusion: The results presented show a low rate of rehospitalization, low death rate and low time of permanency
for the population studied. The main reason for the readmission ofthis population were the infectious causes, with pneumonia being
the most responsible. Such results show indirectly an eﬃcient inhospital management mechanism of the different conditions that
affected the population studied.
P-147
RCT Intervention with robust older people measuring functional
competence, risk of falling and gait modiﬁcation outcomes(LASTIMO)
U. Dapp 1 , L. Neumann 1 , C. Rohn 1 , R. Hoee 1 , V. Nagel 2 , W. vonRenteln-Kruse 1 , A. Daubmann 3 , A. Zech 4 . 1 Albertinen-Haus Centreof Geriatrics and Gerontology, Scientiﬁc Department at the Universityof Hamburg, Hamburg, Germany; 2 Institute of Human Movement
Science, University of Hamburg, Hamburg, Germany; 3 Department ofMedical Biometry and Epidemiology, Medical Center
Hamburg-Eppendorf, Hamburg, Germany; 4 Department of Exercise
Physiology, Institute of Sports Science, Friedrich Schiller University ofJena, Jena, Germany
Introduction: Older persons may be at increased risk of falling
due to functional decline and decreased muscle strength. Therefore,
adequate shoes providing stability are recommended although evidence is lacking. However, such shoes may have negative impact
on the feet muscles and sensitivity, and thereby, may impair movement and posture control. The aim of LASTIMO is to study whether
habitual patterns of gait, and mobility will be modiﬁed by physicaltraining under conditions that are comparable to barefoot.
Methods: RCT with robust (measured with LUCAS-FunctionalAbility-Index, FI [Dapp et al. BMCGeriatrics2014]) older people (70+years). Intervention group (IG): Comprehensive training focused onbalance and coordination 2×/week over 6 months with minimalistic
shoe use (similar to unshod). Control group (CG): Identical training
with familiar shoes. Measurement: CGA (2h) incl. gait parameters(Gaitrite® ) and functional competence (i.e. LUCAS FI, fall risk, SPPB).
Results: The randomisation (1:1) was successful: 56 persons werepart of the IG and 56 part of the CG. Proportion of women was:
IG 55.4%, KG 57.1%. Mean age (SD) accounted in the IG 75.6 (±3.4)
and in the CG 75.6 (±4.5) years. First pre-post-analyses (LUCAS FI,SPPB, fall risk) showed no signiﬁcant differences. In-depths analyses concerning foot and gait stability and variability (Gaitrite® ) arecurrently under way.
Conclusions: Findings and effects concerning functional competence, fall risk and gait modiﬁcations will be integrated in the “Pactfor Prevention Hamburg – staying healthy in old age!” which is
the regional stakeholder framework according to the mandatory
German prevention policy and regulations.

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P-148
Restless leg syndrome and associated factores
S. Bovatekin, G. Bahat, B. İlhan, A. Tufan, Y. Topcu, O. Yilmaz,
T. Öbekli, P. Küçükdağlı, C. Kılıç, M.A. Karan. Department of Internal
Medicine, Division of Geriatrics, Istanbul Faculty of Medicine, Istanbul
University, Istanbul, Turkey
Objective: Sleep disorders are prevelant but an underestimatedproblem in the elderly. RLS is associated cardiometabolic andnorocognitive comorbidities. Especially restless leg syndrome (RLS)
is common among sleep disorders. Studies regarding prevalence
and associated factors of RLS and are limited. We aimed to assess
RLS prevelance and its associated factors.
Methods: We included the elders 60–99 years of age admitted toIstanbul Medical School Geriatrics outpatient clinic in 2013–2016years period. International RLS diagnosis criteria was used for RLS
diagnosis and Cardiovascular Health Study group criterias were used
for frailty. Activities of daily livin (ADL) and Instrumental activities
of daily livin (IADL) were deﬁned by Katz/Lawton index. Handgrip
strength was measured with jamar hydrolic dynamometer. Statistical methods were chi-square analysis, independent-T-test, logistic
regression model analysis.
Results: 405 were male (%32), 854 (%68) were female from 1259
subjects. Mean age was 74,65±7 years. RLS prevelance was %28,4.
Mean handgriph strength measurement was 26±8.5. Mean ADL
and IADL were 17.2±1,39, 20,76±4,6 respectively. Median fraility
score was 1±1,192 (minimum score was=0 maximum score=5). After
regression analysis, RLS was associated with IADL, frailty and lower
handgriph strength (p<0,001, p<0,001, p=0.13 respectively). But it
was not associated with ADL (p=0,9).
Conclusion: RLS is associated with geriatric syndromes as likecardiometabolic diseases. RLS is associated with frailty, lower
handgriph strength, and functional dependence. Frailty should beconsidered in patients with RLS because of increased sensivity toevery kind of systemic disease. New studies are needed to light its
pathophysiological mechanism.
P-149
Screening of oropharyngeal dysphagia in a community old
population suffering from dementia
A. Michel 1 , F. Roca 1 , M. Bordage 1 , L. Druesne 1 , E. Vérin 2 ,P. Chassagne 3 . 1 Centre Hospitalier Universitaire de Rouen, Rouen,
France; 2 Centre Régional de Médecine Physique et de Réadaptation Les
Herbiers, Bois Guillaume, France; 3 Centre Hospitalier Universitaire
Vaudois, Lausanne, Suiss
Introduction: Oropharyngeal dysphagia (OD) is a common geriatric syndrome associated with negative outcomes (malnutrition
or aspiration pneumonia). In community-dwelling old populations,the 3-Oz test (3-ounce water swallow test) has been previously
validated as an effective screening tool for OD. Recently, the V-VST(Volume-Viscosity Swallow Test) has been suggested as a relevant
screening method. We aimed to assess in an ambulatory setting therelevance of V-VST comparing to the 3-Oz test in a population ofold demented patients.
Methods: This prospective, monocentric study was conducted witha population recruited from our geriatric outpatients clinic. Patients
aged 70 years or older with a diagnosis of dementia (NINCDSADRDA criteria) with an effective cough and attention capacities
preserved for testing. Each patient was evaluated by applying
consecutively the 3-Oz test and the V-VST in order to compare theprevalence of OD diagnosed by the two tests. Feasibility of V-VST
was deﬁned by measuring the mean time necessary to realize thetest and the rate of patients capable of successfully completing it.
Results: 117 patients were included (77 women, mean age =84.5±5.1
years). The prevalence of OD was signiﬁcantly higher (p=0.04) when

applying the V-VST (86.6%) in comparison to the 3-Oz test (15%).
The mean time necessary to apply V-VST was 8 minutes which has
been successfully achieved in 96% of studied patients.
Conclusions: The V-VST is a screening test, easily applied and welltolerated in the elderly population suffering from dementia thatshould be preferred to the 3-Oz test in this population.
P-150
Sensitivity to change of Berg Balance Scale, Timed Up and Go
test, Four Square Step Test for older adults
K. Cekok 1 , T. Kahraman 2 , B.O. Ugut 2 , P. Keskinoglu 3 , A. Genc 4 .
1 Department of Physical Therapy and Rehabilitation, Medical Park

Hospital, Izmir, Turkey; 2 Department of Physiotherapy andRehabilitation, Faculty of Health Sciences, Izmir Katip Celebi
University, Izmir, Turkey; 3 Department of Biostatistics and Medical
Informatics, Dokuz Eylül University, Izmir, Turkey; 4 School of Physical
Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
Objectives: Balance is an integral component of physical function
and a fundamental area of assessment and intervention in geriatricrehabilitation. Clinicians and researchers in this ﬁeld regularly use
standard balance measures to diagnose balance deﬁcits, measure
the risk of falls, and monitor changes in balance over time. Althoughseveral balance measures are available, there is lack of evidence
regarding the most appropriate measure to assess change in older
adults. The aim was to investigate the sensitivity to change of Berg
Balance Scale (BBS), Timed Up and Go (TUG) Test, and Four Step
Square Test (FSST) for older adults.
Methods: This cohort study is comprised of participants aged older
than 50 years. The BBS, TUG test, and FSST were performed baseline
and after one year. Sensitivity to change was assessed using effectsize (ES) and standardized response mean (SRM).
Results: There were 94 participants in the baseline assessment.
After one year, 35 of them were re-assessed. There was a signiﬁcantbalance deterioration assessed with all measures compared to one
year ago (p<0.01). ES values were small for all the measures(BBS: −0.44, TUG: 0.28, and FSST: 0.26), whereas SRM values weremoderate for BBS and TUG (−0.75 and 0.67, respectively). SRM value
was large for FSST (1.31).
Conclusions: Although BBS, TUG, and FSST have similar responsiveness abilities, the FSST seems much better to sensitively measurebalance deterioration with age in older adults. Since a notablebalance deterioration was observed after one year, regular balance
assessment and appropriate rehabilitation are important.
P-151
Social deprivation and primary care access among elderly
patients – A cohort study on patients hospitalized in a geriatricunit
D. Nghiem, W. Jarzebowski, C. Lafuente, J. Belmin. HopitalCharles-Foix, Ivry-Sur-Seine, France
Context: There are little publications on primary care access for thepoor elderly population, although they are among the frailest.
Objectives: To assess a potential association between poverty
among the elderly and their access to primary care in France.
Design: Cohort study, based on a self-assessment questionnairecompleted by 80 patients hospitalized in two geriatric units of
the Charles-Foix Hospital, between March and September 2016.
The data collected included the deprivation score EPICES, frailty
indicators (Charlson, Rockwood and FiND scores), as well as thenumber of times they consulted their primary care physician theyear before their hospitalization.
Results: In this population, most patients were women (n=49, 61%),
with a mean age of 85 years. They were frail, with a median Rockwood score of 5/7 and also highly comorbid, with a mean Charlson

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

index of 6.8. Most (n=61, 76%) were considered deprived according
to the EPICES score. Mean number of primary care consultations
was 7 per year. By assessing a distribution by quintiles, the EPICES
score was signiﬁcantly associated with the number of consultations
by a complex relationship, in which the lowest and the highest
quintiles had a greater number of primary care consultations per
year (p<0.05).
Conclusion: Primary care access seems to be associated in a nonlinear link with social deprivation among the elderly in France. Morestudies are needed to assess whether the EPICES score could be agood instrument to detect social frailty among geriatric patients.
P-152
Socio-demographical and medical characteristics associatedwith quality of life in very old and frail geriatric oncology
patients
V. Antoine, D. Matelot, A. Martin, B. de Wazieres. CHU Nîmes, France
Background: Quality of life (QOL) has become a major factor
when considering treatment approach and medical care in geriatriconcology. QOL measures have been recognized to help treatment
decisions, prognostic and survival assessment. The objective of thisstudy is to describe the level of QOL in very old and frail geriatriconcology patients and factors associated with a low QOL level.
Methods: Over 100 consenting subjects ≥74 years of age, witha progressive cancer (solid tumors or hemopathy, treated or not)were included from a geriatric oncology clinic in a French university
hospital. The validated QOL questionnaire EORTC QLQ-C30 (version3.0) was administrated to patients. Socio-demographics (age, sex,
lifestyle), cancer (type of cancer, metastatic or not, curative treatment or not), comorbidities, G8 score and geriatric characteristics(cognitive and sensorial functions, depression, nutrition, walking
speed and perimeter, grip strength), pain, hemoglobin, creatinine
clearance, autonomy for activities of daily living (ADL/IADL) werealso collected.
Results: We present socio-demographical and medical data associated with QOL level in a frail and elderly population (mean age 84,
OMS performance status >2: 43%).
Conclusion: Geriatric assessment is important to optimize QOL
evaluation in geriatric oncology.
P-153
Telemedicine as a successful tool for improving territorial careto elderly people
M. Ammendola 1 , A. Castagna 2 , L. Manfredi 2 , P. Gareri 3 , M. Rocca 3 .
1 ASP di CAtanzaro, ITALY; 2 ASP di Catanzaro; 3 ASP di Catanzaro, Italy
Background: Telemedicine offers a number of services addressedto chronic diseases able to improve the quality of care by applying
technology to clinical practice. Elderly people need a highly personalized diagnostic approach aimed to the improvement in the qualityof life and the delay in disease progression.
Aim: The aim of the present work was to compare a sample of
11 patients who underwent telemonitoring of health conditions(group A) with a sample of 11 patients (group B) following theroutine geriatric check-up.
Methods: People were from Catanzaro Lido or Chiaravalle Districts,
age 65 year old or older; they had to be affected with hypertension, diabetes, respiratory insuﬃciency/COPD. Telemedicine tools
included Phebo platform, with a software able to receive signals
from peripheral devices in real time. Devices were directly provided
to patients. All of them were linked to a smartphone with evodroid
system, able to communicate to the central platform through theinternet. Patients were administered a questionnaire for assessing
the compliance in the two groups: 1) self monitoring of parameters, adherence to 2) pharmacological prescriptions and 3) to diet,S834) adherence to parameter monitoring and self-care and 5) theperception of patient’s care.
Results: Telemonitored patients globally presented a better adherence to monitor the examined parameters (blood pressure, oxygen
saturation, glycemia and body weight). The adherence to drug
treatment was higher in group A (82% vs 73%). Unlike group B,
patients of group A declared they never changed drug regimen autonomously. The adherence to diet was overall low in both groups.
The level of perceived quality of assistance was high in both groups(55% in group A vs 45% in group B).
Conclusions: Telemonitored patients presented a high complianceto clinical monitoring and drug treatment and low adherence todiet regimens. Clinical monitoring was much higher compared with
non-telemonitored patients. In conclusion, compliance improved
as much as perceived care got better and the tools provided
by telemedicine offered a valid help for improving parameters
monitoring.
P-154
The European study of older subjects with atrial ﬁbrillation(EUROSAF). Aim and study design
A. Pilotto 1 , S. Maggi 2 , M.C. Polidori 3 , E. Canepa 1 , N. Veronese 1 ,A. Ferri 1 , on behalf of EUROSAF Investigators. 1 Department ofGeriatric Care, OrthoGeriatrics& Rehabilitation, Frailty Area, E.O.
Galliera Hospital, Genova, Italy; 2 EUGMS European Union GeriatricMedicine Society, Europe; 3 Ageing Clinical Research, Dpt. Medicine II,
University Hospital of Cologne, Germany
Introduction: The EURopean Study of Older Subjects with Atrial
Fibrillatio (EUROSAF), NCT 02973984, is a cross-national, prospective, observational study performed in subjects aged ≥65 years with
Atrial Fibrillatio (AF) admitted to European Centers with the aim
to evaluate in a “real word” population of multimorbid frail older
patients with AF the clinical beneﬁt/risk ratio of the anticoagulant
treatment according to the different individual risk proﬁle, as
determined by the Multidimensional Prognostic Inde (MPI).
Methods: All patients at baseline underwent a standardized Comprehensive Geriatric Assesment (CGA), i.e. information on functional(ADL, IADL), cognitive (SPMSQ), nutrition (MNA-SF), risk of pressure
core (Exton-Smith Scale), comorbidity (CIRS), polypharmacy andco-habitation status in order to calculate the MPI. in order tocalculate the MPI. Patients were divided in three MPI-risk groups:
MPI-1-low-risk, MPI-2-moderate-risk, MPI-3-severe-risk of mortality. Systemic thromboembolic risk (according to CHA2DS2-VASC
score), and bleeding risk (according to HAS-BLED score) were also
calculated. During the 12 months follow-up period, information will
be collected on survival/mortality, hospital re-admissions, thromboembolic events, haemorrhagic events and compliance to oral
anticoagulant treatments.
Results: The recruitment period started on November 2016 in threecenters. 156 elderly patients were included (updated 30th april
2017), i.e. 80 males and 76 females, mean age 84.6±5.9 years, range
66–96 years. 36 patients were included in MPI-1 group, 72 to MPI-2
and 48 to MPI-3 group.
Conclusion: EUROSAF study is a multicenter cross-national prospective study to evaluate the clinical beneﬁt/risk ratio of anticoagulant
treatment in frail older subjects with multimorbidity and polypharmacy.
P-155
The experience of formal caregivers in a Portuguese nursing
home care: a case report
C. Laranjeira, Z. Azeredo. RECI - Higher School of Health Sciences
Viseu (Piaget Institute)
Introduction: The need for assistance with personal care or house-

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Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

hold activities is a hallmark of aging. With the increasing of
disability comes the need for more assistance and more formal
caregiving services.
Methods: This study aims to verify the type of care provided byformal caregivers of institutionalized elderly, know the diﬃculties
experienced by formal caregivers and ﬁnd out what their sourcesof satisfaction. We conducted a qualitative study with transversal
approach, whose data collection instrument was the interview,
conducted on a sample of seven formal caregivers of a Nursing
Home Care in Viseu (Portugal).
Results: The results show that the sample is female, aged from 32 to
53 years, most of which has the basic education, with a professional
exercise time between 8 and 16 years, corresponding to the time in
the profession in the current institution they work. There are casesof lack of training on caring for the elderly, and those that have been
in institutional contexts (care for the elderly, health, geriatrics andﬁrst aid), expressing the desire to invest more in their education(geriatrics, long-term care, palliative care and elderly psychology).
The type of care/activities that caregivers provide were hygiene,
food, positioning, live with the elderly, leisure activities, ensure
their welfare and home cleaning. The activities that give more
pleasure to the caregivers perform were living with the elderly andthrow to them. In contrast, the activities in which they feel themost diﬃcult positions are deal with the elderly patient and control
the dementia crisis.
Conclusions: Formal caregivers contribute to many activities. The
diﬃculties experienced are varied (efforts, initial insecurity in relation to the elderly, more autonomous elderly, food, unable tocontrol the old crises, hygiene and degradation of the elderly). Most
caregivers think that their prospect of future change. The mostcomplicated moment with that interviewed faced was the death ofthe elderly. Mostly, the interviewees reveal professional satisfaction
and personal beneﬁts, which is very positive experience in terms of
personal growth.
P-156
The language validation study of the Sarc-F Turkish version
G. Bahat 1 , O. Yilmaz 1 , P. Kucukdagli 1 , M. Oren 2 , M.A. Karan 1 .
1 Department of Internal Medicine Division of Geriatrics; 2 Departmentof Public Health, Istanbul University Istanbul Medical School
Objective: The SARC-F scale is a recently developed practical tool
to screen for sarcopenia and the score ≥4 is deﬁned as positive. We
aimed to perform its Turkish language validation.
Methods: This study is a part of SARC-F Validation Study of sarcopenia special interest group of EUGMS. Firstly a bilingual expert
translated SARC-F in Turkish and the other 2 bilingual expert and aforward translator reviewed the translation and decided on the ﬁnal
draft version. After the consensus, a bilingual translator performed
the back-translation. The expert panel reviewed the all versions andreached a consensus in the translations. Turkish translated version
was applied as pretest to 10 participants. It was validated with thesame 20 participants (10 men and 10 women) in order to assessinter-intra rater reliability.
Results: There was no problem in the translation and pretest
process. There were 5 men and 5 women (mean age of 71.5±10.4
years) in the pretest step. Inter-intra rater reliability participants’mean age was 71.4±8.1 years. Inter-rater reliability was performed
with an ICC of 0.78 CI 95% (0,60–0,89). Result was considered toshow adequate internal consistency. The intra rater reliability was
performed with an ICC of 0.78, 95% CI: (0.61–0.90) two weeks laterand this was also satisfactory.
Conclusions: Turkish version of SARC-F proved to be easy to complete, valid, reliable, and reproducible sarcopenia questionnaire.
This standard form can be used in clinical practice and researchstudies.

P-157
The Older Person’s Assessment and Liason (OPAL) team in
Emergency Department: impact of embedding specialty staff in
ED
R. Barratt, R. Keelan. University Hospital of South Manchester,Manchester, UK
Background: Elderly patients attending the emergency department(ED) have a high rate of hospital admission. The Older Persons
Assessment and Liaison (OPAL) team aim to address the diﬃculties
encountered with the management of frailty syndromes and provide safe alternatives to admission. It currently operates a ﬁve-day
week multidisciplinary service within the ED, led by consultant
geriatricians. This permits timely and comprehensive review ofindividuals who can be better managed in the community.
Method: A questionnaire comprising 11 questions was given tostaff members in ED to assess the effectiveness of, and satisfaction
with, the OPAL team. There were 25 respondents who were asked
to provide their role but were otherwise anonymous. Questions
assessed qualities ascertaining to leadership: approachability, communication, time to response, effectiveness in facilitating discharge,
education, inﬂuence on practice.
Results: The OPAL team in ED are felt to increase thresholds for admission and facilitate safe discharge. Their accessibility, availability
and approachability are valued as is their role as advisors and teamplayers. OPAL referral criteria are generally well understood and thewider inﬂuence on the practice of other clinicians is appreciated,with reported increased conﬁdence and awareness of managing
frail elderly in ED.
Conclusions:• Specialist teams embedded in ED facilitates better patient care
and augments knowledge in non-specialists.
• OPAL team in the ED inspires others and inﬂuences positivechange.
• OPAL team in ED ensures fast and effective assessment of thefrail elderly patient.
• Integral to facilitating safe discharge of frail elderly with establishment of support in the community.
P-158
Use of physical restraints in italian hospitals and nursing homes:
Data from the 2015 “Delirium Day” initiative
P. Mazzola 1 , G. Annoni 1 , S. Di Santo 2 , A. Mazzone 3 , A. Ferrari 4 ,N. Ferrara 5 , M. Trabucchi 6 , M. Alessandro 7 , E. Mossello 8 ,A. Cherubini 9 , G. Bellelli 10 . 1 University of Milano-Bicocca, School of
Medicine and Surgery, Monza (MB), Italy; 2 Department of Clinical and
Behavioral Neurology, Neuropsychiatry Laboratory, IRCCS Foundation S
Lucia, Roma, Italy; 3 Redaelli Geriatric Institute, Milan, Italy; 4 Geriatric
Unit, Department of Neuromotor Physiology, ASMN Hospital, Reggio
Emilia, Italy; Italian Society of Hospital and Community Geriatrics(SIGOT), Roma, Italy; 5 Department of Translational Medical Sciences,
Federico II University of Naples, Naples, Italy; Salvatore Maugeri
Foundation, IRCCS, Scientiﬁc Institute of Telese, Telese Terme (BN),
Italy; Italian Society of Gerontology and Geriatrics (SIGG), Florence,
Italy; 6 Tor Vergata, Rome University, Rome, Italy; Italian
Psychogeriatric Association (AIP), Brescia, Italy; 7 Department of
Rehabilitation and Aged Care “Fondazione Camplani” Hospital,
Cremona, Italy; 8 Research Unit of Medicine of Ageing, Department ofExperimental and Clinical Medicine, University of Florence andAzienda Ospedaliero-Universitaria Careggi, Firenze, Italy; 9 Geriatrics
and Geriatric Emergency Care, IRCCS-INRCA, Ancona, Italy;
10 University of Milano-Bicocca, School of Medicine and Surgery,Monza (MB), Italy; NeuroMI – Milan Center for Neuroscience, Clinical
Neurosciences research area, Milano (MI), Italy
Introduction: Physical restraints, originally intended to prevent

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

falls and injuries, did not show any advantage in terms of fall prevention. Despite their potential of causing delirium and agitation,
restraints are largely used.
Methods: Data from the 2015 “Delirium Day” initiative, a point
prevalence observational study that accounted for 3534 patientsenrolled in a single day. Subjects with complete data included 1867
who were admitted to acute care or rehabilitation wards, and 1439
who were nursing home (NH) residents. Patients of both settings
were also divided according to the use of restraints: no restraints,
bedrails, restraints attached to the body.
Results: NH patients were older than those in acute wards (84.4 vs.
82.0 years, p<0.001). In the latter group, patients who used bedrails
or restraints were older than those without restraints (84.6, 86.0,
and 80.4 years respectively). Patients in acute wards were morecomorbid, more malnourished, and less functionally dependent
than NH patients, but the latter were more affected by dementia,
took more drugs, and experienced more delirium according to the
Delirium-o-meter scale (maximum prevalence among the restraints
users in both settings). Multivariate logistic regressions showedthat age, female gender, number of drugs, low BADL score, bladdercatheterization and dementia were independently associated withthe use of bedrails. Only low BADL, dementia, and delirium wereindependently associated with the use of restraints attached to thebody.
Conclusions: The use of bedrails and of restraints attached to thebody are associated with different risk factors, thus they should beconsidered as different strategies.
P-159
Usefulness of the multidimensional prognostic index (MPI) to
identify older patients who will return home after discharge
from a post-acute care unit
A. Cella, F. Tricerri, N. Vello, M. Pomata, D. Torriglia, A. Delrio, R. Boi,
S. Morelli, A. Pilotto. Geriatrics Unit, Department of Geriatric Care,
Orthogeriatrics and Rehabilitation, Frailty Area, E.O. Galliera Genoa,
Italy
Introduction: The ultimate goal of post-acute care units is toenable patients to return home once their independence has
improved. This study aimed to evaluate the usefulness of the Multidimensional Prognostic Index (MPI), a Comprehensive Geriatric
Assessment (CGA)-based prognostic tool, in identifying patientsable to return home after hospitalization.
Methods: On admission and on discharge, 325 consecutive older
patients admitted to our post-acute care unit (males 150, females
175, mean age 82.0±7.1 years) underwent a standardized CGA tocalculate their MPI by means of Activities of Daily Living-ADL,
Barthel-Index, Instrumental ADL, Short Portable Mental Status
Questionnaire, Mini Nutritional Assessment, Exton-Smith Scale,
Comorbidity Illness Rating Scale, drug use and co-habitation status.
Results: Nineteen patients (5.8%) died; 165 (50.8%) returned home;
130 (40.0%) were admitted to nursing homes; 11 (3.4%) required
re-admission to acute-care wards due to relapsing diseases. The MPI
of subjects who returned home was signiﬁcantly lower than that of
all other patients, both on admission (0.70 vs 0.78, p<0.001) and ondischarge (0.59 vs 0.70, p<0.001). The most signiﬁcant predictorsof returning home were MPI on admission (binary logistic regression: OR 0.017, CI95% 0.001–0.225; p=0.002) and Barthel-Index ondischarge (OR 1.019; CI95% 1.009–1.028; p<0.001).
Conclusions: In post-acute care geriatric facilities, MPI can help
clinicians to identify frail patients able to return home after discharge; improving MPI values can indicate improved functional
status and increase the probability of returning home.

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Area: Delirium

P-160
Anticholinergic burden and delirium in unplanned admissions
with Parkinson’s disease: Prevalence, associations and outcomes
E. Parkinson 1 , A. Thomson 2 . 1 The University of Manchester, UK;
2 Salford Royal Hospital, UK
Introduction: Patients with idiopathic Parkinson’s disease (iPD) areoften exposed to a variety of drugs with anticholinergic effects.
These agents may cause a variety of unwanted antimuscarinic
side-effects which can exacerbate non-motor symptoms, including
effects on cognition. Delirium is associated with poor prognosis andmay be more prevalent in PD patients. This study aimed to examine
the inﬂuence anticholinergic drugs may have on unplanned iPD
admissions and delirium.
Methods: A retrospective case note review of unplanned admissions
in patients with iPD to the medical unit of a University teaching
hospital was undertaken. An anticholinergic burden (ACB) score
was calculated for each admission and the relationships between
ACB score and delirium, with various clinical and non-clinicalparameters, were investigated and adjusted for comorbidities.
Results: 89 patients (52 male, mean age 76.8 years) accounted
for 133 admissions. A positive ACB score was identiﬁed in 70.7%
of admissions with an overall average of 2.008. The ACB score
was found to be signiﬁcantly decreased in patients with dementia(p=0.009) but not associated with delirium alone (p=0.198) or
adverse outcomes requiring further care (p=0.533). Investigation ofdelirium alone demonstrated signiﬁcant associations with dementia (p=0.019), adverse outcomes (p=0.005), infectious pathology(p=0.011) and increased length of stay (p=0.030).
Conclusions: Although adverse cognitive effects of anticholinergic
medications are well-recognised, there was no correlation withdelirium in this cognitively vulnerable group. This absence of association in Parkinson’s disease patients seems counterintuitive, andthe reasons for this warrant further investigation.
P-161
Assessment of risk of delirium in geriatric patients using the
Neecham Confusion Scale
S. Blandfort, M. Gregersen, K. Rahbek, E.M. Damsgaard. Departmentof Geriatrics, Aarhus University Hospital, Aarhus, Denmark
Objectives: Delirium frequently occurs among elderly hospitalized
patients. Currently more than 40 delirium screening instruments
exist. Confusion Assessment Method (CAM) is the most commonly
used. However, CAM does not predict whether patients are at riskof developing delirium during hospital stay or assess the severityof the condition. The Neecham Confusion Scale (NEECHAM) isdeveloped for that purpose. Our aim was to validate NEECHAM(translated from Swedish) in Danish patients in a geriatric ward.
Methods: A pilot study included 60 patients (aged ≥75 years),acutely admitted to a geriatric ward at Aarhus University Hospitalfrom 15 September to 14 October 2016 for both medical and surgicalreasons. Delirium was assessed morning and evening using CAM,
which is part of the usual procedure. NEECHAM was measured
within 24 hours after admission to the ward. Tests for concurrent
and predictive validity were used to compare NEECHAM with CAM
as the golden standard. The total score ranges from 0 (confusion) to30 (normal function). A value of 25 or more was considered to benormal.
Results: The mean age of the patients was 86 years (± 5.5). Sixty-six
percent were women. The incidence of delirium was 16.7%. The
sensitivity of NEECHAM was 50% and the speciﬁcity was 35.2%. The

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Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

positive and the negative predictive values were 7.89% and 86.4%,
respectively.
Conclusion: NEECHAM does not seem to be suitable for predicting
delirium in older geriatric patients acutely admitted to hospital dueto the low positive predictive value.
P-162
Delirium as a predictor of mortality and institutionalization in
nonagenarian patients admitted to an intermediate care unit
N. Leiva, C. Roqueta, S. Ubero, M.I. Martínez-Fernández, S. Burcet,
R. Miralles, O. Vázquez. Geriatric Medicine Department, Centro
Fórum, Parc de Salut Mar, Barcelona, Spain
Aim: To assess whether delirium in nonagenarian patients is apredictor of mortality and institutionalization at discharge of anintermediate care unit.
Patients and method: Prospective study of nonagenarian patients
admitted to an intermediate care unit. Demographic variables (age,sex) and main medical diagnoses (fracture-injury, neurological,
cardiopulmonary, vascular and others) were recorded. The presenceof delirium was evaluated during admission using the Confusion
Assessment Method (CAM). Patients who died during admission
and were discharged to nursing home were registered. The patients
who came from a nursing home prior to admission, died and weretransferred to the acute care hospital were excluded
Results: Two hundred and twelve patients (75.90% female) wererecorded. Ninety (42.45%) had delirium, 18 (8.50%) died and 54(32.53%) were institutionalized at discharge. The main medical
diagnoses were: 124 (58.50%) fracture-injury; 30 (14.15%) neurological; 20 (9.43%) cardiopulmonary, 7 (3.30%) vascular and 31 (14.62%)
others. Of the 18 patients who died, 12 (66.67%) had delirium and6 (33.33%) had not. Of the remaining 194, 78 (40.21%) had deliriumand 116 (59.79%) had not (p=0.030). Of the 54 patients who were
institutionalized, 30 (55.56%) had delirium and 24 (44.44%) had not.
Of the remaining 112, 34 (30.36%) had delirium and 78 (69.64%) had
not, (p=0.002).
Conclusions: The prevalence of delirium in nonagenarian patients
hospitalized in an intermediate care unit was high. The delirium
could be a predictive factor of mortality and institutionalization
at discharge in nonagenarian patients admitted to an intermediatecare unit.
P-163
Delirium in a geriatric population suffering from dementia:
Complication or picture at the onset?
M.J. Ceravolo, C. Alfano, S. Geniere Nigra, G. Cuzzoni, L. Venturini,
G. Ricevuti. Department of Internal Medicine and Therapeutics,
University of Pavia
Delirium is a serious syndrome related to an increase of the lenghtof hospitalization, the risk of instituzionalization, the morbility andthe mortality. Delirium can be found in any medical condition andis common in hospitalised elderly patients in his hyperactive, hypoactive and mixed form. This syndrome occurs in 20% of subjects
affected by dementia.
Study design: The aim of the current experimental study is todetermine factors associated with the incidence of delirium in a
hospitalized geriatric population with dementia.
Materials and methods: Over the course of 15 months, 167 patients
aged 65 years and older, with cognitive decline, were enrolled in the
Alzheimer Unit of the S. Margherita Hospital of Pavia. The patientscame from the home or from acute wards. The diagnosis of delirium
has been provided by applying the criteria of the DSM-V supportedby the use of CAM.
Results: Delirium had been recorded in 10,18% of the patients,
in almost all cases in its hypoactive form. On admission it wasstrongly associated with several conditions: cognitive decline, vascular dementia and Alzheimer disease, adverse drugs effects, severe
cardiovascular and pulmonary diseases, neuropsychiatric disorders,
hospitalization, urinary/kidney tract infection, liver disease, alcohol
withdrawal, neoplasms. The data obtained from this work are inagreement with the international literature on the acute mental confusion. We can identify three potential pathophysiologicalmechanisms underlying the clinical condition: a state of systemic
inﬂammation, poor nutritional/metabolic conditions, a state ofdehydration.
Conclusion: Our results conﬁrm the presence of an association
between delirium and advanced age, reduced autonomy and multicomorability. Our study also conﬁrms the association between
delirium and systemic inﬂammatory markers, malnutrition anddehydration.
P-164
Delirium in elderly patients with hip fracture
S. Jiménez Mola 1 , J. Idoate Gil 1 , M. López Viñas 2 , P. Sáez López 3 ,E. Martín Pérez 4 , K. López López 5 . 1 Complejo Asistencial
Universitario de León, León. Spain; 2 Centro de Mayores de Armunia,
León. Spain; 3 Complejo Asistencial de Avila, Avila. Spain; 4 Hospital San
Juan de Dios, León. Spain; 5 Hospital San Juan de Dios, Burgos. Spain
Introduction: One of the most common postoperative complications after hip fracture repair is delirium. The aim of the present
study was to evaluate the occurrence of delirium in patients admitted to hospital for femur fracture and to identify individuals at highrisk of delirium.
Methods: We enrolled 534 patients with hip fracture, aged 75 years
or older in an Orthogeriatric Unit between December 2013 andNovember 2014. Underwent comprehensive geriatric assessmentthat evaluates comorbidities, medication use, ability to performbasic activities of daily living, place of residence, anesthesia risk
as measured by the ASA score, type of fracture, type of surgery
and anesthesia, in-hospital mortality, and healthcare variables(pre-operative and overall stay). Delirium was evaluated by theConfusion Assessment Method (CAM).
Results: Among the 534 participants, 499 (93%) underwent surgery.
The mean age 86.1±7.3 years (75–105 years) and 75.4% were women.
Only 132 (25%) had a previous diagnosis of dementia. Forty-threepatients (36,7%) developed delirium. The incidence of delirium waslower in the group without dementia (26%) than in the groupwith probable dementia (56%) and with Mild Cognitive Impairment(49%), (p<0.001). In comparison to patients without delirium, those
who developed delirium were not signiﬁcantly older, more limited
in outdoor mobility and basic activities of daily living (p>0.5).
Patients who developed delirium presented a longer length of stay
(median 13.09 versus 11.30; p<0.001).
Conclusions: Clinicians treating people with a hip fracture should
be vigilant towards peri-operative delirium if their patients havepre-existing cognitive impairment.
P-165
Delirium in hospitalized older patients – An educational projectto raise awareness and minimize risks
A. Hofmann 1 , E. Kaufmann 2 , M. Gosch 1 . 1 Geriatric department,
Klinikum Nürnberg, Paracelsus Medical University, Prof. Ernst-Nathan
Str.1; 2 Center for Medicine of Ageing, Klinikum Nürnberg, Paracelsus
Medical University, Prof. Ernst-Nathan Str.1
Introduction: Delirium affects more than 50% of hospitalized older
persons and is often followed by serious and even life threatening
complications. Furthermore delirium is associated with a high burden not only for the patient but also for caregivers. Still delirium inclinical practice often remains unrecognized.

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

Methods: We established a hospital-wide case-based interprofessional training programm on delirium including preventive, screening and non-pharmacological treatment methods. The programm
was built up on a structured management pathway. Incidence andduration of delirium as well as rate of diagnosed delirium accoring
to DRG-system were assessed before and after the intervention.
Care giver burden before and after the intervention was assessed bysemistructured interviews. The program also included informationof relatives, the results so far are not completely assessed.
Results: After implementation of the training programm a significant increase in the diagnosis of delirium was mentioned andduration of delirium was shortened, whereas no changes wererecorded regarding the incidence of delirium. In semi-structured
interviews care-giver knowledge on key aspects in the managementof delirium was associated with diminished burden.
Conclusions: Structured, case based training programs can be
implemented in a broad setting and have a positive effect onawareness and duration of delirium.
P-166
Delirium recognition in clinical practice according to severity
and motor subtype: Data from the “Delirium Day 2016” national
surveyE. Mossello 1 , A. Morandi 2 , A. Mazzone 3 , S.G. Di Santo 4 ,A. Cherubini 5 , A. Marengoni 6 , M. Bo 7 , A. Zambon 8 , F.L. Fimognari 9 ,M. Campanini 10 , M. Montorsi 11 , I. Penco 12 , F. Perticone 13 ,N. Ferrara 14 , M. Trabucchi 15 , G. Bellelli 16 . 1 Research Unit of Medicine
of Ageing, Department of Experimental and Clinical Medicine,
University of Florence and Azienda Ospedaliero-Universitaria Careggi,
Firenze, Italy; 2 Department of Rehabilitation and Aged Care
“Fondazione Camplani” Hospital, Cremona, Italy; 3 Redaelli GeriatricInstitute, Milano, Italy; 4 Department of Clinical and Behavioral
Neurology, Neuropsychiatry Laboratory, IRCCS Foundation S Lucia,
Roma, Italy; 5 Geriatrics and Geriatric Emergency Care, IRCCS-INRCA,
Ancona, Italy; 6 Department of Clinical and Experimental Sciences,
University of Brescia, Italy; 7 Division of Geriatrics, Città della Salute edella Scienza – Molinette, Torino, Italy; 8 School of Medicine andSurgery, University of Milano-Bicocca; 9 Italian Society of Hospital’s
and Community Geriatrics (SIGOT); 10 Federazione Italiana delle
Associazioni Dirigenti Ospedalieri Internisti (FADOI); 11 Italian Societyof Surgery; 12 Italian Society of Palliative Care; 13 Italian Society ofInternal Medicine (SIMI); 14 Italian Society of Gerontology andGeriatrics (SIGG); 15 Italian Psychogeriatric Association (AIP); 16 Schoolof Medicine and Surgery, University of Milano-Bicocca, and Division ofGeriatrics, San Gerardo University Hospital, Monza, Italy
Introduction: Delirium is often not recognized and recorded inclinical practice. The present large multicenter study aimed (1)to assess the ability of nurses to identify delirium features incomparison with a standardized clinical assessment; (2) to identify
the effect of delirium severity and motor subtype on delirium
recognition.
Methods: 2877 Italian inpatients aged 65+ were included in “Delirium Day 2016”, a national delirium point prevalence study. The
nurse on duty was asked to report the presence of three delirium features (acute change, ﬂuctuations and impaired arousal) for
each subject, who was formally assessed using 4AT afterwards,
with scores >4 indicating delirium. Delirium severity was deﬁned
according to 4AT score (4–7 mild; 8+ severe) and motor subtype
according to Delirium Motor Subtype Scale-4. Vital status one
month after the assessment was recorded.
Results: Prevalence of delirium was 22% (n=634). Nurse identiﬁcation of at least one delirium feature had an 86% [83, 89] sensitivity
and an 81% [79, 82] speciﬁcity for delirium diagnosis. Sensitivity
was 80% for mild cases and 93% for severe ones. Sensitivity waslowest for delirium without motor features (59%) and highest

S87

for mixed (hypo/hyperkinetic) one (97%). Delirium deﬁned eitherwith 4-AT or according to nurse observation showed a similarly
increased mortality risk, with severe cases being associated withgreater mortality (13%) compared with mild ones (5%).
Conclusions: Systematic record of nurse observation in routine
practice might be an eﬃcient method to detect delirium, especiallyof severe cases with a greater impact on survival.
P-167
Developing family-centered delirium care: A participatory
action research study
L. Van Humbeeck, L. Dillen, R. Piers, N. Van Den Noortgate. Ghent
University Hospital, Ghent, Belgium
Introduction: Delirium is probably the most common symptom of
disease at old age. Healthcare professionals (HCPs) at acute geriatricwards are well-trained in delirium management. Yet delirium often
leaves a signiﬁcant impression on family caregivers, who are pivotal
partners during and after admission. Although HCPs are awareof this impact, family’s concerns are often overlooked. This study
aimed at supporting HCPs in developing family-centered delirium
care (FCdC).
Methods: The study was conducted at the delirium room, a fourbed unit at the acute geriatric ward of Ghent University Hospitalwith round-the-clock nursing care for agitated geriatric patients. A
working group of HCPs developed a tailored FCdC trajectory basedon participatory action research (PAR). Two 0.5 FTE researchers enabled co-creation between HCPs, patients and family and monitored
the action cycles.
Results: First, shadowing and benchmarking of FCdC occurred. In
a second phase the working group was composed and started todevelop FCdC goals. Based on discussing care situations it was
decided to develop and unroll a new welcome policy for family.
An action plan was made up and tested. Finally, the project wasevaluated by interviewing all stakeholders.
Conclusion: Delirium in acute geriatric wards asks for a multifactorial, interdisciplinary, and individualized care approach: all aspects
in which HCPs are well trained. Yet delirium also asks for a FCdC
approach, an aspect that often challenges HCPs. PAR, a relatively
new approach, allowed to develop a tailored FCdC approach. It
offers a ﬂexible trajectory that uses local knowledge and takes into
account possible hindrances.
P-168
Development and validation of the delirium risk assessmentscore (DRAS)
R. Vreeswijk 1 , I. Kalisvaart 2 , A. Maier 3 , C.J. Kalisvaart 1 . 1 Spaarne
Gasthuis, Haarlem (NL); 2 IGZ, Utrecht (NL); 3 VU Amsterdam (NL)
Objectives: Development and validation of a simple clinical prediction rule for identifying patients at risk for delirium during
their hospitalstay. Using evidence based predisposing risk factors
for delirium and easily assessed at hospital admission without theadditional testing or labresults.
Design: A prediction model was developed in a mixed patient
cohort (N=842). Al risk factors were weighed to establish theirrelation with delirium. Validated in 2 orthopedic patientcohorts(N=408, N=365) and in N=365 cohort the DRAS was comparedcalculating AUC, sensitivity and speciﬁcity with 3 other prediction
rules: the Inouye, Kalisvaart and Dutch VMS rules which require amore extensive data collection.
Results: Nine risk factors were analyzed, 8 were signiﬁcantly
predictive and after −2log likelihood calculation for weighing thefactors, the ﬁnal DRAS is obtained by given 3 points to acute admission, alcoholabuse>4 units/day, cognition problems, 2 point to ADL
problems, 1 point to age (>75), hearing/vision problems, polyphar-

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Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

macy (>5), previous delirium. Comorbidities>2 was excluded. The
delirium incidence 31.8%, the AUC 0.76 (95% CI: 0.72–0.79), sensitivity 0.77, speciﬁcity 0.60. At >5 points the delirium risk is considered
positive. DRAS AUC in the validation studies was 0.75 (95 %CI:
0.96–0.81), and 0.76 (95% CI: 0.70–0.83), Kalisvaart AUC 0.74 (95%
CI: 0.67–0.81), Inouye AUC 0.70 (95% CI: 0.62–0.78) and VMS AUC
0.70 (95% CI: 0.62–0.77). DRAS sensitivity ranges from 0.65 to 0.77,
speciﬁcity 0.60 to 0.72.
Conclusion: The DRAS is an easily established delirium risk scorebased on the admission interview using predisposing delirium risk
factors. The simplicity of the DRAS means that the data collection
required is feasible in busy wards without the extra testing orlabvalues. The DRAS performs well in comparison to more elaboratescores.
P-169
Drug prescription and delirium in older persons. Results fromthe Italian Delirium Day 2016
G. Aloisi 1 , A. Marengoni 2 , A. Cherubini 3 , E. Mossello 4 , S. Di Santo 5 ,A. Mazzone 6 , M. Bo 7 , P. Porrino 7 , F. Fimognari 8 , M. Campanini 9 ,M. Montorsi 10 , I. Penco 11 , N. Ferrara 12 , F. Perticone 13 ,M. Trabucchi 14 , A. Morandi 15 , G. Bellelli 16 . 1 Post-graduate School in
Geriatrics, University of Brescia, Brescia, Italy; 2 Department of Clinicaland Experimental Sciences, University of Brescia, Brescia, Italy;
3 Geriatrics and Geriatrics Emergency Care, IRCCS-INRCA; Ancona,
Italy; 4 Department of Experimental and Clinical Medicine, University
of Florence and Azienda Ospedaliero-Universitaria Careggi, Florence,
Italy; 5 Department of Clinical and Behavioral Neurology,
Neuropsychiatry Laboratory, IRCCS Foundation S Lucia, Roma, Italy;
6 Department of Rehabilitation, Redaelli Geriatric Institute, Milan, Italy;
7 SCDU Geriatria e Malattie Metaboliche dell’Osso, Citta’ della Salute edella Scienza Molinette-Torino; 8 Italian Society of Hospital’s andcommunity Geriatrics (SIGOT); 9 Federazione Italiana delle Associazioni
Dirigenti Ospedalieri Internisti (FADOI); 10 Società italiana di Chirurgia;
11 Società italiana di Cure Palliative; 12 Department of Translational
Medical Sciences, University of Naples “Federico II” and Italian Societyof Gerontology and Geriatrics, Italy; 13 Italian Society of Internal
Medicine, Rome, Italy; 14 Department of Systems Medicine, Universityof Rome “Tor Vergata” and Geriatric Research Group, Brescia (Italy);
15 Department of Rehabilitation and Aged Care “Fondazione Camplani”
Hospital, Cremona, Italy; 16 School of Medicine and Surgery, Universityof Milano-Bicocca
Objective: The aim of this study was to evaluate the association
between number of prescribed drug categories and delirium inolder persons.
Methods: Data were collected during the “Delirium Day”, a point
prevalence study including 4810 patients (65+ year-old) acrossacute and long-term wards in Italy. Delirium was assessed on thesame day according to 4AT Score. Prescriptions were classiﬁedby main drug categories. Analyses were carried out in patients
admitted to acute clinical and surgical units (n=2517).
Results: 573 out of 2517 participants had delirium (22.8%). The
mean number of drug categories after the exclusion of psychotropics, i.e. neuroleptics, trazodone and benzodiazepines, was similarin patients with or without delirium (5.2 vs. 5.1, p=0.330). When
we analysed separately patients admitted to clinical (n=2261) andsurgical units (n=256), we found that patients admitted to surgical units and diagnosed with delirium were prescribed with ahigher number of drugs than those without delirium (6.5 vs. 4.7,
p<0.001). This association was still signiﬁcant after adjustment forage, sex, education, dementia and the Charlson Index (OR=1.3;95%
CI: 1.1–1.5). No prescription of psychotropic medications was inversely correlated with delirium in the whole sample (adjusted
OR=0.54;95% CI: 0.43–0.68) and in the two hospital settings.
Conclusions: The association between number of drugs and delir-

ium varies by hospital setting being signiﬁcant only in surgical units
and rising the issue of medication reconciliation in those units. The
inverse association between no prescription of psychotropics anddelirium could be a proxy of the absence or a lower severity ofmental diseases.
P-170
Factors associated with delirium superimposed on dementia:
The results of the “Italian Delirium Day 2016” study
A. Morandi 1 , A. Zambon 2 , A. Mazzone 3 , S. Di Santo 4 ,A. Cherubini 5 , E. Mossello 6 , A. Marengoni 7 , S. Gentile 1 , M. Bo 8 ,F. Fimognari 9 , M. Campanini 10 , M. Montorsi 11 , I. Penco 12 ,F. Perticone 13 , N. Ferrara 14 , M. Trabucchi 15 , G. Bellelli 2 .
1 Department of Rehabilitation and Aged Care “Fondazione Camplani”
Hospital, Cremona, Italy; 2 School of Medicine and Surgery, Universityof Milano-Bicocca; 3 Redaelli Geriatric Institute, Milan, Italy;
4 Department of Clinical and Behavioral Neurology, Neuropsychiatry
Laboratory, IRCCS Foundation S Lucia, Roma, Italy; 5 Geriatrics andGeriatric Emergency Care, IRCCS-INRCA, Ancona, Italy; 6 Research Unitof Medicine of Ageing, Department of Experimental and Clinical
Medicine, University of Florence and Azienda OspedalieroUniversitaria Careggi, Firenze, Italy; 7 Department of Clinical andExperimental Sciences, University of Brescia, Italy; 8 Section ofGeriatrics, Città della Salute e della Scienza – Molinette, Torino, Italy;
9 Italian Society of Hospital’s and community Geriatrics (SIGOT);
10 Federazione Italiana delle Associazioni Dirigenti OspedalieriInternisti (FADOI); 11 Società italiana di Chirurgia; 12 Società italiana diCure Palliative; 13 Italian Society of Internal Medicine, Rome, Italy;
14 Italian Society of Gerontology and Geriatrics (SIGG; 15 Italian
Psychogeriatric Association (AIP)
Objective: Few studies have investigated delirium superimposedon dementia (DSD) showing an association with mortality andfunctional declined. However, no studies have studied factors
speciﬁcally associated with DSD. To ﬁll the current gap we havedesigned the current investigation to evaluate factors associatedwith DSD in patients admitted to acute hospital and rehabilitation
settings.
Methods: This was part of the “2016 Delirium Day”, an Italianmulticenter study to evaluate the delirium point prevalence amonga large number of older patients (65 years and older) admitted
to acute medical and surgical hospital wards and long-term carefacilities. Dementia was deﬁned through clinical records. Delirium
was determined with the 4-AT. A multivariable logistic regression
was used to determine factors associated with DSD, deﬁned a priori.
Results: A total of 908 patients with dementia were included and424 (47%) had delirium. The mean age was 85±6 years. A total of
577 (64%) were evaluated in acute hospitals and 331 (36%) in rehabilitations. Factors associated with DSD were severe malnutrition(Odds Ratio: 2.1, 95% Conﬁdence Intervals: 1.27–3.16), prescriptionof antibiotics (OR 1.6, 95% CI: 1.16–2.26), typical and atypical neuroleptics (OR 1.71, CI: 1.16–2.5; OR 1.6, CI: 1.6–2.3), presence of
intravenous lines (OR 1.56, CI: 1.14, 2.14), urinary catheter (OR 1.8,
CI: 1.31–2.58), and wrist bends (OR 13.5, CI: 1.7–104).
Conclusions: The current study reports speciﬁc factors associatedwith DSD in patients admitted to acute hospital and rehabilitation
setting, suggesting possible areas of interventions to reduce theburden of DSD related outcomes.
P-171
How to ﬁght the delirium of ages: A position paper from an
Italian interdisciplinary experience
C. Paolillo 1 , G. Bellelli 2 , M. Trabucchi 3 , F. Perticone 4 ,M.P. Ruggieri 5 , N. Ferrara 6 , C. Tommasino 7 , A. Ferrari 8 , P. Gnerre 9 ,G. Ricevuti 10 . 1 Emergency Department, Udine Healthcare andPoster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

University Integrated Trust; 2 Università degli Studi di Milano-Bicocca,
SCC Geriatria, AO San Gerardo, Monza, Italia; 3 Università di Roma “TorVergata”, Roma, Italia, PRESIDENTE AIP; 4 Department of Medical andSurgical Sciences, University Magna Graecia of Catanzaro, Italy,
PRESIDENTE SIMI; 5 Medicina d’Urgenza e Accettazione, Ospedale San
Giovanni Addolorata, Roma, Italia, PRESIDENTE SIMEU; 6 Medicina
Interna e Geriatria, Università degli Studi di Napoli “Federico II”,
Napoli, Italia, Presidente SIGG - Società Italiana di Gerontologia e
Geriatria; 7 Dipartimento di Scienze Biomediche, Chirurgiche ed
Odontostomatologiche, Università di Milano, ASST Santi Paolo e Carlo
Polo Universitario, Milano, Italia, SIAARTI; 8 UOC di Geriatria, ASMNAzienda Ospedaliera di Reggio Emilia, Italia, PRESIDENTE SIGOT;
9 Medicina, Ospedale San Paolo di Savona, Italia, FADOI; 10 Azienda
Servizi alla Persona, S. Margherita Institute, Pavia, Italy, Department ofInternal Medicine and Therapeutics, Section of Geriatrics, University ofPavia, Italy
Over the age of 80 years, more than one third of those in hospitalwill experience Delirium. Despite its high prevalence, delirium
often goes undetected and undetected delirium is associated withthe highest mortality. Delirium prevalence is not bound by specialty
and crosses over to both hospital and community settings. Given
its ubiquity and its heterogeneous presentation, delirium diagnosis
and management is the responsibility of all clinicians. To help
address the need of develop a cultural movement that stressed
early identiﬁcation and the immediate removal of predisposing
factors that can made an old patient more susceptible to delirium, in February 2017 an interdisciplinary group of clinicians andresearcher belonging to ﬁfteen Italian Scientiﬁc Societies (geriatricians, emergency physicians, internal physicians, anesthesiologists,surgeons, psychiatrists and toxicologists) shared ideas on advancing
the best care practices in this ﬁeld. After a review of internationalguidelines a writing group composed a draft and turned aroundby email, than after picking up suggestions and modiﬁcations theﬁnal document was produced. In summary, the document focusedon the need of diagnosing delirium and the opportunity of acomprensive patient-care program that prevents delirium. A little
attention was given to pharmacological therapy, last beach only
when the patient is in danger. To make the document as widely
know as possible, it will be published in the Oﬃcial Journal of theSocieties in the coming months. We believe that only by involving
all team members within the hospital we can ﬁght that so common
syndrome.
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Impaired cognition is highly prevalent and independently
associated with adverse outcomes in older patients presenting
to the emergency department; the APOP study
J. Lucke 1 , J. de Gelder 2 , C. Heringhaus 1 , J. Fogteloo 3 , S. Anten 4 ,G.J. Blauw 2 , B. de Groot 1 , S. Mooijaart 5 . 1 Department of Emergency
Medicine, Leiden University Medical Center, Leiden, The Netherlands;
2 Department of Gerontology and Geriatrics, Leiden University Medical
Center, Leiden, The Netherlands; 3 Department of Internal Medicine,section of Acute Care, Leiden University Medical Center, Leiden, The
Netherlands; 4 Department of Internal Medicine, section acute care,
Alrijne Hospital, the Netherlands; 5 Department of Gerontology andGeriatrics, Leiden University Medical Center, Leiden, The
Netherlands/Institute for Evidence-based Medicine in Old Age (IEMO),
Leiden, The Netherlands
Introduction: We investigated whether impaired cognition is associated with adverse outcomes in older emergency department (ED)patients, because this association could have large implications for
ED management and follow-up after disposition.
Methods: A prospective multi-center cohort study was performed
in all acutely presenting older patients visiting the ED (APOP study).

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Demographic data, disease severity and geriatric characteristics
were collected during the ﬁrst hour of the ED visit. Cognition wasmeasured using the 6 Item Cognitive Impairment Test (6CIT). Cognitive impairment was deﬁned as a 6CIT ≥11, self-reported dementia
or the inability to perform the cognition test. Adverse outcome
after three and twelve months was deﬁned as a 1 point decreasein Katz-ADL, new institutionalization or mortality. Multivariable
regression analysis was used to assess whether impaired cognition
independently associates with adverse outcome.
Results: Of the 2131 included patients 588 (27.6%) had cognitive
impairment. A total of 375 (24.5%) patients with normal cognition
suffered from adverse outcomes after three months, comparedto 280 (47.8%) patients with impaired cognition. The association
remained after correction for baseline functional status, disease
severity and comorbidities (OR 1.71, 95% CI: 1.36–2.15). After twelve
months 332 (27.9%) patients with normal cognition suffered fromadverse outcome, compared to 240 (54.5%) patients with impaired
cognition (adjusted OR 1.89, 95% CI: 1.46–2.46).
Conclusions: Cognitive impairment is highly prevalent in older ED
patients and is associated with adverse outcome after three andtwelve months, independent of baseline functional status, disease
severity and comorbidities. This emphasizes the importance for ED
physicians to assess cognition and possibly intervene.
P-173
Improving behaviour documentation in the acute hospitalsetting
K. Spensley, O. Wilks, L. Tsam. West Middlesex University Hospital,
London, England
Introduction: Behaviour charts are used in hospitals to assist
clinical staff in providing best care for dementia patients withchallenging behaviour (BPSD), and also to assist discharge planning. Staff are poorly compliant with current charts resulting in
sub-optimal care with increased falls risk, discharge delays andreadmissions. A new behaviour chart was thus needed to addressthese issues and aid staff compliance in chart completion.
Methods: Our population consisted of patients over 65 admitted toan acute medical ward with BPSD. No staff had specialist training
for dementia care. A new chart was introduced which consisted
primarily of tick boxes. Using questionnaires, we gathered subjective data about staff perceptions towards the old compared to the
new charts, namely ease of completion and clinical relevance. We
also compared objective data regarding chart completion, length ofpatient stay and patient fall frequency on both charts.
Results: Our preliminary results showed that accurate behaviour
documentation increased from 38.0% to 73.3% (p<0.05) following
new chart implementation. Useful differentiation between aggressive and calm behaviours were identiﬁed in 90% of new charts
compared with 12.5% of the old (p<0.05), and identiﬁcation of
BPSD-triggers doubled. Additionally, staff satisfaction with the newcharts increased from 17.54% to 100% (p<0.05). A preliminary
correlation was noted between new chart use and reduced lengthof stay, although further results are awaited.
Conclusion: The new behaviour chart was well received by staff,
which has improved engagement and positive outcomes for patients.
P-174
Multifactorial pathogenesis and multicomponents treatment of
delirium: A case report in Geriatric Intensive Care Unit (ICU)
S. Venturini, F.M. Nigro, C. Ghiara, M. Torrini, E. Mossello. GeriatricIntensive Care Unit (UTIG), AOU Careggi, University Study of Florence,
Florence, Italy
Background: In elderly, delirium is associated with increase ofS90

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

mortality, extension of hospitalization, loss of functional autonomy.
It’s indicated to adopt preventive measures, identify the causes,
consider the psychoactive therapy in case of persistent agitatedbehavior.
Case: Man, 77 years old, affected by hypertension, diabetes, chronic
kidney failure, who was hospitalized in Geriatric ICU because of
myocardial infarction undergoing PTCA and stenting. The hospitalization was complicated by haemopericardium, anemia, acuteexacerbation of chronic kidney failure undergoing CVVHDF, nosocomial pneumonia treated with ﬂuoroquinoloni. Fourty-eight hours
from hospitalization, developed hyperkinetic delirium with persecutory ravings. In his medical history it’s not present cognitive
impairment; at the admission in the hospital, it was suspended
triazolam, taken to sleep.
Results: The patient, initially sedated under continuous infusion
with midazolam, in order to safety make CVVHDF, even if he was
moved in an ordinary medical division, delirium has not beensolved. He has been moved again in ICU where, once deep sedation
i.v. has been carried on, he has started treatment with antibiotic,
has been hydrated and feed with N.G. tube.
Conclusion: As well as myocardial infarction, infective state, renal
failure, other reasons are the recovery in ICU, the suspension ofchronic therapy with benzodiazepine and the choose of ﬂuoroquinoli. The administration of antipsychotic and the transfer inordinary medical division were not been suﬃcient. The solution is
obtained through intensive therapy, via deep sedation that makes
possible therapies of vital support, nutrition and hydration, tofollow second line of antibiotic therapy and to treat a possible
abstinence from benzodiazepine.
P-175
Precipitating factors for delirium in community-dwellingelderly individuals: a prospective case series
H. Lepetitcorps 1 , M. Pociumban 2 , Z. Bouksani-Kacher 2 , E. Pautas 2 ,J. Belmin 2 , S. Bastuji-Garin 3 , C. Lafuente-Lafuente 2 . 1 Service deGériatrie aiguë, Hôpitaux universitaires Pitie-Salpêtrière-Charles Foix,
APHP, DHU FAST, Sorbonne Universités, UPMC Univ Paris 06, F-75013,
Paris, France; 2 Hôpitaux universitaires Pitie-Salpêtrière-Charles Foix,
APHP, DHU FAST, Sorbonne Universités, UPMC Univ Paris 06, F-75013,
Paris, France; 3 Clinical Epidemiology and Ageing team (CEPIA), Service
de Santé Publique, CHU Henri Mondor, F-94010, Créteil, France
Factors associated with delirium among community-dwelling oldpatients have not been extensively studied. Our aim was to investigate them. Consecutive patients admitted from home to threegeriatric acute care units with a conﬁrmed initial diagnosis of delirium were included. An independent investigator recorded using apredeﬁned form any acute organic medical condition considered
to be a precipitating factor, at the ﬁrst patient assessment andat the end of his stay in acute care unit. The main objective
was to describe the frequency of predisposing and precipitating
factors for delirium in these patients. A secondary objective wasto know if all precipitating factors were correctly recognized atpatients’ ﬁrst assessment at hospital. A total of 208 patients were
included, of whom 74.0% had a pre-existing cognitive disorder and24.0% a history of neurological disease. The most frequent precipitating factors found were: 1) infections (49.0% of all patients),
especially respiratory (22.1%) and urinary tract infections (15.4%);
2) dehydration and electrolytic disturbances (45.7%); and 3) drugs(30.8%). Acute neurological conditions were found only in 38 patients (18.3%). Fewer precipitating factors were found at ﬁrst thanat ﬁnal assessment (1.4 per patient ±0.9 versus 1.9±1.02 respectively, p<0.001). This difference was signiﬁcant for all categories
of precipitating factors. Infections, hydro-electrolytic disorders anddrugs seem to be the most frequent precipitating factors for delirium in community-dwelling elderly individuals. In all categories, asigniﬁcant number of precipitating factors are missed at the ﬁrst
evaluation of patients.
P-176
Prevalence and outcomes of delirium in older persons:
The results of the “Italian Delirium Day 2016” study
G. Bellelli 1 , A. Zambon 1 , A. Morandi 2 , A. Mazzone 3 , S. Di Santo 4 ,A. Cherubini 5 , E. Mossello 6 , A. Marengoni 7 , M. Bo 8 , F. Fimognari 9 ,M. Campanini 10 , M. Montorsi 11 , I. Penco 12 , F. Perticone 13 ,N. Ferrara 14 , M. Trabucchi 15 . 1 University of Milano-Bicocca, Milan,
Italy; 2 Fondazione Camplani Hospital, Cremona, Italy; 3 Redaelli
Geriatric Institute, Milan, Italy; 4 IRCCS Foundation S Lucia, Roma,
Italy; 5 Geriatrics and Geriatric Emergency Care, IRCCS-INRCA, Ancona,
Italy; 6 University of Florence and Azienda Ospedaliero-Universitaria
Careggi, Firenze, Italy; 7 University of Brescia, Italy; 8 Città della Salute edella Scienza – Molinette, Torino, Italy; 9 Italian Society of Hospital’s
and community Geriatrics (SIGOT), Roma, Italy; 10 Federazione Italianadelle Associazioni Dirigenti Ospedalieri Internisti (FADOI), Roma, Italy;
11 Società italiana di Chirurgia, Roma, Italy; 12 Società Italiana di Cure
Palliative, Milano, Italy; 13 Italian Society of Internal Medicine, Rome,
Italy; 14 Italian Society of Gerontology and Geriatrics (SIGG], Firenze,
Italy; 15 Italian Psychogeriatric Association (AIP), Brescia, Italy
Objective: To evaluate the prevalence of delirium and the 1-monthmortality associated with in older hospitalized persons.
Methods: The “2016 Delirium Day” is an Italian multicenter study
to evaluate the delirium point prevalence among older patients(65+ yo) admitted to acute medical and surgical hospital wards andlong-term cares facilities. Delirium was assessed on an index day(Sept 27th, 2016) according to 4AT score. One-month mortality wasevaluated at follow-up. Analyses for the present study were carriedout only in patients with 1-month follow-up after admission toacute clinical and surgical units (n=2480), post-acute care (n=540)
and hospice (n=47).
Results: Overall, 527 (21.3%) in acute hospitals had delirium, while
74 (13.7%) in post-acute care and 20 (42.6%) in hospices. Amonghospital wards, delirium prevalence was 25.7% in Geriatrics, 9.3%
in Cardiology, 8.0% in General Surgery, 18.0% in in-hospital rehabilitation, 13.3% in Infectious diseases, 19.1% in Internal Medicine,
5.9% in Neurosurgery, 26.9% in Neurology and 15.9% in Orthopedics.
At 1-month follow-up, the rate of mortality was 10.0% in patientswith delirium vs 3.3% in those without. In a multivariate analysis,
adjusted for age, education, setting, Charlson Comorbidity index,
dementia and Activities of Daily L score, delirium was independently associated with the 1-month mortality (Odds Ratio: 1.81,
95% Conﬁdence Intervals: 1.18–2.77, p-value =0.006).
Conclusions: The data conﬁrm the ﬁndings of the “2015 Delirium
Day” edition, i.e., that >1/5 patients had delirium in acute hospitals
and also suggest that delirium is an independent predictor ofshort-term mortality in older hospitalized patients.
P-177
Private rooms and prevention of delirium
A. Gade Holdensen, L. Madsen Fredholm. Hospital Lillebælt, Kolding,Denmark
Introduction: In October 2016 the Geriatric Ward at Hospital Lillebælt Kolding moved into new buildings. The old ward consisted ofthree four-bed rooms and three two-bed rooms, to a summary of
18 beds. The new ward consists of fourteen one-bed rooms and one
two-bed room, to a summary of 16 beds. In the old ward constantinterruptions were a part of day and night, and many patients
had trouble sleeping. In the new ward there is a much calmer
environment due to the private rooms and therefore we suspectthat fewer patients develop delirium.
Methods: To investigate the suspected decrease in delirium wePoster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

assessed the use of haloperidol, as it is our ﬁrst choice drug inthe treatment of delirium. We assessed the daily dosages (DDD) of
haloperidol per admitted patient in November 2015–March 2016 in
the old ward and in November 2016–March 2017 in the new ward.
Results: The average use of haloperidol was 0.111 DDD per admitted
patient in the old ward and 0.056 DDD per admitted patient in the
new ward.
Conclusions: The use of haloperidol has decreased by 50% after
moving into the new ward. We have had the same staff, thesame assessment methods for delirium, and our clinical guideline
hasn’t changed between the two periods. The only difference isthe structure of the ward. It is well known that facilitating a calm
environment and securing sleep are major factors in preventing
delirium. This study supports that knowledge.
P-178
Renal function is predictive of delirium in the orthogeriatricsetting: the role of cystatin C
G. Rivasi 1 , V. Tortù 1 , A. Ceccoﬁglio 1 , I. Iacomelli 2 , M. Rafanelli 1 ,A. Cartei 3 , C. Rostagno 3 , A. Ungar 1 . 1 Dept. of Geriatrics, University of
Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy;
2 Dept. of Internal Medicine, Santa Maria alla Gruccia Hospital,
Montevarchi (AR) Italy; 3 Dept. of Cardiology, University of Florence,
Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
Background: The occurrence of delirium is common in older hospitalized patients, particularly after surgery. There are no studies
reffering to the association between delirium and renal function in the orthogeriatric-setting. Aim: To evaluate the predictive
value of renal function in determining the risk of delirium in theorthogeriatric-setting.
Methods: Patients aged ≥65 consecutively referred to the orthogeriatric department for traumatic bone fractures were enrolled.
Six equations were used to estimate glomerular ﬁltration rate(eGFR) based on serum creatinine and/or cystatinC values obtained
within 24hours of admission: Modiﬁcation of Diet in Renal Disease(MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKDEPI) equations based on creatinine (CKD-EPIcr) and/or cystatin C(CKD-EPIcys, CKD-EPIcr-cys) and Berlin Initiative Study equations(BIS1 and 2). During hospitalization, delirium was assessed using
the Cognitive Assessment Method algorithm. The predictive valueof renal function was tested on the basis of creatinine and cystatinClevels and creatinine- and cystatinC-based eGFRs.
Results: 571 patients were enrolled (76.7% female; mean age
82.7±8.2 years). 73% of patients had serum creatinine≤1mg/dL. 192
patients (33.6%) had delirium: they had higher cystatinC levels(p<0.001) and a lower eGFR, regardless of the equation used. At
multivariate analysis, a low CKD-EPIcys eGFR was predictive of
delirium (OR 0.957; CI 0.918–0.998 p=0.042), with a 4% increased
risk for each mL/min of decreasing eGFR. Equations using creatinineor creatinine-cystatinC together did not predict the development of
delirium.
Conclusions: CKD-EPIcys eGFR is a predictor of delirium in orthogeriatric patients with sarcopenia and low creatinine levels.
CystatinC-based eGFR may help improving patient management
during hospitalization.
P-179
Suspicious minds
S. Ponnambath 1 , R. Hinton 1 , M. Devlin 1 , J. Tam 2 , K. Franks 2 ,A. Miller 1 , F. Rickard 1 , P. Toh 1 . 1 University Hospitals Bristol NHS
Foundation Trust, Bristol, United Kingdom; 2 Queen Elizabeth Hospital,
Gateshead, United Kingdom
Case report: A 91 year old lady presented to hospital with poor
mobility, with concern from her residential home that she was

S91

engaging less with staff and fellow residents. On initial assessment she appeared very suspicious and had particularly negative
thoughts towards the staff at her residence. She hadn’t been eating,believing that she was being poisoned and even felt that her family
were conspiring against her. Examination revealed mild dysarthria
and unsteady gait. Routine blood tests were unremarkable andCT brain revealed an old right occipital infarct and small vessel
disease. After taking a careful collateral history it appeared that
her suspicious thoughts began following an episode diagnosed asa TIA four months prior to her presentation. This behaviour persisted across a number of different environments and was having
a hugely negative impact on her life and family relationships. She
was reviewed by the psychiatrist and was given the diagnosis oforganic psychosis secondary to TIA. She was started on low dose
antipsychotics and made a dramatic improvement within a week.
Conclusion: This case demonstrates that TIA and stroke may result in atypical neuropsychiatric presentations, which are likely topresent to psychiatry. This emphasises the importance of thoroughinvestigation and highlights the valuable role antipsychotics canplay in the elderly despite the risks attached to such therapies.

Area: Ethics and end of life care

P-180
Allow natural death: Do words matter
E. Kamp, J. Wright, R. Saad, E. Mucci. East Sussex Healthcare Trust
Introduction: There has been numerous anecdotal reports fromdoctors at East Sussex Healthcare Trust about the diﬃculties in
discussing resuscitation with patients. The wording of Do Not
Attempt Cardiopulmonary Resuscitation (DNACPR) is negative anddetrimental to these discussions. The Gold Standard Framework and
GMC recognise an alternative wording: Allow Natural Death. Our
project looks to change the wording to Allow Natural Death (Do Not
Attempt Cardiopulmonary Resuscitation).
Method: An online survey was emailed to all doctors at ESHT
over a four week period. We received 132 responses from FY1 toconsultant.
Results: There were many reasons why doctors felt patients disagreed with DNACPR decisions. 43% felt the wording of DNACPR
forms contributed. Other factors included: poor understanding of
CPR prognosis (82%), poor understanding of their prognosis (67%)
and family member inﬂuence (55%). On a scale of 0 (very negative)- 5 (very positive) the wording of DNACPR scored 2.55 compared to
3.74 for AND (48% improvement). 66% felt substitution of DNACPR
with AND (DNACPR) would help counteract poor patient response.
Perceived barriers to this change included: diﬃculty changing
established protocol (34%) and confusion for medical staff (44%).
Conclusion: Numerous factors contribute to patient resistance toresuscitation decisions and the wording of DNACPR forms was
one these. Doctors felt that re-wording these forms to AND(DNACPR) would help discussions. In the coming months there will
be educational events promoting this form in conjunction withgood discussion technique. The proposal will be submitted to theresuscitation and end of life committees.
P-181
Association between education and status of receiving careamong community dwelling older adults in Iceland
M. Chang 1 , O.G. Geirsdottir 2 , A. Ramel 3 , I. Kåreholt 4 ,S.H. Sigurdarsdottir 5 . 1 The Icelandic Gerontological Research Center,
National University Hospital of Iceland & Faculty of Medicine,
Reykjavik, Iceland/School of Science and Engineering, Reykjavik

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Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

University, Reykjavik, Iceland; 2 The Icelandic Gerontological Research
National University Hospital of Iceland & Faculty of Medicine,
Reykjavik, Iceland/Unit for Nutrition Research, National University
Hospital of Iceland & Faculty of Food Science and Nutrition, Universityof Iceland, Reykjavik, Iceland; 3 Unit for Nutrition Research, National
University Hospital of Iceland & Faculty of Food Science and Nutrition,
University of Iceland, Reykjavik, Iceland; 4 Aging Research Center,
Karolinska Institute, Stockholm, Sweden/Institute of Gerontology andAging Research Network, School of Health and Welfare, Jönköping
University, Sweden; 5 School of Social Science, University of Iceland,
Reykjavik, Iceland
Background: Older adults in Iceland have a good access to thehealth care and social services that support elderly to maintain independent living. Receiving informal care is common among older
adults living in Iceland. The aim of this study is to analyze whether
education is associated with the use of formal and informal careamong older adults in Iceland.
Methods: The survey of Icelandic older people was conducted in2008. The study population was a national sample of 721 persons
aged 65 years and older living in Iceland. Older adults living in
nursing homes were excluded from the survey. A telephone survey
included questions on socioeconomic status (education and occupation), social network, health status, activities of daily living, andthe status of received help either from the community elderly caresystem and/or from close family members and friends.
Results: Among the total sample, 372 (52%) people reported to receive either type of care. Among those who received care, 197 (53%)
people reported receiving informal care only. The status of receiving
informal care had shown that people with higher education had asigniﬁcantly lower risk to receive informal care compared with people with lower education (odds ratio (OR) 0.67, 95% CI, 0.47–0.97,
p=0.031), however formal care was not signiﬁcantly associated witheducation level.
Conclusions: Informal care which is provided from the social network and family members are an important source for the elderly
care system in Iceland. The contribution of informal care/helpshould be recognized when preparing the care of older people.
P-182
Caregiver burden in older patients with cancer or dementia
J. Massias 1 , N. Oubaya 2,3 , E. Audureau 2,3 , S. Herbaud 1 , E. Alonso 1 ,M.-A. Cariot 1 , F. Canouï-Poitrine 2,3 , E. Paillaud 1,2, *, M. Laurent 1,2, *.
1 AP-HP, Hôpitaux universitaires Henri Mondor, Département demédecine interne et gériatrie, France; 2 UPEC, DHU A-TVB, IMRB, EA
7376 CEpiA (Clinical Epidemiology And Ageing Unit); 3 AP-HP,
Hôpitaux universitaires Henri Mondor, Service de santé publique*These authors contribute equally to this work
Introduction: The caregiver burden must be taken into account inchronic disease such as dementia or cancer in older patients. Levelof the caregiver burden and factors associated with this burden arelittle known.
Objectives: To assess caregiver burden measured with Zarit BurdenInterview (ZBI) in older patients with cancer or dementia, and to
identify clinical factors associated with this burden.
Methods: This was an observational, cross sectional study of ambulatory individuals aged 70 and older. Patients were referred togeriatric clinic in French teaching hospital between 01/11/2013 and01/06/2016. 52 cancer patients (group 1) were age- and gendermatched with 100 patients with dementia (group 2). We used linear
regression and multi-level model to assess factors associated withZBI increase.
Results: 152 patients with a median age (81.9 years group 1/82.2
years group 2) presented similar sociodemographic characteristics.
The median ZBI score was lower in group 1 (14 IQR [7–25]) than ingroup 2 (26 [16–43]), (p<0.00001)). Factors independently associated with caregiver burden were the degree of illness – metastatic
disease in group 1 (p=0.06 and Mini Mental State Examination <10in group 2 (p=0.006), and functional impairment (Activities of Daily
Living score<6- p=0.06 for group 1 and 0.04 for group 2).
Conclusion: Although the caregiver burden is higher in patientswith dementia than in cancer patients, associated factors are similar
in both groups. The follow-up of caregiver burden and its predictive
factors is required to identify most vulnerable caregivers who aremost likely to need speciﬁc support.
P-183
Clinical audit: quality of end-of-life care in Long term carefacilities in Western France in 2015
J. Prud’homme 1 , K. Hammas 2 , A. Corvol 1 , D. Somme 1 . 1 Rennes
University Hospital, Geriatric Department; 2 Rennes University
Hospital, Public Health Department
101 long-term care (LTC) facilities are spread over Western France
out of 572 in all country. In 2006, French Court of Audit considers
that information systems do not give any information on the
end-of-life in LTC facilities. This tranversal study is evaluating thequality of palliative care in LTC facilities between October 2015, the15th and November 2015, the 15th in Western France. The outcome
measure used was the Family Perception of Care Scale, translated
in French. 70 LTC facilities were contacted. 12 participated. 37
deceased patients were identiﬁed. Over 20 family answers, 17 ﬁlled
the questionnary. Families’ satisfaction total mean (± SD) was very
high 145 (±25.1) as well as the sub-scales means (±SD): 63 (± 13.4)
for residents care, 33.6 (± 6) for family support, 36.8 (± 5.8) for
communication, and 11.6 (± 2.3) for rooming. The 3 priority items
for providing quality end-of-life care were “My family member’s
pain was eased by to the greatest extent possible”, “The staff
were sensitive to the needs of my family member”, and “The staff
informed me when they thought that death was at hand”. Those
results are opposite to diﬃculties reported by half of the LTC practitioners, especially about lack of time, lack of human and ﬁnancial
ressources and trainings. Ceiling effect and polarized answers seemto limit the data analysis. Other larger quantitative and qualitative
studies appear to be led as end-of-life care in LTC departments
belong to usual practice and is under-assessed.
P-184
Evaluation of quality indicators for patients with palliative or
end-of-life care in primary health care
L. Sierra-Martínez 1 , R. Martinez-Fuerte 1 , N. Sanz-González 2 .
1 Valladolid Este Primary Assistance Gerency, Valladolid, Spain; 2 JCyL
Social Services Gerency, Valladolid, Spain
Background and aim: Study on the quality of clinical care forpatients Palliative or End-of-Life Care assigned in a Primary Care
Health Center (HC) and to compare them with patients in the
Health Area (HA) and the autonomous community of Castile andLeón (CyL), Spain. (during the period 2015).
Method/Design: Longitudinal evaluation: Palmer’s Quality Cycle.
Setting: An urban health care center. Population and Sample:
Patients (total according to inclusion criteria, year 2015) with
Palliative or End-of-Life Care (n=23). Interventions: Internal evaluation, dimensions: scientiﬁc-technica, quality, adequacy, accessibility, continuity of care; data related to the care process andintermediate results; explicit, evidence-based procedural criteria.
Subjects: analysis of coverage. Analysis on the evolution of treatment compliance. The Z statistical test for comparing proportions,alpha 0,05.3.
Results: Compliance criteria (year 2015): – Number of patients with
the Palliative or End of Life guide, active at least one day in thePoster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

period 2015: HC 23 patients, HA 499 patients, CyL 2026 patients.
– How many have recorded the Visual Analog Pain Scale (VAS) in
the period 2015?: HC 1 patients (4,35%), HA 80 patients (16,03%),
CyL 498 patients (24,98%). – How many have registered skin andmucous care in the period 2015?: HC 0 patients (0%), HA 96 patients(19,4%), CyL 473 patients (23,35%).
Conclusions: The analysis of the records of care process indicators
for patients with patients Palliative or End-of-Life Care makes usaware of the importance of patient control. Registration allows us
to evidence improvements in the care process. To make a goodregistry of the controls, to adapt the interventions with the patient,
adapting them to each case. After our analysis we say that wemust improve the uptake of patients with patients Palliative or
End-of-Life Care and the quality of the records of the care process.
P-185
Gastrostomy’s implantation in the geriatric patient: survival
analysisT. Martínez Maroto, V. Landaluce Pelligra, E. García Tercero,
M. Araujo Ordóñez. Hospital Virgen del Valle, Toledo, Spain
Introduction: Gastrostomy’s implantation in the elderly patient
supposes in many times an ethical issue, especially in relation
to the effectiveness of them extending the life of our patients.
The decision to place the gastrostomy involves, among others, theassessment of the cause of dysphagia.
Study design: Retrospective study in patients older than 75 years
who underwent gastrostomy’s implants due to different causes.
Sample: Patients older than 75 years, hospitalized in the Geriatrics,
Internal Medicine and Neurology departments of Toledo Hospital Complex, in the period from 2011 to 2016, who underwent
gastrostomy’s implants during admission.
Material and methods: For our study, we used a collection notebook with different variables including dysphagia, patient comorbidity, cognitive and functional status, age, place of residence, typeof enteral nutrition, post-implant survival and cause of death If it
had happened.
Results: Sample of 197 patients, 53.3% women. Regarding the causeof dysphagia, in 29.9% of patients it was cerebrovascular accident, in
60.7% the cause was cognitive impairment in different stages and in
the remaining 9.4% it was motivated by other reasons. The service
that most requested the placement of gastrostomy was Geriatrics
department. In 50.3% of the cases, the diet used was normoproteic
and normocaloric. Regarding the survival after gastrostomy, themedian was 16 months (95% CI: 8.78–23.21). In subgroup analysis,
survival after stroke was 22 months (95% CI: 4.15–39.8) and in 17month (moderate-severe) dementia (95% CI: 5.77–28.22) Without
appreciating signiﬁcant differences between them (p: 0.984).
Conclusions: After the analysis, we conclude that the underlying
pathology or the cognitive status should not be an impediment
to the initiation of enteral nutrition, since we did not appreciatesigniﬁcant differences in mean survival after implantation.
P-186
How do the doctors live mourning in their wards?
R. Fernandes, F. Leal-Seabra, A.R. Ramos, P. Monteiro, P. Caiano-Gil,
R. Veríssimo, V. Paixão-Dias, A. Oliveira. Internal Medicine Service,
Centro Hospitalar de Vila Nova de Gaia-Espinho, Oporto, Portugal
The recognition of human ﬁnitude is essential to the knowledge of
all health professionals, since death will be part sooner or later of
their daily lives. Observational, Cross-sectional study, conveniencesampling. Included all the physicians who worked at the Internal
Medicine/Geriatrics wards. An anonymous online questionnaire
was created with Googleforms® , with 47 multiple choice questions
evaluating sociodemographic issues, professional experience andS93

training skills in Clinical Communication (CC), Palliative (PC) andMourning Care (MC). The response rate was 32% (56/175). Therefore
75% were female, 71.4% residents, with 25–30 years old (53.6%).
Most of them (43%) were working less than 1 year. Negative
answers for training skills in PC (57.1%), CC (71.5%) and MC (58.9%).
It is agreed the universal need of MC training (94,6%), because
47,9% are incapable of answering the patients’ needs. Death is anatural process (100%), 12.5% of these professionals had advanced
directives of will (ADW) and about 10% are in mourning. Whena patient dies 87.5% can give bad notices by telephone and 97.4%
personally, but 46% with diﬃculty. The majority (80.4%) feel thatdeath isn’t a clinical failure, 85,7% include the patient/caregivers
in decision-making and 71.5% talk about the patients’ ADW. Then
62.5% can recognize non-adaptive mourning. After the patient’s
death, 5.4% make telephonic contact and around 10% schedule
meetings. Only 5.4% participated in the funeral celebrations. Universal training skills in this area is required, both at the pre-graduate
and post-graduate levels since most of these professionals are very
young and with lack of experience.
P-187
Improvement in DNACPR discussion and form completion inelderly oncology patients
N. Rajcoomar, Z. Ali, S. Holikova, S. Tahir. Broomﬁeld Hospital, Mid
Essex Hospitals NHS Trust, Chelmsford, UK
Introduction: The General Medical Council and Resuscitation
Council UK guidance advises a Do Not Attempt Cardio Pulmonary
Resuscitation (DNACPR) discussion and form should be consideredin patients with advanced disease, irreversible disease or those
approaching end of life. The project aim was to improve forward
planning with early DNACPR decisions in elderly oncology patients.
Methods: We identiﬁed 30 patients over 65 years with end stage
cancer who were audited for DNACPR discussion and form completion. The 1st round interventions included audit result feedback,and teaching. 2nd round interventions included prompting seniorDoctors, increasing DNACPR form availability and addition of a
DNACPR status on the ward list. Re-audits post intervention was
performed to assess improvement.
Results: A n initial audit showed 12 (40%) patients had a DNACPR
discussion and form documented. Following 1st round interventions there was an improvement to 20 (67%) patients, and post
2nd round interventions a further improvement to 26 (87%) of 30
patients, with a DNACPR discussion and form documented.
Conclusions: The project showed that audit feedback, teaching, prompting Senior Doctors, increased form availability and a
DNACPR section on the Oncology patient list, encouraged goodpractice. In turn this improved early and timely DNACPR discussion
and form completion to 87% in elderly end stage oncology patients.
P-188
Inhospital mortality risk model in very old patients admittedwith descompensated congestive heart failure. A view frompalliative careJ. Marttini Abarca, L. Fernandez Arana, E. Lueje Alonso, F.J. Martin
Sánchez, P. Gil Gregorio. Clinico San Carlos Hospital, Madrid, Spain
Introduction: Objective: design a risk model which help identify
patients with descompensated congestive heart failure (DCHF) at
high risk for in-hospital mortality who might beneﬁt from palliative
care in a Geriatric department.
Methods: Retrospective cohort study. Includes patients ≥80 years
old admitted to a Geriatric Acute Care Unit with DCHF. January2012- December2014. Variables included: Age, sex, cardiovascular risk
factors, comorbidity, NYHA class, functional status, geriatric syndromes, treatment, left ventricular ejection function and laboratory

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variables, previous treatment and cause of exacerbation. In-hospitalmortality was the primary outcome. A multivariate logistic regression analysis was performed. Discrimination was examined with
ROC curves and an internal validation and a score were carried out.
Statistical analysis: SPSS version 23.0.
Results: 629 patients, age: 90 (SD5), female: 470 (73.1%). Severecomorbidity (Charlson Index ≥3): 559 (89%). Died during hospitalization: 86 (13.7%). Multivariate analysis: NYHA class III and IV(OR: 2.03; 95% CI: 1.13–3.66), Katz index <2 (OR: 1.77; 95%CI:
0.98–3.19), infection as cause of exacerbation of HF (OR: 2.06; 95%
CI: 1.09–3.87), polypharmacy (OR: 1.87; 95% CI: 1.05–3.33), albumin <3 mg/dl (OR: 1.85; 95% CI: 1.03–3.31), glomerular ﬁltration
rate <60 ml/min (OR: 2.21; 95% CI: 1.12–4.37), hyperkalemia >5.5
mEq/L (OR: 2.60; 95% CI: 1.01–6.69) and RDW >17% (OR: 3.33;
CI: 1.84–6.03). The area under ROC curve was 0.78 (CI: 0.73–0.84,
p=0.029). Internal validation 0.77 (95% CI: 0.71–0.82, p=0.03).
Conclusion: This model allows to detect that older patient withadvanced organ disease that would beneﬁt from palliative care,using easily obtainable clinical variables and analytical parametersin addition to the cardiovascular factors.
P-189
Knowledge about advance directives and attitudes towards
discussing end-of-life care in older people attending primarycare clinics
M. Carpena-Ruiz 1 , M. Puerto del Antonio 2 , S. González-Rodríguez 1 ,M.V. Valverde-Moyar 1 , A.J. Cruz-Jentoft 3 , C. Verdejo-Bravo 4 .
1 Centro de Salud Valdelasfuentes, Alcobendas, Spain; 2 CS Colmenar
Viejo Norte, Colmenar Viejo, Spain; 3 Hospital Universitario Ramón yCajal (IRYCIS), Madrid, Spain; 4 Hospital Clínico San Carlos, Madrid,
Spain
Introduction: Advanced directives on end-of-life care preferenceswere regulated by Law in Spain in 2002. However, little is known
about a, information received and use of living wills by older peoplein our country.
Method: Descriptive study of an opportunistic sample of subjects
65+ years old attending two primary care practices. A structured
interview was used to assess knowledge on advance directives andavailability of a living will, where information was obtained, andattitudes about discussing end-of-life issues.
Results: 243 subjects (88.9% living in the community, 11.1% in carehomes), mean age 78.1 years (65–100), 39.5% males. Education:
23% secondary or higher, 69% primary studies, 7% illiterate. Only
16.9% knew what advance directives are (most of them throughsocial media, few from family or physicians) and only 2 (0.8%) had
a living will. 57.2% of the subjects they were reluctant to discuss
end-of-life issues. Should they start a discussion, 70% would do itwith members of their family, 16% with health care providers, 9%with friends; 5% would never accept discussing this topic.
Conclusions: Roughly 17% older subjects in our country have any
information about advance directives, 15 years after the Law was
passed. They mostly receive information through social media,
with a marginal role for doctors. Less than 1% has a living will. A
large majority are reluctant to discuss this topic and would startsuch discussion with family members. New approaches should be
explored to improve the use of advance directives in our country.
P-190
Living with advanced chronic heart failure: a phenomenologicalstudy
I. Renaud 1 , P. Ponce-Leão 2 , C. Sampaio 1 . 1 Universidade Católica
Portuguesa - Instituto de Bioética; 2 CECH/Universidade de Coimbra
Introduction: Chronic Heart Failure (CHF) is increasing in prevalence and will continue to do so with an ageing population. Few

studies describe the experiences of elderly people who are very ill
and living with advanced CHF from a lifeworld perspective and how
meaning is created about personal dignity in daily life.
Methods: Data were collected through in-depth interviews with
twelve Portuguese older people with advanced CHF. The transcribed
texts from the interviews’ were analysed using phenomenologicalhermeneutical method.
Findings: The results demonstrate two main themes: the perspective of oneself as vulnerable and as a signiﬁcant person. From theelderly people’s stories it is clear that in order to keep a sense ofdignity people need to be seen and respected for who they are.
This study adduces ethical questions about a person’s basic rights
to be cared for with dignity, also providing the elements required
for realizing and maintaining respect in the care of older people inhome settings and the factors connected to it.
Conclusions: Findings demonstrate the need for health care professionals to ﬁnd an approach that ensures both good quality medicalcare and, at the same time, acknowledges the uniqueness of eachsubject.
P-191
Palliative care and symptom control at the end of life in very oldpatients admitted with advanced dementia
J. Marttini Abarca 1 , P. Carrillo Garcia 1 , M. Oviedo Briones 2 ,B. Perdomo Ramirez 3 . 1 Clinico San Carlos Hospital, Madrid Spain;
2 La Paz Hospital, Mdrid, Spain; 3 La Cruz Roja Hospital, Madrid, Spain
Introduction: The objective was to analyze the medical management and symptom control at the end of life of patients withadvanced dementia admitted to an acute geriatric unit (AGU).
Methods: Descriptive study in patients aged 75 and older, with ahistory of severe dementia admitted at the AGU (died from any
cause). January 2014 to December 2015. Variables: demographic
data, medical history, type of dementia, comorbidity (Charlson
index), functional status (Barthel index), polypharmacy, reason foradmission and cause of death, advance directives and adequacyof therapeutic effort. In the last 48 hours we evaluated: symptom
control, treatment, complementary tests. Statistical analysis: SPSS
version 23.0.
Results: 50 patients, age 88.8 (SD: 5.9), female 50%. institutionalized 28%. Number of drugs: 7 (IQR 4–9), median hospital stay:
6 (IQR 3–12.25), primary caregiver - family:66%. Type of dementia (Alzheimer:44%, vascular:6%, mixed:14%, not studied:28%,
others:8%). Charlson index: 2 (IQR 1–3). Pluripathology:80%, Barthel
index <20: 90%, dysphagia:52%. Cause of admission (respiratory
tract:36%, urinary tract:18%, neurological:14%, infected pressure ulcers:12%) Cause of death (respiratory tract:42%, urinary tract:20%,
infected pressure ulcers:10%, neurological:8%) Not control symptoms: pain:14%, dyspnea:48%, psychomotor agitation:24%, nausea:2%, respiratory secretions:60%. Drugs used for symptom control:
sedatives:54%, opioids:82%, neuroleptics:14%, anticholinergics:50%,
analgesics:74%, Oxygen:78%. Complementary tests: blood test:40%,
X-ray:28%. Remained Intravenous hydration:24%, remained active
treatment with antibiotics:24%. DNR order:94%. Active treatment(suspended:66%, not initiated:16%), adequacy of therapeutic effort:84%, information to the family:96%. None of the patients had
advance directives.
Conclusion: There was an adequate clinical recognition of patientsat the end of life. Eventhough a few remained with active treatment
perhaps due to a rapidly progressive deterioration.

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

P-192
The geriatric dilemma: is less aggressive management a trap ofageism or letting nature take its course?
A. Micallef 1 , M. Grech 2 , A. Vella 3 . 1 Mater Dei Hospital; 2 St. Vincent
de Paul Residence, Malta; 3 Karin Grech Rehabilitation Hospital, Malta
We report a case of a ninety-ﬁve year old male who is a known
case of vascular dementia and a resident at St. Vincent de Paul
Residence. His general condition deteriorated owing to episodes ofshortness of breath secondary to recurrent pleural effusions andlung collapse. He was managed with repeated thoracentesis andchest drain insertion. Appropriate management led to a dramatic
improvement. Even though the patient in question was ninety-ﬁve
years of age with co-morbidities, great symptomatic improvement
was achieved. This case highlights how appropriate intervention
has led to an improvement in the quality of life of the patient inspite of his age and his co-morbidities. Thus, the clinician should
not be caught in the trap of ageism and withhold treatment at
a relatively early point in the management of elderly patients indistress.
P-193
The Gold standard Framework in Acute Hospital- Priorities forcare of the dying person
A. Tong, S. Shaﬁq, N. Ruff, C. Hooper, C. Mcgrath, H. Costelloe,
T. Morton, C. Agogbua, K. Niranjan. Queen’s Hospital
Introduction: The Gold Standard Framework (GSF) is a programme
designed to identify patients that are progressing towards the end
stages of their lives and empowering these patients by involving
them in the management plan allowing them to make decisions
regarding their end of life care such as preferred place of care.
GSF also provide appropriate support for patients in community
requiring palliative input also improve communication between
community and hospital teams.
Methods: A retrospective analysis of total 623 patients were registered for GSF and on the palliative registry from 2013 to 2017.
Patients were identiﬁed suitable for GSF by clinical judgement during their admission in hospital. The question posed in identifying
these patients was suitable for GSF discussion with the patient andfamily. Patients were then stratiﬁed into colour coding dependingon their prognosis or life expectancy.
Results: Median Age of the population group was 85, 483 (77%)
patients had passed away since they had been added to the registry,
397 (64%) had decided on a preferred place of care. 175 (28%) patients had chosen their preferred place to be their own home. Clear
escalation plan communicated with patient and family members
and 72% alert recorded in central computer database.
Conclusion: GSF Allows suﬃcient time for physicians to engage inthe topic of end of life and for patients to reﬂect on their end oflife plans also empowers patients and relatives to make decisions
regarding their end of life and minimise traumatic experiences forpatients in their end of life care.
P-194
Validation of the Supportive snd Palliative Care Indicators Tool
(SPICT) in a geriatric population
R. De Bock 1 , N. Van Den Noortgate 2 , R. Piers 2 . 1 Ghent University,
Faculty of Medicine and Health Science, Ghent, Belgium; 2 Departmentof Geriatrics, Ghent University Hospital, Ghent, Belgium
Introduction: Timely identiﬁcation of patients in need of palliative
care is especially challenging in a geriatric population because of
prognostic uncertainty. The Supportive and Palliative Care Indicators Tool (SPICT) aims at facilitating this identiﬁcation, yet hasn’t
been validated in a geriatric population admitted to the hospital.

S95

Methods: All patients admitted to the acute geriatric ward of a
Belgian university hospital between January 1st and June 30th 2014
were included. Data considering demographics, functional status,
comorbidities, Do-Not-Resuscitate (DNR) codes and one-year mortality were collected. SPICT was measured retrospectively by anindependent assessor.
Results: Out of 435 included patients, 54.7% had a positive SPICT,
using a cut-off value of two for the general indicators and a cut-off
value of one for the clinical questions. SPICT-positive patients wereolder (P=0.003), more frequently male (P=0.028) and had morecomorbidities (P=0.015) than SPICT-negative patients. The overall
one-year mortality was 32.2%, 48.7% in SPICT-positive patients and11.5% in SPICT-negative patients (P<0.001). SPICT predicted the
one-year mortality with a sensitivity of 0.841 and a speciﬁcity of
0.579. The area under the curve of the general indicators (0.758)
and the clinical indicators of SPICT (0.748) did not differ (P=0.64). In
71.4% of SPICT-positive cases, a DNR-code was present versus 26.9%
in SPICT-negative cases (P<0.001).
Conclusions: SPICT is a valuable tool for identifying geriatric patients in need of palliative care as it is signiﬁcantly associatedwith one-year mortality and with clinical predictive survival byexperienced geriatricians, as reﬂected by DNR-codes given.
P-195
What leads care managers to engage in end-of-life discussions
with older clients in Japan? An examination on the effect ofclients’ use of home-visiting medical care services
C. Shimada, R. Hirayama, T. Wakui, M. Ito. Tokyo Metropolitan
Institute of Gerontology, Tokyo, Japan
Introduction: Using national long-term care insurance, Japaneseolder adults are supposed to consult with care managers about how
to arrange public care services to negotiate age-related functional
decline. Given the inﬂuence that care managers exert on older
adults’ lives, they have the potential to encourage their clientsto become prepared for their end-of-life. Our aim in this study
was to explore whether and how care managers’ engagement in
end-of-life discussions with their clients was inﬂuenced by clients’use of medical care services in home.
Methods: We conducted a mail survey of care managers fromcertiﬁed home care support oﬃces in both urban and rural Japan(N=3,320). Data were analyzed to identify whether and how thenumber of clients who received home-visiting medical care wasassociated with (a) the proportion of clients with whom participants talked about end-of-life preferences and (b) that of clients
they asked about type(s) of medical treatment wished for in their
end-of-life.
Results: Having had more clients who received home-visiting medical care made it more likely for participants to talk with theirclients about both general end-of-life preferences and wished-for
type(s) of medical treatment. These results were obtained while
controlling for participants’ job-related backgrounds.
Conclusions: Results suggest that Japanese care managers are
urged to engage in end-of-life discussions in the process of arranging in-home medical care services for their clients. Future researchshould investigate what leads them to engage in such discussions
before their clients become so seriously ill as to require substantial
medical care.

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Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

Area: Frailty and sarcopenia

P-196
1-Year change in quality of life, assessed with the speciﬁcquestionnaire SarQol® , is associated with 1-year change inphysical performance
C. Beaudart, M. Locquet, L. Delandsheere, J.-Y. Reginster, O. Bruyère.
Research Unit in Public Health, Epidemiology and Health Economics(URSAPES), University of Liège, Liège, Belgium
Background: Recently, the SarQoL® , a quality of life questionnaire
speciﬁc for sarcopenia has been developed. Our aim was to assess
the relationship between 1-year change in quality of life (QoL) and1-year change in musculoskeletal health.
Methods: The SarQoL® , the speciﬁc QoL questionnaire, as wellas the EQ-5D and the EQVAS, two generic QoL questionnaires
were completed by 301 subjects from the SarcoPhAge study (Sarcopenia and Physical impairments with advancing Age, a cohort
developed in Belgium). Muscle mass (ALM/h2 , assessed with DXA),
grip strength (assessed with hydraulic dynamometer) and gait
speed were evaluated. Sarcopenia was diagnosed according to the
EWGSOP algorithm.
Results: After one year of follow-up, the QoL of the general population (75.0±5.97 years, 59% women) decreased (p<0.001 with
the SarQoL® , p=0.03 with the EQVAS, p<0.001 with the EQ-5D).
The ALM/h2 was not signiﬁcantly modiﬁed but a decrease in muscle strength and gait speed was observed (p<0.001 for both). A
signiﬁcant correlation was found between 1-year decrease in gait
speed and 1-year decrease in QoL only when using the speciﬁcquestionnaire SarQoL® , but not when using the generic EQ-5D or
EQVAS tools. Results indicated a correlation of r=0.21 (p<0.001)
for the whole cohort population and r=0.41 (p=0.013) for the
sarcopenic elders (n=38). These associations were not observed formuscle mass (p=0.65) or muscle strength (p=0.06). Using a multivariate regression the association between decreased gait speed
and decreased QoL, assessed with the SarQoL® , was signiﬁcant,independently of age, sex, number of comorbidities and number ofdrugs (p<0.001 for both whole cohort and sarcopenic subjects).
Conclusion: Our ﬁndings suggest that a decrease in physical performance (gait speed) is associated with a decrease in QoL, speciﬁcof muscle impairments, in elders and more speciﬁcally in those suffering from sarcopenia. The speciﬁc SarQoL® seems better adapted
than generic tools to identify decrease in QoL related to muscle
function.
P-197
A simple, pragmatic frailty detection tool can predict adverse
outcomes when used in the Emergency Department
S. Lewis, L. Evans, T. Rainer, J. Hewitt. Cardiff University, Cardiff,
United Kingdom
Introduction: Older people commonly experience adverse outcomes after urgent care use; early identiﬁcation of frailty is key toallow targeted interventions.
Methods: Casenote review of consecutive emergency department(ED) attendances in patients aged 75+ for the British Geriatrics Society’s Frailsafe screening questions [1] and demographics. Electronic
record review for admission outcomes, mortality, re-attendance at
30, 120, 180 days and institutionalisation at 180 days.
Results: 468 patients were included. Frailsafe was completed in 356
patients. Mean (Standard deviation (SD)) age was 85.8 (5.8) for frail
and 82.2 (5.4) for non-frail patients (p<0.001). More frail than nonfrail patients had died (35/190 (18.4%) vs 15/152 (9.9%), p=0.026) or
been institutionalised (22/190 (11.6%) vs 2/152 (1.3%), p<0.001) at

180 days. Admitted frail patients had greater median (interquartile
range) lengths of stay (LOS) (7 (2–32) vs 4 (2–10), p=0.037), inpatient mortality (12/116 (10.3%) vs 3/81 (3.7%), p=0.043), and 30-day
re-attendance (33/112 (29.5%) vs 11/75 (14.7%), p=0.009). Discharged patients had similar re-attendance rates. Frailsafe independently predicted LOS >28 days (adjusted odds ratio (AOR) 3.42 (95%
CI: 1.41–8.31, p=0.007), 30-day post-admission re-attendance (OR2.73 (1.27–5.88, p=0.010), combined admission-related adverse outcome (LOS>28 days/inpatient mortality/institutionalisation/30-day
re-attendance) (OR 2.67 (1.42–4.99)), 180 day mortality (AOR 3.23
(1.45–7.19)) and institutionalisation (AOR 8.95 (2.01–39.83)) andcombined long-term adverse outcome (death/institutionalisation
at 180 days, AOR 3.55 (1.64–7.67)). Frailsafe did not predict ED
re-attendance.
Conclusions: Frailsafe independently predicts adverse outcomesamongst older ED attendees, suggesting a role for routine use.
References:[1] British Geriatrics Society. Frailsafe. [Accessed Nov 28 2016].
Available from: http://www.frailsafe.org.uk
P-198
Agreement and predictive validity of the EWGOSP and FNIH
sarcopenia deﬁnitions. The Glisten study
S. Volpato 1 , L. Bianchi 1 , E. Maietti 1 , F. Landi 2 , GLISTEN Study
Group, Italy. 1 University of Ferrara, Italy; 2 Università Cattolica delSacro Cuore, Roma, Italy
Background: Sarcopenia may contribute to disability and mortality.
Multiple research groups, including the European Working Groupon Sarcopenia in Older People (EWGSOP) and the Foundation for the
National Institutes of Health (FNIH) Sarcopenia Project, proposed
criteria for sarcopenia diagnosis. Although measures of muscle
mass and muscle strength overlap, the operational deﬁnitions differ. We assessed agreement of EWGSOP and FNIH deﬁnitions andprediction of prevalent disability and mortality risk in a sample ofolder hospitalized Italian patients.
Methods: Cross sectional and longitudinal analysis of 611 participants enrolled in a multicenter observational study of older adults
admitted to 12 hospitals. Weakness was determined according tohandgrip strength using a hand dynamometer, appendicular leanmass using bioimpedance analysis, and walking speed according
to 4-m usual walking speed. For both deﬁnitions two categories
of intermediate and severe sarcopenia were created according to
the presence of two or three criteria, respectively. Analyses were
performed using Cohen’s kappa, logistic regression and Cox models.
Results: Prevalence of intermediate sarcopenia was 24% and 36%
using the FNIH and EWGSOP criteria, respectively, whereas prevalence of severe sarcopenia was 18% and 20%. Agreement between
EWGSOP and FNIH classiﬁcations was low using both deﬁnitions(Kappa Statistic: 0.12 and 0.26, respectively). Intermediate andsevere FNIH sarcopenia was statistically associated with prevalent
ADL disability, but only severe EWGSOP deﬁnition was. In multivariable analyses, both FNIH deﬁnitions predict one-year mortality
whereas EWGSOP deﬁnitions were not signiﬁcantly associated.
Conclusions: Agreement between EWGSOP and FNIH sarcopenia
deﬁnitions is low. FNIH classiﬁcation better predicts important
clinical endpoints.
P-199
Anemia and frailty in the elderly hospitalized in an acute unit:
Preliminary results
X. Sui Seng, N. Kadri, J. Doucet, E. Andres. CHU Rouen
Introduction: Anemia is a frequent reason for hospitalization inacute geriatric units. The elderly are particularly susceptible andcan condition the prognosis in cases of poor tolerance. Our goal is toPoster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

determine if anemia is a geriatric frailty factor. The main objective
is to research the link between anemia and weakness according to
FRIED. The secondary objectives are on the one hand looking for alink between anemia and weakness according to SEGA, and on theother hand, the research for a link between anemia and ADL, IADL,
and MMS.
Method: This is a prospective, observational study, conducted in anacute geriatric unit at Rouen, from May 1 to August 31, 2016. All
patients older than 65 years were included; only palliative patientswere excluded.
Results: 120 patients were included, 62 anemic (51.7%). 77 women(64.2%). The average age of 86.8 years. 7% of subjects aged <75
years; 26% of subjects aged between 75 and 85 years; 68% of subjects aged ≥85 years. In the anemia group: the average age is 87.4
years; with a female predominance (42 patients). 55 patients havecardiovascular antecedents, of whom 13 have a documented heart
failure. The Charlson average is 7.88. On the clinical side, 16 patients
had mucocutaneous pallor and 21 had dyspnea. The hemoglobin
average count is 9.7 g/dl (6 to 11.9), with an average MCV to 91.83ﬂ,thrombocytopenia associated with 2 cases, lymphopenia associatedwith 18 cases and high PNN for 8 cases. On the side of autonomy
and frailty: ADL average is 1.8; IADL average is 0.52; MMS average
is 16.6; Fried average is 3.8 and SEGA average is 17.8. We found 7
deaths in the service. In the group of non-anemic patients: averageage 86.1, with a female predominance (35 cases); history of cardiovascular disease in 49 patients, including 12 with documented heart
failure. The average Charlson score is 7. The average hemoglobin
is 13.48g/dl, albumin at a rate of 29.7g/l; ADL average at 3.7, IADL
average at 1.9, MMS average at 18.6, SEGA average at 12.6 and Fried
average at 2.26. In bivariate analysis, anemic patients are morefragile as evidenced by the Fried’s score (3.87 IC [3.62; 4.12] vs.
non-anemic subjects: 2.26 IC [1.89; 2.63], p<0.0001), but also SEGA
score (17.87 IC [16.99, 18.75] vs. non-anemic subjects: 12.62 [11.33,
13.91], p<0.0001) and less autonomous (ADL: 1.81 IC [1.51; 2.11] vs.
non-anemic subjects IC 3.69 [3.27; 4.11], p<0.0001; IADL 0.53 IC[0.32; 0.75] VS non-anemic subjects 1.88 [1.58; 2.18], p<0.0001). In
multivariate analysis, we can say that on average, anemic subjects
have a FRIED score increase of 1.64 compared to non-anemic (ofthe sample). The increasing of FRIED score in anemics should be
between 1.21 and 2.08. If we adjust on albumin, age, sex, and heart
failure, the result is almost unchanged. This means that albumin,gender, age, and heart failure equal, a subject that has anemia
will have on average a FRIED larger of 1.64 point compared to a
non-anemic subject (95: 1,19; 2.09). These results are signiﬁcant(p<0.0001). Multivariate analysis wasn’t done for the MMS becausesome data is missing.
Conclusion: In all cases, anemia is a frailty marker independent
from albumin, age, sex, heart failure. The clinical contribution ofanemia in evaluating frailty is not obvious. If FRIED was made fora patient, does the information of anemia bring something? To
answer the question, we should analyze the relationship of theadjusted anemia on the FRIED in models explaining an outcome
such as rehospitalization, falls, or death.
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Association between fall in the previous year with somecomprehensive geriatric assessment components
C. Kılıç 1 , R. Demir 2 , G. Bahat 1 , M.A. Karan 1 . 1 Department of Internal
Medicine, Division of Geriatrics, Istanbul Faculty of Medicine, Istanbul
University, Istanbul, Turkey; 2 Cardiology Institute, Istanbul University,
Istanbul, Turkey
Introduction: In this study, we aimed to analyse the association between fall in the previous year with some comprehensive geriatricassessment components.
Methods: The subjects were composed of older adults (>65 y)

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admitted to geriatric outpatient polyclinic of a university hospitalin Istanbul, Turkia between October 2016 and April 2017. We
retrieved data on fall in the previous year, postural instability, shortphysical performance battery, functional reach, BIA detected fat %,ADL, IADL, urinary incontinence, constipation, SARC-F sarcopenia
screening test. The correlation between fall number in previous 1
year and the aforementioned parameters were investigated.
Results: A total of n=186 participants (125 female, 61 male) were
included. There were 82 participants with at least 1 fall in lastyear (58 female, 24 male). Mean age was 76±7.4 years. There wasa moderate and signiﬁcant association between the fall no, urinary incontinence (r=0.54, p<0.0001) and SARC-F sarcopenia score(r=0.38, p=0.004).
Conclusions: In predicting falls, urinary incontinence and sarcopenia detected by SARC-F score may aid the clinicians.
P-201
Association between frailty and phase angle derived frombioelectrical impedance analysis among elderly patientsO. Deniz, S. Kaya, H.D. Varan, M.C. Kızılarslanoğlu, B. Göker. Gazi
University, School of Medicine, Department of Geriatrics
Introduction: Phase angle derived from bioelectrical impedance
analysis is a parameter that has been shown to be associated withsarcopenia and malnutrition in the elderly population. However, its
relationship with frailty has not been adequately studied. Here, we
aimed to investigate association between phase angle and frailty inelderly.
Material and methods: One hundred and eighty-eight elderly patients (age over 65) were included in the study. All patients
underwent comprehensive geriatric assessment. The frailty statusof the patients were evaluated by Fried’s Frailty Index which has
ﬁve components including weight loss, weakness, exhaustion, lowactivity and slow speed walking. Those who had three or morepositive results in this scale were considered “frail”, 1–2 points
were considered “pre-frail” and those who satisﬁed none of thesecriteria were considered “robust”. All patients were evaluated byusing bioelectrical analysis device to determine phase angles.
Results: The median age of the patients were 74 years (min-max:
65–91) and 41.5% were female. The most common co-morbidities
were hypertension (75.5%) and diabetes mellitus (41.0%). Mean ±SD phase angle was lower in frail group compared to pre-frail
and robust groups (4.12±0.79 vs. 4.60±0.63 vs. 5.20±0.80, respectively) (p<0.001). The parameters which were signiﬁcantly different(p<0.2) in univariate analysis were included in multivariate analysis and phase angle (OR: 0.360, p=0.018), age (OR: 1.132, p=0.020),
mini-mental state examination (OR: 0.777, p<0.001) and Yesavage
geriatric depression scale (OR: 1.307, p=0.002) were found to be
independently associated with frailty. Receiver operating characteristic (ROC) analysis suggested that optimum cut-off point of phaseangle for frailty was ≤4.00 with 54.8% sensitivity, 91.0% speciﬁcity,
54.8% positive predictive value and 91.1% negative predictive value(AUC: 0.751, p<0.001).
Conclusion: Our results suggest that phase angle may be an
independently associated factor for frailty. Further prospective
studies are needed to investigate casual relationships between
these entities.
P-202
Association between results on four clinimetric tests at hospitaldischarge and falls after hospitalisation in older patients
I.P.B. Tournoij, H. Nijboer, C.M.J. van der Linden. Catharina Hospital
Eindhoven, Eindhoven, The Netherlands
Introduction: Thirty percent of community dwelling people aged
65 and over fall at least once a year. Emergency room visits have

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Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

increased up to 137% in the last 20 years [1]. Many clinimetric tests
are available to analyse and predict the risk of falling. However,
little is known about the risk of falling after hospitalisation andhow to evaluate this risk. The main objective of this study is toassess the association between the results on four clinimetric tests
at hospital discharge and falls after this hospital stay.
Methods: We performed an observational study including patientsof 65 years or older admitted to internal medicine, pulmonary
and gastroenterology wards of the Catharina Hospital in Eindhoven,
the Netherlands. Participants performed four clinimetric tests atdischarge: timed up and go, chairstand, handgrip strength andlegstrength. After discharge, participants used a fall calendar andwe contacted participants by phone every two weeks for 18 weeks.
We compared outcomes on clinimetric tests of fallers with those ofnon-fallers using Students T-test.
Results: We included 129 participants, of which 41% were female
and mean age was 75 years. Thirty-four participants reported a fall
after hospitalisation. Pair wise comparisons found no difference inresults on clinimetric tests between fallers and non-fallers.
Conclusions: There is no association between results on four clinimetric tests at discharge and falls in four months after discharge.
For predicting fall risk after hospitalisation using clinimetric tests
further research is necessary.
References:[1] Hartholt KA, et al. Trends in fall-related hospital admissions inolder persons in the Netherlands. Arch Intern Med. 2010 May
24;170(10):905–11.
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Association of physical frailty with cognitive function and moodin patients without dementia and depression
R.T. Doğrul, C. Kızılarslanoğlu, H.D. Varan, M.K. Kılıç, F. Sümer,G. Arık, Ö. Kara, B. Can, G.Ş. Ayçiçek, G. Güner, B.B. Yavuz, M. Halil,
M. Cankurtaran. Hacettepe University Faculty of Medicine
Department of Internal Medicine Division of Geriatrics
Aim and background: Frailtyis mostly deﬁned as a geriatric syndrome consists of medical problems and functional loss increasing
the risk of hospitalization and may result in mortality. It is thoughtthat physical frailty is related to cognitive functions and social
status. In this study, we evaluated the associationof physical frailty
with cognitive function and mood in patients without dementia
and depression.
Material and methods: In this study, we evaluated 612 patients
aged 65 years and over admitted to our outpatient clinic. For
evaluation of physical frailty we used Fried criteria. According toFried criteria, the patients having 3 or more points were reported
as frail, having 1 or 2 points as pre-frail and 0 point as robust. We
also performed detailed comprehensive geriatric assessment. Depression status of the patients was screened with Yesavage GeriatricDepression scale. Cognitive functions were screened with MMSE
and clock drawing test. Patients with dementia and depression
were excluded.
Results: Mean age of the patients was 72 and 58% was female.
Diabetes mellitus and hypertention were the most common comorbidities (35,6% and 67,2% respectively). Forty ﬁve percent of patientswere robust, 48.4% were prefrail and 6.5% were frail. When grouped
according to fraility, clock drawing test (p<0.001), MiniMental State
Examination test (p<0.001), Yesavage Geriatric Depression scal
(p:0.01) weresigniﬁcantly different between groups. Age (p: 0.009),
educational level, being university graduat (p:0.031), three words
recall tes (p: 0.014), Activities of Daily Livingscore (p: 0,006), Instrumental Activities of Daily Livingscore (p<0.001), Mini Nutritional
Assessment (p: 0.001) were determined to be independent factors
related to fraility.
Conclusion: In this study, we have demonstrated that cognitive

function and mood are associated with physical fraility in patients
without dementia and depression. Further studies are needed toelucidate the causal relationship between these entities.
P-204
Audit: Implementation of vitamin D guidelines in hip fracture
care pathway to improve management of vitamin D deﬁciency
H. Shah, A. Jacob, A. Brown. Arrowe Park Hospital, Wirral, UK
A growing cohort of evidence suggests Vitamin D supplementationin patients with fracture neck of femur is associated with reduced
readmission rates, improved physical performance and reduced
risk of further fractures. Prior to February 2015, there were norecommendations on the local Hip Fracture pathway regarding
Vitamin D testing or management. 0% of patients had vitamin Dlevels checked. In February 2015, National Osteoporosis Society
guidelines were incorporated into a Hip Fracture Care pathway.
The following audit assessed if incorporation of these guidelines
in the Hip Fracture Care Pathway improved vitamin D deﬁciency
management in fracture neck of femur patients. A cohort of patients
admitted with fracture neck of femur were analysed from February
2016 - Information obtained via patient e-records.49 patients werestudied. 41 patients had vitamin D levels checked on admission(84%). Of these 41 patients, 16 were vitamin D deﬁcient – 8 patientswere given a loading regime of colecalciferol (50%), 5 received themaintenance dose of Adcal (31%) and 3 received no intervention(19%). Where colecalciferol was prescribed, information regarding
monitoring was provided on the discharge letter to primary carein 100% of cases. Patients with vitamin D level >25nmol/L, 92% of
patients received Adcal D3. Incorporation of Vitamin D guidelines
within a hip fracture protocol has signiﬁcantly improved identiﬁcation and management of Vitamin D deﬁciency. To further improve
compliance, we aim to develop a ﬂagged note on e-prescribing
systems when prescribing colecalciferol, advising what to prescribe,and include Vitamin D tests in A&E Triage.
P-205
Cathepsin K activity controls cardiotoxin-induced skeletal
muscle repair in mice
S. Ogasawara, X.W. Cheng, A. Inoue, M. Kuzuya. Department ofCommunity Healthcare & Geriatrics, Nagoya University Graduate
School of medicine
Introduction: Cathepsin K (CatK) is a widely expressed cysteinyl
protease that has gained attention due to its enzymatic function
and nonenzymatic function as signaling. Here, we hypothesizedthat CatK-deﬁcient (CatK−/−) would mitigate injury-related skeletal muscle remodeling and ﬁbrosis in mice, with a special focus on
inﬂammation and cell apoptosis.
Methods: Cardiotoxin was injected into the left gastrocsoleus muscle of male wild-type (CatK+/+) and CatK−/− mice, and then themice were processed for morphological and biochemical studies.
Results: On post-injection day 14, CatK deletion ameliorated themuscle interstitial ﬁbrosis and remodeling and performance. Atan early time point (day 3), CatK−/− educed the lesion macrophage and leukocyte contents and cell apoptosis, the mRNA levelsof monocyte chemoattractant protein-1, toll-like receptor-2, andtoll-like eceptor-4, and the gelatinolytic activity related to matrix
metalloproteinase-2/-9. CatK silencing also restored the changes in
the protein levels of caspase-3 and cleaved aspase-8 and the ratio of
the BAX to the BCL-2. Moreover, CatK deﬁciency protected muscle
ﬁber laminin and desmin disorder in response to CTX injury. These
muscle eneﬁcial effects were mimicked by CatK-speciﬁc inhibitor
treatment. In vitro experiments demonstrated that pharmacological
CatK inhibition reduced C2C12 mouse myoblasts’ apoptosis and thelevels of BAX and caspase-3 proteins induced byCTX.

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

Conclusions: These results demonstrate an essential role of CatK inskeletal muscle loss and ﬁbrosis in response to CTX injury, possibly
via the reduction of inﬂammation and cell apoptosis, suggestinga novel therapeutic strategy for the control of skeletal muscle
diseases by regulating CatK activity.
P-206
Cellular senescence and falls in elderly patients with sarcopenia
J. Sulicka-Grodzicka 1 , K. Piotrowicz 2 , K. Bukowska-Strakova 3 ,M. Strach 2 , T. Grodzicki 2 , A. Skalska 2 . 1 Department of Rheumatology
and Balneology Jagiellonian University Medical College, Krakow,
Poland; 2 Department of Internal Medicine and Gerontology
Jagiellonian University Medical College, Krakow, Poland; 3 Departmentof Clinical Immunology and Transplantology, Children’s University
Hospital, Krakow, Poland
Background: Immunosenescence involves changes in the immune
system which result in chronic, low-grade inﬂammation, higher
prevalence of infections and other age-related diseases. Inﬂammation contributes to age-associated loss of muscle mass, sarcopenia
and elevated risk of falls. The aim of the study was to examine
adaptive immune system and the presence of persistent infectionin the context of functional impairments in elderly patients withsarcopenia.
Methods: Flow cytometry studies were performed in patients 70
years and older with performance score 3–9 points in short physicalperformance battery (SPPB) and sarcopenia diagnosed using SARC-F
questionnaire and DXA measurements. Lymphocytes T and B subsets, including cells representing “immune risk proﬁle”: CD19, terminally differentiated CD8+CD45RA+CCR7-CD27-CD28- (TEMRA),
CD4+/CD8+ ratio were evaluated, as well as cytomegalovirus (CMV)
IgG seropositivity.
Results: Mean age of 38 patients (84% women) was 77.9±5.9
years. The prevalence of CMV serology was 84%. The percentage of CD8+TEMRA lymphocytes was negatively associated with
BMI-adjusted appendicular lean mass (r=-0.35; p<0.05). Over halfof study participants (52%) reported having experienced a fallwithin past year. Patients with falls had higher SARC-F score(3.3±1.4 vs. 1.8±1.5; p=0.003). We found increased prevalence of
CD8+TEMRA lymphocytes in patients with history of falls comparedwith non-fallers (2.0 [1.0–3.3]% vs. 0.6 [0.3–1.6]%; p=0.01).
Conclusion: Our ﬁndings indicate that persistent viral infection
leading to accumulation of senescent, pro-inﬂammatory, highly
differentiated CD8+ T cells may be related with loss of muscle massand may contribute to elevated risk of falls in elderly, sarcopenic
patients.
P-207
Challenges with a new tool in screening of frailty
S.M. Aurelian 1 , R. Dascalescu 2 , A. Zamﬁrescu 1 , V. Elian 1 ,A. Capisizu 1 . 1 University of Medicine and Pharmacy “Carol Davila”;
2 Uniiversity of Medicine and Pharmacy “Carol Davila”
Introduction: Frailty represents an important issue in geriatricassessment. Atherosclerosis is one of the most frequent pathology
and an important risk factor for cardiovascular disease at the elderly[1]. We aimed to create a new index for an easier screening tool offrailty at elderly with diabetes or cardiovascular pathology.
Methods: This is an observational six months study (JuneDecember 2016) included 143 participants; 81.2% female and 18.8%
males; mean age was 72.28±10.098 years, with or without diabetes.
Frail assessment was made by Fried’s ﬁve criteria established. We
included arterial stiffness (Aortic pulse wave velocity-PWVaortic)in the new index. This was measured using an oscillometric device (Arteriograph)[2] in addition to a medical history, physicalexamination, and laboratory tests.

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Results: Outcomes shows statistically signiﬁcant correlation between frailty and arterial stiffness on diabetic than non-diabetic
groups (Chi square test,p=0.010). Women are more frail (Chi square
test,p=0.039) and in particular elderly living alone (Chi square
test, p<0.001) in urban areas. PWV aortic shows a frailty betterclassiﬁcation: frail group (19.57%) became pre-frail (14.68%) androbust (4.89%) in new classiﬁcation.
Conclusions: Vascular assessment is useful in clinical evaluation offrailty, alongside of Fried’s phenotype. A pre-frail old people canbecome a robust one with a personalized cardiovascular treatment.
References:[1] Capisizu A, Aurelian SM, Badiu C, Zamﬁrescu A. Multifactorial hemodynamic entities of hypertension at the elderly. Acta
Medica Mediterranea 2015; 31(4):847–850.
[2] Ring M, Eriksson M, Zierath JR, Caidahl K. Arterial stiffness
estimation in healthy subjects: a validation of oscillometric (Arteriograph) and tonometric (SphygmoCor) techniques.
Hypertension Research (2014) 37, 999–1007.
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Changes in skeletal muscle mass assessed with BIA during acutehospital admission
P. Fdez-Montalbán, J. Albéniz, E. Sánchez, B. Montero, E. Rodríguez,
L. Hernández, A.J. Cruz-Jentoft. Hospital Universitario Ramón y Cajal,
Madrid, España
Introduction: Bio-impedance analysis (BIA) is a simple portable
method to assess skeletal muscle mass in older patients that can beused at bedside during hospital admission. However, dehydrationand ﬂuid overload, frequent in acute care, may limit its value in thissetting. We are studying changes in BIA skeletal muscle mass (SM)during hospital admission, we report here a preliminary analysis of
the ﬁrst subjects included.
Methods: Prospective, observational study of all patients admitted
to a geriatric acute care unit. Muscle mass was estimated by BIA(Janssen’s equation) on admission and at discharge.
Results: 81 patients have been included in the study at this time
(60% women, mean age 93±4 years, mean length of stay 7±5days, mortality 7%). All data were available in 61 patients. When
comparing SM at admission and discharge, 58% had a loss of SM, 4%
had a stable SM and 38% had an increased SM at discharge. Averagechange during admission was 1±1kg (Range: 0.02–14.6kg). Those
who lost SM were more often males (53% vs 22%, p=0.01) and had
more anemia (31% vs 4%, p<0.05). We found no differences in age,
comorbidities, ADLs, use of drugs or social status with those that
did not lose SM. We found no differences according main diagnosis,
or length of stay. Mean CPR was higher in those with loss of SM(118 vs 52, p=0,007).
Conclusions: Skeletal muscle mass can be estimated with BIA
in acute geriatric patients, and changes along hospital admission.
Whether this changes are due to changes in hydration or with a real
loss of muscle mass remains to be determined.
P-209
Characteristics of elderly fallers with hip fractures in Singapore
K. Mamun, M.H. Nguyen, L.L. Chen, W.C. Foo. Singapore General
Hospital
Introduction: Falls leads to an estimated 95% of hip fractures incidence in elderly population resulting in hospitalization, disability,
and loss of independence. One-year mortality rates after this injury
range from 20–30%. Approximately half of patients who used tolive independently became reliant on their caregivers or required
institutionalization. This study aims to characterize the elderly
fallers with hip fracture in Singapore.
Methods: This is a retrospective cross-sectional analysis of patients

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Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

aged ≥65 years via review of medical records, hospitalized from
May–August 2016, due to hip fractures caused by a falls. Elderlywith osteoporotic fracture and low velocity trauma were included.
Results: A total of 104 patient, 81.3±7.5 years old with Barthel score,
91.7±19.4 were hospitalized for falls-related hip fracture during
the study period. Majority were female (70.2%), Chinese (86.5%)
and with 6 or less years of education (72.1%). Most were able
to ambulate independently (65.4%) and 43.3% have no caregivers
before the falls. The population was generally healthy with lowscore on Charlson Comorbidity Index (CCI), median 1 (IQR: 0–2)
and 60.6% have no history of recurrent falls. The Vitamin D level
was low in the population, 20.7±6.6 ng/ml. After hospitalized for
19±13 days, patients were discharged to home (51%), community
hospitals (44.2%) for rehabilitation and nursing home (5%).
Conclusions: Falls leading to hip fractures is devastating, causing
signiﬁcant impact in morbidity and mortality outcomes. Given
these serious consequences, it is vital to adopt a multifactorial
approach, involving education, medication review, exercises andhome modiﬁcation to prevent falls in the community dwellingelderly population.
P-210
Clinical characteristics and outcomes of frail old patients with
anticoagulant therapy for atrial ﬁbrillation
Y. Yamada 1 , T. Kojima 2 , S. Ogawa 2 , M. Eto 2 , M. Akishita 2 .
1 Department of Cardiology, Kitasato University Kitasato InstituteHospital; 2 Department of Geriatric Medicine, Graduate School of
Medicine, The University of Tokyo
Purpose: Preventing embolic cerebral infarction is important since
it decreases activity of daily living and quality of life in oldpeople. However, appropriate use of anticoagulants is diﬃcult infrail old people because of increasing risk of bleeding events.
Thus the present study examined the predictive factor for practicalmanagement of anticoagulants in older patients.
Methods: 783 patients aged 65 who were admitted to the geriatric ward of the University of Tokyo Hospital between 2013 and2015 were enrolled. 90 patients (men 47%, mean age 85 years)
had atrial ﬁbrillation. We followed the patients for 1 to 3 years
after baseline. Major gastrointestinal bleeding, stroke and all cause
mortality were investigated for outcome.
Results: Among them, 52% were taking anticoagulant therapy. Factors affecting the decision about administration of anticoagulants
for physician were risks for fall, history of bleeding, levels of cognition function. There was no signiﬁcant difference between with orwithout anticoagulant therapy in all three outcomes.
Conclusions: Age, risks for fall, cognition function and levels of
ADL might be the predictor factors for practical management of
anticoagulants in frail old people with atrial ﬁbrillation.
P-211
Correlation between the Clinical Frailty Scale and the frailty
phenotype in community dwelling elderly with multimorbidity
A.L. Mazya 1,2 , A.-M. Boström 2,3,4 , A.W. Ekdahl 1,5 . 1 Division ofClinical Geriatrics, Department of Neurobiology, Care Sciences andSociety, Karolinska Institutet, Stockholm, Sweden; 2 GeriatricDepartment of Danderyd Hospital, Stockholm, Sweden; 3 Division of
Nursing, Department of Neurobiology, Care Science and Society,
Karolinska Institutet, Stockholm, Sweden; 4 Department of Nursing,Western Norway University of Applied Sciences, Haugesund, Norway;
5 Institution of Clinical Research, Helsingborg hospital, Lund University,
Helsingborg, Sweden
Introduction: The identiﬁcation of frail elderly is a necessary prerequisite for preventive measures and tailored interventions. The
Fried frailty phenotype (FP) is a validated, albeit resource intensive,

instrument to assess frailty. The Clinical Frailty Scale (CFS) by
Rockwood et al, is based on clinical judgement and is easy to use.
The aim of this study was to test the agreement of the CFS with
the FP in identifying frailty in community dwelling elderly withmultimorbidity.
Methods: A cross-sectional study on data from 24 month follow-up
of the Ambulatory Geriatric Assessment – a Frailty Intervention
Trial (Participants were community dwelling elderly people withmultimorbidity (n=382). Inclusion criteria: age ≥75 years, ≥3 diagnoses per ICD-10, and ≥3 inpatient admissions during the last
12 months. Frailty was assessed by FP (robust, pre-frail, frail) andthe CFS (range 1–7, frail = CSF ≥5). Concurrent validity of the
CFS against the FP was evaluated by Spearman Rho correlationcoeﬃcient.
Results: 211 participants were analyzed. The FP identiﬁed moreparticipants as frail, 44% (n=92), than the CFS, 30% (n=63). The
CFS moderately correlated with severity in FP (r=0.523, p=0.01). Six
frail participants were phenotypically frail but classiﬁed as CSF 2(well). Seven phenotypically robust participants were categorized
as mildly frail (n=1) and apparentely vulnerable (CFS 4–5) (n=6).
Conclusions: In this study the FP identiﬁed more frail older persons
than the CFS and there was a moderate agreement between themethods of frailty assessment.
P-212
Correlation between vastus lateralis muscle ultrasoundparameters and appendicular lean mass in older patients withphysical frailty
A. Ticinesi 1 , M. Narici 2 , F. Lauretani 1 , A. Nouvenne 1 , E. Colizzi 1 ,M. Mantovani 1 , M. Pedrazzoni 1 , T. Meschi 1 , M. Maggio 1 .
1 Department of Medicine and Surgery, University of Parma, Parma,
Italy; 2 MRC-ARUK Centre of Excellence for Musculoskeletal Aging
Research at University of Nottingham, Derby, United Kingdom
Background: Muscle ultrasound (MUS) has not been studied in
the context of sarcopenia assessment of older people. The aim of
this cross-sectional study was to verify the correlation between
right vastus lateralis (RVL) MUS measures and dual-energy X-ray
absorptiometry (DXA)-derived appendicular lean mass (ALM) in agroup of older patients.
Methods: We enrolled 45 older (age 79±5) community-dwellers(28 F) with physical frailty, deﬁned as Short Physical Performance
Battery (SPPB) score ≥3 and ≤9. DXA scans were performed usinga Hologic™ QDR 4500 A densitometer (Hologic, US). We also
performed RVL MUS using a MyLab Gamma™ system (Esaote, Italy)
equipped with a 5MHz linear probe, acquiring longitudinal andtransversal scans with real-time and extended-ﬁeld-of-view (EFOV)
techniques at the 65% of muscle length. Muscle thickness (MT),fascicle length (FL), pennation angle (PA) and EFOV-derived crosssectional area (CSA) were measured using the NIH-ImageJ software.
The age-adjusted Pearson correlation coeﬃcients between crude
ALM and MUS parameters were calculated stratifying by sex.
Results: Mean values of ALM, MT, FL, PA and CSA were 16.1±2.6 kg,
1.7±0.4 cm, 10.6±2.6 cm, 9.3±5.0° and 10.9±4.8 cm2 in females, and21.7±3.2 kg, 1.8±0.4 cm, 12.9±3.1 cm, 9.1±3.0° and 12.8±3.1 cm2 inmales, respectively. ALM was signiﬁcantly correlated with CSA in
both genders (r=0.70, p<0.001, in females; r=0.46, p=0.04, in males)
and MT only in females (r=0.58, p=0.001), but not with FL and PA.
Conclusions: In older patients with physical frailty, RVL MUSderived CSA exhibited a good correlation with crude ALM, particularly in females.

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P-213
Diagnosing sarcopenia using a formula derived walking speed
from the Timed Up And Go Test
V. Hood 1 , M. Azad 1 , R. Moorchilot 1 , M.H. Poon 1 , T. Masud 1 ,C. Hørlyck 2 . 1 Nottingham University Hospitals NHS Trust, United
Kingdom; 2 Aarhus University, Denmark
Introduction: The European Working Group on Sarcopenia in Old
People (EWGSOP) deﬁnes sarcopenia as both low muscle mass andeither slow walking speed (WS) or weak grip strength (GS). Previous
researchers have derived the WS (DWS) using a formula adjustmentof Timed-Up-and-Go-Test (TUG). The aim of this study was to assess
how the DWS performed compared to WS in diagnosing sarcopenia
in a falls clinic.
Methods: Consecutive attenders at a secondary care falls clinic
were recruited. Muscle mass was measured by bio-impedance
to estimate skeletal muscle index (SMI). Handgrip strength wasmeasured. WS (10m) and TUG (3m) were ascertained. TUG wasconverted to DWS by using the formula 6/TUG*1.62 [1]. We used
the EWGSOP cut-off values for WS (0.8 m/s), GS (30 kg men, 20 kg
women) and SMI (8.87 kg/m2 women, 6.42 kg/m2 men) to diagnose
sarcopenia.
Results: Fifty patients (mean age = 80.3±5.9 years; 26 women)
were recruited. Mean SMI was 7.9 kg/m2 for men and 6.8 kg/m2
for women. Mean WS and DWS were 0.63±0.22 m/s and 0.40±0.21m/s, respectively. Pearsons Correlation coeﬃcient between WS andDWS was 0.66 (p<0.001). The formula derived TUG equivalent to
a WS of 0.8 m/s was 12.2 seconds. The sensitivity, speciﬁcity, false
positive rate and false negative rate for diagnosing sarcopenia using
the DWS method were 100%, 92.9%, 96.0% and 100% respectively.
Discussion: We propose that the TUG can be used to estimate theWS with suﬃcient accuracy to diagnose sarcopenia.
Reference:[1] “Skeletal Muscle Function Deﬁcit” in A Nationally Representative British Birth Cohort in Early Old Age, Rachel Cooper et al,
Journals of Gerontology: Medical Sciences, 2015, 604–607
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Does cognitive decline play a role in the operational deﬁnition offrailty? A systematic review
R. Vella-Azzopardi 1,2 , I. Beyer 1,2 , S. Vermeiren 1 , M. Petrovic 3 ,N. Van Den Noortgate 3 , I. Bautmans 1,2 , E. Gorus 1,2 . 1 Gerontology
department and Frailty in Ageing (FRIA) Research department, Vrije
Universiteit Brussel (VUB), Brussels, Belgium; 2 Department ofGeriatrics, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels,
Belgium; 3 Department of Geriatrics, Ghent University Hospital (UZ
Gent), Ghent, Belgium
Introduction: A dvancing age is associated both with frailty andcognitive decline. The quest for a unifying approach has led to a
new and evolving concept, namely cognitive frailty. This systematic review aims to elaborate the trend of assessing the cognitive
domain within the existing frailty instruments.
Methods: The keywords aged; frail elderly; aged, 80 and over;frailty; diagnosis; risk management and classiﬁcation were used
to search for articles related to frailty instruments and publisheduntil December 2016 in the electronic databases PubMed, Web ofKnowledge and PsycINFO.
Results: Out of the identiﬁed 2,863 articles, 116 described original frailty instruments. Thirty-seven were duplicates and 79 were
ﬁnally included in this systematic review, describing ninety-four
original or modiﬁed frailty instruments. Two instruments were
excluded as their items were not suﬃciently speciﬁed. Out of
the remaining 92 frailty instruments, 46% included a cognitive
component. Importantly, 85% of the frailty instruments inclusiveof a cognitive component were published in 2011 or later. The

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correlation between inclusion of cognitive domain in frailty operationalisation and study publication date was signiﬁcant, χ2 =8.45,
p<0.05. This review identiﬁed 7 sub-groups of cognitive assessment – dementia as co-morbidity, objective cognitive screening
instruments (e.g. MMSE), self-reported cognitive screening assessments, signs and symptoms, delirium/clouding of consciousness,
non-speciﬁed and mixed assessments.
Conclusion: Although cognitive assessment has been increasingly
integrated in recently published frailty instruments, this has been
operationalised in a heterogeneous way. Therefore, the next stepis to identify the cognitive domain/s affected in cognitive frailty
followed by the standardisation of its operationalisation. This, obviously, will be the groundwork for the development of preventive
interventional strategies.
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Dynamic approach of the frailty status in nursing homes:
the SENIOR Cohort
F. Buckinx 1 , T. Brunois 1 , C. Lenaerts 1 , J.-Y. Reginster 1 ,J. Petermans 2 , O. Bruyère 1 . 1 Department of Public Health,
Epidemiology and health Economics, University of Liège, Belgium;
2 Geriatrics Department, CHU of Liège, Belgium
Background: This study aimed to assess frailty transitions over
1-year of follow-up among nursing home residents.
Methods: This is an analysis of the 1-year follow-up of the SENIOR
cohort (Sample of Elderly Nursing home Individuals: an Observational Research). All participants included in this cohort wereclassiﬁed into frail, pre-frail or robust according to the Fried’s criteria (i.e. weight loss, weakness, exhaustion, slow gait, low physicalactivity level) at baseline (T0) and after a 12-month follow-up
period (T12). Frailty transitions from T0 to T12 were assessed.
Results: Among the 662 residents included in the SENIOR cohort(83.2±8.99 years, 73.1% of women), 359 were included in thepresent analysis (i.e. 90 residents died, 2 nursing homes refused
to continue the study (58 residents), 91 residents refused to beassessed at T12, 20 moved away from the nursing home, 41 were
physically or cognitively unable to perform the various assessments
at T12 and 3 have incomplete data). Among people with complete
evaluations, respectively 75 (20.9%), 225 (62.6%) and 59 (16.4%)
residents were classiﬁed frail, pre-frail and robust at baseline. At
T12, these categories counted respectively 121 (33.7%; +12.8% fromT0), 184 (51.2%; −11.4%) and 54 (15.1%; −1.3%) residents. Between T0
and T12, 69 (19.2%) became frail and 45 (12.5%) became pre-frail.
More surprisingly, 31 (8.5%) subjects became robust although they
were frail or pre-frail at baseline.
Conclusion: Frailty is a dynamic process with transitions in both
directions, worsening and improvement, even within such a shortperiod and among nursing home résidents.
P-216
Factors affecting the subjective well-being of Japanesecommunity-dwelling elderly at one-year follow-up:
A preliminary study
T. Arai. Mejiro University, Saitama, Japan
Introduction: Subjective Well-Being (SWB) is thought to be one ofthe primary outcome in the health promotion for the communitydwelling elderly. As health promotion specialists, we should consider how to improve or maintain their SWB. The purpose of thispreliminary investigation was to examine the factors which affected
SWB at one-year follow-up.
Methods: Overall, 65 community-dwelling elderly individuals participated in the study (13 men, 52 women, mean age = 75.6
years, range = 66–85). The dependent variable was SWB (ﬁve-grade
evaluation; 1 = very poor, 5 = very good). The independent variables

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included basic characteristics such as age, body mass index, physical functions (walking ability, Timed Up and Go test, one-legged
standing time, handgrip strength), and Frailty Check List (FCL),
which consisted of 25 questions. We investigated these variables
at baseline and one-year follow-up. The associations between SWB
at one-year follow-up and other variables at the baseline were
evaluated by Spearman rank correlation.
Results and conclusions: Overall, 45 subjects participated in the
one-year follow-up investigation. Signiﬁcant associations were detected between SWB and walking ability, total FCL score, andsub-items of FCL (locomotive and depressive symptoms). The results suggested that it is important to improve or maintain thewalking ability and mental health to ensure a higher SWB in
the community-dwelling elderly; therefore, we should developintervention strategies for this population.
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Fear of falling and low-grade inﬂammation in sarcopenic obese
older women
E. Freiberger, R. Kob, W. Kemmler, C. Sieber, N. Rohleder. FAU
Erlangen-Nürnberg
Introduction: Falls and fear of falling (FoF) are both independent risk factors for losing mobility or independency in an aging
population. To date, there is no data if FoF activates stress systems and stimulates inﬂammation fostering further health declines.
Therefore, our goal was to test whether FoF was related withinﬂammation.
Method and results: In the FORMoSA study, community-dwelling
women 70 years and older were recruited for an intervention
to counteract sarcopenic obesity (SO) [1,2]. Forty-nine of those
provided valid blood samples for measuring IL-6 at baseline. In
those, we investigated the relationship between FoF as measured
with FES-I, and low-grade inﬂammation via plasma interleukin(IL)-6.61.2 percent (n=30) of our participants experienced a fallin the past. FoF and IL-6 did not differ between those who had
fallen and those who had not (FoF: F=0.11; p=0.92; IL-6: F=1.6;
p=0.21). However, IL-6 was higher in women reporting more severe
injuries after a fall (bone fractures or muscle injuries vs. bruises
or abrasions; F=3.86; p=0.017), and FoF was signiﬁcantly associatedwith IL-6 (r=0.40; p=0.044). No relationships were found in thewhole group or in those without falls.
Conclusion: Our results in this very speciﬁc but small population
demonstrate ﬁrst trends for a possible impact of FoF on the pathophysiology of sarcopenia. In older women who had experienced afall in the past, more severe falls, and higher fear of falling was
associated with higher IL-6, providing ﬁrst evidence that psychological stress resulting from previous falls was affecting inﬂammation,
thereby potentially contributing to further health declines.
References:[1] Kemmler, W., et al., Prevalence of sarcopenia in Germany andthe corresponding effect of osteoarthritis in females 70 years
and older living in the community: results of the FORMoSA
study. Clin Interv Aging, 2015. 10: p. 1565–73.
[2] Kemmler, W., et al., Prevalence of sarcopenic obesity in Germany
using established deﬁnitions: Baseline data of the FORMOsA
study. Osteoporos Int, 2016. 27(1): p. 275–81.
P-218
Frailty and chronic kidney disease in elderly population:
A prospective cohort study
S.M. Badr 1 , L.A. Bertholon 1 , V. Nonnonhou 1 , A. Wolak-Thierry 2 ,J.-L. Novella 3 , R. Mahmoudi 3 . 1 Department of Geriatrics and Internal
Medicine, Reims University Hospital, Maison Blanche Hospital, Reims,
F-51092, France; 2 Department of Research and Public health, Reims

University Hospitals, Robert Debré Hospital, Reims, F-51092, France;
3 Department of Geriatrics and Internal Medicine, Reims University

Hospital, Maison Blanche Hospital, Reims, F-51092, France; Faculty of
Medicine, EA 3797, University of Reims Champagne-Ardenne, Reims,
F-51092, France
Objectives: Chronic kidney disease (CKD) is associated with physiological changes that may predispose to frailty. The principal aimof this study was to determine the prevalence and characteristics offrailty among patients with CKD. We also tried to determine if CKD
is associated with frailty.
Methods: A prospective study was performed in an acute geriatric unit from February 2015 to June 2016. The frailty syndrome
was assessed using Fried criteria and Modiﬁed Short Emergency
Geriatric Assessment (SEGAm) score. The CKD status was deﬁned using the Chronic Kidney Disease Epidemiology Collaboration(CKD-EPI) equation for a glomerular ﬁltration rate lower than
60 ml/min/1.73m2 . Association between CKD and frailty was performed using logistic regression.
Results: Two hundred and ﬁfty patients were included in this study(mean age =84.6±6.8 years) and 62.5% were women. Of these 250
patients, 34.3% presented a CKD. The prevalence of frailty participants with CKD was 60.2% and 81.3% according to Fried criteria and
SEGAm score respectively. Moreover subjects with CKD presented
a higher burden of comorbidities (p<0.0001) and a higher prevalence of weakness according to Fried criteria (p=0.025) comparedto subjects without CKD. Finally, CKD was associated with frailty
according to SEGAm score (OR 1.772, 95% CI: 1.121–2.801, p=0.014).
Conclusion: Frailty syndrome is prevalent among elderly subjects
with CKD. This study may suggest an association between frailty
and CKD according to the SEGAm score.
P-219
Frailty and chronic pain: A novel association
P. Kucukdagli, G.B. Ozturk, C. Kılıç, T.O. Erdoğan, O. Yilmaz, Y. Topcu,
B. İlhan, S. Muratli, M.A. Karan. Istanbul University, Istanbul Medical
School, Department of Internal Medicine, Division of Geriatrics,
Istanbul, Turkey
Objective: Frailty is most often deﬁned as a syndrome of physiological decline in late life, characterized by marked vulnerability toadverse health outcomes. Frail older adults are less able to adapt tostressors such as acute illness or trauma than younger or non-frail
older adults. We aimed to assess prevalence of frailty in elder
people and it’s relationship with other conditions in this study.
Methods: 1107 individuals ≥60 years of age admitted to IstanbulMedical-School Geriatrics-outpatient clinic for the ﬁrst time theperiod between 2013–2016 were enrolled to study. We used The
International Association of Nutrition and Aging’s FRAIL scale contains 5 simple questions to deﬁne frailty. Frail person was accepted
as who gets ≥3 points in scale. Patients were asked about theirfallings, urinary incontinence, chronic pain, sleep disorders, activities of daily living (ADL), instrumental activities of daily livin (IADL),
cognitive status, number of illness and medication, postural instability and assessed about their nutritional status by Mini Nutritional
Assessment (MNA).
Results: 1107 patients were analyzed with a geriatric assessment.
The sample was composed of wome (66.8%) and me (33.2%) withmean age of 78.5±5.7 years. Prevalence of frailty was 16% (n=179).
Frailty was found independently assosiated with ag (p=0.041),
chronic pain (p=0.021), usual walking spee (p<0.01), malnutrition(p<0.01), IADL (p=0.024) respectively.
Conclusion: Frailty carries an increased risk for poor healthoutcomes, including fall, incident disability, hospitalization andmortality. Elucidating its etiology and natural history is therefore
critical for identifying high-risk subsets and new arenas for frailty

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

prevention and treatment. An important strength of our study isassessment of chronic pain which is a new area of research in frailty
concept. Our ﬁndings provides data on the signiﬁcance of chronic
pain and its association with frailty.
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Frailty and muscle correlates in older people with diabetes:
An MRI explorative study
M. Danet-Lamasou 1 , S. Regueme 1 , G. Catheline 2 , E. Barse 2 ,J. Girard 3 , T. Pickles 4 , L. Rodriguez-Mañas 5 , A.J. Sinclair 6 , K. Hood 4 ,I. Bourdel-Marchasson 1,3 . 1 Pole gérontologie clinique, CHU Bordeaux,Bordeaux, France; 2 UMR 5287 Institut de Neurosciences Cognitives etIntégratives d’Aquitaine (INCIA), CNRS/Université de Bordeaux,Bordeaux, France; 3 UMR 5536 Résonance Magnétique des systèmes
Biologiques, CNRS/Université de Bordeaux, Bordeaux, France; 4 Centre
for Trials Research, College of Biomedical & Life Sciences, Cardiff
University, Cardiff, UK; 5 Department of Geriatrics at Hospital
Universitario de Getafe, Madrid, Spain; 6 Foundation for Diabetes
Research in Older People at Diabetes Frail Ltd, Worcestershire, UK
Introduction: Although diabetes is known as a frailty inducing
disease the characteristics of sarcopenia within this group has notbeen extensively explored.
Method: Among participants of MID-Frail, one recruiting centervolunteers underwent both brain and muscle MRI and functional
assessments. Muscle areas and muscle magnetization transfer(MTR) were calculated in thigh and particularly in rectus femoris(RF). Grey matter volumes and muscle assessments relationships
were described using positive and negative regressions (SPM software).
Results: Twenty-six subjects (7 female, mean age 78.2 y, SD 5.0),
were explored in this sub-study. Among them 6 were frail andthe others were prefrail. Total SPPB was positively related withmaximal rectus femoris area. The sub-scores for walking and risingchair test were related to RF strength but not to RF area or MTR.
Higher walking time was negatively associated with thalamus volume and higher score in chair rising test was positively associatedwith caudate nucleus area. MNA score was related to grey mattervolume.
Conclusions: Frailty in older people is multifactorial and brain
and muscle MRI correlates may improve our understanding of itsdifferent physical components.
P-221
Frailty-guided management model for severely frail older adults
in an acute hospital setting
N.A. Malik, W.K. Panagoda, F.Y.H. Tan, W.Y. Pang. Department ofGeriatric Medicine, Khoo Teck Puat Hospital, Singapore
Introduction: Frailty underpins every aspect of the care of an older
person, from the goals of care to risk-beneﬁts of interventions tofunction, discharge and mortality. We explore the use of a checklistof interventions to augment the medical management of older
acute hospital patients with advanced frailty.
Methods: The Geriatric Frailty Unit (GFU) in our hospital wasestablished to pilot care models for older patients with advanced
frailty, as deﬁned by a score of 7 or 8 on the Clinical Frailty Scale(CFS). We applied a package of 5 core interventions – Listening
Clinic, Care Needs Assessment, Medication Review, Diet Review and
Future Care Planning – on top of usual management of the medical
conditions they had been admitted for.
Results: Data had been collected on 60 patients at time of writing. 85% of patients or surrogates attended the Listening Clinic,
where a Preferred Plan of Care (PPC) discussion was offered to
52% and taken up by 32%. 41% of patients had their medication
list reduced, 17% had their dietary restrictions liberalised and 19%

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had their follow-up appointments reduced. Qualitative feedback
showed almost universal caregiver and staff satisfaction.
Conclusion: A package of interventions applied as an overlay tousual medical management of older patients with advanced frailty
had meaningful effects on streamlining their care and reducing
burdensome treatments that were no longer beneﬁcial at this stageof their life journey. We look forward to further reﬁning the interventions and extending this model to patients admitted under otherdepartments. We also anticipate designing such overlays tailored to
the needs of patients at other stages of the frailty spectrum, such as
the robust and pre-frail, to complement usual medical care.
P-222
French version of the SARC-F questionnaire: translation andlanguage validation
C. Beaudart 1 , M. Locquet 1 , S. Schneider 2 , S. Bornheim 3 ,J.-Y. Reginster 1 , O. Bruyère 1 . 1 Research Unit in Public Health,
Epidemiology and Health Economics (URSAPES), University of Liège,
Liège, Belgium; 2 Centre Hospitalier Universitaire de Nice, Pôle Digestif,
Université de Nice Sophia-Antipolis, Faculté de Médecine, Nice, France;
3 Unité de Kinésithérapie générale, CHU Liège, Liège
Objectives: To obtain a valid translation of the SARC-F questionnaire(giving a predictive symptom score for sarcopenic subjects).
Methods: A global methodology developed by the EUGMS sarcopenia interest group (SIG) regarding the translations of the SARC-F
questionnaire has been followed. The English original version of
the SARC-F has ﬁrst been translated in French by a bilingual expert
and then, back translated by another bilingual expert. An expert
panel has been established in order to identify and resolve any
issues during the process of translation. The translated version has
been pre-tested on 10 sarcopenic subjects and validated (inter-rater
reliability and test-retest reliability) on 20 other sarcopenic subjects. Sarcopenic subjects have been identiﬁed from the SarcoPhAge
study (Belgium) and diagnosed according to the EWGSOP diagnosis
criteria.
Results: The translation from English to French has been performed
without any diﬃculties. No amendment has been made to thequestionnaire following the pre-test (10 sarcopenic subjects, 5 men
and 5 women, mean age of 72.5±4.79 years). The French version of
the SARC-F demonstrated an excellent inter-rater reliability with an
ICC of 0.90, CI 95% (0.76–0.96) (20 sarcopenic subjects, 9 women, 11men, mean age of 75.2±5.02 years) as well as an excellent test-retest
reliability after a two-week interval with an ICC of 0.86, 95% CI:(0.66–0.94) (20 sarcopenic subjects, 15 women, 5 men, mean age of
77.0±6.57 years).
Conclusions: The French version of the SARC-F questionnaire is now
available. The clinical validation of this translated tool (sensitivity,
speciﬁcity, VPN, VPP in order to predict sarcopenia) is currently inprocess. The language validation studies are in progress in 13 other
European languages.
P-223
Handgrip strength as a predictor of functional recovery inelderly patients with hip fracture
L. Del Rosario Evangelista Cabrera, E. Lueje Alonso, V. Garay Airaghi,
L. Fernández Arana, J. Mora Fernández. Hospital Clínico San Carlos,
Madrid, Spain
Introduction: Functional recovery is one of the main purposes on
hip fracture patients. The objective of this study was to describe
the role of grip strength in predicting the short-term functional
recovery after hip fracture.
Methods: Prospective six-month follow up study. Patients aged
>65 with hip fracture (September 2015-August 2016). Variables:
Functional assessment (Barthel index-BI-, Functional ambulation

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Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

classiﬁcation-FAC-, Lawton index-LI-), Comorbidit (CIRS-G), Vitamin D (VitD), nutritional status (Body mass index-BMI-, Mini
Nutritional Assessment-MNA-SF-), handgrip strength (Jamar’s dynamometer; cut points for dynapenia=men<30kg, women<20kg,
and dynapenia_med -according to median values- =men≤16.5kg,
women≤11.5kg). Functional recovery was assessed by the following
formula: (6-month_Barthel – baseline_Barthel)*100/baseline_Barthel.
Successful recovery >-25%. Binary logistic regression analysis was
performed.
Results: 146 patients were included; age 85±7.1, women 76.7%.
CIRS-G 13 (IQR=10–16). Baseline-BI 90 (IQR=75–95), 6-monthBI 78 (IQR=62–95), moderate-severe cognitive impairment 17.1%.
Handgrip strength: women 11.6 (IQR=8–15), men 16.9 (IQR=10–22). Dynapenia 93.8%, Dynapenia_med 47.9%. Successful recovery
56.8%. 6-month-mortality 11%. On univariate analysis age≤85,
FAC>4, normal-mild cognitive impairment, LI>4, lower numberof drugs, non- dynapenia_med, and rehabilitation in the Geriatric Day Hospital were signiﬁcantly associated with successful
recovery. In multivariate analysis the only independent predictors
were non-dynapenia_med (OR: 2.37; 95%CI; 1.09–5.15; p=0,030),
and normal-mild cognitive impairment (OR: 3.14; 95%CI; 1.13–8.69;
p=0.027). VitD ≥20ng/mL showed a non-signiﬁcant tendency. There
was no association with nutritional status.
Conclusions: There is a high prevalence of dynapenia in hip fracture patients. Successful functional recovery at 6 month following
hip fracture was associated with non-dynapenia (using cut points
according to median for our sample) and better cognitive status.
P-224
Health-related quality of life in sarcopenia: Translation andvalidation of the Czech version of the SarQoL® instrument
H. Michalkova 1 , I. Ryznarova 2 , J. Seget 2 , E. Topinkova 1 .
1 Department of Geriatrics, 1st Faculty of Medicine, Charles University,

General Faculty Hospital, Prague, Czech Republic; 2 Geriatric andPost-acute Department, Silesian Hospital, Opava, Czech Republic
Background: Sarcopenia is increasingly recognized in clinical practice. Deﬁned as decreased muscle mass and function sarcopenia isassociated with negative health outcomes and decreased qualityof life. Recently sarcopenia-speciﬁc quality of life questionnaire
SarQoL® has been developed and validated in English. Sarqol®
includes 7 major domains: Physical and Mental Health, Locomotion,
Body Composition, Functionality, ADLs, Leisure activities and Fears.
The aim of the study was to translate and validate SarQoL® for the
Czech language.
Methods: Translation and cross-cultural adaptation followed therecommended protocol in 5 steps: original translation by 2 translators, synthesis, backtranslation, expert review and piloting the
pre-ﬁnal version with sarcopenic subjects for understanding andfeasibility. Further, SarQoL® discriminative power was assessedcomparing sores of sarcopenic and non-sarcopenic individuals andits convergent validity evaluated estimating SarQoL® correlations
between physical functioning subscore of SF-36 questionnaire.
Results: The ﬁnal version of SarQol® in Czech language is available
on www.sarqol.org. In total 99 subjects (16 males, 83 females),mean age 81.39±6.2yrs from two sites (VFN Prague, Silesian Hospital Opava) were included in validation study. The overal SarQoL®
score in sarcopenic (FNIH-deﬁned) subjects N=73 was 61.6±2.7
compared to 26 nonsarcopenic subjects 74.8±4.8 (p<0.05). The
SarQoL® scores correlated with SF-36 total and physical functioning
subscore (Spearman’s correlation good and very good, respectively).
Conclusion: The Czech version of SarQol® is available for publicuse. The preliminary results show good discriminative power andconstruct validity. However, the validation project is still ongoingto test the internal consistency and reliability before SarQol® fullclinical use.

P-225
Hip fracture in the very elderly: Description and characteristicsof the HIPA study
M. Bermudez 1 , B. De Luxan 2 , B. Caballero 2 , G. Guzman 1 ,M. Fernandez 1 , A. Coto 2 , J.J. Solano 1 . 1 Hospital Monte Naranco;
2 Universidad de Oviedo
Aim: Determine differences of physical performance and the variable that are related in the very old that are independent for
activities of daily living with hip fracture after surgery.
Materials and methods: Prospective study. Included patients ≥70
years admitted at the Monte Naranco Hospital’s Orthogeriatric Unit.
They had a Barthel Index (BI)≥80, without history of cognitive impairment, low comorbility (Charlson Index (CI)≤2), without frailty
criteria (Frail Index (FI) ≤2. Assessesment made by a geriatrician
during admission and 3 months after. Main variables included:
physical impairment, frailty, physical performance using BI, Lawton
Index (LI), FI and Short Physical Performance Battery (SPPB). We
analyzed using Welch-test Man-Whitney, Kruskal Wallis, Chi2, andlogistic regression.
Results: 61 patients from 100 included. Mean age 82.56±6.25;
women 85.2%; BI 97.13±5.20; LI 6.58±2.02 women, 4.55±1.61 men;
CI 0.59±0.72; surgical wait time 5.07±21.36 days; Rehabilitation
wait time 2.5±1.61 days; hospital stay 14.51±3.01 days. Type of
surgery: Osteosynthesis 60.65%. Frail Index: Robust 57.4%, prefrail
42.6%. Mean SPPB 5.49±2.63. Two patients within a same groupage with functional impairment (LI) have a 48.92 increase risk of
having a SPPB ≤6 (IC=7.71–310.53;p<0.001). Patients 80 years andolder with hip fracture have a 7.29 increase risk of having a SPPB
≤6 (IC=2.17–24.41; p=0.01). Worsening in FI group is associated in a
8.15 increase risk of having a SPPB ≤6 (IC=1.308–50.806;p=0.025).
Conclusion: Patients with hip fracture and previous good functional
performance will have a physical performance with a moderate
physical impairment. This limitation is related with age, frailty andfunctional impairment.
P-226
Implementation of routine grip strength measurement amongolder inpatients on admission to hospital: identifying facilitatorsand barriers using normalisation process theory (NPT)K. Ibrahim 1,2 , C. May 2 , H.P. Patel 1,3 , M. Baxter 3 , A.A. Sayer 1,2,3,4 ,H.C. Roberts 1,2,3 . 1 Academic Geriatric Medicine, University ofSouthampton, Southampton, UK; 2 NIHR CLAHRC: Wessex, University ofSouthampton. Southampton, UK; 3 Medicine for Older People,
Southampton General Hospital, Southampton, UK; 4 NIHR Newcastle
Biomedical Research Centre, Newcastle University and
Newcastle-upon-Tyne NHS Foundation Trust, Newcastle, UK
Background: Low grip strength in older inpatients is associatedwith sarcopenia, longer length of hospital stay, increased functional
limitations and mortality. Measuring grip strength is simple, often
used in research but not in routine clinical practice. This study
evaluated the feasibility and acceptability of implementing grip
strength measurement into routine clinical practice.
Methods and design: This study was conducted in ﬁve acute medical wards for older people in one UK hospital. Intervention design
and implementation evaluation were based on Normalization Process Theory (NPT). The training program was developed to teachward staff to measure grip strength. A mixed methods design
assessed adoption, coverage, acceptability and basic costs of grip
strength measurement implementation.
Results: 155 staff were trained to measure grip strength. 81% offemale patients had low grip strength <16 kg (median 11kg) and
75% of male patients had low grip strength <27 kg (median 20kg).
Adoption and the average weekly coverage of grip strength measurement varied between 25% and 80% across the 5 wards. UsingPoster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

NPT, implementation enablers identiﬁed included motivated ward
champions, managerial support, engagement strategies, and staff
shared-commitment. High turnover of staff and champions, lack ofmanagerial buy-in and staff commitment were the main barriers to
successful implementation. Both staff and patients found the grip
strength test easy and potentially beneﬁcial. The total cost was < £3800.
Conclusions: It was feasible, cheap and acceptable to train 155
staff to routinely measure grip strength. Most patients had low grip
strength and were at high risk of sarcopenia and poor healthcare
outcomes.
P-227
Improving and maintaining the assessment and documentationof the Clinical Frailty Scale score in an acute hospital setting. A
multiple cycle quality improvement project
R. Haider, N. Rajcoomar, C. Mukherjee, M. Sweeting. Mid Essex
Hospital Services NHS Trust, Chelmsford, UK
Introduction: The prevalence of frailty in the UK is increasing.
Clinical frailty is associated with increasing morbidity, mortality
and length of hospitalisation. The Rockwood Clinical Frailty Scale(CFS) score is a validated tool used to identify clinical frailty,
enabling risk stratiﬁcation and advanced care planning. Broomﬁeld
Hospital, Essex, UK, started using the CFS score after initial audits
revealed poor documentation of clinical frailty. The CFS score wassubsequently introduced on Electronic Discharge Letters (EDLs) tohighlight frail patients to GPs. Consecutive Quality Improvement
Project cycles incorporated interventions aimed at improving thiscommunication.
Methods: A retrospective review of randomly selected EDLs (n=369)
for patients aged >75 conducted between June 2015–March 2017assessed documentation of CFS scores. Cycle 1 introduced a frailtytab (a computerised Rockwood CFS) on the EDL. Cycle 2 focusedon departmental and face-to-face education of medical staff and adesktop and paper simpliﬁed CFS score poster.
Results: Prior to intervention 0% (n=60) of EDLs had documented
CFS scores (June 2015). Introducing the frailty tab improved documentation to 74% (n=60) (October 2015). 12 months after Cycle 1,
CFS documentation was maintained at 75% (n=64) without further
intervention. Following staff education and introduction of theposter, CFS documentation improved to 94% (n=185).
Conclusion: A simple electronic frailty tab in the EDL dramatically improved coding for clinical frailty in the hospital setting.
However, departmental education further improved compliance to94%. When implementing a system-wide change (such as the frailtytab), tailored educational programs should be used alongside suchchanges to ensure the best results.
P-228
Level of physical activity evaluated by accelerometry in older
subjects from the SarcoPhAge study with or without muscle
impairment
M. Locquet 1 , C. Beaudart 1 , L. Delandsheere 1 , J. Petermans 2 ,G. Appelboom 3 , J.-Y. Reginster 1 , O. Bruyère 1 . 1 University of Liège;
2 CHU of Liège; 3 Stanford University Medical Center
Introduction: Our objective was to assess the relationship between
muscle impairment and daily steps.
Methods: We investigated elders from the SarcoPhAge (Sarcopenia
and Physical Impairment with Advancing Age) study. Three measurements were performed: muscle mass (using DEXA), muscle
strength (using a dynamometer) and physical performance (withthe Short Physical Performance Battery test). Using the cut-off limits
proposed by the EWGSOP, women were classiﬁed in the “low muscle mass group” when their muscle mass value was <5.50kg/m2 , inS105

the “low muscle strength group” when their strength was <20kg
and in the “low physical performance group” when their SPPB ≤8
points. Respectively, the thresholds used for men were <7.26kg/m2 ,<30kg and ≤8 points. The number of daily steps was evaluated,over a 7-day period, by a validated accelerometer.
Results: During one week, 174 subjects (74.7±5.7 years, 54.6%
women) wore the accelerometer. In women, a correlation was
found between daily steps and physical performance (r=0.24,
p<0.05). However, no signiﬁcant difference in the number of daily
steps was reported in women with low muscle mass, low muscle strength, or poor physical performance compared to womenwith a better muscle status. In men, the number of daily steps
was signiﬁcantly correlated with physical performance and muscle
strength (r=0.44 and r=0.26, p<0.05). Men with low strength andpoor physical performance walked signiﬁcantly less than men withgood muscle function (4565 steps versus 6672 steps, p=0.004; 4198
steps versus 6554 steps, p=0.005). However, these relationships
were no longer evident when adjusted for confounders (i.e., age,sex, number of comorbidities and number of drugs).
Conclusions: The muscle health status of older individuals does notseem to strongly inﬂuence their number of daily steps.
P-229
Long-term home-based physiotherapy for older people withsigns of frailty - RCT (NCT02305433)
K. Kukkonen-Harjula 1 , P. Kärmeniemi 1 , S. Suikkanen 1 , S. Kääriä 2 ,S. Sipilä 3 , K. Pitkälä 4 , M. Hupli 1 . 1 Rehabilitation, South Karelia Socialand Health Care District, Lappeenranta, Finland; 2 Hyvis-ICT, Kotka,
Finland; 3 Gerontology Research Ctr, Unit of Health Sciences, Universityof Jyväskylä, Finland; 4 Dept. General Practice, University of Helsinki;
Unit of Primary Health Care, Helsinki University Hospital, Finland
Introduction: There is increasing need for new rehabilitation models to postpone disabilities and institutional care in older persons
with signs of frailty. One alternative is home-based rehabilitation.
We applied home-based physiotherapy with emphasis on functional
exercises for 12 months with 12 months’ registry follow-up.
Methods: Three hundred persons (>65 y) were recruited. Frailty
was screened using Morley’s FRAIL questionnaire and veriﬁed
according to modiﬁed Fried’s criteria. Persons were randomized
to a physiotherapy and a usual care arm. The primary outcome
is duration of living at home during 24 months. Secondary outcomes include physical functioning (assessed by SPPB, FIM, IADL),
health-related quality of life (15D), frailty status, use and costs ofhealth and social services (registry information during 24 months),
falls, and mortality. A physiotherapist performs assessments at theparticipant’s home at baseline, 3, 6 and 12 months. MMSE, GDS-15,
MNA and SPS are also assessed. Physiotherapy (60 minutes 2 times
weekly) is based on Otago method, and includes exercises forstrength, muscle endurance, balance and ﬂexibility.
Results: Twelve-month assessments will be completed in August
2017. At baseline the mean age was 82 y, 75% were women, and 61%
were pre-frail (scored 1–2 points). Mean (SD) SPPB was 6.2 (2.6),
FIM 108.8 (10.6), 15D 27.1 (5.1), MMSE 24.4 (3.1), GDS-15 4.8 (2.7),
and MNA 23.0 (3.2) points.
Conclusions: Our trial will provide new knowledge whether longterm home-based physiotherapy improves physical functioning topostpone institutional care in persons with signs of frailty. Supported by Social Insurance Institution
P-230
Muscle mass adjusted for body mass index reveals better eﬃcacy
in relation of sarcopenia with functional measures
A. Tufan 1 , G. Bahat 2 , S. Muratli 2 , C. Kılıç 2 , M.A. Karan 2 .
1 Department of Internal Medicine, Division of Geriatrics, Marmara

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University Hospital; 2 Department of Internal Medicine, Division ofGeriatrics, Istanbul Medical School
Objective: The prevalence of sarcopenia differs according to its
adopted deﬁnition. Hereby, we aimed to examine which Low
Muscle Mass (LMM) adjustment method reveals better eﬃcacy inrelation to its functional outcomes.
Methods: Community-dwelling older adults 60–99 years of age
were included. Body composition was assessed with bioimpedance
analysis. LMM was evaluated according to our national data. Muscle
strength was assessed by measuring hand grip strength (HGS) witha Jamar hydraulic hand dynamometer. The relation of skeletal muscle mass index (SMMI) with hand grip strength, usual gait speed(UGS), activities of daily living (ADL), instrumental ADL (IADL) andfrailty were examined between different adjustment methods.
Results: 1307 older adults (421 male, 886 female) were included.
The prevalences of LMM were 2.1%, 47.2%, 63.4% and 21% andprevalences of sarcopenia were 1.3%, 23.9%, 35.2% and 13.2%
with adjustments by height (H), weight (W), body mass index(BMIa) and BMIb, respectively. HGS was correlated with all SMMIs,
most being adjusted with the BMI (H, r=0.286; W, r=0.298; BMI,
r=0.548, p<0.001). UGS was not correlated with LMM adjusted
by H (p=0.267) but with W (r=0.077, p=0.009) and BMI (r=0.223,
p<0.001). ADL was not correlated with LMM adjusted by H (p=0.71)
but with W (p=0.008) and BMI (p<0.001). IADL was not correlatedwith LMM adjusted by H (p=0.49) but with W (p=0.045) and BMI(p=0.026).
Conclusions: The prevalences of LMM and sarcopenia change signiﬁcantly between SMM adjustment methods. Muscle mass adjustment with BMI proves better relation with functional associationsof sarcopenia.
P-231
Newly suggested deﬁnition of cognitive frailty for epidemiologic
study
C.W. Won. Kyung Hee University
A concept of “cognitive frailty” has recently been proposed byan (I.A.N.A./I.A.G.G.) International Consensus Group. The groupsuggested that “cognitive frailty” means a clinical condition characterized by the simultaneous presence of both physical frailty andcognitive impairment, occurring in the absence of overt dementia
diagnosis. (I.A.N.A./I.A.G.G.) International Consensus Group deﬁned
cognitive frailty as follows: 1) presence of physical frailty andcognitive impairment (CDR=0.5); and 2) exclusion of concurrent
dementia. By the way, CDR is not frequently available in epidemiologic studies and what can be an alternative to CDR=0.5? How
can we exclude the demented in a condition dementia specialists
or neuropsychologists are not available in epidemiology studies?
According to the International Working Group on MCI, MCI was
operationalized as 1.5 standard deviations below that of age appropriate norms in one or more cognitive domains. The revised criteria
for AD dementia, which are comparable to widely used criteria fordementia of the Alzheimer type (DAT), stipulate that impairment
must be present in two or more cognitive domains and must interfere with the ability to function in usual activities. Putting thesethings together, we suggest a new alternative deﬁnition of cognitive
frailty for epidemiologic studies as follows;1) physical frailty and2)
any cognitive function test <1.5 SD of the age-, gender-, education adjusted norm (for example, verbal learning test, Digit Span,
Boston Naming Test, Trail Making Test, and Frontal Assessment
Battery) and3) no dependency in IAD (especially, managing money,
telephone use, responsibility for medication, and shopping, etc)

P-232
One-year change in weight, muscle strength, walking speed,
walking endurance, and physical activity in older adults
T. Kahraman 1 , K. Cekok 2 , B.O. Ugut 1 , P. Keskinoglu 3 , A. Genc 4 .
1 Department of Physiotherapy and Rehabilitation, Faculty of Health
Sciences, Izmir Katip Celebi University, Izmir, Turkey; 2 Department of
Physical Therapy and Rehabilitation, Medical Park Hospital, Izmir,
Turkey; 3 Department of Biostatistics and Medical Informatics, Dokuz
Eylül University, Izmir, Turkey; 4 School of Physical Therapy andRehabilitation, Dokuz Eylül University Izmir, Turkey
Objectives: The normal course of aging affects musculoskeletal
system, and as a result plays an important role in reducing themobility observed in later life. Frailty is a common clinical syndrome in older adults with increased risk for poor health outcomes
including falls, impairment, hospitalization and mortality. In theabsence of consensus, the frailty syndrome requires at least three ofthe following ﬁve characteristics: unintentional weight loss, muscle
weakness, low walking speed, poor endurance, and low physicalactivity. Here, we report one-year change in these domains in older
adults.
Methods: Participants aged older than 50 years were included inthis cohort study. The participants were assessed baseline and after
one year regarding to weight, muscle strength, walking speed, endurance, and physical activity with appropriate measures including,a hand-held dynamometer, 10-MeterWalk Test, Six-Minute Walk
Test, and Rapid Assessment of Physical Activity Questionnaire.
Results: Thirty-ﬁve 35 of 94 participants assessed in the baseline
were re-assessed after one year. There was a signiﬁcant decreasein walking speed, muscle strength, and physical activity level(p<0.05), whereas there was no signiﬁcant difference in weight andwalking endurance (p>0.05).
Conclusion: This study suggests that the relevant physiologicalvariables are changing in favor of frailty syndrome even within ayear. It seems that regular assessment of the frailty syndrome isan important issue to plan the appropriate treatment interventions
and improve rehabilitation outcomes.
P-233
Osteoporotic fractures in geriatrics
A. Brincat 1 , S.D. Brincat 2 , J. Calleja-Agius 3 . 1 Sir Anthony Mamo
Oncology Centre, Msida, Malta; 2 Mater Dei Hospital, Msida, Malta;
3 University of Malta, Msida, Malta
Aim: To present an overview of the physiological process andtreatment of osteoporosis.
Method: A search for the relevant articles was conducted on
PubMed and Google Scholar using the terms ’falls’, ’osteoporosis’,’fractures’ and ’elderly’. A literature review was compiled.
Results: Osteoporosis is a systemic progressive disease characterised by a decrease in bone mass per unit volume enhancing
susceptibility to fractures on minor trauma [1]. The pathophysiology of osteoporosis is multifactorial involving cytokines incombination with genetic and environmental inﬂuences [2,3]. Osteoporotic patients are on the increase as a result of an improved
life expectancy and decreased physical activity [4]. Locally, thecommonest risk factor is menopause (83%) followed by a sedentary
lifestyle (58%) and a family history (30%). Metabolic bone diseases
may occur secondary to co-morbidities or pharmacological therapy[5,6]. With increasing age, females lose more bone mass (35–50%
trabecular bone; 25–30% cortical bone) compared to males (15–45%
trabecular bone; 5–15% cortical bone) resulting in increase in theincidence of fractures [7]. Femoral neck fractures have the most
severe repercussion as 20% die within a year, 40% incapable to carryout activities of daily living, 20% bedridden whilst 25% require institutionalisation [4,8]. The commonest treatment prescribed locally isPoster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

bisphosphonates and calcium supplements [5]. Novel pharmacological therapies targeting osteoporosis from its molecular levels aredeveloped [4,9]. Assessment of the patient’s risk of falls combinedwith non-pharmacological therapy are crucial adjuncts especiallyin the elderly population [7].
Conclusion: Osteoporosis is a major clinical problem in geriatrics.
It increases morbidity and mortality, reduces the patient’s qualityof life and creates an economic burden.
References:[1] World health organisation, World Health Organ Tech Rep Ser.
1994;843:1–129[2] Brincat SD, Borg M, Camilleri G et al. Minerva Ginecol. 2014;
66(4):391–407[3] Salari P, Abdollahi M. Int. J. Pharm. 2011;7(5):552–567[4] Baqir W, Copeland C. The Pharmaceutical Journal. 2010; 284:
345–346[5] Fenech J, Galea R, Serracino-Inglott A et al. Journal of Applied
Therapeutic Research 2011;8:101–106[6] Le Templier G, Rodger MA. Curr Opin Pulm Med. 2008;14(5):403–7[7] Francis RM. Age and Ageing 2001;30-S4:25–28[8] Mayes SL. Nutr Clin Pract. 2007;22(3):276–2859. Cole Z, Dennison E, Cooper C. Br Med Bull. 2008; 86:129–143
P-234
Physical activity, frailty and elderly: Prospective andobservational study over a period of 3 months. Preliminary
results
H. Habchi 1 , M. Drame 2 , N. Kadri 3 , J. Doucet 3 . 1 Hospital of
Chaumont; 2 University Hospital of Reims; 3 University Hospital of
Rouen
Background: In their privileged relationship and repeated contact
with the elderly, general practitioners should be the ﬁrst line ofdefense for the early identiﬁcation of fraily. This would allow areversal of the frail state if appropriate management strategies arein place, including counseling for physical activity adapted to thecondition of the elderly.
Methods: This is a prospective study conducted in a general practice in Chaumont, France. It took place during the period from 1
February 2016 to 30 April 2016 inclusive. The inclusion criterion
was to be age 65 years or more at the primary care oﬃce visit.
Results: Forty-four patients were included, 26 of whom werefemale (59.10%); they had a mean age of 75 years, an average
Charlson score of 2.8, an average MMS of 25.4, an average IADL of
6.7, and an average ADL of 5.8. Sixteen of the subjects (36.36%) wereaccompanied during their medical visit to the doctor. For 25% of thepatients, the reason for the visit was a single medical consultation;for 57%, the visit was a follow-up. We noted 21 patients (47.73%)
who had a manual occupation. Sixteen smoked (36.36%), and 30
said they drink alcohol moderately (68.18%). Arthritic diseases,
cardiovascular history (primarily high blood pressure), and lungdisease were the conditions most frequently encountered in thepatients’ medical histories. Malnutrition was found by the BMI for
11 patients (25.00%), by the MNA for six patients (13.64%), andby albumin levels for three patients); the mean albumin level was
38.4 g/l. We noted weakness among the subjects on the SEGA scale
for seven patients (15.91%) and according to the Fried scale for 25
patients (56.82%). According to the Ricci–Gagnon scale, 10 patients(22.73%) were considered inactive; the average Ricci–Gagnon score
was 22.6. The monopodal support test found pathology in 18
patients; two patients had a Get-Up and-Go Test result of greaterthan 20 s (4.55%). Anemia was present in one patient (2.33%) (Onepatient had missing data); whereas a vitamin D deﬁciency waspresent in 34 patients (85.00%). Among the subjects, six patients(13.64%) practiced a team sport. We did not ﬁnd a correlation

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between the SEGA fragility score and the Ricci–Gagnon physicalactivity (p=0.68), but a slight correlation was found between theFried fragility score and Ricci–Gagnon physical activity (p=0.092);
this may be explained by the small sample size. We found a slightcorrelation between the SEGA fragility score and the monopodal
support pathology test result (p=0.083) as well as between the Friedfragility score and the monopodal support pathology test result,close to signiﬁcance (p=0.06). No correlation was found between
the SEGA fragility score and Get-Up-and-Go Test result >20 s(p=0.17) nor between the Fried score and a Get-Up-and-Go Test
result >20 s (p=0.2), nor even between the SEGA score and teamsport participation (p=0.25) nor between the Fried score and teamsport participation (p=0.6). We did not ﬁnd a correlation between
SEGA fragility and malnutrition according to the BMI (p=0.47),
whereas we did ﬁnd a signiﬁcant link between Fried fragility andmalnutrition according to the BMI (p=0.02). We found a signiﬁcant
link between the Fried score and malnutrition according to the
MNA (p=0.02), but not between SEGA and malnutrition according
to the MNA (p=0.21). We did not ﬁnd a signiﬁcant relationshipbetween the SEGA score and malnutrition according to albumin
level (p=0.002), but not between the Fried score and malnutrition
according to albumin level (p=0.1). No signiﬁcant associations were
found between SEGA and vitamin D (p=0.26), nor for the Fried scorewith vitamin D (p=0.68). Finally, we found a slightly signiﬁcant
link between the SEGA score and comorbidities according to theCharlson score (p=0.07) and a signiﬁcant association between theFried score and comorbidities according to the Charlson score(p=0.05). We studied the physical activity by Ricci–Gagnon score,
and we found signiﬁcant links between inactive character according
to the Ricci–Gagnon scale and the monopodal support pathology
test (p=0.014), a Get-Up-and-Go Test result above 20 s (p=0.0076),
malnutrition according to the MNA (p=0.0057), and the Charlson
comorbidity score (p=0.027), as well as a marginally signiﬁcantcorrelation with age, this most likely associated with a lack of
power (p=0.06). We did not ﬁnd any signiﬁcant correlation withthe team sport participation item (p=0.15), malnutrition according
to BMI (p=0.68), malnutrition according to albumin level (p=0.3), or
vitamin D deﬁciency (p=0.61), and MMS level (p=0,4).
Discussion: It is recognized that physical activity helps curb thedevelopment of frailty in the elderly. A literature review publishedin 2013 explored the contribution of physical activity to several parameters associated with frailty in the elderly. In this work, Cadore
et al. (1) included 20 randomized controlled trials and cited the
beneﬁcial effect of physical activity; decreased fall incidence (basedon 7 studies), improved rapid walking (for 6 studies), improved
balance (based on 10 studies), and increased muscle strength (basedon 10 studies). In our present study, we evaluated physical activity
using the Ricci-Gagnon questionnaire. To our knowledge, there havebeen no previous studies looking for a correlation between the levelof physical activity assessed by this score and the presence of frailty
according to Fried and SEGAm criteria.
Conclusion: Our study could serve as a pilot for other large-scale
trials in order to establish a signiﬁcant correlation between thesetwo parameters, allowing the validation of this simple and rapid
questionnaire and its use by the general practitioner to track andmonitor the condition Frailty of elderly patients.
P-235
Postural muscles weakness in older adults with fall history:
A neural or a muscular deﬁcit?
T. Cattagni 1 , J. Harnie 1 , M. Jubeau 1 , C. Cornu 1 , C. Couturier 2 ,G. Berrut 2 . 1 Laboratory Movement, Interactions, Performance, Facultyof Sport Sciences, University of Nantes, France; 2 Department ofGeriatric Medicine, Hôpital Bellier, CHU Nantes, France
Introduction: The decline in torque production of postural muscles

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during aging is considered as a key factor in the risk of falling.
Recent works showed that the maximal torque of plantar ﬂexor
muscles (PF) was lower in older adults with recent fall history(OF) than in older non-fallers (ONF). The present study aimed toinvestigate the neural and muscular factors associated with thelower maximal PF torque production in OF.
Methods: Fifteen young adults (YA) (22±4 years), 15 OF (84±4years) and 15 ONF (83±4 years) were included in this study. Torqueand electromyographic activity of soleus, gastrocnemii and tibialis
anterior (TA coactivation) muscles were recorded during maximal
voluntary contractions of the PF. Electrical nerve stimulation wasused to assess the voluntary activation level (neural factor) during maximal plantar-ﬂexion and the muscle contractile properties(twitch torque at rest, muscular factor).
Results: The maximal PF torque was lower (P<0.05) for OF (51±12Nm) than ONF (70±15 Nm) and YA (119±40 Nm). The voluntary activation level was lower (P<0.05) for OF (73±18%) than ONF (82±19%)
and YA (90±14%). A similar trend was observed for the maximal
PF electromyographic activity. No difference in TA coactivation wasreported among the three groups. While age affected the contractile
properties of ankle muscles (P<0.001), no difference was observed
between ONF (13±3 Nm) and OF (12±3 Nm).
Conclusions: These results suggest that the alteration of muscle
force production observed in OF could be mainly related to adeﬁcit in muscle activation rather than reduced muscle contractile
properties.
P-236
Prevalence and predictive value of pre-therapeutic sarcopenia incancer patients: A systematic review
F. Pamoukdjian 1 , T. Bouillet 2 , V. Levy 3 , M. Soussan 4 , L. Zelek 2 ,E. Paillaud 5 . 1 APHP, Avicenne Hospital, Geriatric department,
Coordination Unit in Geriatric Oncology, F-93000, Bobigny, France;
2 APHP, Avicenne Hospital, Department of medical oncology, F-93000,
Bobigny, France; 3 APHP, Avicenne Hospital, Clinical Research
Unit/Clinical Research Center, F-93000, Bobigny, France; 4 APHP,
Avicenne Hospital, Department of radiology, F-93000, Bobigny, France;
5 APHP, Henri-Mondor Hospital, Geriatric department, geriatriconcology unit, F-94000, Créteil, France
Background: To assess the prevalence of sarcopenia before cancer
treatment and its predictive value during the treatment.
Methods: We searched MEDLINE via PubMed for articles publishedfrom 2008 to 2016 that reported prospective observational or interventional studies of the prevalence of pre-therapeutic sarcopenia
and its consequences in adults with cancer who were 18 years
or older. Two independent reviewers selected articles based on
titles and/or abstracts before a complete review. Sarcopenia had
to be measured before cancer treatment. Methods recommended
by consensuses (CT scan, MRI, dual X-ray absorptiometry or
bio-impedancemetry) to assess sarcopenia were considered. Characteristics of the studies included the prevalence of pre-therapeutic
sarcopenia and the prognostic value for outcomes during the cancer
treatment.
Results: We selected 35 articles involving 6,894 participants(in/outpatients, clinical trials). The mean age ranged from 53
to 69.6 years. Pre-therapeutic sarcopenia was found in 38.6% of
patients [95% CI: 37.4–39.8]. Oesophageal and small-cell lung cancers showed the highest prevalence of pre-therapeutic sarcopenia.
Pre-therapeutic sarcopenia was signiﬁcantly and independently associated with post-operative complications, chemotherapy-induced
toxicity and poor survival in cancer patients.
Conclusions: Pre-therapeutic sarcopenia is highly prevalent in cancer patients and has severe consequences for outcomes of cancer
patients.

P-237
Prevalence of frailty in two Finnish cohorts born 10 years apart
before and after Second World War
M.M. Koivukangas 1 , M.J. Koiranen 1 , M.R. Leskinen 1 ,T.E. Strandberg 2 , R. Peters 3 , S.M. Keinänen-Kiukaanniemi 1 ,R.L. Antikainen 1 . 1 University of Oulu, Finland; 2 University of Helsinki,
Helsinki University Hospita, /University of Oulu, Finland; 3 Australian
National University, Australia
Introduction: Frailty is a state of vulnerability as a result of decline
in various physiological systems leading to impaired ability to adapt
to external stressors and increased risk of adverse outcomes. Little
data exist about secular trends of frailty. We aimed to investigate
community- dwelling cohorts in relation to frailty. Participants
were born in 1935, before World War II, and after it in 1945, andliving in Oulu.
Methods: Participants born in 1935 (Oulu35, N=593) and in 1945
(Oulu45, N=708) were examined with identical methods at the ageof about 70 years. Frailty was measured using modiﬁed Fried frailty
phenotype (FF), Morley Frail Scale (FS) and by a 70- item Frailty
index (FI). FI -cut point was 0.21. Logistic regressions were made for
associations with marital status, economical satisfaction, educationand sex.
Results: The mean age in Oulu35 was 72 and of Oulu45 69 years.
Prevalence of frailty using FI was 30% in Oulu35 and 17.2% in
Oulu45, using FS or FF, they varied from 1.3% to 4.5%. Prevalences ofprefrailty and frailty combined using FF were was 45.3% in Oulu35
and 32.2% in Oulu45, using FS 38% and 25.9%, respectively. Frailty
was associated to with unsatisfying economical status, ORs 2.5(1.2–5.0) in Oulu35 and 5.9 (2.5–14.1) in Oulu45.
Conclusions: Different frailty instruments detect frailty in different
ways. Prevalences of frailty were was lower in Oulu45 than in
Oulu35. Oulu35 participants were older, they lived their childhood in wartime which may have inﬂuenced their health. Low
economical status was associated with frailty.
P-238
Prevalence of sarcopenia and factors related to sarcopenia in thecommunity-dwelling elderly
H. Şimşek 1 , R. Meseri 2 , S. Şahin 3 , A. Kilavuz 4 , D. Hopanci 5 ,M. Uyar 6 , E. Sumru Savas 3 , F. Sarac 3 , F. Akcicek 3 . 1 Dokuz Eylul
University, Faculty of Medicine, Department of Public Health, Izmir
Turkey; 2 Ege University, Izmir Ataturk School of Health, Department of
Nutrition and Dietetic, Izmir, Turkey; 3 Ege University Hospital,
Department of Internal Medicine, Division of Geriatric Medicine, Izmir,
Turkey; 4 Ege University Hospital, Department of Internal Medicine,
Izmir, Turkey; 5 Ege University Tulay Aktas Oncology Hospital, Izmir,
Turkey; 6 Ege University, Faculty of Medicine, Department ofAnesthesiology and Reanimation, Izmir, Turkey
Aim: The aim of this study is to determine sarcopenia prevalence
and affecting factors in Bornova district of Izmir aged 65 years andolder people.
Method: The population of this cross-sectional study is 28,323
people aged 65 years and older living in centre of Bornova district,Izmir. Minimum sample size was calculated by assuming sarcopenia
prevalence is 10% with 2% error and %95 conﬁdence limit. Twenty
percent of this minimum sample size was added for nonresponse.
1007 individuals were targeted to reach. The dependent variable
is having sarcopenia and diagnosis was made on the basis of
EWGSOP algorithm. Independent variables were sociodemographic
and economic features, healthy life behaviours, condition. Data
were collected by interviewers at home with face-to-face interview,
analysed using chi-square and logistic regression analysis.
Results: The response rate was 90.3%. Mean age is 72.8±6.2,60.2%
were female. The prevalence of sarcopenia is 5.2% (3.0% in 65–74

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

years, 8.6% in 75–84 years and 21.9% in 85 years and older). The
prevalence of having low gait speed is 41.0%, low grip strength
57.0%, low calf circumference 6.1%. The prevalence having both low
gait speed and low grip strength 14.3%. Increase in age (OR 1.084,
p=0.007), physical inactivity (OR=3.924, p=0.017), BMI (OR=29.118,
p<0.001) and having malnutrition risk or malnutrition (OR=7.950,
p<0.001) increases sarcopenia risk.
In conclusion prevalence of sarcopenia is quite high in thispopulation. Increase in age, physical inactivity, low BMI, having malnutrition risk or malnutrition are risk factors for having
sarcopenia.
P-239
Prevalence of sarcopenia in a Danish geriatric out-patient
population
M.G. Christensen 1 , K.S. Piper 2 , R. Dreier 1,3 , C. Suetta 3 ,H.E. Andersen 1 . 1 Department of Internal Medicine, Geriatric section,
Glostrup, University Hospital Amager, Hvidovre, Denmark;2 Department of Occupational Therapy and Physiotherapy,
Rigshospitalet - Glostrup, Denmark; 3 Department of ClinicalPhysiology, Nuclear Medicine & PET, University of Copenhagen,Denmark
Introduction: Using the European Working Group on Sarcopenia(EWGSOP) criterias on a geriatric outpatient-population the aim
was to assess the prevalence of sarcopenia and to describe theassociation between sarcopenia and age, gender, body-mass index(BMI).
Methods: Patients referred to a geriatric outpatient-clinic wereassessed and classiﬁed accordingly EWGSOPs recommendations.
Assessment included Dual Energy X-ray absorptiometry (appendicular skeletal muscle mass (ASM)), Hand-grip strength (HGS),
10-meter Walk (GS). Cutoff points: Skeletal Muscle Mass Index(SMI) ASM/height2 (kg/m2 ). Cutoff men <7.23 kg/m2 , women<5.67 kg/m2 . HGS men <30 kg, women <20 kg, GS <0.8 m/s.
Patients were classiﬁed: No sarcopenia (normal SMI), presarcopenia(reduced SMI, normal HGS and GS), sarcopenia (reduced SMI andreduced HGS or GS) or severe sarcopenia (reduced SMI, HGS andGS).
Results: 189 patients were screened for inclusion; 80 were included. 12 (15%) had severe sarcopenia, 9 (11%) had sarcopenia,
8 (10%) had presarcopenia and 51 (62%) did not have sarcopenia.
Comparing the groups mean age was signiﬁcantly higher in thesarcopenic group (sarcopenia and severe sarcopenia) than in thenon sarcopenic group (presarcopenia and no sarcopenia), (p:000.9).
The nutritional status was signiﬁcantly poorer in the sarcopenic
group (p: <0001). No difference was found in gender distribution(p: 0.729).
Conclusions: Prevalence of sarcopenia was 26% in our study highligthing that this condition in common in a geriatric outpatient
population. Assessment using the EWGSOP diagnostic method
was feasible and is suggested to be part of the standard clinicalcomprehensive geriatric assessment.
P-240
Prevalence of sarcopenia in very old patients hospitalized in ageriatric ward
P. Fdez-Montalbán, J. Albéniz, L. Hernández, E. Sánchez, B. Montero,
A. Merello, A.J. Cruz-Jentoft. Hospital Universitario Ramón y Cajal,
Madrid, España
Introduction: Few studies have described the prevalence of sarcopenia in hospitalized patients. The aim of this study was tomeasure the prevalence of sarcopenia in very old patients admitted
to a geriatric acute care ward.
Methods: Prospective, observational study of all patients admit-

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ted to a single Geriatric Acute Unit in a three months period.
Sarcopenia was diagnosed by the presence of low muscle mass(measured with bioimpedanciometry using Janssen’s equation)plus low muscle strength (measured with a Jamar dynamometer).
Sociodemographic, functional, anthropometric and clinical variables were recorded. The sarcopenic group was compared to thenon-sarcopenic group.
Results: 81 patients were included (60% women, mean age 93±4
years). Mean length of stay 7±5 days. In-hospital mortality 7%. The
prevalence of sarcopenia prevalence on admission was 67%. There
were more women in the sarcopenic group (74% vs 26%, p<0.01),
we found no difference in any other characteristic. Some 30% of
those with sarcopenia were institutionalized, 41% lived at homewith a caregiver. 31% were unable to walk, 69% were dependent
for at least one BADL and 52% were malnourished (MNA≤7) but
almost half had a BMI>28. 54% had dementia, most frequent causeof admission was an infection (72%).
Conclusions: The prevalence in sarcopenia in acute geriatric care
was 67%, with a higher prevalence in women. Sarcopenic patients
did not signiﬁcantly differ from non-sarcopenic patients in othercharacteristics.
P-241
Relation of CT-scan muscle mass to iliopsoas hematoma inpatients treated with anticoagulant? Preliminary results
A. Gioanni. 1. Unit of Peri-Operative Geriatric care, geriatricdepartment, Hôpitaux universitaires Pitié-Salpêtrière-Charles Foix.
DHU FAST, Assistance Publique Hôpitaux de Paris (APHP), Paris, France
Introduction: Iliopsoas hematomas (IPH) represent a classic andlife threatening anticoagulation-related complication in elderly patients. Despite its localization, muscle assessment is not consideredin haemorragic risk assessment. We hypothesized that muscularmass was inversely associated with IPH.
Methods: Retrospective study from 2000 to 2017 in 4 geriatrics
acute wards. Data were obtained from medical charts. Inclusion
criteria: patients treated with anticoagulant and anticoagulationrelated spontaneous IPH conﬁrmed by CT-scan. Controls without
anticoagulation-related spontaneous IPH were matched for age andanticoagulant, and explored by CT-scan. Main criteria was iliopsoas
muscle surface (IPMS) measured by CT-scan on contralateral psoas.
Secondary criteria included fat involution of psoas.
Results: There are preliminary results, including 22 cases with
anticoagulation-related spontaneous IPH (age 85±6 y/o, sex.ratio
1:1, anticoagulant 100%, transfusion 89%, albumin 29±5 g/L). History
was dementia (33%), hypertension (50%), atrial ﬁbrillation (67%),
coronary artery disease (33%), and treatments VKA (60%), DOA(5%), heparin (60%) and antiplatelet therapy (29%). CT-scan analysis
showed an IPH hematoma size of 2005±1010 mm3 . The mean IPMS
of cases vs controls was respectively 938±244 vs 914±308 mm3 ,(p=0.55). Other parameters are being analysed and will be available
for the EUGMS congress.
Conclusion: The CT-scan muscle mass assessment is a feasible tool
to evaluate muscle mass in patients treated with anticoagulant.
From our preliminary results, IPMS is not associated with risk of
IPH, and the role of muscle assessment to evaluate haemorrhagicrisk in elderly patients treated with anticoagulant is questionable.
Further analysis must be provided to conﬁrm our hypothesis.
P-242
Relationship between hearing impairment and frailty in older
patients with diabetes mellitus
S. Sable-Morita 1 , S. Sugiura 2 , Y. Uchida 2 , T. Tanikawa 3 , H. Tokuda 3 ,H. Arai 4 . 1 Nursing Department, National Center for Geriatrics andGerontology, Obu, Japan; 2 Department of Otorhinolaryngology,

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National Center for Geriatrics and Gerontology, Obu, Japan;
3 Department of Endocrinology, Metabolism and Diabetes, National
Center for Geriatrics and Gerontology, Obu, Japan; 4 Deputy Director,
National Center for Geriatrics and Gerontology, Obu, Japan
Objective: Hearing impairment, diabetes, and frailty are three conditions that are increasingly prevalent in older people. Recently,
the assessment of frailty has been recommended for older patientswith diabetes mellitus. However, the relation between hearing
impairment and frailty is still unclear in patients with diabetes.
The purpose of this study was to clarify the relationship between
hearing impairment and frailty among older diabetes patients.
Research design and methods: We used a ﬁnger friction test asa simple auditory screening for the assessment of hearing impairment and the Kihon Checklist (KCL) for the assessment offrailty. Cognitive function was assessed using the Mini Mental
State Examination (MMSE). Logistic regression analysis was used toinvestigate cross-sectional associations between frailty and patientcharacteristics.
Results: The study participants were 283 diabetes patients withan average age of 75.3 years; the prevalence of frailty using the
KCL was 30%. Hearing impairment was present in 32.8% of those
without frailty and 57.6% of those with frailty (p<0.01). In multivariable analysis, frailty in diabetes patients was associated with theprevalence of hearing impairment (odds ratio: 1.96, 95% conﬁdence
interval: 1.07–5.59).
Conclusions: These data suggest that hearing impairment as determined using a ﬁnger friction test could be an important factor
contributing to frailty among diabetes patients.
P-243
Reliability of the sarcopenia screening test (SARC-F) in elderly
patients
A. Doventas 1 , D.C. Ercelebi 1 , H. Yavuzer 1 , M. Cengiz 2 , S. Avci 1 ,F. Demirdag 1 , Z. Kara 1 , S. Yavuzer 2 , M. Yuruyen 3 , D.S. Erdincler 1 .
1 Cerrahpasa School of Medicine, Department of Internal Medicine,
Division of Geriatrics/University of Istanbul, Istanbul, Turkey;
2 Cerrahpasa School of Medicine, Department of Internal
Medicine/University of Istanbul, Istanbul, Turkey; 3 Bakirkoy Dr. Sadi
Konuk Training and Research Hospital, Department of Internal
Medicine, Division of Palliative Care/Republic of Turkey, Ministry of
Health, University of Health Sciences, Istanbul, Turkey
Aim: The aim of this study was to investigate the presence ofsarcopenia in the hospitalised geriatric patients and the role offollowing measurements for diagnosis: antropometric measurements, bioimpedance analyses, handgrip strength, 6 meter walk
test, Barthel index and SARC-F scale.
Method: 116 hospitalised elderly patients in the internal medicine,cardiology, pulmonology and infectious disease clinics were followed. The patients were grouped according to the diagnostic
criteria for EWGSOP. Age, gender, medical history, drugs, lenght of
hospitalization, Barthel index, SARC-F scale were questioned andthe anthropometric parameters were measured.
Results: 85 of 116 patients were mobile, whereas the other 31
patients were immobile. Sarcopenic patients were older than normal patients with statistical signiﬁcance (p=0,001). Weight, BMI,
circumference of hip, waist, upper-middle arm and calf were lower
in sarcopenic patients. The handgrip strength of normal groupwas stronger (18.2±12 kg) than sarcopenic patients (13±9.1 kg)with statistical signiﬁcance (p=0.018). Number of comorbidities anddrugs were higher in normal group (p=0.034; p=0.024, respectively).
SARC-F was positively correlated with age, length of hospitalisation,
number of comorbidities and drugs, nutritional support, Barthel index and calf circumference and negatively correlated with walking
speed, hand grip strength and fat free body mass. SARC-F scale

results were 5.1±3.3 in normal group and 5.8±2.8 in sarcopenic
group (p=0.24).
Discussion: SARC-F scale was not eﬃcient for evaluation of sarcopenia in the hospitalised geriatric patients; but Barthel index,
BIA, hand grip strength and walking speed were relevant with it.
P-244
Sarcopenia and sarcopenic obesity in Japanese geriatric ward
A. Sampei, S. Harada, K. Shibasaki, Y. Yoshioka, M. Yakabe,
A. Yonenaga, K. Toyoshima, T. Kojima, M. Ishii, Y. Kameyama,
Y. Yamaguchi, T. Urano, S. Ogawa, M. Akishita. Department ofGeriatric Medicine, Graduate School of Medicine, The University ofTokyo, Tokyo, Japan
Introduction: Sarcopenia is a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength. It iscorrelated with physical disability, poor quality of life. We evaluatedthe characteristics of sarcopenic elderly patients.
Methods: We analysed 117 patients discharged from the geriatricward in the University of Tokyo Hospital, from April 2016 to March2017. We divided them ﬁrst into two categories; sarcopenia or
non-sarcopenia. Secondly we also looked at the sarcopenic obese,
sarcopenic non-obese, non-sarcopenic obese and non-sarcopenic
non-obese group. In those groups, we assessed various characteristics such as age, sex, duration of hospitalization and comorbidities(hypertension, diabetes mellitus, dyslipidemia, cerebrovascular diseases, and cardiovascular diseases).
Results: After exclusions, we collected 117 patients (47 men and 70
women), aged 81 on average. Out of them, 72 sarcopenic (10 sarcopenic obese, 62 sarcopenic non-obese) and 45 non-sarcopenic (20non-sarcopenic obese and 25 non-sarcopenic non-obese) patientswere identiﬁed. No statistically signiﬁcant differences were foundbetween sarcopenic and non-sarcopenic patients as for age and sex.
However, in sarcopenic patients, we detected longer hospitalization
by approximately one week, and lower complication rates withdiabetes mellitus or with cerebrovascular diseases compared tonon-sarcopenic patients. Especially sarcopenic non-obese patients
showed lower complication rates with diabetes mellitus.
Conclusions: In sarcopenic patients, we observed longer hospitalization and lower prevalence of diabetes or cerebrovasculardiseases. We assume that sarcopenia itself can be the inﬂuential factor for longer hospitalization. And we suspect obesity has stronger
relations with diabetes mellitus or cerebrovascular diseases thansarcopenia.
P-245
Self-assessed kyphosis and chewing disorders predict disability
and mortality in community-dwelling older adults
M. Okura 1 , M. Ogita 2 , M. Yamamoto 3 , T. Nakai 3 , T. Numata 3 ,H. Arai 4 . 1 Kyoto University Graduate School of Medicine; 2 Shiga
University of Medical Science; 3 Kami-cho Municipal Oﬃce; 4 National
Center for Geriatrics and Gerontology
Background: Degenerative changes affecting the spine accumulate
and contribute to an overall trend of kyphosis with increased age.
Since there is no widely accepted deﬁnition of hyper-kyphosis,
current estimates of the prevalence of this condition range between
20 to 40 percent among community-dwelling older people. Particularly, hyper-kyphosis is associated with several adverse healthconditions including thoracic pain, decreased pulmonary function,
limited physical functioning, increased fall risk, increased healthrelated quality-of-life, increased fractures, and increased mortality.
There was no signiﬁcant difference between depressive mood andkyphosis. However, it should be noted that these are studies ofhyper-kyphosis and not of general kyphosis. Research questions:
Our research questions focused on chewing power in common

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

health-related issues of older people caused by frailty. However, it
is not a simple mechanism through which aging affects chewing
power, unlike any other part of the human body. If tooth loss is
not considered as an attribute of physiological aging, then aging per
se may not be a risk factor for masticatory dysfunction. Chewing
power, which is closely related to quality of life, is essential for
maintenance of the activities of daily living in the elderly.
Research signiﬁcance: Both these health issues (the presence of
kyphosis or chewing disorders) are widely observed in aging people. These two adverse health outcomes are easily noticed evenby older people themselves and by the others. Furthermore, these
health issues are preventable through continued everyday healthactivities starting in late middle age.
Research objectives: Therefore, our study objectives were to clarify the following three research questions: (1) Is the existenceof kyphosis or the decrease in chewing ability related to frailty
without being affected by age or sex? (2) How much inﬂuence does
the presence of kyphosis or chewing disorders have on the needfor new coverage under long-term care insurance (LTCI) service requirement? (3) How much inﬂuence does the presence of kyphosisor chewing disorders have on predicting mortality?
Methods and design: A prospective cohort study.
Setting and participants: We analyzed the cohort data for older
adults (65 years or older) from a prospective study in Kami town.
The response rate was 94.3%, and we followed 5,094 older individuals for three years. Thus, we analyzed 5,083 older adults using
Multiple imputation to manage missing data.
Outcome: The outcomes were mortality or new certiﬁcations for
LTCI services in a 3-year period.
Measurements: We developed three groups by asking two selfreported questions on both “no kyphosis” and “good chewing
ability”. The groups were no kyphosis and good chewing ability(GG), kyphosis and poor chewing ability (BB), and kyphosis andgood chewing ability or no kyphosis and poor chewing ability(GB/BG).<Results> The prevalence of BB, BG/GB, and GG were 8.9%,
40.3%, and 50.8%, respectively in our survey. During the 3-year
follow-up period, 5.2% (n=262) died and 13.9% (n=708) individuals
were newly certiﬁed as needing LTCI services. We conﬁrmed thatthese results were consistent with the whole data analysis including
missing data. Similar results were obtained for each frailty domain.
First, those participants who agreed with the statement, “I don’t
think I have kyphosis” had signiﬁcantly lower odds for having
frailty (OR 0.41, 95% CI: 0.36–0.46). Similarly, those who had goodchewing ability showed lower odds for frailty (OR 0.38, 95% CI:
0.32–0.44). When the two were analyzed at the same time, the
GB/BG group (OR 0.40, 95% CI: 0.32–0.50) and the GG group (OR0.16, 95% CI: 0.13–0.20) were less likely to be frail than the BB group.
Second, as determined by multivariate analyses, BG/GB older adults(adjusted hazard ratio (HR) 1.33, 95% CI: 1.13–1.57) and BB older
adults (adjusted HR 1.94, 95% CI: 1.54–2.44) had a signiﬁcantly
higher risk of needing LTCI services than GG older adults. Similarly,
BG/GB older adults (adjusted HR 1.48, 95% CI: 1.12–1.96) and BB
older adults (adjusted HR 2.27, 95% CI: 1.53–3.29) had a signiﬁcantly
higher risk of mortality than GG older adults did. The ORs and HRs
were adjusted for age and sex.
Discussion: As our ﬁrst of objective, we conﬁrmed that prevalenceof kyphosis and chewing disorders was relatively common amongcommunity-dwelling older Japanese adults. However, the prevalence of frailty in our study was slightly higher than other surveys.
In previous studies, kyphosis or chewing disorders were known as
a risk factor for frailty. However, we found that these two healthissues were not only detrimental to health on their own, but had amore negative effect on frailty when combined. As second of objective, multivariate analyses demonstrated that kyphosis and chewing
disorders were independently associated with mortality and newcertiﬁcations for LTCI services. It is meaningful that these health

S111

issues are particularly easy to recognize by both oneself and others,
and to use in self-reported questionnaires for community-dwellingolder adults. Because these two health issues are easy to recognize
by both oneself and others, these could be used as a marker inthe high-risk approach and could be prevented by the population
approach targeting the middle age.
Limitations: First, there is a possibility of underestimation or overestimation compared to the present situation, under the inﬂuenceof individual personality characteristics, because this examination
was self-reported. In this survey, we could not obtain the following:
the degree of kyphosis, the presence or degree of pain in the back,the degree of chewing power, the difference of chewing power
based on the type of food, and so on. Second, we were not able toidentify whether related kyphosis or poor chewing power was thecause of mortality or new certiﬁcations for LTCI services. One of
the aspects that future research should examine is how much effectkyphosis or chewing power had on mortality or new certiﬁcations
for LTCI services.
Conclusion: The presence of kyphosis or poor chewing ability was
related to mortality and new certiﬁcations for LTCI services, and we
found an additive effect of these two factors related to frailty.
Acknowledgements: We are extremely grateful to all the study
participants and to all the staff of the Kami Town Hall who wereinvolved in this study. Conﬂicts of interest: The authors declare no
conﬂicts of interest.
Funding source: This work received ﬁnancial support from Health,Labour and Welfare Sciences Research Grants (Comprehensive Research on Aging and Health, grant number H24-Choju-Ippan-001),
Research Funding for Longevity Sciences from Japan Agency for
Medical Research and Development (grant number 16dk0110019h0001)
and Research Funding for Longevity Sciences from the National Center for Geriatrics and Gerontology (grant number 27–1), Japan. No
support was received from industry. The funding source played norole in the design or conduct of the study; collection, management,
analysis, or interpretation of the data; or preparation, review, or
approval of the manuscript.
P-246
Socioeconomic differences in frailty and frailty components
among 26,014 Dutch citizens aged 55 years and older
C.B. Franse 1 , A. van Grieken 1 , L. Qin 2,3 , R.J.F. Melis 3 ,J.A.C. Rietjens 1 , H. Raat 1 . 1 Erasmus University Medical Center,
department of Public Health, Rotterdam, The Netherlands;
2 Quantitative Solutions, A Certara Company, The Netherlands;
3 Department of Geriatric Medicine, Radboud University Medical
Center, Nijmegen, The Netherlands
Introduction: Older persons with a low socioeconomic status (SES)
are frailer and become frailer over time. Little is known about theassociation of SES with the frailty index (FI) and with its different
components. Our aim was to examine socioeconomic differencesin frailty and FI components and assess whether socioeconomic
differences in number of morbidities can explain socioeconomic
differences in other FI components.
Methods: This was a cross-sectional study of pooled data of 26,014
independently living persons in the Netherlands aged 55 years
and older. Frailty was measured with a previously validated FI
that consisted of 45 items. We selected six FI components basedon previous literature: morbidities, activities of daily living (ADL),
instrumental ADL (IADL), health-related quality of life (HRQoL),
psychosocial health and self-rated health (SRH). SES was measured
by education level and neighbourhood deprivation level. Multilevellinear regression models were ﬁtted to assess the association of SES
with frailty and with FI components.
Results: We found educational differences and to a lesser extent differences in neighbourhood deprivation level in frailty andS112

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

all FI components except ADL limitations, stronger associations
were observed in younger ages. After adjusting for the numberof morbidities, signiﬁcant socioeconomic differences in the otherFI components; IADL limitations, HRQoL, psychosocial health and
SRH, reduced or disappeared.
Conclusions: There are signiﬁcant socioeconomic differences infrailty and in FI components. Morbidities appear to play an important role in explaining socioeconomic differences in frailty at older
age and should not be overlooked in prevention efforts.
P-247
Systematic review of non-pharmacological interventions to treat
well-deﬁned sarcopenia and physical frailty
I. Lozano-Montoya 1 , A. Correa-Pérez 1 , I. Abraha 2 , R.L. Soiza 3 ,A. Cherubini 2 , D. O’Mahony 4 . 1 Servicio de Geriatría. Hospital
Universitario Ramón y Cajal (IRYCIS). Madrid. Spain; 2 Geriatrics andGeriatric Emergency Care, Italian National Research Center on Aging.
Ancona. Italy; 3 Department of Medicine for the Elderly, NHS Grampian.
Aberdeen. UK; 4 Dept. of Medicine (Geriatrics), University College Cork,
IrelandIntroduction: Although exercise and nutritional interventions arerecommended as ﬁrst-line treatment to prevent or treat frailty
and sarcopenia, most systematic reviews (SR) do not use standard
deﬁnitions of the populations included in clinical trials. Following
the ONTOP methodology, we did a review of SR, including primarystudies of non-pharmacological interventions in older patients withphysical frailty (deﬁned by Fried’s frailty phenotype) and sarcopenia(EWGSOP deﬁnition).
Methods: Pubmed, Cochrane, EMBASE, and CINHAL databases weresearched looking for SR. All primary studies from those SRs evaluating any non-pharmacological intervention for physical frailty or
sarcopenia in any setting were included. Quality assessment wasmade using Cochrane and GRADE criteria. A meta-analysis could
not be performed due to the heterogeneity of the studies.
Results: Only 5 primary studies from 10 SR fulﬁlled the inclusion
criteria. The most frequent interventions were physical exercise andnutritional supplementation. Muscle strength (except one study infrail subjects) and physical performance (except another study infrail people) improved with exercise and supplementation withamino acids in frail and sarcopenic older adults. The effects of theseinterventions on falls and ADLs were evaluated in two studies with
opposite results. The overall quality of the evidence was low.
Conclusions: The only interventions studied for physical frailty andsarcopenia are exercise with or without nutritional supplements.
Most of the studies in previous SR include non-frail or sarcopenic
individuals. Interventions improve muscle strength and physicalperformance; there are no solid data on its effects on other healthoutcomes.
P-248
Targeting muscle to improve independence, quality of life andlower health care costs
D. Mijnarends 1 , Y. Luiking 2 , S. Verlaan 3 , M. Wallace 2 , J. Schols 1 .
1 Department of Health Services Research, Maastricht University,

Maastricht, The Netherlands; 2 Nutricia Research, Nutricia Advanced
Medical Nutrition, Utrecht, The Netherlands; 3 Department of Internal
Medicine, Section of Gerontology and Geriatrics, VU University Medical
Center, Amsterdam, The Netherlands
Introduction: Insight in muscle parameters that contribute most to
negative health and economic outcomes could help clinicians withscreening and targeted intervention.
Aim: To assess the association between muscle parameters andactivities of daily living (ADL), quality of life (QoL) and health carecosts.

Methods: The cross-sectional Maastricht Sarcopenia Study (MaSS)
included community-dwelling adults ≥65 years (n=227). Muscle
parameters were assessed by bio-electrical impedance, JAMAR
hand-held dynamometer and the Short Physical Performance Battery. The Groningen Activity Restriction Scale (disability in ADL)
and the EQ-5D-5L (QoL) were used to assess health outcomes. Dataon health care use in the past three months were collected.
Results: Muscle strength and muscle function showed strong correlations with ADL function, QoL, and health care costs; no signiﬁcantcorrelations were observed for muscle mass. Regression analyses
showed that slower gait speed (OR 0.06, 95% CI: 0.01–0.55), slower
chair stand (OR 1.23, 95% CI: 1.08–1.42), and more comorbidities(OR 1.48, 95% CI: 1.15–1.92) were explanatory factors for disability
in ADL. Explanatory factors for QoL and health care costs weredisability in ADL (OR 1.26, 95% CI: 1.12–1.41 for QoL; B =0.09, P<0.01
for costs) and comorbidities (OR 1.44, 95% CI: 1.14–1.82 for QoL;
B=0.35, P<0.01 for costs).
Conclusions: Muscle function and comorbidities were associatedwith disability in ADL. Disability in ADL and comorbidities wereassociated with QoL and costs. This suggests that muscle function
and ADL may be important targets for research and intervention inorder to improve health and economic outcomes.
P-249
The assessment of the frailty in a geriatric rehabilitation
institute: A comparison between various tests
G. Ricevuti 1 , E. Mattiuzzo 1 , G. Cuzzoni 1 , N. Schiﬁno 1 , M. Rollone 1 ,C. Alfano 1 , L. Venturini 1 , S. Geniere Nigra 2 , F. Guerriero 1 .
1 Department of Internal Medicine and Therapeutics, Section ofGeriatrics, University of Pavia, Italy; Azienda Servizi alla Persona, S.
Margherita Institute, Pavia, Italy; 2 Department of Internal Medicine
and Therapeutics, Section of Geriatrics, University of Pavia
Italy, like most of Western societies is characterised by a progressive
increase of average life expectancy. According to ISTAT’s annual,
there are 13.4 million individuals over 65 years of age, i.e. 22%of the total population. Following an increase in life expectancy,
age-related diseases also increase. There is good scientiﬁc evidence
showing that the multiple co-morbidities among elderly people arepart of a broader entity called “elderly fragility”. Such nosologicalentity is still being deﬁned, as there are two schools of thought:
the ﬁrst one considers fragility as a syndrome, the second one as astate. During the course of the last years there have been numerous
tests aiming to deﬁne the boundaries of this entity by assessing
each of its different facets. Considered individually, such tests prove
useful as diagnostic/prognostic tools. However, they are even more
useful when combined, as they describe patients’ clinical condition
in a more ample and complete way. In fact, fragility leads elderly
people to the likelihood of developing numerous conditions witha short-term prognosis. This Study aims to assess a sample ofgeriatric patients at the moment of admission into a rehabilitation centre. The purpose was that of identifying fragile patients,
and classify them through a multi-faceted assessment., as well as
through a comprehensive individual rehabilitation programme. Thiswas carried out through a series of 7 tests, plus a DXA exam for the
sarcopenia. The data collected was analysed individually, and later
integrated into a radar graphic visualising frail patient’s clinicalcharacteristics in various areas. Through this study it was possible
to compare tests that are normally used in the typical CGA ofgeriatric clinical practice. A concordance was noticed between EFS,
GFI, FI, SPPB, PASE, CF in Fragility evaluation. It has been seen that
SHARE-FI and sarcopenia do not agree with the other tests, this ismost likely due to the small number of enrolled patients (n=47) or to
the effect of rheabilitation. An insuﬃcient number of patients does
not allow to have a representative population group and therefore
to be able to perform a valid and repeatable statistical analysis.

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

P-250
The BMD change after Ibandronate (Bonviva® ) treatment In
osteopenic elderly women
K. Choi. Dongguk University International Hospital
Background: Ibandronat (Bonviva® ) is effective in the treatmentof postmenopausal women with osteoporosis. But, there were few
datas about Ibandronat (Bonviva® ) treatment. We evaluated the effect of Ibandronat (Bonviva® ) therapy on bone mass and compared
the effectivity on bone mineral densit (BMD) in 1-year treatmentgroup.
Objective: The aim of the study is to assess the effect of 1-year
treatment with Ibandronat (Bonviva® ) on bone mineral density(BMD) in postmenopausal women with osteopenia or osteoporosis.
Methods: The BMD was assessed in 118 postmenopausal womenwith osteopenia or osteoporosis from March 2007 to January
2011, 42 patents who treated with 2.5 mg per day of Ibandronat(Bonviva® ) were enrolled to study. BMD of lumbar spine (L2-L4)
and femur was assessed by dual energy absortiometry at baseline,
12 months after treatment.
Results: The annual BMD of the lumbar spine showed a 9.11%
increase, while also positive changes were noted in the proximal
femur as a 1.89% increase. The BMD changes were 11% (L: Lumbar
spine) and 1.1% (F: Femur) for the T-scores <−4.0, 6.3% (L) and 0.9%(F) for the T-scores −3.0 to −4.0, and 3.8% (L) and 0.5% (F) for the
T-scores >−3.0 respectively.
Conclusion: This study suggests that Ibandronat (Bonviva® ) treatment in postmenopausal women with osteopenia or osteoposis iseffective in terms of improving BMD.
P-251
The relationship between frailty and osteosarcopenia in
geriatric patients
S. Kaya, O. Deniz, H.D. Varan, M.C. Kızılarslanoğlu, B. Göker. Gazi
University School of Medicine, Department of Geriatrics
Introduction: Osteosarcopenia, deﬁned as the presence of bothsarcopenia and osteoporosis in elderly patients, has been shown
to be related with worse clinical outcomes. However, limited data
are available in the literature about its association with frailty. We
aimed to investigate the association between frailty and osteosarcopenia in the elderly patients.
Material and methods: One hundred elderly patients, who hadbone mineral densitometry (BMD) performed on a routine basis
within last one year, were enrolled in the study. All patientswere evaluated by comprehensive geriatric assessment. Diagnosis
of sarcopenia was done according to the criteria of the European
Working Group on Sarcopenia in Older People. Osteosarcopenia wasconsidered when both sarcopenia and osteoporosis were present.
Frailty status of the patients were evaluated according to the Fried’s
Frailty Index including ﬁve domains weight loss, weakness, exhaustion, low activity and slow walking speed. The patients with threeor more deﬁcits over ﬁve components were considered as “frail”,
those with 1 or 2 deﬁcits as “pre-frail” and no deﬁcits as “robust”.
Results: The median age of the one hundred patients (11 sarcopenic/
non-osteoporotic, 12 osteosarcopenic and 77 non-sarcopenic) were
75 years (min–max: 65–90) and 51.0% were male. Frailty status of
the patients was as follows: 21% frail, 44% pre-frail and 35% robust.
Frailty was more common among osteosarcopenic patients compared to sarcopenic/non-osteoporotic and non-sarcopenic groups(66.7%, 27.3% and 13.0%, respectively) (p<0.001). Osteosarcopenia
was found to be associated with frailty in univariate analysis (OR:11.5, p<0.001). Low handgrip strength and calf circumferences,
higher age, slow walking speed, lower body mass index (BMI),
frailty, decreased scores of basic and instrumental activities of dailyliving (ADL), clock drawing test, mini-mental state examination andS113

mini-nutritional assessment-short from (MNA-SF) were shown to
be associated with osteosarcopenia (all parameters had p<0.05). In
multivariate analysis, age (OR: 1.395, p=0.023), instrumental ADL(OR: 0.550, p=0.042), female gender (OR: 43.203, p=0.012) and BMI(OR: 0.507, p=0.004) were detected to be independently associatedfactors with osteosarcopenia.
Conclusion: Our results suggest that frailty rate in osteosarcopenic
patients may be higher than sarcopenic/non-osteoporotic and nonsarcopenic patients. Further studies with larger number of patientsare needed to elucidate its pathogenetic mechanisms.
P-252
Transitions between frailty states over three years in the MAPT
study
M. Herr 1 , M. Cesari 2 , J. Ankri 1 , B. Vellas 2 , S. Andrieu 2 . 1 UMR 1168,
INSERM and University of Versailles St-Quentin-en-Yvelines, France;
2 UMR 1027, INSERM and University of Toulouse, France
Introduction: The epidemiology of frailty (prevalence and associated factors) has mostly been described in cross-sectional studies.
However, there is increasing evidence that frailty is a dynamic
state that can worsen but also improve. Using repeated measuresof frailty, this work aimed to describe transitions between frailty
states during the three years of follow-up.
Methods: This study is nested in the MAPT trial (randomized trial
to assess the effect of omega 3 supplementation and multidomainintervention on cognitive decline in people aged 70 and over). The
study population included the 842 participants included in thecontrol and omega 3 arms. Frailty was assessed using the Fried
criteria (including measures of grip strength and walking speed) atbaseline and at 6, 12, 24, and 36 months.
Results: The study population included 548 women and 294 men,of mean age 75.4±4.5 years. At baseline, 430 (53.3%) participants
were robust, 349 (43.2%) pre-frail, and 28 (3.5%) frail. A total of 2271
transitions were observed during the 3 years of follow-up. In mostcases, people remained in a robust (36.6% of the transitions) or
pre-frail state (30.5%). The third most observed transition was fromthe robust to the pre-frail state (14.8%). Of note, direct transitions
from robust to frail or from frail to robust were very rare and frail
people were more likely to recover than to stay frail.
Conclusions: This study conﬁrms the dynamic nature of frailty
and shows that recovery is possible. Factors associated with thetransitions will be investigated.
P-253
Untargeted metabolomics reveals pre-frailty sub-phenotypes inelderly
E. Pujos-Guillot 1 , M. Pétéra 1 , D. Centeno 1 , B. Lyan 1 , B. Pietruszka 2 ,A. Santoro 3 , A. Brzozowska 2 , C. Franceschi 3 , B. Comte 4 . 1 Université
Clermont Auvergne, INRA, UNH, CRNH Auvergne, F-63000
Clermont-Ferrand, France; 2Université Clermont Auvergne, INRA, UNH,
Plateforme d’Exploration du Métabolisme, MetaboHUB Clermont,
CRNH Auvergne, F-63000 Clermont-Ferrand, France; 2 WULS-SGGW,
Department of Human Nutrition, Warsaw, Poland; 3 University of
Bologna, Department of Experimental, Diagnostic and Specialty
Medicine, Bologna, Italy; 4 Université Clermont Auvergne, INRA, UNH,
CRNH Auvergne, F-63000 Clermont-Ferrand, France
Introduction: Human ageing is a dynamic process depending on
intrinsic and extrinsic factors and its evolution is a continuum oftransitions, involving multifaceted processes at multiple levels. It
is recognized that frailty and sarcopenia are shared by the major
age-related diseases, thus contributing to elderly morbidity andmortality. They are major health issues in elderly populations,
given their high prevalence and association with several adverse
outcomes. Due to their complex phenotypes and underlying patho-

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physiology, the need for robust and multidimensional biomarkers
is now essential to move towards a more personalized care andprevention.
Methods: The NU-AGE project [1] regroups 1250 free-living elderly
people (65–79 y.o., men and women), free of major diseases, recruited within 5 European centres. Twenty percent of the subjects
were pre-frail as deﬁned by the criteria proposed by Fried et al.[2].
Six hundred twenty ﬁve volunteers were randomly assigned to
an intervention group (1-year Mediterranean diet). A sub-cohort
consisting in ﬁrst, 120 subjects, half pre-frail randomly selectedfrom the Italian and Polish centres, and secondly, 92 subjects
shifting their frailty status were included for untargeted serum
metabolomics at T0 (recruitment) and T1 (after diet intervention).
Results: Metabolomics enables to discriminate sub-phenotypes ofpre-frailty both at the gender level and depending on the pre-frailty
progression and reversibility. Additionally, early and/or predictive
markers of pre-frailty were identiﬁed in both populations.
Conclusion: These results open the door, through multivariate
strategies, to a possibility of monitoring the disease progression
over time and/or in response to interventions at a very early stage.
References:[1] Santoro A, Pini E, Scurti M, Palmas G, Berendsen A, Brzozowska
A, Pietruszka B, Szczecinska A, Cano N, Meunier N, de Groot
CP, Feskens E, Fairweather-Tait S, Salvioli S, Capri M, Brigidi
P, Franceschi C. NU-AGE Consortium. Mech Ageing Dev. 2014
Mar-Apr;136–137:3–13.
[2] Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, Seeman T, Tracy R, Kop WJ, Burke G, McBurnie MA.
Frailty in older adults: evidence for a phenotype. J. Gerontol. A:
Biol. Sci. Med. Sci. 2001 56 (3) M146–M156.
P-254
Urinary incontinance and sarcopenia: a new insight
T. Erdoğan 1 , G. Bahat 1 , C. Kılıç 1 , P. Kucukdagli 1 , O. Yilmaz 1 ,Y. Topcu 1 , İ. Bay 2 , M.A. Karan 1 . 1 Istanbul University, Istanbul
Medical School, Department of İnternal Medicine, Division ofGeriatrics, Istanbul, Turkey; 2 Erzurum Atatürk University, Medical
School, department of Internal Medicine, Erzurum, Turkey
Purpose: Urinary incontinence (UI) is a common cause of morbidity
in the elderly. Identiﬁcation of factors associated with urinary
incontinence is necessary to identify risky individuals and to takepreventive measures. We suggest that sarcopenia may facilitate
urinary incontinence by decrease in muscle mass/strength. In thisstudy, we aimed to investigate the relationship between urinary
incontinence and sarcopenia.
Methods: Elderly people between the ages of 60–99 were included
in study. Demographic data, clinical data, UI and its types wereobtained. Body mass index (BMI), hand grip strength and walking
speed were assesed by using physical examination. Muscle mass
was measured by bioimpedance analysis (TANITA-BC532). Low
muscle mass thresholds were assessed according to national data
(Muscle mass adjusted by height for women <7.4 kg/m2 , for men<9.2 kg/m2 ; muscle mass adjusted by weight for women <33.6%,
for men <37.4%; muscle mass adjusted by BMI for women <0.82
kg/BMI, for men <1.05 kg/BMI, another treshold for muscle mass
adjusted by BMI for women <0.68 kg/BMI, men <1.02 kg/BMI, formen<1.02kg/BMI).
Results: The prevalance of UI was %46.2 (601/1302). Associatedfactors with UI were gender, age, drug-number, BMI, fecal incontinence, constipation, falls, sleep disorders, frailty, activities ofdaily-living, instrumental activities of daily-living, grip strength,
walking speed, bia muscle, skeletal muscle mass, muscle mass
adjusted by weight and BMI. Independent factors related with UI
in regression analysis models; Fecal-incontinence, drug-number,
frailty and instrumental activities of daily-living. While hand-grip

strength was not associated with UI, muscle mass adjusted byweight and body mass index were found to be related to urinary
incontinence.
Conclusion: The results of our study show that UI is independently
associated with sarcopenia. Treatment of sarcopenia may have apositive effect on UI.
P-255
Validation of the Korean version of the SARC-F to assesssarcopenia: KFACS
S. Kim 1 , C.W. Won 2 , M. Kim 3 . 1 Department of Medicine, Graduate
school, Kyung Hee University, Seoul, Korea; 2 Department of Family
Medicine, College of Medicine, Kyung Hee University, Seoul, Korea;
3 College of Medicine/East-West Medical Research Institute, Kyung Hee
University, Seoul, Korea
Introduction: Strength, Assistance in walking, Rise from a chair,
Climb stairs, Falls (SARC-F) scale is a simple screening tool forsarcopenia using a simple 5 item questionnaire. The aim of thisstudy was to validate the Korean version of SARC-F (K-SARC-F) in
Korean community dwelling older adults.
Methods: Using data from the Korean Frailty and Aging Cohort
Study (KFACS), and 1,548 participants who aged over 70 years were
included. Questionnaire items were translated into Korean, and
5 questions were used to calculate the score. Classiﬁcation using
the K-SARC-F score (≥4: sarcopenia group) was compared using
consensus panel criteria from international, European, and Asiansarcopenia working groups. The association of K-SARC-F with otherscales or tests was analyzed Measurements, including appendicular
muscle mass, were taken using dual-energy X-ray, grip strength
using a dynamometer, 4-m gait speed, and time taken for repeatedchair stand.
Results: The participants’ mean age was 76.2 years old, and 726(46.8%) were males. Using K-SARC-F tool, the overall prevalence ofsarcopenia was 10.8% (8% with European, 12.7% with International,
9.7% with Asian working group, male: 4.7%, female: 16.3%). The
SARC-F has excellent speciﬁcity (over 90%) but poor sensitivity forsarcopenia classiﬁcation. The scale was also correlated to othermeasures related to sarcopenia (such as age, gait speed, grip
strength, SPPB, balance, SMI, and frailty).
Conclusion: The K-SARC-F scale is correlated with the sarcopenia
index and is a simple tool to rule out for sarcopenia in a clinicalsetting.
P-256
Validation of the Turkish version of the Clinical Frailty Scale
C. Özsürekci 1 , C. Balcı 1 , C. Kızılarslanoğlu 2 , H. Çalışkan 1 ,R.T. Doğrul 1 , G. Ayçiçek 1 , F. Sümer 1 , E. Karabulut 3 , B.B. Yavuz 1 ,M. Cankurtaran 1 , M. Halil 1 . 1 Hacettepe University Faculty of
Medicine Department of Internal Medicine Division of Geriatrics,
Ankara, Turkey; 2 M.D. Gazi University Faculty of Medicine Department
of Internal Medicine Division of Geriatrics, Ankara, Turkey; 3 Hacettepe
University Faculty of Medicine Department of Biostatistics, Ankara,
TurkeyBackground: Frailty is a geriatric syndrome which develop as aresult of cumulative decline in many physiological systems andresulting in an increased vulnerability and risk of adverse outcomes. The clinical frailty scale (CFS) was validated as a predictor ofadverse outcomes in community-dwelling older people and mixes
items such as comorbidity, cognitive impairment and disability.
Aim: We aimed to study the concurrent validity and inter-rater
reliability of the 9 point CFS in Turkish Population. Design: Crosssectional observational study in a large tertiary, Hacettepe University hospital in Ankara, Turkey.
Methods: Between March 2017 and May 2017, total, 82 patients

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

aged ≥65 years admitted to a geriatric outpatient clinic were
included. Construct validity of CFS was assesed with Fried Frailty
phenotype and FİND questionnaire–Turkish version.
Results: Total 82 patients’ mean age was 75,6 years (SD:6,09
years) and %61 were females. %64.6 patients used ≥4 drugs. CFS
inter-rater reliability and re-test reliability was very strong (kappa
0.811, p<0.001 and 0,899, p<0.001 respectively). When frailty
was examined within 3 groups (normal, prefrail and frail group);concordance of CFS and Fried Frailty phenotype was moderately(Cohen’s kappa 0,514 p<0,001). When frailty was examined within
2 groups (normal and frail group); concordance of CFS and Fried
Frailty phenotype was good (Cohen’s kappa 0,715, p<0,001). The
concordance of CFS and FİND questionnaire–Turkish version waslow (Cohen’s kappa 0,34, p:0,001).
Conclusions: CFS appears to be a quick, reliable, and valid frailty
screening instrument for Turkish community dwelling elderly.
P-257
What are the best 1-year predictors of falls and mortality among
nursing home residents? Results of the SENIOR cohort
F. Buckinx 1 , J.-L. Croisier 2 , J.-Y. Reginster 1 , T. Brunois 1 ,C. Lenaerts 1 , X. Rygaert 1 , J. Petermans 3 , O. Bruyère 1 . 1 Departmentof Public Health, Epidemiology and Health Economics, University ofLiège, Belgium; 2 Department of Sports Sciences and Rehabilitation,
University of Liège, Belgium; 3 Department of Geriatrics, CHU of Liège,
Belgium
Introduction: The present study aimed to ﬁnd clinical predictors offalls and deaths among nursing home residents.
Methods: We studied 662 subjects from the SENIOR cohort (Sample
of Elderly Nursing home Individuals: an Observational Research)
aged 83.2±8.99 years, including 484 (72.5%) women, and living in
nursing homes. Among this cohort, respectively 584 and 565 subjects were monitored during 12 months, for mortality assessmentand for occurrence of falls (i.e. via their medical records). A large
number of clinical characteristics were also collected at baseline,
during a face-to-face examination with each patient. Stepwise
regressions analyses were carried out to predict mortality and falls.
Results: When comparing clinical characteristics of deceased andstill alive subjects, being a man (OR: 1.89, 95% CI: 1.19–3.01,
p=0.002) and being diagnosed with sarcopenia (OR=1.7, 95%CI:
1.1–2.92, p=0.03) were independent factors associated with the
1-year mortality. Other independent factors that were signiﬁcantly
associated, this time with the one-year occurrence of falls were: theresult obtain at the Tinetti test (OR =0.93, 95%CI: 0.87–0.98, p=0.04),
at the grip strength test (OR=0.95, 95%CI: 0.90–0.98, p=0.03) and at
the isometric strength test of the elbow extensors (OR=0.93, 95%CI:
0.87–0.97, p=0.04).
Conclusion: Globally, the frequency of undesirable health outcomes(i.e. falls and mortality) seems to be higher among subjects withlower muscle strength and mobility. These ﬁndings, strategically
exploited, could potentially, but signiﬁcantly, reduce falls and evendeaths.
P-258
What characterises hip fracture cases in AGES-Reykjavik study?
S.S. Skuladottir 1,2 , I. Hjaltadottir 3 , L. Launer 4 , T. Harris 5 ,P. Caserotti 6 , M.F. Cotch 7 , T. Lang 8 , G. Eiríksdóttir 9 ,K. Siggeirsdottir 9 , V. Guðnason 9 , G. Sigurdsson 9 ,L. Steingrimsdottir 1 , I. Halldorsson Thorhallur 1 . 1 Faculty of Food
Science and Nutrition, University of Iceland, Reykjavik, Iceland; 2 The
Icelandic Gerontological Research Institute, Reykjavik, Iceland;
3 National University Hospital of Iceland, Reykjavik, Iceland; 4 National
Institute on Aging, Bethesda, Maryland, USA; 5 National Eye Institute,
Bethesda, Maryland, USA; 6 National Institute on Aging, Bethesda

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Maryland, USA; 7 National Eye Institute, Bethesda Maryland, USA;
8 Faculty of Medicine, University of California, San Francisco, California,
USA; 9 Icelandic Heart Association, Kopavogur, Iceland
Introduction: Elderly people are at increased risk of hip fracture. Apart from poor bone health, hip fracture cases tend to beolder, have lower BMI and are less active. Other factors that may
contribute to the risk of fracture are not well characterised.
Aim: To examine characteristics of people who develop hip fracturecompared to non-hip fractures.
Methods: Longitudinal study of 5764 participants (mean age 77y atbaseline) from the Age, Gene/Environment Susceptibility-Reykjavik
study (AGES-Reykjavik) 2002–2006. Extensive clinical measurements including CT-scans, functional and leaning tests and historyof past and present health was recorded.
Results: During follow-up of 7.2y, were 486 hip-fractures (144
occurred in men). Men and women who developed hip fractures
were signiﬁcantly (p<0.001) older (80 vs. 77y) and had reducedbone mineral density of the femoral neck (213 vs 252 mg/cm3 ),lower serum 25(OHD) (48 vs 54 mmol/L), and longer timed up andgo test (14 vs 12 sec) (p<0.001) poorer leaning test (7.1 vs 8.3cm).
Comparable results were observed for both sexes. In addition,muscle strength of leg in knee extension was 17 and 10 kg among
male and females who did not devlop hip fractures compared to 14
and 9 kg for males and females who devloped hip fracture (p<0.001
for both sexes). Similar pattern was observed for muscle area inthigh. All differences remained signiﬁcant after adjustment for age.
Conclusions: Elderly men and women who develop hip fractures
already manifest signiﬁcantly less muscle strength, mobility andbalance compared to peers of comparable age.

Area: Geriatric education

P-259
A serious game concerning delirium care as educational tool:
effect on skills, attitude and learning motivation
K.R. Spanjers, H.H.M. Hegge, S.E.J.A. de Rooij. Department Internal
Medicine and Geriatrics; University Medical Centre Groningen the
Netherlands
Introduction: Yearly 100,000 patients in Dutch hospitals experience delirium, with very adverse consequences. Good diagnosis
followed by adjusted care are crucial for treatment. Delirium isoften detected late and treated inadequately. The Delirium Experience (DE), a simulation-based serious game, is developed to educate
healthcare professionals in caring for delirious patients.
Methods: A randomised controlled trial was conducted in third year
medical students, to study whether the DE inﬂuences skills and attitude regarding care for delirious patients, and learning motivation.
Participants received a lecture on delirium, the control (c. video
on healthy ageing) or one of the intervention conditions (i1. video
concerning delirium and a patient’s experience or i2. serious gameDE), and were demonstrated an interview of a delirious patient.
Skills were measured by assignments on the interview, attitudewith the Delirium Attitude Scale, and learning motivation with the
Motivation and Evaluation questionnaire. Data were analyzed withthe use of a one-way ANOVA, and pairwise post hoc comparisons.
Results: In total 156 students participated, 31% had experience
with delirious patients. Attitude was more positive in the i1 group,compared to the control group (p=0.007). Learning motivation andskills were higher in the i2 group compared to both other groups(p=0.000).
Conclusion: The serious game DE demonstrated its capacity to train
students’ skills and increase learning motivations but not attitude.

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P-260
Adult children of persons with dementia and their experience:
Thoughts about mental health services

P-262
Associations of total and different types of physical activities
with quality of life in Korean elderly population

V. Giannouli, N. Syrmos. School of Medicine, Aristotle University ofThessaloniki, Greece

J. Han 1 , J.A. Lee 2 . 1 Daehang hospital, Seoul, Korea; 2 Asan Medical
Center, Seoul, Korea

Adult children of persons with dementia and their experience:
Thoughts about mental health servicesVaitsa Giannouli & Nikolaos
SyrmosSchool of Medicine, Aristotle University of Thessaloniki,
Greece Introduction: The aim of this research study is to distinguishthe main factors that inﬂuence the attitudes of adult children of
persons with dementia and reveal their real needs that mental
health experts should focus on.
Methods: Ten adult children of patients with severe dementia (6women, mean age =42.5 years, mean education years =16 years,
and mean age of formal diagnosis for the patient 8.5 years) from
Greece participated in the study. The method that was used weresemi-structured interviews based on grounded theory that aimed
at unveiling (without imposing false categories) the main categories
that shape their everyday emotions and thoughts.
Results: Results indicated that initially 102 categories existed,which were later diminished at 4. The categories can be described
as: 1) the patients’ interaction with others, 2) the social life of thefamily, 3) the general support network, and 4) the thoughts for the
future of the dementia patient. All the above categories were linked
with and causally created from the poor existing health care system
according to the interviewees’ words.
Conclusions: Mental health experts in Greece should try to understand that in many cases there exists an imperative need forthe design of support programs or/and therapeutic programs for
relatives of patients with dementia.

Physical activity is a well-known determinant of Quality of Life
(QoL) in older adults. However, the association between the speciﬁctype of physical activity and QoL has not been evaluated in older
adults and little is known about whether physical activity improves
QoL in retired individuals. This cross-sectional study was conductedusing the latest data from the Korea National Health and Nutrition Examination Survey, 2015. In this nationally representative
study, 1811 participants aged over 60 years were analyzed. We
investigated the association between demographic characteristics
and health related QoL assessed by the EQ-5D index. To evaluate health-related QoL of participants regarding total and thespeciﬁc types of physical activities, multivariate logistic regression
analysis was performed after adjusting the age, sex, householdincome, occupational status, and the number of co-morbidity. In
multiple logistic regression analysis, moderate to vigorous total
physical activity compared to low physical activity showed lower
odds of problem of mobility (OR=0.61, 95% CI: 0.47–0.79), problem
of self-care (OR=0.67, 95% CI: 0.45–0.99) and problem of usual
activity (OR=0.49, 95% CI: 0.34–0.72). Moderate-high commuting
physical activity had inverse association with risk of problem ofmobility (OR=0.64, 95% CI: 0.48–0.85), problem of usual activity(OR=0.47, 95% CI: 0.31–0.72) and problem of anxiety (OR=0.63, 95%
CI: 0.43–0.95). Moderate-high leisure-time physical activity showeddecrease in problem of mobility (OR=0.49, 95% CI: 0.30–0.79).
Moderate-High total, commuting, and leisure-time physical activity
lowered the problem of mobility in QoL. However, occupational
physical activity neither increased nor decreased all subtypes of
QoL in the Korean elderly population.

P-261
Are medical students ageist? Explicit and implicit survey
J. Prud’homme 1 , S. Adam 2 , A. Gentric 3 , D. Somme 1 , P. Missotten 2 ,A. Corvol 4 . 1 CHU Rennes, Université Rennes 1; 2 UPsySen, Universitéde Liège; 3 CHU Brest, Université de Bretagne Occidentale; 4 CHU
Rennes, CRAPE
Introduction: Negative stereotypes concerning elderly persons arewidespread in general population. If health care professionals adopt
such stereotypes, their behavior may result in a decrease the qualityof care for elderly, or even in an induce disability. That’s why medical curriculum should take the question of ageism in consideration.
Though, little is known about ageism among medical students andits determinants.
Methods: We conducted a study on Rennes and Brest University(France) medical students (year 2 to year 6) using online questionnaires. Explicit preferences have been studied with validated
tools, such as Fraboni Scale of Ageism, and innovating ones, suchas verbal ﬂuency task about aging and youth. To underplay thesocial desirability bias, we then used implicit association test (IAT)
to evaluate the strength of implicit stereotypes. Results have been
analyzed according to age, gender, year of study, and geriatrictraining.
Results: Concerning explicit questionnaire, response rate was above
90%, leading to 814 replies. Negative stereotypes seemed lower
in female students, and in those who have regular contact withelderly persons, especially if these contacts are good, with no effectof geriatric training. Implicit survey is in course with already 570
replies.
Conclusion: Ageism is widespread in medical students and should
be addressed in geriatric training.

P-263
Deﬁning the curriculum for medical care in nursing homes
D. Fitzpatrick 1 , O. Samuelsson 2 , I. Holmerová 3 , F. Martin 4 ,D. O’Neill 5 , on behalf of EUGMS Long Term Care Special Interest
Group 5 . 1 ARHC, Tallaght Hospital, Tallaght, Dublin, Ireland;
2 Landspitali University Hospital, Reykjavik, Iceland; 3 Faculty of
Humanities, Charles University, Prague, Czech Republic; 4 Departmentof Ageing and Health, Guy’s and St Thomas’ NHS Foundation Trust,
London, United Kindom; 2 Centre for Ageing, Neuroscience and the
Humanities, Trinity College, Dublin, Ireland
Introduction: The deﬁnition of standards of medical care andcurricula for training of medical oﬃcers in nursing homes has been
neglected until very recently. The EUGMS has taken a lead on this
topic, examining both current national policies [1] and establishing
the ﬁrst set of standards of medical care in the biomedical literature[2]. A topic worthy of research is to deﬁne a core curriculum forcompetence in medical nursing home care.
Methods: Itemizing and comparison of curricular items in a rangeof national and international sources, including the IAGG Handbook,
Irish, Dutch and Australian curricula, and the AMDA competencies
curriculum. These will then be prioritized by a Delphi process
involving members of national societies in the EUGMS.
Results: Items common to all ﬁve sources included: delirium anddementia, mobility and falls, polypharmacy and medication review,
palliative and end of life care and incontinence. Mood disorders,skin care, infection and management of chronic diseases werefeatured in four out of ﬁve sources.
Conclusions: This preliminary work lays the foundation for thedevelopment of an agreed common trunk to an EUGMS curriculum for training of doctors working in nursing homes with older

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

people. It will also allow for the development of audit and quality
indicators
References:[1] Briggs R, et al. European Geriatric Medicine 2012;3(6):365–7.
[2] Briggs R, et al. European Geriatric Medicine 2015;6(4):401–403.
P-264
Design of a geriatric program in United Arab Emirates
F.J. Soria Perdomo 1 , C. González Navajas 2 . 1 Geriatrician Quironsalud
Medical Group, Madrid, Spain; 2 Chief Psychiatry Hospital La Luz
Quironsalud Medical Group, Madrid, Spain
Aims: We created a three days geriatric program for Primary Care
Physicians belonging to United Arab Emirates Health and Prevention Ministry (MOH) sponsored by Quironsalud Medical Group of
Madrid Spain.
Methods: Different interactive activities were prepared related toessential features of geriatric work: Comprehensive Geriatric Assessment, Geriatric syndromes. Special emphasis was placed on
information exchange.
Results: Between April 14th and 16th 2017 a team of two doctors
visited he MOH Training and Development Center in Sharjah doing
different activities with a gropu of 30 doctors from different emirates. The program included comprehensive geriatric assessment,
geriatric syndromes, nutrition in the elderly patient, dementia andcognitive impairment, behavioral symptoms, Perioperative care,
Urinary tract infections and medical cares at the end of life.
Conclusions: During the three days the geriatric team had theopportunity to exchange information with primary care physicians.
Primary care physicians showed a high level of interest in geriatricsubjects. The course received very good reviews and help to establish relation between primary care physicians in the Arab world
and our geriatric team.
P-265
Determination of attitudes of participants in an advanced age
symposium related to age discrimination
S. Şahutoğlu 1 , H. Şimşek 2 , E. Tenli 3 , S. Şahin 4 . 1 Ege University
Hospital, department of Internal Medicine, Division of Geriatrics, İzmir,
Turkey; 2 Dokuz Eylül University School of Medicine, department of
Public Health, İzmir, Turkey; 3 Ege University, Faculty of Nursing, Izmir,
Turkey; 4 Ege University Hospital, department of Internal Medicine,
Division of Geriatrics, Izmir, Turkey
Aim: To detect the perspective of those from different occupations
who are in touch with the world of the elders and attending 1thInternational Izmir 10th Advanced Age Symposium (22–23th March2017).
Method: Ageism Attitude Scale was used. Independent variables
were age, gender, education, visiting nursing home, marital status,
occupation, family type, place where they live, living with theelderly person.
Results: 202 people have been reached. Mean age was 35.8±16.5,%79.9 were women,%8.4 (n=17) 65 years and over. The average scoreis 89.2±7.4 (65–107) and this score is statistically signiﬁcant for
65 years and below (p=0.008). Participants are asked what comesﬁrst to their mind when said “old” and %51.9 of the replies are
determined as negative stereotype, %32.3 are positive stereotype.
Restricting life of elderly score is 36.3±3.1 (26–44), Positive ageism
score is 31.8±4.3 (16–40) and Negative ageism score is 21.1±3.4(6–30). For the married average score of the negative ageism isstatistically signiﬁcant (p=0.002). Positive ageism for the unmarried(p=0.001), for those living in extended family (p=0.029) and those
who have not worked in a unit that serves elderly (p=0.038) is
statistically signiﬁcant.
Conclusion: It was determined that there was a positive attitude

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towards the elderly in the study. In sub-dimensional analysis, it isfound that old age is restrictive and there is a positive ageism. The
more positive attitude is detected for those who have less contact
with the elderly, unmarried and living with extended family.
P-266
Does geriatric interprofessional education increase student’s
conﬁdence in core geriatric presentations?
C. Hallsworth 1 , S. Thompson 2 , J. Riley 1 , G. Alg 4 , Z. Etheridge 1 ,K. Boncey 1 , J. Bowen 1 , A. Montagu 1 , G. Hadley 1 , E. Puffet 3 ,C. Hardy 3 , C. Forde-Johnston 3 , K. Sherrington 3 , N. Lovett 1 ,J. Lafferty 1 , Z. Hussein 1 , C. Pedlar 3 , D. Goyal 1 , S. Wheeler 3 , F. Los 1 ,K. Shah 1 , J. Beale 3 . 1 Oxford University Hospitals NHS Foundation
Trust, Oxford, United Kingdom; 2 University of Oxford Medical Sciences
Division, Oxford, United Kingdom; 3 Oxford Brookes University,Oxford,
United Kingdom; 4 Royal Berkshire NHS Foundation Trust, Reading,United Kingdom
Objective: To assess the eﬃcacy of a case-based interprofessional
education (IPE) programme covering core geriatric topics relevant
across specialties.
Background: The Shape of Training Report 2013 recognises increasing disease burden in our ageing population. “Geriatric giants”
present across specialties, and are often medically or ethicallychallenging, requiring involvement of multiple professionals. Population changes outpace curricula changes and these are often
sparsely taught. Oxford Medical School and Brookes University
continue to deliver geriatric IPE addressing such issues.
Methodology: Anonymous self-assessment in perceived conﬁdence
in adopting inter-professional approach in dealing with geriatric
medical problems was collected before and after IPE sessions. Conﬁdence was measured by using a 5-point Likert scale. Nursing andmedical students worked in small groups on four chosen common
geriatric problems before the arrival of senior nurse and doctor
who facilitated the discussion from the inter-professional team’s
perspective.
Results: 73 nursing and 85 medical students provided feedback(5 excluded as incomplete). Using the paired T test, 63% nursing students had improved conﬁdence post intervention, (meanscore increase 0.77), while 84% of medical students had improved
conﬁdence, (mean score increase 1.21) post-intervention.
Conclusion: There was a statistically signiﬁcant improvement in
students’ conﬁdence following intervention, slightly greater for
medical students, likely due to relative inexperience comparedto nursing students, who already had 3 years clinical experience.
Future sessions could potentially be improved by better matching ofstudent’s level of clinical experience and the involvement of other
health care professionals. This form of geriatric IPE statisticallysigniﬁcantly increases student’s conﬁdence.
P-267
Educational initiative to promote knowledge of cognitive
dysfunction in minority older communities, their caregivers andclinicians
K. Alexander 1,2 , R. Manna 1 , N. Gangai 1 , R.C. Muniz 1 ,B. Korc-Grodzicki 1,2 . 1 Memorial Sloan Kettering Cancer Center, NewYork City, USA; 2 Weill Cornell Medical Center, New York City, USA
Introduction: In addition to the ageing of the population, theUnited States faces a signiﬁcant sociodemographic challenge: thegrowth in the number of minorities. Minorities and older adults are
particularly vulnerable to receiving suboptimal healthcare.
Methods: In collaboration with community organizations anda Federal government grant through the Health Resources andServices Administration (HRSA), the Geriatric Resource Interprofessional Program (GRIP) was set up at Memorial Sloan Kettering

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Cancer Center (MSKCC). It spearheaded an educational initiative on
cognitive dysfunction targeting minority communities in Queens
County. Four sessions were conducted at community centers. An
additional session was conducted to address the needs of caregiversof older adults with dementias. Consecutive interpretation of thelectures was performed to the predominant language of the group.
Two sessions discussing the assessment and management of cognitive syndromes in older cancer patients were delivered to clinicalstaff at regional locations of MSKCC.
Results: A total of 171 people who spoke 15 different primary languages attended the community sessions. Their median age was 66(28–99 years) and 65% were women. 53% were born in Bangladesh,the rest in 16 other countries. 34 providers- nurses, case managers,social workers and oncologists attended the two clinical sessions.
Their median age was 57.5 (31–73 years). 90% were female (N=31)
and 82% identiﬁed as white (N=28).
Conclusions: Challenges to the initiative included differences inliteracy, multiple cultures and languages. Successes and barriers
faced in implementing the educational initiative, as well as pre andpost-test results will be presented.
P-268
End the silence: Developing an educational curricula for healthcare professionals on elder abuse
S. Sarfraz. Brown University, Providence, RI 02906
Background: Elder abuse (EA) is an under-recognized problem
which increases morbidity and mortality among those affected. EA
is deﬁned as a single or repeated act, or lack of action, occurring
within any trust relationship, which causes harm or risk of harm
to an older person. Only 40% of the countries have laws to prevent
EA. In US, physicians report 1% of all EA cases. Lack of education isoften cited as a primary cause of failure to identify and report EA.
Methodology: An educational curriculum based on the adult modelof learning was developed and piloted at the Durham Veterans Affair Medical Center. The curriculum was developed as a 60 minute,multimedia case based interactive lecture for health care providers(HCP) routinely caring for older adults. Components include EA definition, types, risks factors, symptoms, and the reporting processes.
Pre, post, and post-post surveys were done testing knowledge,clinical skills and attitude on EA.
Results: 86 participants included social workers, physical and occupational therapist, nurses, geriatricians, and learners. There wasnoted improvement post and post-post test after the educational
intervention. Most signiﬁcantly, recognition all types to abuse (7/86
to 20/86) and ability to identify sexual abuse as a type of EA (15/86
to 27/86). Focus group analysis suggests that the curriculum waseffective at increasing awareness, ability to identify and report EA.
Conclusion: Our 1- hour curriculum on EA for HCP has since
been reproduced in CD format and interactive webinar and has thepotential to improve knowledge and recognition of EA.
P-269
Fibromyalgia and health education
I. Sierra-Martinez 1 , L. Sierra-Martínez 2 , R. Martinez-Fuerte 2 ,L.A. Diez-Suarez 1 , N. Sanz-González 3 . 1 Traumatology Department,
Hospital of Medina de Campo (Valladolid), Spain; 2 Valladolid Este
Primary Assistance Gerency, Valladolid, Spain; 3 Parquesol SeniorCenter, JCyL Social Services Gerency, Valladolid, Spain
Introduction: Fibromyalgia is a chronic disease with generalised
pain and psychosocial problems which could beneﬁt from multidisciplinary intervention.
Objectives: To create a group of people diagnosed with ﬁbromyalgia
to train them to improve their quality of life. And quantify the
improvement of chronic pain, after a group didactic intervention.

Methodology: Urban primary care center of 15387 patients assigned, where 3% suffers from ﬁbromyalgia. A multidisciplinarygroup was created by a nurse, a social worker, traumatologist anda primary care physician. Group open to the entire population
assigned to the Primary Care Center (PCC) affected by ﬁbromyalgia.
The intervention was a year of one-hour weekly sessions, withprofessionals performing health education in hygienic and posturalcare and evaluating the improvement in the impact on activities ofdaily living.
Results: We started the group with 18 people, who at the end of
the experience had tripled. A descriptive analysis of the participants
was performed: 100% women, mean age 61.5±10.2, 90% married,
95% did not work. Improvement in self-perception was assessed in
58.9% of patients. The mean score on the visual analogue scale ofpain intensity (range 0 to 10) decreased from 4.5±1.9 SD to 3.9±2.4
SD (p=0.02). The satisfaction level was 9 out of 10.
Discussion: Patients improved their attitude about the disease as
well as their emotional state. They have created an association for
their beneﬁt and establishing themselves as an autonomous group.
We are planning to organise eight structured sessions with reducedgroups.
P-270
Mutual respect – how should doctors, nurses & patients addresseach other
J. Narendran, S. Marsh, Z. Subhan, B. Creswell, A. Johansen. Trauma
Unit, UHW, Cardiff, UK
Background: A successful consultation depends upon the initial
rapport built between healthcare professionals and patients. Olderpatients will be used to having been addressed more formallythan is common nowadays, but limited published data is available
questioning whether such patients would prefer to be addressed bytheir ﬁrst or surname.
Objective: We set out to question patients’ perspective – asking
how they would prefer to be addressed, and seeking their views in
how healthcare professionals should introduce themselves.
Method: We approached 66 consecutive in-patients on trauma andorthogeriatric wards. Our hypothesis was that oldest patients might
prefer a more formal form of address than was actually being usedon the ward, so individual patients were questioned by someone
who had not previously introduced them self, and who not involvedin the patient’s clinical care. Questioning was open, without thepresumption of informality sometimes evident in nurses approachto the admissions process. We asked each patient how they would
prefer to be addressed by the staff, how they were actually being
addressed, and how hospital staff introduced themselves.
Results: Nine patients (14%) were unable to answer the questions
due to cognitive impairment. Of the remaining 57 patients themean age was 80 years (range 27 to 101 years), and 63% werefemale. 54 (95%) stated that they preferred to be called by theirﬁrst or nickname, one patient wished to be called by their surname,and two patients stated no preference. 48 (84%) of them stated that
doctors tended to introduce themselves by their title and full name.
On discussion the majority of patients preferred this. 47 (82%) said
that nurses introduced themselves by their ﬁrst name and mostpatients preferred this. “A doctor’s title should be used, I want toknow who I am speaking to.” There was no apparent difference inattitudes between younger and older patients.
Conclusion: Even the oldest patients in hospital are now comfortable with informal forms of address. Traditional attitudes arestill evident in a preference for respecting a doctor’s title and surname. When approaching patients we should introduce ourselvesformally, but ask them what they would like to be called.

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P-271
New educational technologies in gerontology
A. Ilnitski. Belarusian Republican Gerontological Public Association
The aim of study is to implement the best educational practices
among younger’s in gerontology to achieve clear understanding ofhealthy aging and improve knowledge’s in communication withseniors.
Material and methods: Few educational technologies were implemented: interactive games with using of simulators of geriatricsyndromes; education in physical training by using of special exercises for cognitive support (intelligent gym); education in ﬁeld of
local folk and language traditions which can be used in supportingof physical and cognitive functions. The average age of younger’sgroup was 21,2+1,5 years, participants were students of different senior schools, total number of participants of educational programs
was 346. For estimation of effects of training programs special
original questionnaires were used.
Results: During educational programs the level of knowledge inpreventive and healthy behavior increased on 35,5%, the number ofhealthy habits on 15,5%, understanding of healthy aging on 52,0%,
understanding of health and social problems of elders on 70,0%,
the level of ageism decreased on 30,0%. 70,0% of participants ofeducation trainers noticed the increased level of understanding of
problems of their old relatives and neighbours, 82,5% expressedinterest in training because all topics were in fashion in the society.
Conclusion: Achievement of long and healthy lifespan by paying attention to the health status, behavior, habits of younger generationis possible by using of untraditional interactive forms of educationof younger’s in sphere of healthy ageing.
P-272
Prevalence of carotid sinus syndrome in older versus younger
patients presenting with unexplained syncope, falls anddizziness
S. Banu, Z.M. Lwin, S. Mansour, K. Shahpar, T. Masud, M.H. Poon.
Nottingham University Hospital NHS Trust
Introduction: Carotid sinus syndrome (CSS) is a known causeof unexplained syncope, falls or dizziness, although it is often
under-recognised in clinical practice. CSS can be cardio-inhibitory(CI-CSS), vasodepressor (VD-CSS) or mixed. The aim of this study
was to assess the prevalence of CSS in this population.
Methods: We reviewed data from consecutive patients with unexplained syncope, falls or dizziness referred for carotid sinus
massage (CSM). CSM was performed in a standardised manner for
10 seconds bilaterally in supine and upright positions (tilt table)with electrocardiography and digital plethysmography measuring
beat-to-beat blood pressure (BP). The diagnostic criterion for CI-CSS
was 3 second pause and for VD-CSS was 50mm Hg systolic BP drop(or 30mmm with symptoms).
Results: 272 patients (mean age=53.6±22.6; range=18–93; 106=men)
were studied. The overall prevalence (95%CI) of CSS was 8.4%
(5.1–11.7). Prevalence of CI-CSS and VD-CSS were 1.8% and 6.9%
respectively. The CSS prevalence in older (≥65 years) was four-foldhigher than in younger (<65 years) patients [16.3% (9.2–23.4) vs
4.1% (1.3–6.9); p<0.05]. The CSS prevalence in men tended to be
twice that in women [12.3% (6.0–18.6) vs 6.0% (2.4–9.6)]. The prevalence in older (≥65 years) men and women were 23.2% (10.6–35.8)
and 11.4% (3.4–19.4) respectively. No adverse events occurred.
Conclusion: Approximately a quarter of men and one tenth ofwomen aged over 65 years with unexplained syncope, falls or
dizziness were diagnosed with CSS which allowed appropriate
intervention to be performed. This included general advice for
VD-CSS and dual-chamber pacemakers for CI-CSS. CSM procedure
was safe.

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P-273
Quality improvement project to improve the knowledge andprescribing practices by trainee doctors inpatients with
Parkinson’s disease
R. Matthews, A.L.T. Yong, A.M. Thomson. Salford Royal NHS
Foundation Trust, United Kingdom
Introduction: Medication management in patients with idiopathic
Parkinson’s disease (iPD) is challenging for trainee doctors. Education in prescribing practice is limited by the time constraints ofrotas and busy clinical jobs. Using Quality Improvement methodology, this project aimed to identify what learning technique would
be most acceptable to doctors in training.
Methods: Trainee doctors working in the Emergency Assessment
Unit (EAU) of a University teaching hospital were surveyed to assess
their baseline knowledge in prescribing Parkinson’s medications.
A 2-week educational approach was then implemented, including
email messages and a short presentation at twice-daily handover.
A post-intervention survey was used to determine the trainee’s
preferred learning techniques.
Results: 30 trainees completed the pre-intervention survey. This
conﬁrmed knowledge-gaps including route of delivery, contraindicated medications and management of nil-by-mouth status. 32
trainees completed the post-intervention survey. 23/32 (71.9%) felt
the project had improved their prescribing practice in this area.
29/32 (90.6%) agreed they understood the adverse effects of missed
doses, and 26/32 (81.2%) how to manage nil-by-mouth status. Givena choice of a single educational approach, the cohort expressed apreference for seminar-based teaching (33.3%) or an on-line learning module (33.3%), over a daily EAU handover (26.7%) or email atthe beginning of the placement (6.7%).
Conclusions: Although it was not surprising that trainees felt theirknowledge had improved following the intervention, what is more
important is the learning style they wish to adopt. We are now
in the process of developing an on-line education module in thisimportant area of prescribing.
P-274
Relation between falls and consequences in institutionalized
elders, before and after a removal intervention of physical andpharmacological restraints
P. Alcala Manchado, E. Aulló Chavez, S. Bercial Velez, D. Curto i
Prieto, C.M. Garcia Alonso, M. Saez Pomares. Spain
Introduction: Being falls one of the geriatric syndromes with ahighest impact in institutionalized people in nursing homes; thisstudy tries to assess if with a physical and chemical restraints
reduction programme is possible to achieve a reduction in thenumber of falls and its consequences.
Methodology: An intervention in Alcorcón’s nursing home showsthat after training their staff, physical restraints were phased out
compared to last year, where 60% of the residents had a physicalrestraint prescription. The main variables studies were: falls andpsychotropic medication prescriptions.
Results: It is proven that removing physical restraints do not cause
an increase in the number of falls, also showing a positive improvement in its consequences. Likewise, it is shown that is has not beennecessary to increase the prescription of psychotropic medication.
Conclusion: It is veriﬁed that the elimination of physical restraints
has not a negative impact in falls, improving certain aspects of welfare and behavioral changes. It is evident that this program should
be complemented with a removal of pharmacological restraints.

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P-275
Solving an age-old problem, how do our trainees learn about
geriatric medicine
J. Lee 1 , C. Lisk 2 . 1 North London Hospice, London, United Kingdom;
2 Barnet Hospital, London, United Kingdom
Introduction: The UK population is ageing and it is critical that
effective Geriatric Medicine teaching programmes are establishedto train the Physician workforce to effectively care for an ageing
population. We sought to establish how Core Medical Trainees CMT
within North central and North east London learnt about GeriatricMedicine.
Methods: A questionnaire adapted from a survey of training in
Geriatric Medicine in UK medical schools was sent as a web based
survey to all 197 CMTs in March 2016.
Results: 94 trainees responded (response rate 46%). 59.57% (56) had
Geriatric Medicine as part of their 2 year CMT rotation. Workplace
based learning WBL were the predominant source of teaching
and learning in core Geriatric Medicine; delirium 75.9%, dementia
74.7%, falls 72.29%, mental capacity 68.75%, polypharmacy 65%,
advanced directives 62.5%, assessment scales 69%, stroke/TIA 59.4%,
Parkinson’s disease 57.83%, principles of medical ethics 56.2% andosteoporosis 49.4%. Trainees learning about Pressure ulcers, Incontinence, Cancer in the elderly, Cellular aspects of aging, Physiologicalaspects of ageing, Elder abuse, Population ageing, Social ageing andmodels of community based care were poor in local and regional
teaching programmes. E learning was used commonly in Principles
of medical ethics 17.5%, Mental capacity 17.5%, Elder abuse 18.75%
and advanced directives 10%.
Conclusion: This study emphasises that teaching and learning
experiences for CMTs occur in the workplace through day to day
work experiences. It is important to include topics with low WBL
into formal teaching sessions to ensure adequate exposure to all
aspects of Geriatric Medicine.
P-276
The use of the aging simulator in nursing students: A scoping
review
A. Coelho 1 , V. Parola 1 , M. Almeida 2 , S. Duarte 2 , D. Cardoso 1 ,H. Neves 1 , J. Apóstolo 1 . 1 Health Sciences Research Unit: Nursing,Nursing School of Coimbra; Centre for Evidence-Based Practice: aJoanna Briggs Institute Centre of Excellence, Portugal; 2 Health Sciences
Research Unit: Nursing, Nursing School of Coimbra, Portugal
Introduction: The use of Simulation as a teaching/learning strategy
in the training of nurses has increased in the last decades andprovided the acquisition and development of several competences.
However, data regarding the speciﬁc use of the Aging Simulator
are scattered in the literature. The purpose of this Scoping Review
is to analyse and map interventions with the Aging Simulator,
implemented in nursing students.
Methods: Scoping Review conducted according to the methodology proposed by the Joanna Briggs Institute (1,2). This review
considered qualitative and quantitative studies, focused on nursing
students, who used the Aging Simulator. Studies were considered
without limitation of year of publication, in English, Spanish andPortuguese.
Results: Of 195 studies found, two studies were included in thereview. The use of the simulator oscillated between one andthree hours, between the use of the complete simulation suit andonly some constrictors. Empathy evaluation and learning effectiveness tools were implemented. Both studies were implemented in
students of the 2nd year of the Degree.
Conclusions: The characteristics of the intervention, duration andevaluation instruments differ between studies, so a systematic
review of the effect of the Aging Simulator is necessary to deter-mine the best available evidence and guide the training of nursing
students. Further studies should be performed to determine theeffect/ﬁndings of the implementation of the Aging Simulator in
the acquisition and development of competences in a pre and post
clinical context.
References:[1] Peters M, Godfrey C, McInerney P, Baldini Soares C, Khalil H,
Parker D. Methodology for JBI scoping reviews. The Joanna
Briggs Institute Reviewers’ Manual 2015. Adelaide (Australia):
The Joanna Briggs Institute; 2015. p. 1–24.
[2] Peters M, Godfrey C, Khalil H, McInerney P, Parker D, Soares C.
Guidance for conducting systematic scoping reviews. Int J Evid
Based Healthc. 2015 Sep;13(3):141–6.
P-277
Toward physician mediated quality measure for nursing home
care
C.M.P.M. Hertogh. VU University Medical Center
Background: Most quality measures for nursing home care emphasize facility-level processes and structure and are not designed toevaluate the role of the physician in this setting. AMDA, the Society
for Post Acute and Long Term Care Medicine (AMDA) engaged
providers in Europe and the US to identify physician competencies
for nursing home care; however, these competencies have not been
linked to speciﬁc measures that reﬂect the steps of care under thecontrol of these providers.
Methods: Starting in January 2017 and supported by RAND, a
research team that included content experts in nursing homecare from the US, Canada, the Netherlands and EUGMS SIG longterm care identiﬁed existing quality measures that map to AMDA’s
Attending Physician Competencies. Quality Indicators considered
included ACOVE Quality Indicators for community dwelling elders,the ACOVE NH Quality Indicator set, published guidelines, recommendations from “Choosing Wisely” and items in the Consumer
Assessment of Healthcare Providers and Systems (CAHPS) suite ofsurveys. The team updated and adapted measures to create candidate measures that are appropriate for US, Canadian and European
facilities and that reﬂect the achievement of AMDA competencies.
As a next step, an international expert meeting was held in June2017 that used the RAND modiﬁed Delphi process to identify a ﬁnal
set of measures, considering validity and feasibility.
Findings: The presentation will go into the key ﬁndings of theconsensus meeting and present the resulting quality measures.
Special attention will be given to feasibility of these measures indifferent health care systems across Europe.
P-278
Training to adopt National Early Warning Score (NEWS) in
community hospitals: Improvement after training inrecognising unwell patients using the NEWSS. Hyne, B. Lakkappa, K. Kodavali, M. Suppiah. Community Hospitals,
Northamptonshire Healthcare NHS Foundation Trust (NHFT), United
Kingdom (UK)Introduction: NEWS was implemented in the UK to standardise theassessment of acute-illness, severity of all hospital inpatients andalso to track their clinical condition, alerting the clinical teams toany clinical deterioration and triggering a timely clinical response.
The NEWS was adopted in our community hospitals, on threewards for 69 patients in 2015. Lack of timely clinical response fora patient; led to the review of practice and the implementation ofNEWS training for all community hospital staff.
Methods: In 2015, NEWS charts of 30 inpatients were reviewed andthe results showed patient monitoring and clinical response were
not satisfactory. Following the completion of NEWS training to allPoster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

staff, NEWS charts of all inpatients (69 in total) were reviewed on
one day in 2016. The two audits were assessed against Trust andRoyal College of Physicians (RCP) guidelines and compared.
Results There was signiﬁcant improvement seen in every area
assessed when compared between 2015 and post-teaching in 2016.
NEWS Assessment on consecutive days improved from 53% to70%, time documented 53% to 70%, scoring 70% to 81%, scoringcorrectly 77% to 93%, monitoring based on guidance 13% to 78%,
Documentation on electronic medical records from 0% to 53% anddocumentation on NEWS paper charts for action 90% to 100%.
Conclusions: The ﬁndings show clear improvement in patient monitoring and timely clinical response after teaching sessions, withroom for more improvement. Teaching sessions should be incorporated, for any local adaptation and implementation of nationalguidelines to improve staff competency and clinical practice.

Area: Metabolism and nutrition

P-279
A prospective cross-sectional study of hyponatremia among
elderly patients in the Department of Geriatrics at Kaunas
Clinical Hospital (Lithuania)
J. Knasiene 1 , R. Zilinskiene 2 , A. Abramaviciute 2 . 1 Lithuanian
University of Health Sciences, Academy of Medicine, Department ofGeriatrics, Kaunas, Lithuania; 2 Lithuanian University of Health
Sciences, Academy of Medicine, Kaunas, Lithuania
Introduction: HN is frequent electrolyte imbalance in clinical practice. Aging, chronic diseases, use of medications can cause HN.
HN is associated with multiple poor clinical outcomes: increased
mortality, longer hospital stay, higher institutionalization risk.
Methods: In a prospective cross-sectional study we used interview,clinical examination, medical data (n=144, age 83,34±6,78 years).
Patients with HN were deﬁned as serum Na+<135 mmol/L. Variables were evaluated using Chi-square, Spearman test. Data wereconsidered statistically signiﬁcant if value p<0.05.
Results: Prevalence of HN among elderly patients was 28.5% withmean Na+value of 127.85±5.47 mmol/l. This group consisted of
46.3% mild, 29.3% moderate and 24.4% severe HN. The duration of
HN was evaluted as chronic (n=41; 100%). All of patients complained
about weakness, fatigue, 78% felt thirst, 61%-vertigo, 56%-headache,
43.9%-nausea. 36.6% of elderly patients had moving disorders, 39.0%swelling legs, 36.6% consciousness, 31.7% irritability, 29.7% irregularheartbeat, 19.5% fever, vomiting, lethargy. Heart diseases was mostcommon among comorbidity: hypertension (90.2%), coronary arterydisease (78%). 65.9% elderly patients presented chronic kidney diseases, 56.1% anorexia, 61% had anemia,70.7% infections, 87.7% weretaking diuretics. The study had weak positive correlation between
HN and heart diseases (r=0.245), HN and kidney diseases (r=0.375),
HN and use of diuretics (r=0.341) (p<0.05).
Conclusions: 1/3 of elderly patients had chronic HN and even halfof them - moderate or severe HN. Elderly patients with mild HN felt
weakness, fatigue, in moderate cases – nausea, headache, in severecases – vomiting, lethargy. Elderly patients with HN statisticallysigniﬁcant had heart and kidney diseases and were using diuretics
P-280
Analysis of survival in patients >75 years with gastrostomy
according to the cause of indication
E. García Tercero 1 , M. Araujo Ordoñez 1 , T. Martínez Maroto 1 ,V. Landaluce Pelligra 1 , C. Pedro Monfort 1 , R.M. García Tercero 2 ,C. Lanciego 1 . 1 Hospital Virgen del Valle, Toledo, Spain; 2 Hospital
General Universitario Alicante, Alicante, Spain

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Introduction: Gastrostomy is performed more and more frequently
in elderly patients. A retrospective 5-year study evaluating thesurvival of the placement of gastrostomies according to the causeof the indication, whether it’s for stroke or dementia, is proposed.
Method: We performed a data reconnaissance chart on patientswith gastrostomy performed between 2011 and 2015, collecting
different variables: patient age, gender, associated comorbidities,cause of gastrostomy indication, type of nutrition used, The Months
that are alive after the implant or not and the cause of death. In thisposter we’ll focus on the analysis of survival according to the cause
of indication of gastrostomy. On the one hand we have the ACVS
and on the other hand the dementia (GDS3–7).
Results: n=177, ACVs: 33% (59) and Dementia: 66% (118) of the total
sample. Within the ACVS group, mortality was 44.1% and in thedementia group 48.3%. The median survival in the stroke group was
17 months and that of dementias was 22 months.
Discussion: The group of patients in whom ACV gastrostomy was
indicated had no signiﬁcant differences (p: 0.86) in the groupwith indication of dementia, questionnaires in relation to the small
number of cases.
Conclusions: The reason why gastrostomy is placed does not inﬂuence the survival of the same so it should not be a limiting factor
at the time of application. It’s necessary to carry out studies with amore sample to achieve a statistical signiﬁcance.
P-281
Coffee consumption and fracture risk in older men and women:
the Health, Aging, and Body Composition Study
M.R. Olthof 1 , L.A. Schaap 1 , E.S. Strotmeyer 2 , T.B. Harris 3 ,J.A. Cauley 4 , P.M. Cawthon 5 , S.M. Rubin 6 , M. Visser 1 . 1 Department
of Health Sciences, Faculty of Earth and Life Sciences, Amsterdam
Public Health research institute, Vrije Universiteit Amsterdam,
Amsterdam, the Netherlands; 2 Department of Epidemiology, Graduate
School of Public Health, University of Pittsburgh, 130 N. Belleﬁeld Ave.,
5th Floor, Pittsburgh, PA 15213, United States; 3 Intramural Research
Program, Laboratory of Epidemiology, and Population Sciences,
National Institute on Aging, National Institutes of Health, Laboratoryof Epidemiology, Demography, and Biometry, Gateway Building,
3C309, 7201 Wisconsin Avenue, Bethesda, MD 20892, United States;
4 Department of Epidemiology, Graduate School of Public Health,
University of Pittsburgh, 130 N. Desoto Street, A510 Crabtree Hall,
Pittsburgh, PA 15261, United States; 5 California Paciﬁc Medical Center
Research Institute, San Francisco, California, United States;
6 Department of Epidemiology and Biostatistics, University ofCalifornia, San Francisco, California, United States
Introduction: Several studies suggest an association between consumption of coffee and risk of osteoporotic fractures. However,
the results are inconclusive. In this study, we investigated theassociation between coffee consumption and risk of osteoporotic
fractures in older men and women.
Methods: Data on 2542 well-functioning Black and White men
and women aged 70–79 years at baseline were used. The medianfollow-up was 10.4 years. Coffee consumption was assessed withinterviewer-assessed food frequency questionnaires, and categorized as less than 1 cup, 1 cup, 2–3 cups and 4 or more cups
per day. Fractures were assessed every six months and veriﬁed
with radiology reports. Multivariate-adjusted hazard ratios (HR) of
fractures with 95% conﬁdence intervals (CI) were estimated for men
and women separately by Cox proportional hazard models.
Results: During follow-up, 392 participants (127 men and 265
women) experienced an osteoporotic fracture at any site. After multivariate adjustment for demographics, health and lifestyle factors,
consumption of 4 or more cups of coffee per day, compared to lessthan 1 cup of coffee per day, was signiﬁcantly associated with 1.63
times higher risk of osteoporotic fractures in women (HR: 1.63; 95%

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CI: 1.04–2.57). No signiﬁcant association was observed in men (HR:1.54; 0.84–2.83).
Conclusions: Consumption of coffee was associated with increased
risk of osteoporotic fractures in older women, but not in older men.
P-282
Comparison of the nutritional risk in the elderly over 75 years inhome vs health care units
I. Figueiredo 1 , R. Alves 1 , M. Saldanha 2 , F. Lourenço 1 , M. Antunes 1 ,H. Gruner 1 , A. Panarra 1 . 1 S. Medicina7.2 Hospital de Curry Cabral,
Centro Hospitalar Lisboa Central; 2 U Nutrição e Dietetica, Hospital deCurry Cabral Centro Hospitalar Lisboa Central
Introduction: According to WHO, elderly people are especiallyvulnerable due to malnutrition, being related to many different
factors. Our aim was to evaluate if patients from different cohabitation status had the same risk of undernutrition and evaluate
contributing factors.
Methods: Retrospective descriptive study of all patients with >75
years old, admitted to the medical ward of a tertiary hospitalduring a one year period with a nutritional evaluation either by
MUST or NRS. Patients were grouped according to habitation status
home (H) vs health care unit (HCU) and compared per gender, age,autonomy (KATZ score), primary diagnosis, median length of stayand mortality.
Results: A total of 89 patients fulﬁlled the inclusion criteria with a
median age of 83,7 years (37 with >85 years), 60 were female, 44
patients with nutritional risk, median length of stay of 9,89 days
and mortality of 32,4%. Concernig the 2 groups: there were H 15
patients and HCU 74, the patients living in HCU were slightly older(83,9 VS 83,7 years), with a male prevalence (53% VS 28%), lesser
autonomy with a KATZ <3 (73% VS 55,4%) and higher mortalty of
86% VS 14%. The risk ratio for nutritional risk in patients living
in health care facilities patients was 2,06, but the risk ratio formortality in patients with nutritional risk living at Home was 2,53
Discussion: Half of the population above 75 years old is at nutritional risk, that risk is even greater considering the population
living in health care facilities. This study pretends to raise awareness on this subject, considering malnutrition is frequently related
to poor outcomes. In our study the inﬂuence of malnutrition in
mortality was more important in patients living at Home.
P-283
Developing a clinical diagnostic tool for the identiﬁcation ofolder adults with hypovitaminosis D
C. Annweiler 1 , G. Duval 1 , G. Chevallereau 1 , O. Beauchet 2 ,B. Fantino 1 , A. Kabeshova 1 . 1 Angers University Hospital, France;
2 McGill University, Canada
Introduction: Hypovitaminosis D is highly prevalent among older
adults and associated with adverse health events. To rationalize
vitamin D assays and save health costs, our objectives were todevelop and test a clinical diagnostic tool for the identiﬁcation ofolder community-dwellers with hypovitaminosis D.
Methods: 1924 community-dwelling volunteers ≥65 years without
vitamin D supplements were recruited in this cross-sectional study.
A set of clinical variables (age, gender, living alone, individual deprivation, body mass index, undernutrition, polymorbidity, numberof drugs used daily, psychoactive drugs, biphosphonates, strontium,
calcium supplements, falls, fear of falling, vertebral fractures, Timed
Up & Go test, walking aids, lower-limb proprioception, handgrip
strength, visual acuity, wearing glasses, cognitive disorders, sadmood) was recorded from standardized questionnaires and medical
examination at the time of serum 25-hydroxyvitamin D (25OHD)
measurement. Hypovitaminosis D was deﬁned as serum 25OHD≤75 nmol/L, ≤50 nmol/L or ≤25 nmol/L. The whole sample wasseparated into training and testing subsets to design, validate andtest an artiﬁcial neural network (multilayer perceptron, MLP).
Results: 1729 participants (89.9%) had 25OHD ≤75 nmol/L, 1288
(66.9%) had 25OHD ≤50 nmol/L, and 525 (27.2%) had 25OHD≤25 nmol/L. MLP using 16 clinical variables was able to diagnose
hypovitaminosis D ≤75 nmol/L with accuracy = 96.3%, area undercurv (AUC) = 0.938, and κ=79.3 indicating almost perfect agreement.
It was also able to diagnose hypovitaminosis D ≤50 nmol/L withaccuracy = 81.5, AUC=0.867 and κ=57.8 (moderate agreement); andhypovitaminosis D ≤25 nmol/L with accuracy = 82.5, AUC=0.835
and κ=55.0 (moderate agreement).
Conclusions: We developed an algorithm able to identify, from 16
clinical variables, older community-dwellers with hypovitaminosis
D. Such inexpensive tool should help clinicians in decisions to
supplement their patients without resorting to blood tests.
P-284
Development and validation of a short food questionnaire toassess low protein intake in community-dwelling older adults
H. Wijnhoven 1 , R. de Vet 2 , L. Elstgeest 1 , M. Visser 1,2 . 1 Vrije
Universiteit Amsterdam, Amsterdam, the Netherlands; 2 VU University
Medical Center, Amsterdam, the Netherlands
Introduction: In old age, suﬃcient protein intake is importantto preserve muscle mass and function. We developed and validated a short food questionnaire to assess low protein intake incommunity-dwelling older adults.
Methods: We used data of 1392 older adults (>55 years) of theLongitudinal Aging Study Amsterdam. Protein intake was measured
using a 220-item semi-quantitative food frequency questionnaire(FFQ). A restricted multivariate prediction model was built topredict protein intake >1.0 g/kg adjusted body weight, including
original FFQ questions on frequency and amount of speciﬁc foods
as independent variables.
Results: The ﬁnal multivariate model included 13 questions (frequency and/or amount) on intake of bread, dairy dessert, milk, eggs,
pasta, ﬁsh, meat, and cheese. The area-under-the-curve (AUC) was
0.861 (good discriminative ability).
Conclusion: The developed short food questionnaire can be used
to validly assess low protein intake in community-dwelling older
adults in the Netherlands. External validation in other countries isneeded.
P-285
Dietary fat quality is associated with cognition, mobility andnutrient intakes in older populations
S. Jyväkorpi, K. Pitkälä, T. Strandberg, M. Björkman, T. Puranen,
H. Soini, M. Suominen. University of Helsinki
Background: For the prevention of coronary heart disease, a dietwith high polyunsaturated fatty acids to saturated fatty acids(PUFA:SFA) ratio has been recommended. We analyzed fat quality,
deﬁned as higher PUFA:SFA ratio and its associations with mobility,
nutrition and cognition in heterogeneous groups of older people.
Methods: The cross-sectional study combined ﬁve nutritional studies including home-dwelling (n=526) and institutionalized (n=374)
older people. Nutritional status was assessed, using Mini Nutritional Assessment (MNA) and nutrient intakes retrieved from
1–3-day food records. The participants were divided into quartiles
corresponding to PUFA:SFA ratios. Background characteristics, mobility, cognition, energy, nutrient, and ﬁber intakes were classiﬁed
according to the PUFA:SFA ratios.
Results: Higher PUFA:SFA ratios were linearly associated withmobility, cognition, education level and BMI. Protein, ﬁber andmicronutrient intakes were positively, whereas total carbohydrateand sugar intakes were inversely associated with PUFA:SFA ratios.

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

Of the institutionalized participants, 80% were classiﬁed to the lowest PUFA:SFA ratio quartiles. MNA scores were linearly associatedwith higher PUFA:SFA ratios in institutionalized participants, butinversely associated with home-dwelling participants. In homedwelling participants, cognition and age was linearly associatedwith higher PUFA:SFA ratios.
Conclusion: Higher PUFA:SFA ratios were associated with several
positive characteristics of older people, including better mobility, education, cognition, nutrient intake and diet quality. The
institutionalized participants had lower fat quality and nutrient density than the home-dwelling participants. Interestingly, inhome-dwelling older people both cognition and age were associatedwith higher PUFA:SFA ratios although age is usually a determinantof cognitive decline.
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Does diabetes still imply disability in the elderly?
D. Concu 1 , M.A. Spanu 1 , A. Gentilini 2 , A. Fancellu 1 , A. Errigo 3 ,G. Pes 4 . 1 Azienda Sanitaria Locale Sassari, Italy; 2 Azienda Sanitaria
Locale, Sassari, Italy; 3 Azienda Ospedaliera Universitaria, Sassari, Italy;
4 Dipartimento di Medicina Clinica e Sperimentale, Università di
Sassari, Italy
Introduction: The impact of diabetes on the quality of life ofolder people (≥75 years) is not completely understood. It is commonly believed that, owing to the occurrence of severe long-term
complications, the disease tends to accelerate the progression offunctional deterioration. A case-control study on elderly diabetics
from Sardinia aged 75 is currently underway in order to investigate
the relationship between diabetes and functional disability.
Methods: Currently, 27 outpatient diabetics with known disease
duration have been recruited, as well as 27 controls aged ≥75 years.
In both groups, a Comprehensive Geriatric assessment was performed, including ADL, IADL, Barthel, MMSE, GDS and MNA scales.
Differences between the two subgroups were tested statistically.
Results: In diabetics, average disease duration was 15.7±10.5 years.
Mean values of disability indexes in diabetics and controls wererespectively: Barthel 91.7±10.7 and 93.1±10.3; ADL 5.5±0.6 in bothgroups; IADL: 6.2±1.9 and 6.42±1.8. The mean MMSE values were
25.7±2.5 and 26.3±2.5 respectively, while GDS values were 6.2±1.9
and 3.1±3.1. MNA score was 24.3±3.0 in diabetics and 25.2±3.6 incontrols. None of differences were signiﬁcant.
Conclusions: These preliminary results suggest that diabetes does
not necessarily have a signiﬁcant impact on functional autonomy ofthe elderly, even in the case of long-term illness. The current study
aims to analyze a ﬁnal case of 200 subjects in order to strengthen
the results obtained.
P-287
Energy need and energy intake according to the body massindex among patients hospitalized in an acute geriatric unit
S. Allepaerts 1 , G. Doupagne 1 , J. Weber 1 , F. Buckinx 2 , O. Bruyère 3 ,N. Paquot 1 . 1 CHU de Liège; 2 Université de Liège; 3 université de Liège
Background: The aim of this study was to measure the energy
need and the energy intake among patients hospitalized in an acutegeriatric unit regarding to their Body mass index (BMI).
Methods: Energy need or total energy expenditure (TEE) is theenergy used by the human body for daily function, is a combinationof rest energy expenditure (REE), energy used during substratemetabolism and energy used in physical activity. REE was measured
by indirect calorimetry. Energy intake (EI) was measured over a
3-day period. Cut off of BMI was deﬁned according the European
society of enteral and parenteral nutrition (ESPEN) and the World
Health organization (WHO).
Results: Seventy-nine patients hospitalized in acute geriatric unit

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were evaluated (77% of women, 82.4±16.3 years on average). Prevalence of malnutrition was 34%. REE and TEE were signiﬁcantly andconversely correlate with the BMI. The lower was the BMI and thehigher were the REE and the TEE (REE was 21±3.4 Kcal/kg/j in BMI<18.5 kg/m2 vs 14.4±1.7 Kcal/kg/j in BMI >30 kg/m2 ) (p=00001 vs
p=0.009). The EI were also signiﬁcantly and conversely correlatewith the BMI (EI was 37.3±11 Kcal/kg/j in BMI <18.5 Kcal/kg/j and26.3±5.35 Kcal/kg/j in BMI >30 Kcal/kg/j) (p=0.0004).
Conclusion: In patients hospitalized in an acute geriatric unit, theenergy need is correlated to the BMI, which suggests that theenergy requirements to maintain body weight are higher with thedecrease in BMI. Energy intake are correlated with the energy needand increase with the increase of BMI.
P-288
Energy need and energy intake among patients hospitalized inan acute geriatric unit
G. Doupagne 1 , J. Weber 1 , F. Buckinx 2 , O. Bruyère 2 , N. Paquot 1 ,J. Petermans 1 . 1 CHU de Liège; 2 université de Liège
Background: The aim of this study was to compare the energy
need and the energy intake among patients hospitalized in an acutegeriatric unit.
Methods: Energy need or total energy expenditure (TEE) is theenergy used by the human body for daily function, and a combination of rest energy expenditure (REE), energy used during substratemetabolism and energy used in physical activity. REE was measured
by indirect calorimetry. Energy Intake (EI) was measured over a
3-days period. Three groups of population were deﬁned: sarcopenic,
undernourished and frail (moderate and severe). Sarcopenia wasdiagnosed according to the criteria of European working group of
sarcopenia in older people (EWGSOP), undernutrition by the criteriaof European society of parenteral and enteral nutrition (ESPEN), andfrailty by the Edmonton scale.
Results: Twenty-nine patients hospitalized in acute geriatric unit
were evaluated (77% of women, 82.4±16.3 years on average). Prevalence of malnutrition was 34%, sarcopenia was 32%, moderate
frailty was 35% and of severe frailty was 57%. TEE was signiﬁcantly
lower than energy intake among all population, malnourished,well-nourished, sarcopenic, moderately and severely frail patients.
Conclusion: In patients hospitalized in an acute geriatric unit, theenergy intake seemed to be suﬃcient to cover TEE, regardless theirnutritional status. Therefore, food rations can be adapted according
the geriatric proﬁle.
P-289
Evaluation of quality indicators for obesity in patients under 17
years in primary care
L. Sierra-Martínez 1 , R. Martínez-Fuerte 1 , N. Sanz-González 2 .
1 Valladolid Este Primary Assistance Gerency, Valladolid; 2 JCyL Social

Services Gerency, Valladolid
Background and aim: Study on the quality of clinical care provided
to patients under 17 years with Obesity assigned to a medical
practice (during the period 2015).
Method/Design: Longitudinal evaluation: Palmer’s Quality Cycle.
Setting: An urban health care center. Population and sample: Patients (total according to inclusion criteria, year 2014) with obesity(year 2015) (n=120). Interventions: Internal evaluation, dimensions:scientiﬁc-technica, quality, adequacy, accessibility, continuity ofcare; data related to the care process and intermediate results;
explicit, evidence-based procedural criteria. Subjects: Analysis ofcoverage. Analysis on the evolution of treatment compliance. The Z
statistical test for comparing proportions, alpha 0,05.
Results: Compliance criteria (year 2015): Population ≤17 years:
2276. Obesity prevalence: 5,27% (120 patients). Overweight preva-

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lence: 3,73% (85 patients). Patients with Obesity with two BMIs
recorded in 2015: 24 patients. Patients with Obesity with two BMIs
registered and have reduced two measures in 2015: 11 (9,17%).
Conclusions: Establish a plan of intervention activities to improve
results: diagnosis and control of Obesity to avoid complications.
P-290
Factors associated with vitamin D deﬁciency in the elderly: theKorean National Health and Nutrition Examination Survey
2010-2012
J.E. Oh 1 , S.H. Kim 1 , H.S. Shin 1 , Y.J. Cho 1 , Y.G. Lee 2 , C.Y. Cho 3 .
1 Department of Family Medicine, Soonchunhyang University Hospital,
Soonchunhyang University, Cheonan-City, Korea; 2 Department of
Physical Medicine and Rehabilitation, Soonchunhyang University
Hospital, Soonchunhyang University, Seoul, Korea; 3 Department of
Family Medicine, Soonchunhyang University Hospital, Soonchunhyang
University, Seoul, Korea
Introduction: The aim of this study was to evaluate risk factors
associated with vitamin D deﬁciency and its prevalence in Korean
non-institutionalized adults aged 65 or older.
Methods: The study subjects (n=2,687) were individuals who participated in the Korean National Health and Nutrition Examination
Survey (KNHANES) in 2010–2012. Vitamin D deﬁciency was deﬁned
as a serum 25-hydroxyvitamin D concentration <20 ng/mL. The
logistic regression analysis was done to determine the association
between vitamin D deﬁciency and sex, smoking status, physicalactivity, alcohol consumption, sleep duration, chewing diﬃculty, energy intake, calcium intake, skipping meal, and metabolic syndrome.
Results: The prevalence of vitamin D deﬁciency was 56.7%. Multiple
logistic regression analysis showed that independent predictors ofvitamin D deﬁciency were female, BMI (≥25kg/m2 ), current smoker,
low energy intake (male <2,000 kcal/day, female <1,600 kcal/day),skipping breakfast, low intensity physical activity, moderate intensity physical activity, sleep duration (<7 hours/day), and metabolic
syndrome (P<0.05).
Conclusions: In Korean older adults, vitamin D deﬁciency is very
common and is at increased risk for health risk factors related withlifestyle. These results suggest that unhealthy lifestyle in the elderly
may be associated with vitamin D deﬁciency.
P-291
Fluid prescription in the elderly
S.D. Brincat 1 , C. Cassar 1 , M.J. Grech 2 , A. Vella 3 . 1 Mater Dei Hospital,
Msida, Malta; 2 St Vincent De Paul Residence, Luqa, Malta; 3 KarinGrech Hospital, Pieta, Malta
Introduction: A critical aspect in the care of elderly patients is
ﬂuid administration; an integral part of patient’s treatment toprevent and restore abnormal body ﬂuid and electrolyte loss. Elderly patients are particularly vulnerable to complications of ﬂuid
administration.[1,2] The aim of the audit is to assess for appropriate
documentation of ﬂuid prescription of the geriatric population at
St Vincent De Paul long term facility (SVP) and to assess thecompliance of prescribers with the standard guidelines.
Methods: The geriatric population at SVP under the care of all
geriatric ﬁrms, who were prescribed ﬂuids during the preceding 24hours in a 5-day period in May 2016 was selected. Data
from medical and nursing notes, ﬂuid balance charts, observation
charts and computerised results system on iSoft® . Results werecompared to international studies.[3] The standard used was the
National Institute of Health and Care Excellence (NICE) guidelines– “Intravenous ﬂuid therapy in adults in hospital” published in
2013.[4].
Results: Thirty patients were being administered ﬂuid therapy;
all prescribed as part of the medical notes with no documenta-tion regarding stop or review date. Physicians documented limited
intake in 23% (n=7) patients, abnormal losses in 3% (n=1) andrequested parameters charting in 43% (n=13) patients. A request forcatheterisation was documented in 47% patients (n=14). In none ofthe patients, initial or daily weight was requested.
Conclusion: This clinical audit has shown that prescribing, administering and monitoring of ﬂuid administration can be improved. A
local ﬂuid prescribing guideline and prescription ﬂuid chart weredeveloped for rational, standardised and accurate documentation of
the administration of ﬂuid.
References:[1] Gao X, Huang KP, Wu HY, Sun PP, Yan JJ, Chen J et al. Inappropriate prescribing of intravenous ﬂuid in adult inpatients –a literature review of current practice an research. Journal ofclinical pharmacy and therapeutics 2015;40:489–495[2] Sansom LT, Duggleby L. Intravenous ﬂuid prescribing: improving
practices and documentation in line with NICE CG174 guidance.
BMJ quality improvement reports 2014; 3–8[3] Ferenczi E, Datta SS, Chopada A. Intravenous ﬂuid administration in elderly patients at a London hospital: a two-part audit
encompassing ward-based ﬂuid monitoring and prescribing
practice by doctors. Int J Surg 2007;5:408–12[4] National institute for health and care excellence. [Internet] Intravenous ﬂuid therapy in adults in hospital [published 2013 Dec
10; cited 2017 Apr 4]. Available from: https://www.nice.org.uk/
guidance/cg174/resources/intravenous-ﬂuid-therapy-in-over-16sin-hospital-35109752233669
P-292
Handgrip strength among Thai elderly
J. Horpibulsuk 1 , P. Jongjol 2 . 1 School of Internal Medicine, Institute ofMedicine, Suranaree University of Technology, Nakhon Ratchasima,
Thailand; 2 School of Industrial Engineering, Institute of Engineering,
Suranaree University of Technology, Nakhon Ratchasima Thailand
Introduction: The physical of elderly had changed, which included
muscle power and muscle mass. The muscle strength was measured from hand grip strength (HGS). This research studied HGS
and nutritional status of Thai elderly (aged 60 years or older), who
lived in Nakhon Ratchasima province.
Design: A cross-sectional analytic study Methods: Assessment of
HGS of the dominant hand followed standardized testing procedures as per the American Society of Hand Therapists [1] using the
Jamar handheld dynamometer. Measured body mass index (BMI)
was calculated as weight in kilograms divided by height in meterssquared. The subjects were classiﬁed as: underweight (BMI <18.5);
normal (18.5 < BMI <22.9) and overweight (BMI >23) [2].
Results: A total of 491 elderly were studied and the mean (+SD) age was 69.15+6.86 (from 60 to 90) years. When comparing
between elderly males and females, it was found that an elderly
male group had higher height, higher weight, and higher HGS thanan elderly female group (p-value =0.00). When considering HGS of
overall elderly, which divided according to BMI, it was found thatthe elderly with normal weight and overweight had higher HGS
than those who were in a group of underweight (p-value =0.00).
Conclusion: The mean value of the dominant HGS in the elderly
was signiﬁcantly higher in elderly males when compared to elderly
females. Furthermore, elderly with underweight is associated withpoorer HGS than elderly with normal weight or overweight.
References:[1] Fess E. Grip strength. In: Casanova J, ed. Clinical Assessment Recommendations. Chicago: American Society of Hand Therapists,
1992; 41–5.
[2] WHO expert consultation. Appropriate body-mass index for
Asian populations and its implications for policy and intervention strategies. Lancet 2004; 363: 157–63.

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

P-293
Human albumin prescription among the elderly
S. Costa 1 , C. Canha 2 , M.T. Veríssimo 3 , A. Simão 3 , A. Carvalho 3 .
1 Internal Medicine A, Centro Hospitalar e Universitário de Coimbra,
Portugal; 2 CIMAGO; 3 Faculty of Medicine, Universidade de Coimbra
Introduction: The most important nutritional disorder in theelderly is malnutrition, which is associated with increased mortality and reduced quality of life. Serum albumin levels allow theidentiﬁcation of patients at high risk for malnutrition.
Materials and methods: This is a descriptive retrospective study,
aiming to characterize the prescribing policy for human albuminin the population over 64 years of age, admitted in the Internal Medicine ward, within January 1st and December 31st, 2016.
Patients were identiﬁed through data obtained from pharmacy
services. The data collection was performed through consultationof clinical processes and analyzed using Excel.
Results: One hundred and ninety-seven admissions were analyzed,of which 134 were included, corresponding to 99 patients, witha mean age of 81.2±6.7 years, mainly men (79%). In 81% of theprescriptions, patients had a Charlson index above 6 and a Katz
index of 6 in 25% of patients and 0 in 24%. In 57% of the cases
albumin prescription, patients died during hospitalization or during
the ﬁrst 30 days after discharge. The average duration of albuminprescription was 3.7 days, with an average dose of 21.5g per patient.
The most frequent reason for prescribing human albumin was thecorrection of hypoalbuminemia (49%).
Conclusion: Human albumin was prescribed to patients withhigh comorbidities and hypoalbuminemia, both associated withmalnutrition. The mortality was high, which was expectable dueto the high rate of comorbidities. It is important to correct all
the factors that contribute to malnutrition, more than correcting
hypoalbuminemia itself.
P-294
Identiﬁcation of fatty acid biomarkers in human longevity
C. Manca 1 , A. Errigo 2 , E. Murru 1 , G. Carta 1 , S. Banni 1 ,A. Demurtas 1 , L. Muredda 1 , F. Tolu 2 , M. Palermo 2 , M.P. Dore 3 ,G. Pes 3 . 1 Dipartimento di Scienze Biomediche, Università degli Studi
di Cagliari, Italy; 2 Azienda Ospedaliero-Universitaria di Sassari, Italy;
3 Dipartimento di Medicina Clinica e Sperimentale, Università degliStudi di Sassari, Italy
Introduction: Human longevity is a multifactorial condition withgenetic, environmental and behavioral contributions. Fatty acid metabolism may play a role in maintaining lifelong tissue homeostasis
by modulating the formation of fatty acid–derived molecules suchas endocannabinoids, eicosanoids and recently discovered lipokines
such as palmitoleic acid (cis-9-hexadecenoic acid, POA), whichinﬂuence inﬂammatory response, insulin resistance, proliferative
stimuli and neuroinﬂammation, all factors involved in major agerelated chronic disorders such as atherosclerosis, cancer, diabetes
and neurodegenerative diseases.
Methods: In the present study, we aimed to evaluate the fatty acidmetabolism, namely plasma levels of eicosanoids, endocannabinoids and lipokines in a cohort of apparently healthy Sardinian
subjects of different age groups (range 50–90) living in areas within
the island characterised by relatively higher and lower longevity
levels. All subjects were substantially healthy, had normal cognitive
capacity, were functionally independent and well nourished.
Results: Plasma fatty acid proﬁle revealed a peculiar pattern in theelderly of the high-longevity areas with respect to either age-paired
individuals or younger from other areas. Speciﬁcally, POA levels,
POA/palmitate ratio, and the levels of some endocannabinoids weresigniﬁcantly increased, especially in oldest subjects. Dietary records
strongly suggested that this peculiar fatty acid proﬁle was not

S125

related to dietary fatty acid intake, but rather to activation of
speciﬁc metabolic pathways, which in turn may determine a morefavorable tissue homeostatic control.
Conclusions: Our results suggest that well-deﬁned fatty acidmetabolic changes could help to trigger an adequate physiological response against adverse stimuli that may potentially lead to
age-related disorders.
P-295
Impact of nutritional status in elderly patients with acute
myocardial infarction
K. Komici 1 , A. Mancini 1 , S. Provenzano 1 , M. Conte 1 ,L. Bencivenga 1 , C. Morisco 1 , B. Trimarco 1 , G. Corbi 2 , N. Ferrara 3 ,G. Rengo 3 . 1 Federico II University of Naples; 2 University of Molise;
3 University of Naples
Background: Malnutrition is a common condition in the elderly
population and is associated with reduced physical performance,
prolonged hospitalization and increased mortality. However, theprevalence and impact of malnutrition among elderly patients withacute myocardial infarction (AMI) is still poorly studied.
Methods and results: We prospectively enrolled 167 consecutive
elderly patients (age≥65 yrs; mean age=73,7±6,6 yrs) admitted atIntensive Coronary Care Unit (ICCU) for AMI (51,4% STEMI). Demographic, clinical, laboratoristic and echocardiography data werecollected at the time of ICCU admission, together with questioners
included in the geriatric multidimensional evaluation (i.e. Mini
nutritional assessment [MNA], ADL, IADL, SPMSQ, Exton-Smith,
CIRS). According to MNA score, 73 patients (51,4%) presented agood nutritional status (MNA≥24) while 14 (9,9%) presented malnutrition (MNA<17) and 55 (38,7%) were at risk for malnutrition.
Dichotomizing our study population in two groups, malnutrition
plus at risk for malnutrition (69 patients, 48,6%) and good nutritional status (73 patients, 51,4%), we found that these two groups
were homogeneous for demographic characteristics and clinical,
laboratoristic and instrumental data, but were different for the
majority of the geriatric scales measured (Table). Importantly, poor
nutritional status was associated with higher 6-month mortality rate (26,1% vs 5,5%; p<0,001). At multivariate cox regression
analysis, among 13 variables tested MNA emerged as independent
predictor of short-term mortality, together with GRACE score, LVEF
and type of AMI (Table). Kaplan-Mayer Survival analysis conﬁrmedthat the group with good nutritional status had a signiﬁcant better
survival compared to the group with malnutrition or at risk formalnutrition (longrank p<0,001).
Conclusions: Nutritional status is an independent predictor ofshort-term mortality among elderly patients with AMI. Measurement of MNA score in elderly patients with AMI may help prognostic stratiﬁcation and identiﬁcation of patients with/at risk ofmalnutrition in order to apply interventions to improve nutritional
status.
P-296
Innovative food products for oral nutrition supplements:
opportunities for food companies?
J.O. Linschooten 1 , T. Kanters 2 , P.C. Dagnelie 2 , A.J.C. Roodenburg 1 .
1 HAS University of Applied Sciences, Den Bosch, The Netherlands;
2 Maastricht University, Maastricht, The Netherlands
Introduction: Despite the growing attention in recent years, malnutrition remains a major problem in healthcare and at home fora growing group of elderly people. This study investigated the opportunities and barriers for innovative food products and concepts
as alternative to oral nutrition supplements (ONS) in market of
malnutrition in The Netherlands.
Methods: In a qualitative study, semi-structured interviews wereS126

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

held with 11 different stakeholders involved in malnutrition: Representatives from two ONS producers, two home care companies,
two caterers, dieticians from two hospitals, representatives from afood producer, an insurance company and a nursing home.
Results: This study showed that awareness of malnutrition is gradually increasing. ONS products and innovative food products areseen as complementary products, but evidence-based proven effectiveness of these products is required. Main opportunities are: thestepped care treatment of malnutrition, tendency towards patient
self-management and increase of knowledge on and treatmentof malnutrition in both secondary and primary care. Barriers forinnovation are ﬁnancial limitations, organizational complexity andlow awareness of these products and of malnutrition in primarycare. Key factors to success are that these products are tasty, offer
variation and are proven (cost)-effective.
Conclusion: The market of malnutrition is open for large businesspotential. Healthcare organizations are implementing new foodconcepts in order to address the problem of malnutrition in theirorganizations, offering opportunities for industry to collaborate
with these organizations and develop new products to combat
malnutrition.
P-297
Input of multidimensional phenotyping in the metabolic
syndrome stratiﬁcation
E. Pujos-Guillot 1 , S. Monnerie 2 , E. Thévenot 3 , C. Junot 4 , J. Morais 5 ,H. Payette 6 , P. Gaudreau 7 , B. Comte 2 . 1 Université Clermont
Auvergne, INRA, UNH, CRNH Auvergne, Clermont Ferrand; Université
Clermont Auvergne, INRA, UNH, Plateforme d’Exploration duMétabolisme, MetaboHUB Clermont, CRNH Auvergne,
Clermont-Ferrand, France; 2 Université Clermont Auvergne, INRA, UNH,
CRNH Auvergne, Clermont Ferrand, France; 3 CEA, LIST, Laboratory for
Data Analysis and Systems’ Intelligence, MetaboHUB, Gif-sur-Yvette,
France; 4 Laboratoire d’Etude du Métabolisme des Médicaments,
DSV/iBiTec-S/SPI, MetaboHUB, CEA-Saclay, Gif-sur-Yvette, France;
5 Division of Geriatric Medicine, McGill University, Montreal, Canada;
6 Faculté de médecine et des sciences de la santé Université deSherbrooke, Sherbrooke, Canada; Centre de recherche sur levieillissement, Centre intégré universitaire de santé et de services
sociaux de Sherbrooke, Sherbrooke, Canada; 7 Centre de Recherche duCentre hospitalier de l’Université de Montréal, Montreal, Canada;
Département de médecine, Université de Montréal, Montreal, Canada
Introduction: Metabolic syndrome (MetS) is deﬁned by a clusterof cardio-metabolic factors including obesity, hypertension, dysglycemia, and dyslipidemia. It affects a growing number of persons,in particular older adults often suffering from multiple chronic
diseases, and its prevalence is now a public health challenge. In thecontext of personalized medicine/nutrition, new tools are necessary
to bring additional knowledge about MetS etiology, better stratify
populations and customise strategies for prevention.
Methods: A nested case-control study on MetS was designed within
the Quebec Longitudinal Study on Nutrition and Successful Aging(NuAge). It includes 61 cases and 62 controls of similar age (68–82
y.o.), selected among the 853 men. Both targeted and untargeted
metabolomic/lipidomic approaches, available within the MetaboHUB French infrastructure [1], will be performed on serum samples
collected at recruitment 2003–2005 (T1) and three years later (T4).
Data analysis will be performed using reproducible online Galaxy
workﬂows [2].
Results: The metabolomic/lipidomic data will be processed to identify speciﬁc signatures of MetS and its components, and study theirstability over time. Then, these data will be analysed for evaluationof a molecular reclassiﬁcation of the MetS phenotype. Finally, they
will be integrated with phenotypic and detailed nutritional data
available to better characterize sub-phenotypes.

Conclusion: The approach developed here will open a door fora more comprehensive understanding of the metabolic phenotype
resulting from the complex interplay between intrinsic and extrinsic factors. Thus, this project will allow an improved description of
MetS associated characteristics and will offer new tools for better
patient stratiﬁcation in elderly populations.
References:[1] http://www.metabohub.fr[2] http://workﬂow4metabolomics.org
P-298
Longitudinal associations of nutritional status and bodycomposition with outcomes in the elderly, the effect of dietaryadvices – preliminary results
S. Savas 1 , A. Ozdener 2 , F. Sarac 1 , F. Akcicek 1 . 1 Geriatrics Section,
School of Medicine, Ege University, Izmir, Turkey; 2 Internal Medıcıne
Department, School of Medicine, Ege University, Izmir, Turkey
Introduction: We aimed to investigate body composition (BC) andnutritional status (NS) of the elderly in the internal medicine
outpatient clinic (IMOC), and the relationships between each other,and to follow them after dietary advice.
Methods: Patients with ≥65 years of age in the IMOC were included in the study. Mean age, body mass index (BMI), waisthip circumference, waist/hip ratio, fat-free mass and index, Mini
Nutritional Assessment –Short Form score, prealbumin and highsensitivity CRP levels, calf circumference were measured. Patients
who are assessed by the same dietitian and evaluated as at risk ofmalnutrition were advised protein and energy – rich diets whenapplicable. Patients will be followed in the ﬁrst 6 months for
NS, BC, gait speed and hand grip strength; after 12 months for
activities of daily living (ADL) -Instrumental ADL (IADL) disability,
institutionalization, hospitalization, falls-fall related injuries, andmortality. We are presenting the ﬁrst cross-sectional results.
Results: A total of 85 patients with ≥65 years of age were includedin the study. All were independent in ADL and IADL. Age of 38
patients (44.7%) were <70 years of age, where 47 (55.3%) were ≥70
years of age. There was no difference in BMI groups classiﬁed as
normal weight, obese or underweight between age groups > and<70 years of age (P=0.46).
Conclusions: Most (98,8%) of the elderly patients consulted by the
dietician in a period of time were normal to obese for BMI which isinteresting for BC of IMOC elderly patient proﬁle.
P-299
Nutritional needs among sarcopenic patients: a study using
indirect calorimetry
S. Allepaerts 1 , J. Weber 1 , G. Doupagne 1 , F. Buckinx 2 , O. Bruyère 2 ,N. Paquot 1 , J. Petermans 1 . 1 CHU de Liège; 2 Université de Liège
Background: The aim of this study is to assess the energy need ofpatients with sarcopenia.
Methods: Rest energy expenditure (REE) is the energy required
to maintain the body’s basic cellular metabolic activity and organfunctions. REE was measured by indirect calorimetry, at rest, at
fasting and without physical or psychological stress. Total energy
expenditure (TEE) is deﬁned as the amount of energy used by thehuman body for daily function, it is a combination of REE, energy
used during substrate metabolism and energy used in physicalactivity. Nutritional assessment has been performed by the Mini
Nutritional Assessment (MNA). Sarcopenia was deﬁned according
the criteria of the European Working Group on Sarcopenia in Older
People (EWGSOP).
Results: Twenty-nine patients (77% of women, 82.4±16.3 years
on average) hospitalized in acute geriatric unit were evaluated.
The prevalence of sarcopenia was 32%. Sarcopenia was associatedPoster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

with lower Mini nutritional assessment (MNA) (p=0.003), lower
Body mass index (BMI) (p<0.0001). RRE was 978±262 kcal/d insarcopenic patients, signiﬁcantly lower than in non sarcopenic
patient (1120±167 kcal/d) (p<0.004). TEE was 1564±272 kcal/din sarcopenic patients signiﬁcantly lower than in non sarcopenic
patients (1706±228 kcal/d) (p<0.02). REE in sarcopenic patient was
17.7±3 kcal/kg/d.
Conclusion: TEE was lower in sarcopenic patients than in non
sarcopenic patients. REE in sarcopenic patient is similar to the REE
observed in elderly hospitalized patients, about 18 kcal/kg/d.
P-300
Nutritional risk in the elderly – Living at home vs health care
units
I. Figueiredo 1 , R. Alves 1 , S. Castro 1 , M. Antunes 1 , M. Saldanha 2 ,H. Gruner 1 , A. Panarra 1 . 1 S. Medicina 7.2 Hospital Curry Cabral,
Centro Hospitalar Lisboa Central; 2 S. Nutrição e Dietetica, Hospital
Curry Cabral, Centro Hospitalar Lisboa Central
Introduction: According to WHO, elderly people are especiallyvulnerable due to malnutrition, being related to many different
factors. Our aim was to evaluate if patients from different cohabitation status had the same risk of undernutrition and evaluate
contributing factors.
Methods: Retrospective descriptive study of all patients with >75
years old, admitted to the medical ward of a tertiary hospitalduring a one year period with a nutritional evaluation either by
MUST or NRS. Patients were grouped according to habitation status
home (H) vs health care unit (HCU) and compared per gender, age,autonomy (KATZ score), primary diagnosis, median length of stayand mortality.
Results: A total of 89 patients fulﬁlled the inclusion criteria with a
median age of 83,7 years (37 with >85 years), 60 were female, 44
patients with nutritional risk, median length of stay of 9,89 days
and mortality of 32,4%. Concernig the 2 groups: there were H 15
patients and HCU 74, the patients living in HCU were slightly older(83,9 VS 83,7 years), with a male prevalence (53% VS 28%), lesser
autonomy with a KATZ <3 (73% VS 55,4%) and higher mortalty of
86% VS 14%. The risk ratio for nutritional risk in patients living
in health care facilities patients was 2,06, but the risk ratio formortality in patients with nutritional risk living at Home was 2,53.
Discussion: Half of the population above 75 years old is at nutritional risk, that risk is even greater considering the population
living in health care facilities. This study pretends to raise awareness on this subject, considering malnutrition is frequently related
to poor outcomes. In our study the inﬂuence of malnutrition in
mortality was more important in patients living at Home.
P-301
Nutritional risk in the elderly in an Internal Medicine ward
I. Figueiredo 1 , R. Alves 2 , S. Castro 2 , M. Antunes 2 , M. Saldanha 3 ,F. Lourenço 2 , A. Panarra 2 , H. Gruner 2 . 1 S. Medicina 7.2 Hospital
Curry Cabral, Centro Hospitalar Lisboa Central; 2 S. Medicina 7.2
Hospital de Curry Cabral, Centro Hospitalar Lisboa Central;
3 U.Nutrição e Dietética, Hospital de Curry Cabral, Centro Hospitalar
Lisboa Central
Introduction: Malnutrition is a determinant of health, associatedwith a global decline in function and poorer outcomes. It is under
diagnosed in the elderly, though nutritional deﬁciencies are present
in 20–65% of hospitalized elders.
Methods: Retrospective descriptive study of patients with >65
years, admitted to the medical ward (tertiary hospital) for 1-year,with a nutritional evaluation either by MUST or NRS. The patientswere grouped in A (at risk) and N (no risk) and characterised
by gender, age, autonomy (Katz Score <4 dependent, or >4 au-

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tonomous), primary diagnosis, mean length of stay and mortality.
Comparison between groups was done with proportions and themortality evaluated with risk ratio.
Results: 131 patients were included, with a mean age of 79,1years(37 patients >85years), of which 83 female, 67 patients (61.1%)
were dependent. Concerning the groups 64 were NR and 67 AR,
with no difference by gender (NR:AR - fem 0,9 and masc 1), age(NR:AR - <75 years 0,9, 75–85 years 1,08 and >85 years 0,85) and
Katz (NR:AR - autonomous 0,82 and dependent 0,76). In AR group,
there was a higher prevalence of respiratory diseases (1.57), renal(2.75), neoplasia (3), but not cardiovascular diseases (0.44). Mean
length of stay was higher for AR (11,27) vs NR:9,82. Mortality in AR
patients had a RR of 8.93.
Discussion: In our small sample, almost half the patients wereat risk of malnutrition. Patients with a risk of malnutrition had alonger length of stay, with greater costs and higher mortality.
P-302
Nutritional status, functional status and mortality in the
Caucasian elderly and oldest-old: Results of the PolSenior study
M. Puzianowska-Kuznicka 1,2 , A. Kurylowicz 1 , J. Borkowska 1 ,M. Olszanecka-Glinianowicz 3 , K. Wieczorowska-Tobis 4 ,A. Skalska 5 , A. Szybalska 6 , M. Mossakowska 6 . 1 Mossakowski
Medical Research Centre, PAS, Warsaw; 2 Centre of Postgraduate
Medical Education, Warsaw; 3 Medical University of Silesia, Katowice;
4 Poznan University of Medical Sciences, Poznan; 5 Jagiellonian
University Medical College, Cracow; 6 International Institute of
Molecular and Cell Biology, Warsaw, Poland
Introduction: Obesity increases the risk of aging-related diseases,
disability and mortality.
Methods: Four thousand six hundred twenty-four seniors aged ≥65
years completed a detailed questionnaire and underwent medical
examination. Their survival was taken from the Population Register.
Results: Approximately 34% of seniors were obese (38.42% women,
25.52% men) and 88.55% had abdominal obesity (89.2% women,
72.61% men). Median BMI, waist (WC) and arm (AC) circumference
decreased with age in both genders (all p<0.001). The percentageof obese seniors and these with abdominal obesity also decreased(both p<0.001). Notably, the higher ADL score, the higher weremedian BMI, WC and AC values (all p<0.001). In multivariate
analysis taking age into account, all three body measurements remained independent predictors of physical performance in women(p=0.008, p=0.004 and p<0.001, respectively), while in men only
AC (p<0.001). Similarly, the higher MMSE score, the higher weremedian BMI, WC and AC values (all p<0.001). In multivariate
analysis, all three measurements remained signiﬁcant predictors ofcognitive performance in women (p=0.001, p=0.002 and p<0.001,
respectively), while in men only AC (p<0.001). There was no association between the number of aging-related diseases and BMI or
WC or AC. In individuals aged ≥80 years, overweight and obesity
were associated with the highest probability of survival (bothgenders p<0.001), as were abdominal obesity (women p=0.0011,
men p<0.001) and the highest AC (both genders p<0.001).
Conclusions: In seniors, overweight and obesity are associated with
better physical and cognitive function, and with a higher probabilityof survival.
P-303
Obesity survival paradox in older-cancer patients: results fromthe Physical Frailty in Elderly Cancer patients (PF-EC) cohort
study
F. Pamoukdjian 1 , T. Aparicio 2 , B. Duchemann 3 , V. Levy 4 , P. Wind 5 ,N. Ganne 6 , G. Sebbane 1 , L. Zelek 3 , E. Paillaud 7 . 1 APHP, Avicenne
Hospital, Geriatric Department, Coordination Unit in GeriatricS128

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

Oncology, Bobigny, France; 2 APHP, Avicenne Hospital, Department of
Gastroenterology, Bobigny, France; 3 APHP, Avicenne Hospital,
Department of medical oncology, Bobigny, France; 4 APHP, Avicenne
Hospital, Clinical Research Unit and Clinical Research Center, Bobigny,
France; 5 APHP, Avicenne Hospital, Department of Surgery, Bobigny,
France; 6 APHP, Jean Verdier Hospital, Liver Unit, Bondy, France; 7 APHP,
Henri-Mondor Hospital, Geriatric Department, Geriatric Oncology
Unit, Créteil, France
Background: The obesity survival paradox is an emergent issue inoncology, but its existence remains unclear particularly in older
cancer patients.
Methods: All consecutive outpatients 65 years and older referred
for geriatric oncology assessment (GA) before a therapeutic decision
between November 2013 and September 2016 were enrolled in the
PF-EC cohort study. A Cox proportional hazard regression model
was performed in non-survivors for GA, oncologic variables (cancer
site, extension and treatment modalities) and C-reactive protein(CRP). Obesity was deﬁned as a body mass index (BMI) ≥30 kg/m2 .
A stepwise procedure was conducted to assess the speciﬁc effect ofeach predictor. We created three models to adjust BMI categories
for sex and geriatric variables (model 1), oncologic variables (model2) and C-reactive protein (model 3).
Results: 433 patients with a mean age of 81.2±6.0 years were
included, of whom 51% were women. Eighty-six of these patients(20%) were obese at baseline. Seventy-three patients (17%) diedduring the 6-month follow-up period. Obesity was negatively andindependently (age, sex, Mini-Mental State examination, local status, best supportive care and CRP) associated with overall 6-monthmortality after stratiﬁcation by cancer site. This association was
strengthened after adjustment for gait speed. KEY
Conclusions: Our study conﬁrms the obesity survival paradox inolder cancer patients. This paradox seems closely linked with themetabolic healthy obese phenotype, which exhibits better survival.
P-304
Optimized selection process to identify a metabolic syndrome
metabolomic/lipidomic signature in older adults of the NuAge
cohortN. Lenuzza 1 , E. Thévenot 1 , S. Monnerie 2 , J. Morais 3 , H. Payette 4 ,P. Gaudreau 5 , B. Comte 2 , E. Pujos-Guillot 6 . 1 CEA, LIST, Laboratory for
Data Analysis and Systems’ Intelligence, MetaboHUB, Gif-sur-Yvette,
France; 2 Université Clermont Auvergne, INRA, UNH, CRNH Auvergne,
Clermont Ferrand, France; 3 Division of Geriatric Medicine, McGill
University, Montreal, Canada; 4 Faculté de médecine et des sciences dela santé Université de Sherbrooke, Sherbrooke, Canada; Centre derecherche sur le vieillissement, Centre intégré universitaire de santé etde services sociaux de Sherbrooke, Sherbrooke, Canada; 5 Centre deRecherche du Centre hospitalier de l’Université de Montréal, Montreal,
Canada; Département de médecine, Université de Montréal, Montreal,
Canada; 6 Université Clermont Auvergne, INRA, UNH, CRNH Auvergne,
Clermont Ferrand, France; Université Clermont Auvergne, INRA, UNH,
Plateforme d’Exploration du Métabolisme, MetaboHUB Clermont,
CRNH Auvergne, Clermont-Ferrand, France
Introduction: Metabolic syndrome (MetS) is characterized by acluster of risk factors including obesity, metabolic dysregulations
such as insulin resistance, hypertension, and dyslipidemia, raising
the risk for type 2 diabetes development and its complications.
It involves multifaceted processes at multiple levels that are still
far from being understood. New tools are therefore necessary tobring new knowledge about MetS, better stratify populations andcustomise strategies for its prevention and/or reversal.
Methods: The Quebec Longitudinal Study on Nutrition and Successful Aging (NuAge) regroups 853 men and 940 women, aged
68–82 at recruitment in 2003–2005 (T1) and followed up annuallyfor three years (T2-T4). In the present study, a nested case-control
study on MetS was designed to identify a metabolomic/lipidomic
signature of MetS in older men, reﬂecting its phenotypic spectrum.
An optimized participant selection strategy was developed basedon presence and number of MetS criteria, including medication,
their stability over 3 years, as well as the identiﬁcation of outliers.
Results: The ﬁnal selection included 123 men, 61 cases and 62
controls, with similar age and partial overlap of values deﬁning
MetS. This design is necessary to precisely detect and estimate
the amplitude of metabolic deviations among the massive data
sets, at an individual metabolite level as well as for a multivariate
description.
Conclusion: This selection process, optimized to limit cofounding
effects, will allow identifying speciﬁc metabolomic/lipidomic signatures along with signiﬁcant features for sample classiﬁcation.
Thus, one complex molecular phenotyping will provide a new
approach/tool for a better MetS stratiﬁcation in elderly.
P-305
Predictors of incident malnutrition in older nutritionDay
participants in nursing homes – a MaNuEL secondary data
analysis
G. Torbahn 1 , M. Streicher 1 , K. Schindler 2 , M.J. Hiesmayr 3 ,C.C. Sieber 1 , D. Volkert 1 . 1 Institute for Biomedicine of Aging,Friedrich-Alexander-University Erlangen-Nürnberg, Nuremberg,
Germany; 2 Department of Internal Medicine III, Division of
Endocrinology and Metabolism, Medical University Vienna, Vienna,
Austria; 3 Division Cardiac-, Thoracic-, Vascular Anaesthesia andIntensive Care, Medical University Vienna, Vienna, Austria
Introduction: Malnutrition in nursing home (NH) residents is associated with poor outcomes. For the prevention of malnutrition, theknowledge of risk factors is crucial. Therefore, we were interested
in predictors of incident malnutrition in older NH residents.
Methods: NH residents participating in the nutritionDay project(nD) between 2007 and 2014, aged ≥65 years with complete dataon malnutrition at enrolment (previous weight loss (WL) >5kg
or BMI <20kg/m2 ) and 26 potential predictors were included.
Incident malnutrition was deﬁned as WL ≥10% or BMI <20kg/m2 at
6-month follow-up. All variables were separately analysed in univariate generalized estimated equation (GEE) models with NH-unit
as cluster variable. Signiﬁcant (p<0.05) variables were selected for
multivariable GEE analyses. Effect estimates are presented as Odds
ratios (OR) and their respective 95%-conﬁdence intervals (95%-CI).
Results: The incidence of malnutrition was 12.1% (n=701, n total=5,814). Female gender (vs. male: OR 1.33, 95%-CI [1.06; 1.65]),no intake at lunch (OR 2.92 [1.85; 4.60]) or only a quarter (OR2.38 [1.79; 3.16]) or half (OR 1.60 [1.34; 1.93]) of lunch intake (vs.
complete intake), lower BMI (OR 0.935 [0.91; 0.96]) and increasing
number of days in hospitals (OR 1.05 [1.03; 1.06]) remained as
signiﬁcant parameters in the ﬁnal model (aROC 0.66 [0.64; 0.68]).
Conclusions: According to nD data, particular attention shouldbe paid to vulnerable groups, such as females, persons with low
BMI, poor meal (lunch) intake, and residents with hospital stays toprevent malnutrition in nursing home residents.
Conﬂict of interest: None declared
P-306
Prevalence and associated factors of overweight and obesity
among older Iranian adults: Findings from a population-based
study (Urban HEART-2)
V. Rashedi 1 , M. Asadi-Lari 1 , M. Foroughan 2 , R. Fadayevatan 2 ,A. Delbari 2 . 1 Iran University of Medical Sciences, Tehran, Iran;2 University of Social Welfare and Rehabilitation Sciences, Tehran, IranIntroduction: The elderly obese are at increased risk of mortality

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

and morbidity of many obesity-related chronic diseases, such as
hypertension, diabetes and coronary heart disease. This study examined the prevalence and associated factors of overweight andobesity among older Iranian adults based on the Urban HEART-2
study in Tehran, Iran.
Methods: In this large cross-sectional population-based study, dataon 15069 persons 60 years and older, the participants of second
round of the Urban Health Equity Assessment and Response Tool
(Urban HEART-2) which had been selected based on a multistage, cluster sampling in Tehran, Iran, in 2011, were analyzed.
All the participants were interviewed and the information regarding the self-reported weight and height and socio-demographic
variables were gathered. Predictors of overweight (Body Mass Index [BMI]=25.0–29.9 kg/m2 ) and obesity (BMI>30 kg/m2 ) relative
to normal weight (BMI=20.0–24.9 kg/m2 ) were examined using
logistic regression analyses.
Results: The mean age of the participants was 68.93±7.27 years
and of the total study population, 54.8% were male. Among older
adults, 2.2% was found to be underweight, 40.1% normal weight,
40.8% overweight, and 17% obese. Multivariate logistic regression
showed that being female, being married, having low levels of
education, being retired, lack of history for smoking and being inearly stages of aging are risk factors for overweight and obesity inthis population.
Conclusions: This study showed a high prevalence of overweight
and obesity among older adults living in Tehran. This ﬁnding points
to the need of educating healthy life style and healthy eating habits
to Iranian older adults and also designing and implementing more
effective weight-control interventions for overweight older people
to have a longer and healthier life.
P-307
Prevalence of poor appetite and associated conditions amongcommunity dwelling older adults in Iceland: Age,
Gene/Environment Susceptibility-Reykjavik study
M. Chang Gudjonsson 1 , O.G. Geirsdottir 2 , G. Eiríksdóttir 3 ,T.B. Harris 4 , L.J. Launer 4 , V. Guðnason 5 , M. Visser 6 ,I. Gunnarsdottir 7 . 1 The Icelandic Gerontological Research Center,
Landspitali University Hospital & University of Iceland; 2 The Icelandic
Gerontological Research Center, Landspitali University Hospital &University of Iceland, Faculty of Food Science and Nutrition, Universityof Iceland; 3 Icelandic Heart Association, Kopavogur; 4 Epidemiology &Pop Science Lab, National Institute on Aging, National Institute of
Health, Bethesda, MD, USA; 5 Icelandic Heart Association, Kopavogur,
Faculty of Medicine, University of Iceland; 6 Vrije Universiteit,
Amsterdam, The Netherlands; 7 Unit for Nutrition Research, Faculty ofFood Science and Nutrition, University of Iceland & Landspitali
University Hospital
Background: Poor appetite is common among hospitalized older
adults or nursing home residents which may lead to inadequate
dietary intake and weight loss. However, the prevalence of poor
appetite among community-dwelling older adults and its contributing risk factors has been little explored. The aim of the study
was to investigate the prevalence of having poor appetite amongcommunity-dwelling older adults and its associated conditions.
Methods: It is a cross-sectional study design. A large communitybased population residing in Reykjavik, Iceland participated in theAge, Gene/Environment Susceptibility-Reykjavik Study (n=5764).
Appetite and its associated conditions were evaluated by questionnaire. Poor appetite was deﬁned for having conditions or illnesses
associated with poor appetite. The questionnaire included poor
appetite related list of illnesses and conditions with the additional
open question for other reasons of poor appetite.
Results: Among 5764 study population, 804 people reported having
appetite problem (n=804, 15%). The reported illnesses contributing

S129

to poor appetite were teeth, dysphagia, taste, smell, and indigestion such as pain and bloating in stomach, and diarrhea. Among
those reported illnesses associated with appetite, the poor digestive
related condition had the highest prevalence (50%).
Conclusion: Appetite is a subjective experience which is diﬃcult tomeasure. Our study explored the prevalence of poor appetite withdetailed questions about major illnesses and conditions associatedwith appetite among community-dwelling older adults. The digestive related problem was the most associated condition for having
poor appetite among community-living older adults.
P-308
Ready-meal consumption in older people: associations withnutritional status and dietary intake
G. Soriano 1 , P. De Souto Barreto 1 , S. Goisser 2 , S. Guyonnet 2 ,B. Vellas 1 , S. Andrieu 1 . 1 Inserm UMR1027, Université de Toulouse III
Paul Sabatier, Toulouse, France; 2 Gérontopôle, Centre Hospitalier
Universitaire de Toulouse, Toulouse, France
Introduction: Diﬃculties with cooking are prevalent in older persons [1]. One way to simplify meal preparation and thus maintainindependence in food intake is the use of convenience food [2].
Ready-meals are often low in protein and rich in energy [3], which
could have a negative impact on nutritional status [4]. However,studies investigating associations between ready-meal consumption, nutritional status and dietary intake are lacking, particularly
in older adults.
Objectives: We examined whether diet quality and malnutrition areassociated with ready-meal consumption in older French people.
Methods: This is a secondary analysis using data from the Multidomain Alzheimer Preventive Trial (MAPT). Diet quality andready-meal consumption were assessed in 421 subjects who fulﬁlled a food frequency questionnaire, using mPNNS-GS. BMI wasused to assess malnutrition signed by underweight (BMI <21kg/m2 ) or overweight/obesity (BMI >25 kg/m2 ). Adjusted multiple
linear regressions were performed.
Results: Older participants, those with a lower education level,with lower physical, cognitive and/or functional status, with moredepressive symptoms and declaring more diﬃculties with cooking
consumed signiﬁcantly more ready meals (p<0.05). In multivariate analysis, weekly ready-meal consumption was associated witha lower diet quality (p=0.037) but not with nutritional status(p=0.603). Moreover, the more ready meals people consumed, themore they judged their dietary quality to be poor.
Conclusions: In our population, ready-meal consumption was
higher in older people with age-related impairments, lower education levels and more depressive symptoms, but this was not
associated with a lower nutritional status or diet quality.
References:[1] M. Ferry, B. Sidobre, A. Lambertin, and P. Barberger-Gateau, The
SOLINUT study: analysis of the interaction between nutritionand loneliness in persons aged over 70 years, J. Nutr. Health
Aging, vol. 9, no. 4, pp. 261–268, Aug. 2005.
[2] Convenience foods and health in the elderly - Maturitas. [Online]. Available: http://www.maturitas.org/article/S0378-5122(15)00826-9/abstract. [Accessed: 11-May-2017].
[3] J. Remnant and J. Adams, The nutritional content and costof supermarket ready-meals. Cross-sectional analysis, Appetite,
vol. 92, pp. 36–42, Sep. 2015.
[4] K. van der Horst, T.A. Brunner, and M. Siegrist, Ready-meal consumption: associations with weight status and cooking skills,
Public Health Nutr., vol. 14, no. 2, pp. 239–245, Feb. 2011.

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P-309
Regression tree analysis and detection of hypovitaminosis D:a cross-sectional hospital-based study
G. Chevallereau, G. Duval, C. Annweiler. Angers University Hospital,
FranceIntroduction: Hypovitaminosis D is common among geriatric patients. The correction of hypovitaminosis D is not recommended
without assessing the vitamin D status at ﬁrst. To reduce costs
linked to blood tests, we hypothesized that hypovitaminosis D
could be diagnosed using clinical criteria. Our objective was to
identify the clinical proﬁles of geriatric patients with hypovitaminosis D.
Methods: 156 participants ≥75years taking no vitamin D supplements and consecutively admitted into the department ofgeriatric medicine of Angers University Hospital, France, were included in this analysis. Hypovitaminosis D was deﬁned as serum
25-hydroxyvitamin D concentration ≤75 nmol/L. An age-adjusted
regression tree (CHAID algorithm) was used to determine the clinical proﬁle of participants with hypovitaminosis D based on risk
factors for hypovitaminosis D (age, gender, sun exposure, ethnicity,
consumption of fatty ﬁsh and eggs, BMI, weight loss, oral mycosis,
renal failure, use of anti-epileptics or glucocorticoids, loss of autonomy, institutionalization, isolation) and clinical manifestationsof hypovitaminosis D (osteoporosis, falls, bone fractures, asthenia,
sadness, cognitive disorders, multimorbidity).
Results: 84.6% of patients had hypovitaminosis D. Patients with the
proﬁle “Caucasian, non-sad, BMI >21 kg/m2 ” had the lowest risk ofhypovitaminosis D (67.6%). In comparison, the proﬁles “Caucasian,non-sad, BMI <21kg/m2 ”, “Caucasian, sad, history of vertebral fracture” and “non-Caucasian” were associated with a 1.48-fold higher
risk of hypovitaminosis D (100%); and the proﬁle “Caucasian, sad,no history of vertebral fracture” with a 1.30-fold higher risk (87.6%).
Conclusions: Three clinical proﬁles of geriatric patients had 100%
hypovitaminosis D. These patients should receive vitamin D supplementation without prior blood test.
P-310
Relationship between the risk of dysphagia and functional
outcomes in older community-dwellers
S. Tagliaferri, L. Gionti, F. Lauretani, A. Ticinesi, T. Meschi, G.P. Ceda,
M. Maggio. Department of Medicine and Surgery, University of Parma,
Parma, Italy
Background: Oropharyngeal dysphagia (OD) is a swallowing disorder highly prevalent in older community-dwellers, increasing
the risk of malnutrition and aspiration pneumonia. However, it
is frequently underdiagnosed and its association with functional
performance is still unclear.
Methods: With a cross-sectional study design, we enrolled 228
older (mean age 81) community-dwellers evaluated at the FrailtyMultimorbidity Lab Geriatric Clinic Unit of Parma UniversityHospital. Subjective dysphagia was assessed with 10-item Eating
Assessment Tool (EAT-10). Nutritional screening was performed
calculating BMI and Mini-Nutritional Assessment-Short Form
(MNA-SF) score. Physical and muscle performance was assessedwith Short-Physical Performance Battery (SPPB) test and handgrip
strength. Cognitive performance was screened with Mini-Mental
State Examination (MMSE) test. The relationship between EAT-10
and nutritional, physical, cognitive and motor performance wasestimated through univariate analysis in sex- and age-adjusted andmultivariate linear regression model. A logistic regression analysis
was run to identify the most predictive factor of dysphagia risk.
Results: In the univariate models, EAT-10 score was signiﬁcantly and negatively correlated with SPPB score (β=-0.18±0.04,
p<0.0001), handgrip strength (β=-0.35±0.11, p=0.001) and MNA-

SF (β=-0.43±0.07, p<0.0001). In the multivariate model, EAT-10
score conﬁrmed as signiﬁcantly associated with SPPB (β=-0.29±0.10,
p=0.003) and handgrip strength (β=-0.12±0.05, p=0.02), but not with
MNA-SF. In logistic regression analysis, SPPB was the only factor
signiﬁcantly associated with EAT-10 score (OR=0.82, 95%IC=0.70–0.96).
Conclusion: In older outpatients, the risk of dysphagia was significantly correlated with physical performance and muscle strength.
The screening of OD should be implemented in the geriatric setting.
P-311
Serum leptin levels in very elderly patients with coronary arterydisease
S.V. Topolyanskaya 1 , I.A. Gusev 2 , O.N. Vakulenko 2 , T.A. Eliseeva 2 ,N.A. Balyasnikova 2 , G.A. Kalinin 2 . 1 First Moscow State Medical
University, Department of hospital therapy N2, Moscow, Russia; 2 War
Veterans Hospital N3, Moscow, Russia
Introduction: Very limited data are available on leptin in very
elderly patients. Therefore, we evaluated serum leptin levels andtheir relationship with obesity and other disorders in patients withcoronary artery disease (CAD).
Methods: Serum leptin levels were measured in 90 hospitalized
patients (aged 88.3+4.3 years, females - 65.5%, males - 34.5%) with
CAD. Fat mass was assessed by the dual-energy X-ray absorptiometry.
Results: Mean leptin concentration in the study group was 17.2
(0.49–100) ng/ml. 60% of patients had increased leptin levels. Serum
leptin levels in women were 2.3 times higher than in men; increased concentrations were detected in 67.7% of women and in 45%
of men (p=0.03). Decrease of leptin concentration was registeredin 14.4% of patients; all but one of these had severe heart failure.
Serum leptin levels were strongly correlated with body mass index(p<0.0001). Signiﬁcant positive correlations between serum leptinand fat mass were revealed: p=0.0001 – for total fat, p=0.002 – forabdominal fat, p=0.004 – for upper extremities, p=0.003 – for lower
extremities fat. Leptin levels were positively correlated with totalcholesterol and triglycerides (p=0.0002). Higher leptin levels werein patients with diabetes mellitus (21.01 vs 16.26 ng/ml, p=0.06);
increased leptin was associated with higher glucose level (p=0.004).
There was trend to higher leptin in patients with atrial ﬁbrillation(19.3 vs 14.6 ng/ml, p=0.2).
Conclusions: Study results demonstrated high prevalence of leptin
abnormalities in very elderly patients with CAD. High leptin levels
are associated with increased fat mass. Serum leptin levels arestrongly correlated with various disorders.
P-312
Serum lipid proﬁle in very elderly Russian patients withcoronary artery disease
S.V. Topolyanskaya 1 , O.N. Vakulenko 2 , T.A. Eliseeva 2 ,N.A. Balyasnikova 2 , G.A. Kalinin 2 , L.M. Kupina 2 . 1 First Moscow State
Medical University, Department of hospital therapy N2, Moscow,
Russia; 2 War Veterans Hospital N3, Moscow, Russia
Introduction: There are few data available on serum lipids in very
elderly patients with coronary artery disease (CAD); these data are
conﬂicting.
Methods: Cross sectional data from 555 hospitalized patients(aged 86.8±5.02 years, females – 74.5%, males – 25.5%) with CAD
were analysed. Serum levels of total cholesterol (TC), high density
lipoprotein (HDL-C), low density lipoprotein (LDL-C), triglycerides(TG), atherogenic index) were determined.
Results: Prevalence of high serum total cholesterol and triglycerides
was 13.3% and 10.4%, respectively; increase of LDL-C level wasobserved in 26.3% of patients. Decrease of HDL-C was registered inPoster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

10.5% of patients. Signiﬁcant negative correlation between TC andLDL-C concentrations and patient’s age was revealed (p=0.001 for
TC). Mean TC level in patients aged 75–80 years was 5.43±1.44,
in patients ≥90 years – 4.7±1.08 mmol/L (p=0.001). Females had
higher concentrations of all lipids than males (p<0.0001 – for TC).
Lower lipids concentrations (mainly TC level) were associated withclinically signiﬁcant heart failure (p<0.0001) and atrial ﬁbrillation(p<0.0001). Higher TC and triglycerides levels were correlated withhigher blood pressure values (both systolic and diastolic) (p=0.001).
Signiﬁcant positive correlations between triglycerides and glucose
concentration (p<0.0001) as well as between TG and uric acid level(p=0.001) were revealed. Higher triglycerides and lower HDL-C levels were registered in patients with higher creatinine level (p=0.001
and p=0.0003, respectively). Only 11.4% of patients were treatedwith low doses of statins.
Conclusions: The study results demonstrated some features of lipid
proﬁle in very elderly patients with CAD. In this population serum
lipids are strongly correlated with various disorders.
P-313
Subcutaneous hydration in geriatric patients – what is theevidence? A systematic review
M.B. Danielsen 1 , M.G. Jørgensen 1 , S. Andersen 1,2 . 1 Dept. of GeriatricMedicine, Aalborg University Hospital, Aalborg, Denmark; 2 Dept. ofClinical Medicine, Aalborg University, Aalborg, Denmark
Introduction: The use of subcutaneous hydration differs between
geriatric departments with a trend for underuse. A systematic
review of the underlying evidence is missing.
Method: We performed a systematic search in Pubmed and Embase
for clinical trials on subcutaneous hydration in geriatric patients.
We excluded papers on the relevance hydration in palliative patients and papers written in languages other than English or
Scandinavian. Each paper was evaluated for risk of bias by two
independent authors and outcomes were rated according to GRADE.
Results: We included 19 papers. Only ﬁve papers compared the useof subcutaneous vs. iv. hydration and found comparable side effects(GRADE-rating ⊕⊕OO). The use of hyaluronidase was evaluatedin three papers and these suggested insuﬃcient reason to add
hyaluronidase (GRADE-rating ⊕⊕OO). Ten observational studies,four RCT and two case reports reported on the safety of subcutaneous hydration. Pooled data on the use of subcutaneous hydrationsuggest a low incidence of serious side effects (2.2% of patients;
GRADE-rating ⊕⊕OO), and an acceptable number of mild, local side
effects (GRADE-rating ⊕OOO). No studies compared different typesof ﬂuid, but data suggest that a combination of saline and glucose
is safe (GRADE-rating ⊕ ⊕ ⊕O). Isotone glucose with potassium is
insuﬃciently studied to support its use (GRADE-rating ⊕OOO).
Conclusions: Low quality evidence suggests that subcutaneous
hydration is safe in geriatric patients.
P-314
Subjective Global Assessment (SGA) is a reliable and valid
instrument to asses nutritional status in hospitalized older
patients in Turkey
C. Balcı 1 , B. Bolayır 2 , F. Sümer 1 , R.T. Doğrul 1 , G.Ç. Ayçiçek 1 ,C. Özsürekci 1 , H. Çalışkan 1 , B.B. Yavuz 1 , M. Cankurtaran 1 ,M. Halil 1 . 1 Hacettepe Universtiy Faculty of Medicine Department ofInternal Medicine Division of Geriatrics; 2 Gazi University Faculty of
Medicine Department of Internal Medicine Division of Endocrinology
and Metabolism
Objective: Malnutrition is a state resulting from lack of intake or
uptake of nutrition that leads to altered body composition bodycell mass. It is a frequent occurrence despite the fact that it isfrequently seen in hospitalized patients, prolonging the hospital

S131

stay, increasing morbidity and mortality. In this study, the validity
and reliability of the Turkish version of the Subjective Global
Assessment (SGA) test used to assess malnutrition in hospitalized
older people was evaluated.
Methods: A total of 98 patients 56 women (57.1%) and 42 men(42.9%) with an average age of 73.3±6.6 were included in the study.
50 (51%) and 48 (49%) of the patients were followed at the medical
and surgical wards respectively. Two geriatricians experienced in
the ﬁeld of malnutrition who were unaware of the SGA results,
interpreted the patients nutritional status after the evaluation ofseveral parameters such as medical history including weight loss,
appetite, disease severity, neuropsychological problems, mobility
problems, dependency in activities of daily living, anthropometricmeasurements, biochemical markers, bioimpedance analysis, hand
grip strength, geriatric assessment and 3-day dietary records. Basedon these groups of data, the patients were divided into “at nutritional risk” and “not at nutritional risk” groups by specialists.
Concordance between the two clinicians’ clinical assessment was
analyzed by kappa statistics and excellent concordance was found(kappa = 0.861), therefore the more experienced specialist’s decisions was accepted as gold-standard. A third physician performed
SGA within 48 h of admission. At the end of the SGA evaluation patients with a category A were classiﬁed as “non-malnourished” andthose with categories B and C were classiﬁed as “malnourished”.
Results: In general, SGA was found to be 91% both sensitive andspeciﬁc compared to the clinician’s assessment of malnutrition. The
positive predictive value and the negative predictive value were89% and 91%, respectively.
Conclusion: The Turkish version of the SGA test in hospitalized older people is a valid and reliable method for evaluating
malnutrition.
P-315
The impact of nutritional status on mortality in long-term carefacilities residents
A. Parnicka 1 , B. Wizner 1 , B. Gryglewska 1 , J. Wójkowska-Mach 2 .
1 Department of Internal Medicine and Gerontology, Jagiellonian

University Medical College, Kraków, Poland; 2 Department ofMicrobiology, Jagiellonian University Medical College, Kraków, Poland
Introduction: The aim was to assess whether nutritional statusof residents living in long-term care facilities inﬂuence on risk ofdeath.
Methods: The observational study has been conducted in one nursing and two residential homes in Cracow. At baseline demographic
characteristics, nutritional and health status were analysed. The
nutritional status was assessed based on the screening part of
the Mini Nutritional Assessment® and BMI. After 12 months offollow-up, the data on general health condition were collected.
Results: 122 residents have completed data on nutritional status
and BMI. Mean age (±standard deviation) of the residents was
78.89±8.6 (range: 60 to 100 years), 67.2% were women. Malnutrition was identiﬁed in 19 (15,6%), at risk of malnutrition was 36(29,5%) and normal nutritional status was in 67 (54,9%) of thesubjects. Residents at risk of malnutrition and malnourished wasolder than residents with normal nutritional status, respectively:
79.3±8.6 yrs and 82.0±9.6yrs vs 77.6±8.2 yrs. During the follow-up
16 residents have died, among them 12 (75.0%) were women; 12(75.0%) were at risk of malnutrition or malnourished and 13 (81.3%)
were residents of nursing homes. In univariate analysis as well as
age-gender-settings adjusted analyses the nutritional status basedon MNA screening part was signiﬁcantly linked with risk of death.
Conclusions: The impairment of the nutritional status affected
almost 50% of the residents. Risk of death was increased in malnourished only in univariate analysis probably due to small numberof deceased.

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P-316
The Nutritional Risk Screening (NRS2002) tool predicts mortality
in elderly people after discharge from a geriatric hospital
A. Mendes 1 , F. Hermann 1 , G. Gabriel 1 , C. Graf 2 , L. Genton 3 ,G. Gold 1 , D. Zekry 1 . 1 Geriatrics, Dept. of Internal Medicine,
Rehabilitation and Geriatrics, Geneva University Hospitals andUniversity of Geneva, Geneva; 2 Medical Rehabilitation, Dept. of
Rehabilitation and Palliative Medicine, Geneva University Hospitals
and University of Geneva, Geneva; 3 Clinical Nutrition, Geneva
University Hospitals and University of Geneva, Geneva, Switzerland
Introduction: The nutritional risk screening (NRS2002) is validated
to detect the presence of malnutrition and to estimate the risk ofdeveloping it during hospitalisation. We aim to determine whether
the NRS2002 predicts mortality after discharge from geriatric acutecare.
Methods: Cohort of 439 patients selected by randomization atadmission in the Geriatric University Hospital in Geneva. Clinicaldata was collected from medical records retrospectively by thesame experienced rater. The NRS2002 comprises a nutritional and aseverity of disease scores (0–3 points each) with an additional point
attributed if age ≥70y. Cox-regression models were used to assess
the association between NRS2002 and 12y all-cause mortality.
Kaplan-Meyer survival curves were compared using log rank test.
Results: Of 439 patients (mean age 86y; 74% female), 235 (53.5%)
had high nutritional risk and 201 (45.8%) enhanced risk. The mean
survival was 4.74y (SD=4.08). No survival differences were observed
when comparing groups according to NRS2002 classiﬁcation cutoff for nutritional risk diagnosis (HR 0.834, 95% CI: 0.68–1.022,
p=0.081). However, patients at very high global score (NRS2002 ≥5)presented increased mortality risk (HR 1.825, 95% CI: 1.275–2.612,
p=0.001). After adjustments for age, sex, albumin and inﬂammatory
status, the association remained statistically signiﬁcant (HR 1.704,
95% CI: 1.177–2.468, p=0.005). A severity of disease score of 3 points
independently predicted mortality (HR 2.82, 95% CI: 1.543–5.155,
p=0.001).
Conclusions: The NRS2002 predicts mortality after discharge fromgeriatric acute care. These results may help to develop preventive
strategies selecting patients who would beneﬁt the most fromgeriatric follow-up in the community after discharge.
P-317
Trends in the management of type 2 diabetes in a short term
geriatric unit in Sherbrooke from 2005 to 2015
D. Tessier 1 , L. Trottier 1 , A.-C. Thébeau 1 , I. Bourdel-Marchasson 2 .
1 Centre de Recherche sur le Vieillissement, Sherbrooke, Canada;
2 Université de Bordeaux, France
Introduction: Type 2 diabetes is a growing epidemic and the main
considerations in this population are hypoglycaemia and the target
glycated hemoglobin (HbA1c) in relation to the frailty status.
Method: This quality act retrospective transversal study was realized at the short term geriatric unit in Sherbrooke. Data werecollected regarding prescriptions regarding hypoglycemic agentsand insulin, HbA1c and rate of hypoglycaemia episodes in patientswith type 2 diabetes hospitalized in 2005, 2010 and 2015.
Results: We looked at 100, 83 and 94 charts for the years 2005,2010 and 2015, respectively. We noticed an increase in prescriptionsof metformin and DPP-4 inhibitors over time (p<0.001) and adecrease in prescriptions of thiazolidinediones and sulfonylureas.
Long acting insulin seems to be favoured to intermediate, prandial
and premixed insulin in 2015 compared to 2005. The mean glycatedhaemoglobin value increased from 6.48 in 2005 to 6.72 in 2010
and 7.15 in 2015 (p=0.001). The rate of hypoglycemic event (glucose
value <4) and severe hypoglycemic event (glucose value <2.8) weresigniﬁcantly reduced over this period.

Conclusion: Our study demonstrates a change in drug prescription
tendency for type 2 diabetes between 2005 and 2015. We thinkthat this practice, along with higher target glycated haemoglobin,
explains the reduction in hypoglycemic events.
P-318
Two components of the new ESPEN diagnostic criteria ofmalnutrition, body mass index and fat free mass index, areindependent predictors of lung function in hospitalized patientswith chronic obstructive pulmonary disease (COPD)
A.R. Ingadottir 1 , A.M. Beck 2 , C. Baldwin 3 , E. Weekes 3 ,O.G. Geirsdottir 4 , A. Ramel 5 , T. Gislason 6 , I. Gunnarsdottir 1 . 1 Unit
for Nutrition Research, Landspitali University Hospital & Faculty ofFood Science and Nutrition, University of Iceland, Reykjavik, Icelandand Department of Clinical Nutrition, Landspitali University Hospital,
Reykjavik, Iceland; 2 Department of Nutrition and Health, Faculty of
Health and Technology, Metropolitan University College, Copenhagen
N, Denmark; 3 Division of Diabetes and Nutritional Sciences, King’s
College London, London, UK; 4 Unit for Nutrition Research, Landspitali
University Hospital & Faculty of Food Science and Nutrition, Universityof Iceland, Reykjavik, Iceland andThe Icelandic Gerontological ResearchCenter, Landspitali University Hospital & University of Iceland,
Reykjavik, Iceland; 5 Unit for Nutrition Research, Landspitali University
Hospital & Faculty of Food Science and Nutrition, University of Iceland,
Reykjavik, Iceland; 6 Faculty of Medicine, University of Iceland,
Reykjavik, Iceland and Department of Respiratory Medicine and Sleep,
Landspitali University Hospital, Reykjavik, Iceland
Introduction: Diagnosis criteria of malnutrition were proposed by
the European Society for Clinical Nutrition and Metabolism (ESPEN)
in 2015. The aims of the study were to assess the prevalenceof malnutrition in patients with chronic obstructive pulmonary
disease (COPD) applying the ESPEN criterion, and to examine theability of each criteria to predict length of stay (LOS), 6 and 9months mortality and hospital readmissions within 30 days.
Methods: Subjects were COPD patients (n=121) admitted to Landspitali in the period March 2015- March 2016. Patients werescreened for nutritional risk using Icelandic screening tool (ISS)and NRS-2202. Body composition was measured with a bioelectrical impedance analyser (BIA). Lung function was measured withspirometry.
Results: The prevalence of malnutrition according to the ESPEN
criteria was 21%. The association between nutritional assessment(with all methods and different components of the ESPEN criteria)
and severity of the disease was highly signiﬁcant, low FFMI (kg/m2 )being the variable associated with the highest risk of being at asevere or very severe stage of the disease (OR 4.77 95% CI: 2.03,
11.20; p<0.001). Furthermore, there was a trend towards higher
risk of hospitalization for >7 days in subjects with low FFMI (OR2.46 95% CI: 0.92, 6.59; p=0.074).
Conclusion: Our study is the ﬁrst to describe the prevalence ofmalnutrition in hospitalized COPD patients using the ESPEN criteria
from 2015. It might be suggested that FFMI should be used as anindependent criteria for diagnosis of malnutrition in COPD patients.
P-319
Vitamin D status in octogenarians: data from elderly database in
VilniusV. Alekna 1 , A. Mastaviciute 1 , M. Tamulaitiene 2 , J. Kilaite 1 . 1 Facultyof Medicine of Vilnius University; Vilnius, Lithuania; 2 Faculty of
Medicine of Vilnius University; National Osteoporosis Center, Vilnius,
Lithuania
Objective: The aim of this study was to assess vitamin D concentration in octogenarians.
Methods: A cross-sectional study was performed in National Osteo-Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

porosis Centre based in Vilnius, Lithuania. Persons aged ≥80 years
from Vilnius community dwelling elderly people database were
included. Vitamin D (25(OH)D) and parathyroid hormone (PTH)concentrations in serum were measured with Cobas E411. Participants were divided into three groups according to their vitamin
D concentration: deﬁcient, insuﬃcient, suﬃcient. One-way ANOVA
with post hoc test was used to determine comparisons between
groups. Association between vitamin D and PTH concentrations wasassessed using Spearman correlation.
Results: The study was performed on 81 octogenarians: 45 (55.6%)
women and 36 (44.4%) men. The average age of participants was
83.59±2.99 years, average height was 160.82±9.27 cm, and weight– 73.11±13.05 kg. Mean vitamin D concentration was 11.77±8.12
ng/ml and PTH – 68.79±42.11 μ g/ml. Seventy (86.4%) octogenarians
had vitamin D deﬁciency, 7 (8.6%) – insuﬃciency, and only 4 (4.9%)
persons were vitamin D suﬃcient. Of all participants, two persons
were taking vitamin D supplements, of which one was in deﬁcientgroup and other was in insuﬃcient group. Vitamin D groups did not
differ in age, height, weight or PTH concentration. No statisticallysigniﬁcant correlation was found between PTH and vitamin D
concentrations (p=0.18).
Conclusion: The Vitamin D deﬁciency was found in the majorityof octogenarians. There was no correlation between vitamin D andPTH concentrations.
P-320
Which factors inhibit food intake in newly discharged,
malnourished older adults?
E.M. Damsgaard 1 , P.U. Pedersen 2 . 1 Department of Geriatrics, Aarhus
University Hospital, Denmark; 2 Aalborg Univeristy, Aalborg, Denmark
Introduction: Disease-related malnutrition leads to poor appetiteand decreased food intake that affects the convalescence negatively
in malnourished older adults after discharge from hospital.
Objective: To identify factors associated with decreased food intake.
Method: The study sample constitutes two intervention groups
from a RCT. Inclusion: Malnourishment or risk of malnutrition,
75+years, home dwelling, and living alone. Exclusion: Terminal
illness, cognitive impairment, and nursing home residency. At discharge, all patients received a diet plan covering their individualenergy needs. Individualised nutritional counselling was performed
one, two, and four weeks after discharge. Information about foodintake (was the food intake consistent with the diet plan?) as
well as inhibiting factors to food intake were recorded. A logistic
regression models was used to estimate Odds Ratios (OR) with 95%
conﬁdence intervals.
Results: One week after discharge 121 patients were contacted, 111
at two weeks, and 99 at four weeks. The occurrence of fatigue theﬁrst 2 weeks after discharge was associated with decreased foodintake between weeks 2 and 4 after discharge, OR 0.41, 95% CI:
0.19–0.92; p=0.03. Eating all meals alone was associated with poor
food intake, OR 0.34, 95% CI: 0.15–0.73; p=0.006. Gastro-intestinal
problems and sadness affected food intake, OR 0.32, 95% CI: 0.08–
1.16; p=0.08, and OR 0.37, 95% CI: 0.12–1.84; p=0.09 respectively,
but not signiﬁcantly.
Conclusion: Decreased food intake is associated with eating alone
and fatigue. This knowledge may help healthcare professionals toprovide eﬃcient nutritional support to malnourished older adults
and thereby prevent some negative consequences of disease-related
malnutrition.

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Area: Organisation of care and gerotechnology

P-321“Never event” insulin: Audit of insulin administration in a
French nursing home
B. Lewden-Bernadac 1 , M. Nauleau 1 , S. Lafargue 2 , V. Lebreton 1 ,S. Pergeline 3 , F. Delamarre-Damier 4 , V. Bricard-Pacaud 1 . 1 GCS Paysde Retz, France; 2 EHPAD Mer et Pins, Saint-Brévin, France; 3 HIPR,
Pornic, France; 4 University hospital Nantes and Saint-Laurent surSèvre Montfort nursing home, France
Introduction: Insulin administration errors constitute events thatshould never occur (i.e “never event”). However, the nursing home
adverse events annual report has recently described several adverse
events concerning insulin. Analysing reasons for such errors is an
essential preliminary step to establish an adapted action plan. The
objective is to compare gaps between professional practices, (i)oﬃcial recommendations and (ii) theoretical knowledge. Then, thisanalysis may help us to choose “preventive measures” adaptable to
our local context.
Methods: Two different audit grids were developed by the pharmacist in collaboration with the physician, pharmacy technicians and aquality specialist: one for nurses and one for physicians. Questions
covered the whole medication circuit. Data were collected throughinterviews and observations during visits in services by pharmacy
technicians.
Results: Nine forms were completed by nurses, two by doctors
and a pharmacy technician did eight visits. A lack of knowledge
about oﬃcial and local recommendations and discrepancy between
knowledge and practical implementation were observed. For example, insulin pencils were identiﬁed with the patient name but
the expiry date was never notiﬁed, dispensing was not nominative,
etc.
Conclusion: Gaps and mysfunctions highlighted during this audit
allowed us to take decisions to improve control on-patient drugcare. The main actions consisted in modifying insulin storage anddispensing system, creating a checklist for nurses. An assessment
will be performed after one year with a second audit and continued
monitoring of insulin adverse events.
P-322
A new way to assess care needs in Germany – New assessment
procedure
S. Hindrich. Acaddemic ORPEA Germany
After 20 years the dependancy assessment of care change completely. Changes by the new concept of the need for care:• The concept of nursing neediness changed not only the evaluation.
• He has an effect on the entire system of professional care.
• Through the three Maintenance strengthening law of transition
designed to promote and a performance-related maintenance toa person-centered and comprehensive care, care and relief.
The deﬁnition of the need of care in relation to independance haschanged: before it was: “What I can do for you” and now “Whatare you able to do by yourself”. This new one involve an assesmentof: 1. Subject module 1 – Mobility. 2. Subject module 2 – Cognitiveand communicative abilities. 3. Subject module 3 – Behaviors andmental problems. 4. Subject module 4 – Self care. 5. Subject module
5 – Dealing with disease - and therapy-related requirements andburdens. 6. Subject module 6 – Life in social relationships Design ofeveryday life and social contacts.
Background of the reform: Reason 1: More care by demographics:
Currently, about 2.7 million people in germany are reliant. Forecast:

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Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

For 2030 assuming care about 3.5 million. Currently, 1.5 million
people in Germany are ill with dementia. Forecast: by 2050 thenumber of dementia patients will be twice as high. Reason 2:
Previous care means-tested term formed from too little demential
diseases. Consequence: People with dementia get fewer services
than handicap people. Reason 3: The long-term care insurance aredesigned in the long term on a secure ﬁnancial foundation. This
new assesment (NBI: Neues Begutachtungsinstrument) starts on
january 2017. Our experience since the begining of the year allow
us to notice: Pro: better assesment of dementia, more services forcaring, a faster access to get the services, same tool for evry lander
in Germany. Contra: no suitable procedure for mobile patients suffering from dementia, at the beginning complicated to understandand assess, need of training, lack of teachers in the nursing school,patients without cognitive problems get less services than before(because the law is focused on dementia).
Conclusion: The policy of the government is that every person inneed of care should remain as long as possible at home. The beneﬁts
for nursing care are higher at home than for nursing home. An
evaluation is required; Staﬃng basis for long-term care, advantages
for certain patient groups, more experience is necessary to evaluate
these new assessment procedures
P-323
ACANTO: a robotic friendly walker
M. Valdés Aragonés 1,2 , P.A. Moreno 2 , R. Pérez-Rodríguez 2 ,L. Rodríguez-Mañas 1,2 . 1 Hospital Universitario de Getafe, Getafe,
Spain; 2 Fundación para la Investigación Biomédica del Hospital
Universitario de Getafe, Getafe, Spain
Introduction: ACANTO is an European project, funded by EU Horizon 2020 program, aimed at improving physical performance inelderly people through physical exercises provided by a robotic
friendly walker (FriWalk). To evaluate the FriWalk’ s clinical scenarios and user requirements, two focus groups were carried out, onewith physicians and the other with potential elderly users.
Methods: The two focus groups were composed of 9 physicians(n=9), and 8 elderly people (n=8) respectively. Initially, the project
and the target of the session were explained with the aim at collecting opinions/suggestions, clinical utility, weaknesses and strengths
about each clinical scenario: rehabilitation after hip fracture, functional decline and diagnostic tool. After the participants had ageneral idea of the project, the FriWalk was presented. Moreover,some exercises demonstration took place and some volunteers
could use it under supervision.
Results: All physicians highlighted that for the whole set of clinicalscenarios proposed, the FriWalk is an excellent tool to monitor
exercise programs and prescribe treatments. In addition, having
available information related to the evolution of the patients isof great clinical interest. The focus group of elderly participants
agreed that the Fri-Walk is a positive tool that could help them intheir daily life, since they could improve their self-conﬁdence andbecome more independent.
Conclusions: Proposed clinical scenarios were accepted by bothgroups who agreed that FriWalk helps to improve physical performance. Finally, collected results have determined the clinicalframework for ACANTO pilot study.
P-324
Agression and violence against caregivers in nursing home andlong term care units
M. Blanchard 1 , A. Corvol 2 . 1 Faculté de médecine, université deRennes 1, France; 2 Service de gériatrie, CHU Pontchaillou, Rennes,
CRAPE UMR 6051, France
Introduction: Workplace violence (WV) against caregivers is afrequent phenomenon, particularly in psychiatric, geriatric andemergency medical units.
Methods: The aim of this study was to understand how physicalviolence affects professional caregivers working in long term careand nursing homes, to evaluate the usefulness of post-incident
follow-up through incident reporting (IR), and to enumerate theexpectations of caregivers. This study was based on IR data covering
the 2013–2015 period from Rennes University Hospital’s nursing
home and long term care units and from 20 semi-directed caregiverinterviews.
Results: Over the 3-year study period, 76 IR claims were ﬁled. These
claims covered 108 aggressive incidents broken down as follows:
44.4% blows or slaps, 20.4% aggressive incidents using physicalforce, 10.2% assaults with objects and 10.2% threatening gestures.
More than half of these incidents occurred in the nursing home’s
Alzheimer’s Unit. The interviews show that violence is largely
under-reported, with important variations among caregivers. Thirty
percent of caregivers ﬁle IRs several times a week. IR is hampered
by both the trivialization of the violence due to the frequency
and repetitive nature of the attacks, as well as by the guilt of thedeclarant, the fear of colleagues’ judgement, and the lack of managerial support. Available WV training courses were not adapted tothe speciﬁc issues inherent in dealing with dementia patients.
Conclusion: Monitoring IR is necessary to avoid trivializing workplace violence and its repercussions. Incident reporting, especiallyof cases with physical or psychological consequences, should be
encouraged by medical institutions.
P-325
Analysis of the oncogeriatric activity of Saint Joseph Hospital
Marseille in 2016: toward a transversal oncogeriatricorganization
S. Tournier Louvel. Saint Joseph Hospital Marseille
Introduction: The geriatric activity of Saint Joseph Hospital Marseille has been organized around a mobile team (2012), an
out-patient department, and a day hospital (2016). Our objective
was to analyze the oncogeriatric activity in 2016 to optimize its
organization.
Material and methods: This retrospective study analyzed 186 consecutive medical records of patients with cancer evaluated from
01/01 to 31/12/2016 directly in-hospital or in out-patient department. The analysis focused on oncologic geriatric assessments(OGA) versus oncologic multi-disciplinary team meetings (OMDM)
and on geriatric recommendations.
Results: In 2016, 165 patients (86 women, 79 men) from 70 to
97 (mean age 84.1±5.5) were evaluated through 186 interventions(144 in-hospital and 42 in out-patient department). In 2016, thenumber of OGA represented only 14.6% of all OMDM (147/1008).
OGA were solicited in 46% of sinonasal and throat cancer OMDM,
29% digestive cancer OMDM, 19% of broncho-pulmonary cancer
OMDM, and 6% of other cancer OMDM. Only 16.5% of the geriatricrecommendations were “compliant” with OMDM whereas 37.9%
were “compliant with reserve”. On average 4.1±1.4 oncogeriatricrecommendations/patient were proposed: acts of nutrition (91.4%);
physiotherapy (89.9%), complementary examinations (81.3%), social support (73.4%), pain support (41.7%) and depression support(33.1%).
Conclusion: Too few oncologists required OGA in 2016. Therefore OGA brought signiﬁcant contribution to patient care throughcomplementary recommendations. A strong awareness campaign
should be organized toward organ specialists and doctors to systematize oncogeriatric requests. To manage this foreseeable increase,
it seems necessary, maintining the same geriatric team size, toestablish a transversal oncogeriatric strategy

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

P-326
Community hospital geriatric ward cover through remote accessrobotic tele-presence: A pilot study
A. Mathur. University Hospitals of Leicester NHS Trust, Leicester,
United Kingdom
Introduction: A 4-month pilot study was done to establish the suitability of remote assessment of frail older patients in a community
hospital ward by a “robotic tele-presence”. This technology allows
virtual audio-visual interaction through a remote controlled mobile
robot to replicate physical presence, all of which can be controlledfrom a distant location through an “app” on a smart device.
Methods: The parameters assessed through “robotic tele-presence”
ward rounds were: a) quality of clinical assessment, b) technicalquality, c) patient experience and, d) staff experience. The Consultant Geriatrician was in a different geographic location and controlled the robot through a smart device “app” for these ward rounds.
Results: Diﬃculties were experienced in some aspects of physicianpatient interaction, particularly where there was a need for physical examination and interpretation of ﬁndings. However, preassessment reviews, formulating problem lists and communicating
management plans to patients were satisfactory. Technical quality
was affected by variable WiFi connectivity, ambient noise and initialproblems in steering the robot remotely. Patient experience waslargely positive for overall interaction, including engagement withthe doctor and clarity of image but mixed for clarity of voice. Staff
experience was mixed, largely due to more prolonged ward rounds,
often due to variable connectivity and technical issues.
Conclusion: This exciting technology using “robotic tele-presence”
relies on uniformly good connectivity and may not replace “traditional” ward rounds, but should be tested further as a potentiallyvaluable asset for providing specialist opinion remotely to multidisciplinary teams, carers, families and social workers by bridging
distances.
P-327
Dependency is associated with age, cognitive impairment andinfections: LPZ study in Turkish hospitals
B. Saka 1 , C. Kocaturk 2 , I. Tasci 3 , S. Akin 4 , S. Savas 5 , T. Atli 6 ,P. Tosun 7 , M. Halil 8 , D.S. Erdincler 9 , M. Varli 10 , A. Curgunlu 11 ,A. Tufan 12 , Z.A. Ozturk 13 , G. Sezgin 14 , F. Kirbiyik 15 , M.A. Karan 16 .
1 Istanbul University Istanbul Faculty of Medicine; 2 Health Sciences
University, Yedikule Chest Diseases Hospital; 3 Health Sciences
University, Gülhane Faculty of Medicine; 4 Erciyes University School of
Medicine; 5 Ege University School of Medicine; 6 Ankara Guven
Hospital; 7 Health Sciences University, Erzurum Teaching Hospital;
8 Hacettepe University School of Medicine; 9 Istanbul University,
Cerrahpasa Faculty of Medicine; 10 Ankara University School of
Medicine; 11 Istanbul Bilim University School of Medicine; 12 Marmara
University School of Medicine; 13 Gaziantep University School of
Medicine; 14 Maltepe University School of Medicine; 15 Nutricia Turkey,
Istanbul; 16 Istanbul University, Istanbul Faculty of Medicine
LPZ is an annual international multicenter cross-sectional prevalence measurement of care problems on institution, department
and patient level. It evaluates, risk, prevalance, prevention andtreatment interventions.
Materials and methods: Measurement was done on November
2016 in 14 hospitals of Turkey. LPZ tool included 3 forms including
questions related with the institutions, departments, care-givers
and patients. Patients ≥65 years old were evaluated. This study was
supported by Nutricia Turkey.
Results: 281 patients were taken into the study (%53 males). According to LPZ tool, 29.5% of the patients were extensively/completelydependent, 14.6% were partially dependent and 55.9% were extensively/completely independent. Median number of care-givers

S135(nurse, care worker) per ward was 9 in day time, 4 in the evening
and 3 in the night shifts. Dependency was related with infectious
diseases, mental and behavioural disorders, dementia and stroke.
Patients with increased risk for pressure ulcer, malnutrition, falls
and polypharmacy also showed increased dependency. Dependency was also found associated with age, BMI (kg/m2 ), urinary
incontinance, dysphagia, falls and pain. According to multivariate
analysis, dependency was associated with age, infectious diseases
and dementia.
Conclusion: This study provided important data about 6 care problems in hospitalised elderly in Turkey. Dependency in elderly was
found associated with age, dementia and infections.
P-328
Enhancing the continuity of care: Assessing the quality ofdischarge documentation for our elderly population
A.P. Howe, S. Akbar, H. Ashraﬁ, W. Chmiel, H. Choonara, L. Kent,
K. Yip, O. Gaillemin, A. Vilches-Moraga. Salford Royal NHS
Foundation Trust, Salford, UK
Objectives: Good quality documentation is essential to the safe
transition of care for elderly patients at the point of discharge.
We intended to review the quality of discharge documentation forpatients discharged from acute inpatient services.
Methods: Utilising the electronic patient record we reviewed summaries for patients aged ≥74 years from acute medical, surgical andageing and complex medicine wards. The content of summaries
was compared against established national and local standards.
Results: 321 documents were reviewed. Team members involvedin patient care authored 88% of summaries. A succinct summary of
the admission with relevant investigations or procedures were adequately documented in 306 (95%) records. However, a clear list of
new diagnoses and an up-to-date past medical history were present
in only 207 (64%) and 161 (50%) summaries respectively. Episodesof delirium and diagnoses of dementia were appropriately recorded
98% of the time.273 (85%) patients had an amendment made to their
medication regime. When required, this was adequately recorded
83% of the time, with rationale for changes included in 73% of
documents. Information for patients, in lay terms, was recorded in
254 (79%) summaries.
Conclusions: High quality discharge summaries are authored byteam members involved in a patient’s care. Though events ofadmission are recorded well for this cohort; further work is required to improve recording critical elements such as medication
amendments and new diagnoses. Relaying information in lay terms
for the patient and carers should be viewed as a vital element of
this transfer of care document.
P-329
Evaluation of Motor Abilities in young and older subjects using
HD-sEMG and IMU data
L. Imrani 1 , S. Xérès 1 , K. Lepetit 1 , M.M. Al Harrach 1 , S. Boudaoud 1 ,K. Kinugawa 2 , F. Marin 1 . 1 Sorbonne Universités, Université detechnologie de Compiègne, UMR CNRS 7338, Compiègne, France;
2 Functional Exploration Unit, Hôpitaux universitaires Pitié-SalpêtrièreCharles Foix. DHU FAST, Assistance Publique Hôpitaux de Paris (APHP),
Paris, France; Sorbonne Universities, University Pierre and Marie Curie(UPMC) Paris 06, UMR CNRS 8256 B2A Institute of longevity, France
Introduction: The aim of this study is to characterize the motor
abilities of young compared to older subjects by combining a
recent electromyography technique, the HD-sEMG (high density
surface electromyography), and the Inertial Measurement Unit
(IMU) to estimate muscle activation and motion eﬃciency during
the sit-to-stand test (STS).
Materials and methods: Twelve subjects participated in the STS

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Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

test. Seven of which were healthy young subjects (25±5.7 years),and ﬁve were elderly subjects (80±7.8 years). All subjects performed
sit-to-stand motion 5 times at spontaneous pace. The muscle activity was quantiﬁed using speciﬁc descriptors such as contraction
timing and intensity. Two 8×8 HD-sEMG grids were placed on theright and left femoral muscles. Simultaneously, the trunk maximum
acceleration obtained by the IMU during STS test was measured.
The results between young/older and men/women were compared.
In addition, the statistical correlation was computed for age, sex,
and body mass index (BMI) of the subjects.
Results: The results showed that the sex did not have a signiﬁcant
inﬂuence on the motor eﬃciency in the STS test. However HD-sEMG
descriptors related to muscular activity, and the trunk maximum
acceleration are discriminant with the age (p<0.001***). The BMI
has also signiﬁcant impact on speciﬁc descriptors (P<0.01**).
Conclusion: The obtained results demonstrated the potential of the
combination of HD-SEMG and IMU data processing for evaluating
functional motor abilities. Further developments are promising forthe evaluation of motor aging and sarcopenia for clinical routine.
Acknowledgements: This work has received support from “Agence
National de Recherche” ANR-11-IDEX-0004–02 under Idex “Sorbonne Universités” in the investments for the future program.

by phone weekly follow-up (PWPC) assured by a trained nurse
practitionner (NP).
Methods: Our Program created at the instigation of French Ministryof Health was driven by a medical oncologist (MO) and a NP. Every
EP beginning an OT met the NP to detail OT side effects and plan aweekly schedule of phone call (PC). Each PC was standardized withquestions concerning, observance, and speciﬁc SE. According to
the answers, preplanned actions were implemented. Toxicity alerts
were triggered and MO advice was required. After 3 months followup if no toxicity > grade 2 was observed, EP went out of the PWPC.
Results: Between 2015 and February 2017, 244 EP entered theProgramm. Mean age was 79 (70–94). 142 EP had solid tumorsand 102 hematological diseases. 94% of EP had locally advanced
or metastatic disease. Mean duration of follow-up was 159 days
(1–515). Mean duration of PC was 8 mn. 39% of EP went out of
the PWPC because of tumoral progression, 26% because of goodtolerance, 26% because of toxicity, 9% because of EP’S refusal or on
non medical ground. 39 unplanned hospital admissions occured,
only 8 were triggered by the NP. No toxic death occurred.
Conclusion: PWPC was widely accepted by EP. Only a randomized trial comparing this Program versus usual care could provesuperiority of this follow-up in EP under OT for cancer.

P-330
Family participation in the care of patients in a geriatric ward.
A literature study

P-332
Geriatric outpatient consult in a general Portuguese hospital

I.V. Gomez Bruinewoud, M.C. Faes. Department of Geriatric Medicine,
Amphia Hospital, Breda, The Netherlands
Introduction: Family participation during hospital admittance isassociated with good nursing practice. Participation of the family
in hospital care promotes recovery and well-being of the geriatricpatient. The aim of this study is to explore methods of structuring
family participation in the hospital care of geriatric patients.
Methods: A PubMed, Cochrane, Medline and Biomed Central search
was performed. The search terms participation, partaking, hospital,
geriatric ward, family member, informal caregiver, relatives, aged,
inpatient and elderly were used. All publications were screened forrelevant information in title and abstract. The full text of relevant
articles was read.
Results: 126 articles were identiﬁed, after screening title andabstract, the full text of 9 articles was read. Structured multicomponent intervention programs such as the Hospital Elder Life Program(HELP) have been successful in preventing delirium in frail older
patients by using trained volunteers. The FAM-HELP program onfamily caregiver training and intervention to prevent delirium wasproven feasible. Cultural aspects determine the degree of participation of family members in hospital care. The participation of family
in hospital care should be planned and structured to ensure a safe
and satisfying experience for patients and caregivers.
Conclusion: There is limited information on methods of structuring participation of family members in hospital care of geriatricpatients. The FAM-HELP program is feasible, but focuses mainly on
delirium prevention. More research concerning integrating family
members in hospital care and extending it to other areas beyond
delirium prevention is needed.
P-331
Follow-up by phone of elderly cancer patients treated with oral
chemotherapy or oral targeted therapy: Results of ﬁeld
experience in a comprehensive cancer center
E. Cini. Institut Paoli Calmettes, Aix Marseille Université, Marseille,
FranceIntroduction: Oral therapy (OT) of cancer is widely used. To secure
the use of OT in elderly patients (EP) we created a Program of

R. Tourais Martins, J. Milho, P. Marques, E. Doutel Haghighi. Hospital
Vila Franca de XiraIntroduction: Geriatric medicine is slowly growing in Portugal, acountry where it had been sparse until a few years ago despite
the increasing elderly population. With the rising awareness ofthe challenge involving the aging-related medical issues, it became
clear that medical institutions had to adapt. Therefore a multidisciplinary Geriatric Outpatient Consult (GOC) was created in our
general hospital on May 2016.
Methods: A retrospective, observational and descriptive study was
conducted by evaluating the demographic and clinical characteristics and the initial comprehensive geriatric assessment of patientsreferred for a ﬁrst GOC from May 2016 to April 2017. Demographic
and variable analysis was conducted using Excel 2013® .
Results: 50 patients were referred to GOC, 68% were female. Meanage of 81,8years. 46% were referred after an Internal Medicine ward
admission. 82% patients took more than 4 drugs, with a median
number of drugs taken of 8, reduced to 6 after the ﬁrst consult.
Median Katz score and Lower-Brody score were 5 and 2, respectively. 20% were malnourished and 38% were at risk of malnutrition.
30% and 22% patients had mild and severe cognitive impairment,
respectively. 48% had a Yessavage score >6. 84% had more than 3
active medical problems identiﬁed.
Conclusion: It is clear that there’s a population beneﬁting from being evaluated in GOC. Being in its early beginning, there’s still room
for improvement but with time we hope to show positive results interms of enhanced health outcomes for Portuguese elderly patientsthat could be replicated in other hospitals.
P-333
GeroS – gerontological public health indicators inextricably
linked by CEZIH
S. Tomek-Roksandic, B. Kolaric, Z. Šostar, M. Huić, I. Popek,
N. Tomasovic-Mrcela, S. Mravak, M. Maltaric, M. Lukic, S. Predavec,
A. Balenovic, T. Benjak, S. Matijevic-Hlatki. Reference Centre for
Health Care of the Elderly of the Ministry of Health of the Republic of
Croatia, Center of Health Gerontology, Andrija Štampar Teaching
Institute of Public HealthAt the initiative of the Ministry of Health Reference Centre RH forPoster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

elderly health care - the Center for Gerontology Health Teaching
Institute for Public Health “Dr. Andrija Štampar” and the Croatian
Institute for Health Insurance established the aims and objectives
in the ﬁeld of computerization of monitoring gerontology andgeriatric health care for the elderly. The main goal is to link theprovision of gerontological health care at all three levels, fromprimary health care for the elderly in homes for the elderly withthe use of geriatric nursing documentation for geriatric health careto the hospitalized geriatric insured on long-term treatment and togeronto dental services. Gerontology services accompanied Gerosa
infection, inextricably linked within CEZIH’s (Central Croatian central information system) refer to the monitoring and evaluation ofhealth needs and functional ability of gerontological insured andgeriatric patients. The ultimate goal of the project is the computerization of the entire health care for the elderly and geriatricpatients, regardless of ownership of institutions in which they arelocated, as well as Gerontologic insured persons and the elderly in
long-term treatment in hospitals and palliative geriatric and psycho
geriatric care to gerontological public health indicators were all
in one place, the central health care system, integrating it with
CEZIH infection via GeroS. Computerization of health care for theelderly will cover the medical services provided to the elderly, but
individual gerontological approach which includes institutional andnon-institutional care for the elderly provided by the Gerontology
Center. All these gerontology health information will be collected in
GeroS, CEZIH subsystem for the monitoring and evaluation of healthneeds and functional ability of geriatric patients and Gerontology
insured provided objectiﬁcation of identifying and evaluating andlinks all three levels of health care for the elderly. The system will
be inextricably linked to CEZIH infection, the most important segments of gerontological health care will be recorded in the planned
gerontology e-cards. This will make the entire health system is eﬃcient, adequate, accessible and properly regulated legislatively, withevaluation of geriatrics health care, and the purpose of promoting
the protection of the elderly and the rationality of the growing
geriatric health care spending.
P-334
Impact of admission medication reconciliation in elderly at riskof loss of autonomy
A. Potier 1 , L. Argoullon 1 , C. Motte 2 , L. Bucy 2 , V. Zirabe 2 ,A. Kearney-Schwartz 2 , C. Perret-Guillaume 2 . 1 Department ofPharmacy, University of Lorraine, Nancy, France; 2 Geriatrics andInternal Medicine Department, University of Lorraine, Nancy,
FranceIntroduction: Elderly patients at risk of loss of autonomy alreadybeneﬁt from an Hospital Discharge Form including clinical, pharmaceutical and medico-social informations. A clinical pharmacist
carries out pharmaceutical analysis and treatment optimisation in
a 60-bed geriatric department. This study aims at assessing the impact of the implementation of admission medication reconciliation(MR) in a 20-bed part of the department.
Methods: A prospective observational study was carried out from
November 2016 to March 2017. The pharmacist consults at least
3 sources of information to establish the best possible medication
history (BPMH) on every patient admitted. Proactive MR helps towrite the admission medication order (AMO) whereas retroactive
MR includes identifying and documenting discrepancies by comparing the BMPH to the AMO in order to amend the AMO where
needed. The evaluation uses the standardised MedRec indicators.
Results: 143 of the 151 patients beneﬁted from MR, among which
83.9% within 24 hours of admission. MR was proactive in 14% ofcases. 187 medication errors were intercepted at admission, on
average 1.5 per patient, and eventually 1.1 were corrected. The
number of undocumented intentional discrepancies was 0.4 per

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patient. 61.8% of patients presented with at least one medication
error. 4.4 sources were consulted per MR for information gathering.
Conclusions: The large number of medication errors interceptedand corrected at admission demonstrates that MR performed bya clinical pharmacist is a necessary starting point for treatment
optimisation and must be combined with a program aiming at
reducing the risk of early re-hospitalization.
P-335
In-hospital non-surgery-related mortality is the highest in
patients suffering from nervous system, respiratory andcardiovascular diseases: A 5-year cohort study of 6,581,081
hospitalizations in seniors
M. Puzianowska-Kuznicka 1,2 , M. Walicka 3 , M. Chlebus 4 ,A. Sliwczynski 5 , M. Brzozowska 5 , D. Rutkowski 5 , L. Kania 1,3 ,M. Czech 6 , A. Jacyna 5 , E. Franek 1,3 . 1 Mossakowski Medical ResearchCentre, PAS, Warsaw, Poland; 2 Centre of Postgraduate Medical
Education, Warsaw, Poland; 3 Central Clinical Hospital of the Ministryof the Interior and Administration, Warsaw, Poland; 4 University of
Warsaw, Warsaw, Poland; 5 National Health Found, Warsaw, Poland;
6 Warsaw University of Technology, Business School, Warsaw, Poland
Introduction: Hospitalizations of elderly patients are more frequent
than of younger individuals, consume a large amount of ﬁnancial
resources, and carry a high risk of being prolonged and terminatedwith death. Therefore, the aim of this study was to assess inhospital non-surgical mortality in a very large group of patients.
Methods: Data from the database of the National Health Fundinsuring almost 100% of Polish citizens were used for analysis regarding 15,345,025 hospitalizations of adult patients not related tosurgical procedures, including 6,581,081 hospitalizations of seniors(≥65 years), that occurred between 2009 and 2013.
Results: The mean mortality rate increased with age from
0.12±0.01% in the 18–24 years old group to 4.17±0.08%, 7.39±0.12%,
14.87±0.20%, and 26.65±0.30% in the 65–74, 75–84, 85–94, and≥95 years old groups, respectively. The mean odds ratio for
in-hospital non-surgery-related death also increased with age,reaching 229±15.06 in the ≥95 years old group vs. the youngest
adults. In seniors, the mean mortality rate was highest in thesesuffering from the nervous system, respiratory, as well as heart andvascular diseases (10.22±0.35%, 9.54±0.25% and 7.84±0.27%, respectively), while the lowest mortality rates regarded bone and muscle,
as well as head and neck diseases (1.26±0.08% and 0.62±0.08%,
respectively).
Conclusions: The in-hospital non-surgery-related mortality signiﬁcantly increases with age. In the elderly, it was highest due
to the nervous system, respiratory and cardiovascular diseases.
Hospitalizations due to the bone and muscle, as well as head andneck diseases were associated with a low risk of death, even inoldest-old.
P-336
Interest and impact of pocket ultrasonography screening in ageriatric unit
N. Azulay 1 , C. Arlaud 2 , E. Ferrer 2 , J.M. Turpin 2 , L. Van Eslande 2 ,S. Gonfrier 2 , C. Raffaelli 1 . 1 Hopital Pasteur II, CHU de Nice, France;
2 Hopital de Cimiez, CHU de Nice, France
Material and method: We ran a interventional cross descriptive
study in a short term geriatric unit. After consenting, each patientwas examined with a pocket-size ultrasound and Doppler device(iViz, Sonosite, Seattle, USA). The examination concerned 15 organs
and his duration shouldn’t exceed 15 minutes. The impact onpatient care was judged after the examination by the pratician
in charge of the patient, and was divided in 4 categories: Direct,
delayed, neutral, and negative.

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Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

Results: During 6 months, 501 patients were examined. Mediantime used was 13 minutes. The examination resulted in a direct
impact in 35% and in a delayed impact in 23% of cases, for a
total of positive impact of 58%. Negative impact concerned 0.8% of
patients. Double reading of ultrasound iconography gave a excellent
concordance between both readers. Abdominal examination was
the most important part of the examination, and cervical was theless important one. Having a direct impact in patient care didn’t
impact signiﬁcantly the duration of stay of patients.
Conclusion: Running a routine ultrasound examination at patient’s
entry in a geriatric unit has a direct impact in patient care in 35%
of cases. The versatility of ultrasound’s applications, and the recent
progresses made with mobility and miniaturization are perfectly
adapted with the polypathologic proﬁle of geriatric patients.
P-337
Literature review: comparison of the treatment ofinstitutionalized patients exhibiting a degenerative dementia in
specialized care units and in conventional extended stay careunits between 2006 and 2016
M.-A. Sanchez 1 , A. Letty 1 , P. Denormandie 1 , S. Sanchez 2 . 1 Institut
du Bien Vieillir; 2 Centre hospitalier de Troyes
Introduction: The number of individuals living in designated lodgings for elderly individuals (DLEI) in France continues to increase,amounting to close to 9% of the individuals over the age of 75
in 2012. The aim of our work was hence to provide a review of
the recent literature from 2006 to February 2016 regarding thetreatment of institutionalized patients exhibiting a neurodegenerative illness in specialized care units compared to conventional careunits, according to speciﬁc criteria for quality of life, maintenanceof higher functions, and in terms of behavioral changes or loss ofautonomy.
Methods: This involved a selective literature review carried out by
a digitally-assisted search. The selected studies had to be less than
10 years old at the time of the data collection. The articles had to be
published in English, or in French so as to include published studies
that speciﬁcally addressed features relating to the French caresystem. Only studies addressing differences in treatments between
speciﬁc (SCU) and non-Speciﬁc (n-SCU) units were considered, theothers being excluded.
Results: To compare treatment in SCUs and in n-SCUs, the studies
used reproducible and validated scores for assessing quality oflife, cognition, behavioral issues, as well as autonomy in each of
the units. Use of medicinal therapeutics, hospitalization rates, andphysical restraints were also often investigated. Our work focusedon recent studies taking into account the latest measures put inplace in DLEIs comprising SCUs. A literature review carried out in2012 that took into account historical studies did not ﬁnd that SCUs
were generally better in regard to providing care for patients withdementias.
Conclusion: In conclusion, by speciﬁcally considering only themore recent studies, this work has allowed knowledge of the meritsof development of specialized units to be updated, particularly interms of the treatment of dementias.
P-338
Management of geriatric syndromes in older adults with cancer:
First experience from a newly founded oncogeriatric unit in a
German hospital
A.-S. Schmidt, A. Frey, J. Thönes, T.W. Köninger, R.-J. Schulz,
V. Goede. Oncogeriatric Unit, Dept. of Geriatric Medicine, St. Marien
Hospital
Introduction: It is unclear which type of clinical setting andinfrastructure is best to manage geriatric syndromes in cancer

patients. We here report routine care data after having establishedan Oncogeriatric Unit as part of a large geriatric clinic at the St.
Marien Hospital in Cologne, Germany.
Methods: Older adults with cancer were enrolled into the newly
founded unit to receive geriatric evaluation and intervention.
Results: From January to March 2017, a total of 60 patients wereenrolled (53% males, median age 80 years, median Barthel index 45
points). Most were referred from other hospitals (9 from oncology
clinics, 16 after tumor surgery, 33 from non-oncology clinics).
Referrals were mainly driven by immobility or falls, delirium, andnutritional problems. In 58% and 32% of the patients, respectively,
cancer/cancer treatment was key for referral or highly relevant for
geriatric intervention planning. The spectrum of cancers included
solid (72%) and hematological (28%) malignancies with colorectal
cancer, prostate cancer, and lymphoma being most common. In
10 patients (17%), chemotherapy was administered immediately
before or after staying at the unit. Oral cancer treatment had tobe administered in 7 patients (12%) while staying at the unit. Twopatients (3%) received radiation therapy and 4 patients (6%) died. In
patients having completed a comprehensive geriatric care program,median increase of the Barthel index was 10 points.
Conclusions: Oncogeriatric units within geriatric clinics allow a
focused management of geriatric syndromes in older adults withcancer. Comprehensive geriatric care in such patients results infunctional improvement.
P-339
Measurement of quality of care in elderly in Turkish hospitals
using LPZ tool
B. Saka 1 , C. Kocaturk 2 , I. Tasci 3 , S. Akin 4 , S. Şahin 5 , T. Atli 6 ,P. Tosun 7 , M. Cankurtaran 8 , H. Yavuzer 9 , M. Varli 10 , A. Curgunlu 11 ,A. Tufan 12 , Z.A. Ozturk 13 , S. Nalbant 14 , M. Firtina 15 , M.A. Karan 16 .
1 Istanbul University Istanbul Faculty of Medicine; 2 Health Sciences
University, Yedikule Chest Diseases Hospital; 3 Health Sciences
University, Gulhane Faculty of Medicine; 4 Erciyes University School of
Medicine; 5 Ege University School of Medicine; 6 Ankara Guven
Hospital; 7 Health Sciences University, Erzurum Teaching Hospital;
8 Hacettepe University School of Medicine; 9 Istanbul University,
Cerrahpasa Faculty of Medicine; 10 Ankara University School of
Medicine; 11 Istanbul Bilim University School of Medicine; 12 Marmara
University School of Medicine; 13 Gaziantep University School of
Medicine; 14 Maltepe University School of Medicine; 15 Nutricia Turkey,
Istanbul; 16 Istanbul University, Istanbul Faculty of Medicine
LPZ is an annual international multicenter cross-sectional prevalence measurement of care problems on institution, department
and patient level. It evaluates, risk, prevalance, prevention andtreatment interventions.
Materials and methods: Measurement was done on November
2016 in 14 hospitals of Turkey. LPZ tool included 3 forms including
questions related with the institutions, departments, care-givers
and patients. Patients ≥65 years old were evaluated. This study was
supported by Nutricia Turkey.
Results: 281 patients were taken into the study (%53 males). LPZ
tool showed 47.2% PU risk, 12.8% stage ≥1 PU and 5% nosocomial PU.
Active/reactive support surface (43.8%) and repositioning (33.8%)
were used to prevent and treat PU. 42% of the patients had UI(n=118). Main interventions for UI were urinary catheters, medications, bladder training and inlay pads/underslips. Malnutrition(MN) risk was 43%. 68 patients had dysphagia. Energy/protein richsnacks were given to 24.1%, oral nutrition supplements to 15.6%
and parenteral nutrition to 8.5%. Fall risk, fall prevalance in thelast 12 months and in the hospital were 62.3%, 28.8% and 8.5%
respectively. Interventions were evaluation of drugs, exercise, alarmsystem, low bed and restraints. 18 mechanical, 5 physical, 18 medical and 6 psychological restraints were reported. 171 patients werePoster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

complained from pain. 77.2% received pharmacological treatment
for pain (paracetamol: 52.6%, NSAII: 15.8%, opioids:22.8%).
Conclusion: This study provided important data about 6 careproblems in hospitalised elderly in Turkey. Annual measurement of
risk/prevalance, preventive measures and treatment interventions
will provide better hospital care plans for elderly.
P-340
Overcoming challenges of digital self-management in older
adults with multimorbidity: The promise of social
connectedness?
J. Kuiper 1 , A. Jacobs 1 , J. Doyle 2 , E. Murphy 3 , S. Smith 2 ,C. Hannigan 3 , J. Dinsmore 3 . 1 imec-SMIT, Vrije Universiteit Brussel,
Brussels, Belgium; 2 NetwellCASALA, Dundalk Institute of Technology,
Dundalk, Ireland; 3 TCPHI, Trinity College Dublin, Dublin, Ireland
Introduction: Digital self-management for older people holds
promises for aging well. However, the adoption readiness remains
limited due to barriers in e.g. digital literacy, health and support.
Furthermore, older people with multimorbidity (PwMs) are at increased risk of experiencing social disconnectedness. This living lab
study explores the role of social connectedness in dealing with thechallenges of digital self-management.
Methods: Data was collected in Belgium and Ireland as part of
the ProACT project, which aims to develop a digital integrated
health ecosystem to support self-management for older PwMs.
Semi-structured interviews and focus groups were conducted with
38 older PwMs, 17 informal carers, 29 formal care workers and 41
healthcare professionals (HCPs). Subsequently, several co-creation
sessions were held with PwMs and informal caregivers. Interviews
and focus groups were transcribed and analysed using thematic
analysis.
Results: Both the expected barriers in digital self-management,
and the lack of social connectedness arose. HCPs and formal carers
identiﬁed loss or lack of social contacts as a key factor in thedeterioration of health, wellbeing and self-management abilities.
Across stakeholders, the social context was considered an important
determinant of PwMs motivation for self-management. Therefore,in ProACT, a tool is developed to support this. We present theconcepts of this tool, and the feedback collected on them.
Conclusion: This study demonstrates the different dimensions of
the importance of supporting social connectedness in digital caresolutions for older PwMs. We also explored different concepts to
support social connectedness, overcome the common challenges ofdigital self-management and increase adoption.
P-341
Potentially inappropriate prescribing in elderly patient: analyze
before/after hospitalization
L. Argoullon 1 , A. Potier 2 , A. Valance 3 , M.A. Manciaux 2 ,A. Bonneville 1 . 1 Pharmacy, CHRU Nancy, France; 2 Geriatric, CHRU
Nancy, France; 3 Emergency CHRU Nancy, France
Introduction: In the context of improved medication managementin the elderly patient, we were interested in the reevaluation of
drug prescription during hospitalization. The aim of this study is
to assess the prevalence of inappropriate prescribing in the elderly
patient before and after hospitalization.
Methods: This is a descriptive and retrospective study of drugprescriptions in a non-geriatric unit. Prescriptions were analyzed
using STOPP/START v2 tool.
Results: Seventy-two patients over 65 years-old were included. A
polymedication of 5 or more drugs was reported in 76% of cases(n=55) at entry and in 90% (n=65) at discharge. Inappropriateprescribing rate with at least one STOPP criteria decreases from
58% to 29% after hospitalization (p<0.0005). Potential prescribing

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omissions rate decreases from 46% to 42% after hospitalization(p<0.5465). Drugs most frequently involved were benzodiazepines(21%), antiplatelet agents (11%) and opiates (8%). There was improvement rather qualitative than quantitative of prescribing after
hospitalization.
Conclusion: Collaboration between different health professionals
seems essential to ensure optimal medication management. Thispharmaceutical follow-up approach should make it possible toundertake a multidisciplinary collaboration.
P-342
Preliminary studies using wearable motion sensors to identify
elderly persons with Parkinson’s Disease
M.E. Williams 1 , J.W.E. Williams 2 , J.C. Williams 3 . 1 UNC Chapel Hill
USA; 2 McGill University Canada; 3 UNC Wilmington USA
Introduction: Small wearable microelectronic sensors (accelerometers) can detect motion, gravitational acceleration, and velocity
with six degrees of freedom (forward-backward, up-down, andside-to-side plus rotational vectors). The purpose of this study was
to test the feasibility of using these motion sensors to create new
analytical tools called biokinetographs (BKGs) to identify persons
with Parkinson Disease (PD).
Methods: Twenty-two members of a PD support group with clinically diagnosed PD (mean age 68.6) and seventy-six members of alife-care community (mean age 80.3) agreed to participate. Subjects
wore wristwatch-sized accelerometers attached with Velcro straps
on their right wrist, sacrum, and over each ankle while walking aclosed 30-meter course.
Results: Principal component analysis of the ankle sensor BKGs
identiﬁed gait speed, right single stance time, double stance time,left heel strike amplitude, difference in toe off amplitudes and left
spectral peak and right spectral frequency as discriminating PD
from no PD subjects. A regression model using these variables identiﬁed 20 of 22 of the people with PD (90.9%) and 71 of 76 people
without PD (93.4%). Remarkable visual differences in “functional
walking signatures” are evident on the BKGs of persons with PD.
Conclusion: We conclude that BKG functional signatures may be
associated with clinically obvious PD and suggest that this area
is rich in potential for additional validation studies using thisobjective, noninvasive, wearable technology.
P-343
Role of dependency on overall survival in elderly cancer
patients: results from a French study
A. Galvin 1 , C. Helmer 2 , C. Bellera 1 , G. Coureau 1 , B. Amadeo 1 ,V. Rondeau 3 , M. Rainfray 4 , P. Soubeyran 5 , F. Delva 1 ,S. Mathoulin-Pélissier 1 . 1 Univ. Bordeaux, Inserm, Bordeaux
Population Health Research Center, Epicene team, UMR 1219,
Bordeaux, France; 2 Univ. Bordeaux, Inserm, Bordeaux Population
Health Research Center, Leha team, UMR 1219, Bordeaux, France;
3 Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center,
Biostatistics team, UMR 1219, Bordeaux, France; 4 Department ofClinical Gerontology, Bordeaux University Hospital, Pessac, France;
5 Clinical and Epidemiological Research Unit, INSERM CIC1401, Institut
Bergonie, Comprehensive Cancer Center, Bordeaux, France
Introduction: Several population-based studies have reported disparities on survival among elderly cancer patients related to age,gender, marital status, socioeconomic status, stage at diagnosis
and comorbidities. However, these studies did not consider impairments, and none was carried out in Europe. Our aim was to study
determinants of overall survival in French elderly cancer patients.
Methods: We merged data from four cancer registries (one generaland three specialized) and three elderly cohort studies (PAQUID,
3-City and AMI) to identify elderly cancer patients. We included

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subjects aged 65 years and over, alive January 1, 2005 and residentof Gironde, a French department, with a validated cancer diagnosis
recorded in one of the four cancer registries from 2005 through2014. Primary endpoint was all-cause survival. Studied variables
were demographic and socioeconomic, cancer-related, health, dependency, neurocognitive and area factors. Cox proportional hazard
models were ﬁtted.
Results: We included 486 elderly cancer patients, 263 (54.1%) of
which died by the end of the follow-up. In multivariate analyses,
advanced age, male gender, residence in urban area, dependency,
advanced stage at diagnosis and no treatment were associated withlower overall survival (p<0.05).
Conclusions: Association between age, gender and stage and survival are commonly reported in the literature. Regarding treatment,
results are heterogeneous mainly because studies are about speciﬁccancer types and/or treatments. Studies on urban residence arescarce and do not report any association. Dependency has not beenstudied, but studies in the general elderly population report anassociation with survival.

Hospital La Luz and Private consults of Fundación Jiménez Diazprivate geriatric consults that are part of the consultations offeredby Quironsalud. There is also a support team attending surgicalpatients in Hospital Sur of Alcorcon.
Aims: To study the activity of multidisciplinary team and theconsultations in QuironSalud private hospitals to determine futureareas of development.
Methods: Activity of geriatric unit were registered. It was recorded
the number of consultations, also the visits for follow up both
inside and outside the hospitals. E-consults were also recorded.
Results: Consultations of geriatric units receive am average number of 150 patients every month. Surgical support team performs
200 visits every month. Patients with comorbidities or frail weretransferred to consultation.
Conclusions: In the last ﬁve years geriatric consultation is one of
the services offered by Quironsalud Hospital Group. Contributing toincreasing ﬁdelity of elderly patients to our hospital. Also we had
the possibility to create different geriatric circuits in order to work
to different services such as Neurology and Psychiatry.

P-344
Structuring diabetes mellitus care in long term nursing homeresidents

P-346
Telemedecine in nursing homes and geriatric evaluation: An
option to therapeutic optimization. an observational study in
Bordeaux University Hospital

D. Fitzpatrick 1 , E. Ibrahim 1 , S. Kennelly 2 , D. O’Neill 2 , M. Sherlock 3 .
1 Peamount Healthcare, Dublin, Ireland; 2 Centre for Ageing,
Neuroscience and the Humanities, Trinity College Dublin, Ireland;
3 Department of Endocrinology and Diabetes, Tallaght Hospital, Dublin,
IrelandIntroduction: Nursing home residents have more complex careneeds with higher levels of comorbidity, disability and cognitive
impairment. It is estimated that 1 in 4 nursing home residents hasdiabetes mellitus. These patients are particularly vulnerable andrequire special attention.
Methods: We compared current practice in the 44 long term
residents in Peamount hospital with the standards recommended
in the Diabetes UK “Good Clinical Practice Guidelines for Care Home
Residents with Diabetes”.
Results: Of 44 residents, 11 were diabetic. Only one resident was
screened for diabetes on admission. Residents did not have speciﬁc
diabetes care plans. There were no algorithms for the management of hypoglycaemia, hyperglycaemia or diabetic complications.
73% of residents with diabetes had a HbA1c checked in the lastyear, but there was no formal schedule of HbA1c monitoring.
There was no protocol for screening for diabetic foot disease andretinopathy with low uptake of the national retinal screening andfootcare programmes. In house access to dietetics and chiropody
was provided.
Conclusions: Despite some elements of good practice, diabetes care
was delivered on an ad hoc basis without screening for diabetes,
individualised diabetes care plans, documented glycaemic targets,or scheduled monitoring for complications. National and local policy to guide management of diabetes mellitus in long term careneeds to be developed. There should be individualised diabetes
care plans and clear policies for the management of hypoglycaemia,
hyperglycaemia and long term diabetes complications.
P-345
Surgical medical support team of Hospital Sur de Alcorcon andgeriatric unit in Quironsalud Hospital group in Madrid: First
5 yearsF.J. Soria Perdomo, L.M. Martín Rodríguez, J. Ramírez Peñaherrera,
M. Pastor de Blas, C. Sánchez Mingo, R. García de Viedma,
A.M. Moreno Collado. MD Quironsalud Hospital Group, Madrid, Spain
Introduction: Since 2012, in Hospital Quironsalud Sur of Alcorcon,

N. Bourdin, E. Thiel, R. Fossaert, N. Salles. Geriatrics Department of
Bordeaux University Hospital, Pessac, France
Geriatric items represent 62% of teleconsultations currently leadingin Aquitaine for nursing home residents. An observational study was
led since november 2014 to march 2017 for therapeutic optimization evaluation according to the START & STOPP list. A descriptive
analysis and a stepwise logistic regression were performed. Therapeutic optimization represented 86% of total acts. Misuse wasobserved in 55% of cases (neuroleptics – 38%, antidepressants –22%, cardiovascular treatments – 20%), underuse in 53% of teleconsultations (antalgic treatments – 35%, anxiolytics – 24%). Overuseconcerned 11% of cases (anxiolytics – 28%, neuroleptics – 18%, antihypertensive treatments – 10%). Propositions to stop or decrease
dosage was associated with: getting a diagnosis by experts (OR=2,
p=0.004), at least one additional item covered during the teleconsultation (OR=2.5, p<0.0001), the presence during the telemedecine
act of: care assistant (OR=1.6, p=0.03), coordinating doctor (OR=1.7,
p=0.02), and psychologist (OR=1.6, p=0.03). Additional treatment
or increase dosage was associated with: ≥1 comorbidity classiﬁed
Cumulative Index Rating Scale for Geriatrics = 4 (OR=2.5, p=0.021),
at least one additional item covered (OR=1.8, p<0.04), the presenceof: family (OR=1.5, p=0.08), and care assistant (OR=1.8, p=0.008).
Telemedecine represents one solution to therapeutic optimization
for dependant nursing home residents. Its deployment must be
encouraged according to french health autority.
P-347
That’s how I always did it – Adaptability in older people
V. Moser-Siegmeth, D. Hebesberger, M. Weninger, M.-C. Gambal,
M. Jelovcak, B. Prytek, I. Swietalsky, D. Würzl, C. Fida, V. Staus. Haus
der Barmherzigkeit
Adaptability is the capacity to adjust without great diﬃculty tochanging circumstances. Within our project, we aimed to detect
whether older people lose this ability to adapt or not. There islack of evidence in the literature how the adaptability of older
people changes over the time. The following research questions
were generated: (1) Are older residents of a long-term care facility
able to adapt to changes within their daily routine? (2) How long
does it take for older people to adapt? This study was designed asa convergent parallel mixed method intervention study carried out

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

within a four-month period and took place within seven wards ofa long-term care hospital in Vienna, Austria. As a planned intervention, a change of meal-times was established. The inhabitants
were surveyed with qualitative and quantitative questionnaires anddiaries before, during and after the intervention. In addition, asurvey of the nursing staff was carried out in order to detectchanges of the people they care for and how long it took them toadapt. Quantitative data was analyzed with SPSS, qualitative datawith a summarizing content analysis. The results show that theability to adapt to changes does not deteriorate with age or by
moving into a long-term care facility. This can be conﬁrmed by
the nursing staff. Although there are different determinants likethe health status that make an adjustment to new situations morediﬃcult. This study is able to serve as the basis for further research.
P-348
The beneﬁt of mixed methods in a nursing research project
V. Moser-Siegmeth, D. Hebesberger, M. Weninger, M.-C. Gambal,
M. Jelovcak, B. Prytek, I. Swietalsky, D. Würzl, C. Fida, V. Staus. Haus
der Barmherzigkeit
Mixed methods research is an approach to inquiry involving collecting both quantitative and qualitative data. The core assumption
is that the combination provides a more complete understandingof a research problem. In 2016 we initiated a project at sevengeriatric units of a nursing home shifting the mealtimes towards
evening. The aim of this intervention was to assimilate the daystructure of the nursing home towards the day-structure at home
before entering. With the added value of mixed methods we try
to detect whether adaptability gets lost over the time in nursing
home residents. Working systematically through the literature, we
found out that there is paucity of evidence pointing towards themeaning of adaptability. In order to close this gap we exploredthe topic with a convergent parallel mixed method intervention
study by integrating the opinion of nursing home nurses on the one
hand and patients on the other hand. Qualitative interviews andquantitative questionnaires with patients and nurses were carriedout as well as a diary, which was kept by the patients. In ourpresentation we will provide an account of this particular aspect ofthe project and discuss the process of developing a mixed methods
research design. We illustrate how the combination of qualitativeand quantitative methods can help to better understand complex
phenomena like the one under study and we critically appraise thepros and cons of our approach.
P-349
The experience of being a family caregiver in Flanders: Does
tube feeding in patients with oropharyngeal dysphagia affect myquality of life?
T. Claeys. Vives University College, Department of Health Care, Bruges,
Belgium
Introduction: Flanders is facing an increasing number of challenges
such as limited ﬁnancial resources, socio-demographic changes,
rising health care cost and increasing health demands. Due tothis issue a shift from institutional care towards home care isnoted. Many medical conditions, diseases and disorders require theuse of tube feeding in non-institutional settings. For this reason
the importance of informal caregivers is growing in the changing
landscape of healthcare. The objective of this study was to examine
how family caregivers in Flanders experience taking care for adultpatients with oropharyngeal dysphagia who need nutrition support.
Methods: The qualitative methodology for this study was based on
the grounded theory to analyze the experience of being an informal
caregiver. Data were gathered by individual in-depth interviews.
An inductive approach was applied to identify and categorize theS141

data. Selection of participants is based on ad random sampling but
the appropriate number will be guided by data saturation. All indepth interviews were tape-recorded, transcribed and scrutinized
to identify the main themes.
Results: Ten informal caregivers participated the in-depth interviews. Saturation will determine the majority of qualitative sample
size. The basic research question is an opportunity to delve moredeeply into different issues of this topic if we want to investigate
and understand the experiences of informal caregivers in Flanders.
Further interviews are needed.
Conclusions: Informal caregivers do experience important changes
in their lives and informal caregiver burden is well described inliterature. Strategies are needed for family caregivers in Flanders
to help and reduce the psychosocial, occupational and economic
burden associated with informal care.
P-350
The geriatric patient in the global payment with standardization
N. Berg 1 , C. Petit 2 , P. Heirman 3 , N. Laport 4 . 1 CHR de Liege Service degériatrie Belgium nicolas.berg@chrcitadelle.be; 2 CHR de Liège, service
de gériatrie Belgium; 3 CHR de Liège, service RHM Belgium; 4 CHU deLiège, Medical and Economic Studies Department Belgium
Introduction: The Belgian Ministry of Social Affairs and Public
Health together with the National Institute for Health and Disability
Insurance (RIZIV-INAMI) will be introducing a Global Payment withStandardization (GPS) the ﬁrst of January 2018. This is a prospective
hospital payment system for pathologies of low variability. In a ﬁrst
phase, it is estimated that €438 Million remuneration of medical
specialists will now be distributed based on a lump sum per
APR-DRG’s (3M™). This replaces a fee-for-service payment system.
However, this new system doesn’t differentiate between age groups.
The lump sum remuneration per APRDRG will not take in account
if the patient is pediatric, adult or geriatric. Even when the medical
approaches for the same pathology will clearly be very different.
Methods: We examine if it will be relevant to add age or admission
in a geriatric ward as an extra criterion for the 32 APR-DRG’s
adopted in the new GPS system. We use data from two hospitals(one teaching hospital and one general hospital, 800–1000 bedseach). Data from more than 20.000 hospitals stays from patientsolder than 70, hospitalized in 2014–2016 were analyzed.
Results: Data shows that although geriatric patients are not surprisingly more often classiﬁed in pathology groups with a higher
Severity of Illness (less than 5% has a SoI of 1), this is not enoughto explain and compensate the differences observed in medical
approach, measured by the fee-for-service payment.
Conclusions: A reﬁnement of the new GPS system for the geriatricpatient is thus necessary
P-351
The multi-disciplinary team (MDT) is essential to reduce lengthof stay (LOS) in the acute frailty unit (AFU)
S. Mather, S. Pradhan, L. Oldham, N. Gillibrand. Royal Bolton
Hospital, Greater Manchester, UK
Introduction: MDT assessments of patients can improve LOS. We
aimed to assess whether a seven day enhanced therapy service
improved LOS compared to standard ﬁve day in AFU.
Method: A retrospective observational study at Royal Bolton Hospital in Greater Manchester. Patients were admitted from assessmentand emergency departments. The “enhanced” service was from
3/8/2014–31/7/2015 and the ‘standard’ ﬁve day from 18/8/2015–
14/8/2016. Data was collected for demographics, LOS and admission
reason. Our primary outcome was LOS. Our secondary outcomes
were the LOS for patients awaiting 24hour care, intermediate care
(IC), and discharge home. Data was analysed with Excel.

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Results: In 2014/15 1272 vs 946 in 2015/16 were admitted. In
2014/15 common admission reasons were falls (280/22%), respiratory conditions (140/11%), urinary tract infection (UTI) (109/8.6%).
In 2015–2016 common admission were falls (292/30%), respiratory
conditions (66/7%), UTI (95/10%). Average LOS in 2014/15 was
8 days (d) (median=6, n=1272) compared with 10d (median=8,n=946) in 2015/16 (p<0.0000001). Average LOS in 2014–15 of thosedischarged to 24 hour care was 20d (median=17, n=60) and intermediate care was 11d (median=8, n=215). The average LOS in 2015–16
of those discharged to 24 hour care was 21d (median=15, n=33) andintermediate care was 14d (median=11, n=120). The average LOSof those discharged home increased from 5d (median=5, n=504)
in 2014/15 to 6d (median=6, n=297) in 2015/16. Outlying patientswere similar in both groups with 51/31 respectively.
Conclusions: LOS was improved with a seven day therapy service
suggesting that having a proactive therapy team can enhance ﬂow
within an acute unit.
P-352
The ROSIE project. A comprehensive review of ﬁeld trials ofsocial robots in the geriatric sector in France: practices,
socioeconomic aspects and ethical framework
M. Pino 1 , E. Berger 1 , L. Rochaix 2 , J.C. Dupont 2 , B. Dervaux 3 ,I. Dufour 4 , E. Karoubi 5 , C. Monnet 1 , A.S. Rigaud 6 . 1 Gérond’if;
Hôpital Broca-LUSAGE, Paris, France; 2 Hospinnomics, Paris, France;
3 Université Lille 2; 4 Gérond’if, Paris, France; 5 Gérond’if, Hôpital Paul
Brousse, Villejuif, France; 6 Hôpital Broca-LUSAGE, Université Paris
Descartes, CEN Stimco, Gérond’if, Paris, France
Introduction: In France more than 100 geriatric institutions are taking part in ﬁeld trials of social robots. However, results from thesetests are little known. This is mainly due to their exploratory natureand to the discontinuity between research and clinical practices.
Despite the rapid progress of robot-mediated interventions, there is
no guide to best practices in this area. Also, it lacks a consensual
ethical framework to inform these interventions. Moreover, theireconomic and organizational impact have rarely been addressed.
The ROSIE project’s main objective is to conduct a comprehensive
review of recent and current trials of social robots, within the ﬁeldof geriatrics, in France.
Methods: Feedback from ﬁeld trials will be collected through asurvey and a series of case studies. Experiences will be analyzed
adopting a multidimensional perspective (clinical, organizational,
economic, social, ethical, ...).
Results: Outputs of the project will be: (1) an international state-ofthe-art on the use of social robots in geriatrics; (2) a comprehensive
inventory of ﬁeld trials in France; (3) three tools to support the implementation and evaluation of these interventions: best practices
guide, ethical chart, and methodological manual for their economic
evaluation.
Conclusions: Results will help to better understand uses and limitations of robotic interventions: (a) clinical indications, (b) factors
encouraging acceptance and adoption; (c) logistic requirements; (d)resources involved; (e) ethical issues. Besides its focus on these
innovative practices, the project proposes an original approach byrelying on existing trails and capitalizing on them.
P-353
The use of a new telemedicine system in nursing home (NH)C. Dalla Costa, S. Barbieri, A. Bracco, E. Conterno, E. Lenta, L. Neri,D.N. Sabet, G. Viglino. Division of Nephrology, Dialysis and ClinicalNutrition, Department of Medicine, San Lazzaro Hospital, Alba (Cn),ItalyIntroduction: Considering the diﬃculty of ensuring therapeuticcare’s continuity for patients in NH, we started a monitoring projectthrough the use of a speciﬁc telemedicine system called eViSus® .
Aim of this study was to verify the system’s effectiveness in various
therapeutic-care contexts.
Methods: Remote monitoring has been achieved through eViSus® ,composed by:• Totem station in NH: it consists of touchscreen display, highresolution webcam, mic/speaker, PC, and communication box;
• Control Station in hospital: it consists of display, webcam andPC with client software. During the A/V remote sessions theoperator controls zoom and movements of the remote totem
camera.
• Central Control Server: server software in the cloud manages
totem and control stations through encrypted channels preserving communications privacy and integrity.
Results: From August 1st, 2016 to April 30st, 2017 the followings
have been performed:• 107 examinations in malnourished patients. Patient’s clinicalevaluation was always possible;• 6 evaluations of 6 patients suffering from pressure ulcers.
Human resources involved: a medical doctor and a dietician in
hospital and a healthcare assistant in NH. Moreover, NH nurses
were supervised by specialized nurses in hospital in the following
activities (training and retraining):• Vascular device’s medications: 13 video-consults in 6 patients;• Automated Peritoneal Dialysis management: 53 connection/
disconnection procedures in 2 patients.
Conclusions: eViSus® system’s beneﬁts were numerous:• Different clinical evaluations avoiding patient’s transportation;• Better audio/video quality compared to traditional video conferencing devices allowed to replace the face-to-face visit;• Limited needs of human resources;• Educational capability by experienced staff, with the chance ofrepeated audits, eventually practicable also at domicile.
P-354
Value based health care in the elderly hospital population
C.J. Kalisvaart, R. Vreeswijk, D. Zwijnenburg. Spaarne Gasthuis
Based on the research of Professor Porter (Harvard), Value-Based
Health Care is a framework for restructuring health care systems
with the overarching goal of value for patients—not access, cost
containment, convenience, or customer service. It is outcome based.
The International Centre of Health Outcomes (ICHOM) is a leading
initiative for constructing evidence based methods to evaluatepatient based outcomes. In the region of our hospital we decided to
put this into practice for elderly patients with a hip-fracture. Thereis no ICHOM program for elderly patients with hip-fracture, so weconcentrated on the program for frail elderly in combination with
the Dutch hip-fracture audit. Based on these values we analysed
data from previous years and constructed “mirror talks” with patients and their caregivers. From this information we used 6 values
for outcome improvement for the coming 12 months: mortality,
morbidity, delirium, length of hospital stay and costs, length ofrehabilitation and costs and patient experience and satisfaction. We
then divided the hip-fracture pathway into 3 major steps:1. The
patient before the fracture: vulnerable at home or in the nursing
home with all kind of problems (e.g. polyfarmacy, comorbidity,
cognitive disorders and ADL-dysfunction) and (unknown) wishes
regarding to treatment restrictions and rehabilitation institutions.
We developed a leaﬂet for all the frail elderly in our region to store
at home. 2. Intra hospital: from the ambulance to 3. The start ofrehabilitation in a centre or at home. Now we are at a weekly basis
evaluating effects on the 6 outcomes and costs with GP, rehab drs
and (para0medics) to sharpen the program even further. With verysatisﬁed patients.

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P-355
What older adults in Lithuania think about gerontechnologies,
speciﬁcally fall detectors

P-357
A case presentation of a necrotic scalp rash misdiagnosed for a
Herpes Zoster infection

G. Damulevičienė 1 , V. Lesauskaitė 1 , A. Janavičiūtė 2 ,E. Kazanavičius 2 , J. Knašienė 1 , U. Markevičiūtė 1 . 1 GeriatricDepartment, Lithuanian University of Health Sciences; 2 Kaunas
University of Technology, Lithuania

D. Kondova. Department of Geriatric Medicine University Hospitals of
Leicester, United Kingdom

Introduction: Although the Lithuanian population is ageing, theexpectancy of autonomous life in older people remains one of theshortest in Europe. Falls are particularly common in the older population and it is known that over 30% of people fail to get up unaided,
which can result in severe consequences. Fall detection devices can
noticeably reduce the fear of falling and ensure that the person receives aid in time. One of the aims of the research project supportedby the Research Council of Lithuania “Smart Gerontechnology for
Healthy Ageing” (grant No.SEN-06/2016) was to determine theknowledge about various technologies and the opinion about theusage of fall detection devices among older adults.
Methods: 308 patients (≥60 years): 56 patients of Geriatric Department and 252 older adults living in the local community werequestioned about the usage of technologies and their opinion about
fall detectors.
Results: The mean age of respondents was 75.8±6.1 years, 80.2%
were female. A signiﬁcant relationship was found between lower
education and rarer usage of refrigerators, vacuum cleaners andwashing machines, mobile phones and the Internet. A signiﬁcantrelationship was found between higher education and the intention
to test new technical devices (P<0.001). 33% of respondents knew
about fall detection, 80% of respondents wanted to use fall detection
devices, especially females. Only 65.5% of respondents would havethe Internet access if needed for the fall detection.
Conclusions: Older adults with higher education were more informed about technologies. Most of older adults would like to use
fall detectors.

Area: Acute careP-356
A case of Cefepime-induced encephalopathy in an elderly patientJ. Cabradilla, E. Marasigan, D.Y. Yoong. Tan Tock Seng Hospital,
Singapore
Cefepime-induced encephalopathy has been sporadically reported
worldwide. Previous reports documented cases of encephalopathy
and seizures especially in patients with renal impairment. We
report a case of an elderly gentleman with diabetic nephropathy
who was given Cefepime. Cefepime was empirically started forcatheter-related UTI and dose adjusted according to the creatinine
clearance. On the 3rd day of Cefepime, patient developed oral
and upper limb dyskinesia together with altered mental status.
Blood tests did not show any electrolyte imbalances. Urine andblood culture were negative. Magnetic resonance imaging of thebrain was negative for any acute lesions. Electroencephalogram wassuggestive of severe diffuse encephalopathy. Cefepime was immediately discontinued. Patient received anti-convulsant medications
to cover for a possible seizure. Within 4 days of discontinuing Cefepime, there was complete resolution of the symptoms and patient
returned to his baseline sensorium. Based on this case, Cefepimeinduced encephalopathy can still occur despite administering a
renally adjusted dose. Closer monitoring of patients with renal
impairment given Cefepime should be done especially in elderly
patients. A revision of the recommended dose may be needed forelderly patients with renal impairment.

Introduction: Giant cell arthritis (GCA) is the most common formof systemic granulomatous vasculitis in elderly. Scalp necrosis is arare unusual complication and can be the ﬁrst presenting feature of
GCA.
Methods: I am presenting a case of necrotic lesion affecting righttemporoparietal area in a 75 years old man.
Results: The man presented to his GP with a necrotic skin rashwith a size of ﬁve pence coin which was tender on palpation.
He received a seven-day course of Acyclovir as it thought to be
Herpes Zoster infection. The lack of resolution of symptoms post
the antiviral treatment prompted the GP to seek second opinion.
This man had a history of lethargy and a stone weight loss for aperiod of 4 month. He denied any other constitutional symptoms,
polymyalgia symptoms or jaw claudication. He did not complain ofheadache but he reported tenderness at the abnormal area of skinnecrosis and the adjacent vessel. On clinical examination, there wasevidence of necrotic round skin lesion in the temporoparietal area
and tender on palpation prominent vessel attached to it. The lesion
was covered by a scab. There was no tongue necrosis or visual ﬁeld
defect. The biochemical markers for inﬂammation were raised. The
differential diagnosis of GCA came as a possibility and this was
conﬁrmed with the temporal artery biopsy.
Conclusion: Skin necrosis is a rare clinical presentation of GCA.
Clinically, it might be misdiagnosed as erosive pustular dermatosis,
pyoderma gangrenosum or herpes zoster infection.
P-358
Acute confusional syndrome in the elderly – case report
M. Gonçalves, L. Brites, E. Gaspar, M. Veríssimo. Internal Medicine
Service of Centro Hospitalar e Universitário de Coimbra
The acute confusional syndrome is a frequent reason to attend theemergency department (ED) in the elderly. It is an entity characterized by altered state of consciousness, global affection of cognitive
functions, disorientation, psychomotor agitation/inhibition, andsleep-wake disorders, which arise suddenly, may be ﬂuctuatingor recurrent, and being most often associated with infection or
iatrogeny. A 74-year-old woman went to the ED for disorientation
and agitation with 4 hours of evolution. She was disoriented,
non-cooperative, verborreic, subfebrile (37.8°C), hemodynamicallystable, with no other changes. Analytically, leukocytosis (12,400
G/L) and anemia (hemoglobin 11.4 g/dl). Chest X-ray and rapid
urine test not suggestive of infection. Computed tomography (CT)showed multiple expansive lesions with surrounding edema andleft midline deviation, suggestive of brain metastases. She wasadmitted in the internal medicine department to investigate thepossibility of occult neoplasm. Several complementary diagnostic
tests were performed, including thoracoabdominal-pelvic CT scanshowing pericymetric nodules in the liver and an area of eccentricparietal thickening in the sigmoid loop compatible with primarytumor lesion. Rectosigmoidoscopy with a biopsy conﬁrmed a presence of adenocarcinoma. During the hospitalization she maintained
corticotherapy with dexamethasone and, even after performing palliative cerebral radiotherapy, remained confusional. Thus, she wasreferred to a Palliative Care Unit after consensus in the therapeutic
decision meeting. The acute confusional syndrome in the elderly, as
demonstrated, requires high clinical suspicion, special attention toclinical data and a careful selection of complementary exams to the
etiological diagnosis and for a correct therapeutic approach.

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P-359
An early geriatric follow-up visit results in more
hospital-initiated treatments compared to an early geriatricfollow-up phone call
L. Holst Pedersen, I. Barat, M. Gregersen, E.M. Damsgaard. Aarhus
University Hospital, Aarhus, Denmark
Introduction: In a previous study, we found that an early geriatricfollow-up visit signiﬁcantly reduced readmissions among geriatricpatients admitted to the emergency department (ED). This effectwas strongest the ﬁrst week after discharge. Therefore, we investigated and compared hospital-initiated treatments performed
during the ﬁrst week after discharge in the intervention group andthe control group, respectively.
Method: The study was a quasi-randomised controlled trial. The
participants were 75 years or older, admitted to the ED with
one of the following diagnoses: pneumonia, chronic obstructive
pulmonary disease, dehydration, delirium, constipation, anaemia,
heart failure, urinary tract infection or other infections. Patientswere discharged directly from the ED. Intervention group patients
received a follow-up visit, the patients in the control group received
a phone call. Hospital-initiated treatment was registered throughpatient records.
Results: Treatment of 524 patients was registered from 1th December 2015 until 31th November 2016. During the ﬁrst week
after discharge more patients of the intervention group experienced
changes in medication (77% vs 24%, <0.001), blood tests (57% vs23%), increase in the amount of home care (17% vs. 6%p<0.001),
and treatment with iv. antibiotics in the home (9% vs. 5%, p=0.05).
Also, a tendency towards more patients having ﬂuid replacement
therapy was observed (15% vs. 10%, p=0.09).
Conclusion: An early geriatric follow-up visit resulted in more
hospital-initiated treatments compared to an early geriatric followup phone call.
P-360
Anticholinergic burden scales disagree on degree of burden in
an older inpatient population
C. Adams 1 , T.J. Welsh 2 . 1 Royal United Hospitals Bath NHS Foundation
Trust; 2 Royal United Hospitals Bath NHS Foundation Trust; Universityof Bristol
Introduction: Medications with anticholinergic properties arewidely used in clinical practice. The concept of cumulative anticholinergic burden is widely accepted and has been associatedwith adverse outcomes. Any attempt to reduce anticholinergic burden relies on the methods used to quantify it. This abstracts reports
work from a quality improvement cycle testing the agreement
between different anticholinergic burden scales on a cohort of older
patients admitted to an acute frailty unit.
Methods: A retrospective review was completed of the ﬁrst 100
admissions to the acute frailty unit from the 1st of February 2017.
Medication on admission was recorded. Anticholinergic burden wasthen calculated using the Anticholinergic Cognitive Burden Scale(ACB), the Anticholinergic Risk Scale (ARS) and the Anticholinergic
Drug Scale (ADS). The median score per patient was compared.
Results: Data was available from 86 admissions. Mean age 83(SD 7.5), 63% female. There was a signiﬁcant difference in mediananticholinergic burden as quantiﬁed by the different scales ACB
1 (IQR 0–3), ARS 0 (IQR 0–1), ADS 1 (IQR 0–2) P<0.001. There
was a clinically signiﬁcant difference in those identiﬁed as having
signiﬁcant anticholinergic burden ACB 23 (27%), ARS 12 (14%) and
ADS 18 (21%).
Conclusions: The different scales do not agree on the cumulative
anticholinergic burden experienced by individuals in this patientgroup. The clinical use of different scales to target and reduce anti-

cholinergic burden would result in meaningfully different changes
to medication for patients. These ﬁndings are highly relevant to thedevelopment of potential interventions to reduce anticholinergic
burden.
P-361
Are patients who are admitted following a fall more likely tohave a multi-factorial falls risk assessment (MFRA) than thoseadmitted for other reasons?
N. Vasilakis 1 , S. Rai 1 , C. Tsang 2 , S. O’Riordan 1 . 1 The Royal College ofPhysicians, London, UK; 2 The Royal College of Surgeons of England,
London, UK
Introduction: The National audit of inpatient falls (2015) evaluatedhospital services primarily against NICE CG161 which makes recommendations to prevent falls for all hospital inpatients aged 65+.
This included a case note review of up to 30 patients (per hospital)
aged 65+ who were admitted for any non-elective reason (not justfalls).
Methods: Using 23 questions in the audit relating to MFRA, comparisons were made between patients who were admitted for a fallor other reasons. The two patient groups were compared using theMann-Whitney test or chi-square test, as appropriate.
Results: Approximately a quarter of patients were admitted because of a fall (23.5%; n=1,140/4,846). 12 of the 23 audit questions
were statistically signiﬁcantly more frequently reported for patients
who were admitted because of a fall (p<0.05): 1. Asked about
history of falls; 2. Assessed for cognitive impairment; 3. Assessedfor presence/absence of delirium; 4. Assessed for fear of falling; 5.
Mobility care plan; 6. Record of use of walking aids; 7. Lying andstanding blood pressure measured; 8. Assessed for medications that
increase falls risk; 9. Medication review with regard to falls risk; 10.
Falls care plan; 11. Given written information about falls risk; 12.
Given oral information about falls risk.
Conclusions: NICE CG161 states that all patients aged 65 years orolder (not just those admitted following a fall) should be considered
for a MFRA however, a range of assessments and interventions forprevention of falls were statistically more frequently reported forpatients admitted because of a fall than for other reasons.
P-362
Atypical illness presentation in elderly patients evaluated in theemergency room
O. Saavedra 1 , M. Bermudez 1 , B. Cámara 1 , G. Guzman 1 , B. García 1 ,M. Fernández 1 , C. Herrera 1 , J.J. Solano 2 . 1 Hospital Monte Naranco,
Oviedo, España; 2 Director of the eldery medicine department at
Hospital Monte Naranco, Oviedo, España
Introduction: Elderly patients with an infectious disease, frequently manifest atypical symptoms which implies greater diﬃculty in making a proper diagnosis. Our objective was to determine
the incidence of atypical symptoms in elderly patients evaluatedby a team of geriatricians in the emergency department and thedifferent forms of presentation of the disease.
Methods: We conducted a prospective descriptive study on 148 elderly patients presented at the emergency unit and diagnosed withpneumonia or urinary tract infection. Pneumonia was establishedas the appearance of pneumonic condensation in Rx and urinary
infection as the existence of pyuria in the urinary sediment.
Results: A total of 148 patients were included, with a mean ageof 87.5 years. 60.1% had pneumonia and 39.9% had a urinary
tract infection (UTI). 54.1% were women, the average Barthel Index
was 55 points, 45.3% had cognitive impairment and 58.8% lived
with family. According to the triage Manchester were classiﬁed asminimum Urgent (yellow) 96.4%. 73.6% of the patients presented
some atypical data (Pneumonia 66.3%, UTI 84.7%), in 27% of thePoster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

cases the clinic was exclusively atypical (Pneumonia 11.2%, UTI51%). Patients with IB <40 or with cognitive impairment are more
likely to present atypical clinic. We found no association between
atypical clinical presentation or cognitive impairment and death
during hospitalization.
Conclusions: Atypical illness presentation in elderly patients in theemergency department is highly prevalent, more common in patients with cognitive and/or previous functional impairment. These
conditions were associated with higher mortality during admission.
P-363
Audit presentation on CT head requests in patients over the ageof 70 presenting to acute admissions units at Leicester RoyalInﬁrmary, United Kingdom
D. Kondova 1 , F. Mehedi 1 , C. Phyu 2 , D. Lachani 1 . 1 Department ofGeriatric Medicine, University Hospitals of Leicester, United Kingdom;
2 Department of Acute Medicine University Hospitals of Leicester,
United Kingdom
Introduction: CT head (CTH) is an increasingly frequent investigation among elderly patients. It is commonly used in the assessmentof CVAs; dementia; falls; acute neurological illness and staging of
tumours. There is evidence that CT head is routinely requested
to investigate patients with confusion, despite recommendations
against the routine use. We conducted an audit looking at the
CT head requests among elderly patients admitted in the Acute
Medical Units at Leicester Royal Inﬁrmary.
Method: We audited notes of 80 patients admitted in admissions
units at LRI who had CT head between November 2016-January
2017. We looked at:• Most common reasons for CTH requests.
• Were the requests in line with the current existing guidelines for
CTH requests?
• Most common reasons for CTH requests in confused patients andtheir justiﬁcation.
Results: Common reasons for CTH requests: Fall and head injury(35%), Fall without head injury (32%), confusion alone (25%), other(8%). 66% urgent (1 hr) CTH requests were not in line with the current NICE guidelines for CTH requests in head injury & stroke.30% of
CTH requests for delirium/confusion could be classiﬁed as low risk
& inappropriate. Out of 77, 30 (39%)had previous CTH in 12 months& 16 (53%) were for same reason. 78% of CT scans requested did notshow acute changes.
Conclusion: There would appear to be tendency to over investigate
with CT head. We continue to order CT head in patients admittedwith delirium (without always documenting guideline –compliant
reasoning). There appear to be a lack of appreciation of guidelines
when CT head were requested.
P-364
Barriers to older medical patient walking in hospital
R. McCullagh 1 , D. Dahly 2 , N.F. Horgan 3 , S. Timmons 4 . 1 Centre forGerontology & Rehabilitation, School of Medicine, University College
Cork; 2 Health Research Board-Clinical Research Facility, Cork, Ireland;
3 School of Physiotherapy, Royal College of Surgeons in Ireland, Dublin;
4 Centre for Gerontology & Rehabilitation, School of Medicine,
University College Cork, Ireland
Background: We aimed to identify patient- and time-speciﬁcbarriers to walking among older medical inpatients.
Methods: 154 medical inpatients aged ≥65 years, premorbidly
mobile, with an anticipated length of stay ≥3 days, were recruited.
Step-count (Stepwatch Activity Monitor) and potential barriers towalking were recorded daily until discharge or for a maximumof ﬁve weekdays. These included medical status, walking ability,
tethering to the bed, agitation/confusion, reported fatigue, pain,

S145

fear of falling, and instructed bed-rest. Linear mixed effects models
were used to measure the associations between log-transformed
daily step-count and potential barriers, adjusting for patient characteristics on admission: demographics, physical performance (SPPB),
number of medications, and illness severity (CIRS-G).
Results: Complete data existed for 147 patients. In the fully adjusted
mixed effects model, walking increased linearly (12%, 95% CI: 2%
to 23%) for each observed day. However, the mixed effects modelwith patient-level random intercept and slope factors ﬁt the data
best, suggesting there was considerable patient-level variability instep-count. The ability to walk independently was associated withmore daily walking (46%, 95% CI: 12% to 91%); while a fear of falling(−27%; 95% CI: −46% to −1%), tethering to the bed (−21%; 95% CI:−39% to −3%) and instructed bed-rest (−68%; 95% CI: −78% to −47%)
were associated with less walking.
Conclusion: Daily walking was variable, even when adjusted forpatient characteristics on admission. The results suggested thatpatients tethered to the bed, unable to walk independently, andfear falling may require more support to walk in hospital.
P-365
Beneﬁts of an In-reach programme & Emergency Care Bundle forpatients with idiopathic Parkinson’s disease
A. Thomson 1 , R. Irving 2 , C. Miller 1 , L. Partington 1 , P. Cotton 1 .
1 Salford Royal Hospital; 2 HEE-NW

Introduction: Previous analysis of unplanned admissions in patients with idiopathic Parkinson’s disease (iPD) to our hospital in2014 identiﬁed opportunities to improve speciﬁc areas of care. The
aim of this study was to determine the beneﬁts of introducing a
reliable, structured assessment protocol to this group of patients.
Methods: A daily, Geriatrician-led in-reach visit to the Emergency
Assessment Unit of a University teaching hospital was commenced.
This incorporated an Emergency Care Bundle to prevent and address
harms arising from medication errors, missed delirium and otherelements of essential care. The project was deployed from August
2015. After a 12-month period, data was collated retrospectively
and analysed. This was compared with the 2014 cohort.
Results: 90 patients (male 58.9%, mean age 77.3 years) accounted
for 134 admissions. Mean age, sex and dementia prevalence (34.4%)
were similar between the 2014 and intervention cohorts. 86/134(64.2%) admissions were seen by the in-reach team. An increase in
the proportion of patients seen within 24-hours of admission wasobserved from 8.8% to 61.2%, and a fall in those never seen from
65.4% to 23.9%. There were improvements across the spectrum of
medication errors, but particularly a fall in missed doses (24.3% to16.6%). There was a rise in detection of delirium (22.1% to 29.1%)
and fall in median length of stay by 2 days.
Conclusions: Introduction of this simple, cost-effective intervention improved quality markers of care, reduced potential harms andenhanced patient ﬂow, with additional beneﬁts in staff educationand expressed patient/caregiver satisfaction.
P-366
Black and Blue... and Yellow
R. Hinton, S. Ponnambath, F. Rickard, A. Miller, R. Patel, R. Belcher,
R. Preskey, D. Betney. University Hospitals Bristol NHS Foundation
Trust, Bristol, United Kingdom
Case report: A 77 year old lady with no medical history wasadmitted after a fall with a long lie. On examination she was noted
to be jaundiced with scleral icterus, with confusion and signs ofhead injury. Blood tests showed macrocytic anaemia (Hb 90, MCV108), platelets of 25, CK of 2860. Bilirubin was 28, with an ALTof 70 and ALP of 37. The CRP was raised and renal function wasacutely impaired. The initial differential was between a hepatic or

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haemolytic cause. She was treated with ﬂuids and antibiotics forsepsis of unclear source. Abdominal ultrasound was normal. She
was reviewed by Haematologist who felt her symptoms could be
explained by B12 deﬁciency and advised intramuscular B12 replacement whilst awaiting the results of haematinics and haemolysis
screen. Direct Coombs test was negative, folate was normal, but
B12 level was markedly low at 50. Reticulocyte count 46.1 10 9/L.
Blood ﬁlm showed red cell anisopoikilocytosis, with oval macrocytes, no evidence of polychromasia, true thrombocytopenia, andneutrophilia with hypersegmented neutrophils. This blood ﬁlm wassuggestive of B12 or folate deﬁciency. Collateral history revealed she
had poor diet for some years. After starting intramuscular hydroxocobalamin there was good reticulocyte response and normalisationof platelets.
Conclusion: Vitamin B12 deﬁciency is a familiar cause of low cellcounts, but is less well known as a rare but recognised cause of
jaundice due to high conjugated bilirubin. Untreated the haematological and neurological sequelae may be severe, and prompt
recognition and treatment is essential.
P-367
Bleeding risk with direct oral anticoagulant and vitamin K
antagonist in geriatric patients
F. Labouree, C. Boully, A.-C. Cadilhac, L. Caillard. Co-author
Background: Few “real world” data with direct oral anticoagulants(DOAC) are available in geriatrics population Objective: To compare
the risk of bleeding in very old patients with non valvular atrial
ﬁbrillation (NVAF) hospitalized in geriatric care, receiving DOAC orvitamin K antagonist (VKA), with a follow up of one year.
Methods: Prospective, observational study in very old patients
hospitalized in geriatric units with NVAF, included between January
2013 and June 2014. Follow-up data (bleeding events or death wereobtained by phone calls to the General Practitioner. Major or non
major bleeding events were deﬁne according the ISTH criteria. Risk
factors of hemorrhages were estimated using a logistic regression.
Results: Four hundred and forty-one patients (71% were female)
were included (300 VKA and 151 DOAC users). Mean age wasrespectively 87.1 (SD 5.4) and 85.7 (SD 5.1) years. In the overall
population mean MMSE was 19.1 (SD 7.2), HASBLED score was 2.3(SD 0.9). Cockcroft creatinine clearance was 48.8 (SD 22.1) ml/min,albumin was 31.4 (SD 5) g/l. During the one year of follow up, 103
bleedings outcome were reported, with a lower tendency in the
DOAC group (19.9%) compare to the VKA group (24.3%), p=0.06.
Risk factor of bleeding with VKA were history of bleeding (OR:5.36 (95%CI, 1.69–16.98)), creatinine clearance <40ml/min (OR:2.30 (95%CI, 1.13–4.68) and hypoalbuminemia (OR: 2.03 (95%CI,
1.06–3.90)). Risk factor of bleeding with DOAC was a lower platelet
rate <250000/mm3 (OR: 2.69 (95%CI, 1.06–6.85)). Death rate wassigniﬁcantly lower in the DOAC group (21.8%) than in the DOAC
group (33.3%), p=0.005.
Conclusion: These “real world” data in geriatrics population indicate that DOAC are well tolerated in comparison to VKA. Further
studies in larger population are necessary to conﬁrm these results
P-368
Can we modify the functional and cognitive trajectory in a
hospital with exercise? A randomized clinical trial
N. Martinez-Velilla 1 , A. Casas-Herrero 1 , M. Lopez Sáez De
Asteasu 2 , F. Zambon Ferraresi 2 , M. Gutiérrez-Valencia 1 , F. Amu
Ruiz 2 , J.A. Renedo 1 , B. Gonzalez Glaria 1 , M. Gonzalo Lazaro 1 ,M. Izquierdo 2 . 1 Servicio de Geriatria. Complejo Hospitalario deNavarra, Pamplona, Spain; 2 Universidad Publica de Navarra,
Pamplona, Spain
Introduction: Frail older adults have reduced functional and phys-iological reserves, rendering them more vulnerable to the effects
of hospitalization. Despite the theoretical support for the idea thatexercise can prevent nosocomial disability, this idea has not been
fully translated into clinical practice.
Methods: Randomized clinical trial in patients admitted to a Department of Geriatrics. Patients who met inclusion criteria wererandomly assigned to the intervention (IG) or control group (CG).
The intervention consisted of a multicomponent exercise training
programme, composed of supervised progressive resistance exercise training at low-moderate intensities, balance-training, andwalking for 5–7 consecutive days. Evaluations of function, cognition,
depression and quality of life have been conducted at admission
and previous to discharge.
Results: 267 patients have completed pre/post evaluations. Control
group (CG) n=141, intervention group (IG) n=126). Dropout has been
59, due to different medical reasons. Mean age was 87.10, mean
BMI 27.16, mean CIRS-G 12,04, mean MNA 23.41. In the IG, signiﬁcant improvements were observed after the intervention in all
the variables related with function: SPPB, gait speed, handgrip andBarthel (p<0.01), cognition MMSE, TMT-A, Isaacs test (p<0.005),
depression: Yesavage 15 (p<0.05), quality of life: EQ-5D (p<0.05)
and pain (p<0.05). The CG had no signiﬁcant improvements in anyof the cognitive, mood or quality of life parameters studied.
Conclusion: An individualized multicomponent exercise programis a feasible and an effective therapy in frail older adults admitted
to a Department of Geriatrics and should be prescribed routinely
P-369
Causes and impact of surgical delay in patients undergoing hip
fracture
C. González-Villaumbrosía, M.E. Baeza-Monedero,J. Martínez-Peromingo, C. Oñoro-Algar, B. García-Martín,
A. Castañeda-Pastor, O. Caamaño-Selma, R. Barba-Martín. Hospital
Rey Juan Carlos, Madrid, Spain
Objective: To study the causes of surgical delay (SD)-more than
48hours since the admission-, in patients with hip fracture and theimpact in the hospital stay, thefunctional impairment, complications and mortality.
Methods: Observational study prospective that includes all patients
admitted for fracture since 1st July 2015 and 15th February 2017
in a secondary hospital in Madrid. We did a descriptive analysis of
the population characteristics, as well as an univariate analysis ofdifferences between the two groups of patients to study (patient
without SD and with SD more than 48 hours) by χ2 test and T for
independent samples.
Results: n: 286 patients, of which 273 were treated surgically(95.5%). Of these, 61.9% was operated in the ﬁrst 48 hours, 9.9%
had SD due to treatment with anticoagulants or antiplatelet drugs,
6.2%b y clinical instability and 20.1% by logistical problems. Analyzing the causes of DQ for days in the week, it was noted that only
18% of the patients who came to the emergency room on Friday wasintervened in the ﬁrst 48 hours in front of the 71.7% of the rest of
the week days (p<0.001), due to logistical problems (52% vs. 13.9%
respectively, p<0.001). Mortality, theaverage of complications andfunctional decline showed no statistically differences between thepatients with SD and without SD. The hospital stay was higher,
however, in patients with SD (12.9 Vs 10.3, p=0.007).
Conclusion: A high percentage of patients admitted for hip fracture
does not intervene in time recommended by clinical guidelines due
to logistical problems, being especially important in patients thatare admitted in weekend. The SD was associated with a higher
hospital stay, not existing in the present study differences between
both groups in mortality, complications and functional impairment.

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

P-370
Clinical impact of a clinical pharmacist team’s interventions inacute geriatric ward
M.-A. Cerfon 1 , J. Bonhomme 1 , A. Vignoles 2 , M. Haution-Bitker 2 ,C. Falandry 3 , M. Bonnefoy 2 , C. Rioufol 4 , S. Parat 1 . 1 Dépt. de
Pharmacie Clinique et Médicaments - GH Sud Hospices Civils de Lyon;
2 Service de Court Séjour Gériatrique - GH Sud Hospices Civils de Lyon;
3 Service de SSR Gériatrique - GH Sud Hospices Civils Lyon; 4 Dépt. de
Pharmacie Clinique Ontologique - GH Sud Hospices Civils de Lyon
Elderly patients are at increased risk of drug related problem(DRP) due to polypharmacy, pharmacokinetic and pharmacodynamic changes. In order to prevent and reduce DRP, a ward-based
clinical pharmacist team conducts medical review in an acutegeriatric ward. The objective of this study was to assess clinical impact of pharmacist’s intervention (PI) on DRP identiﬁed on elderly
hospitalized patients.
Methods: This prospective study was conducted in a 24-bed acutegeriatric unit of a French university hospital from December 2016
to April 2017. Type of DRP and PI, deﬁned by the French Society ofClinical Pharmacy’s (SFPC) codiﬁcation, were collected. PI’s clinicalimpacts were assessed by a panel of nine geriatricians with the
French validated tool CLEO of SFPC (6 levels: vital, major, moderate,
minor, null, and negative).
Results: Total of 135 PIs were analyzed on 82 patients. Meanage were 84.7±6.8 years and mean number of medication 7.9±3.6
per patients. Geriatricians have accepted 97/135 PI. Most involved
drugs were psychotropic, antithrombotic and analgesic drugs. Geriatricians’ panel considered clinical impact of PI as: 3.7% vital,
17% major, 20.7% moderate, 37% minor, 12.6% null. 6.7% would
have compromised the vital prognosis of the patient if PI were
accepted by geriatricians. 80% of vital PI concerned drug induced
QT syndrome and torsades de pointe.
Conclusion: The work of clinical pharmacist team permitted to
avoid 1 vital DRP per 15 patients. Active involvement of clinicalpharmacists in geriatric team leads to optimize drug therapies andensure medication safety in elderly hospitalized patient.
P-371
Community based urgent care: An alternative to hospital
admission
N. Nidh, P. Sarin, R. Keelan. University Hospital of South Manchester
NHS Foundation Trust. UK
Introduction: The current and projected rise in the elderly population is putting traditional NHS care under unprecedented pressure.
It has been estimated that up to 12% attendances to A+E could
have their needs met elsewhere [1]. The recently published NHS 5
year forward view requires care providers to integrate care more,with a focus on out of hospital care [1]. The Integrated Community
Urgent Care Service in South Manchester was designed to meet thisneed. The urgent care team is an integrated team which includes
community nurses and social work assessors. Referrals are invitedfrom any health or social care staff when it is identiﬁed that an
urgent assessment and needs based care plan are required within
24 hours.
Methods: The service gathers data on reasons for referral andoutcome of assessments. This data is gathered contemporaneously
and this study has looked at 4 months of data.
Results: A total of 259 calls were received.154 (59.5%) were referredto the urgent care team for assessment and 105 were forwarded
straight to another appropriate community service.132 (85.7%) wereconcerning admission avoidance.9 (5.8%) were from A+E relating toadmission deﬂection.13 (8.5%) were regarding supporting transfer
of care back into the community. Only 2 people required hospital
admission following assessment.

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Conclusions: The Integrated Urgent Care Service has demonstrated
that an integrated health and social care assessment team canfacilitate the co-ordination of local care in the community, avoiding
unnecessary hospital admissions.
References:[1] NHS England (2017) NHS Five Year Forward View, Available at: https://www.england.nhs.uk/ﬁve-year-forward-view/next-steps-on-the-nhs-ﬁve-year-forward-view/ (Accessed: 14th
April 2017).
P-372
Comparison of independent predictors of emergency
department length of stay in the 70+ population in the Nijmegenregion, The Netherlands
Ö. Sir 1 , Y. Schoon 2 . 1 Department of Emergency, Radboud University
Medical Center, Nijmegen, The Netherlands; 2 Department of Geriatrics,
Radboud University Medical Center, Nijmegen, The Netherlands
Introduction: The amount of older patients attending the emergency department (ED) is increasing and contributing to crowding
at the ED. Therefore, predictors for prolonged ED length of stay
(ED-LOS) in the 70+population was examined.
Methods: All patients ≥70 years who visited the ED of two hospitals, of which one university hospital (Radboudumc) in the year
2014 were included. A random selection of 2000 patients in eachhospital was made. Data was collected retrospectively by examining
all 4000 medical ﬁles. Prolonged ED-LOS was deﬁned as a length ofstay that lasted longer than 75th percentile of ED-LOS in the study
population. Independent predictors of ED-LOS were established bylogistic regression analysis.
Results: The 75th percentile of ED-LOS in Radboudumc was 293
minutes (mean 230, SD 115.5), versus 240 minutes in other hospital(mean 189, SD 91.1). All patient and visit characteristics differ
signiﬁcantly between hospitals (p<0.05), except for part of the day(p=0.79) and part of the year (p=0.12) on arrival. In both hospitals
matching predictors for prolonged ED-LOS were, respectively: seenby specialism internal medicine (OR 2.7, 95% CI: 1.9–3.8; OR 3.0,
95% CI: 2.3–4.0); total amount of diagnostics and treatment (OR1.5, 95% CI: 1.4–1.7); total amount of consultations (OR 2.3, 95% CI:
1.9–2.8; OR 2.6, 95% CI: 2.1–3.3); being hospitalized (OR 1.4,95%,
CI: 1.1–1.9; OR 2.6, 95% CI: 2.1–3.3) and moderate urgency category(OR 2.8, 95% CI: 2.0–4.1; OR 1,3, 95% CI: 1,003–1,8). Age, cognitive
impairment, polypharmacy or higher co-morbidity index were notassociated with prolonged ED-LOS.
Conclusions: Seen by specialism internal medicine, higher amountof diagnostics and treatment, higher amount of consultations, amoderate urgency category and being admitted to hospital werematching predictors for prolonged ED-LOS of both hospitals.
P-373
Determinants of self-rated health in older adults before andthree months after an emergency department visit:a prospective study
F.J. van Deudekom 1 , J. de Gelder 1 , J.A. Lucke 2 ,A. Oostendorp-Lange 1 , S. Anten 3 , G.J. Blauw 1 , B. de Groot 4 ,S.P. Mooijaart 5 . 1 Department of Gerontology and Geriatrics, Leiden
University Medical Centre, Leiden; 2 Department of Gerontology andGeriatrics, Leiden University Medical Centre AND Department ofEmergency Medicine, Leiden University Medical Centre, Leiden;
3 Department of Internal Medicine, Alrijne Hospital, Leiderdorp;
4 Department of Emergency Medicine, Leiden University Medical
Centre, Leiden; 5 Department of Gerontology and Geriatrics, Leiden
University Medical Centre AND Institute for Evidence-Based Medicine
in Old Age (IEMO), Leiden, The Netherlands
Introduction: Older patients often experience adverse health out-

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comes after an Emergency Department (ED) visit which potentiallyaffects self-rated health (SRH). We investigated the determinants ofdecline in SRH during three months after an ED visit.
Methods: This was a multi-center prospective cohort study including acutely presenting older (≥70 years) patients in the Emergency
Department (The Netherlands). Patients were asked to self-rate
their health prior to the acute disease episode between 0–10, anda geriatric assessment was administered. The main outcome was a
decline in SRH deﬁned as a transition of a SRH ≥6 to a SRH <6three months after the patient’s visit to the ED.
Results: At baseline there were 1219 (81.2%) patients with a suﬃcient SRH and 283 (18.8%) patients had an insuﬃcient SRH. After
three months, 870 patients had a stable SRH (71.4%), 140 patientsdeclined in SRH (11.5%). Independent predictors of decline in SRH
were: male gender (OR 1.84), living in residential care or nursing
home (OR 2.76), number of medications (OR 1.08), using a walking device (OR 1.73) and Katz-ADL score (OR 1.23). Patients withfunctional decline three months after an ED visit, show a steeper
decline in mean SRH (0.68 points) than patients with no functional
decline (0.12 points, p<0.001).
Conclusions Decline in SRH after an ED visit in older patients ismainly dependent on factors of functional capacity and functional
decline. Preventive interventions to maintain functional status
could be the solution to maintain SRH.
P-374
Developing a bedside vision screening tool as part of a multifactorial falls risk assessment (MFRA)
N. Vasilakis 1 , J. Windsor 2 , S. O’Riordan 1 . 1 The Royal College ofPhysicians, London, UK; 2 NHS Improvement, London, UK
Introduction A comprehensive national audit in 2015 of 4,846
patients aged 65+ showed that only 48% of inpatients had a visionassessment by the third day of admission. NICE CG161 states that a
MFRA should identify the patient’s individual risk factors for fallingin hospital and this may include visual impairment.
Methods: The RCP collaborated with the British and Irish Optic
Society, The College of Optometrists, The Royal College of Ophthalmologists and the Royal College of Nursing and NHS Improvement
to produce a straightforward bedside vision check tool.
Results: The tool is designed to alert staff to potential concerns that
can then be discussed with the medical team for evaluation. The
tool contains:• Suggested questions to ask the patient to check general vision.
• Sample visual tests for distance and near vision.
• Information for clinicians about vision conditions common inolder people.
• Guidance for improving immediate safety concerns relating topoor eyesight.
Conclusions: Compared with normal-sighted persons, individuals
with a visual problems are almost twice as likely to fall and tohave recurrent falls and resultant fractures [1,2]. Despite this, arecent audit revealed that less than half of older patients had avision assessment when admitted to hospital. Feedback from auditsite participants made it apparent that clinicians struggled to ﬁnd
a workable, standardised approach to basic vision assessment thatis achievable in an acute hospital setting. We hope by providing clearer guidance may promote a better and more consistent
approach.
References:[1] Legood R, Scuffham P, Cryer C (2002) Injury Prevention 8.(2),
155–160[2] Thomas Pocklington Trust (2013).

P-375
Development of a staff questionnaire for the national audit ofdementia (care in general hospitals)
C. Hood, C. Snowdon. Royal College of Psychiatrists, London, UK
Introduction: The National Audit of Dementia measures the performance of general acute hospitals in England and Wales against
criteria relating to the care of people with dementia. For Round
3 of the National Audit of Dementia, a staff questionnaire wascreated through consultation with frontline hospital staff, allowing
comparison of data given by the hospitals at an organisation level
and the experience of staff working on the wards.
Method: Ten pilot sites took part in workshops to establish questionnaire content and question format. The questionnaire wasdistributed in 199 hospitals across England and Wales to staff
working with adults in inpatient facing roles. Questionnaires werereturned anonymously.
Results: A total of 14,416 eligible questionnaires were returned.
Staff experience was compared with organisational stated practiceon aspects of care. 99.5% hospitals have a system to collect personal
information about the person with dementia. 40% of staff said they
could not access such information. 86% of hospitals have 24-hourfood provision, but 73% staff said they could provide food between
mealtimes. 98% of hospitals reported mealtimes free of clinicalactivity. 68% of staff agreed.
Conclusions: Creating a staff questionnaire for Round 3 allowed
comparison between staff opinions and organisation reporting on
key items relating to information supporting care and patient nutrition. This identiﬁes gaps between hospital policies and practiceat a national and local level.
P-376
Diagnostic eﬃcacy of bedside-ultrasound to detect dehydrationin elderly patients
H. Diederich, H. Burkhardt. Universitätsmedizin Mannheim Geriatrisches Zentrum
Background: To determine whether an elderly patient is dehydrated or not often reveals challenging, as both, clinical andlaboratory signs are unspeciﬁc and may be frequently ﬂawed byage-driven factors.
Methods: Bed-side ultrasound was applied in a random sampleof patients attending an emergency unit. Candidate ultrasoundmarkers had to be easily retrievable by bedside-ultrasound andassociated with changes in ﬂuid balance. Those were analyzed andcompared with the clinical diagnosis. As there is no gold-standard
available in a bedside-setting, a clinical synopsis was applied to
identify patients with dehydration. A control group of patients
without signs of signiﬁcant disturbances of ﬂuid balance was used
as reference.
Results: Following the clinical algorithm 78 patients were classiﬁed as dehydrated and compared with 121 patients without signsof signiﬁcant ﬂuid dysbalance. There were signiﬁcant differences
found between these two groups concerning compressibility, variability of diameter assessed by M-mode and diameter during an
inspiration maneuver of the vena cava inferior (<0.001). However,a ROC-analysis gave only moderate values for diagnostic eﬃcacy for
all these parameters, the best results in this context showed thediameter of the vena cava inferior while an inspiration maneuver
was performed. AUC=0,73.
Discussion: Ultrasound can easily be applied in a bed-side setting
and may support diagnosis of dehydration in the elderly. To conﬁrm
this diagnosis, however, remains challenging and still needs asynopsis covering both clinical and technical data.

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

P-377
Is electroconvulsive therapy effective and safe in elderly withsevere depression?
S. Hammami 1 , A. Mhalla 2 , L. Gaha 2 . 1 CHU F Bourguiba, Department
of Internal Medicine, University of Monastir, Tunisia; 2 CHU F
Bourguiba, Department of Psychiatry, University of Monastir, Tunisia
Background: Depression in late life is an important public healthproblem. Between 30–40% of elderly depressed patients fail to
respond to oral antidepressive treatments. Therefore electroconvulsive therapy (ECT) may be in alternative. The aim of this study wasto assess the eﬃcacy and safety ECT in depressed elderly patients.
Patients and methods: It is a retrospective (2013–2016) study including all inpatients aged over sixty years and treated by ECT for asevere depression.
Results: We gathered six cases, mean age was 65 (60 - 75 years),
83,3% were married and 66,6% had a law educational level Family
history of mental illness was found in 16,6%. Personal history of depressive was found in 66,6%. Medical history of chronic illness wasfound over 33,3% of our patients. In all cases, several antidepressive
oral treatments were tried before the ECT was indicated. The
clinical characteristics were a severe depressive symptoms associated with: cognitive impairment (16,6%), psychotic features (50%),
melancholic features (50%), with both psychotic and melancholicfeatures (33,33%), suicidal thought or attempts (66,6%). The Global
Assessment of Functioning scale increased signiﬁcantly after ECT(25 vs 60, p<0.05). The Hamilton Depression Rating Scale dropped
from 26 to 8 after ECT Incident during the ECT were noted in twocases (teeth and tongue injury and bradycardia).
Conclusion: Although our small sample, the results of our study
suggest that ECT might be an effective and safe technique in elderly.
It has to be considered as an alternative to oral treatment especiallyin resistant depressive episodes.
P-378
Early stage of non-Hodgkin lymphoma diagnosed by biopsy
from head and neck area in elderly
K. Natori, A. Shibuya, D. Nagase, Y. Mitsui, Y. Kuraishi, H. Izumi.
Division of Hematology and Oncology, Toho University Medical Center
Oomori Hospital
Introduction: The malignant lymphoma to develop from lymphoidtissues accounts for a major ratio in hematological malignancies. It
is often that superﬁcial lymphadenopathy is a diagnostic opportunity as for the non-Hodgkin lymphoma (NHL). Performed biopsy,
head and neck area is very easy to approach. We reviewed themalignant lymphoma that led to a diagnosis by the biopsy of thehead and neck area in elderly.
Methods: From 2003 to 2014, we intended for 80 patients whom
malignant lymphoma was diagnosed from head, neck area anddecided clinical stage I and II by Ann Arbor clasiﬁcation. We
studied more than 65years patients about gender, site of biopsy,
pathological ﬁndings, clinical stage, therapy, prognosis.
Results: All cases are 48 cases, male female ration is 25/23, medianage 75years. Site of biopsy, cervical lymph node 17 cases, tonsil
5 cases, oral cavity 6 cases, nasal cavity 5 cases, laryngeal tumor
4 cases, papiloid gland 3 cases, eye lid 2 cases, eye cavity 1 case,maxillary antrum 2 cases. Clinicl Stage by Ann Arbor classiﬁcation,
stageI, 28 cases, II, 20 cases. Pathological ﬁndings, diffuse large B
cell lymphoma (DLBCL) 32 cases, MALT 6 cases, follicular lymphoma
2 cases, NK/T cell lymphoma 2 cases, others 6 cases. About therapy,
R-CHOP therapy or CHOP based therapy 38 cases, radiation therapy
alone 4 case, best supportive care 2 cases, watchfull waiting 2cases, other chemotherapy 2 cases. In DLBCL that was most popular
pathological type, complete response rate was 84.6%, median survival time was not reached, 5-year overall survival was 69.9%, there

S149

were no signiﬁcant diference between male and female, less than
80 years and more than 80 years.
Conclusions: Head and Neck area are very important biopsy site formalignant lymphoma. And very good prognosis in StageI&II elderly
patients. Age was not inﬂuence for clinical outcome in more than
65 years.
P-379
EBV-positive diffuse large B-cell lymphoma of the elderly:
A differential diagnosis for sepsis
R. Ortés-Gómez 1 , G. Lozano-Pino 2 , E. Villalba-Lancho 2 ,E. Pardal-De la Mano 3 . 1 Geriatric Unit, Virgen del Puerto Hospital,
Plasencia (Cáceres), Spain; 2 Geriatric Unit, Virgen del Puerto Hospital,
Plasencia (Cáceres), Spain; 3 Hematology Service, Virgen del Puerto
Hospital, Plasencia (Cáceres), Spain
Introduction: Epstein-Barr virus (EBV)-positive diffuse large B-cell
lymphoma (DLBCL) of the elderly is an uncommon aggressive lymphoma subtype arising in immunocompetent patients >50 years.
Disease in elderly could have an atypical presentation and compromised functioning. We report a fatal case of EBV-positive DLBCL of
the elderly in an 84-year-old man presenting as a respiratory sepsis
and multiorgan failure.
Methods: Mr. E., an 84-year-old man, was admitted to hospital witha 3-days history of asthenia, functional decline, fever, unintelligible
speech, and delusions. It was associated since two months ago
with anorexia, weight loss, and an exertional dyspnea. Imaging
demonstrated pulmonary inﬁltrate at right lower lobe. Mr. E. wastransferred to Acute Geriatric Unit with diagnosis of pneumonia
and delirium. Empirical treatment with antibiotics was started
despite which we observed persistent fever, elevated bilirubin andcholestasis. CT-scan showed pulmonary patched consolidation andretroperitoneal and mediastinal lymphadenopathy.
Results: He developed renal and liver failure, and shock, and he
was referred to Intensive Care Unit. Nevertheless he worsened
with multiorgan failure, metabolic acidosis, and pancytopenia, and,accordingly, it was done bone marrow aspirate. He died sixteen
days after his hospital admission. Bone marrow aspirate showed aneoplastic polymorphous lymphoid population composed of ReedSternberg (HSR)-like cells which expressed CD20, CD30, EBV/LMP
and MUM-1 and the diagnosis of EBV-positive DLBCL of the elderly
was made.
Conclusions: Disease in elderly could have an atypical presentationand compromised functioning. EBV-positive DLBCL is an uncommon
aggressive lymphoma subtype and has a worse survival than would
be expected in patients with EBV-negative DLBCL.
P-380
Education of emergency physicians in geriatrics improveknowledge and skills towards older patients admitted to theemergency department
Ö. Sir 1 , Y. Schoon 2 . 1 Department of Emergency, Radboud university
medical center, Nijmegen, The Netherlands; 2 Department of Geriatrics,
Radboud university medical center, Nijmegen, The Netherlands
Introduction: The amount of older patients attending the emergency department (ED) is increasing. Emergency physicians (EP’s)
regard care for older patients as time consuming and complex,
while they lack suﬃcient geriatric knowledge and skills to provide
adequate and timely care. This study evaluates the effect of a geriatric curriculum on knowledge, attitudes and medical treatment of
EP’s.
Methods: EP’s of an university hospital participated in a one-year
designed geriatric curriculum, started in 2016 with a six-weeke-learning module followed by monthly eigth interactive sessions
by a geriatrician. Effects were measured by multiple-choice knowl-

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edge tests, questionnaires regarding emergency doctor’s attitudes(Aging Semantic Differential and self-perceived knowledge (Needs
Assessment Scale). Also, patient records were judged regarding
presence of geriatric assessment components performed by the EP
before and after the intervention.
Results: 13 EP’s participated, all completed the six-week e-learning
module, monthly session attendance differed between EP’s (mean6.3±2.6 hours). Knowledge on geriatric syndromes increased: before
5.1 versus after 6.8, p<0.01. Self-perceived knowledge increased signiﬁcantly: before 41.8 versus after 54, p=0.000. There was no change
in aging stereotype attitudes (before 94.6; after 91.5; p.027). EP’s
paid more attention to social support (before present in 30%, afterin 52%; p=0.02) and activities of daily living (before 12%, after 28%;p=0.05) after intervention.
Conclusions: Geriatric education equips EP’s with more knowledge
and conﬁdence to handle geriatric emergency presentations.
P-382
Evaluation of quality indicators for patients with acutecerebrovascular accident in Primary CareL. Sierra-Martínez 1 , R. Martinez-Fuerte 1 , N. Sanz-González 2 .
1 Valladolid Este Primary Assistance Gerency, Valladolid; 2 JCyL Social
Services Gerency, Valladolid
Background and aim: Study on the quality of clinical care for acutecerebrovascular accident (ACVA) patients assigned in a Primary
Care Health Center (HC) and to compare them with ACVA patientsin the Health Area (HA) (during the period 2015).
Method/Design: Longitudinal evaluation: Palmer’s Quality CycleSetting: An urban health care center. Population and Sample:
Patients (total according to inclusion criteria, year 2015) with ACVA
(n=315). Interventions:-Internal evaluation, dimensions: scientiﬁctechnica, quality, adequacy, accessibility, continuity of care; data
related to the care process and intermediate results; explicit,
evidence-based procedural criteria. Subjects: analysis of coverage.
Analysis on the evolution of treatment compliance. The Z statistical
test for comparing proportions, alpha 0,05.
Results: Compliance criteria (year 2015):-Population with a history
of ACVA: HS 315, HA 5268.-Patients with ACVA, who have atleast one TA <140/90 in the period:HS 190 patients (60.32%), HA
3326 patients (63.14%).-Patients with ACVA registered in the period
2015: HS 45 patients, HA 904 patients.-ACVA 2015 patients with
Atrial Fibrillation (AF): CS 3 patientns, AS 163 patients.-ACVA 2015
patients with AF and anticoagulants: CS 3 patients (100%), AS 131
patients (80.37%).
Conclusions: The analysis of the records of care process indicators
for patients with ACVA makes us aware of the importance of patient
control. Registration allows us to evidence improvements in thecare process. To make a good registry of the controls, to adapt theinterventions with the patient, adapting them to each case. Afterour analysis we say that we must improve the uptake of patientswith ACVA and the quality of the records of the care process.
P-383
Exacerbated chronic heart failure at moment of discharge
S. Duarte, R. Amaral, J.J. Eira, P. Vaz Marques. Centro Hospitalar deTrás os Montes e Alto Douro - Hospital de Vila Real, Vila Real, Portugal
Introduction: Evidence-based clinical practice guidelines for treatment of CHF (chronic heart failure) are available worldwide, but
its application is not always transverse to all patients. This hasrepercussions on patients and health care systems [1].
Methods: Retrospective study of the total admissions at an Internal
Medicine Department of a Portuguese hospital, with the main diagnosis of CHF exacerbated by infratherapeutic treatment or natural
evolution of disease. Data was obtained through SClinico systemand processed by SPSS 24.0® software. Were excluded patients whodied during hospitalization. The aim was to evaluate the repercussions on 1-year rehospitalization and mortality, of long-term
survival modifying pharmacologic therapy and control therapy ofcongestive symptoms recommended by the European Society ofCardiology (ESC) guidelines.
Results: Total of 176 hospitalizations with mean duration of
9.22±9.5 days. 58.7% were female, with a mean age of 77.4±11 years.
At discharge, treatment was altered in 78.2% patients, 95.5% wereon diuretics, 77.1% on ACE (angiotensin-converting enzyme) inhibitors/ARB (angiotensin receptor blocker), 73.7% on beta-blockers
and 57.5% on both. 1-year rehospitalization rate was 44.1% andmortality rate 16.8%. Therapeutic adjustment in these patientsat discharge was associated with fewer 1-year rehospitalizations(OR=0.31, 95% CI: 0.14–0.64, p=0.01), but without relation to mortality. Use of ACE inhibitors/ARB, beta-blockers and both at discharge
was associated with lower 1-year mortality, respectively: OR=0.36,
95% CI: 0.16–0.84, p<0.05; OR=0.11, 95% CI: 0.05–0.26, p<0.01;
OR=0.10, 95% CI: 0.04–0.29, p<0.01. The same did not occur with
diuretics.
Conclusions: When the cause of exacerbation is infratherapeutic
treatment or natural evolution of the disease, adjustment of thebaseline medication at discharge appears to be beneﬁcial in maintaining patient’s clinical stability. Recommended survival modifying
therapy should be ensured whenever possible in CHF patients.
References:[1] A.P. Maggioni et al. Are hospitalized or ambulatory patientswith heart failure treated in accordance with European Societyof Cardiology guidelines? Evidence from12 440 patients of the
ESC Heart Failure Long-Term Registry. European Journal of Heart
Failure (2013) 15, 1173–1184
P-384
Factors that predict outcome of intensive care treatment in very
elderly patients
J.E. Mateus, D. Oliveira, M. Simões, S. Beirão, M.T. Veríssimo,
J. Pimentel. Centro Hospitalar e Universitário de Coimbra (CHUC),
Coimbra, Portugal
Introduction: The aging of the population is a critical worldwide
trend, with major consequences on health system. The aim of thisstudy was to evaluate clinical characteristics and factors associatedwith mortality in very elderly subjects admitted to an ICU.
Methods: Retrospective analysis of patients aged 80 years or more
admitted to a portuguese ICU from 2012 to 2016.
Results: In this period 3473 patients were admitted to the UCI, of
which 732 (21.1%) were very elderly. Global ICU mortality rate was13%. Among the very elderly: 58.9% were men, mean age 85 years,
mean length of stay 11.8 days, mean APACHE II 21, mean SAPS II 50
and mortality rate 34.7%. Regarding the cause of admission: 35.3%
had respiratory disfunction, 17.2% digestive disease and 16.9% septic
shock. Trauma patients had a longer length of stay (19 vs 11 days,p<0.001). Patients with septic shock were younger (84.2 vs 85.2
years, p<0.05), had higher values of APACHE II (23 vs 20, p<0.001)
and SAPS II (55 vs 50, p<0.05) and a higher mortality rate (43.6%
vs 33.0%, p<0.05). Advanced age was not associated with increased
mortality.
Conclusions: The very elderly admitted to the ICU had a higher
mortality rate compared with subjects of other ages. However,advanced age was not associated with increased mortality. Therefore, ICU admission or treatment for very elderly patients must be
carefully considered. It is not appropriate to refuse ICU admission
or restrict treatment to patients simply because they are aged 80 orolder.

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

P-385
Familial diseases are also expressed in elder age. Case report
C. Alcaraz López, J. Jaramillo Hidalgo, T. Lapeña Montero,
M. González Becerra, J. Gómez Pavón. HCCR. Hospital Central de la
Cruz Roja, San José y Santa Adela. Madrid, Spain
A 92-year-old male with sudden beginning ﬂuid and solid dysphagia. History: vascular parkinsonism, mixed dementia and a brotherwith Myasthenia Gravis (MG); Barthel index 72/100; he lives withhis family. Systemic examination: ﬂaccid dysarthria and abundantsecretions. During hospitalization: two aspirative pneumonias and,facing the impossibility of using mouth, a feeding tube was placed
until percutaneous endoscopic gastrostomy placement. Both laryngoscopy and gastroscopy discard mechanics dysphagia and a cranial
CT didn’t show acute cerebrovascular pathology. Then, in orderto his brother’s diagnostic, we requested tests directed to MG
diagnostic: high levels of AChR and a thoracic CT without thymoma
were obtained. It wasn’t possible to perform an electromyogram
and the jitter wasn’t valuable. Finally, with our diagnostic “Familiar
late onset AChR positive non tymomathous Myasthenia Gravis”
piridostigmine was inicialised with positive results. Late onset MG
is inﬂuenced by immune system’s aging. Although it’s underdiagnosed, it’s more and more frequent and it prevails in men [1,2]. It
has got more severe symptoms; and ocular and bulbar forms prevail[2]. Myastenic crisis and seronegative and seropositive patients
percentages are similar to early onset MG [2,3]. Thymoma is not
usually present [4]. Cholinesterase inhibitors keep on being ﬁrst line
on treatment. Piridogtismine, prednisone, plasmapheresis and intravenous antibody are good options [2], being the last one ﬁrst line
in myastenic crisis. Thymectomy in non-thymomatous MG has notshown beneﬁts [2,5]. Remissions are maintained around 90% [2]. Infamilial forms, the most frequent relationship is between brothers.
Many intra-family variability clinical and treatments response wereobserved [6].
P-386
Feasibility of a hospital at home setup for older patients with anacute medical illness: recruitment, patient acceptability,
healthcare professionals’ experiences, and economic evaluation
A. Tanderup 1 , J. Ryg 1 , A. Lee 2 , A. Touborg Lassen 3 , K. Birkemose
Mejer 4 , G. Lyngholm Soerensen 4 , B. Dinesen 4 , T. Larsen 2 ,T. Masud 5 , J.-U. Rosholm 6 . 1 Department of Clinical Research,
University of Southern Denmark, Odense, Denmark; 2 Department of
Public Health, University of Southern Denmark, Odense, Denmark;3 Department of Emergency Medicine, Odense University Hospital,
Odense, Denmark; 4 Department of Health Science and Technology,
Aalborg University, Aalborg, Denmark; 5 Nottingham University
Hospitals NHS Trust, Nottingham, United Kingdom; 6 Department ofGeriatric Medicine, Odense University Hospital, Odense, Denmark
Background: The older population is increasing with an expected increase in hospital admissions and associated cost. Outof-hospital-treatment in the form of a hospital at home (HH) is apotential alternative, but the evidence is limited. This study aimed
to test feasibility of performing a full trial of HH in acutely ill older
patients.
Methods: We conducted a feasibility study in acutely ill patients≥65 years admitted to the Emergency Department. Patients were
included based on ﬁve main criteria: general eligibility, medical
status, treatment requirement, cognition, and willingness to participate. Patients were transferred home within 36 hours withsubsequent daily visits from healthcare professionals. Telemedicine
technologies were used to increase the safety of the patients.
Results: Of 601 patients screened (median age=80 years, 56% female) only 7 (1%) were eligible and willing to participate. Main
reasons for not participating were poor status of health and scepti-

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cism towards the home admission. Patients admitted at home felt
safe and found several positive aspects. Health-care professionals
found that the HH intervention gave the opportunity to create apatient-centred treatment. The intervention was not successfully
integrated because of the few cases resulting in unfamiliarity withthe setup. Economic evaluation found that HH had no economic
advantages over usual in-hospital admission.
Conclusion: HH for older acute medical patients was not feasible
in the design that we tested. The severity and complexity of patients, together with the existing competences of the municipality
health-care staff, does not justify proceeding to a large randomised
controlled trial with this set up.
P-387
Frail and Older Person Advice and Liaison Service (FOPALS),
improving care for the frail and elderly people at acute hospitals
D. Chan, T. Ashraﬁ, C. Agogbua, D.L. Ngandu, J. Barrett, K. Amin,
K. Haque, A. Ahonkhai, K. Lewis, D. Walker. Queen’s Hospital
Introduction: With an increasing aging population, more elderly
and frail patients presents to hospital with highly complex healthand social needs. FOPALS (The Frail and Older Peoples Advice andLiaison Service) was established at Queen’s Hospital in 2013 toaddress the local population’s needs.
Methods: FOPALS consists of a team of geriatric consultants andspecialist nurses. They provide advice and assessments for elderly
and frail patients seen in the community as well as the Emergency
department, 7-day a week, allowing early geriatric input. FOPALS
use a local BHRUT Frailty score to objectively identify suitable
candidates to be reviewed. Patients over 75 years of age and score>3 points from the BHRUT Frailty score*, will automatically be seen
by FOPALS.
Results: Data was collected retrospectively from January 2015 to
December 2016. A total of 9532 patients were seen by FOPALS
during the study period. 74% of the patients fulﬁlled the FOPALS
criteria. Over 1/3 of patients (34.6%) seen by FOPAL was discharged
the same day. The average length of stay (LoS) for all patientsseen by FOPAL reduced by half (6.65 days versus 11.25 days priorestablished FOPAL service). The 30-day re-admission rate also fellby 13% (from 33% down to 20.2%) with a 1-year mortality rate of
7.66%.
Conclusion: Since the introduction of the FOPALS service at Queen’s
Hospital, the unit has not only witness a signiﬁcant reduction in
unnecessary hospital admission but also a drastic reduction in the
LoS for the elderly and frail patients.
*BHRUT Frailty Score:
1. Presence of 1 or more Geriatric Syndromes: 2 points
a. Falls
b. Reduced mobility from baselinec. Confusion/Dementia OR 4-point-AMT <4
d. Incontinencee. Signiﬁcant comorbidities (>3) AND evidence of polypharmacy
f. End of Life Care
2. Require assistance with ADLs: 1 point
3. In-patient stay within the last 6 months: 1 point
4. Signiﬁcant sensory impairment: 1 point
5. Malnutrition/low BMI: 1 point
Exclusion Criteria:• Non-medical patients• Acute stroke, GI bleeds and MI• Patients requiring HDU/ITU• Oncology emergencies

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P-388
Frailty in hospital: a survey of UK clinicians
J. Taylor 1 , J. Fox 2 , P. Shah 1 , A. Ali 2 , M. Hanley 1 , R. Hyatt 3 . 1 Central
Manchester University Hospitals NHS Foundation Trust; 2 Salford RoyalNHS Foundation Trust; 3 East Lancashire Hospitals NHS Trust
Introduction: Despite numerous national campaigns, frailty remains under-recognised in UK hospitals. We performed the ﬁrst
ever national survey of hospital clinicians designed to identify
barriers to the identiﬁcation and best practice management offrailty.
Methods: Electronic and paper based surveys were distributed tohospital-based clinicians across the UK. As well as statement-based
agree/disagree/not sure questions across ﬁve domains (personalunderstanding of frailty, identiﬁcation of frailty, assessments forfrailty, management of frailty and education), this survey also
included free text comment space to allow broader qualitativeevaluation.
Results: 402 clinicians were surveyed across 24 specialties and 26
hospital sites. Consultants made up 54% of responders, specialty
trainees 19% and junior doctors 24%. Although the majority werefamiliar with the term frailty, personal understanding was variable,
especially amongst junior doctors. 74% of responders agreed frailty
assessments should be undertaken for all older people admitted
to hospital, yet only 36% felt this was currently feasible. Only 24%
of responders reported they used validated assessment tools to
identify frailty. Free text responses highlighted scepticism towards
the clinical validity and utility of frailty as a clinical syndrome,
the perceived value of so-called “end of the bed” assessments, andissues surrounding service capacity.
Conclusions: Results highlight multiple areas for improvement,
and raise some interesting questions about the perceived value offrailty assessments in the acute setting. We recommend a particularfocus on better training of staff, the promotion of validated frailty
assessment tools, and investment in front line services for older
people presenting to hospital.
P-389
Functional decline associated with hospitalization in an acutegeriatric ward
G. Cristofori, Z. Rivas García, A. Socorro García, J. Baztán Cortés.
Department of Geriatrics, Cruz Roja Hospital, Madrid, Spain
Introduction: Objective is to describe functional decline associatedwith hospitalization in an acute geriatric ward and to evaluate
related risk factors.
Methods: Descriptive, longitudinal study. 1317 patients admitted
to the acute geriatric ward at Cruz Roja Hospital in Madrid, during 2009. Functional decline associated with hospitalization wasdeﬁned as 5 or more points loss between discharge and preadmission Barthel Index (BI). Exclusion criteria (N 441) were death,data loss, pre-admission BI less than 5 points. Bivariate analysis
was performed for age, sex, lenght of stay, admission albumin,creatinine, hemoglobin, Charlson index, previous mental Cruz Rojascore, previous and admission BI, living in nursing home, causesof admission (ictus, cardiac failure, neumonia, urinary tract infection, chronic obstructive pulmonary disease). Signiﬁcative variables(p<0.05) were studied with multiple logistic regression analysis.
Results: 46.2% of patients suffered functional decline associatedwith hospitalization, with mean age 87 years (SD 6.4), 67.9%
women. Signiﬁcative association resulted with age, female sex,
living in nursing home, lenght of stay, admission BI, ictus, chronic
obstructive pulmonary disease, admission albumin. In multivariate
analysis age (OR 1.02, CI 95%: 1.00–1.05, p<0.05), lenght of stay
(OR 1.08, CI 95%: 1.05–1.1, p<0.01), admission BI (OR 0.98, CI 95%:
0.98–0-99, p<0.01), and ictus as cause of admission (OR 7, CI 95%:

3.27–14.96, p<0.01) were associated with functional decline during
the hospitalization.
Conclusions: Older patients, admitted for ictus, with lower admission BI and longer lenght of stay have an higher risk of functional
decline associated with the hospitalization
P-390
General practitioners’ point of view and involvement in theadmission of their elderly patients in intensive care unit
S. Peiffer 1 , L. Zerah 2 , A. Gioanni 2 , J. Cohen-Bittan 1 , M. Verny 2 ,J. Boddaert 2 , H. Vallet 2 . 1 Geriatric Department, groupe hospitalierPitié Salpêtrière Charles Foix, Paris, France; 2 Geriatric Department,groupe hospitalier Pitié Salpêtrière Charles Foix, Paris, France;
Sorbonne Universités UPMC Univ Paris 06
Context: The population aged more than 60 years has tripled during
the last 50 years and will triple again before 2050. The intensive
care units (ICU) are affected by this demographic change, with 9
to 18% of their patients aged 80 years and more. Nevertheless,clear ICU admission guidelines as well as data considering generalpractitioner (GP) implication in ICU admission of their patients arestill lacking. We aimed to evaluate the GP’ point of view, and theirinvolvement in the admission of their geriatric patients in ICU.
Material and methods: Retrospective study carried out in La PitiéSalpêtrière hospital. All patients >75 years admitted in the geriatricward after an ICU stay between November 2014 and May 2015
were included. Each attending physicians of patients were called
between July and December 2015 to answer a survey including an
individual clinical vignette about their patients or clinical situationsof ICU admission.
Results: Twenty-ﬁve patients were included (age 84±5 years;
CIRS52 score 12 [2–21].). Main diagnoses for ICU admission were
acute respiratory failure (40%) and shock (36%). Twenty-two GPs
answered the survey (medical experience 30 [25–30] years),. None
was contacted at the time of their patient’s admission in ICU,
whereas 86% (n=19) would have liked to. Moreover, GPs knew theirpatient’s advance directives in 28% of case.
Conclusion: The GPs are rarely associated with ICU admission orcare of their elderly patients. Since GPs have crucial information
about patients wishes, they should be more involved in ICU management, for example by creating advanced care plans based on
their personal advanced directives.
P-391
Geriatric assessment at the Acute Medical Unit: Improving theoutcomeJ. Blomgreen 1 , A. Ekmann 2 , H. Nygaard 2 , A.K. Demény 2 ,M.R. Wejse 1 , E. Pressel 1 . 1 Dept. of Geriatric Medicine, Bispebjerg andFrederiksberg Hospital, Copenhagen; 2 Emergency Department,
Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
Background: Elderly patients at the Acute Medical Unit (AMU) at
our hospital, count for 53% of all bed-days. Elderly patients areoften characterized by complex health related problems, functionalloss and atypical symptoms. Due to demographic changes thesenumbers are expected to rise. The aim of this study was to describe
clinical characteristics of these patients and to investigate the effectiveness of an acute geriatric assessment conducted by a GeriatricAcute Team (GATE).
Methods: All patients >65 years admitted to the AMU, between
March and June 2016, were screened for eligibility. Exclusion criteria were medical unstable conditions. Patients randomized to thecase group, received an acute geriatric assessment and follow-up by
a senior consultant in geriatric medicine, whereas, control patients
received treatment by usual standard. Data were retrieved frommedical journals.

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

Results: We randomized 72 and 96 patients to usual treatment
and GATE, respectively. Average age was 81 years, triage level atadmission was low and ﬁrst measure of Early Warning Score was on
average 2 (0–8).17% of the patients were delirious at inclusion, theyused on average 7.7 pharmaceuticals and 68% had >3 simultaneous
chronic diseases. Compared to usual treatment, assessment by
GATE gave shorter hospitalization times at the AMU (p=0.03), fewer
doctors attending the single patient (p=0.02) and fever 30-day
readmissions (p=0.05).
Conclusion: Although elderly patients are less clinical affected bytheir acute disease at admission, they have a high grade of multimorbidity, polypharmacy and signiﬁcant delirium rates. Hence,
they beneﬁt from an acute geriatric assessment.
P-392
Geriatric assessment may reduce re-visits in the emergency
department in older patients with positive identiﬁcation ofsenior at risk (ISAR) screening
K. Slankamenac 1 , G. Haberkorn 1 , O. Meyer 2 , M. Gagesch 2 ,H.A. Bischoff-Ferrari 2 , D.I. Keller 1 . 1 Emergency Department,
University Hospital Zurich, Zurich, Switzerland; 2 Department ofGeriatrics, University Hospital Zurich, Zurich, Switzerland
Introduction: The “Identiﬁcation of Seniors at Risk” (ISAR) screening is a tool to identify older patients at risk for adverse outcomes.
We investigated whether older patients with a positive ISAR screening have an increased risk for re-visits and health-service costs
when admitted to the emergency department (ED).
Methods: In a pilot study, we enrolled 96 patients aged ≥70 yrs
who received an ISAR screening in the ED. We compared the rateof ED re-visits and in-hospital costs between ISAR positive (≥2 pts)
and ISAR negative (<2 pts) patients. A geriatric physician performeda single geriatric consultation (GC) during the stay in the ED toassess older patient’s needs.
Results: Fifty patients (52%) were ISAR positive and showed anincreased risk for ED re-visits (RR 6.5, 95%-CI 2.1–20.1, p=0.001). In
29 patients, a single GC was performed. In ISAR positive patients
who received a single GC, the risk for ED re-visits decreased andwas no more signiﬁcant (RR 2.2, 95%-CI 0.4–13.9, p=0.38). ISAR
positive patients with GC did not have higher in-hospital costs than
ISAR negative patients without GC (p=0.85).
Conclusion: Older ISAR positive patients have an increased risk for
ED re-visits. A single GC in the ED may reduce ED re-visits. Regardless of GCs in the ED, in-hospital costs were not increased in ISAR
positive patients. Based on these ﬁndings, we are establishing acomprehensive outpatient geriatric assessment program to identify
relevant risk factors for ED re-visits and to recommend preventive
strategies in older patients.
P-393
Geriatric Assessment Team in Emergency Department. Resourcesmanagement strategies
I. Fedyuk 1 , D. Donniacono 2 , B. Fontecha 2 , L. Reig 2 . 1 Resident
Doctor, Department of Geriatrics and Palliative Medicine, Moises
Broggi Hospital, Sant Joan Despí, Barcelona, Spain
Introduction: An evaluation by the Geriatric Assessment Team in
Emergency Department can avoid admission of fragile patients in
Acute Care Hospital (ACH). In our area, derivations of geriatricpatients to Emergency Department are very frequent. We contemplate the implantation of an assessment team in the emergency
department for speciﬁc attention, resources management and to
avoid an inappropriate admission in ACH.
Objective: To analyse the impact of the establishment of thismeasure.
Patients and method: Observational retrospectively study with

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historical cohort comparing the number of hospitalization avoided
during the ﬁrst trimester of 2017 in relation to the same period of
the previous year.
Results: The number of admissions requested during the ﬁrst
quarter of 2017 was 580, 176 of these were cancelled in relation
to the same period of 2016 where 491 admissions were requested
and 83 were rejected, what represent the 16.9% of all admissions
requested during the ﬁrst quarter of 2016 and 30.3% of the requests
made during the same period of 2017.
Conclusion: 1. During the ﬁrst quarter of 2017 were relocated out
of ACH 47.1% more patients than during the same period of 2016; 2.
We cannot reduce the number of admissions in ACH due to increaseof the total number of requests; 3. It was possible to maintain thesame number of admissions in ACH despite the increase in thenumber of requests.
P-394
HFrEF, HFmrEF and HFpEF: Which is the treatment of choice atdischarge? Real world data from the ATHENA registry
C. Ghiara 1 , F. Orso 1 , A. Pratesi 1 , S. Parlapiano 2 , A. Herbst 2 ,A.C. Baroncini 1 , A. Lo Forte 1 , G. Biagioni 2 , F. Fedeli 2 , M.L. Di Meo 1 ,L. Gabbani 3 , M. Di Bari 1 , A. Ungar 1 , S. Baldasseroni 1 . 1 GeriatricIntensive Care Unit, Careggi University Hospital, Florence, Italy;
2 University of Florence, Florence, Italy; 3 Department of Medicine andGeriatric, Florence, Italy
Introduction: Heart failure is a highly prevalent condition in elderly. Prognosis has improved in HFrEF due to the availability ofevidence based treatments. Currently, no treatments have proveneﬃcacy in HFpEF patients and also in HFmrEF, new category of HF,
introduced by the ESC.
Methods: Evaluate treatments at discharge in real world setting ofelderly patients after AHF in three different groups: HFpEF, HFrEF,
HFmrEF. Data derived from ATHENA retrospective observational
study which included elderly patients admitted with diagnosis of
AHF to University hospital in the period 12.01.2014–12.01.2015.
Results: 246 patients were enrolled: 19.5% HFmrEF, 30.5% HFrEF
and 50.0% HFpEF. Mean age was respectively 83.8, 84.5, 79.9 years,
p<0.001. BBs and MRAs were only two classes of drugs that hada statistically different prescription rate across three HF groups:
patients with HFmrEF received BBs in similar percentage to patientswith HFrEF. MRAs prescription rate in HFmrEF was intermediate
compared to the other two groups. Furthermore, the average number of drugs taken by patients at the time of discharge was 11.8
with no differences across the groups.
Conclusion: In the absence of evidences from randomised clinical
trials, patients with HFmrEF are treated similarly to those with
HFrEF. Also, a high percentage of patients with HFpEF receive
treatments that only have been demonstrated to improve prognosis
in HFrEF patients. Evidences from randomised clinical trials areneeded to appropriately treat HFmrEF patients.
P-395
Identifying and managing older people with “frailty” in the
Acute Medical Unit in a busy district general hospital in an
effective and safe manner
C. Martin-Marero 1 , G. Rolph 2 , C. Mccann 3 , C. Dineros 4 , C. Farrant 5 ,N. Jobzs 6 , N. Jetha 7 , M. Lethby 7 . 1 Consultant Geriatrician andPhysician, Department of Care of the Elderly, West Middlesex
University Hospital/Chelsea and Westminster NHS FT; 2 Information
Business Partner, Emergency and Integrated Care Division, Chelsea andWestminster NHS FT; 3 Senior Clinical Specialist Nurse, Directorate of
Nursing, West Middlesex University Hospital/Chelsea and Westminster
NHS FT; 4 Clinical Specialist Nurse, Directorate of Nursing, West
Middlesex University Hospital/Chelsea and Westminster NHS FT;S154

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

5 Senior Occupational Therapist, Therapy Department, West Middlesex

University Hospital/Chelsea and Westminster NHS FT; 6 Occupational
Therapist, Therapy Department, West Middlesex University
Hospital/Chelsea and Westminster NHS FT; 7 Specialist Trainee in
Geriatric Medicine and General Internal Medicine, Department of Careof the Elderly, West Middlesex University Hospital/Chelsea andWestminster NHS FT
Introduction: People aged 75+ are at high risk of hospital admission. The ﬁrst 72 hours are key to accurately assess and manage
them. There is growing evidence suggesting that “hospital at home”
for selected patients offers advantages, lowering mortality andreducing functional decline. We created the multidisciplinary Acute
Frail Elderly Team (AFET) to deliver the Comprehensive Geriatric
Assessment within the AMU for the elderly. To identify suitablepatients we used Improvement Methodology and developed a local
WMUH-Clinical Frailty Score (CFS) based on Geriatric Giants anddependency. We used Rockwood-CFS concordance for comparisonand scoring.
Methods: Identiﬁed patients are assessed/managed by AFET, withdaily MDT meetings discussing each case, writing personalised careplans in our booklet for each patient and handing-over to AMU.
AFET has strong links with community professionals and refers patients to these services facilitating safe, fast and effective discharges.
To cover these, the Rapid Access Clinic for the Elderly (RACE) andoutreach Richmond’s Senior Health Clinic were developed. AFET
outcomes are compared with other AMU patients and “usual care”
patients transferred to wards using key metrics.
Results and conclusions: WMUH-CFS identiﬁes a distinct and older
cohort of patients with “Frailty”; – AFET majority of our patientsare 85+, female preponderance and higher CFS with age; – AFET
improves early discharge home of these patients minimising institutionalisation, falls, confusion and nosocomial infections, reduces
readmissions and mortality in this cohort compared to usual care.
References:[1] Rockwood et al. A Global Clinical Measure of ﬁtness and frailty
in elderly people. CMAJ 2005;173: 489–495/Canadian Study on
Health & Aging. Reviewed 2008.
P-396
Impact of an In-reach programme & Emergency Care Bundle ondelirium in patients with idiopathic Parkinson’s disease
A. Thomson 1 , R. Irving 2 , C. Miller 1 , L. Partington 1 , P. Cotton 1 .
1 Salford Royal Hospital; 2 HEE-NW

Introduction: Previous analysis of unplanned admissions in patients with idiopathic Parkinson’s disease (iPD) to our hospital in2014, identiﬁed a high prevalence of delirium. The aim of this study
was to determine whether the introduction of a reliable, structured
assessment protocol would improve outcomes in iPD patients withdelirium.
Methods: A daily, Geriatrician-led in-reach visit to the Emergency
Assessment Unit of a University teaching hospital was commenced.
This incorporated an Emergency Care Bundle to prevent and address
a number of key elements of care, including delirium, in patientwith iPD. The project was deployed from August 2015. After a
12-month period, data was collated retrospectively and analysed.
This was compared with the 2014 cohort.
Results: 90 patients (male 58.9%, mean age 77.3 years) accounted
for 134 admissions. Mean age was similar between the 2014 and intervention cohorts with delirium, although the incidence of known
dementia higher in the intervention group (30% vs 42.9%). 86/134(64.2%) admissions were seen by the in-reach team. There was arise in detection of delirium (22.1% to 29.1%). The incidence ofdelirium developing after admission remained unchanged (8.1% vs8.2%). The mortality rate in those patients with delirium at any

point in their admission fell from 10/41 (24.4%) to 7/50 (14%), withno change in mortality in the non-delirious groups (1.1% vs 2.4%).
Conclusions: Introduction of this simple, cost-effective intervention improved delirium identiﬁcation and management in patientswith iPD, and could be adapted for use across a variety of other
healthcare settings.
P-397
Impact of anesthesia drugs on postoperative cardiovascular
events after hip fracture surgery in elderly patients
H. Vallet 1 , M. Baque 2 , J. Cohen-Bittan 2 , A. Gioanni 1 , M. Verny 1 ,M. Raux 3 , A. Mézière 4 , B. Riou 5 , L. Zerah 1 , J. Boddaert 1 . 1 Unit ofPeri-Operative Geriatric care, Groupe Hospitalier (GH)Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (APHP).
Sorbonne University, University Pierre and Marie Curie (UPMC) Paris
06, University Hospital Department Fight Aging and Stress (DHU
FAST), Paris, France; 2 Unit of Peri-Operative Geriatric care, Groupe
Hospitalier (GH) Pitié-Salpêtrière, Assistance Publique-Hôpitaux deParis (APHP), Paris, France; 3 Departments of Anesthesiology andCritical Care, GH Pitié-Salpêtrière, APHP. Sorbonne University,
University Pierre and Marie Curie (UPMC) Paris 06, University Hospital
Department Fight Aging and Stress (DHU FAST), Paris, France;
4 Department of Rehabilitation, GH Charles Foix, APHP, Ivry sur Seine,France; 5 Departments of Emergency Medicine and Surgery, GH
Pitié-Salpêtrière, APHP. Sorbonne University, University Pierre andMarie Curie (UPMC) Paris 06, University Hospital Department Fight
Aging and Stress (DHU FAST), Paris, France
Introduction: Postoperative cardiovascular events (PCE) are frequent and strongly associated to hip fracture mortality. We aim tocompare patient with or without PCE with regard to drugs theyreceived during anesthesia in elderly patients with hip fracture.
Methods: Between 2009 and 2016, all patients (>70 years) admitted after hip fracture surgery into a dedicated unit of peri-operative
geriatric (UPOG) care were included. The primary end point was
drugs associated with PCE occurrence.
Results: 559 patients (age 86±6 years, CIRS 9 [6–12], 5 [3–6]) were
included. In postoperative time, 145 patients (26%) presented ≥1
PCE. Patients with PCE were older (87±6 vs 86±6; p=0.02), withmore comorbid conditions (CIRS 10 [7–13] vs 8 [6–11]; p=0.003) notably cardiovascular conditions (coronary artery disease 32% vs 14%;p<0.001, chronic cardiac failure 37% vs 11%; p<0.001). Remifentanyl, etomidate and transfusion were more frequently used during
anesthesia in patients with PCE (10% vs 5% (p=0.01), 37% vs 25%(p=0.006) and 33% vs 23% (p=0.01) respectively), and remained
associated with PCE in a multivariate logistic regression model (respectively OR=2.43 [1.13–5.17], p=0.02; OR=1.67 [1.06–2.61], p=0.02;
OR=1.70 [1.12–2.61], p=0.01) whereas age and comorbid conditions
were not.
Conclusion: Some anesthesia drugs are associated with the occurrence of PCE in elderly patients admitted in UPOG after hip fracture
surgery. All drugs used during hospital care pathway should beconsidered to analyze potentially drug related-outcomes. Geriatricians and anesthesiologists will have to work together to determine
optimized drug protocols, according to outcomes.
P-398
Intersectorial Clinical Unit (ICU) – A cooperative effort:
Municipality and hospital
J. Bennedsen, S.T. Feizi, S.G. Dawids. Bispebjerg Hospital Denmark
Introduction: ICU is a joint hospital unit for fast track diagnosis
and treatment of citizens above 64 years in the local municipality. It started 2013 and is staffed with nurses from Public Social
Healthcare and hospital physician. The aim: to avoid many hospital
admissions of elderly.

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

Methods: During the period June 2014–January 2016 patients in
ICU were registered – inter alia – age, sex, blood samples, cultures, X-ray/CT-/MR-scan/ECG, endoscopy, diagnoses and outcome(hospitalization/ambulatory/home).
A follow up was made of readmissions to hospital or to ICU (withdiagnosis) up to 6 months.
Results: Of 1001 patients visiting ICU 34% were admitted to hospitalwhile 66% were discharged (51% were ended without further plans
and 15% were sent to ambulatory follow up).
Within 30 days 18% of all the patients were readmitted to hospitalor ICU. A considerable part of these required repeated transfusions
due to cancer and other causes. Most frequent diagnoses were
respiratory, cardiovascular, haematological and endocrine – mainly
diabetics.
Conclusions: The combination of Public Municipal Health Careand hospital facilities appears to be a very eﬃcient way to treat
elderly patients. Rapid investigation and treatment is combinedwith optimizing the home situation or to place the patient temporary in a rehabilitation facility. These combined measures prevent
deterioration of the patients’ health condition.
P-399
Involvement of a geriatrician at a Dutch emergency department
reduces length of stay for elderly
Ö. Sir 1 , Y. Schoon 2 . 1 Department of Emergency, Radboud University
Medical Center, Nijmegen, The Netherlands; 2 Department of Geriatrics,
Radboud University Medical Center, Nijmegen, The Netherlands
Introduction: The amount of older patients attending the emergency department (ED) is increasing and contributing to crowding
at the ED. Geriatrician involvement at the ED in relation to ED
length of stay (LOS) in the 70+population was examined.
Methods: All patients ≥70 years who visited the ED of an university hospital in 2014 were included. A random selection of 2000
patients was made. Patient and visit related data were collected
retrospectively by examining all 2000 medical ﬁles. Cases weredivided for logistic regression analyses in groups divided by medianand by quartiles of LOS.
Results: The 2000 patients (mean age 78.1years, SD6.1) represented 42% of the 70+ population that visited the ED in 2014.
The median LOS was 216 minutes (mean 230, SD115.5). Independent protective factors for LOS were geriatrician involvement (OR0.4, 95% CI: 0.2–0.6), surgical diagnosis (OR0.5, 95% CI: 0.3–0.9),
multi-trauma patient (OR 0.2, 95% CI: 0.5–0.7) or resuscitation(OR0.01, 95% CI: 0.01–0.4). In contrast, we found that amount of
diagnostics (OR1.6, 95% CI: 1.4–1.7), consultations (OR2.3, 95% CI:
1.9–2.7), lower urgency category (U3-U4;OR 7.6, 95% CI: 3.5–16.7),
specialisms surgery (OR3.7, 95% CI: 2.4–5.7) and internal medicine(OR2.7, 95% CI: 1.0–3.8), hospital admission (OR1.4, 95% CI: 1.1–1.8)
and afternoon arrival (OR1.4, 95% CI: 1.1–1.8) were independently
associated with prolonged LOS.
Conclusions: Involvement of a geriatrician at the ED reduces LOS
for elderly. The amount of diagnostics and consultations, lower
urgency category, the specialisms surgery and internal medicine,
hospital admission and arrival in the afternoon are independent
predictors for prolonged LOS.
P-400
Is early geriatric follow-up within 24 hours after discharge able
to reduce functional decline?
B.B. Jørgensen, M. Gregersen, E.M. Damsgaard. Aarhus University
Hospital, Department of Geriatrics, Aarhus, Denmark
Objectives: Functional decline is observed in almost two thirds ofelderly on admission to an emergency department. After discharge
there is elevated risk of further reduction in physical function. The

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aim is to examine whether early geriatric follow-up within 24 hours
after discharge can reduce functional decline compared to thosereceiving standard geriatric care after discharge by home dwellers.
Methods: Community-dwelling 75+ years old adults were consecutively enrolled on admission to the Emergency Department
where the patient’s physical functional capacity was assessed. The
patients were followed-up eight weeks after discharge with thesame assessment. Outcome: Change in functional capacity as measured during hospitalization, based on a retrospective assessmentof physical functioning 14 days before current illness evaluated by
Functional Recovery Score (FRS) and again 8 weeks after discharge
also by FRS.
Results: In total 153 patients were examined at the emergency
department and followed-up eight weeks after discharge. Meanage was 86.2 years (±5.5) (range 75–101). Fifty nine percent were
women. Using logistic regression analysis there was no signiﬁcant difference in the two groups of having a functional decline
measured eight weeks after discharge by FRS when adjusted forco-morbidity, dementia, previous injurious falls, and actual fall(Coeﬃcient = −7.55 [95% CI: −16.3; 1.15]), p=0.09.
Conclusion: Early geriatric follow-up within 24 hours after discharge at home-dwelling elderly medicine patients can not reduce
the risk of further functional decline compared to those receiving
standard geriatric care after discharge.
P-401
Late-onset IgA vasculitis, clinical characteristics and outcomes
S. Hammami, I. Chabéne, R. Klii, M. Kechida, R. Mesfar, I. Kochtali.
CHU F Bourguiba, Internal Medicine Department, Faculty of Medicine,
University of Monastir, Tunisia
Introduction: Henoch—Schönlein purpura (HSP) is an acute systemic micro vascularitis that is common in children while it is veryrare in adults, often presenting with signs of an acute abdomen.
This disease is diﬃcult to diagnose in adults and seems to differ
from that in children by the incidence and severity of clinical sign.
The aim of this study was to determine the clinical features andoutcomes of IgA vasculitis in elderly (>65 years).
Methods: All consecutive adult patients who were diagnosed withIgA vasculitis between Mai 2005 and January 2015, in the Internal Medicine department in Monastir university Hospital, werereviewed retrospectively.
Results: In total, 30 adult patients were diagnosed with IgA vasculitis, of whom 6 (20%) had late-onset disease. The mean age
was 71.3 years (65–87). Clinically, the gastrointestinal symptoms
were the most frequent (66,6%), type of acute pancreatitis and aleucocytoclastic digestive vasculitis. The articular and renal involvement was mentioned in 50% of patients, leading in two cases to achronic renal insuﬃciency. The treatment was based on parenteral
corticoids, prescribed in two cases. The evolution was good in
50% of patients. One patient was died by a nosocomial infectious
pneumonia.
Conclusions: Patients with late-onset IgA vasculitis in elderly
exhibit distinct clinical features characterized by greater renal involvement and worse renal outcomes. Thus, watchful follow-up
might be needed for adult IgA vasculitis patients, in particular thosewith late-onset disease.
P-402
Long term evaluation of quality of life in elderly breast cancer
S. Messouak 1 , F. Guinet 1 , H. Bailly 2 . 1 Oncology Department
Montceau les Mines Hospital; 2 Geriatric Department Dijon University
Hospital
Introduction: Cancer mainly concern elderly people, particularly
frail population. Progresses in oncological management have re-S156

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

sulted in a decrease in overall mortality and an improvement in thesurvival rate of patients. But the beneﬁts in terms of quality of life
are discussed.
Objective: To analyze the impact of cancer and its treatments on
the quality of life of elderly women with breast cancer and theirexperience at a distance from initial management.
Methods: Quantitative mono-centric, descriptive, retrospective cohort study and qualitative study in the oncology department of
the Montceau-les-Mines hospital between 30 June and 09 August
2016. The inclusion criteria were women over 65 years of age withbreast cancer who had been followed for at least 1 year. The EORTC
quality of life questionnaire was submitted to patients, as well asa measure of the ADL Katz and Charlson scores. Various medicalvariables (date of diagnosis, tumor extension, type of treatment
and side effects) and socio-demographic variables (age, home care,place and lifestyle) were also taken into account. A descriptive
analysis was ﬁrst performed, followed by univariate analysis in
search of signiﬁcant associations between the quality of life andthe various variables measured, followed by a multivariate analysis.
For the qualitative study, semi-directive interviews were carriedout, recorded and completely transcribed. The verbatims were thenanalyzed by software of textual analysis, allowing to show the
emergent ideas and to prioritize them.
Results: 30 women were included in the study (mean age 81.3±4.9
years). Overall self-assessed quality of life correlated negatively
with comorbidities (r=−0.351; p=0.0571) and number of hours ofhome help (R=−0.614; p=0.0002). Quality of life score was betterin patients with T1 (68.7±16.8) or T4 (75±8.3) than in patientswith T2 (53.7±19.6) or T3 (55.6±9.6) states. Peripheral lymph
node invasion appeared to be associated with a better quality oflife (69.3±12.4 vs 57.0±21.0, p=0.0586). No correlation was foundbetween age nor treatments with quality of life. Patients withneurological side effects reported poorer quality of life (50.0±18.0
vs 67.7±15.9, p=0.0185). Multivariate analysis revealed two major
axes: a ﬁrst “energy/autonomy” axis where the variables of qualityof life, emotional functions, executive functions and social activities
were opposed to fatigue; a second axis “physical integrity” wherethe variable of the body image is opposed to the mammary andbrachial symptoms. In the qualitative study, the most commonly
reported side effect was alopecia (n=12; 40%). Alopecia (n=4; 13.3%)
followed by surgery (n=3; 10%) were the most signiﬁcant featuresof the history of the disease. Relativism was the most commonlyoccurring component of the disease (n=12; 40%). Some patients
reported a lack of psychological support (n=2; 6.7%), while others
reported overly aggressive therapies (n=2; 6.7%). The most important elements of their quality of life were the ability to perform
household tasks (n=13, 43.3%), ability to walk or go out (n=12,40%) and the presence of the entourage (n=10; 33.3%). Walking(n=13; 43.3%) and household tasks (n=13; 43.3%) were the mostly
impacts by cancer management. Qualitative study showed that
quality of life is possible with a positive evaluation despite a greater
locoregional tumor evolution in patients who survived a potentiallyfatal situation. The nature of treatments does not seem to have asigniﬁcant long-term impact on quality of life, but the occurrenceof chemo-induced neuropathies is signiﬁcantly related to a lower
quality of life. Patients emphasize alopecia and surgery in the experience of their illness, sometimes with insuﬃcient psychologicalsupport.
Conclusions: These results lead us to reevaluate our practices inorder to guarantee a better quality of life to our patients by being
more attentive to their expectations and by strengthening our collaborations with the other medical, surgical and paramedical actors
during the management. In particular, it is advisable to care theoccurrence of chemo-induced neuropathies in order to maintain
good autonomy to ensure a better quality of life

P-403
Long term prognosis of upper gastrointestinal bleeding in theelderly population
A. Negers 1 , N. Carbonell 2 , L. Zerah 3 , A. Gioanni 3 , M. Verny 3 ,C. Thomas 1 , J. Boddaert 3 , D. Thabut 4 , H. Vallet 3 . 1 GeriatricDepartment, GH Hôpitaux Universitaires de l’Est Parisien - Saint
Antoine Hospital, Paris; Assistance Publique-Hôpitaux de Paris (APHP),
Paris, France; 2 Gastroenterology Department, GH Hôpitaux
Universitaires de l’Est Parisien - Saint Antoine Hospital, Paris;
Assistance Publique-Hôpitaux de Paris (APHP), Paris, France; 3 GeriatricDepartment and Unit of Peri-Operative Geriatric care, Groupe
Hospitalier (GH) Pitié-Salpêtrière, Assistance Publique-Hôpitaux deParis (APHP) Sorbonne University, University Pierre and Marie Curie(UPMC) Paris 06, University Hospital Department Fight Aging andStress (DHU FAST), Paris, France; 4 Gastroenterology Department,Groupe Hospitalier (GH) Pitié-Salpêtrière, Assistance PubliqueHôpitaux de Paris (APHP), Paris, France
Introduction: Although upper gastrointestinal bleeding (UGIB)
represents a frequent medical situation with a high in-hospitalmortality rate in aged patients, data concerning long-term prognosis are lacking. We aimed to described evolution and recoveryof aged patients with UGIB to provide original data essential to
improve medical care.
Material and methods: Prospective observational study. All patients with gastrointestinal bleeding and upper endoscopy were
included between June 2015 and may 2016. Comorbidities (CIRS
score), autonomy (ADL and IADL) and frailty (Rockwood) were
prospectively collected. Primary objective was the 6-month mortality. Secondary objective was 6 month functional recovery.
Results: Sixty-six patients were included (age 83±4 years, 55%
women, CIRS score 12 [8–15], ADL and IADL 5.5 [4–6] and 2 [1–4]
respectively, Rockwood 5 [3–6]). Main clinical presentation andetiology were respectively represented by melena (n=48, 73%) andgastroduodenal ulcers (n=44, 67%). Sixty-two percent of patients(n=41) presented at least one complication during hospitalization,and 30 day mortality rate was 15% (n=10). The 6 month mortality was 42%, with 89% of home return in survivors. Considering
6-month functional recovery, there was no difference between
pre-hospitalization and 6-months ADL, IADL and Rockwood scores(6 month values respectively 4.5 [3–6] (p=0.09), 1 [0–3] (p=0.08), 6[4–6] (p=0.4)).
Conclusion: Aged patients with UGIB experienced a high 6-monthmortality rate, but no functional decline was observed in survivors
at 6 months
P-404
Malignant lymphoma more than 80 years old cases
K. Natori, Y. Mitsui, D. Nagase, A. Shibuya, Y. Kuraishi, H. Izumi.
Division of Hematology and Oncology, Toho University Medical Center
Oomori Hospital
Introduction: Because of aging society, the number of nonHodgkin’s lymphoma (NHL) patients were increasing. So we investigated NHL of more than 80 years.
Methods: The subjects in this study were 80 cases who were
histopathologically diagnosed as malignant lymphoma and morethan 80 years old, from January 2003 to December 2014. Survival
curves and the median survival times were estimated by the
Kaplan-Meier method and any signiﬁcant differences between thetwo groups were evaluated by the Log rank test. The authors andcoauthors have no conﬂict of interest to disclose.
Result: All cases were 80 cases including male 38 cases, female 42
cases, median age was 82 years. Pathological ﬁndings, Hodgkin’s
lymphoma 3 cases, non-Hodgkin’s lymphoma (NHL) 77 cases, in
NHL, diffuse large B cell lymphoma (DLBCL) 48 cases, follicularPoster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

lymphoma 6 cases, intravascular large B cell lymphoma 3 cases,
peripheral T cell type 3 cases. MALT 3 cases, others 17 cases.
In DLBCL (48 cases) that was most popular pathological type ofabout therapy, R-CHOP therapy or CHOP based therapy 34 cases,
radiation therapy alone 1 case, best supportive care 8 cases, otherchemotherapy 3 cases, death before therapy 1 case. About clinicaloutcome, complete response rate was 45.8%, median survival time(MST) was 20M, 5-year overall survival rate (5y-OSR) was 40.8%,
about gender, MST were male 10M, female 86M, 5y-OSR were 27.2%,
female 55.2%. There were signiﬁcant difference between male andfemale.
Conclusions: Even if elderly patients, especially 80 years oldpatients, necessary to aim to cure.
P-405
Management of arterial hypertension in patients over 80 years
old hospitalized in a geriatric medical unit
M. Gryllaki, M. Kotsani, A. Kearney-Schwartz, A. Benetos. GeriatricDepartment, CHRU de Nancy, Université de Lorraine, France
Introduction: There is little evidence available regarding the optimal management of arterial hypertension (AH) in older frail adults.
Beneﬁt/risk balance should be evaluated in each opportunity,
including acute hospitalization.
Objective: To investigate changes in antihypertensive treatment ofgeriatric patients during an acute hospitalization.
Methods: A retrospective, medical record based, study was conducted in patients ≥80 years old, hospitalized in a two months’
period, for various reasons, in a Geriatric Medical Unit.
Results: We studied 119 persons (100 women), mean age 87.8±4.8
years. In 37.8% of cases there was a reason of hospitalization potentially related to AH. During the hospitalization 103 antihypertensive
molecules were stopped and 38 were introduced, leading to a 27.1%
reduction of the overall 240 molecules taken at admission. Ninety
patients (76.5%) underwent antihypertensive medication changes.
Antihypertensive drugs were reduced from 2.0 (±1.1) at admission
to 1.5 (±1.1) at discharge (p<0.001), reﬂecting mostly diuretics’and renin-angiotensin inhibitors’ reductions. In 74.7% of cases thereasoning of medication changes was not referred in the discharge
letter. Mean systolic blood pressure (SBP) was 137.2 (±29.3)mmHg
at admission and 129.8 (±21.4)mmHg at discharge (p=0.042). The
prevalence of SBP<130mmHg was 43.7% at admission and 55.5%
at discharge (p=0.05). Among those patients, 75.0% at admission
and 45.5% at discharge received >1 antihypertensive drugs. The
percentage of patients with SBP>160mmHg was reduced (21.8 vs10.1%, p=0.016).
Conclusion: Despite the tendency to reduce antihypertensive medication during hospitalization, SBP levels remain low at discharge.
Many patients with low SBP receive combination antihypertensive
therapy and could be considered as overtreated.
P-406
Mobile Geriatric Unit: we will take care of you wherever you are
C. Girardi 1 , G. Larissa 2 , F. Meroni 2 . 1 Ente osepdaliero Cantonale,
Ospedale Regionale di Lugano, servizio sottocenerino di Geriatria, sede
ospedale Italiano. Lugano - Svizzera; 2 Ente Ospedaliero Cantonale,
Ospedale Regionale di Lugano, servizio sottocenerino di Geriatria, sede
ospedale Italiano. Lugano - Svizzera
Introduction: Emergency department and medical and surgicalwards are always more confronted with the complexity of older
patients.
Methods: Since September 2015 in the regional Hospital of Lugano
a geriatric project is ongoing to improve the taking in charge of theelderly patients at their arrival in the emergency department andto take care of them throughout their stay in hospital by a transver-

S157

sal approach. At the arrival at the emergency room, the patientundergoes to modiﬁed ISAR score and if it is positive MGU (Mobile
Geriatric Unit) is contacted to evaluate the patient. The geriatrics
inpatient are referred to medicine and surgery department, and thegeriatrician cooperate in a multidisciplinary assessment. The geriatrician also attend constantly to grand rounds in surgery for taking
in charge of complex geriatric patientsThe clinical nurse specialistin geriatrics collaborates in educational training for nursing staff ofvarious specialties to improve the total care of the elderly patientsand to help the caregivers for an appropriate approach.
Results: Since September 2015, approximately 17% of patients in
ED had more than 75 years, and 15% of these had a positive
modiﬁed ISAR score. The 32% of these patients were hospitalized.
The 30% had one of the great geriatric syndromes as reason of
hospitalization. Patients with a positive ISAR in 25% had an hospital
readmission, as described in medical literature, but we found a
decrease in inappropriate hospitalizations.
Conclusions: A better taking charge of geriatrics inpatient andoutpatient reduce inappropriate hospital re-admission
P-407
Multiple neoplasms including hematological malignancies ofthe more than 80 years elderly
K. Natori 1 , D. Nagase 2 , Y. Mitsui 2 , A. Shibuya 2 , Y. Kuraishi 2 ,H. Izumi 2 . 1 Division of Hematology and oncology, Toho University
Medical Center Omori Hospital; 2 Division of Hematology andOncology, Toho University Medical Center Oomori Hospital
Introduction: Progress of therapy and supporting therapy improved
a prognosis. Synchronous type patients were diﬃcult to treat. We
reviewed synchronous type of multiple neoplasms including thehematological malignancies of more than 80 years old.
Methods: In the case that hematologic malignancy was diagnosedin our hospital from 1988 to 2015, we intended for double cancer
340 cases including hematological malignancy. We reviewed 46
multiple neoplasms of synchronous type of the more than 80 years.
The examination factors are kind of the hematological malignancy,
treatment, gender, tactics of therapy.
Results: All cases were 46 cases, including male 31 cases, female
15 cases, number of malignancies, double 39 cases, triple 6 cases,
quadple 1 case. Hematological malignancies to constitute were
non-Hodgkin’s lymphoma (NHL) 24 cases, multiple myeloma 3case, myelodysplastic syndrome 8 cases, acute leukemia 4 case,chronic leukemia 2 cases, others 6 cases, about solid cancer, gastriccancer 14 cases, prostate carcinoma 7 cases, lung cancer 6 cases,colon cancer 11 cases, pancreatic cancer 3 cases, breast cancer 4
cases, others 8 cases. About therapy, chemotherapy (CTx) + Ope
29 cases, CTx only 6 case, CTx + palliative therapy 5 cases, Ope +transufusion (TF) only 5 cases, TF only 1 case. About cause of death,19 death cases, hematological malignancy 14 cases, solid cancer 5
cases.
Conclusions: Even if more than 80 years old synchronous multiple
neoplasms, they have chance to survive.
P-408
Neuroleptic malignant syndrome giving rise to malignant
hypertension in a Lewy body dementia patient
N. Aquilina 1 , V. Bugeja 2 . 1 Karin Grech Rehabilitation Hospital,
Guardamangia Hill, Pieta’ PTA1312, Malta; 2 St. Vincent de Paul
Institution, Ingiered Road, Luqa
Introduction: A 91 year old obese lady with Lewy body dementia(LBD) was on quetiapine, which dose recently upped from 25 to
50mg. She was found to be obtunded (Glasgow coma scale 9/15),
ﬂushed, warm and generally rigid, with leadpipe hypertonicity oflimbs. Pyrexia of 41°C was present with rapid, shallow tachypnoea

S158

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247(35 breaths/minute) and hypoxaemia (89% saturation probe), withblood pressure (BP) of 300/160 mmHg.
Method: Fundoscopy revealed ﬂame haemorrhages, urine was clear
but a burgundy colour with dipstix showing full bilirubin andblood readings, examination not yielding additional ﬁndings. It
was reasoned that microangiopathic haemolysis occurred from accelerated hypertension damaging arterial endothelia, which shear
erythrocytes releasing free intravascular haemoglobin, original trigger being subacute neuroleptic malignant syndrome (NMS) fromthe quetiapine increment, which was stopped. Aggressive forced
diuresis with running intravenous (IV) saline and 6mg bumetanide
aliquots to ﬂush the kidneys undertaken; BP controlled with IVlabetalol. Left on paracetamol (for fever) with 8 hourly IV ﬂuids
and bumetanide to preserve good urine output. Haemoglobinuria
cleared after 2 days.
Results: Creatinine kinase and renal function remained normal,
indicating that rhabdomyolysis and renal damage was averted.
Fragmented erythrocytes on blood ﬁlm, unconjugated hyperbilirubinaemia, high lactate dehydrogenase and low haptoglobin conﬁrmed haemolysis. She regained full conciousness and normal tone
within a couple of hours.
Conclusions: LBD renders subjects sensitive to antipsychotic adverse reactions, not least NMS. Accelerated hypertension may
complicate NMS, forced diuresis is imperative to avoid renal
damage and wash out any myoglobin crystals in the event of
rhabdomyolysis.
P-409
Optimizing the ISAR-HP to screen eﬃciently for functional
decline in older patientsJ. de Gelder 1 , J.A. Lucke 1 , L.C. Blomaard 1 , E. Haenen 1 , H.G. Klop 1 ,R.A.J. Smit 1 , K. Mesri 1 , B. de Groot 1 , A.J. Fogteloo 1 , S. Anten 2 ,G.J. Blauw 1 , S.P. Mooijaart 1 . 1 LUMC; 2 Alrijne Hospital
Introduction: The Identiﬁcation of Seniors At Risk-Hospitalized
Patients (ISAR-HP) has recently been included in guidelines as afrailty indicator to identify patients for comprehensive geriatricassessment. Previous studies showed that the conventional cut-off
score classiﬁes a high percentage of patients as high risk incorrectly.
We aimed to optimize the predictive value of ISAR-HP by using
different cut-offs in older acutely hospitalized patients.
Methods: A prospective follow-up study was performed in two
Dutch hospitals. Acutely hospitalized patients aged ≥70 years were
included. Demographics, illness severity parameters, geriatric measurements and the ISAR-HP scores were obtained at baseline. The
primary outcome was a combined end point of functional decline
or mortality during ninety day follow-up.
Results: In total 861 acutely hospitalized older patients were
included, with a median age of 79 years, of whom 276 (36.1%) experienced functional decline or mortality. The conventional ISAR-HP
cut-off of ≥2 assigned 432/765 patients (56.5%) as high risk, witha positive predictive value (PPV) of 0.49 (95% CI: 0.45–0.54) and anegative predictive value of 0.81 (95% CI: 0.76–0.85). Thus, 51% of
those whom the ISAR-HP denoted as high risk did not experience
the outcome of interest. Raising the cut-off to ≥4 assigned 205/765
patients (26.8%) as high risk, with a marginally increased PPV to
0.55 (95% CI: 0.48–0.62).
Conclusion: The ISAR-HP with the conventional cut-off of ≥2 incorrectly identiﬁes a large group of patients at high risk for functional
decline or mortality and raising the cut-off to 4 only marginally
improved performance. Caution is warranted to ensure eﬃcient
screening and follow-up interventions.

P-410
Peculiarities of pneumonia in patients treated in thedepartment of geriatrics
J. Knasiene 1 , V. Medzeviciute 2 . 1 Lithuanian University of Health
Sciences, Department of Geriatrics, Kaunas, Lithuania; 2 Lithuanian
University of Health Sciences, Kaunas, Lithuania
Introduction: Pneumonia in the elderly often present with atypicalsymptoms and radiographic or laboratory tests can be uninformative.
Methods: Using an questionnaire, 83 patients were interviewed.
Main factors inducing the occurrence of pneumonia and physical,
laboratory, radiological data and their incidence were assessed.
Results: Patients had underlying diseases: cardiovascular 91.6%,
cerebrovascular 54.2%, pulmonary 43.4%, neurological 26.5%, kidney 25.3%, chronic infections18.1%, diabetes 14.5%, oncological 12%.
Within 1 month, 30.1% of patients had intravenous therapy, 10.8%- wounds treatment. Within 3 month >2days, 37.5% were hospitalized and 10.8% were nursing home residents. Prostheses were wornby 62.3%, 16.9% of them did not have teeth, caries was observed in
13%. 51.9% of subjects did not have fever, 37.8% had no leukocytosis,
content of neutrophils in 10.8% was within the normal range. No
inﬂammatory inﬁltration was observed in 24.4%. The right lung was
penetrated with inﬁltration in 39%, the left one in 20.8% left, andboth in 20.8%. Hydrothorax evolved in 23.4% of patients.
Conclusions: Main factors inducing the occurrence of pneumonia
in older age are severe comorbidities, interventional procedures,previous hospitalization, life in nursing home, poor oral hygiene. Interpretation of clinical pneumonia data in older age can be diﬃcult:more than half of the subjects did not have fever, a third of them– leukocytosis. A quarter of subjects did not have any inﬁltration
lesions, which complicates the diagnosis
P-411
Peripheral venous catheter replacement – implementation of
new ﬁndings (research protocol)
J. Sousa 1 , H. Neves 1 , B. Augusto 2 , C. Fernandes 2 , A.F. Almeida 2 ,J. Ferreira 2 , A. Cristina 2 . 1 Health Sciences Research Unit: Nursing Portugal Centre for Evidence-Based Practice: a Joanna Briggs InstituteCentre of Excellence, Coimbra, Portugal; 2 Neurologia A - Centro
Hospitalar e Universitário de Coimbra, Coimbra, Portugal
Introduction: New evidence suggest routine replacement of peripheral venous catheters (PVC) should no longer be criteria.
Instead, new studies have proven that clinical criteria versus routine criteria reduce the incidence of phlebitis. As such, and since
implementation of previous guidelines that indicated the need ofroutine replacement lead to a yearly reduction of 3.5% in a neurology ward in a central hospital in Portugal, a new study answering
these new ﬁndings will be developed in the same setting.
Methods: A two phase study of quantitative nature will be developed during a year period. Phase I will target understanding ofpotential gains of this change in criteria, through application of achecklist based on clinical data for PVC replacement and compared
related with the time since placement. Phase II will target nursing
team expertise through workshops in order to improve knowledge,
and the introduction of the clinically-indication as routine for PVC
replacement.
Results: It is expected that change in routine will improve phlebitis
rates by increasing knowledge and expertise in the nursing team.
Conclusions: Guideline implementation are a challenge in macroand micro organisations. With globalisation and access to new
information and ﬁndings, it is important to keep constant update toimprove the standard of care with impact in the patients’ quality oflife.

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

P-412
Persistence of direct oral anticoagulants (DOAC) treatments anddeterminants of their discontinuation in a geriatric population
C. Boully, F. Labouree, L. Caillard, O. Hanon. Université Paris
Descartes, Sorbonne Paris Cité, Paris, France; Assistance Publique–Hôpitaux de Paris, Hôpital Broca, Service de Gériatrie, Paris, France
Introduction: European guidelines underline the necessity of introducing an anticoagulant for elderly people with atrial ﬁbrillation(AF). However, older age of the patients remains one of the main
brakes preventing the prescription of anticoagulants and the continuation of the treatment appears to be low under vitamin K
antagonist (VKA). The arrival of direct oral anticoagulants (DOAC)
offered a new possibility of treatment of the AF but the continuation of the treatment is poorly known. The objective of thestudy is to evaluate the persistence of treatment by DOAC and toanalyze the determinants of their discontinuation in a populationof very old patients, hospitalized in geriatric care unit, presenting a
non-valvular atrial ﬁbrillation.
Methods: Prospective study, conducted between January 2013 andJanuary 2015. One hundred and thirty two patients beneﬁted
from the initiation of a treatment by DOAC (dabigatran or rivaroxaban). The persistence of DOAC use and the determinants of
their discontinuation during 6 months of follow up were analyzed
by descriptive statistics and a model of logistic regression withadjustment on the age, the sex and confusing factors.
Results: The mean age of the population was of 85.2 (SD=4.8),
70% (n=91) were women 12% (n=16) had a history of bleeding, 38%(n=51) had a history of cerebrovascular event. The mean clearance
according to Cockcroft formula was 57.4 ml/min (SD=19.86) and themean score of thromboembolic risk CHA2DS2-VASC scores was 4.17
(SD=1.32). The rate of DOAC’s persistence after a 6 month-period
was 66% (n=89). The main causes of DOACs discontinuation were
the onset of a bleeding event in 33% (n=14), a degradation of therenal function in 19% (n=8), a galenic problem in 9% (n=4), palliative
care in 7% (n=3), a stroke in 5% (n=2), fall and fracture in 5%(n=2) and an unknown cause in 19% (n=8) The main determinantsof DOAC discontinuation were younger age [OR (95% CI) =0.86(0.77–0.95), p=0.004], a history of bleeding [OR (95% CI) = 4.04
(1.09–16.3), p=0.02], a clearance of creatinine lower than 50 ml/min[OR (95% CI) = 3.57 (1.4–9.6), p=0.008] and low albumin (<30g/l)[OR (95% CI) = 2.89 (1.15–7.51), p=0.02].
Conclusion: In this population of very old patients, the continuation of the DOAC appears to be relatively low (66%). In 50% of thecases, discontinuation of treatment resulted from a bleeding eventor impairment of renal function. In a third of the cases, no justiﬁed
reason of treatment discontinuation was found. Speciﬁc studies ingeriatrics are necessary to better estimate the beneﬁt-risk of the
DOAC in very old patients with multiple disorders.
P-413
Prevalence in patients older than 75 years with gastrostomy
placement
V. Landaluce Pelligra, E. Garcia Tercero, T. Martinez Maroto,
M. Araujo, J.C. Manchipa. Complejo Hospitalario de Toledo
Introduction: Placement of gastrostomies in patients older than
75 years is increasing. We propose a retrospective study of 5
years (2011–2016) of patients who underwent gastrostomy in the
Complejo Hospitalario de Toledo, to establish the most frequentgeriatric proﬁle to which a gastrostomy is placed and its outcome.
Methods: Using the collection book of the interventional radiology
service we recorded the name and petitioner’s service retrospectively with sex, age, institutionalization, functional scales (Katz),
cause of request for gastrostomy placement, type of nutrition,
current situation (deceased or alive) and comorbidity.

S159

Results: n=197, 43.7% are men. 50.3% live in the house, 48.7%
in residence. 29.9% of the gastrostomies were placed for stroke,
1.5% for mild dementia, 14.2% for moderate dementia, 44.7% forsevere dementia. 74.6% of patients were hospitalized in geriatrics,
69.5% were hypertensive, 32% were diabetic, 34% were dyslipemic,
11.17% had chronic ischemic heart disease, and 15.74% pressure
ulcers. 51.8% of the patients had a KATZ G, 11.2% KATZ F and theclassiﬁcation was not collected in 20% of the patients. 54.8% of thepatients died, of which the cause of death was not collected in
71.6%, 15.2% died from pneumonia, 3.6% from digestive causes.
Conclusions: We can conclude that the most frequent is to place
gastrostomy in a woman, who lives at home, has dysphagia secondary to moderate-severe dementia, is admitted to the geriatrics
department, has hypertension and KATZ G index. She is given
normocaloric/normoprotein nutrition and dies, ignoring the causeof death.
P-414
Proactive geriatric consultation for elderly orthopedic patients
reduces mortality and length of stay
R. Tellem 1,2 . 1 Tel Aviv Medical Center, Tel Aviv, Israel; 2 Tel Aviv
Univeristy, Tel Aviv, Israel
Background: Traumatic injuries and osteoarthritis are leading
causes for functional deterioration, morbidity and mortality in theolder population. Following orthopedic interventions, older patientsare susceptible to various medical complications - wound and systemic infections, VTE, delirium, pressure sores, and exacerbation ofchronic medical conditions. Delayed identiﬁcation and treatmentof these complications may increase length of stay, morbidity andmortality and increases the risk for functional deterioration andunwanted institutionalization. Geriatricians are trained to perform
early identiﬁcation and treatment of these complications as well as
to direct a multidimensional discharge plans. In the current study
we made an adjustment to the standard care of older patients byemploying a proactive geriatric consultation. Geriatricians served as
an integral part of a multidisciplinary team providing care for older
patients in the orthopedic division. The geriatricians conducted
early post-operative evaluation and continued follow-up in selectedpatients.
Design: Retrospective single center cohort study.
Setting: Orthopedic division of a large tertiary academic hospital.
Methods: Retrospective data was collected for the years 2011–2015.
(The intervention took place between 01.2015 and 31.12.2015). Timefrom operation to geriatric consultation, post-operative length ofstay in the orthopedic division and perioperative mortality werecompared for patients during the intervention period (n=736) andprevious years (n=5786).
Results: Time from operation to geriatric consultation decreased(93 hours to 67 hours median time, P<0.01). Post-operative lengthof stay decreased (6.8 days to 5.9 days, P value <0.01). During
intervention year mortality rate was reduced signiﬁcantly (38 to 34
yearly death rate, P<0.001).
Conclusions: Integrating geriatricians into the multidisciplinary
orthopedic team and applying a proactive geriatric approach led toreduced length of stay and mortality.
P-415
Risk factors for falls in hip fracture older patients admitted to an
Orthogeriatric Unit during the ﬁrst 7 months
L. Costa 1 , A. Santos 1 , I. Ferreira 1 , M. Martins 1 , R. Vaz 1 , S. Pardal 1 ,S. Duque 1, 3 , J. Guimarães Consciência 2 , L. Campos 1 . 1 Orthogeriatric
Unit, Internal Medicine Department, São Francisco Xavier Hospital,
Occidental Lisbon Hospital Center, Lisbon, Portugal; 2 Orthogeriatric
Unit, Orthopedics Department, Occidental Lisbon Hospital Center,

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Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

Lisbon, Portugal; 3 University Geriatric Unit, Faculty of Medicine,
University of Lisbon, Lisbon, Portugal
Introduction: Hip fracture (HF) in elderly usually occurs as acomplication of a fall. To prevent future falls it is important tounderstand the risk factors for falls (RFF) and to correct them. Our
goal is to identify the most prevalent RFF in elderly assisted during
the ﬁrst 7 months of a new Orthogeriatric Unit.
Methods: Retrospective study of elderly admitted due to HF
between June and December 2016 through hospital record analysis.
Results: 134 patients included (123 underwent comprehensive
geriatric assessment, 124 underwent pharmacological assessment).
Average age 83.87 years, 78.4% females. Average baseline Barthelscore 80.3, average Cumulative Illness Rating Scale Geriatrics 7.45.
6.9 RFF per patient in average and the most prevalent were: fallrelated drugs (FRD) use (81%, 2 FRD/patient), being female (78%),
polypharmacy (5 or more drugs) (69%, 6.5 drugs/patient), limitationin activities of daily living (69%), older age (≥85 years) (53%), cognitive impairment (48%), use of mobility aids (48%), malnutrition(26%), inactivity (24%), falls history (21%), cerebrovascular disease(21%), diabetes (19%), obesity (18%), gait impairment (17%), anaemia(15%), living alone (15%) and sphincters incontinence (15%), visual impairment (14%), osteoarthrosis (14%), hyponatremia (13%),depression (12%) and osteoporosis (10%). 59% were consuming
psychotropic drugs: benzodiazepines (32%), antipsychotics (19%),
selective serotonin reuptake inhibitors (19%). Other FRD prescribed
were: proton pump inhibitors (43%), antihypertensive drugs (33%)
and diuretics (28%).
Conclusions: Prescription of FRD is a very prevalent RFF in patients
admitted for HP and must be systematically assessed during theadmission to prevent future falls.
P-416
Risk factors for negative outcome in elderly emergency
department patients

P-417
Sleeping quality and sleep disturbing factors assessed bygeriatric patients in single-bed or multiple-bed hospital
H. Saugbjerg Weng 1 , M. Bredahl Sørensen 1 , M. Gregersen 2 . 1 VIA
University College, Aarhus, Denmark; 2 Department of Geriatrics,
Aarhus University Hospital, Aarhus, Denmark
Introduction: Lack of sleep during acute hospitalization has single
effects such as increase in infection rate. Also, it increases bloodpressure, and the risk of behavioral and psychological changes.
Thereby recovery after illness extends. Our aim was to explore
sleeping quality and sleep disturbing factors in older patients insingle-bed compared to multiple-bed rooms.
Methods: In a cross-sectional study, we consecutively included cognitive well-functioning older patients admitted to a geriatric ward
before and after the ward was moved from a multiple-bed hospital
to a newly built single-bed hospital. They were acutely admitted
primarily due to infection, hip fracture, or stroke. By a short-form
questionnaire each patient was asked once in the morning ≥2 daysof hospitalization: “Did you sleep well during the night?”, and “Didanything disturb your sleep?” If the patient had been disturbed, thecauses of disturbances were registered.
Results: In total, 226 (111/115) patients were included. Mean age
was 83.6 years (±8.0), and 63% were women. Overall, 69% of thepatients slept well, and 46% were disturbed during night. Morepatients in single-bed rooms assessed their sleep as good comparedto the patients in multiple-bed rooms (p=0.01). Quality of sleep
and disturbances were associated (p<0.001). External disturbances
e.g. noise from staff or fellow patient were fewer in single-bed (4%versus 14%) (p=0.01). Internal disturbances e.g. pain and urge tourinate were equal (15% versus 18%).
Conclusion: Older inpatients assess their sleeping quality betterin single-bed than in multiple-bed rooms, and experience fewer
disturbances during the night.

Ö. Sir 1 , Y. Schoon 2 . 1 Department of Emergency, Radboud university
medical center, Nijmegen, The Netherlands; 2 Department of Geriatrics,
Radboud university medical center, Nijmegen, The Netherlands

P-418
ST Segment Elevation Myocardial Infarction (STEMI) in theelderly over 75 years: retrospective study in a general hospital

Introduction: The amount of older patients attending the emergency department (ED) is increasing. Execute interventions to
reduce negative outcome in elderly are important. Therefore, risk
factors for negative outcome were identiﬁed.
Methods: From all patients ≥70 years who visited the ED of anuniversity hospital in 2016, 2000 patients were randomly selected.
Patients and visit related information were collected retrospectively.
Negative outcome was deﬁned as: in-hospital mortality and/or ICU
admission, and unplanned ED revisit within 30 days. Risk factors fornegative outcome were determined by logistic regression analysis.
Results: Of the 2000 patients (mean age 78.3years, SD6.5), 222(11.2%) had a negative outcome; 65 patients (3,3%) in-hospitalmortality, 111 (5.6%) patients ICU admission and 46 (2,3%) patient
who died in the hospital during or after ICU care combined. The
total revisit rate within 30 days was 12.1% (n=228). The rates fordischarges (12.9%;n=94) and admitted (11.6%; n=134) patients did
not differ signiﬁcant (p=0.39). A diagnosis in neurology (OR 4.2,
95% CI: 1.5–11.6), surgery (OR2.3, 95% CI: 1.0–5.1), pulmonology andcardiology (OR 2.9, 95% CI: 1.1–7.6) or multi-trauma (OR12.3, 95%
CI: 1.2–127.1), ambulance transportation (OR3.5, 95% CI: 2.2–5.3) ortrauma helicopter transportation (OR 30.8, 95% CI: 8.1–116.5) are
independent factors predicting negative outcome.
Conclusions: Independent risk factors for negative outcome are
diagnosis in neurology, surgery, pulmonology and cardiology or
multi-trauma, next to transportation by ambulance or trauma
helicopter.

M. Kerif 1 , N. Kadri 2 , J. Doucet 2 . 1 Hospital of Troyes; 2 University
Hospital of Rouen
Introduction: Data on ST elevation myocardial infarction in patients
aged over 75 years remains sporadic.
Methods: We completed a retrospective study at the Centre Hospitalier de Troyes, including all patients aged over 75 years treatedby emergency physicians in pre-admissions or in emergency wards
presenting with acute ST elevation myocardial infarction between
January 2015 and February 2016 inclusive. We also identiﬁed asecond group of subjects, aged below 75 years, with the same
number of members, in order to be able to perform a cross-analysis.
Results: We retrieved details of 32 patients aged over 75 years,
with a mean age of 84.56 years (75–100 years), of which 22 were
women. The mean Charlson comorbidity score is estimated at 3.44
(1–8) and the mean Grace score is estimated at 216 (168–345).
Reperfusion was performed by way of an angiogram in 46.75% ofcases; no patient in this group was subject to thrombolysis. The
mean time before performance of the initial angiogram is estimatedat 5,149 minutes (or over 85 hours); approximately 21.9% of patientswere treated by way of insertion of a stent. One half of angiograms
were not accompanied by the insertion of stents. Mortality duringhospitalization occurred in ten cases and, in total, 12 patients
passed away within six months. Thirty-one patients aged below 74
years, with a mean age of 55.06 years (25–74 years) were included
in a study over a shorter period, namely three months, with the
majority being men (27 subjects). Angiograms were performed in
96.77% cases, whereas thrombolysis was performed in the cases ofPoster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

only two patients. We did not record any mortality during hospitalization, nor at an interval of one month or three months. There are
more female subjects among patients aged over 75 years and moremale subjects among patients aged below 75 years (p<0.0001).
Subjects aged over 75 years were more likely to have consulted
their treating physician prior to attending the emergency ward
(p=0.002). The Charlson score is more signiﬁcant in subjects aged
over 75 years (p<0.0001); the same applies for the Grace score(p<0.0001). Subjects aged over 75 years were provided with less access to angiograms than subjects aged below 75 years, and were lesslikely to beneﬁt from a stent insertion (p<0.0001). Age≥75 years
increases the risk of mortality during hospitalization (p=0.001), at
one month (p=0.001) and at six months (p<0.0001). The prognosis
for ST Segment Elevation Myocardial Infarction (“STEMI”) patientsis bleak. Mortality at one year in patients aged over 80 years
is seven times higher than for patients aged below 70 years in
the ASC II register. In the GRACE register, age was highlighted as
an independent factor correlated with the absence of reperfusion
treatment during the acute phase, along with a history of surgicalrevascularization, diabetes, heart failure, and the absence of chest
pain. In the PLATO ELDERLY study, angiograms were deployed in
56.6% of cases, with angioplasty a featuring in 73.2%. A recent study
on sudden cardiac arrest in elderly patients based on the ACOS
register shows that mortality during hospitalization was recorded
at a rate of 12.5% among the medical treatment group, compared
to 6% among the group that beneﬁted from an invasive treatment
strategy. In the FAST-MI register, 85.3% of patients aged below
65 years were treated via angioplasty or ﬁbrinolysis in cases of
STEMI, compared to only 53.6% of subjects aged over 85. According
to Kuch, angioplasty is the single predictive factor for survival at
18 months. Coronary angioplasty in subjects aged over 85 years
is thus technically feasible with a satisfactory success rate andacceptable rates of morbidity and mortality, given the severity of
the coronary condition and the associated comorbidity. Mortality is
the criterion used in studies to judge the effectiveness of coronary
angioplasty in octogenarian patients, but it is also important toassess quality of life as suggested by Shah et al, demonstratingthat angioplasty performed in subjects aged over 75 suffering fromSTEMI is an independent predictive factor for an improvement inlong-term survival, and also demonstrating that their quality of life
is comparable with that of a similarly aged, non-institutionalized
control population.
Conclusion: STEMI in elderly subjects remains a current topic, bothin terms of therapy and prognosis.
P-419
Stroke as ﬁrst manifestation of essential thrombocythemia in anonagenarian
I. Elhani, M. Pierre, P. Lescure. Centre Hospitalier Universitaire,
Normandie Université, UNICAEN, Caen, France
Introduction: Essential thrombocythemia is a myeloproliferative
disease characterized by an elevation of platelet count. On rareoccasions it can cause ischemic disorders such as strokes. They canaccount for 0.54 to 1% of ischemic strokes. They are exceptionalin the oldest-old population, in which the two major causes ofischemic strokes are embolism and atherosclerosis.
Case description: A 92-year-old woman with history of hypertension was admitted with broca’s aphasia. We diagnosed her with left
sylvian ischemic stroke. There was no evidence of atrial ﬁbrillation,
carotid stenosis, endocarditis, dyslipidemia or diabetes. Her platelet
count had been measured over 6G/L several times in 3 years, andwas each time attributed to an infectious or inﬂammatory event.
There was no iron deﬁciency or chronic inﬂammation. She hadno history of thrombosis or bleeding manifestations. The V617F
mutation of JAK2 was positive. We diagnosed her with essen-

S161

tial thrombocythemia. She was treated with a daily dose of 160
milligrams of aspirin.
Conclusion: Stroke revealing Essential thrombocythemia is rare.
Even though the age of diagnosis is rarely over 70, clinicians mustsuspect a hematological neoplasm included in a geriatric population. Esssential thrombocythemia can easily be suspected with asimple blood count. Persisting high platelet count should alert thephysician and lead to a non-invasive detection of the V617F mutation of JAK-2, especially if ischemic manifestations are reported.
Indeed, the preventive treatment by combined antiplatelet andcytoreductive therapy could be proposed to allow the maintenanceof functional ability and quality of life in the elderly.
P-420
Symptom recognition in acute heart failure patients
J. Pereira Sousa 1 , M. Santos 2 . 1 Instituto Ciências da Saúde Universidade Católica Portuguesa, Porto, Portugal; 2 Centro deInvestigação Interdisciplinar em Saúde, Porto, Portugal
Introduction: Heart Failure is a chronic disease that requires patients to develop appropriate self-care behaviours, and to be able
to detect early symptoms and signs of disease as well. Diﬃcultyin early detection of heart failure signs and symptoms can delay
contact with healthcare providers, possibly leading to severe physiological changes and hospital admission. The aim of this study was
to identify if Heart Failure patients were able to recognize symptoms of the disease, after an educational program about symptom
recognition.
Methods: Through an exploratory study we analysed if Heart
Failure patients, admitted to an Intensive Heart Failure Unit Care,receiving education about signs and symptoms at time of discharge,
could mention them one week and one month after discharge.
Results: 28 patients were enrolled. One week after discharge
patients were contacted by telephone and asked if they could
mention Heart Failure symptoms. 74.1% could recognize dyspnoea,
44.4% tiredness, 29.6% weight gain, and only 14.8% mentioned ankle
oedema. One month after discharge, in a clinic follow-up, 61.5%
mentioned dyspnoea, 34.6% tiredness, 11.5% weight gain, and only
3.8% (one patient) referred ankle oedema.
Conclusions: These ﬁndings suggest that heart failure patients may
beneﬁt from a disease management program that facilitates earlier
reconnaissance of signs and symptoms of this disease.
P-421
The consumption of benzodiazepine substances in the elderly
S. Hammami, I. Chabéne, A. Mhalla, L. Gaha. CHU F Bourguiba,
Department of Internal Medicine, University of Monastir, Tunisia
Objectives: To evaluate the consumption of psychoactive substances (PAS) in elderly patients followed in outpatient psychiatry
and geriatic and identify factors correlated with the dependence on
benzodiazepine (BZDs) or tobacco.
Methods: We conducted a transversal study, over a period of
six months, that involved 100 patients aged over 65 years. The
patients answered the scale of “Fagerstrom” for the evaluation of
the nicotine dependence and the cognitive scale of attachment to
BZDs (ECAB).
Results: The mean age of patients was 69 years (65–82). The
sex-ratio was 0,96; 82% of patients had not exceeded the level ofsecondary education and 72% of them were married. Thirty-ﬁve
percent had a somatic co morbidity. The depressive disorder was
the most common on (41%). Antipsychotics were prescribed in
56% of case, anxiolytics (BZDs) in 40% of patients. 73% of the ourpatients consumed regularly at least one PAS (the BZDs in 40% witha dependency ratio of 90%). 92,5% of patients consumed the BZDs
for at least 2 years with an average dose 3,87 mg per day. Regarding

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smoking, 34% of patients smoked regularly with an average amountof cigarettes 42,3 per day. The half of smokers had a strong orvery strong nicotine addiction. No patients reported an alcohol
consumption or use of illicit products.
Conclusion: In the elderly, dependence on psychoactive substances
can affect daily life and be responsible of somatic, cognitive andpsychiatric complications. The BZDs are the most often involved. It
is therefore essential to respect their indications, contraindications
and educate patients.
P-422
The course of geriatric syndromes from admission to threemonths post-discharge and their effect on adverse outcomes:
results from the Hospital-ADL cohort study
R. van Seben 1 , L.A. Reichardt 1 , J.J. Aarden 2 , M. van der Schaaf 2 ,R.H.H. Engelbert 3 , J.A. Bosch 4 , B.M. Buurman 5 . 1 Department ofInternal Medicine, Section of Geriatric Medicine, Academic Medical
Center, Amsterdam, The Netherlands; 2 Department of Rehabilitation,
Academic Medical Center, The Netherlands & Amsterdam Center for
Innovative Health Practice (ACHIEVE), Faculty of Health, Amsterdam
University of Applied Sciences, Amsterdam, the Netherlands;
3 Amsterdam Center for Innovative Health Practice (ACHIEVE), Facultyof Health, Amsterdam University of Applied Sciences, Amsterdam, theNetherlands; 4 Department of Clinical Psychology, University of
Amsterdam, Amsterdam, The Netherlands; 5 Department of Internal
Medicine, Section of Geriatric Medicine, Academic Medical Center,
Amsterdam, The Netherlands & Amsterdam Center for Innovative
Health Practice (ACHIEVE), Faculty of Health, Amsterdam University ofApplied Sciences, Amsterdam, the Netherlands
Introduction: Studies have addressed the prevalence of geriatricsyndromes during hospitalization and showed their association
with adverse outcomes. However, data on their course postdischarge and association with recovery are scarce. This study
assessed the course of geriatric syndromes from admission until
discharge and then monthly until three months post-discharge andtheir impact on functional decline, readmission, and mortality.
Methods: A multi-center cohort study, the Hospital-AssociatedDisability and Impact on Daily Life (Hopital-ADL) study, was conducted, including 400 acutely hospitalized patients aged ≥70 years
admitted to an internal, cardiology or geriatric ward from six Dutch
hospitals. Geriatric syndromes assessed included: fatigue; malnutrition; fall risk; fear of falling; shortness of breath; incontinence;
pain; dizziness; depressive symptoms; cognitive impairment.
Results: 80% of patients experienced fatigue at admission, which
remained present among 50% up to three months post-discharge.
40% were malnourished at admission, and still 20–30% in the ﬁrst
three months post-discharge. Almost 40% experienced a fall six
months prior-hospitalization, and 11–12% had a fall in the ﬁrst,
second and third month respectively. 40% were afraid to fall at
admission, 30% in the ﬁrst months post-discharge. 15–35% experienced shortness of breath, incontinence, pain and dizziness during
and post-hospitalization. 22% experienced depressive symptoms at
admission, 11% post-discharge. 20% was cognitive impaired at admission, which decreased to 11% post-discharge. At admission andpost-discharge, depressive symptoms, malnutrition, fear of falling,
shortness of breath and pain were associated with functional
decline, readmissions and mortality.
Conclusion: Our study underpins the importance of addressing
geriatric syndromes in transitional care interventions.
P-423
The frequency of short and long term readmissions in thegeriatrics ward
F.O.K. Kocak 1 , S. Şahin 1 , H. Şimşek 2 , F. Akcicek 1 . 1 Ege University

Hospital, Department of Internal Medicine, Division of Geriatrics,
Izmir, Turkey; 2 Dokuz Eylül University Hospital, Department of
Healthcare, Izmir, Turkey
Introduction: Patient readmissions increase the mortality and morbidity and also cause a heavy ﬁnancial burden. The purpose of thisstudy is to determine the frequency of readmissions in the geriatricward and related factors.
Methods: 129 patients who have been admitted to the Geriatrics
Ward of Ege University between April 2016–2017 were reviewed
retrospectively. The demographical data, medical histories and thereasons of admission of the patients were obtained from theelectronic ﬁles.
Results: 39 (30.2%) of the admitted patients were male whereas 90(69.8%) of them were female. The average of age was 79.6+7.5 (65–100). The average admission period was 13.5+8.5 (2–51)(SS:0.7).
60.5% of those patients had 3 or more chronic disease. 17 patients
have been readmitted within a year (13.1%). Despite no signiﬁcantrelation has been found between the frequency of readmission andthe age or gender, it was seen that it is related to the coronary
artery disease (ﬁsher’s p:0.029). Even if there is not any signiﬁcant relation between the number of diseases and the frequencyof readmission, while performing Cox regression analysis, it wasseen that when the number of diseases increase, the possibilityof readmission increases 5.9 times and the reason of obtaining a
conﬁdence interval of 1–34.4 was correlated with having limited
number of patients.
Conclusions: There is a signiﬁcant relation between the coronary
artery disease and the frequency of readmission. It is necessary to
carry out studies covering higher number of patients in this respect.
P-424
The hidden abscess
S. Ponnambath, R. Hinton, A. Miller, F. Rickard, S. Kestenbaum,
J. Brazier, H. Kirk, E. Barton. University Hospitals Bristol NHS
Foundation Trust, Bristol, United Kingdom
Case report: A 91 year old lady was admitted with a fall andconfusion. Past medical history included TIA, hypertension, cognitive impairment and diverticular disease. Examination revealed
decreased power in the right upper and lower limb, right uppermotor neuron facial nerve palsy and right sided sensory loss. She
had sustained a laceration to the right leg. CT brain revealed
intraparenchymal haemorrhage within the left frontal lobe. She
underwent rehabilitation with signiﬁcant improvement. 3 weeks
into the admission she developed fever and elevated CRP. Examination did not reveal localised infection. Investigations including
a leg wound swab, urine culture, blood cultures, chest radiographand trans-thoracic echocardiogram were all normal. No conﬁrmed
source of infection could be identiﬁed, and the fever and inﬂammatory response continued. She appeared otherwise well andwas haemodynamically stable. A dental team visited the ward toreview all our patients’ oral hygiene. They noted this lady’s bottom
teeth were loose though not painful, and recommended imaging
with an orthopantomogram. This revealed a dental abscess, which
explained her recurrent fever. She was treated with intravenous coamoxiclav, responded well and the CRP normalised. The infection
resolved fully and she made a good recovery.
Conclusion: Our case reinforces the need to take a broad andthorough approach when investigating occult infections, as well as
highlighting the value of ready access to dental care for patientsduring long inpatient admissions. Dental abscess is not commonly
thought of and can be easily missed.

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

P-425
The importance of a quick treatment
E. García Tercero 1 , T. Martínez Maroto 1 , V. Landaluce Pelligra 1 ,M. Araujo Ordoñez 1 , L.A. Porta Gonzalez 1 , R.M. García Tercero 2 .
1 Hospital Virgen del Valle, Toledo, Spain; 2 Hospital General
Universitario Alicante, Alicante, Spain
A woman (78 years-old) goes to Emergency, referring in the last two
weeks to intense headache and double vision with an intermitent
look to the left. The day of admission wakes up with worsening painand drooping eyelid. FFCC: conscious and oriented. No alterationsof the language. PPCC: anisocoric pupils with right mydriasis notreactive to light. Paralysis of the upper right, lower right, and rightinternal binocular diplopia in all positions of the eye except for
the right lateral view. Right parietal ptosis contacting upper pupil
border. V, VII, VIII and normal low pairs. F.of eye not papiledema(Valued by normal AV ophthalmology in both eyes). Tone andforce conserved in the four extremities 5/5. ROT ++/++++. Bilateral
ﬂexor RCP. Superﬁcial and painful tactile sensitivity conserved in
the 4 extremities. No dysmetria or dysdiadochokinesias. Analytical: Normochromic normocytic anemia. Rest as normal. VSG 57.
Biochemistry: without alterations.
Differential diagnosis: Tumor metastasis, ophthalmoplegic migraine, cerebral aneurysms, temporal arteritis (Comparative table is included where the ﬁnal diagnosis is indicated). TREATMENT: Methylprednisolone 1g i.v. 3days. Subsequently prednisone
60mg/day when the visual loss stabilized.
Discussion: Giant cell arteritis is the most common form of systemic
vasculitis affecting the elderly with potentially severe systemic andophthalmologic complications. It’s a diagnostic challenge becauseof its clinical presentation, which has a wide and variable spectrumof signs and symptoms. In the case of the patient, treatment withcorticosteroids was started, improving rapidly from the clinic so it
was not possible to perform a biopsy of the temporal. It evolved
favorably and in the month-to-month review was asymptomatic
P-426
Trajectories of depressive symptoms and apathy from
hospitalization to three months post-discharge; The
Hospital-ADL study
L. Reichardt 1 , R. van Seben 1 , J. Aarden 2 , M. van der Schaaf 1 ,R. Engelbert 2 , J. Bosch 3 , B. Buurman 1 . 1 Academic Medical Center,
Amsterdam, The Netherlands; 2 Amsterdam University of Applied
Sciences, Amsterdam, The Netherlands; 3 University of Amsterdam,
Amsterdam, The Netherlands
Depressive symptoms and apathy are both causes for and aconsequences of hospitalization among older persons. Depressive
symptoms and apathy are highly heterogeneous in its course, andpsychological or physical recovery may be related to distinct trajectories. These trajectories are unknown in the context of acutehospitalization and possibly important for post-hospital recovery.
Therefore, the aim of this study was to identify distinct trajectories
of depressive symptoms and apathy from acute hospitalization
until three months post-discharge and to study the incidence offunctional decline and mortality three months post-discharge inthese trajectories. We conducted a multicenter prospective cohort
study, the Hospital-Associated Disability and impact on daily Life
(Hospital-ADL) study, including 400 acutely hospitalized patientsof 70 years and above. Data were collected in six Dutch hospitals.
We identiﬁed three depressive symptoms consistently trajectories
among acutely hospitalized patients: 1]high level of depressive
symptoms (10%), 2]moderate level of symptoms (28%), and 3]minimal symptoms (62%). Percentages of functional decline in theﬁrst, second and third group were 32%, 31%, and 12%, respectively.
Mortality rates per group were 25%, 17%, and 5%, respectively.

S163

We identiﬁed three apathy trajectories: 1]consistently high levelof symptoms (19%), 2]), 2]consistently moderate level (23%), and3]moderate level of symptoms and decreasing post-discharge (15%).
Percentages of functional decline were 23%, 7%, and 15% respectively. Mortality rates per group were 14%, 3%, and 0% respectively.
These distinct trajectory groups of depressive symptoms and apathy provide information about the possible prognosis of these
symptoms and functional recovery after an acute hospitalization.
P-427
Two men with unexplained weight loss
F. Rickard, S. Ponnambath, E. Stratton, T. Allain, R. Hinton, A. Miller,
L. Nel, C. Holmes. University Hospitals Bristol NHS Foundation Trust,
Bristol, United Kingdom
Case report: We present two cases of 70 year old men: both British,
Caucasian, heterosexual, and working in professional roles. The ﬁrst
presented with unexplained diarrhoea and colonoscopy showed
lymphocytic colitis. Over next 6 months he developed ophthalmic
shingles and lost 12kg in weight. He then presented with left sided
weakness. MRI showed acute and multiple old right cerebellar
infarcts. He was diagnosed with post-zoster stroke syndrome andtreated with intravenous aciclovir and antiplatelets. Further testing
revealed him to be HIV and syphilis positive, with CD4 count of
80 and viral load of 28474 and commenced on ART. The second
had a 4-week history of deteriorating cognition on a backgroundof 4 years of chronic ill health, including muscle wasting andweakness, 16kg weight loss, recurrent oral candida, and Bell’s Palsy.
MRI brain revealed cerebral volume loss. He then presented withthrombocytopenia and worsening confusion. Testing revealed him
to be HIV positive, with CD4 count of 28 and viral load >1 million. Diagnoses of HIV-associated dementia and immune mediatedthrombocytopenia were made. IVIg and HAART were commenced
and his confusion improved.
Discussion: The age distribution of newly diagnosed HIV is changing, with diagnoses in older adults increasing. Late diagnosis isassociated with HIV-related morbidity and mortality in UK, andolder adults, particularly white, heterosexual men, are at increased
risk of late diagnosis. Both gentlemen had been investigated for
conditions which, in hindsight, were HIV-related and according to
British HIV Association guidelines should have triggered an HIV
test.
P-428
Understanding the phenomenology of unplanned admissions inpatients with Parkinson’s disease, to drive service development
and quality
A. Thomson, C. Miller, L. Partington, P. Cotton. Salford Royal Hospital
Introduction: Patients with idiopathic Parkinson’s disease (iPD)
may be admitted to hospital with unanticipated acute illness. An
understanding of the factors associated with hospital admission
could be used to design a bespoke service to enhance patient careand safety, and promote discharge home.
Methods: All unplanned iPD admissions to the Emergency Assessment Unit (EAU) of a University teaching hospital between 1st
January and 31st December 2014 were identiﬁed by electronic
search for coded cases. Retrospective electronic case note review of
each admission was undertaken.
Results: 80 patients (male 52.5%, mean age 77.2 years) accounted
for 136 admissions. 26/80 (32.5%) were known to have dementia.
The principle diagnoses on admission were falls (24.3%), delirium(9.6%) and immobility (7.4%). The overall delirium rate was high(30.2%) and strongly associated with mortality. Medication errors
in the ﬁrst 24 hours of admission were also common (76.9%), with
137/563 (24.3%) doses missed. Mean length of stay was noted to be

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Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

longer on non-Geriatric specialty wards (23.1 days versus 16 days).
65.4% never saw a member of the iPD team during their stay.
Conclusions: Having determined patterns of admission and targets
for quality improvement, an in-reach programme was developedin 2015. This involved a timetabled, Geriatrician-led presence by amember of the iPD team on the EAU, and incorporated an Emergency Care Bundle to address medication management, delirium
screening/intervention and other strategies. This framework has
further evolved to include an email alert system for admissions andenhanced follow-up for the duration of that patient’s stay.
P-429
Why can I see two doctors?
E. García Tercero 1 , V. Landaluce Pelligra 1 , T. Martínez Maroto 1 ,M. Araujo Ordoñez 1 , M. Alonso Seco 1 , R.M. García Tercero 2 .
1 Hospital Virgen del Valle, Toledo, Spain; 2 Hospital General
Universitario Alicante, Alicante, Spain
A 76-year-old woman who has been admitted for dizziness, feverand general malaise for two days. In Urgencias, ITU is targeted. And
enter with ceftriaxone 2g/24h. At the ﬁrst day she had, partiallyyielding with antipyretics. It also refers to frontally predominantheadache and vomiting. Decreased consciousness level. Her familyﬁnds her more oblivious than previous days. In the face of suspectedencephalitis, a large study is urgently conducted and empiric treatment with acyclovir is initiated. No allergies, Diabetes, ex-moderatedrinker, colonic diverticulosis. Medication: Metformin 850mg/12h.
Exploration: Conscious, bradypsychic. Well moisturized, perfusedand colored. AC: rhythmic without blows. AP: normal. EEII: withoutedema. NEURO: normal. Analytics: CT CRANEAL and RM CRANEAL:
normal. EEG: Irritative activity with pseudoperiodic complexes
ofBilateral temporal topography predominating to the right. PCR
for HSV1: positive. Diagnosis: Herpetic encephalitis. Treatment:
Acyclovir 800mg/8h – 14 days. Evolution: It presented a favorable
evolution. After 2 weeks of treatment, the patient was discharged
with severe amnestic sequelae. Herpetic encephalitis is a serious
disease, with a high mortality rate and neurological sequelae in
relation to others. It is mainly caused by HSV 1 by 90%. The clinicalpresentation together with EEG, MRI and CSF analysis are key in its
diagnosis. The treatment is intravenous acyclovir at a dose of 10
mg/kg/8 h for 10–21 days. A high diagnostic suspicion and a fast
onset of treatment dramatically change the prognosis, improving
survival. It’s recommended to initiate antiviral therapy in the ﬁrst
four days to avoid mortality and short-term complications.

Area: Geriatric rehabilitation

P-430
ACCRA Project: Agile Co-Creation for Robots and Aging
L. Fiorini 1 , G. D’Onofrio 2 , R. Limosani 1 , D. Sancarlo 2 , A. Greco 2 ,F. Giuliani 3 , A. Kung 4 , P. Dario 1 , F. Cavallo 1 . 1 Scuola SuperioreSant’Anna; 2 Complex Unit of Geriatrics, Department of Medical
Sciences, IRCCS “Casa Sollievo della sofferenza”, San Giovanni Rotondo,
Foggia; 3 ICT, Innovation and Research Unit, IRCCS “Casa Sollievo della
Sofferenza”, San Giovanni Rotondo, Foggia; 4 Trialog, Paris, France
Introduction: European population is getting older. This is the result of a simultaneous drop in fertility rates, longer life expectancies
and a shift of the post-war baby boom generations to the top of
the age pyramid. This demographic shift implies the understandingof healthy aging and age-related diseases as one of our futurechallenges. The aim of ACCRA (Agile Co-Creation for Robots andAging) is to enable the development of advanced ICT Robotics
based solutions for extending active and healthy ageing in daily

life by deﬁning, developing and demonstrating an agile co-creation
development process.
Methods: ACCRA robotics solutions will be designed and developed
to be tested in three different domains: walking support, housework, conversation in four countries (i.e. Italy, France, Netherlands
and Japan). ACCRA project consists of three robotic applications
which aims to promote the independent living by means of personal mobility application, to support the daily life management
thanks to housework application and to promote conversation
rehabilitation tailored on personal attitude by means of dedicatedsoftware programme. Additionally, ACCRA project will be designed
and developed on open source framework (i.e. ROS, FIWARE, universAAL and Rospex) to promote the interoperability among scientiﬁccommunity.
Conclusions: The availability of new solution to increase independence and increase quality of life in a sustainable manner appear to
be mandatory considering the actual socio-economic situation overthe industrial countries.
P-431
An intervention project for the community-dwelling elderly
living in a rural area of Izmir to prevent falls
B. Deger 1 , F. Sarac 2 , S. Savas 2 , F. Akcicek 2 . 1 Institute of Health
Sciences, Ege University; 2 Geriatrics Section, Department of Internal
Medicine, School of Medicine, Izmir, Turkey
Introduction: Balance disorders (BD) are one of the most importantrisk factors leading to falls. The purpose of the present study was
to determine the elderly people with BD and history of falls, theetiologies, and to identify the elderly who need aids and to supply
support for them in a rural area.
Materials and methods: A total of 639 elderly living in a ruralarea over 65 years of age who were selected by stratiﬁed random
sampling were enrolled. The study was performed as face to facesurvey study at homes of the elderly. BD was determined by “Berg
Balance Scale” (BBS).
Results: The frequency of BD and falls in the previous year were
34.6% and 39.1%, respectively. The mean of BBS score was 43.49.
Older age (mean: 73.99±6.6) (p<0.001), female sex (p<0.001), presence of defective vision (p=0.001) and impaired walking (p<0.001),
increase in the number of chronic disease (p<0.001) and drugs
used (p<0.001), presence of incontinence and nocturia (p<0.001),
no regular physical activity (p<0.001), loneliness (p<0.001), absence of free time activity (p<0.001), a history of falls (p<0.001)
were associated with BD. The support supplied will be discussed.
Conclusion: BD and falls are common in the elderly, and it is crucial
to prioritize preventive health services in the elderly population.
P-433
Assessment of burden and its associated factors among the
caregivers who provide home care to their family members over
the age of 65
C. Sogut, P. Dundar, B. Cengiz Özyurt. Celal Bayar University Facultyof Medicine Public Healt Department, Manisa, Turkey
Aim: Care needs of the elderly are an important issue affecting
the well-being of caregivers and the elderly in Turkey due to theburden placed on family members. This study aimed to the burden
and ﬁnd out the factors associated with burden among caregivers
who involve in the home care for their family members, who are atleast 65 years old in Manisa, Turkey.
Method: This cross-sectional study comprised 156 individuals
above the age of 65, who applied to home care service and their 156
family members, who provide them home care. Data were collectedwith the Personal Information Form, Katz Index of Activities of Daily
Living and Zarit Caregiver Burden Scale. In order to carry out this

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

research, legal permissions have been taken both from the ClinicalResearch Ethical Committee of the Medical Faculty of Celal Bayar
University. All data was evaluated using descriptive analysis andt-test, Mann- Whitney U Test, ANOVA, Kruskal-Wallis test, Pearson
correlation analysis.
Results: The average burden of caregivers have been shown to be
29,7 with a standard deviation of 14,08. Most of the caregivers
have been identiﬁed as individuals, who are woman, married,with children, with low educational degree, with social security,and housewives. Having the caregiver in the lower social class,having the patient’s daughter-in-law, extended family structure andpatient’s bad health perception are the reasons that increase thecaregiver’s burden.
Conclusion: The study determined that primary caregivers bore aheavy burden of care. Therefore, caregivers’ burden of care levels
and diﬃculties should be determined, and they should be given
professional support including counseling services.
P-434
Audit of accident and emergency reattendance following
discharge from Discharge-to-Assess Unit Wellington House
S. Jay 1 , L. Wentworth 2 , J. Kelly 2 , J. Williams 2 . 1 University ofManchester, UK; 2 University Hospital of South Manchester, UK
Introduction: Wellington House (WH) is a novel unit operatinga discharge-to-assess model in South Manchester, UK. The unit
accepts frail patients from the acute hospital who require further
assessment of cognitive impairment or time to correct deconditioning. The goal is to facilitate safe discharge to a patient’s own
home, thereby reducing 24hr care admission through promotion ofpatient independence. Accident and Emergency (A&E) reattendance
following a stay at WH was examined, alongside independence
indices, to determine the effect of WH on future acute presentation.
Method: The audit period was deﬁned as December 2014 to January 2016, all patients who were treated at WH during this time
were identiﬁed. Data was collected regarding the number of A&E
attendances by the cohort in the 6 months before their stay and in
the 6 months after their stay. Further data was collected concerning
the cohort’s Bartel independence index score on admission and ondischarge.
Results: There were 444 A&E attendances by the WH cohort in the
6 months before their stay, and 202 attendances in the 6 months
after their stay. This represents a reduction of 55%. Average Bartel
independence on admission was 9, which raised to 14 on discharge.
Conclusions: WH cares for a frail elderly population and achieves
an increase in their independence status. The model results in amarked reduction in A&E attendance among the cohort.
P-435
Audit of readmissions following admission to
Discharge-to-Assess Unit Wellington House
S. Jay 1 , L. Wentworth 2 , J. Kelly 2 , J. Williams 2 . 1 University ofManchester, UK; 2 University Hospital of South Manchester, UK
Introduction: Wellington House (WH) is a novel discharge-toassess unit operating in Manchester, UK. It accepts patients fromthe acute hospital who are deconditioned or require further assessment of their cognitive impairment. WH focusses on enablingsafe discharge to a patient’s own home and reducing 24hr careadmission by promoting patient independence and early mobilisation. Avoidable and non-avoidable readmissions to the acutehospital following discharge from WH were reviewed, with a view
to determining the effect of WH on future hospital admission.
Methods: All readmissions between December 2014 and January
2016 were examined. Data was collected pertaining to presenting
complaint and length of stay (LOS) using a standardised proforma.

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Avoidability of the readmissions was assessed both objectively andsubjectively.
Results: Of the 220 patients treated at WH during the audit period
33 were readmitted, giving a readmission rate of 15%. The LOS on
readmission was 3 days shorter than during the original admission.
Most patients were readmitted with different problems to their
original admission. The number of patients readmitted with falls
fell by 70%. 14% of the readmissions were felt to be potentiallyavoidable by staff or processes at WH, the principle culprit being
communication errors.
Conclusions: The WH model produces a low readmissions ratewith a reduced length of stay compared to original admission. The
service is effective at treating the reason for admission, particularly
with regards to falls. There is scope for improvement in staff
communication.
P-436
Characteristics and rehabilitation outcomes of older
parkinsonian patients attending a day hospital
A. Fallon 1 , L. Kilbane 1 , S. Quinn 2 , S.P. Kennelly 1 . 1 Department of
Age-Related Healthcare, Tallaght Hospital, Dublin 24; 2 Physiotherapy
Department/Age-Related Healthcare, Tallaght Hospital, Dublin 24
Introduction: Day hospitals provide older people with ambuatory
access to multidisciplinary team (MDT) assessment, though there islimited evidence on their effectiveness. The Irish National Clinical
Programme for Older People recommends developing Day Hospitals
as hubs, coordinating care needs of patients with complex conditions and co-morbidities such as Parkinson’s disease (PD). This
study aims to examine characteristics and rehabilitation outcomesof older patients attending a day hospital, including those with PD.
Methods: Data was collected for patients attending a Day Hospitalincorporating a PD review clinic in a tertiary referral university
teaching hospital from January-March 2012 and January-March2016. Information on demographics, duration of rehabilitation andpre/post functional scores were collected. Electronic data wasreviewed for PD patients, examining subtype, medications andrehabilitation outcomes.
Results: In 2012, a total of 150 patients attended day hospitalfor an average of 6.9 weeks. Mean age was 79.5. 24.7% (37/150)
attended PD review clinic for an average of 5.4 weeks. In 2016,
123 patients attended, for 7.3 weeks on average. Mean age was
79.3. 30.9% (38/123) attended for PD review, for an average of 6.5
weeks. Though not electronically recorded for all, mean UPDRS
motor scores increased from 13.4 in 2012 to 35.5 in 2016 and timed
up and go from 12 to 17.5seconds.
Conclusions: Day hospitals are a valuable resource for older patients and review of rehabilitation outcomes is ongoing. Thoughfewer attended in 2016 than 2012, the increasing proportion ofParkinson’s patients and higher average scores recorded suggest
those attending may be increasingly complex.
P-437
Chronic dysfunctional foot in older persons
M.D. Clantau, B. Mitoiu, G. Gheorghievici, A.S. Nica, R. Nartea.
University of Medicine and Pharmacy “Carol Davila”, Bucharest,
Romania
Introduction: Older people frequently develop impaired balance
and functional ability. One main cause of this affections is represented by the the foot and ankle problems. This conditions affect
the quality of the life in elderly. One important role in the disabilityof this patients is played by the painful foot.
Material and method: In this study we want to demonstrate therelationship between the painful foot, the disability and the qualityof life in older people. We selected 30 patients (17 women and 13

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Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247men), aged between 65- 80 years old, who suffered from severefoot pain associated with disability for the last 3 months or more.
We observed the walking speed, the endurance and we correlated
this with the analog visual scale. We modulated this with gender,
race, age, IMC, comorbidities, smoking status and the number ofother pain locations.
Results: We could observe that the incidence of foot pain is reallyhigh, and also is increasing in the last years. This symptom isdirectly proportional with the disability prevalence and also withthe limitation of the activities of the daily living. Hallux deformities,
calluses or corns, edema, hammer toes and pes planus are the main
affections that cause this symptom.
Conclusions: The two components of pain, the sensory and theemotional, inﬂuence each other and correlated with the reduced
functional ability, the increased risks of falls and the reduced physical and mental (depression) aspects inﬂuence the quality of life
for older persons. This aspects are very important ones especiallywhen the treatment solutions is in discus.
P-438
Effect of a novel elongation training (ELT) on frail old adults’
physical abilities
J. Miyazaki 1 , A. Takahashi 2 , A. Uematsu 3 , H. Koda 1 , T. Saiki 4 .
1 Kyoto tachibana University, Kyoto, Japan; 2 Akashi Ninju Hospital,
Akashi, Japan; 3 Dokkyo Medical University, Tochigi, Japan;
4 Ritsumeikan University, Kusatsu, Japan
Purpose: We developed an original ELT which is able to execute
easily by a frail old adult. The purpose of this study was to examine
effect of our ELT on frail old adults’ physical ability.
Methods: 34 frail old adults (age: 83.1±6.7 yrs) who join to an
ambulatory rehabilitation program participated in the study. They
were randomly assigned to the ELT (ELT group, n=23) and to thestandard physical therapy groups (control group, n=11). The training program consisted of 24 sessions administered over 12 weeks.
Contents of single session for ELT group were 10 minutes ELT and
10 minutes physical therapy. Contents of single session for control
group were 20 minutes physical therapy. We measured participants’physical abilities (muscle strength and lower leg muscle functions)in baseline, after 4, 8, and 12 weeks. The key analysis was 2-way
mixed-design ANOVA, and a Bonferroni’s contrast was used for post
hoc test. Statistical signiﬁcance was set for all analysis at p<0.05.
Results: There was no signiﬁcant time by group interaction in allmeasured score. The time main effect was found in 30-second chairstand test, knee extensor strength, and 2 step test.
Conclusion: Results of this study suggested that our ELT produces
effects to increase old adults’ physical abilities in similar level withthe standard physical therapy. The main merits of our ELT do notneed other’s help and old adults can execute our ELT easily in sitting
and/or lying positions.
P-439
Effects of high-intensity interval training on the cardiac
rehabilitation in the elderly patients
J. Kim. Department of Rehabilitation Medicine, Wonkwang University
School of Medicine
Objectives: To investigate the effect of high-intensity interval training (HIIT) on the outcomes of cardiac rehabilitation (CR) in elderly
patients and young patients after myocardial infarction (MI).
Methods: From January 2015 to December 2016, we retrospectively
reviewed the medical records of the patients who received HIIT
through the outpatient clinic. A total of 15 patients were enrolled,
6 of whom were elderly (≥55 year) and 9 were younger (<55 year).
The HIIT program was composed of 10 minutes of warm-up, 30
minutes of interval aerobic exercise, and 10 minutes of cool down.

The interval aerobic exercise consisted of 3-minute usual intensity
work phase (60–70% of heart rate/VO2 reserve) and 4-minute ofhigh-intensity work phase (70–90% of heart rate/VO2 reserve) (Fig.
1). Exercise capacity was measured by symptom-limited exercise
tests before and after hospital-based CR.
Results: A ll 15 patients were male and the mean age of the overallpatients was 53.4±9.2 years. The mean age of the younger (<55year) group was 47.2±4.2 years, and that of elderly group (≥55 year)
was 62.7±6.3 years. Between before and after HIIT, resting heart rateand submaximal rate pressure product at stage 3 were signiﬁcantly
decreased and metabolic equivalent tasks, peak oxygen consumption and maximal oxygen pulse were signiﬁcantly increased in theelderly group, but there was no signiﬁcant difference in the younger
group. In comparison of the percent changes in the exercise capacity
before and after HIIT, there was no signiﬁcant difference between
the two groups.
Conclusions: There was signiﬁcant improvement on exercise capacity in the elderly group compared to the younger group after HIIT.
The degree of improvement in cardiopulmonary exercise capacity
after HIIT between elderly group and younger group was similar.
For improving cardiac function, active interventions in possible
elderly groups are necessary.
P-440
Evaluation of physical training upon endocrine, physiologicaland sexuality status in elderly men
C.R. Revnic 1 , F. Revnic 2 , C. Pena 2 , B. Paltineanu 3 , S. Voinea 1 . 1 UMF“Carol Davila”, Bucharest, Romania; 2 NIGG Ana Aslan, Bucharest,
Romania; 3 UMF Tg. Mures, Targu Mures, Romania
Introduction: With rapidly growning geriatric population andwith the improvement in quality of life, sexuality is becaming an
increasingly aspect of aging.
Objective: Investigation of the role of physical training programof moderate intensity on endocrine modulation, amelioration ofdepression and sexual function in elderly men. Our study was doneon 42 patients aged 60–82:21 active (groupA) and 21 sedentary(group B) admited in Rehabilitation Clinique for different osteoarticular and postraumatic pathologies. Standard physical exercise
program (F.Revnic et al. GERIATRIA, vol.XIV, nr.1 2002] was applied for 16 weeks.hTSH,T3, T4, HGH, Testosteron and Cortisol were
evaluated before and after training with1234 DELFIA Research Spectroﬂuorimeter using Eu+ labbeled kits purchased from Pharmacia.
The results were processed with a Multicalc program. Evaluation ofmuscle eﬃcieny was done before and after training with Schwartzer
Picker 2000 EMG
Results: 70% patients from group A were euthyroid, HGH, Testosteron and Cortisol were in normal range, with a positive atitude
towards sexual life. 56% sedentary patients of group B presented
hTSH values >6I.U/ml corresponding to hypothyroidism with elevated levels of Cortisol and low levels of HGH and Testosteron. They
exhibited anxiety with the following symptoms: irritability, exagerated fear for the future, tiredness, diﬃculty in communication,
sleep disorders and a negative atitude towards sex. After training,adecrease in Cortisol and an increase in Testosteron and HGH ingroup B was recorded with a positive consequence upon affectivity(interest in sex).
Conclusion: Physical training with its multiple aspects (cognitive,
mental and socio-afective)had a great impact upon reorganisationof hypothalamo-pituitary-thyroid-adrenal-gonadal axis in elderly
men connected with changes in many effector hormones secretion
with a positive impact upon emotional well being, mental healthand an increase in desire for sexual life

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

P-441
Everyday life in older men living alone – a complex view needs aholistic perspective
P. von Heideken Wågert 1 , S. Nygård 2 , S. Cederbom 1,3 . 1 Departmentof Physiotherapy, School of Health, Care and Social Welfare,
Mälardalen University, Västerås/Eskilstuna, Sweden; 2 Rehabilitation
Unit, Kungsör Municipality, Kungsör, Sweden; 3 Department of
Physiotherapy, Faculty of Health Sciences, Oslo and Akershus
University College of Applied Sciences, Oslo, Norway
Introduction: To be an older man living alone might mean a decreased health, and good health is a strong predictor for increased
abilities in everyday activities. The life situation of this group is notwell studied and need to be explored in a greater extend. The aim
was to explore how older men living alone describe their everyday
activities as well as their ability, and what could facilitate theirability, in performing everyday activities.
Methods: Qualitative semi-structured interviews were analysedwith inductive content analysis. Eight men aged over 65 years,
living alone with home help services, being able to walk and with
suﬃcient cognitive ability were included.
Results: The analysis resulted in one theme “A will to make iton their own, but are dependent of a helping hand” and twelve
categories. The men described a daily routine and it was important
to be able to get out of their homes, to be physically active andto be part of a social context. Though, medical, psychological andenvironmental factors constrain these activities. Support from people in the participants’ environment, improved medical conditions,and own strategies may facilitate everyday activities. The wish of
performing everyday activities by themselves are strong, but also
an acceptance of not being able to do this anymore.
Conclusions: The results reﬂect a complex view of these older
men’s everyday life. It is important for their independence that
health care and rehabilitation staff have a holistic view and works
from a biopsychosocial perspective.
P-442
Factors associated to activities of daily living and gait recovery at
1-year follow-up in hip fracture patients admitted to an acuteorthogeriatric unit
P.Y. Condorhuamán Alvarado, T. Alarcón, R. Velasco, P. Gotor,
I. Martin Maestre, J.I. Gonzalez Montalvo. Geriatrics Dept., Hospital
Universitario La Paz, Universidad Autonoma, IdiPaz, Madrid. Spain
Introduction: Hip fracture (HF) affects 50,000 people annually in
Spain. Potential complications include long-term functional decline.
The aim of this study was to assess the factors associated tofunctional recovery (FR) one year after HF.
Methods: A cohort of HP patients admitted to an Orthogeriatric
Unit at a University Hospital was followed during 1-year. Sociodemographic, clinical, nutritional, functional, cognitive and analytic
variables were analyzed. Functional status was assessed by Barthel
Index (BI) and ability to walk by Functional Ambulation Classiﬁcation scale (FACs). Patients were considered to have FR if thescore of BI or FACs at 1-year was equal to or greater than baseline.
A multivariate logistic regression analysis was ruled out with thevariables associated to FR in the bivariate analysis.
Results: A sample of 103 patients was studied. At baseline all thepatients were independent or slightly dependent (BI >65). One-year
after HF, 54.4% and 75.7% of the patients had recovered or improved
the BI and the ability to walk, respectively. In multivariate analysis,
patients with FR of BI were younger (OR: 3.16) and had normal
values of vitamin D at admission (≥30 ng/ml) (OR: 1.24). Patientswith FR of FACs were younger (OR: 3.8) and had better cognitive
status at admission – Pfeifer Questionnaire score <5 – (OR: 7.31)(All with p<0.05).

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Conclusions: Age, levels of vitamin D and cognitive status at admission play a role in long-term FR in patients with HF.(Supported
in part by a grant from Nestlé Health Science to the IdiPAZ).
P-443
Fatigue post-stroke – a 7 year follow-up study
M.H. Ursin 1 , G. Hagberg 2 , H. Naess 3 , H. Ihle-Hansen 2,6 , B. Fure 4 ,B. Thommessen 5 . 1 Bærum Hospital and Diakonhjemmet Hospital,
Norway; 2 Bærum Hospital, Norway; 3 Haukeland University Hospital,
Norway; 4 The norwegian knowledge centre for the health service,
Norway; 5 Akershus University Hospital, Norway; 6 Hospital and Oslo
University Hospital, Norway
Introduction: Post-stroke fatigue (PSF) is a common and distressing problem after stroke [1] but there is a lack of knowledge
on long-term prognosis. This study explores fatigue in an elderly
population with mean age of 72 years when suffering the initialstroke. The cohort is followed for 7 years. The subjects included
were participants in the project “Cognitive impairment after stroke
and TIA” [2].
Methods: A longitudinal study of participants with ﬁrst-ever stroke
or TIA explored fatigue for 123 of 210 participants at the one-year
follow-up. The Fatigue Severity Scale (FSS) measured fatigue at 1
and 7 years after the initial stroke. Sociodemographic characteristics
reported was gender, age, education (more or less than nine years),
vascular risk factors, weight and height. Body Mass Index (BMI)
was calculated. The exclusion criteria were pre-stroke cognitive
impairment and dementia.
Results: A total of 65 participants (49% women), mean age 80.7
years were included in the analyses, with registered score on FSS
at 1 and 7 years post-stroke. Mean total fatigue score were 31.2
(SD=13.4) at one-year follow up and 30.53 (SD=13.6) at the sevenyear follow up. In the multiple regression analyses FSS showedassociation with Trail making Test A (TMT-A) (p=0.001) and Trailmaking Test B (TMT-B) (p=0.001), Hospital Anxiety and Depression
Scale (HADS); depression (p=0.03) and anxiety (p=0.01) at the
one-year follow-up. Age, gender, education or neurologic impairments measured by NIHSS showed no signiﬁcant associations to
FSS (p>0.05).
Conclusions: The included participants reports fatigue at the sevenyear follow at the same level as at the one-year follow-up. The
results indicate that cognitive ﬂexibility, attention and executivefunctioning, as well as depression and anxiety at one-year may
predict PSF 7 years after stroke.
References:[1] Wu S, Kutlubaev MA, Chun H-YY, Cowey E, Pollock A, Macleod
MR, Dennis M, Keane E, Sharpe M, Mead GE: Interventions forpost-stroke fatigue. Cochrane Database of Systematic Reviews
2015[2] Ihle-Hansen H, Thommessen B, Fagerland MW, Oksengard AR,
Wyller TB, Engedal K, Fure B: Multifactorial vascular risk factor
intervention to prevent cognitive impairment after stroke andtia: A 12-month randomized controlled trial. Int J Stroke 2012
P-444
FIT4FRAIL: Fitness training for frail elderly during orthopaedic
geriatric rehabilitation
D. Visser 1 , H.L. Gerrits 2 , E.M. Wattel 1 , A.J. de Groot 1 , F.J. Meiland 1 ,C.M.P.M. Hertogh 1 . 1 Department of General Practice & Elderly Care
Medicine, Amsterdam Public Health research institute, VU University
Medical Center, Amsterdam; 2 Department of Human Movement
Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam
Movement Sciences, VU University Amsterdam, The Netherlands
Introduction: Physical Fitness Training (PFT) is a core elementof orthopaedic Geriatric Rehabilitation (GR), aimed at improving

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Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

physical functioning and independent living, but there are large
differences with respect to its implementation in current GR
programs. Lack of clear recommendations underlie this variation
among elderly care centres and it is likely that current programs
are sub-optimal. In addition, it is unclear which patient related
factors as well as environmental determinants are most importantin orthopaedic GR. Hence, it is unknown whether and how existingknowledge on PFT can be translated to frail patients admitted toorthopaedic GR.FIT4FRAIL aims to 1) develop recommendations
for PFT in orthopaedic GR programs and 2) study the feasibility
and effects of implementing these recommendations for PFT in
orthopaedic GR.
Methods: Three separate work packages are planned: 1. A systematic review and a Delphi study to obtain evidence based recommendations on the characteristics of PFT. 2. Identifying the speciﬁccharacteristics, barriers and facilitators of current orthopaedic GR
programs of geriatric care centres within the University Network(UNO-VUmc). 3. Designing and piloting a new PFT program in asample of GR patients.
Results: Results will include 1) scientiﬁc evidence and expert opinions on preferred PFT in 2017, 2) characteristics and factors involved
during current orthopaedic GR in 2019, and 3) knowledge on thefeasibility and effects of a new PFT program in 2021.
Conclusions: Speciﬁc recommendations will be given for tailored
Physical Fitness Training in orthopaedic Geriatric Rehabilitation.
P-445
Functional independence and related factors in older people
with osteoarthritis referring to hospitals in Mashhad, Iran in2016
M. Ahmadpour 1 , A.D. Kakhki 1 , M. Zandi 1 , P. Davidson 2 . 1 Shahid
Beheshti University of Medical Sciences, Tehran, Iran; 2 Johns Hopkins
University, Baltimore, Maryland
Introduction: Osteoarthritis is one of the leading causes of disability and loss of functional independence in older people. This study
was conducted to describe functional independence and related
factors in older people with osteoarthritis in Mashhad, Iran.
Methods: This descriptive-correlational study was conducted on
300 older people with osteoarthritis above 60 years old attending
clinics of rheumatology and rehabilitation in hospitals of Mashhad
University of Medical Sciences in 2016. Self-report demographicand disease status and activities of daily living (ADL) questionnaires were used for data collection. Data were analyzed with SPSS
software.
Results: The mean age of participants was 70.75 (±7.27) years. 61%
of older people were female. 65% had body mass index (BMI) between 25% and 30%. 68.32% had osteoarthritis lower than 10 years
and the knee was the most involved joint (40.66%). Taking a bathand a shower (54%), getting to the bathroom (69%), and walking(78%) were the most troublesome ADLs of older people. Younger
participants who were male, married and lived with partner andchildren, of higher education and income, lower BMI, and shorter
duration of osteoarthritis had more independence in activities ofdaily living.
Conclusions: Osteoarthritis impact on ADLs in older people. Tailored and targeted strategies are necessary to promote functional
independence of older people in activities.
P-446
Functional recover after hip fracture in elderely patients
R. Nartea, I. Mitoiu Brindusa, M. Constantinovici, M.D. Clantau,
A.S. Nica. INRMFB, UMF “Carol Davila”, Bucharest, Romania
Hip fracture prevalence increased with advanced age. Sarcopenia,
age, comorbidities, cognitive status and environmental origin has

an impact in rehabilitation department. We studied functional
outcome after rehabilitation hip fracture in old elderly (75 years
and older) compared with young elderly (65–75 years) inpatients
admitted in 3rd Rehabilitation Clinic during July–December 2016.
On admission to rehabilitation treatment, old elderly have moredepressed mood in MMSE scale, were more cognitive impaired, andmore suffer from pain. Improvement in Functional Independence
Measurement (FIM) scale was found in both groups but signiﬁcantly
better in young elderly than in old elderly. The change in FIM during
the rehabilitation period was in FIM total and in those parts of
FIM concerning locomotion. The mean duration of rehabilitation
stay was signiﬁcantly longer in old elderly patients. On discharge
old elderly patients more suffer from pain and difference between
the groups according to the FIM, VAS and to the cognitive data
increased. Statistical data was analyzed using Windows version 10.0
and Epi Info7. Data was analyzed was given in mean ± standard deviation, minimum and maximum. The correlation test and student-t
were used for the comparison of parametric and non-parametricresults. P values of less than 0.01 were considered statistically signiﬁcant. Short-term results for most patients showed improvementof pain, function and cognitive status followed by better toleranceof physical therapy program. The limits of the study are given by
the small number of patients included, a lack of a medium and longterm assessment.
Conclusions: Age per se is indicator of frailty and determinate
functional recovery after hip fracture.
P-447
Gender differences in functional mobility and physical activity
in older adults
K. Cekok 1 , T. Kahraman 2 , B.O. Ugut 2 , P. Keskinoglu 3 , A. Genc 4 .
1 Department of Physical Therapy and Rehabilitation, Medical Park
Hospital, Izmir, Turkey; 2 Department of Physiotherapy andRehabilitation, Faculty of Health Sciences, Izmir Katip Celebi
University, Izmir, Turkey; 3 Department of Biostatistics and Medical
Informatics, Dokuz Eylül University, Izmir, Turkey; 4 School of Physical
Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
Objectives: Functional mobility and physical activity (PA) are thebasis of active aging and are closely associated with health statusand quality of life. Gender is often described as a personal trait thatcan change the effects of social and environmental inﬂuences on
behaviors such as functional mobility and PA. Since few attempts
have been made to determine the gender effect, the aim was toinvestigate the gender differences in functional mobility and PA in
older adults.
Methods: This cross-sectional study included age-matched female
and male adults aged older than 65 years. Functional mobility
measures included the 6-Minute Walk Test (6MWT), 10-Meter Walk
Test (10MWT), Four Step Square Test (FSST), Berg Balance Scale(BBS), Timed Up and Go (TUG) Test, and 30-Second Chair Stand
Test (30CST), and Barthel Index (BI). PA was assessed with theInternational Physical Activity Questionnaire (IPAQ)–Short Form.
Results: There were 50 participants (25 female). The 6MWTand 30CST scores were signiﬁcantly better in male participants(p<0.05), however there was no signiﬁcant difference in 10MWT,
FSST, BBS, TUG, and BI (p>0.05). PA level was signiﬁcantly higher
in male participants (p<0.05). IPAQ was signiﬁcantly correlatedwith 6MWT and 30CST in males (p<0.05), however not in females(p>0.05).
Conclusions: Gender differences were observed in walking endurance, functional lower extremity strength, and PA. Because, PA
was not associated with walking endurance or functional lower
extremity strength in females, particular attention should be paid
to investigate the other possible causes of gender differences suchsocial or environmental in PA behavior.

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

P-448
Impact of cognitive function on functional recovery after strokeand hip fracture: the FRAIL-BCN study
C. Udina 1 , A. Calle 1 , M. Roqué 2 , F. Lombardini 1 , E. Calvo 1 ,E. Ruzafa 1 , M. Mesas 1 , M. Inzitari 1 . 1 Parc Sanitari Pere Virgili,
Barcelona, Spain; 2 Fundacio Salut i Envelliment, Barcelona, Spain
Introduction: Stroke and hip fracture (HF) are frequent in older
adults and associated with poor health outcomes. We studied theimpact of cognitive function on functional recovery after stroke and
HF in older adults.
Methods: Cohort study of patients ≥65 years old admitted togeriatric rehabilitation after stroke or HF (January 2015-January2016). We assessed functional status at admission and after 30 days
[Barthel Index (BI), Lawton Index (LI), Gait Speed (GS)], nutritional
assessment, Charlson comorbidity index and polypharmacy at admission. Cognitive assessment included: Mini-Mental State Exam
(MMSE), Symbol Digit Modalities Test (attention+psychomotor
speed), Yesavage Geriatric Depression Scale and Confusion Assessment Method (for delirium). We selected improvement in BI (≥20
points), in BI’s gait item (≥5 points) and in GS (≥0.1m/s) (day30–admission) as outcomes.
Results: We enrolled 202 patients (mean age+SD=83.34±6.71; 69%
women), 100 (49.5%) admitted after stroke and 102 (50.5%) after HF. Main baseline characteristics were (mean+SD): in stroke
patients, BI=38.6±17.9; GS=0.11±0.15; LI=3.9±2.1; MMSE=21.8±6.0;
National Institute of Health Stroke Score (NIHSS)=5.4±3.2. In HF:
BI=46.6±17.7; GS=0.07±0.07; LI=4.1±2.2; MMSE=23.2±5.4. In logistic
regression models, adjusted for sex, age and BI, in HF, MMSE wasassociated with GS improvement (OR=3.04, 95% CI: 1.21–7.61) andBI improvement (OR=4.01, 95% CI: 1.44–11.20). In stroke patients,
cognitive measures were not independently associated with theoutcomes.
Conclusions: In our sample, global cognition was associated withfunctional recovery after HF, but not after stroke. Our results
reinforce the importance of cognitive assessment in geriatric rehabilitation, but MMSE may not be the better tool to assess cognitionin subacute stroke patients.
P-449
Indoor geriatric early rehabilitation; a randomised outcome
study of 2,579 patients
C. Angleitner. Department of Geriatrics and Remobilisation
Introduction and aims of the study: Indoor geriatric early rehabilitation is very well implemented and suﬃciently standardized
in many countries. But is indoor geriatric early rehabilitation
suﬃciently in functional outcome for patients from all assigning
specialist departments?
Purpose: Is it possible to reach for all indoor geriatric early rehabilitation patients no matter from which department they come froma suﬃcient therapeutic progress in functional outcome?
Methods: The retrospective study includes all the patients from2008 to 2015 which our department of Geriatrics and Remobilisation took over from the neurologic, traumotologic, orthopaedic
and internal/cardiological departments. The development was measured with the FIM (functional independence measure). The takeover FIM was taken inside 72 hours after arriving and the discharge
FIM was taken inside the last 48 hours before leaving.
Results: The study contains 2,579 patients, 848 orthopaedic patients with an average age of 77.67 years, a residence time from17.79 days and a FIM development from 98 to 113 points; 736 traumatological patients with an average age of 81.75 years, a residence
time from 19.02 days and a FIM development from 84 to 103 points;
695 neurological patients with an average age of 77.20 years, a
residence time from 20,66 days and a FIM development from 74

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to 90 points as well as 300 cardiological/internal patients with anaverage age of 80.78 years a residence time from 18.18 days and a
FIM development from 76 to 96 points. The IM development of all
patient groups is 1.20 (±0.15 points) per therapeutic day. The recommended aim value of the American Rehabilitation Counselling
Association (ARCA) amounts to1 FIM point per therapeutic day.
Conclusions: It is possible to obtain a suﬃcient functional progressfor all patients in indoor early geriatric rehabilitation independently
from which specialist department they were overtaken from.
P-450
Interrupted geriatric rehabilitation requiring transfer to acutehospital setting: Incidence and outcome
C.N. Osuafor, S.N.M. Sahimi, S. Enduliri, F. McCarthy. Medicine forElderly Department, St Mary’s Hospital, Phoenix Park, Dublin, Ireland
Introduction: Elderly patients after acute hospitalization are at
risk of functional decline. A period of rehabilitation to optimize asafe home discharge is often required. These patients may havetheir rehabilitation interrupted when they become unwell thereby
requiring transfer to acute hospital setting. Our objective wasto determine the incidence and outcome of interrupted geriatricrehabilitation.
Methods: A retrospective analysis of patients admitted into a
23-bed skilled geriatric rehabilitation ward in St Mary’s Hospital,
Phoenix Park from March 2012 to February 2016.
Results: 539 patients were admitted for rehabilitation over the
study period. 50/539 (9.3%) patients had their rehabilitation interrupted and were transferred to acute hospital setting. 33/50 (66%)
were females; Mean age 82.1±8.7 years (range 51–95 years). Finaldiagnosis after acute hospital transfer was acute severe infections(44%), traumatic fracture secondary to fall (10%), intraabdominal
complications (10%), cardiac complications (8%), acute neurologicalevent (6%) and others (22%). Of these patients, 42% had a fatal
outcome, 32% returned for rehabilitation, 10% were discharged
home and 8% were discharged to long term care. Patients who
required acute hospital transfer and subsequently had a fatal outcome seemed more likely to be older and had higher Charlson
Comorbidity Index compared to those who did not.
Conclusions: Interrupted geriatric rehabilitation requiring acutehospital transfer occurred in 9.3% of patients; acute severe infection
was the commonest cause. These transfers are associated withsigniﬁcant mortality. Rehabilitation programs should focus improvement efforts on identifying suitable subjects for rehabilitation,
optimizing care transitions and minimizing rates of transfers.
P-451
Muscle ultrasound in the assessment of older
community-dwelling patients with chronic obstructive
pulmonary disease. Relationships between cross-sectional areaof the muscle rectus femoris, handgrip strength, and fat-freemass
D. Sánchez-Rodríguez 1 , P. Mínguez-Blasco 2 , C. Ramírez-Fuentes 2 ,F. Ostiz 3 , J.M. Muniesa 4 , E. Marco 5 . 1 Geriatrics Department, Parc de
Salut Mar (Centre Fòrum - Hospital del Mar), Barcelona; Rehabilitation
Research Group. Institut Hospital del Mar d’Investigacions Mèdiques(IMIM), Barcelona; School of Medicine, Universitat Autònoma deBarcelona; School of Medicine, Universitat Pompeu Fabra, Barcelona;
2 Physical Medicine and Rehabilitation Department Parc de Salut Mar(Hospital del Mar - Hospital de l’Esperança), Barcelona; 3 Physical
Medicine and Rehabilitation Department Centre d’Atenció PrimàriaSant Andreu, Institut Català de la Salut, Barcelona; 4 Rehabilitation
Research Group. Institut Hospital del Mar d’Investigacions Mèdiques(IMIM), Barcelona; Physical Medicine and Rehabilitation Dpt. Parc de
Salut Mar (Hospital del Mar – Hospital de l’Esperança); School ofS170

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Medicine, Universitat Autònoma de Barcelona; 5 Rehabilitation
Research Group. Institut Hospital del Mar d’Investigacions Mèdiques(IMIM), Barcelona; Physical Medicine and Rehabilitation Dpt. Parc de
Salut Mar (Hospital del Mar – Hospital de l’Esperança); School of
Medicine, Universitat Autònoma de Barcelona; Universitat
Internacional de Catalunya
Introduction: The objective was to determine the relationshipbetween rectus femoris muscle size, quadriceps strength, and body
fat composition in older men with chronic obstructive pulmonary
disease (COPD) and healthy controls.
Methods: This cross-sectional study included 18 communitydwelling robust men aged 65–80 years with stable, severe, or very
severe COPD, and 17 healthy controls. Outcome variables werecross-sectional area and antero-posterior diameter on ultrasoundof the nondominant rectus femoris muscle, maximum quadriceps
strength measured by isometric dynamometry, and fat-free massindex (FFMI) assessed by electric bioimpedance.
Results: Compared with controls, COPD patients had lower quadriceps strength (mean difference 10.4 Kg, 95% CI: 5.2–15.5), area andanteroposterior diameter (mean differences 1.3 mm2 , 95% CI: −2.1
to 0.5 and 1.8 cm, 95% CI: −0.03 to 3.7, respectively), FFMI (meandifference 1.5 kg/m2 , 95% CI: −4.3 to −1.2) and 6-minute walking
test (mean difference 148 m, 95% CI: −216 to 80). Cross-sectional
area was 4.3 (SD 1.05) cm2 in patients in front of 5.6 (SD 1.25) cm2
in controls. A moderate correlation was observed between rectus
femoris area and strength of the nondominant quadriceps (R=0.497,
p=0.036), fat-free mass (R=0.584, p<0.001), dry lean mass (R=0.572,
p<0.013), and FFMI (R=0.549, p<0.018).
Conclusion: Isometric dynamometry, electric bioimpedance, andmuscle ultrasound provide complementary and relevant information that is useful in the assessment and monitoring of older
patients during COPD rehabilitation.
P-452
Participation in medical rehabilitation among older Poles –Results of PolSenior study
A. Szybalska 1 , K. Broczek 2 , P. Slusarczyk 1 , E. Kozdron 3 , J. Chudek 4 ,M. Mossakowska 1 . 1 International Institute of Molecular and Cell
Biology in Warsaw, Warsaw, Poland; 2 Department of Geriatrics,
Medical University of Warsaw, Warsaw, Poland; 3 Department ofRecreation Methodology, Faculty of Tourism and Recreation, Jozef
Pilsudski University of Physical Education in Warsaw, Warsaw, Poland;
4 Pathophysiology Unit, Department of Pathophysiology, Medical
Faculty in Katowice, Medical University of Silesia, Katowice, Poland
Introduction: The rehabilitation process’ aim is restoring lost
functions which contribute to improving the quality of life andmaintaining independence. In this study, we evaluated the participation in medical rehabilitation among older Poles and its
socio-economic and health-related determinants.
Methods: Data regarding medical rehabilitation were obtained fromthe nationwide, multidisciplinary PolSenior project (2007–2012) for
4,813 respondents (48.3% women) aged 65+. Socio-economic status, physical functioning, chronic pain occurrence, medication andformal disability occurrence were accounted for.
Results: One in six respondents (18.9% women vs 15.8% men,p<0.005) took part in medical rehabilitation in the past 12 months
prior to the survey. Rehabilitation users underwent most commonly: electrotherapy or light radiation therapy (61.3%), massage(52.0%) and passive exercises (51.4%). Logistic regression analysis
revealed that women aged 75+ had a lower chance of taking part inrehabilitation than the youngest ones (65–69 y.o.) and participation
decreased with age. In men, this pattern was less regular. Village
dwellers were less likely to use rehabilitation services than citydwellers. Higher education, functional independence, and multiple

medication use promoted participation in rehabilitation the most in
both genders. Disability certiﬁcate holders and those who reported
chronic pain were more likely to take part in analyzed services.
Functional independence in women and men, as well as partial
dependence only in men, were positively associated with utilizationof rehabilitation.
Conclusions: Participation in medical rehabilitation was related toage, place of residence, the level of education, functional status,
disability, chronic pain occurrence and medication, both in womenand men.
P-453
Post-fall syndrome risk factors, a case-control study of 70
patients
M. Meyer, P. Le borgne, T. Vogel, G. Kaltenbach, E. Schmitt.
Strasbourg University Hospital
Introduction: The objective of the study was to identify risk factors
for post-fall syndrome.
Methods: We performed a case-control study in wich we included
every patients older than 70 years old admitted to the hospital
after a fall. Patients who couldn’t perform transfer, or couldn’t walkindoors, patients with an acute neurologic or orthopedic condition
directly responsible for the functional decline were not included.
The post-fall syndrome was only held in cases of functional decline
observed after a fall.
Results: The study was performed from March 29, 2016 throughJune 7, 2016. We included 70 patients. Twenty-nine patients exhibited a post-fall syndrome (41,4%). Risk factors for post-fall syndrome
included age (p=0,002), walking disorder prior to the fall (OR=9,63
IC 95 p.100: 2,49; 37,30 p<0,001), the use of a walking aid prior to
the fall (OR=9,10 IC 95 p.100: 2,38; 34,85 p<0,001), no unaccompanied outdoor walk in the week before the fall (OR=4,95 IC 95
p.100: 1,24; 19,79 p=0,017), visual impairment making close reading
impossible (OR=3,48 IC 95 p.100: 1,18; 10,31 p=0,021), stiffness inankle dorsiﬂexion (p=0,003), grip strength (p=0,002) and the fear of
falling (OR=4,45 IC 95 p.100: 1,29; 15,42 p=0,014).
Conclusions: The study showed the existence of body funtions
and structure impairments and activity limitations prior to the fallamong patients exhibiting a post-fall syndrome. Identifying fallers
presenting these risk factors as early as possible could ensure thebest possible outcome in handling of psychomotor disadaptation.
P-454
Prevalence and consequences of unrecognized benign
paroxysmal positional vertigo in nursing homes
L. Pensart, L. Stiers, J. Spildooren. UHasselt, BIOMED (REVAL),
Diepenbeek, Belgium
Introduction: Benign Paroxysmal Positional Vertigo (BPPV) is themost common cause of balance disorders and dizziness among
elderly, affecting 11% of a group of 75-year old community dwellingindividuals [1]. Even though fall incidents and balance problems arehigher in institutionalized older adults, the prevalence of BPPV in
residential care centers is unknown.
Methods: Forty-one institutionalized older adults (29 female, 11
male; average age, 86.6±5.96 years) were evaluated for the presenceof BPPV by vestibular bedside testing (i.e. Dix-Hallpike-, side lyingand roll-test). Romberg test with eyes closed and Timed-up and go(TUG) were registered using APDM 3-axes wearable accelerometer
sensors.
Results: Eleven residents had unrecognized BPPV (6 posterior canal,
3 horizontal canal, 2 combination horizontal and posterior canal).
Group with and without BPPV was comparable for age, cognition(MMSE) and dizziness handicap inventory (DHI). Residents with
BPPV had a signiﬁcant higher sway area (0.55 m2 /s]text4 versus 0.40

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

m2 /s4 ; p=0.05) and sway velocity (0.44m/s versus 0.29m/s; p=0.01)
during the Romberg test and a tendency towards less elevation at
midswing during gait (0.78 cm versus 1.11 cm; p=0.06).
Conclusions: Prevalence of BPPV among residents in nursing homes
is higher than in healthy community dwelling elderly. BPPV is in thispopulation not related to vertigo or dizziness but to an increased
fall risk.
References:[1] Von Brevern M, Radtke A, Lezius F, et al. Epidemiology ofbenign paroxysmal positional vertigo: a population based study.
J Neurol Neurosurg Psychiatry 2007; 78: 710–715.
P-455
Prevalence of sarcopenia and frailty in older adults in geriatricrehabilitation and its association with malnutrition
J. Wojzischke 1 , J.M. Bauer 2 , S. Egert 3 , A. Hein 1 , R. Diekmann 1 .
1 Department of Health Services Research, Carl von Ossietzky

University Oldenburg; 2 Geriatric Centre University Heidelberg,
Agaplesion Bethanien Hospital Heidelberg; 3 Institute of Nutritional
and Food Sciences – Nutritional Physiology, Rheinische FriedrichWilhelms-University Bonn
Introduction: Malnutrition is a common in geriatric rehabilitation
patients and interacts strongly with sarcopenia and frailty. However prevalence data for sarcopenia and frailty based on standard
deﬁnitions is still scarce in the ﬁeld of geriatric rehabilitation.
Methods: Older adults ≥70 years consecutively admitted for a geriatric inpatient rehabilitation at the Division of Geriatric Medicine at
the Rehabilitation Centre Oldenburg were included at admission (+3 days) in the present study. Sarcopenia was diagnosed based on thedeﬁnition of the European Working Group. Frailty was diagnosed
according to the Fried criteria and malnutrition was identiﬁedusing the Mini Nutritional Assessment-Short Form (MNA-SF). Statistical analysis was done with Wilcoxon-Mann-Whitney U Test andKruskal-Wallis Test (α=0.05) for MNA-Sf scores of patients with andwithout sarcopenia or frailty.
Results: 122 patients (69.7% female, 81.5±5.6 years) were enrolled.
The prevalence of sarcopenia was 38.4%. 63.9% of the patientswere frail, 33.6% pre-frail and 2.5% were robust. Malnutrition wasprevalent at 31.1%, 59.8% were at risk of malnutrition and 9.0% had
a normal nutritional status. Mean MNA-SF score tend to be lower
in patients with sarcopenia compared to those without sarcopenia(8.2±2.5 versus 9.2±2.3 points). According to the Fried criteria mean
MNA-SF scores were the lowest in frail patients (7.9±2.2 points),
followed by pre-frail patients (9.7±2.0 points) and robust patients(12.3±1.5 points). Results were not signiﬁcant.
Conclusions: Sarcopenia and frailty were widespread among older
adults in geriatric rehabilitation. MNA-SF scores were lowest in
patients with sarcopenia and frailty without being signiﬁcant.
P-456
Quality of life and its predictors of patients undergoing geriatricrehabilitation – A pilot study
S. Bordne 1 , R.-J. Schulz 2 , S. Zank 3 . 1 University of Cologne, PhD
programme “Gerontological Research On Well-Being” (GROW),
Cologne, Germany; 2 Clinic of Geriatric Medicine and Rehabilitation, St.
Marien-Hospital, Cologne, Germany; 3 University of Cologne,
Department of Rehabilitation Science, Cologne, Germany
Introduction: Given demographic change geriatric rehabilitationand the Quality of Life (QoL) of geriatric patients become morevital each day. Whereas the assessment of QoL is often limited tointernal clinical criteria of success such as ADL or autonomy there
seem to be other rather soft concepts such as Subjective Well-Being(SWB) which should be taken into account when looking at geriatricpatients’ QoL.

S171

Methods: A pilot study is recently conducted with inpatients of ageriatric rehabilitation ward in Germany. At hospital admission QoL
and potential predictors are assessed in a face-to-face interview.
The instruments used in this study for functional criteria of QoL
assess (I)ADL-abilities, mobility and autonomy. SWB as the other
QoL facet is on the one hand represented by hedonic measures suchas life satisfaction or affect and on the other hand by eudaimonicmeasures such as self-acceptance or meaning in life. Furthermore awide range of medical and psychosocial parameters are included as
antecedents (e.g. pain, control beliefs or social network).
Results: Due to this broad approach to QoL in geriatric inpatientsthe aim of this pilot study and following research is to derive abio-psycho-social model for QoL in patients undergoing geriatricrehabilitation to get a comprehensive view on what constitutes undcontributes to QoL in geriatric patients.
Conclusions: For future research such a model can be of greatvalue as it may create a better understanding of important factors
for reaching the geriatric aim of “Restitutio ad Optimum” for eachgeriatric patient.
P-457
Relationship between physical activity, risk and fear of falling inelderly people
K. Tamosiunaite 1 , M. Tamulaitiene 2 , V. Alekna 1 ,I. Tamulaityte-Morozoviene 1 . 1 Faculty of Medicine of Vilnius
University; Vilnius, Lithuania; 2 Faculty of Medicine of Vilnius
University; National Osteoporosis Center, Vilnius, Lithuania
Objective: To investigate the associations between physical activity,
risk and fear of falling in elderly people.
Methods: The study involved community-dwelling Vilnius residents aged 65 years and over, without diseases or conditions which
could dramatically decrease their mobility. A specially prepared
questionnaire for demographic and falls data, the Tinneti test forassessment of fall risk, and physical activity questionnaire Physical
Activity Scale for the Elderly (PASE).
Results: The study sample consisted of 94 elderly people aged from65 to 88 years. Of all study subjects, 54.2% had experienced falls. Of
those who fell, 61 percent had injuries, while 39 percent did not
suffer any injuries. In those persons who experienced falls, fear of
falling and risk of falling were higher than in those who did not fall
(reported fear of falling in 90.2% versus 60.5%, p=0.015; Tinnetti testscore 24.8 versus 21.3, p=0.015). Those who have experienced falls,
more often stated they feel pain, depression or anxiety than those
who did not experience fall. The moderate negative correlation between risk of falling and physical activity (r=-0,472; p<0,001) was
found. No statistically signiﬁcantly relationship was found between
fear of falling and physical activity.
Conclusions: In persons who fell during the previous 12 months,
the fear of falling and fall risk was higher than in those who did not
fall. In community-dwelling people older than 65 years, the fall risk
negatively correlated with physical activity.
P-458
The association between the walking endurance, walking speed,balance, and fear of falling in older adults
T. Kahraman 1 , K. Cekok 2 , B.O. Ugut 1 , P. Keskinoglu 3 , A. Genc 4 .
1 Department of Physiotherapy and Rehabilitation, Faculty of Health

Sciences, Izmir Katip Celebi University, Izmir, Turkey; 2 Department of
Physical Therapy and Rehabilitation, Medical Park Hospital, Izmir,
Turkey; 3 Department of Biostatistics and Medical Informatics, Dokuz
Eylül University, Izmir, Turkey; 4 School of Physical Therapy andRehabilitation, Dokuz Eylül University, Izmir, Turkey
Objectives: Walking is an important physiological process that requires coordination of motor, sensory and central nervous systems.

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Although evidence suggests that walking speed is associated withbalance and fear of falling in older adults, their relationship withwalking endurance is not yet known. Therefore, the aim was toinvestigate the relationship between walking endurance, walking
speed, balance, and fear of falling in older adults.
Methods: Adults aged older than 50 years were included in thiscross-sectional study. Walking endurance and speed were assessedwith the 6-Minute Walk Test (6MWT) and 10-Meter Walk Test
(10MWT), respectively. Balance was assessed with the Four Step
Square Test (FSST), Berg Balance Scale (BBS), Timed Up and Go(TUG) Test, and 30-Second Chair Stand Test (30CST). Fear of falling
was assessed with the Falls Eﬃcacy Scale-International (FES-I).
Results: Ninety-four adults (51 female) with mean age of 71.1
(SD=10.6) years were included. The 6MWT had moderately correlated with the 10MWT, FSST, BBS, TUG, and 30CST (p<0.01). The
10MWT had week to strong correlations with the 6MWT, FSST,BBS, TUG, and 30CST (p<0.01). The 30CST, FES-I, and TUG were thesigniﬁcant predictors of the 6MWT with explaining 57.1% of thevariance. The TUG was the predictor with explaining 90% of thevariance in the 10MWT.
Conclusions: The study has indicated that better walking endurance and speed were associated with better balance and lessfear of falling in adults older than 50 years. Additionally, the fear of
falling is a strong predictor of the walking endurance.
P-459
The effects of complex decongestive physiotherapy in elderly
women with breast cancer related lymphedema
O.T. Atalay, A. Yilmaz, E. Baskan, N. Yağcı. Pamukkale University,
School of Physical Therapy and Rehabilitation
Objective: Older women have a higher incidence and worse survival rate from breast cancer than younger women. Lymphedema
is a common complication of breast cancer treatment and breast
cancer-related lymphedema (BCRL) continues to affect at least
20% of women undergoing breast cancer treatment with axillary
clearance.Complex decongestive physio therapy (CDP) is the mostcommon and effective treatment of BCRL among the others. The
aim of this study was to analyze the effects of CDP in elderly womenwith BCRL.
Methods: Eighteen women with BCRL were included in the study.
The mean age of subjects was 68,32±4,32 (min: 62, max: 78). The
subjects received CDP for 5 times/week for 4 weeks. The extremity
circumference, the range of motion (ROM) and muscle strength ofsubjects were also assessed before and after CDP. A goniometer
was used for the measurement of ROM and the muscle strength
was measured by a handgrip dynamometer. For the evaluationof volume reduction, circumferential measurements were used to
calculate the volume of the arms with Frustum Formula.
Results: At the end of CDP, there was a signiﬁcant reduction in theextremity volume of subjects (p<0,05). There was only signiﬁcant
increase in shoulder abduction in ROM assessments (p<0,05) but
any signiﬁcant difference was not found in muscle strength after
the CDP (p>0,05).
Discussion: The CDP can be an effective treatment for volume
reduction in elderly women with BCRL but some other conservative
physiotherapy methods are needed to improve ROM and muscle
strength.
P-460
The effects of osteopathic manipulative therapy on chronic low
back pain: middle age versus older adults
N. Yagci, E. Aslan Telci, M. Oztop. Pamukkale University School ofPhysical Therapy and Rehabilitation, Denizli, Turkey
Introduction: Osteopathic manipulative treatment appear to pro-vide some beneﬁts when used in addition to usual care for thetreatment of chronic nonspeciﬁc low back pain. The aim of thisstudy is to determine the effects of Osteopathic Manipulative Therapy (OMT) comparing middle aged and older adults with chronic
low back pain.
Methods: One hundred four participants with chronic low backpain were included in the study. They were divided into twogroups by age: middle-aged adults (45–64 yr; n=71), and older
adults (65–84 yr; n=33). All groups received OMT (soft tissue
mobilization and vertebral mobilization) three times in a week for
4 weeks. Pain intensity (Visual Analog Scale; VAS), disability level(Roland Morris Disability Questionnaire and depressive symptoms(Beck Depression Scale) were evaluated before and after treatment
program.
Results: The results indicate that there were signiﬁcant improvements in pain intensity, disability level, and depressive symptoms
in the two groups (p<0.0001). There were no any signiﬁcantdifferences between the groups (p>0.05).
Conclusions: Osteopathic manipulative therapy can be used torecovery low back pain symptoms in both middle aged and older
adults. This means OMT is a safe method which can also be in older
adults.
P-461
The evaluation of the balance in geriatric hypertensive
individuals
F. Hajebrahimi, H. Özbek, Z.C. Algun. Istanbul Medipol University
This study is designed to evaluate the relationship between thebalance performance of the geriatric hypertensive and normotensive individuals and ﬁnd out the effect of hypertension in thebalance behavior of the elderly people. 61 geriatric people were
included in our study. All the patients were 65 years old andolder and were participating to our study with their own approval.
Demographic information of the participants has been recorded.
Basic activities of daily living are measured by the KATZ Index of
ADLs, cognitive status is measured by Standardized Mini-Mental
State Examination, depression status is measured by Geriatric Depression scale, Quadriceps muscle strength is measured by hand
held dynamometer, ankle dorsiﬂexion range of motion is measured
by goniometer, gait is measured by Timed Up and Go Test andbalance performance is measured by Nintendo Wii. The systolicand diastolic blood pressure is measured before the balance test.
Hypertensive group had higher performance time in Timed Up and
Go test than normotensive. (p=0.030). Parameters of “Completed
seconds in Wii Single Leg Balance Test”, “Performance score in Wii
Single Leg Balance Test” and “Wii ﬁt age” between both hypertensive and normotensive groups were determined signiﬁcant in thestatistical analysis (p<0.05). Hypertension seems to affect different
parameters of balance among elderly people. For controlling theirbalance, elderly people should consider their high blood pressure
beside their falling history.
P-462
The impact of physical training upon bone and skeletal muscle
remodeling in elderly female with osteoporosis
C.R. Revnic 1 , F. Revnic 2 , C. Pena 2 , B. Paltineanu 3 , S. Voinea 1 . 1 UMF“Carol Davila”, Bucharest, Romania; 2 NIGG Ana Aslan, Bucharest,
Romania; 3 UMF Tg.Mures, Targu Mures, Romania
Our study was done on 48 elderly female patients aged between
65–78 years old with osteoporosis divided into three groups of 16
patients each: Group A without speciﬁc antiosteoporotic medication (only Ca++ and Vitamin D and Kineto program), Group B withantiosteoporotic medication, Ca++Vitamin D and Kineto program,Group C without physical effort, Kineto program with antioseo-

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

porotic medication, Ca++ and Vitamin D. Kineto program has been
performed for the ﬁrst two weeks in kinetotherapy laboratory,
three times/week for 50 minutes. At home the patients have been
instructed to follow up the training with daily walks in alert rhythm
for 30 minutes and to perform heel drops 50/day. HGH and Cortisol
serum levels were evaluated before and after training with 1234
DELFIA Research Spectroﬂuorimeter using Eu+ labelled HGH and
Cortisol kits purchased from Pharmacia LKB. Motor neuron training
was achieved with a Schwartzer-Picker EMG of biceps and triceps
muscle using 4 kg weight training.
Results: Our data pointed out that kineto program can prevent or
reduce the % of bone loss in elderly postmenopausal female. Supplementation with calcium and vitamin D improves the eﬃciencyof physical exercise upon BMD by stimulation of hGH secretion
with anabolic effects upon all type of cells from the body and by
decreasing the levels of Cortisol known as stress hormone with anegative impact upon bone metabolism.
Conclusion: The decline with aging in hGH secretion is not irreversible and physical training is one of the ways which canstimulate hypothalamus and anterior pituitary lobe to produce hGHin elderly female patients with osteoporosis
P-463
The impact of physiotherapy program on pain intensity and fear
avoidance behavior in patients with chronic non-speciﬁc low
back pain: Age differences
N. Yagci, E. Aslan Telci, M. Oztop, S. Sekeroz. Pamukkale University
School of Physical Therapy and Rehabilitation, Denizli, Turkey
Introduction: Fear avoidance behavior associated with low backpain is a condition that has adverse effects on physical activity,
quality of life and mental state in the elderly. The aim of this study
is to compare the effect of the Conventional Physiotherapy Program(CPP) on pain intensity and fear avoidance behavior in elderly
and young adult patients with Chronic Non-speciﬁc Low Back Pain
(CNLBP).
Methods: Twenty-three elderly patients with CNLBP (65–85 yrs;
mean age: 68.67±4.70 yrs) and 19 young adults with CNLBP (18–39 yrs; mean age: 30.53±6.64 yrs) were included in this study.
Both groups were treated with CPP consisting of Hotpack, Ultrasound, TENS and exercise (total 14 sessions). Pain intensity wasassessed with Visual Analogue Scale and fear avoidance behavior
was assessed with Tampa Kinesiophobia Scale before and after
treatment.
Results: In both groups, there was a decrease in pain intensityand fear avoidance behavior after treatment compared to before
treatment (p=0.001). There was no difference between the groups
in terms of improvement in pain intensity (p>0.05), while improvement of fear avoidance behavior in young adult patients was foundto be higher than in elderly patients (p=0.031).
Conclusions: The results of our study showed that the applied
treatment program provided more improvement in fear avoidance
behavior in young adult patients with CNLBP compared to elderly
patients with CNLBP. We believe that the application of the necessary patient education and treatment strategies for eliminate thefactors that cause this behavior in the elderly will provide morehealing.
P-464
The results of a rehabilitation program in elderly with low backpain
R. Nartea, A.S. Nica, M. Constantinovici, I. Mitoiu Brindusa. INRMFB,
UMF “Carol Davila” Bucharest, Romania
Our clinic has a day care unit specialized in rehabilitation programs
adapted for different types of pathologies, low back pain being one

S173

of the most frequent diagnosis. In geriatrics we often have different
comorbidities intricating the basic ethiology so the response varies.
We have worked on a prospective study including 21 out patients
aged between 71 and 86 with chronic sharpened low back pain
lasting from one to three months with history of NSAID treatment.
Their comorbidities included cardiovascular changes, chronic obstructive pulmonary disease and chronic kidney disease. They havebeen included in a rehabilitation program consisting of physicaland occupational therapy, low frequency electrotherapy and TENS,
Laser therapy and manual therapy. Their pain using VAS scale andtheir capacity of walking using the six minutes walking test wereassessed in the beginning and in the end of ten rehabilitation
sessions. The results show the positive effect of the rehabilitation
program with an improvement of the pain level but with no signiﬁcant changes regarding the capacity of walking. In order to improve
both pain and functionality a rehabilitation program created for theelderely should include more sessions spread on a longer period oftime. A further assessment step should be included as a medium
term evaluation.
P-465
The role of low power laser therapy, kinetotherapy andphysiotherapy in the management of degenerative
osteoarticular pathologies in elderly patients
C.R. Revnic 1 , F. Revnic 2 , C. Pena 2 , B. Paltineanu 3 , S. Voinea 1 .
1 UMF“Carol Davila”, Bucharest, Romania; 2 NIGG “Ana Aslan”,
Bucharest, Romania; 3 UMF Tg Mures, Targu Mures, Romania
Aim of study: To see to what extent Low power Laser therapy(LPLT) combined with kinetotherapy (KT), physiotherapy (PT) andantiinﬂamatory medication (AIM) contributes to amelioration of
osteoarticular pathology in elderly population and the impact upon
daily living activity (DLA) and quality of life (QOL). 200 patients
aged between 55–75 years old were admited in Rehabilitation Clinique, with degenerative pathology of locomotor system: 95 with
Scapulohumeral periarthritis (SHP), 81 women and 14 men, simple
painful shoulder (SPS)and 105 cases with bilateral gonarthrosis (BG)
85 women and 20 men. Patients were included into 2 groups: A(LPLT) + (AIM) + (PT) and (KT) and B: (AIM) and (PT). After (LPLT)
treatment combined with (KT), (PT) + (AIM) in group A there was anamelioration of local algic phenomena – the score on Pain Scale being under 3; For 74 (SHP) patients with pain scale between 3 and 4,
pain has decreased from 2 to 1; i.e. 78,2%. For 19 patients with 2 and3, pain scale has decreased from 1 to 0, i.e. 19,5%. For 2 patients with
the initial value 5, Pain intensity has decreased from 3 to 2, i.e. 3%. 3.
Conclusions: Aplication of (LPLT) in degenerative pathology of locomotor apparatus in elderly patients associated with (KT) had net
beneﬁc antialgic and antiinﬂamatory effects than in group B. DLA
amelioration for (SHP) was approx. 80% and for knee articulation∼86%, resulting in: an increase in well being state, in professionaland social reinsertion, and in family reintegration. In this context (LPLT) is strongly recomended in treatment of degenerativeand post traumatic pathologies and their complications in elderly
patients either in hospital or in Ambulatory
P-466
The role of physiokinetotherapy in the management of
Parkinson’s disease
C.R. Revnic 1 , F. Revnic 2 , C. Pena 2 , B. Paltineanu 3 , S. Voinea 1 . 1 UMF“Carol Davila”, Bucharest, Romania; 2 NIGG “Ana Aslan”, Bucharest,
Romania; 3 UMF Tg.Mures, Targu Mures, Romania
Objective: Evaluation of physiokinetotherapy (PKT) program associated with medical treatment for Parkinson’s disease (P.D) in
different evolutionary stages.
Material and method: 42 patients aged between 40–79 years

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old with P.D. evaluated by clinical neurological examination havebeen taken in our study. A three weeks (PKT) program has been
performed including: thermotherapy designed for amelioration ofmusclular pain and rigidity, sedative massage applied before andafter kinetotherapy for P.D. stage II and III patients and also forpatients imobilised in bed, along with electrotherapy and continuos
magnetodiaﬂux.
Results and discusion: Out of 14 patients in stage IV on Hoehn& Yahr scale, 6 have achieved amelioration of walking, without asubstantial amelioration of posture. 5 out of 10 patients in stage III
improved posture during walking, but walking has been performed
with small steps.P.D. patients stage IV improved daily living activities (ADL) (12 out of 14 patients at the end of 3 weeks therapy) did
not required any assistance for ADL but, the remaining two patientsrequired partially assistance. For P.D. patients stage III at the end of
three weeks treatment, 9 out of 10 have recovered, only one needassistance for dressing. For patients in stage II the effort for getting
dressed was less than before treatment. No signiﬁcant amelioration
for patients in stage V was recorded.
Conclusions: PKT program improved control over gross motor
movements such as walking, improved posture and greater conﬁdence in performing daily activities in P.D. patients. The progresivityof PKT program is very important and must be continued at home
and in advanced P.D.stages there is necessary cooperation of family
members
P-467
The use of trained volunteers to encourage increased
ambulatory activity among hospitalised older people:
a feasibility study
S. Lim 1,2 , G. Strike 3 , M. Baxter 3 , A. Purkis 3 , A. Rogers 2 ,A.A. Sayer 1,2,4,5 , H.C. Roberts 1,2,3 . 1 Academic Geriatric Medicine,
University of Southampton, UK; 2 NIHR CLAHRC Wessex, University ofSouthampton, UK; 3 University Hospital Southampton NHS FT, UK;
4 Ageing, Geriatrics & Epidemiology, Institute of Neuroscience,
Newcastle University; 5 NIHR Newcastle Biomedical Research Centre in
Ageing and Chronic Disease, Newcastle University and Newcastle upon
Tyne NHS Foundation Trust
Introduction: Sedentary behaviour among older inpatients is
associated with functional decline, social isolation, prolonged hospitalisation and nursing home admission. The objective of this study
was to explore the use of trained volunteers to promote increased
ambulatory activity among older inpatients.
Methods: This pre-post feasibility study was conducted on acute
Geriatric Medicine wards at one hospital. Inclusion criteria were
patients aged ≥70 years, who were able to walk prior to admission
and provide consent. Participants received twice daily volunteer-led
bedside exercises or walking sessions on weekdays. Participants
who were not independently mobile performed exercises only. The
StepWatch Activity Monitor measured mean daily step count before
and during the intervention as the primary outcome.
Results: 42 patients (mean age 87.2 years, SD 4.6) had their activity
measured (median daily step count 636 steps, IQR 298–1468)
pre-intervention. 17 volunteers received half-day training including
competency assessment. 50 patients (mean age 86.2 years, SD 5.1)
were recruited to the intervention group and 310 activity sessions
were offered. The median daily step count of the intervention group
was 912 steps (IQR 337–1824), an increase of 43.4%. Adherence tothe activity sessions was 74.2% (230 sessions). Common reasons for
declined participation were patients feeling unwell or tired, and theneed for clinical care. No falls or adverse incidents were reported.
Conclusion: Volunteers can be recruited and trained to safely
encourage older inpatients to increase ambulatory activity, with anaverage increase of 276 steps/day. Research into the acceptability
and impact of this intervention is on-going.

P-468
Use of new technologies in the treatment of post-stroke
hemiplegia
R. López-Liria 1 , J. García-Molina 2 , F.A. Vega-Ramírez 3 ,P. Rocamora-Pérez 1 . 1 Department of Nursing Science, Physiotherapy
and Medicine. University of Almería. Almería. Spain; 2 Physiotherapist.
Almería. Spain; 3 Torrecárdenas Hospital, Almería. Spain
Objective: To ﬁnd alternative techniques to Bobath treatment
in post-stroke hemiplegia, through literature search in different
databases, its impact on research and clinical practice and thecurrent lines of development.
Method: Systematic review. The search was conducted in the databases Medline, Pubmed, Web of Science and Dialnet, using the following descriptors: hemiplegia, virtual reality, rehabilitation, stroke,
new treatment, telerehabilitation and Wii, in the last 10 years.
Exclusion criteria were non hemiplegic patients after cerebrovascular disease, or non alternative technique to conventional physiotherapy treatment. Jadad scale was used for articles assessment.
Results: 14 articles were selected, in which different treatments forpost-stroke hemiplegia based on new technologies were applied.
All results supported the advantages of using new technologies inthe treatment. Twelve of them focused on virtual reality (as Tetrax
Biofeedback, Wii Balance Board), one was related to robotics, andone addressed the issue of telerehabilitation. The variables understudy were: main motor function (gait and balance) and ability toperform activities of daily living. The scales used for the assessment
were Timed Up and Go Test, Berg scale, Step test, Time up and Down
Stair test, 10 metre walk test, Gait Speed test, Two minutes walkdistance test, Caregiver burden scale, Activities-Speciﬁc Balancescale and Barthel index.
Conclusion: The use of new technologies in addition to conventional physical therapy can constitute a great combination for thetreatment of post-stroke hemiplegia, being adaptable to each case,increasing patient’s adherence to treatment and allowing assistanceregardless the patient’s location.
P-469
Utility of inpatient rehabilitation in elderly acute stroke patients
bound for placement in nursing homes
K.H.R. Goh, N. Tang, E. Chew. National University Health System,
Singapore
Background: Singapore is facing rapid societal ageing and thenumbers of elderly nursing homes are projected to increase [1].
Currently elderly patients bound for placement at nursing homes
receive lower prioritisation for rehabilitation. The increase in volume of elderly nursing home residents highlights the need formore active rehabilitation of acutely debilitated elderly to optimisefunction and decrease burden of care during institutionalisation.
Objective: To evaluate the utility of active inpatient rehabilitation
under specialised inpatient rehabilitation team for elderly acutestroke patients heading for nursing home versus those planned forhome.
Methods and results: A retrospective review of 81 geriatric stroke
patients in 2015–2016 receiving inpatient rehabilitation was conducted. FIM (Functional Independence Measure) scores (total, motorand cognitive components) and FIM eﬃciency was compared [2].
11 patients were discharged to nursing homes, while the rest wenthome. The mean FIM gain of total, motor and cognitive scoresamong patients going to nursing home were 19.5 (SD = 7.6), 15.3
(SD = 5.8) and 4.3 (SD = 3.7) respectively. Comparatively, the mean
FIM gain among patients going home were 18.6 (SD = 10.7), 14.9
(SD = 8.3) and 3.6 (SD = 5.4).
Conclusion: There were no statistically signiﬁcant difference inthe length of stay, improvement and eﬃciency of scores between

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

patients placed in nursing homes and those who went home.
This suggests a role for active inpatient rehabilitation of elderly
stroke patients planned for nursing home placement optimising
function which translates into reduced burden of care [3]. Further
prospective studies needs to be done.
References:[1] Yap Mui Teng, Kang Soon Hock and Chua Chun Ser, Scenarios of
future population growth and change in Singapore, IPS update,
March 2011.
[2] Linacre, John Michael, et al. The structure and stability of
the Functional Independence Measure. Archives of physicalmedicine and rehabilitation 75.2 (1994): 127–132.
[3] Hamilton, B.B., et al. Cost of disability as measured by the
Functional Independence Measure (FIM™) instrument: spinal
cord injury. NIDRR Project H133G90157 (3rd ed.) Center for
Functional Assessment Research, Buffalo (NY) (1997).
P-470
Validation of post-stroke rehabilitation proﬁles in older adults
L.M. Pérez 1 , J. Salas 1 , R. Galvadà 2 , J. Castro 1 , A. Barrios 1 ,N. Martínez 1 , M. Gallofré 3 , M. Inzitari 1 . 1 Parc Sanitari Pere Virgili,
Barcelna, Spain; 2 Department of Computer Science, Universitat
Politécnica de Catalunya, Barcelona, Spain; 3 Pla Director Malaltia
Vascular Cerebral, Department of Health, Government of Catalonia,
Barcelona, Spain
Introduction: Despite the high prevalence of stroke in older adults,
evidence on post-stroke rehabilitation is scarce. We previously
developed (Pérez LM, et al, PlosOne 2016) a classiﬁcation of
post-stroke rehabilitation complexity in older adults, and aim at
assessing external validity in a different cohort.
Methods: Cohort study enrolling stroke survivors ≥65 years old
admitted to an intermediate care hospital during 2016. According
to baseline characteristics (stroke severity, cognitive status, current
and previous functional status, available caregiver), patients wereassigned to 3 rehabilitation proﬁles, through a decision tree. We analyzed between-proﬁles differences on functional improvement (FI,Barthel Index), relative functional gain (Montebello/Heineman index), length of hospital stay (LOS), rehabilitation eﬃciency (FI/LOS),
home discharge and costs using multivariable regression models.
Results: We enrolled 170 post-stroke survivors (mean age 79.0±9.3,female 48.8%, 83.5% ischemic stroke), classiﬁed in: a) Lower
Complexity with Caregiver (LCC, N=68), b) Moderate Complexity
without Caregiver (MCN, N=52), and c) Higher Complexity with
Caregiver (HCC, N=50). In logistic regression models, both LCC
and MCN, compared to HCC, showed higher chances of functional
improvement (OR=4.9, 95% CI: 2.1–11.1 and OR=3.8, 95% CI: 1.7–
8.8, respectively), higher relative functional gain (OR=4.4, 95% CI:
1.6–10.8 and OR=4.5, 95% CI: 1.7–11.9, respectively, top Vs lower
tertiles), and higher chance of home discharge (OR=12.2, 95% CI:
4.9–30.5 and OR=4.0, 95% CI: 1.7–9.3). Compared to MCN, LCC had ahigher likelihood of home discharge (OR=2.1, 95% CI: 1.2–7.1). Other
outcomes showed no differences between proﬁles.
Conclusion: In our sample, we conﬁrmed differences in functional
outcomes among post-stroke proﬁles. This classiﬁcation could help
to design tailored interventions to optimize recovery.
P-471
ViTA (Virtual Trainer for Aging): Developing of an experimental
system to improve the life of people with dementia
P. Leo 1 , G. D’Onofrio 2 , D. Sancarlo 2 , F. Ricciardi 3 , M. De Petris 3 ,F. Giuliani 3 , G. Ciarambino 3 , S. Peschiera 1 , A. Failla 4 , F. Renzi 1 ,A. Greco 2 . 1 Research & Business Unit, IBM; 2 Complex Unit ofGeriatrics, Department of Medical Sciences, IRCCS “Casa Sollievo dellasofferenza”, San Giovanni Rotondo, Foggia; 3 ICT, Innovation andS175

Research Unit, IRCCS “Casa Sollievo della Sofferenza”, San Giovanni
Rotondo, Foggia; 4 Fondazione IBM Italia
Introduction: By the year 2050 more than 130 million people over
the world will suffer of dementia. A number of areas are under investigation to slow the pathology progression that can complement
the pharmacological treatments such as nutrition, physical andcognitive training and social support. In this context we starting todevelop the project VITA (Virtual Training for Aging) with the aim
to collect and improve the memory of people with dementia.
Methods: ViTA is an experimental system based on the cognitive
platform IBM Bluemix integrating a number of cognitive services
already available on that platform as well as integrates additional
research components developed for the project. The system will beavailable through a Tablet. Caregivers will interact with it to collectfragments of memory and organizes them into a knowledge map
in which each fragment is linked to the other through emotionalawarestories. Patients could access to the system to review theirmemories and stories leveraging a conversational interface basedon speech and textual interaction modalities in addition to traditional interactive interface. ViTA will be tested in the next few
months on a small cohort of elderly people with mild cognitive
impairment in the Geriatrics Department of the IRCCS Casa Sollievodella Sofferenza. Every patients will be evaluated with a multidimensional assessment and complete neuro-psychological battery
including also quality of life and caregiver burden.
Conclusions: This innovative system based on cognitive andemotion-oriented care approach will try to improve cognitive, emotional and social functioning by supporting patients with dementia.
P-472
Volunteer-led mobilisation of older inpatients: qualitative studyof stakeholders’ views
A. Baczynska 1 , K. Ibrahim 2 , A.A. Sayer 3 , H. Roberts 1 . 1 Academic
Geriatric Medicine, University of Southampton; NIHR Southampton
Biomedical Research Centre, University Hospital Southampton NHSFoundation Trust; NIHR CLAHRC: Wessex, University of Southampton;
2 Academic Geriatric Medicine, University of Southampton; NIHR
CLAHRC: Wessex, University of Southampton; 3 Academic GeriatricMedicine, University of Southampton; NIHR Southampton Biomedical
Research Centre, University Hospital Southampton NHS Foundation
Trust; NIHR CLAHRC: Wessex, University of Southampton; Ageing,
Geriatrics & Epidemiology, Institute of Neuroscience, Newcastle
University; NIHR Newcastle Biomedical Research Centre, Newcastle
University and Newcastle-upon-Tyne NHS Foundation Trust
Introduction: Mobilisation of older inpatients can reduce medical
complications and loss of function. Time-pressured nurses andtherapists report that this activity is frequently compromised. The
aim was to explore a wide range of views on trained volunteers
supporting mobilisation in hospital.
Methods: Semi-structured interviews and focus groups were conducted with 20 inpatients, 7 relatives, 28 staff members and 3
mealtime volunteers at one UK hospital. Interviews were audiotaped, transcribed verbatim, coded and analysed thematically by
two researchers to identify commonalities and differences among
the participants.
Results: Interviewees were generally positive. However staff
thought recognition of unwell patients was important and patients awaiting social input would be most suitable. Volunteer
related issues included: their roles and personal characteristics emphasised by therapists, legal responsibilities highlighted by doctors
and nurses, training and supervision discussed by nurses and therapists. Environmental issues around timing, space, hospital routinesand other patients’ health status were noted by nurses and doctors.
Concerns including potential staff miscommunication, additional

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work for nurses and education regarding volunteers’ role were
explored by therapists. Many patients were very positive about
this idea; others anticipated diﬃculties motivating participants
and limited space in hospital. Relatives agreed that promotion ofmobility and mental stimulation would be the main beneﬁts of thisprogramme. Only one relative believed it would be inappropriate tohand this task over to a non-member of staff.
Conclusions: In this qualitative study interviewees expressed positive attitudes to volunteer-led mobilisation of older people provided
that speciﬁc issues are considered prior to implementation.
P-473
War on constipation: Quality improvement project involving a
multidisciplinary constipation prevention and management
algorithm
C.N. Osuafor 1 , S. Enduliri 1 , E. Travers 1 , A.M. Bennett 2 ,M.E. Deveney 3 , S. Ali 1 , F. McCarthy 1 , C.W. Fan 1 . 1 Medicine forElderly Department; 2 Dietetics Department; 3 Nursing Department, St
Mary’s Hospital, Phoenix Park, Dublin, Ireland
Introduction: Constipation is common in older adults and often
leads to increased incidence of adverse events and prolonged hospitalization. The aim of this project was to improve the quality of careof older adults undergoing rehabilitation in relation to prevention
and management of constipation.
Methods: Quality improvement (QI) Plan-Do-Study-Act (PDSA) cycles were used. PDSA 1 was an initial audit of the incidence ofconstipation in our rehabilitation wards. PDSA 2 included meeting with key stakeholders and the multidisciplinary team (MDT)
involved in the care of the patients and development of an algorithm for the prevention, early detection and effective treatmentof constipation. PDSA 3 was a re-audit of the service after the
introduction of the algorithm. PDSA 4 was the institutionalizationof the developed algorithm.
Results: In the audit 2, 19% of patients were noted to be constipatedcompared to 33% in audit 1. 100% of patients in audit 2 who wereconstipated were on regular laxatives compared to only 30% of
those in audit 1. 72% of all patients in audit 2 were on laxatives on
as needed basis compared to 40% of patients in audit 1. The project
also resulted in improved communication between patients and the
MDT around their bowel habits.
Conclusions: Using a QI methodology, this project resulted inearlier detection, earlier intervention and overall reduction in incidence of constipation in older adults undergoing rehabilitation. The
new algorithm was subsequently introduced to all the wards of our
hospital

hemodynamically stable, fever 38.7°C, without other changes. No
relevant personnal background. Blood tests: ESR 120 mm/h, RCP
12.6 mg/dL, Hb 10.5 g/dL, MCV 79 fL, WBC 14.9×109 /L. No analytical alterations of renal and hepatic functions. Chest x-ray,abdominal ultrasound, and urinalysis without changes. Initially theauthors interpreted this clinical case as paraneoplastic syndromeor polymyalgia rheumatica. The patient did upper digestive endoscopy, colonoscopy, and bone scintigraphy without alterations.
ANA: 160. At the end of one week of hospitalization, the patient
has several episodes of hemoptysis, with severe acute respiratory
failure. A thoracic CT scan: bilateral and symmetrical parenchymal
densiﬁcation without active hemorrhage. Subsequently, pANCA andMPO antibodies were positive. It made megadoses of methylprednisolone 1g for 3 days and later 80 mg of prednisolone daily. With
the improvement of respiratory insuﬃciency, the patient performbiopsies, and the diagnose was pulmonary vasculitis.
Conclusion: Although lung vasculites are not frequent at this age,they may arise and adequate treatment should not be delayed.
P-475
A systematic analysis on amino acid transporters of the aging
blood-brain barrier
N. Haaning Rasmussen. Aarhus Universitetshospital Skejby, Geriatrisk
Afdeling, Danmark
Introduction: The blood-brain barrier (BBB) prevents toxic molecules
to penetrate from the bloodstream to the brain. The BBB assuresadequate delivery of nutrients such as amino acids, fatty acids,
glucose. We investigated whether aging changes the ability of thebrain capillaries to transport amino acids from blood to brain
through the BBB.
Methods: Systematic literature review combined with databasesearch for amino acid transport through the BBB and search forexpression of amino acid transporters by the endothelium of theaging human brain. Our literature search revealed few humanstudies, we also performed our search in experimental animals suchas rats and mice.
Results The systematic review of the literature revealed that research on nutrient transport at the BBB has been sparsely studied.
We identiﬁed less than ten human studies. They did however
demonstrate effects on transport of certain amino acids in the aging
brain. This was also the case in aging experimental animals.
Conclusion: Examination of amino acid transport and their carriers
at the BBB in the aging brain revealed that the availability of humanstudies is sparse. Studies in experimental animals were also few but
support a hypothesis that the brain’s uptake and transport of aminoacids through the BBB correlates negatively with increasing age.

Area: Geriatrics in organ disease

P-476
Acute heart failure in elderly patients with mid-range ejection
fraction: realworld evidence from ATHENA RegistryP-474
A clinical case of pulmonary vasculitis in the elderly

S. Parlapiano 1 , F. Orso 2 , A. Pratesi 3 , A. Herbst 1 , A.C. Baroncini 2 ,A. Lo Forte 2 , C. Ghiara 2 , E. Carrassi 1 , G. Biagioni 1 , F. Fedeli 1 ,M.L. Di Meo 2 , N. Marchionni 4 , L. Gabbani 5 , M. Di Bari 2 , A. Ungar 2 ,S. Baldasseroni 2 . 1 University of Florence, Florence, Italy; 2 GeriatricIntensive Care Unit, Careggi University Hospital, Florence, Italy;
3 Department of Experimental and Clinical Medicine, University of
Florence, Florence, Italy; 4 Division of General Cardiology, Careggi
University Hospital, Florence, Italy; 5 Department of Medicine andGeriatrics, Careggi University Hospital, Florence, Italy

P. Lopes, I. Alen, J.E. Mateus, D. Ferreira, M. Ferreira, J.F. Gomes,
J. Porto, M. Veríssimo. Centro Hospitalar e Universitário de Coimbra
Background: Systemic vasculitis is a group of diseases characterized by inﬂammation of blood vessels with ﬁbrinoid necrosis andresulting ischemic changes. In the geriatric population it has beenfrequently described with patient age playing an important role inboth the diagnosis and treatment of these diseases. Vasculitis may
mimic many common clinical situations of the elderly.
Case report: Female 84 years admitted to hospital for anorexia,
asthenia, paleness with 15 days of evolution, associated with symmetric and additive polyarthritis, shoulderes, hips, and knees. She
reported morning stiffness greater than 30 minutes. Conscious,

Introduction: Our purpose was to better characterize the newcategory of patients with heart failure mid-range ejection fraction(HFmrEF) and to compare them to those with HFpEF and HFrEF ina real world setting of elderly patients hospitalised for acute heart
failure (AHF).

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

Methods: Data derived from the ATHENA retrospective observational study which included elderly patients (≥65 years) admittedwith diagnosis of AHF (worsening or de novo) to the emergency
department (ED) of a tertiary University teaching-hospital andtransferred to cardiology, internal medicine and geriatric wards inthe period 01.12.2014–01.12.2015.
Results: 246 patients were enlisted (patients with HFmrEF were
19.5%, 30.5% had HFrEF and 50.0% had HFpEF). Mean age was 83.8,
84.5 and 79.9 years for HFmrEF, HFpEF and HFrEF respectively,
p<0.001; the prevalence of females was 41.7%, 67.5% and 32.0%
for HFmrEF, HFpEF and HFrEF respectively, p<0.001. There wereno signiﬁcant difference regarding cardiovascular risk factors andmain comorbidities between the three groups. A history of coronary
artery disease, instead, was more frequently reported in patientswith HFmrEF (41.7%) and in those with HFrEF (36.0%) compared topatients with HFpEF (19.5%), p=0.004. There was not signiﬁcantly
different in in-hospital mortality; the hospital length of stay was:
11.7 days, 9.4 days and 10.1 days for HFmrEF, HFpEF and HFrEF
respectively (p=0.18).
Conclusions: Our study shows that patients with HFmrEF appear
to be very similar to patients with HFpEF, except for the ischemic
feature that seems to bring them closer to those with HFrEF.
P-477
An unusual cause of heart failure in octogenarian patients
V. Landaluce Pelligra, E. García Tercero, A. Escolante Melich.
Complejo Hospitalario de Toledo
79-year-old patient presented dyspnea on moderate exertion, associated in the last 15 days with increased edema in the lower
limbs, testes and subjective increase of the abdominal perimeterwith decreased diuresis rhythm. Physical examination: abolitionof vesicular murmur in the left pulmonary base and generalized
crackles, edema of abdominal wall and edema with foveas to root oflimbs. In the tests, cardiomegaly, bilateral pleural effusion with interstitial edema and NT-proBNP 7174 pg/mL were evidenced. On theechocardiogram: left ventricle with increased thickness, suggestive
refringence of inﬁltrate, moderately depressed LVEF. Cardiac MRI:
Myocardial diffuse uptake compatible with amyloidosis pattern.
Moderate biventricular systolic dysfunction. The patient presented
alterations of ventricular contraction for 7 years, is admitted for
medical treatment and study with 99mTc-DPD scintigraphy because of poor clinical status. It requires high doses of diuretics ininfusion, obtaining a good negative diuresis balance and improvement of heart failure, however, it presents febrile peaks evidencing
methicillin-resistant S. aureus in blood cultures. In view of thepresence of a pacemaker, it is treated as bacterial endocarditis,scheduling removal of the device and delaying the scintigraphy.
The patient presented poor evolution, passing away at 15 days. The
senile amyloidosis reaches a prevalence of 36% in patients over
80 years, affects mainly men producing cardiac manifestation, themanagement is easier to control, with an average survival of 75
months, being the main cause of death arrhythmias and progressionof HF. Our patient presented an evolution of 7 years, greater than
the average of survival.
P-478
Characteristic aspects of widespread pain in older adults
G.I. Prada 1 , R.M. Nacu 1 , I.D. Alexa 2 , A.G. Prada 3 , A. Kozma 4 .
1 N.I.G.G. “Ana Aslan”, U.M.F. “Carol Davila”, Bucharest, Romania;
2 U.M.F. “Gr. T. Popa”, Iassi, Romania; 3 U.M.F. “Carol Davila”, Bucharest,
Romania; 4 Institute of Anthropology “Fr. I. Rainer”, Bucharest,
Romania
Introduction: Chronic pain is a major condition often encounteredin elderly and has signiﬁcant consequences on quality of life. Study

S177

objective was to identify speciﬁc patterns of widespread pain inelderly.
Material and methods: A transversal study was carried out on
584 subjects, age-range 50–92 years. They were divided into twogroups, both presenting widespread pain: 292 adults (50–64 years),
292 elderly (75–92 years).
Results: Most patients were from urban area. Marital status:
married adults signiﬁcantly more prevalent (p<0.01), most elderly women were widows (p<0.01), elderly men were divorced(p<0.05). Obesity was more prevalent in elderly women. Alcohol
consumption was declared only in men, slightly higher prevalencein younger group. Most adults had chronic pain for 5 years, whileelderly had chronic pain for more than 10 years. For most subjects,
irrespective of age, pain was cvasi-continuous. Exercise less involved in amplifying pain, while cold weather was more importantin adult women (p<0.001) and elderly men (p<0.01). Most often
localization of pain was vertebral regions, mainly lower back, andgirdles. Morning fatigue, more intense in elderly (p<0.01). Other
associated somatic symptoms; nocturia more prevalent in elderlymen, muscle weakness more prevalent in elderly irrespective ofgender, insomnia more prevalent in elderly slightly more often in
women. Paresthesia, vertigo and headache were more frequent inelderly. Loss of short-term memory and attention deﬁcit occurredin elderly.
Conclusions: Chronic widespread pain has an important impact onolder people, is often associated with mood and cognitive disorders
and requires a global management.
P-479
Clinical presentation of giant cell arteritis: a study of 94 patients
M.S. Hamdi, T. Ben Salem, M. Lamloum, I. Ben Ghorbel,
M.H. Houman. Internal Medicine Department, La Rabta, Tunisia
Introduction: Giant cell arteritis (GCA) is a granulomatous arteritis
involving especially the extra cranial branch of the carotid arteries,
usually occurring after 50 year-old. The aim of this study is toillustrate the epidemiological and clinical features of GCA in a groupof Tunisian patients.
Methods: A retrospective, descriptive study interesting patients
presenting GCA diagnosed between 2000 and 2015. ACR 1990
criteria were used.
Result: A total of 94 patients were included. Sex-ratio was 1.08.
Mean age at diagnosis was 72 years (52–88 years) with a mean
diagnosis time of 3 months. Hypertension was noted in 35% of
patients while diabetes was observed in 13%. Headache was therevealing symptom in 63% of patients. Jaw claudication and scalp
hyperesthesia were noted respectively in 56 and 47% of patients.
cranial ischemic events occured in 13% of patients with only one
case happening after diagnosis of GCA. Arthralgia, cervicalgia andfever were observed respectively in 22, 51 and 35% while polymyalgia rheumatic was present in 47% of cases. Anterior ischemic
optic neuropathy was found in 31% of patients. Temporal pulse
was absent or weak in 72% of patients. Laboratory evidences ofinﬂammation were noted in 87% of patients. GCA was biopsyproven in 55% of cases. Corticosteroids were prescribed in all cases,
methotrexate in 20% of patients. Mean follow-up was 37 months.
Recurrence was noted in 25% of patients.
Conclusion: No female predominance was found in our study.
Headache is still the main feature of the disease and polymyalgia
rheumatic was present in nearly half our patient.

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P-480
Determinants of oral anticoagulants treatment in elderly
patients with atrial ﬁbrillation: Descriptive study and 1 year
survival in 100 patients hospitalized in geriatric medicine
M. Deidda, I. Martin, J. Gauthier, S. Da Silva, E. Mazen, M. Dipanda,
S. Asgassou, P. Manckoundia, P. Jouanny. Geriatric Department
Introduction: Atrial ﬁbrillation (AF) is the most frequent arrhythmia in the elderly providing thromboembolic events in the lack oforal anticoagulants (ACO). Our study aims to evaluate the determinants of prescribing ACO through an analysis of the professional
practices of geriatric and general practitioners and the outcome at
one year.
Methodology: Firstly, retrospective descriptive study of 100 consecutive AF patients 75 years and over hospitalized in geriatric
medicine in University Hospital of Dijon (Burgundy – France).
Secondarily, prospective study of one year follow-up of patients bya survey of their general practitioners.
Results: Of the 100 patients included, 85% had a known historyof AF. Of these, 74.1% were under ACO at entry. Treatment with
ACO at discharge was signiﬁcantly correlated with anticoagulant
treatment at entry (p<0.0001). The signiﬁcant determinants of
non-prescription of ACO are hemorrhagic risk (Hasbled 2.9±0.9 vs2.3±0.9; p<0.01) and comorbidities (Charlson 8.3±2.1 vs 7.2±2.2;
p<0.05). Of the 93 patients discharged alive from the hospital, 81
were evaluated at 1 year. The mortality rate was 40.7% (33/81).
Adverse events under ACO at one year were stroke (7%) and hemorrhage (15%). ACO treatment was signiﬁcantly associated were lower
mortality (23.3 vs 71.9%; p<0.05).
Conclusion: This study showed a high percentage of anticoagulation in patients throughout follow-up according to scientiﬁcrecommendations. The choice of ACO treatment appears correlatedwith hemorrhage risk factors and frailty determinants. Despite
a lower mortality rate under ACO treatment, the presence ofsigniﬁcant adverse events could lead to ﬁrst-line prescription of
direct oral anticoagulants that seem to have a better ratio of eﬃcacy/tolerance/ease of use, even in elderly polypathologic patients.
P-481
Diseases of older people referring to elderly centers of Tehran in
2016
A.D. Kakhki 1 , Z.A. Saeedi 1 , A. Delavar 2 . 1 Shahid Beheshti Universityof Medical Sciences, Tehran, Iran; 2 Allameh Tabatabai University,
Tehran, IranIntroduction: Aging is a natural experience that is usually accompanied by a variety of diseases. This study was conducted todescribe older people’s disease rate and the number of times theyrefer to Elderly Centers in Tehran.
Methods: This descriptive study was conducted on older people
above 60 years old attending 20 Elderly Centers that were locatedin ﬁve regions of Tehran in 2016. 740 older people were selectedfrom Elderly Centers based on convenience sampling. Self-reportsocio-demographic and disease rate questionnaires were used fordata collection. Data were analyzed with SPSS software.
Results: 471 (63.6%) of older people were male and 269 (36.4%)
female with a mean age of 69.76 (±7.5). 586 (83%) reported at least achronic disease. Besides, 293 (39.4%) people had heart diseases, 165(22.2%) musculoskeletal diseases, 149 (20.1%) endocrine diseases,
and 88 (11.8%) urological and gynecological diseases. Moreover, 657(88.5%) participants had referred to doctors and therapeutic centersat least once during the last year. 265 (35.7%) visited ﬁve or more.
Furthermore, 266 subjects (35.9%) were hospitalized at least once
last year.
Conclusions: The prevalence of diseases in older people is morethan expected. Most older people refer to doctors and therapeutic

centers, which is indicative of the fact that they suffer from diseases
and need varied health services in a developing country. Tailored
and targeted strategies to improve the health status of older people
are necessary.
P-482
Frailty in older patients receiving transcatheter vs surgical aortic
valve replacement
J. Albéniz, P. Fdez-Montalbán, C. Lozano, L. Salido, M. Michelena,
E. Sanchez, A.J. Cruz-Jentoft. HRYC Hospital Ramón y Cajal, Madrid,
EspañaIntroduction: To compare the prevalence of baseline frailty (using
Fried’s criteria) in older patients with severe symptomatic aortic
stenosis treated having a TAVI with those receiving valvular surgery.
Methods: Single center, observational, descriptive study. Inclusion
criteria: all patients admitted consecutively to receive an aortic valve replacement in a 16 month period. Sociodemographic,
functional and clinical (EuroSCORE 1 and NYHA) variables weregathered. Frailty was diagnosed using Fried’s criteria in three levels:
robust, pre-frail and frail. Length of stay and hospital mortality werealso noted.
Results: 107 patients were included (58.9% received a TAVI, 41.1%
either an aortic valve replacement, 15.9% with simultaneous coronary surgery.TAVI patients were older (mean 82.0±8.3, vs. 78.0±4.7
years, p=0.01). There were no differences in gender or social status.Patients treated with TAVI were more dependent (mean BADL
5.3±0.9 vs. 5.8±0.4, p=0.06, mean IADL 5.3±2.2 vs. 5.8±1.5, p=0.27).
Their mean EuroSCORE was higher (12.3±7.4 VS. 8.2±5.0, P=0.03)
and they were in, worse cardiac functional class (73% vs. 24.4%
in NYHA III-IV, p=0.01). Prevalence of frailty was similar on bothgroups: 30.2% frail in TAVI vs. 27.3% in surgery, pre-frail 28.6%
vs 43.2%. There were no differences in walking speed or muscle
strength. Length of stay was shorter in the TAVI group (9.3±11.7 vs.
10.9±16.2 days, p=0.04), with no differences in hospital mortality(1.6% vs. 2.7%, p=0.7).
Conclusions: Patients receiving a TAVI to treat aortic valve disease
are older and more dependent than those surgically treated. They
have higher EuroSCOREs and worse NYHA class. The prevalence offrailty is similar in both groups.
P-483
Gender inﬂuence in clinical, biological and histological featuresof giant cell arteritis
T. Ben Salem, S. Hamdi Mohamed, M. Khedher, I. Ben Ghorbel,
M. Lamloum, M.H. Houman. Internal Medicine Department, La Rabta
Hospital
Introduction: Giant cell arteritis (GCA) is the most common systemic vasculitis in elderly patients. The aim of this study is tocompare GCA epidemiological, clinical, biological and histologicalcharacteristics according to gender.
Methods: A retrospective study including patient diagnosed with
GCA between 2000 and 2015. GCA Diagnosis was based on 1990
ACR criteria. Patients were divided in two groups: group1 (men)and 2 (women) and were compared.
Results: Ninety-four patients were studied; sex-ratio (M/W) was
1.08. Mean age at diagnosis was signiﬁcantly high in men(74.12±6.73 years vs 69.56±6.83 years; p=0.002). Mean delay todiagnosis was similar in the two groups. Headache was the mostfrequent revealing sign in both groups (respectively in 59% and 68%
of patients). Regarding clinical features, there were no differencesin the two groups; headache (93.9 vs 100%), jaw claudication (63vs 50%), arthralgia (18.4 vs 26.7%), fever (43 vs 26%), polymyalgia
rheumatica (51 vs 42%) and ocular manifestations (40.4 vs 40.9%).
Elevated C-reactive protein (94.4 vs 77%, p=0.04) and hypergam-

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

maglobulinemia (51.3 vs 21.6%; p=0.007) were signiﬁcantly more
frequent in men. Histological features were similar in the twogroups. Recurrence was observed in 45.7% of men and 23% of
women (p=0.053).
Conclusion: Our study showed no signiﬁcant difference between
men and women concerning GCA clinical presentation, but biological data were more frequent in men. Outcome was similar in thetwo groups.
P-484
General practitioner and oncogeriatric supportive care in Lyon
M. Valero 1 , C. Falandry 1 , M. Bonnefoy 1 , K. Mensah 2 , A. Chabert 3 .
1 Centre Hospitalier Lyon-Sud; 2 Princeton; 3 Soins et SantéIntroduction: Age-related increase in cancer incidence and thedevelopment of outpatient treatments lead general practitioners(GPs) to play a pivotal role. To favor ambulatory care, there is a need
to identify their treatment perceptions and diﬃculties.
Methods: A web survey was developed to evaluate GPs’ clinicalpractices and perceptions on supportive care at home. It was
validated within a testing cohort and sent by email to 697 GPs from
Lyon area.
Results: The response rate was low (6,88%). A majority of GPs(87,50%) declared taking care of less than 5 patients per year.
Considering practices, a majority reported regular assessments ofpain (100%), depression (97,50%), undernutrition (96,87%) and quality of life (97,50%). They declared to frequently request unplanned
hospital admissions (42.50%), since palliative complex situations are
diﬃcult to manage at home. Reimbursed paramedical aids (nurses,
home care services, supportive care mobile team, physiotherapists)
were more frequently known and used than non-reimbursed cares(dieticians and psychologists). Considering perceptions, main causesof GPs’ diﬃculties were family exhaustion (84,61%) and caregivers’
distress (74,35%). The lack of time (87,17%) and pay (66,66%) were
two more important constraints than lack of training (33,33%).
Conclusions: Supportive care in cancer is complex and concern
several areas. It seems to represent a weak proportion of GPs’ practice and educational priorities. However, GPs claimed to perform aregular assessment of the most frequent symptoms associated withcancer and to prescribe reimbursed paramedical aids.
P-485
Geriatric assessment and frailty score predicts clinical outcomeof transcatheter aortic valve implantation
E. Skaar 1,2,7 , L.S.P. Eide 3 , T.M. Norekvål 1,2 , A. Hylen Ranhoff 2,7 ,J.E. Nordrehaug 2 , D.E. Forman 4 , A.W. Schoenenberger 5 ,K.O. Hufthammer 6 , K.K.J. Kuiper 1 , Ø. Bleie 1 , E.J.S. Packer 1 ,J. Langørgen 1 , R. Haaverstad 1,2 , M.A. Schaufel 8 . 1 Department ofHeart Disease, Haukeland University Hospital, Bergen, Norway;
2 Department of Clinical Science, University of Bergen, Norway;
3 Western Norway University of Applied Science, Bergen, Norway;
4 University of Pittsburgh, USA; 5 University of Bern, Switzerland;
6 Centre for Clinical Research, Haukeland University Hospital, Bergen,
Norway; 7 Kavli Research Centre for Geriatrics and Dementia,
Haraldsplass Deaconess Hospital Bergen, Norway; 8 Department ofThoracic Medicine, Haukeland University Hospital, Bergen, Norway
Introduction: Established risk scores prior to cardiac intervention
have limitations in the elderly. Some patients may be too frail
for endovascular intervention and will beneﬁt more from a palliative approach. Our aim was, based on comprehensive geriatricassessment, to create a frailty score for risk prediction prior toTranscatheter Aortic Valve Implantation (TAVI).
Methods: We performed a prospective observational study inelderly patients (>70 years) accepted for TAVI at a university hospital during 2011–2015. All patients were evaluated by the Heart

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Team and declined for open heart surgery. Prior to the procedure
MMSE, SOF, NEADL, HADS and Charlson Comorbidity Index were
performed. Based on expert opinions we developed a frailty score.
Primary outcome was 1- and 2-year mortality. Secondary outcome
was disabling stroke.
Results: 147 patients, mean age 84 (SD 4) years, whereof 80 (54%)
women with severe and symptomatic aortic stenosis were included.
All patients completed the MMSE and SOF. NEADL questionnaire
was completed in 83% and the HADS questionnaire in 95%. Mean
MMSE was 26 (SD 3) points, Charlson co-morbidity score 3 (SD 1),
logistic EuroSCORE 17 (SD 9) %. All-cause mortality at 1- and 2-year
was 8% and 11%, respectively. Within the ﬁrst 6 months 3% suffereda disabling stroke. Calculation of a frailty score is in progress andwill be presented.
Conclusion: Mortality and morbidity after TAVI in the present study
is unexpectedly low. We will explore and present a frailty score to
identify patients that may not beneﬁt from TAVI.
P-486
Hip fractures in Lithuanian residents aged 80 years and over
M. Tamulaitiene 1 , V. Alekna 2 , M. Jaramaviciene 2 , J. Jaramavicius 2 ,A. Mastaviciute 2 . 1 Faculty of Medicine of Vilnius University; National
Osteoporosis Center, Vilnius, Lithuania; 2 Faculty of Medicine of Vilnius
University; Vilnius, Lithuania
Objective: The aim of this study was to analyze epidemiological
data of hip fractures in persons aged 80 years and over.
Methods: A retrospective study was performed on Lithuanian residents aged 80 and over, who sustained primary hip fracture. Data
were collected from patient charts at 47 orthopaedic-traumatology
inpatient departments. Treatment was categorised into 3 types: osteosynthesis (screws, plates, and intramedullary nails), arthroplasty(subtotal or total), and conservative treatment. The outcomes were
rehabilitation, long-term care hospital, discharge home, transfer toanother department, or death.
Results: In 2001–2010, a total of 10 093 hip fractures occurredin Lithuanian residents aged 80 years or more, 83.5% of themwere females. Overall male:female ratio was 1:5, the highest ratio
was found in 90–100 years age group (1:5.6). Age-standardised
fracture rate was 729.2/100.000 (95% CI: 694.2–764.1) in men and1246.3/100.000 (95% CI: 1219.7–1273.0) in women. Low energy
traumas caused 93% of fractures. Mean duration of hospitalization
was 12.2 days. Of all patients, 68.3% were treated using osteosynthesis, 19.5% – arthroplasty, and 12.2% were treated conservatively.
Main outcomes were: discharge home (36.1%) and rehabilitation(34.4%). Death occurred in 2.8% of all cases (73% in women), andincreased from 2.3% in 80–85 to 8.2% in 100+ years age group.
Conclusions: In 2001–2010, in Lithuanian residents aged over 80
years, the age-standardised hip fracture incidence was 729.2/100.000
in men and 1246.3/100.000 in women. Hip fractures were mostly
caused by low energy trauma. Deadly outcome grew along withpatient age.
P-487
Histopathology and prognostic outcome of endovascularthrombectomy for the elderly stroke patients
H. Ishibashi-Ueda 1 , N. Funatsu 2 , Y. Ikeda 1 , K. Ohta-Ogo 1 ,M. Matsumoto 1 , Y. Iwasaki 3 , K. Fujita 3 , M. Hayakawa 3 , K. Toyoda 3 .
1 Department of Pathology, National Cerebral and CardiovascularCenter, Osaka, Japan; 2 Department of Neurosurgery, Gifu University
School of Medicine, Gifu, Japan; Department of Cerebrovascular
Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan;
3 Department of Cerebrovascular Medicine, National Cerebral andCardiovascular Center, Osaka, Japan
Introduction: Endovascular thrombectomy (EVT) for intracranial

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thrombotic occlusion is performed for stroke patients regardlessof ages. Histology of retrieved thrombi from cerebral arteries bycatheter can provide useful information.
Methods: We histopathologically analyzed obtained thrombi by
EVT from the consecutive 74 acute stroke patients (women 48.6%,
70 to 96 years) from January 2011 to March 2017. The average age
was 80.4 years and the median age was 81.5 years. We divided thepatients into 2 age groups, 37 seventies (70 to 80 years) as S groupand 37 eighties and over (81 to 96 years) as E group, to compare
the obtained thrombi and outcome between the 2 groups. Amongthe enrolled patients, 27 (73.0%) showed atrial ﬁbrillation in both S
group and E group.
Results: Successful reperfusion resulted in excellent prognosis revealed 51.4% in S group and 24.3% in E group (p<0.01). The fatal
cases were recognized in 2 patients in each group respectively(5.4%). The remaining cases showed fair prognosis requiring continuous therapy. Obtained platelets and ﬁbrin thrombi suspected to becardiogenic emboli were found in 86.5% of S group and in 79.5% of E
group. Atheromatous gruel which was suggested as athero-thrombiby the plaque rupture of local cerebral arteries was observed in 5
cases (13.5%) in S group and 3 (8.1%) in E group.
Conclusion: EVT can be effective for good outcome of stroke events.
Successful EVT is suﬃcient procedure for even in the very elderly
acute stroke patients to prevent poor prognosis.
P-488
Hyperuricemia and its determinants in elderly patients withpersistent atrial ﬁbrillation
M. Migliorini 1 , S. Pupo 1 , I. Giannini 1 , A. Scardia 1 , S. Boni 1 ,G. Boriani 2 , C. Borghi 3 , N. Marchionni 1 , L. Padeletti 4 , S. Fumagalli 1 .
1 ICU Careggi Hospital University of Florence; 2 Cardiology Division,
University of Modena and Reggio Emilia, Modena, Italy; 3 Departmentof Medical and Surgical Sciences, University of Bologna, Bologna, Italy;
4 University of Florence, Italy
Introduction: Recent evidence suggests that hyperuricemia could
be associated to atrial ﬁbrillation (AF) development and to its relapses after speciﬁc interventions. Aim of this study was to evaluate
the predictors of hyperuricemia in a population of elderly patients
undergoing external cardioversion (ECV) of a persistent form of thearrhythmia.
Methods: In all consecutive subjects we studied neurocognitive,
mood and functional proﬁle. Arterial stiffness (AS) was measured
using the Cardio-Ankle Vascular Index (CAVI). Hyperuricemic (HU)
patients were identiﬁed by concentrations of uric acid (UA) ≥6.5
mg/dL or by present therapy with allopurinol, Controls (C) had
normal UA levels.
Results: We evaluated 57 subjects (age: 77±7 years; women: 33.9%;
September 2015 - December 2016). Hypertension and chronic heart
failure (CHF) were the main causes of the arrhythmia (33.3% and54.4% of patients, respectively). HU subjects represented 40.4% of
the whole population (UA – HU: 6.8±1.5 vs. C: 4.9±0.9 mg/dL,
p<0.001). ECV effectiveness did not differ by HU status (HU: 100
vs. C: 88.2%, p=0.140). Logistic regression analysis showed that thepresence of CHF (p=0.022) and creatinine concentrations (p=0.001)
were directly associated to the HU condition. Conversely, a greater
arterial stiffness characterized C subjects (p=0.009).
Conclusions: In elderly patients with persistent AF, hyperuricemia
is common and it seems associated to CHF and renal function.
Further studies are needed to clarify the inverse relation between
the condition and AS, and to evaluate the existence of a link
between UA and AF relapses.

P-489
Hypothermic patients admitted to a tertiary center in a ﬁve year
periodJ.E. Mateus, J. Fonseca, P. Lopes, C. Silva, D. Ferreira, J. Porto,
M.T. Veríssimo, A. Carvalho. Centro Hospitalar e Universitário de
Coimbra (CHUC), Coimbra, Portugal
Introduction: Hypothermia can be caused by various factors including cold exposure, infection or endocrine abnormalities. Although
hypothermia may be associated with an increased risk of mortality,
its inﬂuence on the severity and outcome of critically ill patients is
not well understood.
Methods: Patients aged 65 or more years admitted with hypothermia from 2012 to 2016 to a tertiary center in Portugal were
included in the study. Patient characteristics, physiological data andmortality were assessed.
Results: In this period 151 patients were admitted with hypothermia: mostly women (64%), mean age 85 years. Comorbidities
were common: 85% hypertension, 56% congestive heart failure, 31%
chronic kidney disease and 26% diabetes. According to Katz Index
of Independence in Activities of Daily Living, 52% were evaluated asvery dependent. At admission mean temperature was 31.8°C, mean
serum lactate was 1.9 mmol/L and mean pH was 7.33. Most patients
had central nervous system dysfunction (85%) and cardiovascular
dysfunction (60%). Regarding the cause of hypothermia, 67% had infection, 26% had endocrine abnormalities and 3% had cold exposure.
Mean hospital length of stay was 10 days and hospital mortality was
30%. Lower temperatures were associated with lower pH (<28°C:
7.20 vs ≥32°C: 7.39) and a higher incidence of cardiovascular
dysfunction (31.2 vs 32.8°C) and hematologic dysfunction (29.5 vs32.0), p<0.05.
Conclusions: The elderly are at increased risk of developing hypothermia and its complications due to decreased physiologic
reserve and chronic diseases that impair compensatory responses.
Therefore, they should be urgently assessed if found to be hypothermic.
P-490
Impact of geriatric assessment for the therapeutic decisionmaking of breast cancer: results of a French survey. AFSOS* andSOFOG** collaborative work
I. Krakowski 1 , H. Curé 2 , E. Carola 3 , P. Soubeyran 1 , O. Guérin 4 ,G. Freyer 5 . 1 Bergonie Institute, Bordeaux, France; 2 CHU Grenoble, La
Tronche, France; 3 Groupe Hospitalier Public du Sud de l’Oise, Senlis,
France; 4 Hôpital Cimiez, Nice, France; 5 Hospices Civils de Lyon & Lyon
University, Lyon, France
Background: Cancer management in the elderly is often considered
as suboptimal and heterogeneous. Data are needed to understanddecision making processes in this population.
Methods: A survey was performed in France to describe decision making in gynaecologic patients over 70. It followed a threesteps method: (1) 101 representative physicians questioned about
treatment-decision criteria; (2) simpliﬁed individual data were collected as well as (3) detailed data patients receiving chemotherapy.
This analysis refers to breast cancer subgroup of patients.
Results: Main decision criteria were performance status, comorbidities and renal function. In adjuvant setting, the main concern
was life expectancy, whereas it was quality of life in metastatic setting. Of the 631 patients entered in the simpliﬁed analysis, 41% had
been evaluated by a geriatrician, 67% received chemotherapy. In thedetailed analysis, patients older than 75 were more likely to receivea monochemotherapy and to be treated with weekly/divided dose.
In adjuvant setting, respectively 19%, 55% and 26% of the patientswere treated with regimen validated in the elderly, validated in ayounger population and not validated. A G-CSF was prescribed inPoster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

48% of the patients, as primary prophylaxis in 78% and in 41% of
patients with a risk of febrile neutropenia <10%.
Conclusion: Geriatric covariates become an increasing concern
in the decision-making process. This survey also suggests an insuﬃcient use of validated chemotherapy regimens. To date, age
remains a risk factor for heterogeneity in oncologic practice justifying a persistent effort for elaborating and disclosing speciﬁcrecommendations.
P-491
Interdisciplinary assessment in elderly patients with severe
aortic stenosis: Decision making process for transcatheter aortic
valve implantation
C. Roqueta 1 , N. Farre 2 , B. Vaquerizo 2 , M.I. Martínez-Fernández 3 ,A. Sánchez-Carpintero 2 , A. Mases 4 , R. Millan 2 , M. Ble 2 ,A. Mas-Stachurska 2 , M. Cladellas 2 , S. Ruiz 2 , N. Ribas 2 , R. Serrat 2 ,A. Fort 2 , J. Martí 2 , O. Vázquez 3 . 1 Geriatric Medicine Department.
Parc de Salut Mar. Centre Fórum. Hospital del Mar/UniversitatAutònoma de Barcelona. Barcelona, Spain; 2 Department of Cardiology.
Parc de Salut Mar. Hospital del Mar. Barcelona, Spain; 3 GeriatricMedicine Department. Parc de Salut Mar. Centre Fòrum. Hospital delMar. Barcelona, Spain; 4 Department of Anesthesiology and
Resuscitation. Parc de Salut Mar. Hospital del Mar. Barcelona, Spain
Aim: To evaluate transcatheter aortic valve implantation (TAVI)
indication by an interdisciplinary team.
Methods: Thirty patients (50% women) with severe aortic stenosis
were prospectively evaluated by an interdisciplinary team (clinicalcardiologist, image specialist, invasive cardiologist, anesthesiologist,
nurse and geriatrician). A geriatric assessment was performed:
previous living situation, functional status [Barthel (BI) and Lawton
index (LI)], walking speed (m/s), cognitive status [Mini-Mental
Examination of Folstein (MMSE)], emotional status (GDS Yesavage), nutritional status [Mini-Nutritional Assessment abbreviated(MNA)], comorbidity (Charlson index) and number of geriatricsyndromes.
Results: Mean age: 82.2±6.8. Twenty-two (73.3%) lived with family.
TAVI was indicated in 17 patients (56.6%) and refused in 13 (3asymptomatic, 2 lung cancer, 1 not attending controls, 1 highcomorbidity, 3 no beneﬁts for other cardiologic causes and 3
frailty). Mean values of geriatric assessment parameters in the
17 patients who received TAVI treatment were: age: 81.6±7.1; LI:
5.0±1.8; BI: 97.0±6.4; walking speed: 0.6±0.2; MMSE: 27.1±2.9; GDS
Yesavage: 1.4±1.4; MNA abbreviated: 12.3±1.8; Charslon: 2.6±1.2;
number of geriatric syndromes: 2.2±1.2 and in the 3 patients who
in which TAVI was refused because of frailty: 82±8.8 (p=0.939);
2.0±1 (p=0.013); 74.6±19.2 (p<0.001); 0.4±0.1 (p=0.149); 20.6±2.3(p<0.001); 2.3±2.0 (p=0.341); 11.6±2.3 (p=0.563); 1.6±1.1 (p=0.229)
and 5.6±0.5 (p<0.001), respectively.
Conclusion: 1. Half of the patients evaluated by interdisciplinary
team were considered appropriate for TAVI. 2. There were several
causes for the exclusion of this therapeutic option. 3. Patients who
were excluded due to frailty had signiﬁcantly worse functional andcognitive status, and a higher frequency of geriatric syndromes.
P-492
Masked hypertension in geriatric age: an underdiagnosed
problem associated with end organ damage
M. Esme 1 , B. Yavuz 2 , S. Asil 3 , R.T. Doğrul 4 , F. Sümer 4 , M.K. Kılıç 4 ,M.C. Kızılarslanoğlu 4 , H.D. Varan 4 , A. Sağır 5 , C. Balcı 4 , M. Halil 4 ,M. Cankurtaran 4 , B.B. Yavuz 4 . 1 Hacettepe University Faculty of
Medicine, Department of Internal Medicine, Ankara, Turkey; 2 Medical
Park Hospital, Department of Cardiology, Ankara, Turkey; 3 Hacettepe
University Faculty of Medicine, Department of Cardiology, Ankara,
Turkey; 4 Hacettepe University Faculty of Medicine, Department of

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Internal Medicine, Division of Geriatric Medicine, Ankara, Turkey;
5 Hacettepe University Faculty of Medicine, Department of Internal
Medicine, Division of Geriatric Medicine Psycologist, Ankara, Turkey
Introduction: Masked hypertension (MH) describes the state thatblood pressure values are within normal ranges when recorded byoﬃce measurements but the average daytime blood pressure, mean
blood pressure at night or the 24-hours average blood pressure
values are above the normal range when recorded by ambulatory
measurements. The prevalence of masked hypertension in geriatricage is not known. It is also a question whether masked hypertension
leads to end organ damage in the early stages. The aim of thisstudy is to investigate the possible associations between masked
hypertension and end organ damage in geriatric population.
Methods: One hundred-two patients who were admitted to theGeriatric Medicine outpatient clinic of Hacettepe University, Facultyof Medicine, Department of Internal Medicine consecutively were
included in the study. Patients who have been diagnosed withhypertension or dementia previously or using any antihypertensive medication were excluded. All patients underwent ambulatory
blood pressure measurement procedures and values were recorded
as three separate parameters, which were average daytime bloodpressure, mean blood pressure at night and the 24-hours average blood pressure. Comprehensive geriatric assessment tests andneuropsychological tests were administered to all patients. The
diagnosis of masked hypertension was based on the deﬁnitions in
the 2013 guideline of the European Society of Cardiology (ESC).
Results: As a result of the analysis, 44 of 102 patients (43%)
were diagnosed with masked hypertension. Median MMSE scores
were 28 (18–30) in patients with masked hypertension and 29(18–30) in normotensive group. Patients with masked hypertension
had signiﬁcantly lower scores on Mini-Mental State Examination(MMSE) test (p=0.011). The albumin/creatinine ratio in the masked
hypertensive group was 9.61 mg/gr and in the group with normal
blood pressure values, it was 7.12 mg/gr (p=0,021). In addition,left ventricular mass index (LVMI), which is one of the parameters
showing the end organ damage and reﬂects the negative effectof hypertension on the heart, was found to be higher in themasked hypertension group than in the normal group. Mean LVMI
scores were 107,76±16,37 in patients with masked hypertension
and 100,39±19,32 in normotensive group. These differences in theratio of spot urinary albumin/creatinine ratio and left ventricularmass index, which are the end organ damage parameter, were also
statistically signiﬁcant (p=0.021; p=0.046; respectively).
Conclusion: This study shows that geriatric patients with masked
hypertension, compared to normotensive patients have decreased
cognitive functions. In addition, urinary albumin excretion andleft ventricular hypertrophy which are the parameters of endorgan damage caused by hypertension, were signiﬁcantly higher
in masked hypertension patients. These results show that masked
hypertension may cause end organ damage and should not be
overlooked in geriatric patients.
P-493
Monoclonal gammapathies in elderly patients
T. Ben Salem, M. Khedher, M.S. Hamdi, I. Ben Ghorbel, M. Lamloum,
M.H. Houman. Internal Medicine Department, La Rabta Hospital
Introduction: Monoclonal gammopathies (MG) are common in thegeneral population. The objective of this work is to describe clinical,
biological characteristics and etiologies of MG in elderly patients.
Materials and methods: A retrospective study was performed in
an internal medicine department over a period of ten years. All
ﬁles patients with MG were studied (114). Clinical, biological andetiological features of patients aged over 65 years were analyzed
and compared with younger patients.

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Results: Forty-nine elderly patients with MG were studied; 27 men
and 22 women. Their median age was 73.4±5.55 years. Mean level ofmonoclonal component was 33.7 g/l. GM isotypes were IgG (n=24),
IgA (n=16) and IgM (n=4). Light chains were lambda or kappa,
each one in 50% of patients. GM was frequently revealed withbone pain (16 cases). Poor general state was noted in 27 patients.
Renal insuﬃciency and hypercalcemia were respectively observedin 27 and 23 patients. Anemia and thrombopenia was respectively
found in 39 and 10 patients. There were no differences in clinicaland biological data when compared to young patients. GM wasrelated to multiple myeloma (n=33), lymphoma (n=2), cryoglobulinemia (n=2) and amyloidosis (n=2). Gammapathy of unknown
signiﬁcance was diagnosed in 6 patients. There were no differences
regarding GM etiologies when compared to patients under 65 years
old.
Conclusion: MG are common in clinical practice and specially inelderdy. Etiological study is a real challenge for physicians. in ourstudy, their spectrum wasn’t different in elderly patients.
P-494
Mortality and quality of life in elderly patients on dialysis in New
Zealand: Results from the Dialysis Outcomes in the >65s Study(DOS65+)
G.M.E. Pearson 1 , R.J. Walker 2 , S. Derrett 2 , A. Samaranayaka 2 ,J.B.W. Schollum 2 . 1 University of Bristol, Bristol, United Kingdom;
2 University of Otago, Dunedin, New Zealand
Background: New Zealand (NZ), and indeed the world, has a
growing population of elderly patients with end-stage renal failure(ESRF) requiring dialysis. Physicians and patients making decisions
around dialysis require information on the prognosis and qualityof life (QoL) associated with all available options. However, there
is limited evidence available on dialysis outcomes in the elderly,
particularly QoL.
Methods: The Dialysis Outcomes in the >65s Study (DOS65+) is a
prospective longitudinal cohort study of patients >65 with ESRF.
This is a cross-sectional analysis of mortality and QoL outcomes atbaseline and 2 years.
Results: We found that mortality nor QoL vary with dialysis vintage, modality or location of treatment, whereas high burdens of
co-morbidities and ESRF-related symptoms were associated with
reduced QoL. Increasing age was found to be associated withmortality, however there was no correlation between age and QoL
on dialysis. Contrary to previous studies on other diseases, wehave shown no signiﬁcant differences in mortality or QoL in ESRF
between the various ethnicities in NZ. Interestingly, socioeconomic
factors including living with others, family involvement and sense ofcommunity contribute signiﬁcantly to QoL in our patients, and lackof family involvement was also signiﬁcantly related to mortality.
Conclusions: Our ﬁndings are consistent with the growing bodyof evidence around dialysis outcomes in the elderly, highlighting
several key variables contributing to survival and QoL on dialysis
which should be considered by doctors and patients when making
decisions about the management of ESRF.
P-495
Multiple osteolytic lesions due to Primary Bone Lymphoma (PBL)
P. Voukelatou, I. Vrettos, A. Ragkou, A. Didaskalou, A. Bitsikokou,
A. Katsoras, D. Theotoka, A. Kalliakmanis. 2nd Department ofInternal Medicine, General Oncological Hospital of Kiﬁssia “TheAgioiAnargyroi”, Athens, Greece
Background: PBL is a rare entity. Usually is of Non-Hodgkin Lymphoma (NHL) type and of diffuse Large B-cell Lymphoma (DLBCL)
subtype. It represents <1% of all NHLs’. Even rarer is the presenceof multiple osteolytic lesions in the context of PBL.

Objective: To describe a 74 years-old female patient with PBL andmultiple osteolytic lesions.
Case presentation: Patient was admitted for evaluation of an osteolytic lesion found in a plain radiography of the right ankle. She
experienced diﬃculty in walking for one month. Her medical history was unremarkable. Her blood test, basal metabolic panel andtumor markers were normal. Magnetic resonance imaging (MRI) of
the right ankle demonstrated a lytic lesion in the right ﬁbula, withpermeative extension in the surrounding tissues and multiple small
osteolytic lesions in the ﬁbula and the leg. Bone scintigraphy withtechnetium-99 showed high accumulation in multiple sites especially at the lower limbs and the pelvis. Bone marrow aspiration
and biopsy were normal and Computed Tomography (CT) scans of
the chest and the abdomen revealed no evidence of distal nodal
or extranodal tissue involvement. She underwent a ﬁne-needle
aspiration biopsy of the lesion. The histopathological examinationand immunohistochemistry revealed NHL, of DLBCL subtype andthe patient was referred to the Hematology Department for speciﬁc
treatment.
Conclusion: PBL should be considered in the differential diagnosis
of multifocal osteolytic lesions. Timely diagnosis and treatment
is mandatory as multifocal bone DLBCL patients exhibit a better
prognosis compared to patients with other extranodal DLBCLs’.
P-496
Myelodysplastic syndromes and giant cell arteritis in the elderly:
A non-fortuitous association that geriatricians need to know
A.-L. Gérard 1 , J. Cohen-Bittan 1 , A. Gioanni 2 , P. Fenaux 3 , M. Verny 4 ,O. Fain 5 , J. Boddaert 4 , L. Zerah 4 . 1 Department of Geriatrics, Unit ofPeri-Operative Geriatric Care, Hôpital Pitié-Salpêtrière, Assistance
Publique-Hôpitaux de Paris (APHP), Paris, France; 2 Department ofGeriatrics, Unit of Peri-Operative Geriatric Care, Hôpital
Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (APHP), Paris,
France; University Pierre and Marie Curie (UPMC) Paris 06, University
Hospital Department Fight Aging and Stress (DHU FAST), Paris, France;
3 Department of Senior Haematology, Hôpital Saint Louis, Paris 7
University, Assistance Publique-Hôpitaux de Paris (APHP), Paris,
France; 4 Department of Geriatrics, Unit of Peri-Operative GeriatricCare, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris(APHP), Paris, France; Department of Senior Haematology, HôpitalSaint Louis, Paris 7 University, Assistance Publique-Hôpitaux de Paris(APHP), Paris, France. 4 Centre National de la Recherche Scientiﬁque(CNRS), UMR 8256, Paris, France; 5 Department of Internal Medicine,
Hôpital Saint Antoine, UPMC, DHU i2B, Assistance Publique-Hôpitauxde Paris (APHP), Paris, France
Introduction: The association between myelodysplastic syndrome(MDS) and autoimmune disease is well recognized in the literature,
but large vessel vasculitis associated to MDS are really uncommon.
Giant Cell Arteritis (GCA) occurring in the setting of MDS is important to recognize from the geriatricians in regard to prognosis andtreatment options.
Methods and results: We present a rare case of a 79-year-old
woman hospitalized for asthenia, weight loss, headache and two
previous episodes of transient diplopia. Laboratory data revealed
a major inﬂammatory syndrome (C-reactive protein (CRP): 204mg/L) and an isolated lymphopenia at 780/mm3 ; the temporalartery biopsy conﬁrmed GCA. Urgent corticosteroid therapy has
been started (5 methylprednisolone bolus followed by 1 mg/kg/dayof prednisone) and medical condition improved with a decrease of
CRP (25 mg/L). Three-months later, the patient remained steroiddependent (20 mg per day of prednisone) with the reappearanceof asthenia and a CRP level at 93 mg/L. Laboratory data revealed
pancytopenia and the emergence of circulating blasts justifying
an urgent bone marrow aspiration leading to the diagnosis of
MDS. Unfortunately, one month later, a new bone marrow aspira-Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

tion revealed an acute myeloid leukemia and chemotherapy was
initiated.
Conclusion: In elderly patients with GCA, a poor response tosteroids or steroid dependence should suggest the presence of
associated MDS, particularly in presence of cytopenia. The association of MDS with vasculitis appears to predict adverse outcome,and may in particular precede transformation to overt AML. It
seems judicious to treat MDS quickly, considering vasculitis as aparaneoplastic syndrome.
P-497
New assessment of clinical signs of subclinical hypothyroidism
associated with aging
R. Gourmelon 1 , S. Donadio-Andréi 2 , K. Chikh 2 , M. Rabilloud 3 ,C. Falandry 4 , E. Kuczewski 5 , A.-S. Gauchez 6 , A. Charrié 5 , E. Disse 4 ,C. Thivolet 4 , H. Du Boullay 7 , A. François-Joubert 7 , A. Vignoles 5 ,C. Ronin 2 , M. Bonnefoy 8 . 1 UCBL1, HCL, Faculté Médecine Lyon Est,
69003 Lyon, France; 2 Siamed’Xpress, Hôtel Technologique Morandat,
13120 Gardanne, France; 3 Service de Biostatistiques, Hospices Civils de
Lyon, Lyon, France; 4 UCBL1, HCL, Faculté de Médecine Charles Merieux,
69600, Oullins, France; 5 Hospices Civils de Lyon, 69002 Lyon, France;
6 UMR-S INSERM 1037, 38000 Grenoble, France; 7 Laboratoire duService de Médecine Nucléaire, Centre Hospitalier Métropole Savoie,
73000 Chambéry, France; 8 Univ-Lyon, CarMeN laboratory, Inserm
U1060, INRA U1397, UCBL1, INSA Lyon, Faculté de Médecine Charles
Merieux, 69600, Oullins, France
Background: Subclinical hypothyroidism (SCH) is deﬁned as theassociation of normal T4 and a high TSH. Two phenomena may
have an impact on this syndrome outlines: the improvement of TSH
dosing and the age-related variations of TSH bioactivity.
Methods: Eleven classical hypothyroidism clinical signs (hCS) were
prospectively collected in a multicentric trial. We tested in a“young” vs “older” population (<60 vs ≥60 years old) SCH prevalence with a recent dosing test of TSH, T3/T4 ratios and the presenceof hCS in patients with SCH vs euthyroidism.
Results: From 2012 to 2014, 807 “young” and 531 “older” individuals were included. The rate of TSH was higher in the “older”
population (2.36mUI/L vs 2.14mUI/L, p<0.05). The T3/T4 ratio was alittle lower (0.26 vs 0.27, p<0.01), illustrating a probable loss of TSH
bioactivity. Considering the presence of hCS in the “older” comparedto the “young” group, a paradoxical higher prevalence was shownin the euthyroid population (1.9 vs 1.6, p<0.01) but not in the SCH
population (2.3 vs 2.6, p=0.41). The percentage of subjects with 3
or more signs increased when TSH becomes >4.05mIU/L (42.6% vs25.0%) for young people but not in the elderly population (34.4% vs33.9%). Only 3 hCS were related to SCH in “older” subjects.
Conclusion: While mean TSH and SCH prevalence are higher inthe older population, the lower T3/T4 ratio and fewer hCS lead toconsider a probable loss of bioactivity and perhaps the need toreevaluate the TSH reference range in that population.
P-498
Observational prospective cohort of elderly withhypervitaminosis B12: An important cancer prevalence
C. Arlaud, C. Rambaud, J.M. Turpin, S. Gonfrier, R. Boulahssass,
O. Guérin. CHU Nice
Few studies were performed but suggest a link between cancers
andhypervitaminosis B12. The aim of this study was to analyze
the cancer prevalence of elderly with hypervitaminosis B12. An
observational cohort study was conducted from November 2015 to
May 2016 including all the patients >70 years with vitaminosis
B12 >700 pg/ml in a referent geriatric center. The presence ormalignancies discovered during the hospitalization was reported.
Characteristics of cancer and socio-demographic data were also

S183

collected. The realization of complementary exams during the hospitalization was mentioned. A total of 131 patients were included
with 63% (n=82) women and mean age was 86 years (SD 5.7
years). The average vitamin B12 was 1267 pg/ml. Among the 131
patients, 25% (n=33) had a cancer identiﬁed by histology, 16%(n=21) highly suspicious images of neoplasms and 17% (n=22) had
lesions suspected to be due to metastatic disease. About 5% (n=6) of
all hypervitaminosis B12 result from hematological malignancies.
Among the solid cancers, digestive (33.3%) and lung (16.7%) cancers
were most frequent. The vitamin B12 levels was not signiﬁcantly
different between patients with neoplasia and the rest of the study
population (1269 vs. 1264 pg/ml, p=0.965). Among 25% patients
died, 43% are with known or suspected malignancies.With a quarter of patients dying during hospitalization, it also appears as apossible prognostic factor of mortality. Future research is warranted
to complete these result establish the value of systematized clinicaland paraclinical assessments in case of hypervitaminosis B12.
P-499
Overall survival in elderly patients with colorectal cancer:
a population-based study in the Caribbean
C. Joachim 1 , L. Godaert 2 , M. Dramé 3 , J. Veronique-Baudin 4 ,J. Macni 5 , J. Smith-Ravin 6 , J.-L. Novella 7 , R. Mahmoudi 3 . 1 Registre
Général des cancers de la Martinique; 2 University Hospital ofMartinique; 3 University Hospital of Reims; 4 registre général desCancers de la Martinique; 5 Registre Général des Cancers de laMartinique; 6 Université des Antilles; 7 University of Reims
Background: Population-based Cancer registries (PBCR) play animportant role in cancer surveillance and research. The aim of
this study was to examine overall survival in elderly patients withcolorectal cancer (CRC) by analysing data from the Martinique PBCR
between 1993 and 2012.
Methods: The log-rank test was used to assess the statisticaldifferences of the survival curves by each categorical variable:
age at diagnosis, sex, histology, zone of residence, subsite, stage
at diagnosis, and chemotherapy in incident. A multivariable Coxmodel was performed to identify independent prognostic factors
for overall survival in elderly patients with colorectal cancer.
Results: Among 2230 patients included in the study, 60.8% wereaged ≥65 years; mean age at diagnosis of these patients was
75.7±7.2 years. For the period 2008–2012, 532 elderly patientswere analysed; mean age of those receiving chemotherapy was
73.0±0.4 versus 77.9±0.4 years for those not receiving chemotherapy (p<0.0001). Stage at diagnosis was evaluated in 87.8% (467/532)
of patients; 63.0% (294/467) had stage III-IV and 49.3% of thesepatients (145/294) received chemotherapy. Chemotherapy was lessfrequently prescribed in patients aged 75–84 and ≥85 years ascompared to those aged 65–74 years (41.1% and 15.0% versus
64.6% respectively; p<0.0001). Stage III-IV at diagnosis (HR=5.25;
3.70–7.45; p<0.0001), and not receiving chemotherapy (HR=3.05;
2.23–4.16; p<0.0001), were independent prognostic factors foroverall survival.
Conclusion: Our study highlights the role of PBCR in evaluating
cancer survival and patterns of care in elderly people of the FrenchWest-Indies. Chemotherapy was less frequently prescribed among
the elderly.
P-500
Pharyngeal dilator muscle recruitment during increasing
respiratory efforts in awake young and older healthy subjects
A. Brodsky, M. Somri, A. Oliven, R. Oliven. Bnai Zion Medical Center,
Haifa, Israel
Background: Pharyngeal patency depends on interaction between
peri-pharyngeal muscles. Older subjects are known to be prone

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Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

to obstructive sleep apnea compared to younger subjects. We
hypothesized that recruitment of dilator muscles during increasing respiratory efforts differs between young and older healthy
subjects.
Methods: Esophageal pressure (Pes), airﬂow and EMG of thegenioglossus (GG) and other per-pharyngeal muscles (non-GG:
styloglossus, geniohyoid, sternocleidomastoid and sternohyoid, 3
EMGs/subject) were recorded in 5 young (21.2±0.4yrs) and 7 older
healthy subjects (68.6±8.7yrs), all validated as non-apneic by fullnight polysomnography. Data recorded during wakefulness, whensubjects produced a range of negative Pes levels while breathing
through a partially obstructed inspiratory port, was used to plot
individual peak EMG/Pes slopes.
Results: Peak inspiratory EMG of all muscles increased with increasing respiratory efforts (larger negative Pes). The increase in GG
and non-GG EMGs with increasing negative Pes were signiﬁcantly
steeper in the young as compared to the older subjects: −0.95±0.37
vs. −0.47±0.29 (p<0.05) and −0.87±0.31 vs. −0.40±0.24 (p<0.01)
EMG%max/cmH2O for the GG and non-GG muscles, respectively.
Conclusions: With increasing respiratory efforts, older healthy men
recruit dilator muscles signiﬁcantly less than young men, suggesting age-related remodeling of neuromuscular drive. In addition to
age-related anatomic-structural changes, alterations in control ofbreathing may contribute to the higher prevalence of sleep apnea
in older subjects.
P-501
Primary cutaneous small vessel vasculitis. A case report
C. Palicio, M. González, Z. Rivas, A. Socorro, F.J.G. Pavón. Hospital
Central Cruz Roja
Objective: We present the case of a 77-year-old woman admitted
for blistered necrohemorrhagic cutaneous lesions in lower limbs.
Methods: The patient referred edema on her legs, with blisteredpurpuronecrohemorrhagic lesions. Initially up to her knees, they extended to the back side of both thighs and right hemithorax. In theemergency room she was diagnosed with cellulites and prescribedamoxicillin-clavulanic, but returned again for high temperature,
dysuria and intense throbbing leg pain. Background: hypertension,
lumbar canal stenosis, secondary hypothyroidism, cataract surgery,and appendectomy. Baseline status: Barthel 80/100, without cognitive impairment and lived alone.
Results: Physical examination revealed both heart failure dataconsisting on thigh edema that required intravenous deplective
treatment and urinary retention. Attending to the lower limbs, she
presentend conﬂuent papules and plaques as well as vesicles andblisters up to 5cm diameter from feet to buttocks, and also along herback and right hemithorax. Steroid treatment with prednisone 50
mg and local cures with silver sulfadiazine were recommended bydermatology a on suspicion of vasculitis, and antibiotic treatment
with meropenem was also associated due to necrotic ulcer related
febrile syndrome. Cutaneous biopsia was informed as leukocytoclastic vasculitis of superﬁcial vessels, without deposits of IgA, IgM
and IgG.
Conclusion: This small vessel cutaneous disorder is mostly a selflimited condition in terms of duration and clinical involvement.
A cutaneous biopsy and thorough initial diferential diagnosis arenecessary, as its clinical features can resemble multiple disorders.
P-502
Relationship between the severity of cerebral white matter
hyperintensities and sympathetic nervous activity in the elderly
K. Kozaki, T. Obara, H. Hasegawa, T. Ebihara. Kyorin University Schoolof Medicine
Introduction: Cerebral white matter hyperintensities (WMH), vi-

sualized on brain magnetic resonance imaging, represent an abnormality related to the development of geriatric syndrome andvascular events. Studies have suggested that low sympathetic nervous activity (SNA) might be associated with physical and cognitive
dysfunction, leading to increased mortality in the elderly. In thisstudy, we investigated the relationship between the severity of
WMH and the SNA, measured by the heart rate variability (HRV).
Methods: We performed a cross-sectional study of 39 elderly
patients (79.4±7.0 years old, 14 males and 25 females). Holter
electrocardiogram (30 minutes) was recorded, thereafter, low frequency/high frequency (LF/HF), index of SNA, and other indices ofthe HRV were measured. In regard to the severity of the WMH,
periventricular hyperintensities (PVH) and deep white matter hyperintensities (DWMH) were semi-quantitatively rated according to
the previous method.
Results: The LF/HF was signiﬁcantly lower in patients with apparent
DWMH than those without DWMH. From the univariate regression
analysis, the LF/HF showed signiﬁcant negative correlations withthe total and regional PVH, as well as DWMH. Multiple regression
analysis showed that the negative associations remained signiﬁcantbetween the LF/HF and DWMH (total, temporal, occipital area).
Furthermore, fall risk index, one of the important geriatric syndrome, showed signiﬁcant correlations with the LF/HF, total and theoccipital DWMH.
Conclusions: The severity of DWMH was associated with the LF/HF
and the fall risk, one of the important geriatric syndrome, suggesting that WMH, sympathetic nervous dysfunction, and the geriatricsyndrome are interrelated.
P-503
Sinus rhythm restoration determines an improvement ofphysical performance in elderly patients with persistent atrial
ﬁbrillation
S. Pupo 1 , A. Scardia 1 , M. Migliorini 1 , I. Giannini 1 , S. Boni 1 ,F. Sacco 1 , M. Di Bari 1 , T. Potpara 2 , N. Marchionni 1 , S. Fumagalli 1 .
1 ICU Careggi Hospital University of Florence; 2 University of Belgrade,
Belgrade, Serbia
Introduction: Atrial ﬁbrillation (AF) is the most frequent arrhythmia of the elderly. Some evidence suggests that AF is associatedwith a faster physical functional decline. Aim of this study was toevaluate the impact of sinus rhythm (SR) restoration on physicalperformance of aged patients with persistent AF.
Methods: We studied all consecutive subjects undergoing external
cardioversion (ECV) of the arrhythmia between March 2015 andAugust 2016. At baseline (BL) and at the follow-up (FU), patientswere assessed using the Short Physical Performance Battery (SPPB).
Results: We evaluated 46 patients (age: 77±7 years; men: 65.2%;
MMSE: 27.6±3.0; GDS: 4.0±2.5). Hypertension was the most frequent cause of AF (41.3%). At BL, median value of SPPB was 10/12(33th-66th percentile: 8–11) and it was inversely associated with
the CHA2DS2-VASc (p=0.003) and the GDS (p=0.001) scores. ECV
was effective in 91.3% of patients. At FU (median: 141 days), SR
was observed in 24/46 patients (52.2%), and it was associated witha signiﬁcant improvement of SPPB (BL: 9.6±2.3 vs. FU: 10.9±1.6;
p=0.002), whilst no changes were observed in patients with AF(BL: 8.6±2.2 vs. FU: 9.2±2.4; p=0.130). At multivariate analysis, thepresence of SR, when compared to AF, was associated with an
improvement of SPPB at FU (+1.1±0.4 points; p=0.018).
Conclusions: In elderly patients with persistent AF, SR restoration
seems to be associated with an improvement of physical functioning. If these results will be conﬁrmed, a rhythm-control strategy
could be preferred in aged patients at risk of disability development.

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

P-504
Submandibular mass in the elderly – an unusual diagnosis
I. Rego Figueiredo, R. Vieira Alves, S. Guerrreiro Castro, M. Antunes,
F. Lourenço, H. Gruner. S. Medicina, Hospital de Curry Cabral, Centro
Hospitalar Lisboa Central
Introduction: The differential diagnosis of a submandibular massis challenging in all ages, especially in the frail elder that does
not complain, and always includes neoplasia and infections. Pertinence of invasive exams is doubtful and concerning treatment
expectations, palliative care must be considered.
Case report: An 88-year-old female patient, bedridden, with dementia and hypertension, was admitted with a 3-month historyof prostration and on examination a right submandibular mass.
Exhaustive studies showed no elevated inﬂammatory parameters(ERS 27 mm/h), negative viral serologies (HIV, HCV, CMV, EBV) andhemocultures. Complete ear nose and throat with nasoendoscopic
examination was performed. Contrast enhanced CT-scan showed
necrotic lymph nodes, ﬁne-needle aspiration biopsy showed pyocites, panniculitis with neutrophilic and histiocitary inﬁltration,
the gram was negative. There was no response to 2 courses of antibiotherapy, with persistence of the mass. The differential diagnosisof the subacute asymptomatic neck mass, was between metastatic
neoplasia and tuberculosis.Further exams showed focal lesion onright mammary gland and biopsy triple positive invasive carcinoma. The cultural exam on the 52nd day, showed “mycobacterium
tuberculosis”. As such she started tuberculostatics and tamoxifen.
Discussion: Tuberculosis in the fragile elderly remains a frequentdiagnosis as the inherent imunosenescence contributes to reactivation of inactive mycobacteria from previous contacts. Initial clinicalpresentation of tuberculosis as a cold abcess of the submandibular
gland is a rare clinical entity, especially as there was no evidenceof concomitant tuberculosis elsewhere in the body, in this case, thepresence of neoplasia contributed to the reactivation.
P-505
The clinical characteristics and the selection of medical services
in the subjects with gastric cancers according to the age
J.H. Kim 1 , H.H. Jeon 2 , Y.W. Son 2 , T.J. Jeon 3 , J.Y. Park 3 . 1 Dongguk
Unversity Ilsan Hosptial, Dongguk University college of medicine,
Goyang, Republic of Korea; 2 National Health Insurance Service Ilsan
Hosptial, Goyang, Republic of Korea; 3 Inje University Sanggye Paik
Hospital, Seoul, Republic of Korea
Introduction: Gastric cancer is the ﬁfth leading cause of cancer
and the third leading cause of death from cancer making up 7%
of cases and 9% of deaths in 2012. Behavioral patterns of subjects
with gastric cancer are not unknown in terms of the selection of
medical institution. We investigated the clinical characteristics ofthe subjects and the selection of medical services according to theage.
Methods: From January 2007 to December 2016, medical records
of a total of 248 subjects with gastric cancer were retrospectively
reviewed in two groups as aged younger than 40 years old and aged
over 65 years old. The clinical ﬁndings were compared between thetwo groups.
Results: The mean age of the two groups were 35.8±3.6 yr old and72.7±6.5 yr old, respectively. In old group, male was more frequent(67.7% vs 49.6%, p=0.04). Atrophic change (50.5% vs 7.3%, p<0.01)
and intestinal metaplasia (48.1% vs 11.6%, p<0.01) were also more
frequently observed. Moreover, cancer in the old group was more
frequently located at lower body of the stomach (75.6% vs 63.0%,
p=0.046) and treated by endoscopic submucosal dissection (27.7%
vs 1.4%, p<0.01). Location at mid body (11.0% vs 25.9%, p<0.01) andsurgical treatment (45.1% vs 63.5%, p<0.01) were less frequently
observed in old group. However, transfer to other hospital (19.5% vsS185

22.6%, p=0.64) and proportion of EGC (55.6% vs 47.8%, p=0.25) were
not different between two groups.
Conclusions: Although clinical characteristics of stomach cancer inthe old group were different from those of the young group, there
was no difference in terms of the referral to other hospital between
two groups.
P-506
The relationships between health-related quality of life andwell-being in women aged 60–74 years
A. Cernovas 1 , K. Kluonaitis 1 , M. Tamulaitiene 2 , R. Stukas 1 ,V. Alekna 1 . 1 Faculty of Medicine of Vilnius University; Vilnius,
Lithuania; 2 Faculty of Medicine of Vilnius University; National
Osteoporosis Center, Vilnius, Lithuania
Objective: To investigate the relationships between health-related
quality of life and well-being in elderly women aged 60–74 years.
Subjects and methods: This cross-sectional study was performedon community dwelling women aged 60–74 years. Exclusion criteria were musculoskeletal or nervous system diseases or conditions
that could restrict the mobility. Data was collected by direct interviewing and recording the answers on a survey which consistedof sociodemographic questions and three questionnaires. Healthrelated quality of life was measured using European Quality ofLife Five Dimensions (EQ-5D), well-being – Control, Autonomy,
Pleasure, and Self-realization (CASP-19) and Satisfaction with Life
Scale (SWLS) questionnaires. Correlations were determined using
Spearman correlation coeﬃcient.
Results: The study was performed on 66 women; their mean age
was 67.06±3.37 years. It was found that 9 (13.6%) women were
single, 24 (36.4%) married, 17 (25.8%) widowed, and 11 (16.7%)
divorced. Analyzing education level we found that 6 (9.1%) women
had secondary (secondary or vocational school), 5 (7.6%) postsecondary (junior college), 8 (12.1%) vocational (institute), 4 (6.1%)
non-university higher (college) and 39 (59.1%) higher university
education. Our ﬁndings suggest that EQ-5D score statistically signiﬁcantly (p<0.001) moderately positively correlated with: total
CASP-19 score (r=0.57) and separately with each of CASP-19 main
domains scores – control (r=0.68), autonomy (r=0.63), pleasure(r=0.48), and self-realization (r=0.66). The data have revealed positive moderate correlation between EQ-5D and SWLS scores (r=0.42,
p<0.001).
Conclusion: Our study showed the positive associations between
health-related quality of life and well-being: EQ-5D score moderately correlated with CASP-19 and with SWLS scores.
P-507
Unprovoked pulmonary embolism in older adults: incidence andprognosis
D. Justo 1 , M. Aharoni 2 , N. Horesh 3 , O. Rogowski 4 , A. Kremer 5 ,H. Mayan 6 . 1 Geriatrics Division, Sheba Medical Center, Tel-Hashomer;
Israel; 2 Sackler School of Medicine, Tel-Aviv University, Israel; 3 Surgery
Department, Sheba Medical Center, Tel-Hashomer, Israel; 4 Internal
Medicine C, Sourasky Medical Center, Tel-Aviv, Israel; 5 Geriatrics
Division, Sheba Medical Center, Tel-Hashomer, Israel; 6 Internal
Medicine E, Sheba Medical Center, Tel-Hashomer, Israel
Introduction: The incidence of unprovoked pulmonary embolism(UPE) in older adults has been seldom studied, and its prognosis
has never been studied, to the best of our knowledge.
Methods: A historical prospective study. The medical charts of allolder adults (aged 70 years or more) with pulmonary embolism (PE)that were admitted to a tertiary medical center between 2010 and2012 were reviewed. Patients were divided into three groups: UPE,
provoked PE (PPE), and malignancy-associated PE (MAPE). PPE andUPE patients were those with and without obvious causes for PE,

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respectively. MAPE patients were those with an active malignancy.
The all-cause 1-year cumulative survival rates following admission
were compared between the groups.
Results: The ﬁnal cohort included 249 patients with PE: 161 (64.7%)
were women; the mean age was 79.8±5.7 years. Overall, 36 (14.5%)
patients had UPE, 81 (32.5%) patients had MAPE, and 132 (53.0%)
patients had PPE. Overall, 30 (12.0%) patients died during their
hospitalization, 76 (30.5%) patients died six months later, and 101(40.6%) patients died within one year of admission. Relative to PPE
and MAPE patients, the cumulative survival rate was signiﬁcantly
higher in UPE patients at every time point within one year ofadmission (p<0.05 and p<0.0001, respectively). Regression analysis showed that UPE was independently associated with reduced
1-year mortality (odds ratio 0.3, 95% conﬁdence interval 0.1–1.0).
Conclusions: UPE in older adults is not uncommon, and its
prognosis is better than PPE and MAPE in this population.
P-508
Using a multidimensional prognostic index (MPI) based oncomprehensive geriatric assessment (CGA) to predict mortality
in elderly undergoing transcatheter aortic valve implantation
M.-L. Bureau 1 , E. Liuu 1 , L. Christiaens 2 , A. Pilotto 3 , J. Mergy 2 ,F. Bellarbre 1 , P. Ingrand 4 , M. Paccalin 1 . 1 Pôle de Gériatrie, Centre
Hospitalier Universitaire de Poitiers, Université de Poitiers, Poitiers,
France; 2 Service de Cardiologie, Centre Hospitalier Universitaire dePoitiers, Université de Poitiers, Poitiers, France; 3 Department ofOrthogeriatrics, Rehabilitation and Stabilization – Frailty Area – E.O.
Galliera Hospital, Hospital of National Relevance and HighSpecialization, 16128 Genoa, Italy; 4 Pôle Biologie, Pharmacie et Santé
Publique, Centre Hospitalier Universitaire de Poitiers, Université dePoitiers, Poitiers, France
Background: Selection of appropriate elderly who can beneﬁt fromtranscatheter aortic valve implantation (TAVI) is challenging. We
evaluated the prognosis of this procedure according to the comprehensive geriatric assessment (CGA) based on the multidimensional
prognostic index (MPI).
Methods: Prospective observational monocentric study from January 2013 to December 2015. Consecutive patients aged ≥75 who
underwent TAVI and a complete CGA were included. Baseline demographic, geriatric and cardiologic data were collected. CGA wasused to calculate the MPI score that is divided in three groups
according to the mortality risk. Follow up was performed until
December 2016 and mortality rate was assessed at one, six and 12
months.
Results: 116 patients were included. Mean age was 86.2±4.2 years,
mean European system for cardiac operative risk evaluation (EuroSCORE) was 19.2±11.3%, mean MPI score was 0.39±0.13. Forty-ﬁve(38.8%) patients belonged to MPI-1 group, 68 (58.6%) to MPI-2
group and three to MPI-3 group. MPI score and Euroscore weremoderately correlated (Spearman correlation coeﬃcient rs =0.27,
p=0.0035). Mortality rate was signiﬁcantly different between MPI
groups at six and 12 months (p=0.040 and p=0.022). Kaplan Meiersurvival estimates at one year stratiﬁed by MPI groups was signiﬁcantly different (hazard ratio HR =2.83, 95%conﬁdence interval (CI)
1.38–5.82, p=0.004). Among variables retained to perform logistic
regression analysis, the score of instrumental activities of dailyliving appeared the most relevant (p<0.001).
Conclusions: This study indicates that CGA based on MPI tool isaccurate to predict prognosis in elderly patients undergoing TAVI
procedure.

P-509
Using the multidimensional prognostic index to deﬁne risk inolder patients undergoing a transcatheter aortic valve
replacement
J. Albéniz, P. Fdez-Montalbán, C. Miret, A. Merello, L. Hernandez,
E. Sanchez, A.J. Cruz-Jentoft. HRYC Hospital Ramón y Cajal, Madrid,
Spain
Introduction: The multidimensional prognostic index (MPI) is avalid tool to classify older patients in different settings. We used
MPI to describe patients selected for transcatheter aortic valvularreplacement (TAVR).
Methods: Single-center, prospective, observational study. Inclusion
criteria: older patients in need of an aortic valve replacement withTAVI for severe aortic stenosis. MPI used all domains of geriatricassessment (sociodemographic, functional, nutritional, cognitive,
comorbility, number of medicines) to calculate an index that deﬁnes three groups according to the mortality risk: MPI-1 (≤0.33,
low risk), MPI-2 (0.34–0.65, moderate risk) and MPI-3 ((≥0.66, highmortality risk). Clinical variables were also collected (EuroSCORE
and NYHA).
Results: Sixty-three patients were included (mean age 83.0±8.3
years, 57% women). 91.1% were independent for BADL, 72.2% for
IADL. Most of them lived with their families (77.8%) and somepresented cognitive impairment (20%). 68.9% of them had >2
comorbidities in need of treatment and 54% severe polypharmacy.
95.5% were at risk of malnutrition risk. Mean MPI score was
0.33±0.15 (53.4% of the patients were in MPI-1 group, 42.2% in
MPI-2, and only 4.4% in the high risk MPI-3). Mean EuroSCORE was
12.3±7.4%; 65.1% of the patients were in NYHA class III. Only one
patient died during follow-up, prognostic value of MPI for mortality
in this sample cannot be yet calculated.
Conclusions: Most older patients receiving a TAVI have a low ormoderate mortality risk.

Area: Infectious diseases and vaccines

P-510
A case of a chest wall mass in elderly male
S. Brazão, R. Costa, C. Ferreira, N. Pedro, S. Leitão, L. Santos,
T. Veríssimo, A. Carvalho. Centro Hospitalar e Universitário de
Coimbra (CHUC), Coimbra, Portugal
Introduction: Chest wall masses are caused by a spectrum of
entities, and its etiology is diverse. A careful history and physicalexamination can guide the physician to the diagnose. Imaging canhelp to identify the location, size and composition, and biopsies areoften required.
Case report: A 77-year-old man with a history of heart failure, presented with depressive mood, asthenia and anorexia with a weightloss of 20 kg. Concomitantly, presented with a 1 month, painlesschest wall mass, with well deﬁned contours, about 6 cm in diameterand elastic consistency. No trauma history. The mammary ultrasound revealed cystic formation that could correspond to a partiallyorganized hematoma. The aspiration cytology revealed necrotic
background without viable cells. Computed tomogram of the thorax: liquid collection in the left anterior thoracic wall, associatedwith irregularity and discontinuity of the 4th left costal cartilage; inthe upper left lobe a nodulation with 22 mm, cavitated, that suggest
pulmonary tuberculosis. PET: Hipodense masses in the left anterior
thoracic wall, with increased FDG uptake. Acid-fast bacilli smear
and culture of the sputum were positive, however HIV serology was
negative. He started quadruple therapy with tuberculostatics andwas discharged on the 26th day after negative smear.

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

Conclusion: In this case, the indolent onset of unspeciﬁc symptoms, made it diﬃcult to diagnose Pulmonary tuberculosis, that was
conﬁrmed by positive culture and imaging. It’s important to value
all the symptoms so we can achieve the diagnosis, and prevent
more serious complications.
P-511
A case report of thoracic spondylodiscitis, epidural andparaspinal abscesses without elevated inﬂammatory markers
and fever
P. Voukelatou, I. Vrettos, A. Ragkou, A. Bitsikokou, A. Didaskalou,
A. Katsoras, D. Theotoka, A. Kalliakmanis. 2nd Department ofInternal Medicine, General Oncological Hospital of Kiﬁssia “TheAgioiAnargyroi”, Athens, Greece
Background: More than 80% of patients with spondylodiscitis,
epidural and paraspinal abscesses have elevated CRP and ESR levels
and more than 50% present with leukocytosis. Fever may be absent.
Objective: To describe a83 years-old female patient with spondylodiscitis, epidural and paraspinal abscesses who never had neither
fever nor any elevated inﬂammatory markers.
Case presentation: Patient was admitted for evaluation of paraspinal
and epidural masses found in MRI, performed to investigate her
persistent back pain. Her current diagnosis was spinal metastases.
MRI revealed lesions at T6–T7 and T7–T8 discs, T6,T7 and T8 vertebral bodies, epidural and bilateral paraspinal regions. She reported
no fever and inﬂammatory markers were not elevated (WBC: 9.480
K/μl, CRP <3.27 mg/l, ESR: 8 mm/h). The patient was referred forneedle biopsy and the results revealedpolymorphonuclear inﬁltration of the tissue specimen. Unfortunately the specimen was notsent for staining and cultivation. The patient denied the repetitionof needle aspiration. The Orthopedics and Neurosurgery specialists
suggested no operative intervention. Patient received Levoﬂoxacin,
Rifampicin and Clindamyciniv, followed by pos administrationafter
6 weeks. Both the effectiveness of treatment and the duration oftherapy, had to be based only on MRI ﬁndings. After four months,
the MRI was unchanged. After eight months, the lesions gradually
retreated and ﬁnally resolved after 1.5 year of therapy.
Conclusion: Biopsy specimens from epidural and paraspinal masses
must be sent for cultivation and staining as they mayconceal infection, even in the absence of fever or elevated inﬂammatory
markers.
P-512
Adult vaccination for pneumococcal disease: A comparison of
the national guidelines in Europe
D. Mertens 1 , C. Bonnave 1 , B. Ghesquiere 2 , K. Cobbaert 2 ,W. Peetermans 3 , J. Verhaegen 4 , M. Deschodt 5 , J. Flamaing 6 . 1 Dept.
of Geriatrics, University Hospitals Leuven, Belgium; 2 Dept. of
Geriatrics, AZ Delta Roeselare, Belgium; 3 Dept. of Internal Medicine,
University Hospitals Leuven, Belgium; 4 Dept. of Clinical Biology,
University Hospitals Leuven; 5 Dept. of Clinical & Experimental
Research, University of Leuven, Belgium; 6 Dept. of Geriatrics,
University Hospitals Leuven; Dept. of Clinical & Experimental
Research, University of Leuven, Belgium
Background: Pneumococcal disease constitutes a major global
health problem. Adults aged 50 years or older and younger adults
with speciﬁc chronic health conditions are at particular risk forinvasive pneumococcal disease, associated with substantial morbidity and mortality. In Europe, two types of vaccines are used in
adults for pneumococcal immunization: pneumococcal polysaccharide vaccine (PPV23) and pneumococcal conjugate vaccine (PCV13).
The aim of this study is to provide an overview and compare thenational guidelines for pneumococcal immunization for adults in
Europe.

S187

Methods: In November 2016, national guidelines on pneumococcal
vaccination for adults of 27 European countries were obtained
by Google search, the website of European Centre for Disease
Prevention and Control and contacting public health oﬃcials. In
our analysis we distinguished between age-based and risk-based
guidelines.
Results: We observed great variability regarding age, risk groups,
vaccine type and use of boosters. In age-based guidelines, vaccination is mostly recommended in adults aged 65 years or older,using PPV23. A booster is generally not recommended. An upper
age limit for vaccination is reported in two countries. In the immunocompromised population, vaccination with both vaccines andadministration of a booster is mostly recommended. In the population with chronical health conditions, there is more heterogeneity
according vaccine type, sequence and administration of boosters.
Asplenia is the only comorbidity for which all countries recommend
vaccination.
Conclusions: There is great variability in European pneumococcal
vaccination guidelines regarding age, risk groups, vaccine type andboosters. For ease of implementation, European uniﬁcation of theguidelines is needed.
P-513
Atypical presentation of bacteremia in the elderly is a risk factor
for death
C. Hyernard 1 , A. Breining 2 , S. Duc 1 , C. Cazanave 3 , M. Lambert 4 ,P. Mercie 4 , P. Duffau 4 , M. Rainfray 1 , C. Roubaud-Baudron 1 .
1 Geriatrics Department, Bordeaux University Hospital, Bordeaux,France; 2 Geriatric Department, Groupe hospitalier Pitié
Salpétrière-Charles Foix APHP, Paris, France; 3 Infectious Disease
Department, Bordeaux University Hospital, Bordeaux, France; 4 Internal
Medicine Department, Bordeaux University Hospital, Bordeaux, France
Introduction: The absence of typical signs of infection is describedin elderly patients impacting diagnosis and prognosis. The objective of this study was to determine risk factors for mortality ofbacteremia in this population and factors associated with atypicalpresentation.
Material and methods: We conducted an observational prospective
study at Bordeaux University Hospital (France) in 2016. All consecutive patients ≥75yo with bacteremia were included. Atypicalpresentation was deﬁned by the absence of temperature ≥38.3°C
or <36°C, chills or severe sepsis. Mortality and functional status
were recorded at 1 week (D7) and 3 months (M3)Results: 131
patients (mean age 85yo, 46.6% female) were included. D7 and M3
death rates were 9.2 and 41.4% respectively. In multivariate analysis,
at D7, atypical presentation tended to be associated with death(odd ratio (OR)=3.4, 95% conﬁdence interval (CI) (0.9–14), p=0.092).
M3-mortality risk factors were: atypical presentation (OR=4.0, 95%
CI: (1.3–11), p=0.013), nosocomial infection (OR=5.7, 95% CI: (2.0–15), p=0.001), congestive heart failure (OR=4.9, 95% CI: (1.9–12),
p=0.001), and malignancy (OR=3.2, 95% CI: (1.1–9.0), p=0.029).
Diabetic patients and those infected by Staphylococcus aureus weremore likely to have atypical signs of infection. Bacteremia impact
long term functional status: ADL score decreased from 3.6 (±2.0)(before bacteremia) to 2.9 (±2.2) 3 months later (p=0.003).
Conclusion: Elderly patients with bacteremia have a poor vital andfunctional prognosis in the short and long term. Physicians should
be attentive to patients without infectious typical signs becauseof an increased risk of death. Blood sample should be consideredin elderly, especially diabetic patients, with unexplained clinicalmanifestations.

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P-514
Combined plasma elevation of CRP, intestinal-type fatty acidbinding protein (I-FABP), and sCD14 identiﬁes older patients athigh risk for healthcare-associated infections
E. Paillaud 1 , S. Bastuji-Garin 2 , A. Plonquet 3 , Y. Levy 4 , S. Hue 3 .
1 Groupe Hospitalier Henri-Mondor, Département de médecine interneet gériatrie, Creteil, France; 2 Hôpital Henri-Mondor, Pôle Recherche
Clinique et Santé Publique, Creteil, France; 3 Hôpital Henri-Mondor,
Service d’immunologie biologique, Creteil, France; 4 Vaccine ResearchInstitute (VRI), Université Paris Est Créteil, Faculté de médecine, France
Introduction: We hypothesized that low-grade inﬂammation was
driven by microbial translocation and associated with an increased
risk of healthcare-associated infections (HAIs).
Methods: We included 121 patients aged 75 years or over inthis prospective cohort study. High-sensitivity-C-reactive protein(hs-CRP) as a marker of low-grade inﬂammation, I-FABP as a marker
of intestinal epithelial barrier integrity, and sCD14 as a marker
of monocyte activation were measured at hospital admission ofpatients.
Results: HAIs occurred during hospitalisation in 62 (51%) patients.
Elevated hs-CRP (≥6.02 mg/L, i.e., the median) was associated witha signiﬁcantly higher HAI risk when I-FABP was in the highest quartile (odds ratio [OR], 4; 95% conﬁdence interval [95%CI], 1.39–11.49;
P=0.010). In patients with hs-CRP elevation and highest-quartile
I-FABP, sCD14 elevation (≥0.65 pg/mL, i.e., the median) was associated with an 11-fold higher HAI risk (OR, 10.8; 95%CI, 2.28–51.1;
P=0.003). Multivariate analyses adjusted for invasive procedures
and comorbidities did not change the associations linking the threemarkers to the HAI risk.
Conclusions: Increased levels of hs-CRP, I-FABP, and sCD14 may
reﬂect loss of intestinal epithelial barrier integrity with microbial
translocation leading to monocyte activation and low-grade inﬂammation. In our cohort, these markers identiﬁed patients at high risk
for HAIs.
P-515
Comparison between the clinical forms at the acute phase of
Chikungunya virus infection as deﬁned by the WHO, and theclinical presentation in elderly subjects
L. Godaert 1 , S. Bartholet 1 , F. Najioullah 1 , S. Yactayo 2 , M. Dramé 3 .
1 University Hospital of Martinique, Martinique, France; 2 World HealthOrganization, Geneva, Switzerland; 3 University of Reims,
Champagne-Ardennes, France
Introduction: In Chikungunya virus infection (CHIKV) three clinicalforms at the acute phase have been deﬁned by the World HealthOrganization (WHO), namely acute clinical cases, atypical cases, andsevere acute cases. We aimed to compare the clinical presentation
presented by elderly patients during the acute phase of CHIKV withthe deﬁnitions by the WHO.
Methods: Cross-sectional study performed in the University Hospital of Martinique from retrospective cases. Patients aged ≥65 years,
who attended the emergency department with a positive biological diagnosis of CHIKV (RT-PCR), between January and December
2014 were considered eligible. They were compared to a randomly
selected sample of younger controls (<65 years).
Results: A total of 267 elderly patients (80±8 years), and 109
controls (46.2±12.7 years) were included. In terms of clinical formsof disease, in elderly and controls, typical presentation was present
in 8.2% and 59.6% (p<0.0001) respectively, atypical presentation
was present in 29.6% and 5.6% (p<0.0001) respectively, severe
presentation was present in 19.5% and 17.4% (p=0.65) respectively.
In the elderly group, 114 (42.7%) could not be classiﬁed in any
category (absence of fever, absence of joint pain, or both); In thecontrols group, 19 (17.4%) could not be classiﬁed (p<0.0001).

Conclusions: Only 8,2% of the elderly subjects presenting at theacute phase of CHIKV have typical forms. These results suggestthat the most frequent clinical presentation of CHIKV in the elderly
population differs from that most commonly observed in younger
populations.
P-516
Early diagnosis of sepsis: Is quickSOFA a good screening tool?
I. Arnau-Barrés 1 , À. Pedragosa 2 , R. Miralles 1 , R. Güerri-Fernández 3 .
1 Geriatrics Department, Hospital del Mar, Barcelona, Spain;
2 Emergency Department, Hospital del Mar, Barcelona, Spain;
3 Infectious Diseases Department, Hospital del Mar, Barcelona, Spain
Introduction: The qSOFA score, is offered as a quicker screening
tool for sepsis that can be easily used at the bedside.
Methods: We conducted a retrospective cross-sectional study. The
records of all patients older than 65, hospitalized between January
and September2016 with the diagnosis of sepsis (ICD-10) werereviewed. Clinical information at admission and vital signs, laboratory and microbiology results, APACHE2 score and qSOFA wereobtained; and also 30-day-mortality. We performed descriptive anda multivariable analysis. A multivariate logistic regression model
was ﬁtted to study mortality predictors.
Results: A total of 223 patients were included. Median age (75 (IQR
71–82 years old)). 30-day-mortality was 22 patients (14%). Seventyﬁve patients (48%) presented with urinary tract infection, 45 (29%)
with respiratory infection and 26 (11%) with abdominal infection.
Bacteriemia was present in 95 patients (42%). No differences in
qSOFA nor in 30-day mortality were found among different sites ofinfection nor in patients with bacteremia. At admission 40 patients(17%) with sepsis fulﬁlled the qSOFA criteria. The 30-day-mortality
in patients who scored positive in qSOFA was of 12%. Moreover, in
70% of patients that fulﬁlled the SIRS criteria, qSOFA score was <2(p<0.001). Multivariate logistic regression analysis revealed thatalbumin levels (OR=0.3, 95% CI: −0.17–0.56, p<0.0001), C-Reactive
Protein (CRP) (OR=1.03, 95% CI: 1.02–1.23, p=0.07)and Charlson
comorbidity index (OR=1.32, 95% CI: 0.978–1.806; p=0.007)were
the independent risk factors for 30-day-mortality.
Conclusions: qSOFA is not a good predictor for the diagnosis ofsepsis in elderly patients in our study. Only 24% of patients with
conﬁrmed diagnosis of sepsis fulﬁlled the qSOFA criteria, whereas
70% fulﬁlled SIRS criteria. The main predictors of mortality were:albumin, CRP and Charlson comorbidity index.
P-517
Effectiveness of live zoster vaccine in preventing postherpetic
neuralgia (PHN)
P. Saddier 1 , J. Bartlett 2 , B. Fireman 2 , M. Marks 1 , J. Hansen 2 ,E. Lewis 2 , L. Aukes 2 , Y. Chen 3 , E. Bresnitz 4 , N. Klein 2 , R. Baxter 2 .
1 Pharmacoepidemiology Department, Merck & Co., Inc; 2 Kaiser
Permanente Vaccine Study Center; 3 Pharmcoepidemiology
Department, Merck & Co., Inc; 4 Merck & Co., Inc
Introduction: A single dose, live attenuated zoster vaccine, islicensed in >50 countries for the prevention of herpes zoster and
PHN. Duration of protection is evaluated in a long-term observational study. We previously reported that vaccine effectiveness (VE)
to prevent zoster tended to decline over time and was on average
45–50% over 5 years in people ≥60 (60+) years. We present here
the results of VE against PHN.
Methods: The study is conducted in a US healthcare plan as anopen cohort that members enter unvaccinated when they become
age-eligible for vaccination. PHN cases among vaccinated and unvaccinated zoster cases were identiﬁed as having a PHN-speciﬁc
diagnosis code ≥90 days after ﬁrst zoster code. VE against PHN
was estimated using Cox regression adjusting for sex, birth year,Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

race/ethnicity, healthcare use, comorbidities and immunocompromise status.
Results: In 2007–2014, ∼400,000 subjects were vaccinated (coverage >50% in 60+) and ∼50,000 zoster episodes with >3000 PHN
cases occurred. VE against PHN was 82% (95% CI: 76–87) in the ﬁrst
year, decreased in the second year, and then remained relatively
stable through year 5, with an average VE over the ﬁrst 5 years
following vaccination of 72%, 69% and 61% in people vaccinated atage 60–69, 70–79, and 80+ years, respectively.
Conclusions: Overall VE against PHN was ∼70% in all 60+ age
groups. VE against zoster and PHN in people 80+ was similar toyounger 60+ groups, supporting vaccination of all eligible people,
including the elderly who are at increased risk of zoster and PHN.
P-518
Eﬃcacy of a short-term prophylactic antibiotic protocol inprostatic surgeries for elderly with indwelling catheter
C. Arlaud, C. Rambaud, J. Courjon, E. Demonchy, V. Mondain,
N. Retur, F. Lieutier, M. Durand, O. Guérin. CHU Nice
Introduction: Indwelling urinary catheters (IUC) are overused in
the elderly population and represent a major risk factor for urinary
tract infections (UTI) and loss of functional autonomy. Surgicalprocedures are available for catheterization cessation but healthcare associated infections can occur. We evaluated the eﬃciency
of a speciﬁc antibiotic protocol implemented for the prevention of
perioperative prostatic surgery infections.
Material and methods: A multidisciplinary team was establishedto include patients over 70 years with IUC eligible for an alternative
treatment option using comprehensive geriatric assessment during
a 1-year period in 2016. Based on preoperative urine analysis,
patients received antibiotic therapy during 5 days (2 day before
and 2 days after the surgery). Use of narrow spectrum drugs wasprioritized. Favorable outcome was deﬁned as the absence of UTI
during the month after surgery.
Results: Twenty-two patients with a mean age of 84.3 years (72–93
years) were included among which 7 had a sterile urine analysis and
15 received the antibiotic treatment. The main bacteria involved
were Klebsiella pneumoniae (n=4), Enterococcus faecalis (n=4),
Escherichia coli (n=3), 4 urine analysis were polymicrobial. With
only one post-operative infection, we recorded a 95.5% eﬃciency
rate of our protocol.
Conclusion: These ﬁrst results suggest that a 5 days perioperative
antibiotic therapy for prostatic surgery in IUC carriers is effective forpost-operative infection prevention. Monitoring data should allow
to complete these results with a longer follow-up and validate theprotocol.
P-519
Establishing an antibiotic stewardship team in a geriatricdepartment of a German hospital and introducing an online
evaluation and documentation tool
S. Langenfeld. St. Marien Hospital Köln
Introduction: Facing the challenge of the rise of multiresistentagents, especially in the Gram-negative ﬁeld and Clostridium difﬁcile as a result of decades of inconsiderate use of anti-infective
substances it is highly important to rethink and to build structures
to avoid further progression.
Methods: By establishing an antibiotic stewardship team structures
were built to analyze resistance rates and the use of antibiotics.
Recommendations in the choice of substances due to common andspecial infections were worked out considering the local characteristics. Therefore, we developed an online tool for evaluationand documentation of the orders of antiinfective substances before
application.

S189

Results: After the use of antiinfectives had another rise comparing
2015 to 2016 from 351,7 RDD per 100 cases to 386,0 we came tothe decision to get more control of the use of antibiotics. Moreover,the cases of clostridium diﬃcile infections had a rise of almost 29%
comparing 2015 to 2016. Therefore, the antibiotic stewardship teamwas founded, consisting of three antibiotic stewardship experts,
one out of each department, the hospital hygienist and a clinicalpharmacist.
Conclusions: It’s an urgent necessity to decrease the usage of antiinfectives to avoid further multiple resistance and unwanted side
effects like clostridium diﬃcile associated diarrhea. Therefore, we
founded an antibiotic stewardship team and developed an online
tool, which rises attention evaluating the deﬁnitive need for antibiotic therapy and documents antibiotic therapy for intermittent
analysis.
P-520
Impediments for inﬂuenza and pneumococcal vaccination in
geriatric oncology
D. Matelot, A. Martin, B. de Wazieres, A. Di Castri, L. Geronimi,
C. Labarias, C. Le Guillou, F. Santoni, G. Solinas, V. Antoine. CHUNîmes, France
Background: Inﬂuenza and invasive pneumatic diseases are more
frequent and deadly in immuno-compromised older cancer patients. Vaccinations are recommended, however the majority do
not receive the vaccine. The objective of this study was to assesscharacteristics of elderly patients with cancer preventing them fromaccessing and accepting inﬂuenza and pneumococcal vaccination.
Methods: More than 100 consenting patients over 75 years’old
with progressive cancer (solid tumors or hemopathy, treated ornot) were included in a French university hospital. Descriptionof socio-demographics (age, sex, lifestyle), cancer (type of cancer,
date of diagnosis, metastatic or not, curative treatment or not),comorbidities and geriatric characteristics (cognitive function, depression, nutrition, walking perimeter, autonomy for activities ofdaily living ADL/IADL), vaccination status against inﬂuenza andpneumococcal, opinion of the patient’s general practitioner andoncologist regarding vaccination.
Results: We present socio-demographical and medical characteristics of patients associated with the absence of vaccinationand discuss measures to enhance inﬂuenza and pneumococcal
vaccination.
Conclusion: Accessing and/or accepting inﬂuenza and pneumococcal vaccination is still a challenge for elderly patients withcancer.
P-521
Improving factors of PPSV23 vaccine coverage rates in adults
aged 65 years in Japanese municipalities – nationwide
community-based survey
S. Kanazu 1 , Y. Nishiwaki 2 , M. Oba 3 , A. Watanabe 4 , Y. Murakami 3 .
1 Vaccines, Medical Affairs, MSD K.K., Tokyo, Japan; 2 Department ofEnvironmental and Occupational Health, Toho University, Tokyo,
Japan; 3 Department of Medical Statistics, Toho University, Tokyo,
Japan; 4 Research Division for Development of Anti-Infective Agents,
Institute of Development, Aging and Cancer Tohoku University, Miyagi,
Japan
Introduction: In the 23-valent pneumococcal polysaccharide vaccine (PPSV23) program for elderly in Japan, various measures
including notiﬁcation of program eligibility through newsletters,
broadcasting and ﬁnancial support to reduce out-of-pocket costs,
are taken by municipalities to raise PPSV23 coverage rates. We investigated whether both notiﬁcation methods and ﬁnancial support
raise the PPSV23 coverage rates in Japan.

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Methods: A postal and web-based nationwide survey was sent inJune 2016 to all municipalities of Japan (n=1741). We used a selfadministered questionnaire to collect the PPSV23 coverage rates inadults 65 years. Details on notiﬁcation method and out-of-pocket
costs for vaccination were also collected by the questionnaire.
Additional municipality-level variables were collected from thenational statistics in Japan, including demographic, socioeconomic
and health system indicators. Multiple regression was used to explore the effect of the notiﬁcation methods and out-of-pocket costs
on PPSV23 coverage rates adjusting for municipality-level factors.
Results: 1022 responded to the survey (response rate 58.7%). Median PPSV23 coverage rate among municipalities was 41.3% (IQR;
32.2–48.5%). In multiple regression, PPSV23 coverage increased
with the number of notiﬁcations sent to an eligible individual(p<0.001, adjusted means; none; 23.7%, once; 42.8%, twice; 49.2%,
three times and more; 47.4%). PPSV23 coverage decreased by 3.0%
(2.3–3.7%) per 1000 Yen increase in out-of-pocket costs (p<0.001).
The type of notiﬁcation was not signiﬁcantly associated with
PPSV23 coverage (P=0.60).
Conclusions: The number of notiﬁcations, as well as out-of-pocket
costs, were associated with PPSV23 uptake in Japanese municipalities.
P-522
Inﬂuenza vaccination in 65 and over age adults in a Turkish
county, Soke
H. Elbi 1 , B. Deger 2 . 1 Celal Bayar University, School of Medicine; 2 Soke
Municipality, Health Affairs Directorate, Turkey
Introduction: Seasonal inﬂuenza viruses, which are beginning toappear from autumn, are more lethal in less than 6 months and over
65 years. As a result of changes in the structure of inﬂuenza virus,
different strains are emerging each year. The most effective methodof prevention is inﬂuenza vaccination every fall. The aim of thisstudy is to determine the frequency of inﬂuenza vaccination and toinvestigate the sociodemographic factors related to inﬂuenza vaccination in those who live in the Söke District of Söke Municipality
Health Services Department over 65 years of age.
Methods: The study was carried out among people over 65 years ofage who served by Söke Municipality Health Affairs Directorate. Asa data source, a questionnaire consisting of 13 questions developedin the research team was used.
Results: A total of 641 persons (385 women, 256 men, averageage 74.13±6.7 years) were reached. 88.9% of the patients withany chronic illnesses were detected. 22.3% of the participants
stated that they had regular seasonal inﬂuenza vaccination every
year and 8.9% had irregular seasonal inﬂuenza vaccination. When
asked about who recommended seasonal inﬂuenza vaccination,
44.0% was recommended by the family physician and 45.0% wasachieved by the non-physician. Among the vaccine recipients, therate of inﬂuenza vaccination was 11.0% with the recommendationof physicians outside of the family physician.
Conclusions: Inﬂuenza is seen as a health threat for the elderlyas it can lead to serious complications. Particularly fragile elderly
are among the high risk groups because of inﬂuenza complications,which may lead to bacterial pneumonia and exacerbation of chronic
illnesses. In the study conducted by Polat et al. In Antalya in 2006,
the percentage of inﬂuenza vaccination in the population over 65
years of age was determined as 15.0%. The transition to the family
medicine system from 2011 onwards in our country may explain
the fact that the percentage of those who have inﬂuenza vaccine in
our country (22.3%) is slightly higher.

P-523
National prevalence study of healthcare associated infections
and antibiotic use in nursing homes (France 2016)
A. Machut 1 , Y. Lestrat 2 , G. Gavazzi 3 , A. Berger-Carbonne 2 . 1 CClin
Sud-Est; 2 Santé Publique France, Paris, France; 3 University Hospital,
Grenoble, France
Introduction: The ﬁrst national point prevalence study (PPS) of
Healthcare associated infections (HAI) and antibiotic use (AB) was
conducted in French nursing homes (NH).
Objectives: Describe and measure prevalence of HAI and AB, raiseawareness of HCW and prescribers, identify needs for intervention,
training or additional resources.
Methods: PPS was proposed to a random sample of 719 NH selectedamong 7,387 French NH. Data were collected in May-June 2016,
concerning NH organization and resources, HAI & AB use. We
focused on urinary tract infection/UTI (including micro-organisms
and resistance pattern), C. diﬃcile infection/CDI, pneumonia/PNE,
low respiratory tract infection/LRTI, inﬂuenza/FLU, skin & soft tissue
infection/SSTI, wound & pressure sores infection/WPSI, scabies/SCA,
catheter-related infection/CRI. Results were weighed according tosampling design.
Results: Data concerned 367 NH (51%) and 28,277 residents. Exposure to invasive procedures was low: 3.3% catheters (mostly
subcutaneous), 1.7% urinary catheters and 0.9% surgery <30 days.
Prevalence rates were 2.9% [CI 95%: 2.57–3.29] residents with HAI(med 2.5, range 0–21.1) and 2.8% [2.46–3.07] residents with AB(med 2.3, range 0–21.1). Among HAI, 36.9% were UTI, 24.0% IRB,
11.0% PNE, 20.4% SSTI, 5.6% WPSI, 1.3% CRI and 0.3% SCAB, 0.1% CDI.
Only 68.8% of UTI were conﬁrmed microbiologically: Enterobacteriaceae were predominant with 26.3% 3GC resistance and 13.3%
EBSL. Concerning AB use, most frequent AB were 20.9% 3GC, 19.0%
penic. A, 16.0% amoxicillin-clavulan., 12.3% macrolides, and 11.4%
ﬂuoroquinolones. A high level of prophylaxis was observed (13.7%).
Conclusion: This PPS provides French NH with reference data andappears effective in monitoring local and national strategies for HAI
prevention and AB use.
P-524
Native aortic valve endocarditis due to Pseudomonas stutzeri ina ninety-one-year-old woman
R. Héquette-Ruz 1 , A. Charpentier 1 , I. Delabriere 1 , C. Loiez 2 ,R. Le Guern 2 , B. Guery 3 , F. Puisieux 1 , J.-B. Beuscart 1,4 . 1 CHRU Lille,
Geriatrics Department, F-59000 Lille, France; 2 CHRU Lille, Institut demicrobiologie, F-59000 Lille, France; 3 Infectious Diseases Service,
Department of Medicine, University Hospital and University of
Lausanne, Lausanne, Switzerland; 4 Université de Lille, EA 2694 – Santépublique: épidémiologie et qualité des soins, F-59000 Lille, France
Introduction: Pseudomonas stutzeri (P. stutzeri) is an aerobic,
non-fermenting, Gram-negative bacteria. This environmental contaminant is usually isolated in soil and water; in human, P. stutzeri
isolation is usually considered as contamination or colonization.
Here we report the case of native valve endocarditis (NVE) due to P.
stutzeri.
Case description: A ninety-one-year-old woman was admitted toour acute geriatric unit in August 2016 after she fell. Clinicalexamination ﬁndings were poor (no fever nor heart murmur or
splenomegaly). Native aortic valve endocarditis was diagnosed according to European Society of Cardiology (ESC) 2015 modiﬁed
diagnostic criteria with two major modiﬁed Duke’s criteria: persistently positive blood cultures (ﬁve blood cultures positive for P.
stutzeri) and trans-esophageal echocardiography positive for infective endocarditis (IE) with a 5 mm oscillating intra-cardiac mass on
the posterior aortic cusp. FDG-PET did not contribute to ﬁnd thesource of infection nor extra-cardiac septic localizations. ClinicalPoster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

cure was achieved after 6 weeks of intravenous administration of
antibiotic combinations, with no need for surgical treatment.
Conclusions: To our knowledge, this is the ﬁrst case of communityacquired native valve endocarditis due to P. stutzeri. Elderly patients are more likely to experience infections due to non-virulent
pathogens. Malnutrition and immunosenescence may contributeto uncommon infections’ susceptibility. This case emphasizes theneed for clinical recommendations for diagnosis and treatment of
non-HACEK Gram-negative endocarditis.
P-525
Perihepatitis associated with peritoneal tuberculosis mimicking
male Fitz-Hugh-Curtis syndrome; a case report
S. Lee 1 , H.P. Hong 2 , S.H. Kwak 3 , D. Kim 3 , E. Kim 3 , J. Cho 3 ,H.S. Choi 3 . 1 Department Neuropsychiatry, Rogen Hospital,
Dongducheon, Korea; 2 Department of Emergency Medicine, Kyung Hee
University Hospital, Seoul, Korea; 3 Department of Emergency
Medicine, Kyung Hee University Hospital
Perihepatitis is deﬁned as inﬂammation of the peritoneal capsuleof the liver. Fitz-Hugh-Curtis syndrome has been described as focal
perihepatitis accompanying pelvic inﬂammatory disease caused
by Neisseria gonorrhoeae and Chlamydia trachomatis. The highest
incidence occurs in young, sexually active females. There are few reports in the literature of Fitz-Hugh-Curtis syndrome associated withpelvic infection by Mycobacterium tuberculosis in female patients.
But none were reported with male patients. We experienced a caseof perihepatitis in a 72-year-old male patient, associated with peritoneal tuberculosis, mimicking male Fitz-Hugh-Curtis syndrome in
ED, and we report a case with a review of the literature.
P-526
Pharmacokinetics of ertapenem administrated by subcutaneousor intravenous route in patients aged over 75. PHACINERTA,
preliminary results
C. Roubaud-Baudron 4 , R. Legeron 4 , J. Ollivier 1 , F. Bonnet 2 ,C. Greib 2 , C. Cazanave 3 , D. Kobeh 4 , V. Cressot 4 , N. Monéger 4 ,M.-N. Videau 4 , E. Thiel 4 , A. Lafargue 4 , A. de Thézy 4 ,I. Bourdel-Marchasson 4 , J. Durrieu 4 , G. Pinganaud 4 , D. Breilh 5 .
1 PK/PD Group INSERM 1034, Pharmacokinetics andPharmacodynamic, Bordeaux University, Bordeaux, France; 2 Internal
Medicine Dept, Bordeaux University Hospital, Bordeaux, France;
3 Infectious Disease Dept, University Hospital, Bordeaux, France;
4 Geriatrics Dept, Bordeaux University Hospital, Bordeaux, France;
5 PK/PD Group INSERM 1034, Pharmacokinetic and Pharmacodynamic,
Bordeaux University, Bordeaux, France
Background: Antibiotic administration through subcutaneous (SC)injection is common practice in France, especially in Geriatrics asan alternative to IV route in case of poor venous access or delirium.
Ertapenem is a long-acting parenteral carbapenem indicated especially in the treatment of extended spectrum β-lactamase (ESBL)
producing enterobacteria infection. Sparse PKPD data are available
for such a practice.
Methods: Patients >75yo receiving ertapenem (1g once daily) for atleast 48h (IV or SC, steady state) were prospectively included after
informed consent was obtained. Ertapenem concentrations (H0,H+0.5h and H+2.5h) were determined by Liquid chromatographymass spectrometry and analysed regarding the administrationroute. Using our data, AUC (area under the curve) between 0 and 24
hours (AUC0–24) was estimated using the trapezoid method. Computations were performed with the Monolix® software. Tolerance
and eﬃcacy were monitored as well.
Results: 10 (mean 87±7.0 yo) and 11 patients (mean 88±5.0 yo)
were included in IV and SC group respectively. All patients completed the 3 blood collections. Mean ertapenem residual observed

S191

concentrations were not different between IV (mean 11±8 ug/mL)
and SC (11±7 ug/mL). At the end of the infusion, observed Peakconcentration was 6-fold higher in the IV (186±98ug/mL) groupcompared to SC group (29±22 ug/mL) and 2 fold higher 2 hours after
the end of the infusion (101±34 versus 58±36 ug/mL). Individual
predicted AUC0–24h were not signiﬁcantly different between IV
and SC groups (986±302 versus 887±212 ug/ml*h, p=0.27). Moreresults regarding safety and eﬃcacy are on progress.
Conclusions: The preliminary results of this original pharmacokinetics study on ertapenem support the hypothesis that SC
administration could be an effective alternative to IV route. Conﬁrmation of these results could avoid or shorten hospitalisation ofthis population.
P-527
Predicting the 28-day mortality rate in elderly patients with
community-acquired pneumonia: Evaluation of 11 risk
prediction scores
H. Elbi, A. Bilge, H.I. Dayangac, O. Dikmen. Celal Bayar University,
School of Medicine
Introduction: Community-acquired pneumonia (CAP) is the mostfrequent cause of infectious disease-related morbidity, and mortality among all patients. Elderly patients are at a higher risk ofdeveloping severe CAP because of many underlying disease, changes
in the health status. In this study, we evaluated the performanceof existing risk scores for predicting the 28-day mortality rate inpatients presenting with community-acquiring pneumonia (CAP) inan emergency department.
Methods: We conducted a cross-sectional study at the Celal Bayar
University Hospital in Manisa, Turkey. The records of consecutive
elderly patients with CAP were reviewed for this retrospective
study. All patients were followed-up to assess their outcome within
28 days of the admission. The discriminative performance of the 11
risk prediction scores for patients with CAP was assessed using thearea under the receiver operating characteristic curve (AUC).
Results: A total of 151 elderly patients [mean age, 76.6±7.8 years(range, 65–94 years); 65.6% men] with CAP were evaluated. There
were 30 deaths by 28-day, an allcause mortality rate of 19.9%. All
scores except the CAP-PIRO achieved an AUC greater than 0.700,
demonstrating fair discriminative power. All scores were evaluatedby the Z-test to see if there were signiﬁcant difference between
them.
Conclusion: Four of the existing scores had good discriminatory
power (AUC >0.800) to predict the 28-day mortality rate. The best
discrimination was demonstrated by CURB-age, a score designed
for the elderly patients with CAP. Only one score was under
the level that is considered to indicate fair discriminative power(AUC <0.700). Additional research is needed to determine the bestrisk score for predicting early mortality rates of elderly patients
following CAP.
P-528
Prediction of inhospital mortality in elderly patients with
Chikungunya virus infection in Martinique (French West-Indies)
L. Godaert 1 , S. Bartholet 1 , F. Dorléans 2 , F. Najioullah 1 , M. Dramé 3 ,J.-L. Fanon 1 . 1 University Hospital of Martinique, Martinique, France;
2 Agence régionale de santé, Martinique, France; 3 University of Reims,
Champagne-Ardennes, France
Introduction: Chikungunya virus (CHIKV) infection spreads following an endemic-epidemic pattern with high prevalence [1–3].
Excess mortality has been reported during outbreak [4–6]. We
aimed to predict inhospital mortality in 65+ population hospitalised with CHIKV Infection.
Methods: The study was performed in the University Hospital of

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Martinique from retrospective cases. Eligible patients were aged
≥65 years, admitted to any clinical ward from January to December 2014, and underwent RT-PCR testing for CHIKV infection. A
predictive score was created using adjusted odds ratio of factors
associated with inhospital mortality. ROC curve was used to determine the best cut-off. Bootstrap analysis was used to evaluate its
internal validity.
Results: In all, 385 patients aged ≥65 were included (average age:
80±8 years). Half of them were female and 35 (9.1%) had died during
the hospital stay. Seven variables were found to be independently
associated with inhospital mortality (cardiovascular disorders: 12
points; concurrent respiratory infection: 10 points; concurrent sensorimotor deﬁcit: 8 points; absence of musculoskeletal pain: 3
points; history of alcoholism: 3 points; concurrent digestive symptoms: 2 points; presence of confusion or delirium: 2 points). The
area under the curve was excellent (0.90; 95% CI: 0.86–0.94). The
best cut-off was score ≥8 points; sensitivity was 91% (82%-100%)and speciﬁcity was 75% (70%-80%).
Conclusions: Score based on easy-to-access clinical features has
good discrimination and calibration properties in the elderly. It will
be very helpful to help for early care management of elderly subject
in the context of CHIK outbreaks.
References:[1] Sissoko D, Moendandze A, Malvy D, et al. Seroprevalence andrisk factors of chikungunya virus infection in Mayotte, Indian
Ocean, 2005–2006: a population-based survey. PLoS One 2008;
3:e3066.
[2] Staples JE, Breiman RF, Powers AM. Chikungunya fever: an
epidemiological review of a re-emerging infectious disease. Clin
Infect Dis 2009; 49:942–8.
[3] Petersen LR, Powers AM. Chikungunya: epidemiology. F1000Res
2016; 5.
[4] Mavalankar D, Shastri P, Bandyopadhyay T, Parmar J, Ramani KV.
Increased mortality rate associated with chikungunya epidemic,
Ahmedabad, India. Emerg Infect Dis 2008; 14:412–5.
[5] Cardona-Ospina JA, Henao-SanMartin V, Paniz-Mondolﬁ AE,
Rodriguez-Morales AJ. Mortality and fatality due to Chikungunya virus infection in Colombia. J Clin Virol 2015; 70:14–5.
[6] Labeaud AD, Bashir F, King CH. Measuring the burden of arboviral diseases: the spectrum of morbidity and mortality from four
prevalent infections. Popul Health Metr 2011; 9:1.
P-529
Prevention of nosocomial inﬂuenza in a French geriatric unit
during inﬂuenza season 2016/2017
D. Nizigiyimana 1 , D. Gantz 2 , C. Masson 2 , J. Lupo 3 , S. Levet 2 ,M.-R. Mallaret 4 , G. Gavazzi 5 , C. Landelle 4 . 1 University clinic ofGeriatric Medicine, CHU Grenoble Alpes, Grenoble, France; 2 Infection
control unit, CHU Grenoble Alpes, Grenoble, France; 3 Virology
Laboratory, CHU Grenoble Alpes, Grenoble, France; 4 Infection control
unit, CHU Grenoble Alpes and University Grenoble Alpes/CNRS,ThEMAS TIM-C UMR 5525, Grenoble, France; 5 University clinic ofGeriatric Medicine, CHU Grenoble Alpes and University Grenoble
Alpes/GREPI, EA 7408, Grenoble, France
Introduction: Inﬂuenza presents a life-threatening infection for
geriatric patients, who might be nosocomially infected via healthcare workers (HCWs), patients or visitors. Our objective was toevaluate a multimodal strategy to prevent nosocomial inﬂuenza.
Methods: A multimodal strategy was implemented in a 32 bed
Geriatric unit: HCWs’ education on Inﬂuenza disease, promotionof Inﬂuenza vaccination (HCWs), rapid identiﬁcation of inﬂuenza
cases by PCR, isolation of inﬂuenza cases, curative and preventive
use of oseltamivir, systematic use of mask for all HCWs and visitors(evaluated 2 times per week), and prospective survey of all inﬂuenza cases. All hospitalized patients were included. Nosocomial

inﬂuenza was deﬁned by a time interval between admission andsymptoms’ onset >72 hours.
Results: Among 174 patients hospitalized (01.12.16 to 19.02.17)
98 (56%) patients have presented respiratory symptoms and were
tested for Inﬂuenza; 26 (27%) patients were positive for Inﬂuenza
A: 5 (19%) were nosocomial. Among 26 inﬂuenza cases, 16 patientswere vaccinated and 4 were not vaccinated (vaccination status
unknown for 6). Among 5 nosocomial inﬂuenza cases, 1 patient was
vaccinated and 2 were not vaccinated (vaccination status unknown
for 2). HCWs’ inﬂuenza vaccination rate was 53% (26/49). Compliance with systematic use of mask was 83% (168/203) for HCWs and
75% (41/55) for visitors.
Conclusions: Despite the implementation of a multimodal strategy,
nosocomial inﬂuenza cases occurred. Level of compliance for systematic use of mask was high for HCWs and should be encouraged
for visitors. Inﬂuenza vaccination for HCWs and patients should be
strengthened to prevent nosocomial inﬂuenza.
P-530
Prospective review of the quality of antibiotic prescriptions inan acute geriatric ward
C. Cuvelier 1 , K. Diallo 2 , C. Perret-Guillaume 2 , A. Benetos 2 ,C. Pulcini 2 . 1 HUG, Geneve, Suisse; 2 Université de Lorraine, Nancy,
FranceObjective: We wanted to assess the compliance of antibiotic
prescriptions to guidelines.
Methods: We conducted a prospective clinic study during 98 days.
All the antibiotic prescriptions were analyzed after clinical andmedical records examination, at the ﬁrst day initiation (D1) and at
48h-72h (D3) and compared to reference. They were classiﬁed as
unnecessary, not conform and conform prescriptions.
Results: 149 prescriptions were analyzed (61 to D1, 88 to D3).
They were classiﬁed as unnecessary in 13% of cases to D1 andD3, and not conform in 49% and 39% of cases to D1 and D3
respectively. The wrong choice of the molecule, the extended duration and intravenous administration were the main causes of notconform prescriptions. We can not identiﬁed a non-compliance risk
factor. The third generation cephalosporin was the major class ofantibiotics prescribed.
Conclusion: Only the fragility and comorbidities can not justify thefrequency of non-compliance in antibiotics prescriptions. Reduce
probabilistic prescriptions and the duration of antibiotics can limit
overuse of antibiotics. Take into account microorganisms identiﬁcations need to be improved. A second study to measure the eﬃcacy
of help to antibiotic prescriptions is necessary.
P-531
Psoas abscess due to Mycobacterium tuberculosis in a patientwith total hip arthroplasty
M. Oviedo Briones 1 , A. Rico 1 , M. Grados 2 , M. Quiles 1 ,R. Fernández 1 , P. Condorhuamán Alvarado 1 . 1 Hospital Universitario
La Paz, Madrid, Spain; 2 Hospital Universitario de Getafe, Madrid, Spain
A 70 year-old female had a left hip arthroplasty eight years ago. She
had a one-year history of ﬂuctuating pain in her left hip treatedwith analgesics with partial relief of symptoms. She came to thehospital with complaints of ﬁve days of fever, pain and swellingof left hip and posterior aspect of the thigh. C-reactive protein
was 75.5mg/L. A computed tomography (CT) showed an iliopsoas
abscess (6.5×7×7.5cm). Needle aspiration was performed obtaining
120 ml of abscess ﬂuid. Cultures were negative, and broad-spectrum
antibiotics were started. After ﬁve days, there was persistent yellowish drainage through the wound opening. A surgical inspection
revealed a pseudocyst with dense material near the prosthesis.
It was completely aspirated. The prosthesis was not removed.

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

Drainage for the wound was sent for PCR ampliﬁcation (Gene-Xpert
MTB/RIF assay) for Mycobacterium tuberculosis (MTB), which was
positive. Adenosine deaminase was 80UI/L. A week after beginning
the tuberculostatic drugs, the drainage stopped. A new CT showeda remarkable decrease in the size of the collection. Psoas abscessis a collection of pus in the iliopsoas muscle compartment. It may
be clinically diﬃcult to diagnose because of its rarity, insidious
onset, and non-speciﬁc clinical presentation. In this case her hip
prosthesis might had been colonized by MTB protected inside the
bioﬁlm. In a Spanish review of 30 cases of psoas abscess, 17% weretuberculosis and 83% were pyogenic. MTB should be considered inwhere tuberculosis is common.
P-532
Pulmonary manifestations and death due to aspiration inpatients diagnosed with ischemic and non-ischemic stroke
P. Terpstra 1 , L. Terpstra 2 , L. Oswald 2 , W.G. Boersma 2 . 1 Departmentof General Practice and Elderly Care Medicine, VU University Medical
Center, Amsterdam, The Netherlands; 2 Department of Pulmonary
Diseases, Medical Centre Alkmaar, Alkmaar, The Netherlands
Objectives: To evaluate pulmonary manifestations and death due
to aspiration in patients submitted for ischemic and non-ischemic
stroke.
Design: Retrospective study.
Setting: Hospital care setting in the Netherlands, NWZ Alkmaar.
Participants: A retrospective medical records review was conducted for patients submitted at the neurological ward with adiagnosis of ischemic or non-ischemic stroke for the year 2009.
Data collection included: demographics, comorbidity, mortality,
cause of death, infection parameters and medication. Additionally
we scored for the presence for known risk factors for pulmonary
aspiration syndrome (PAS). Primary and secondary outcome measures The primary outcome is death due to PAS, secondary weinvestigated the known risk factors for aspiration among otherpulmonary symptoms. Univariate and multivariate logistic analysis
was performed.
Results: 303 patients were identiﬁed with ischemic and nonischemic CVA in 2009; 155 (51%) subjects were female. In theentire group age ranged from 31–96 years, with a mean of 71
years. The majority of this group, 245 subjects (80%) were diagnoses
as ischemic stroke. 25 out of 300 patients developed PAS. The
diagnosis of PAS required the presence of a consolidation at chest
X ray, increased CRP and fever >38.5 °Celsius in presence of one
or more of the following: naso gastric tube feeding (p<0,001),
impaired swallowing (p<0,001), documented vomiting (p=0,299),
witnessed aspiration (p<0,001), lowered EMV ≤8 (p<0,001). All ofthese risk factors showed signiﬁcance except for vomiting. Almost
one third; 8 out of 25 patients (31%) who developed PAS died. Age>70 was non signiﬁcant (p=0,054) for patient with PAS for a fatal
outcome.
Conclusions: If PAS developed there was a high risk of mortality,
almost one third of these patients died. Age >70 was close to be ofsigniﬁcance. Of the previously described risk factors only witnessed
vomited was non-signiﬁcant. We re-established the value of the
known risk factors. Awareness might assist the identiﬁcation ofhigh-risk patients for fatale outcome.
P-533
Screening for Chikungunya virus infection in the elderly:
Development and internal validation of a new score
L. Godaert 1 , S. Bartholet 1 , F. Najioullah 1 , J.-L. Fanon 1 , M. Dramé 2 .
1 University Hospital of Martinique, Martinique, France; 2 University ofReims, Champagne-Ardennes, France
Introduction: This study aimed to derive and validate a score

S193

for Chikungunya virus infection (CHIKV) screening in old people
admitted to acute care units.
Methods: It was performed in the Martinique University Hospitals
from retrospective cases. Patients were 65+, admitted to acute careunits, for suspected Chikungunya virus infection (CVI) in 2014,
with biological testing using Reverse Transcription Polymerase
Chain Reaction (RT-PCR). RT-PCR was used as the gold standard. A
screening score was created using adjusted odds ratio of factors
associated with positive RT-PCR derived. A ROC curve was used todetermine the best cut-off of this score. Bootstrap analysis was used
to evaluate its internal validity.
Results: In all, 687 patients were included, 68% with conﬁrmed CVI.
Patients’ mean age was 80±8, and 51% were women. Four variables
were found to be independently associated with positive RT-PCR(fever: 3 points; arthralgia of the ankle: 2 points; lymphopenia:
6 points; absence of neutrophil leucocytosis: 10 points). The best
cut-off was score ≥12; sensitivity was 87% (83%-90%) and speciﬁcity
was 70% (63%-76%). The uncorrected C-statistic was the same as thebootstrapped C-statistic, namely 0.86 (95% CI: 0.83–0.89).
Conclusions: This score has good performances and good internal
validation and could be helpful to screen elderly people with CHIKV,
specially during outbreak in low- and middle-income countries.
P-534
Seasonal inﬂuenza and vaccination: Survey of Health Care
Workers in a gerontologic department
S. Hesse, A. Morisot, S. Louchart de la Chapelle, A. Pesce. Rainier III
Gerontologic Center, Princess Grace Hospital, Monaco
Introduction: Inﬂuenza is an acute viral infection that spreads
easily from person to person, causing serious complications incertain risk groups. Despite WHO and European recommendationsfor Health Care Workers (HCW) to get vaccinated against seasonal
inﬂuenza, low coverage is observed. In our department, inﬂuenza
vaccine is around 25% in HCW (versus 80% in patients). Lack ofcomprehensive data on inﬂuenza vaccine among HCW presentsa challenge for understanding low coverage, and to improve prevention. That is why we investigated the HCW perception andknowledge of inﬂuenza and vaccines.
Methods: Anonymous, self-administered questionnaires, distributedin Gerontologic Department, in autumns 2015 and 2016. Questions
are about inﬂuenza knowledge, vaccines perception, reasons forgetting vaccinated or not, inﬂuence of previous information campaign. Data are compiled and analyzed by the clinical research
unit.
Results: Participation rate around 36%. Three socio-professional
categories under represented (maybe less concerned by the subject). Link between non-vaccination and age. In prevention, amongpeople who do not get vaccinated, 15% use homeopathic vaccine,
48% use vitamins, phytotherapy or special diet, 37% nothing. 70%
underestimate inﬂuenza severity.
Conclusion: We observe a lack of conﬁdence not only in inﬂuenza
vaccination, but in vaccination in general (14% of respondents).
These results help to adapt prevention campaign in information,arguments to improve, and people to be reached, even beyond HCW(as animation team, food service staff, administrative staff), andthe way to diffuse the campaign (physicians seem more likely torecommend inﬂuenza vaccination to HCW they are working with).
Moreover, they provide a baseline to measure future improvements
in seasonal inﬂuenza vaccine uptake.

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P-535
The impact of dosing schedules on vaccination acceptability inolder people in the UK
I. Matthews 1 , H. Dawson 1 , I. Wood 2 , L. Olding 2 . 1 Merck Sharp &Dohme Ltd; 2 Bryter Research
Background: Research with UK health care professionals indicatedmultiple-dose vaccines are less acceptable to older patients andcould lead to reduced vaccine uptake compared with single-dose
vaccines [Value in Health (2016), 19, A42]. Access to a medical
appointment and population preferences were cited as likely issues.
This survey aimed to explore these concerns with older people.
Methodology: One thousand individuals aged 65–89, randomly
selected to be representative for age, gender, socio-economic grade
and regionally across the UK were interviewed by telephone in
October 2016.
Results: Diﬃculties affecting the ability of respondents to attend
primary care were explored, with the most common reason given as’Unable to get an appointment’ (62%).Eighty per cent of respondents
had received a vaccination within the last 2 years. When asked,
84% preferred vaccination courses to be completed in one doseover multiple doses and 79% preferred to have multiple different
vaccinations in one visit, rather than individual appointments foreach vaccine type. Only 37% of respondents agreed they would
return for a subsequent dose of a vaccine if they had tolerability
issues with the ﬁrst dose.
Conclusions: Accessing primary care can be a challenge for older
people and it is unsurprising that they express a clear preference forsingle-dose vaccines. This research suggests that the effectivenessof a multi-dose vaccination programme could be impacted if theﬁrst dose is associated with tolerability issues or diﬃculty getting afollow-up appointment for subsequent dose(s) with the result thatpeople do not return to complete the course.
P-536
The value of C-reactive protein in infection diagnosis andprognosis in elderly patientsO. Karasahin 1 , P.T. Tasar 2 , O. Timur 3 , F. Yıldırım 3 , D.N. Binici 3 ,S. Şahin 4 . 1 Regional Training and Research Hospital, Infectious
Diseases Clinic, Erzurum, Turkey; 2 Regional Training and Research
Hospital, Geriatrics Clinic, Erzurum, Turkey; 3 Regional Training andResearch Hospital, Internal Medicine Clinic, Erzurum, Turkey; 4 Ege
University School of Medicine, Department of Internal Medicine,
Department of Geriatrics, Izmir, Turkey
Introduction: Diagnosing infection in the elderly is diﬃcult, but
early diagnosis and treatment is critical due to the high incidenceof morbidity and mortality in these patients. The aim of this study
was to determine the value of C-reactive protein (CRP) level in the
diagnosis and prognosis of infection in elderly patients.
Study population: This prospective study included inpatients in thepalliative care unit during the 1-year period between January 2016
and January 2017. Patients’ demographic data, comorbid diseases,
clinical and laboratory ﬁndings, Acute Physiology and Chronic
Health Evaluation (APACHE II) score, and Charlson Comorbidity
Index were recorded. Blood and urine samples were collected fromall patients at admission for culturing, as well as sputum samples
from patients with respiratory symptoms. Cultures were repeatedafter 48 hours to determine microbiologic response according to
the focus of infection.
Results: A total of 233 patients (50.6% females) with a mean
age of 77.6±11.0 years were included in the study. A total of 199
instances of infection were diagnosed in 175 (75.1%) of thosepatients; 75.3% of the infections were detected at admission and24.7% during hospitalization. At a cut-off value of 4.82, CRP value
had 81.0% speciﬁcity and 75.4% sensitivity in the diagnosis of in-

fection. Among the patients with infection, there was no difference
between those who died and those who survived in terms ofbaseline CRP level, but a signiﬁcant difference emerged in CRP
level at 48 and 96 hours. Factors which were found to signiﬁcantly
reduce survival time were the presence of chronic kidney disease,chronic obstructive pulmonary disease, hypoxia and tachycardia at
admission, APACHE-II score over 20.5, initial albumin level below
2.44 g/dL, and serum CRP clearance rates of less than 11% at 48
hours and 20% at 96 hours.
Conclusion: In elderly patients with infection, initial CRP value
alone does not have prognostic value, but changes observed inserial CRP measurement are a valid indicator of prognosis.

Area: Longevity and prevention

P-537
A gender perspective on factors affecting quality of life whenbeing a caregiver in old age; Findings from the Swedish National
Study on Aging and Care (SNAC) study
C. Fagerström 1 , L. Sandin Wranker 2 . 1 Blekinge Center ofCompetence, Sweden; Dept. of Health and Caring Sciences, Linnaeus
University, Kalmar, Sweden; 2 Dept. of Health Sciences, Div. of GeriatricMedicine, Lund University, Sweden
Introduction: Elderly persons (60+) are an increasing part of the
population. With higher age follows that more people often needcare. All the care cannot be met by the public health services, why
informal caregiving becomes more and more important, and theglaze often lands on the relatives. In this perspective the careers’
individual health problems such as pain and how it affects thequality of life (QoL) when being a career, need to be addressedand highlighted. In this study, relationships between pain, QoL andtaking care of a relative are investigated gender wise.
Methods: The SNAC random sample (n=3444) comprised individuals, from the southern part of Sweden (SNAC-Blekinge andGÅS-Skåne), aged 60–96 years, of which 54.0% were women. Pain
and QoL (SF-12) were analyzed using descriptive statistics.
Results: In total 395 (11.5%) reported themselves as caregivers andof them 53.7% were women. The male caregivers were more often
married, lived together with someone and reported better ﬁnancial
situation compared to the female caregivers. More than half ofthe caregivers reported pain. Even if the female caregivers wereyounger than the male (68.50 years, SD 8.57, 70.41 years, SD 9.68,
p=0.039) they reported pain in higher intense than the male caregivers, mostly in the back and legs. They also scored lower mental
QoL (53.20, SD 9.22) than the men (54.33, SD 9.08), p<0.003.
Conclusions: Although the women reported higher pain intense,
the association between pain intense and QoL was higher in men(OR 1.32 vs OR1.17).
P-538
A systematic review of the prevalence of oropharyngeal
dysphagia in the nursing home population
D. McCartan, R. Briggs, D. O’Neill. Tallaght Hospital, Dublin
Introduction: Oropharyngeal dysphagia (OPD) is an importantcause of morbidity and mortality in the nursing home (NH) population. We reviewed the literature systematically to determine an
estimate of prevalence of OPD in nursing home populations and to
catalogue the methodology employed in identifying its presence.
Methods: We undertook a systematic review identifying original
research papers that estimated a prevalence of OPD amongst a
general NH population. The databases searched were Pubmed andEmbase with keywords “dysphagia”, “deglutition” and “nursing

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

home”. The inclusion criteria comprised any paper identifying theprevalence of OPD (by any method) in older NH residents. In
addition, we tabulated the methods, where described, of screening
for OPD, and clariﬁed how many reported engagement of Speechand Language Therapists (SLT) in assessment and/or management.
Results: We screened 2562 papers. 33 papers, published between
1996 and 2016, were included in the study with estimates of theprevalence of OPD in the NH population ranging from 12% to 88%.
OPD estimates varied with the investigative methodology usedwith qualitative questionnaires revealing lower estimates to thoseobtained from objective measures. Referral to SLT was reported injust two papers.
Conclusions: The wide range of prevalence estimates found in thissystematic review reﬂects the lack of standardisation in deﬁning,
investigating and managing OPD internationally. There is a need forlarger local and international studies of the prevalence of OPD in
NH residents with the aim of creating a systematic approach to OPD
screening and management in this vulnerable population.
P-539
Ageing cities: Planning with the future in mind
A. Jakupaj, L. Stock. Watford General Hospital
By 2050, 89% of the UK’s population will live in cities and 24%
will be aged over 65 [1–3] There is also increasing recognition
that cities should aim to meet the needs of an ageing population.
The concept of an “age-friendly city” was developed by the World
Health Organisation (WHO). The WHO identiﬁes eight domains ofage-friendly cities that enable older people to participate in all
aspects of life, including social, economic, cultural and civic affairs[4–7]. 210 cities in 26 countries were identiﬁed as part of the Global
Network Initiative of age friendly cities [8], with the USA, Spainand France having the highest number. Twelve cities in the UK are
also members. We have examined the many ways in which twoof these cities have expanded, adapted and progressed to care foran ageing population. We have researched projects and institutions
that have already been set up in the United Kingdom in London
and compared this to the existing social infrastructure in the USA in
Madison, Wisconsin. In conclusion, we found that both the physicaland mental environment play a key role in making cities better
places for older people. Research shows that accessibility and safety
are important factors in making housing, outdoor spaces and transport more age-friendly. Lessons learnt here have a high potential
to be applied throughout the world. This project and recurrent
themes from feedback indicate there is still more to be done - bynational and local government, service providers, employers, andindividuals, to make our cities more age-friendly and supportive ofboth physical and mental wellbeing.
P-540
Arterial hypertension prevalence and blood pressure levels incentenarians: Preliminary results of the Moscow CentenarianStudy
O. Tkacheva 1 , Y. Kotovskaya 2 , N. Runikhina 1 , N. Sharashkina 1 ,V. Ostapenko 1 , D. Kashtanova 1 . 1 Pirogov Russian National Research
Medical University - Russian CLinical and Research Center ofGerontology, Moscow, Russian Federation; 2 RUDN University, Pirogov
Russian National Research Medical University - Russian CLinical andResearch Center of Gerontology, Moscow, Russian Federation
Aim: The number of centenarians is increasing but they are still
underinvestigated population. The aim of the Moscow Centenarian Study (NCT02876809) was to perform complex evaluation ofcentenarians living in Moscow. Preliminary results on arterial hypertension prevalence and blood pressure levels are reported in thisabstract.

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Methods: The study included 82 subjects (10 men) aged from 97
to 105 years living at home. All centenarians were visited by ageriatrician at home for comprehensive geriatric assessment andcardiovascular measurements. Medical history including history ofarterial hypertension and current antihypertensive treatment wascollected during interview with centenarians, their relatives/ carers
and using medical notes if available. Blood pressure (BP) was
measured twice with 1 min interval after at least 7 minutes rest insupine position by BPLab device (Petr Telegin, Nizhniy Novgorod,
Russia) using its oﬃce mode.
Results: Arterial hypertension was reported by 64 (78%) centenarians and 29 (45%) of hypertensive subjects used antihypertensive
drugs. Average supine BP was 147±26/74+14 mm Hg. Minimal
systolic BP was 105 mmHg, maximal 215 mmHg, for diastolic BP
respective values were 30 and 110 mmHg. Systolic BP <120 mmHg
was found in 19%, 120–139 mmHg – in 25%, 140–159 mmHg – in
29%, 160–179 mmHg – in 11%, >180 mmHg – in 16%. Diastolic BP<60 mmHg was observed in 21%, 60–69 – in 3%, 70–79 mmHg
37%, 80–89 mmHg – 25%, 90–99 mmHg in 10%, >100 mmHg in
5%. Predominant type of arterial hypertension is isolated systolichypertension: 41% isolated elevation of SBP, 15% – systolo-diastolichypertension.
Conclusion: The preliminary results of Moscow centenarian Study
demonstrate wide ranges of systolic and diastolic BP in centenarians. BP impact on physical status and cognitive functions should be
evaluated for better understanding of health status in centenarians
P-541
Assessment of awareness of cancer screening of Turkish patients
admitted to geriatric outpatient clinic
H.D. Varan, O. Deniz, S. Kaya, M.C. Kızılarslanoğlu, B. Göker. Gazi
University Faculty of Medicine, Deparment of Internal Medicine,
Division of Geriatric Medicine
Introduction: The aim of this study is to evaluate the awareness ofcancer screening of Turkish geriatric patients.
Material and methods: Patients aged 65 years or older, admitted
to the geriatric outpatient clinic, were included in this study. A
questionnaire assessing awareness of cancer screening were applied
to the patients consequently.
Results: A total of 111 patients were included in this study. Medianage was 72 years (min-max: 65–87) and %56.8 of them were female.
Of all patients, 64.9% had knowledge about cancer screening and37.8% of the patients learned from television, 18.2% of them fromdoctors and 23.2% from their relatives or neighbors. The threemost common cancers known to be screened were lung, breast,and bowel (38.2%, 34.5% and 22%, respectively). When asked tothe patients “have you ever been screened for cancer?” 30% of
the patients answered “Yes”. However, the rate of applying at least
one type of cancer screening tool in medical history was 51.4%of the patients. Three most commonly performed screening tools
were mammography, pap-smear and fecal occult blood test (32.1%,
22.9% and 22%, respectively). While 90% of the patients thoughtthat cancer screening was required and useful, 1.8% thought it was
unnecessary and useless.
Conclusion: It was shown in this study that vast majority of thepatients declared they had knowledge about cancer screening, but
the rates of implementation of these preventive medicine applications were lower than expected. It is important to try to increase
the implementation of preventive medicine in clinical practice.

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P-542
Assessment of physical activity in patients with diabetes
mellitus type 2
M. Daszkiewicz, K. Lindner, R. Bywalec, M. Sobieszczańska. Clinic ofGeriatrics, Wroclaw Medical University, Poland
Introduction: It is known that a regular intensity physical activity has cardioprotective effects, by decreasing atherosclerosis risk
factors, including blood glucose level and insulin resistance.
Methods: A study group consisted of 80 patients (52 womenand 28 men; mean age: 63.6±10.1 years), with deﬁned diabetes
mellitus type 2 (DMt2) lasting up to 7 years (mean: 4.4±2.1 years).
Examined diabetics were treated only with oral hypoglycemic
drugs. Besides the antropometric measurements (BMI, body massindex; WHI, waist hip ratio), biochemical parameters (e.g., fasting
glucose, HbA1c, lipids, hs-CRP), and clinical examinations (RR,
echocardiography, exercise and Holter ECG, and SCORE chart), also
the questionnaire about life style (diet, tobacco smoking, bodymass changes) was proposed to be answered. The questionnaire
concerned also a physical activity of the examined diabetics;
its frequency, intensity and caloric expenditure per week wereassessed.
Results: The average time devoted to physical activity (walking,bicycle riding, garden works) was ca. 2 hours/week (550 kcal),which does not fulﬁll current recommendations. Of 80 patients, 20(25%) did not take up any physical activity. Comparative analysis
showed that the “active” diabetics had signiﬁcantly lower WHR,
lower blood glucose and HbA1c, lower hs-CRP and triglicerydes, aswell decreased blood pressure and lower SCORE results (10.0±8.1 vs17.5±14.3), as compared with the “non-active” diabetics.
Conclusions: The physical activity level in the examined elderly
diabetics was generally unsatisfactory, however even small dosesof exercises proved to be beneﬁcial in context of cardiovascularprevention.
P-543
Assessment of the common predictors and their correlation in
subjective wellbeing among elderly in Bohol, Philippines
J.A. Tariga 1 , J. Cempron-Cutamora 2 . 1 Amana Healthcare Medical andRehabilitation Hospital; 2 Cebu Normal University
Introduction: This study aimed to determine the predictors that
affect the subjective well-being among elderlies. The researchers
intended to evaluate whether selected individual variables (educational attainment, health status, employment status, and presenceof stressors), family variables (marital status, family size, family income, quality of family relationship and family support), andneighborhood variables (social relationships, church attendance, access to amenities/transportation, safe environment and community
participation) inﬂuence the achievement of subjective well-being
among elderlies in Bohol, Philippines.
Methods: The researchers utilized a descriptive correlational design to identify patterns of relationship that existed between thevariables and to measure the strength of the relationship. The study
was conducted in the municipality of Sagbayan, Bohol, Philippines.
The researcher utilized a self-made questionnaire, the Perceived
Stress Scale, Spiritual Well-being Scale and the Satisfaction withLife Scale (SWLS) to gather the needed information relevant to thevariables under study. Multiple regression using the SPSS software
was utilized in the treatment of the data gathered.
Results: It was found out that the mean level of subjective wellbeing among elderly falls under the average level of life satisfaction(4.23) which means that the elderlies are generally satisﬁed withthe different aspects of their lives but there are certain domainsthat they would very much like to improve.
Conclusion: Increased levels of subjective well-being among el-

derly are signiﬁcantly inﬂuenced by age, health status, perceived
stress, community participation, family income and neighborhood
safety. Implications of these results are noted for the developmentof programs and initiatives to enhance subjective well-being among
elderly.
P-544
Awareness of cancer screening and vaccination among Turkish
geriatric patients
H.D. Varan, O. Deniz, S. Kaya, M.C. Kızılarslanoğlu, B. Göker. Gazi
University School of Medicine, Department of Internal Medicine,
Division of Geriatric Medicine, Ankara, Turkey
Introduction: Preventive medicine, including cancer screening andvaccination, is crucial for improving quality of life, as well as
decreasing morbidity and mortality in geriatric patients. The aimof this study is to evaluate the awareness of cancer screening andvaccination among the geriatric patients.
Material and methods: Patients aged 65 years or older, admitted
to the geriatric outpatient clinic, were included in this study.
Demographic characteristics of the patients were recorded. Twoquestionnaires assessing awareness of cancer screening and vaccinations were consequently applied. SPSS 16 version was used forthe statistical analysis.
Results: A total of 111 patients were included in this study. Medianage was 72 years (min-max: 65–87) and 56.8% were women. Of all
patients, 83.6% had information about adult vaccination, however,vaccination rate (at least one kind of vaccine) was 48.2%. Inﬂuenza
was the most frequently known and applied vaccine (59% and 39.1%,
respectively). Adult vaccination had never been recommended to54.1% of the patients previously. Patients were asked if they considered vaccination useful or harmful for older adults. 79% answered“useful”. Of all patients, 64.9% had information about cancer screening and 37.8% learned from television, 18.2% from doctors and 23.2%
from their relatives or neighbors. The three most common cancers
known to be screened were lung, breast, and bowel (38.2%, 34.5%
and 22%, respectively). Patients were asked if they have ever been
screened for cancer, 30% answered “Yes”. However, the rate ofapplying at least one type of cancer screening tool was 51.4% in the
medical history of the patients. Three most commonly performed
screening tools were mammography, pap-smear and fecal occult
blood test (32.1%, 22.9% and 22%, respectively). While 90% of thepatients thought that cancer screening was required and useful,
1.8% thought it was unnecessary and useless.
Conclusion: Majority of the elderly patients declared that they had
knowledge about adult vaccination and cancer screening. However,
the rates of implementation of these preventive applications werelower than expected. Further studies are needed to identify theunderlying factors playing role in low implementation rates despitehigh level of awareness.
P-545
Beneﬁts of a personalized, ergocycle-based endurance training
program in the community-living elderly
C. Schnell, X. Sirlin, A. Derajinski, Y. Groc, Y. Passadori. Groupe
Hospitalier Régional Mulhouse Sud Alsace, Mulhouse France
Introduction: The Centre d’Evaluation et de Remise en Forme(CERF) offers a personalized endurance training program for aged
people with physical deconditioning and living in the Mulhousearea. The substance of the 18 training sessions is established after
a medical examination and a VO2 Max measurement. Ergocyclebased endurance training aims at preserving a good health status,
preventing the development of frailty and promoting the pursuit of
any regular physical activity. The program is achieved in a hospitalenvironment, enabling a continuous monitoring.

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

Methods: This retrospective study based on 2016 data analyses thevariations of hemodynamic and metabolic parameters during the
program. The comparison covers the ﬁrst and last sessions, whose
implementation conditions (developed power and duration) are
identical.
Results: 409 people entered the program. An intermediate sampling, based on 82 patients, with an average age of 67.9 [66; 69,71]
years, shows a signiﬁcant 22% improvement of the endurance,
determined by the ventilatory threshold (VT1) (t=18.509; df=81;
p<0.0001). Furthermore, a mean reduction in heart rate of 5 beats
per minute is observed for a similar effort. However, the forced
vital capacity (FVC) isn’t signiﬁcantly modiﬁed. Final outcomes andanalysis of every metabolic, hemodynamic and spirometric data
will be detailed in the ﬁnal publication.
Conclusion: Entering a managed and personalized training program provides, with only 18 sessions, a signiﬁcant improvement ofendurance. The complete data analysis will allow us to assess theimpact of the medical and sports history on the people’s potential
for improvement
P-546
Blood pressure and 5-years survival of the very elderly treatedhypertensive patients
Y. Kotovskaya 1 , N. Vororbjova 2 , O. Tkacheva 2 . 1 RUDN University,
Pirogov Russian National Research Medical University - Russian
Clinical and Research Center of Gerontology, Moscow, RussianFederation; 2 Pirogov Russian National Research Medical University Russian Clinical and Research Center of Gerontology, Moscow, RussianFederation
The aim of the study was to evaluate impact of on-treatment bloodpressure (BP) level on 5-year total mortality in the very elderly
subjects living in the community.
Methods: One hundred and sixty-three patients (42 men) aged
75–98 years (mean age 87,5±3,5 years, 28% were 90 years andolder, 94% received antihypertensive treatment) were followed-up.
Baseline systolic BP (SBP) was 137±16 mmHg, diastolic BP (DBP) was
77±10 mmHg, pulse pressure (PP) was 60±13 mmHg. Kaplan-Meieranalysis and Log Rank (Mantel-Cox) test were applied to evaluate
5-years survival of patients.
Results: Baseline SBP varied from 100 to 200 mmHg (median (Me)
140 mmHg, interquartile range (IQR) 130–140 mmHg), DBP wasfrom 50 to 100 mmHg (Me 80 mmHg, IQR 70–80 mmHg), PP
varied from 30 to 100 (Me 60 mmHg, IQR 50–70 mmHg). Patients
distribution by SBP level: <130 mmHg was observed in 20,9%,
130–139 – in 21,5%, 140–149 – in 42,3%, 150–159 – in 11,7%, >160
– in 7,9%. Me of follow-up was 3,83 years (min 2 weeks, max 5,43
years, IQR 3,11–4,42 years). Sixty-ﬁve (40%) patients died. There
was no signiﬁcant difference in SBP, DBP and PP between those
who died or survived. Kaplan-Meier survival curves revealed nosigniﬁcant relationship between SBP, DBP and PP values above or
below median value: for SBP χ2 =0,017, p=0,897; for DBP χ2 =0,047,
p=0,828; for PP χ2 =1,67, p=0,196.
Conclusion: The study revealed no signiﬁcant impact of BP on 5years survival of the very elderly hypertensive subjects with treated
and well-controlled according to the current European guidelines
on arterial hypertension. Additional factors should be considered todetermine predictors of survival in this population.
P-547
Cardiovsacular risk factors and diseases in centenarians:
Preliminary results of the Moscow Centenarian Study
O. Tkacheva 1 , Y. Kotovskaya 2 , N. Runikhina 3 , N. Sharashkina 3 ,D. Kashtanova 3 , V. Ostapenko 3 . 1 Pirogov Russian National Research
Medical University - Russian Clinical and Research Center of

S197

Gerontology; 2 RUDN University, Pirogov Russian National Research
Medical University-Russican Clinical and Research Center ofGerontology; 3 Pirogov Russian National Research Medical
University-Russican Clinical and Research Center of Gerontology
Aim: The number of centenarians is increasing but they are still
an underinvestigated population. Traditionally centenarians are
considered to be an example of “healthy aging” meaning people
free from cardiovascular diseases with favorable cardiovascularrisk factors proﬁle. The aim of the Moscow Centenarian Study(NCT02876809) was to perform complex evaluation of centenarians
living in Moscow. Preliminary results of analysis of cardiovasculardisease and risk factor prevalence are reported in this abstract.
Methods: The study included 82 subjects (10 men) aged from97 to 105 years living at home. All centenarians were visitedby a geriatrician at home for comprehensive geriatric assessment
and cardiovascular measurements. Medical history evaluations was
based on medical notes (presumably) and/or interview with centenarians, their relatives/carers. Blood samples for metabolic risk
factors assessment were obtained in fasting conditions.
Results: Positive medical history of arterial hypertension was foundin 64 (78%) centenarians, coronary heart disease in 52%, documented history of myocardial infarction in 20%, chronic heart
failure in 32%, stroke 21%, peripheral arterial disease in 4%, diabetes
mellitus in 4%. The use of antihypertensive drugs was reported by
35%, statins by 4%, aspirin by 18%. Mean fasting glucose was 4,98±1,9mmol/l, HbA1c 5,88±0,58%. Lipid proﬁle was evaluated in 64 centenarians: total cholesterol (TCh) 5,04±1,18 mmol/l, triglyicerides (Tg)
1,09±0,36 mmol/l, LDL 3,26±0,92, HDL 1,37±0,36 mmol/l. TCh >5,0mmol/l were observed in 14 (22%) centenarians, Tg>1,7 mmol/l in 1(2%), LDL>3,0 mmol/l in 17 (27%), low HDL (<1,2 in female, <1,0 inmale) in 28 (44%).
Conclusion: The preliminary results suggest that Moscow centenarians are not free from cardiovascular disease though cardiovascularrisk factors prevalence seems to be signiﬁcantly lower than usually reported for elderly and very elderly population. Exceptional
longevity achieved by the evaluated people may suggest thatthey have protective mechanisms against long-term exposure to
cardiovascular risk factors.
P-548
Cohort study of the oldest-old of Japan: the Arakawa 95+ study
H. Niimura 1 , Y. Eguchi 1 , H. Kida 1 , W. Nishimura 1 , M. Takayama 2 ,M. Mimura 1 . 1 Department of Neuropsychiatry, Keio University Schoolof Medicine, Tokyo, Japan; 2 Department of Foreign Language andLiberal Arts, Keio University School of Science and Technology,
Yokohama, Japan
Introduction: In Japan, with the progressive ageing of society, thepopulation of the oldest-old is expected to increasing, however, thecharacteristics of this population remain to be precisely studied. We
established a population-based cohort of persons aged 95 years orolder (95+) and conducted a baseline survey.
Methods: The subjects of this study were the residents of Arakawa
ward in Tokyo who were 95+ years old on January 1st 2016, andprovided informed consent for participation in this survey. We
mailed questionnaires to assess their physical, mental and social
health-related factors. We visited homes or nursing homes andconducted face-to-face interviews with the participants who provided responses to our questionnaires, and assessed their mental
health, cognitive function and physical functioning. We also mailed
simpliﬁed questionnaires to those subjects who did not respond to
the full questionnaires.
Results: Of the 210,000 residents of Arakawa ward, 50,000 were65+ years old and 542 were 95+. We excluded dead residents,
mailed 457 questionnaires, received 40 replies, and visited 26

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participants. We mailed 363 simpliﬁed questionnaires, to which
128 provided responses. The mean age of the responders (N=168)
was 98.5±2.4 years. The diagnoses in the 26 participants that wevisited (97.7±2.1 years old) were as follows; dementia, 9 (35%);
dementia+depression, 3 (12%); mild cognitive disorder (MCI), 10(39%); MCI+dementia, 2 (8%); normal health, 7 (27%).
Conclusions: The participants of the questionnaire survey andface-to-face interviews were healthier than the non-responders.
The diagnostic criteria for dementia in the oldest-old should be
discussed from the perspective of their social function level.
P-549
Creativity and well-being in older adults: a correlational study
C. Cristini 1 , F. Nannini 2 , G. Cesa-Bianchi 3 , E. Bologna 4 , E. Riva 1 ,M. Cesa-Bianchi 3 , A. Antonietti 2 . 1 University of Brescia, Italy;
2 Catholic University of the Sacred Heart, Milan, Italy; 3 University of
Milan, Italy; 4 Fondazione Ferrero, Alba, Italy
Objectives: During the old stage of life, creativity helps individuals
to be active and stimulates skills and capabilities that are declining.
In addition, it leads people to ﬁnd a new meaning in their life. Being
creative, as many artists and scientists showed, enable persons toconsolidate and improve well-being, overall when cognitive functions are concurrently trained. The aim of this study was to assess
possible relations between creativity and well-being in the elderly.
Methods: A sample of 139 adults, aged 60–85 yrs, were involvedin the investigation. Part of them were living at home and theother part were hospitalized. They were administered two tools
to measure the inclination to activate creative thought processes(WCR test) and the ability to elaborate stimuli in a divergent way (asubtest from the TTCT) and the self-report scale “Satisfaction With
Life”.
Results: Positive correlations between the creative measures andthe level of life satisfaction emerged. Different patterns of correlations according to the age level of participants were found,supporting the notion that creativity play different functional roles
in supporting subjective well-being. Differences in both creativity
attitude and skills, as well as in well-being, due to hospitalization
were recorded.
Conclusion: Findings showed that creativity, thanks to the opportunity to focus on curiosity and passions it promotes, allows elderly
people to achieve goals and look for new experiences, thus realizingthemselves. In addition, the creative attitude leads affective relations to grow so that people are motivated in living, learning, anddiscovering.
P-550
Effect of haptic supplementation provided by a cane on posturalcontrol and gait parameters during locomotion in older adults
M. Vintrou 1 , C. Amiot 2 , A.-L. Couderc 2 , A. Amranie 2 , B. Aymes 2 ,P. Villani 2 , J.-J. Temprado 3 . 1 AP-HM, Hôpital Sainte Marguerite,
Service de recherche clinique, Pôle gériatrique, Marseille France;
2 AP-HM, Service de Médecine Interne Gériatrie et Thérapeutique,Hôpital Sainte Marguerite, Marseille, France; 3 Aix Marseille Univ,
Institut des Sciences du Mouvements, UMR 7287, Marseille, France
Many older adults who use a cane to move, use it to slightly touch
the ground rather than as mechanical support. The present study
aimed to assess the beneﬁts of these different uses. 17 participants(6 women, 11 men; age: 83.1±5) were included in the experiment.
As a preamble, we veriﬁed that the participants were sensitive tohaptic supplementation in a static postural task paradigm inspired
from Albertsen’s study. Then, three walking conditions were completed, at preferred speed, on the GAITRite walkway: without cane(WC1), with a cane used as mechanical support (WC2) or as lighttouch (WC3). Gait speed, cadence, stride length, Basis of Support(BS), stance time (in % of gait cycle), and acceleration of Centerof Mass (CoM) were measured. Results showed that gait speed,
cadence, and stance phase were deteriorated in WC2 and WC3,
relative to WC1. No difference was found between WC2 and WC3.
Stride length decreased with light touch as compared to simple
walking. No signiﬁcant difference was found between WC2 andWC1. Finally, the amplitude of the CoM in AP direction signiﬁcantly
increased in WC2 relative to WC1. No effect of light touch was
found. These results suggest that using a cane deteriorates gaitparameters, independent of the type of use. Notably, only cane use
as mechanical support improves the control of the center of massin the anteroposterior direction. The question remains however ofwhether a longer period of familiarization of cane use could resultin positive effects.
P-551
Elderly falls in Turkey: A review
B.T. Dikmen, N. Bayraktar. Near East University, Nicosia, Cyprus
Introduction: Falls which are important health problems of older
adults result in medical and socio-economic burden. This problem
may cause to increase in mortality rates, disability and dysfunction,
anxiety and depression, loss of conﬁdence, and post-fall syndrome
and reduced quality of life among the elderly people. This review
provides an overview to studies about elderly falls in Turkey.
Methods: A literature search (2006–2017) was carried out, using
MEDLINE, CINAHL, Pub Med, Science direct, Web of Science, Scopus,
Cochrane library, Turkish Medical Index and related institutional
websites. Key words included “Older adults”, “Elderly”, “Falls”.
Results: It was determined that the studies were conducted between 2006 and 2017; a prospective study was about identifying
risk of falls in elderly, a cross-sectional study was about complete
comprehensive geriatric assessment and questioned for fall history,
three of the descriptive study was about evaluation of balance inelderly fallers and frequency, features, and related factors for falls ina group of subacute stroke patients, two prospective, single-blind,randomized and controlled trial was about comparison of theeffectiveness of programmes on older adults at risk of falling.
Conclusions: Especially we realized that it was a important problem in Turkey and there was insuﬃcient as a number of studies.
This review explored that we need more studies about falls in
geriatric patient Turkey. It could be a reference for future studies.
P-552
Elderly people as vulnerable group in disasters
N. Bayraktar, Ü.D. Yılmaz. Near East University Faculty of Health
Sciences, Nursing Department, Nicosia, Turkish Republic of Northern
CyprusIntroduction: Disasters are extraordinary and catastrophic events
that occur somewhere in the world every day. The World Disasters
Report noted a 60% increase in disasters in the last decade. Disasters result in high numbers of deaths and injuries, and economic
loss. Elderly people are among the most vulnerable population fordisasters. This review provides an overview to relevant literature on
elderly people as vulnerable group in disasters.
Methods: A literature search (2000–2017) was carried out, using MEDLINE, Pub Med, Science direct, Scopus, Cochrane library,
Turkish Medical Index and related intuitional websites. Key words
included “Older adults”, “Elderly”, “Disasters”, “Vulnerable groups”.
Results: Several studies have found that older adults are more
affected by disasters compared with younger people. Disasterstatistics frequently demonstrate higher mortality and morbidity
rates for older adults. In the 2011 Japanese Tsunami, 77% of diedpeople were elderly. This group is more vulnerable to the negative
impacts of disasters due to biological, psychological and social

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changes associated with aging. Having the highest prevalence rates
for multiple chronic conditions, limitations in activities of dailyliving, physical and cognitive disabilities, and sensory impairments
makes older adults particularly vulnerable to physiological stresses
during disasters.
Conclusions: Despite greater vulnerability to disasters, most fatalities, injuries, and damage caused by disasters are preventable.
Preparing older adults for disasters with comprehensive disastermanagement plans may improve the health-related quality of lifeof older people and, thereby may reduce the damage that occurs in
disasters.
P-553
Engaging older people with health data and technologies –a citizen engagement project
J. Taylor 1 , T. Tay 2 , L. Hassan 1 , K. Holmes 1 , S. van der Veer 1 . 1 Healthe-Research Centre, Farr Institute for Health Informatics Research,
University of Manchester, Manchester, UK; 2 School of Medicine,
University of Manchester, Manchester, UK
Introduction: Engaging older people with health data and technologies research is challenging. We designed a public engagement
project that aimed to capture older people’s view through a novel
technique know as “community reporting”. Community Reporters(CR) is an open platform, global interface that allows members of
the public to upload their personal stories as short video recordings
onto the web.
Method: CR training was held over a 6-week period. Participants
were taught to create, edit and upload their own videos. Their ﬁrst
CR project was based on the “health data” theme. Participants werealso provided with “smart watches” (accelerometer based activity
trackers) and encouraged to create videos documenting each others
experiences.
Results: All 18 participants created video content despite variable
familiarity with technology. Over 30 videos are available to viewon the CR website (https://communityreporter.net, datasaveslives
project). Motivators to engagement with health data and technology
included: intrigue into personal data, a desire to collect objective
data to inform health professionals, and perceived beneﬁt of thedevices as part of a positive personal attitude to health. Trepidation
related to unfamiliar technologies was a common theme, withmany participants highlighting the need for dedicated support inany future research projects. A survey of participants whom undertook the CR training reported the programme was both enjoyable
and worthwhile.
Conclusions: This project has highlighted multiple motivators andbarriers to engagement with health data and technologies researchby older communities. The CR scheme can be used as an effective
public engagement technique.
P-554
European pattern of pleasure for elderly: A cross-sectional study
about well-being representations
P. Denormandie 1 , A. Letty 2 , S. Sanchez 3 . 1 Institut du Bien Vieillir;
2 Institut du Bien vieillir; 3 Centre hospitalier de Troyes
Introduction: Since a few years concepts such as “ageing in health”,“ageing with success”, ageing with “high function level” or “ageingwell” are frequently used.
Objective: The main goal of our survey was to describe the representation of pleasure and their patterns in the population over
65 years old in 4 European countries. The second aim of our study
was to create a pattern of representation by country in the elderly
population to individualize, for each country analyzed, their own
features.
Results: Our results showed different typology concerning the way

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of “living Well, ageing Well” and also more or less surrounded byrelatives. The geographic typology of approach enables us to differentiate speciﬁc proﬁles from “fragile and aged” to “familial hedonist” with, in the middle, the “sociable” and the “independent” ones.
Discussion: Well ageing is a large deﬁnition depending on various
items including the state of mind. Designing a category in which thepatient could be placed, could lead to a better global health caring.
As a preventive action, public health politicy could be including
those descriptions to improve the well ageing of elderly.
P-555
Evaluation of osteoporosis among inpatients with hip fracture –a quality improvement intervention
L. Gustavsson, A. Koldestam. Sahlgrenska University hospital, Sweden
Background: Osteoporosis is an undertreated condition in Sweden. 12% receive bone-speciﬁc treatment following an osteoporosis
related fracture, according to The National Board of Health andWelfare.Geriatric Medicine Mölndal (GER-SU/M) is the center for all
hip fractures (HF) at Sahlgrenska University Hospital (SU), a 2000bed teaching hospital in Western Sweden.Fracture liaison service(FLS) is a model of care to identify persons with osteoporosis after
a low impact fracture. An FLS was introduced at SU in 2014 andwas extended to cover hospitalized HF patients at GER-SU/M in2015. The aim of this study was to evaluate the impact of a basic
FLS, consisting of a standard protocol for blood chemistry tests andﬂowcharts to support individualized treatment recommendations,on the quality of osteoporosis care after HF.
Methods: We performed reviews of medical records of all HF
patients in deﬁned periods comprising 12–16 weeks/year 2015
(year 1) and 2016 (year 2), with December 2014 considered baseline. Outcome was deﬁned as number of documented osteoporosis
assessments and bone-speciﬁc treatment at discharge.
Results: The proportion of documented osteoporosis assessment
was 24% (10/42) at baseline, increased to 82% (293/359) in year
1 and to 93% (224/242) in year 2 (p-value for trend <0.001).
Treatment rates were 9.5% (4/42) at baseline, 18% (64/359) in year
1 and 29% (70/242) in year 2 (p<0.001).
Conclusions: After introduction of the FLS the number of osteoporosis assessments among patients with HF has signiﬁcantly
increased, as well as the proportion of in hospital initiated treatments.
P-556
Exercise patterns in older adults randomized to moderate- or
high- intensity training: The Generation 100 study
L. Skarsem Reitlo 1 , H. Viken 2 , N.P. Aspvik 3 , J.E. Ingebrigtsen 3 ,S. Bucher Sandbakk 4 , X. Tan 5 , U. Wisløff 2 , D. Stensvold 4 . 1 K.G.
Jebsen Center of Exercise in Medicine at Department of Circulation andMedical Imaging, Norwegian University of Science and Technology,
Trondheim, Norway; 2 K.G. Jebsen Center of Exercise in Medicine at
Department of Circulation and Medical Imaging, Faculty of Medicine,
Norwegian University of Science and Technology, Trondheim, Norway;
3 Department of Sociology and Political Science, Faculty of Social
Sciences and Technology Management, Norwegian University of
Science and Technology, Trondheim, Norway; 4 K.G.Jebsen Center of
Exercise in Medicine at Department of Circulation and Medical
Imaging, Faculty of Medicine, Norwegian University of Science andTechnology, Trondheim, Norway; 5 Department of Neuroscience,
Faculty of Medicine, Norwegian University of Science and Technology,
Trondheim, Norway
Introduction: Few studies have investigated how older adults exercise when they are not under controlled laboratory settings. The
aim of this study was to describe the exercise patterns among older
adults randomized and instructed to perform moderate- intensity

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training (MIT) or high- intensity training (HIT) over a one year
period.
Methods: Frequency, rating of perceived exertion, type, locationand social setting of exercise were assessed using exercise logs from
618 older adults (70–77 years, 291 women) randomized to MIT or
HIT. Participants completed exercise logs after each exercise session
they performed during one year.
Results: The mean number of exercise sessions per week was
2.2±1.3 in both training groups with 1.3±0.8 versus 0.4±0.5 performed with high intensity in HIT and MIT, respectively. Walking
was the most common type of exercise in both groups, but MIT
had a higher proportion of sessions with walking and resistancetraining than HIT, while HIT had a higher proportion of sessions
with jogging, cycling, swimming, dancing and combined endurance
and resistance training. Exercise location was most often reported
to be outdoors in both groups, but HIT exercised more frequently ata gym or sports facility than MIT. Both groups performed an equalamount of exercise sessions alone and together with others.
Conclusions: This study provides new knowledge of how older
adults included in an exercise randomized controlled trial exercise
in a free- living situation. Our ﬁndings indicate that older adults
randomized to MIT versus HIT have different exercise patterns.
P-557
Growth hormone, insulin-like growth factor-1, insulin resistanceand leukocytes telomeres length as determinants of vascular
aging in subjects free of cardiovascular diseases
I.D. Strazhesko 1 , O.N. Tkacheva 2 , E.N. Dudinskaya 2 ,A.S. Kruglikova 3 , D.U. Akasheva 3 , E.V. Plokhova 3 ,N.V. Sharashkina 2 , N.V. Brailova 4 , V.S. Pykhtina 3 , O.Y. Isaykina 3 ,M.S. Pokrovskaya 3 , V.A. Vygodin 3 , D.A. Skvortsov 3 , S.A. Boytsov 3 .
1 National Center for Preventive Medicine, Moscow, Russia, Lomonosov
Moscow State University, Moscow, Russia; 2 The Pirogov Russian
National Research Medical University, Moscow, Russia; 3 National
Center for Preventive Medicine, Moscow, Russia; 4 The Pirogov Russian
National Research Medical University
Introduction: Increased carotid-femoral pulse wave velocity (c-f
PWV), intima-media thickness (IMT), atherosclerotic plaques number (ASP) are considered as important aspects of arterial aging basis for cardiovascular diseases (CVD). Growth hormone (GH) andinsulin-like growth factor (IGF)-1 deﬁciency and “short” leukocytes
telomeres length (TL) have been proposed as independent predictors of CVD. The aim of this study was to determine the role of
GH/IGF-1 in their interaction with TL and cardiovascular risk factors
in vascular aging process.
Methods: The study group included 303 participants (104 males
and 199 females) mean age 51.8±13.3 years, free of known CVD,
diabetes mellitus, antihypertensive and lipid lowering medications.
IMT and ASP were determined by ultrasonography in both left
and right carotid arteries. c-f PWV was appreciated with thehelp of SphygmoCor (AtCor Medical). TL was determined by qPCR.
Serum IGF-1 and GH we measured using immunochemiluminescentanalysis.
Results: Through multiple linear regression analysis, in “younger”
group (mean age 40.9±8.7, n=144) unlike the “older”, GH/IGF-1 weresigniﬁcantly associated with arterial wall characteristics. C-f PWV
was positively associated with HOMA-IR (p<0.0001) and negatively
associated with GH (p=0.03) and TL (p=0.004). IMT was positively
associated with HOMA-IR (p=0.0001), negatively associated withGH (p=0.05) and IGF-1 (p=0.004). ASP was positively associatedwith HOMA-IR (p=0.0001) and negatively associated with IGF-1(p=0.045).
Conclusions: 1. GH/IGF-1 along with insulin resistance and TL determine the main parameters of arterial aging in healthy participants2.
GH/IGF-1 axis demonstrates vascular protection in aging

P-558
Healthy Ageing Through Internet Counselling in the Elderly(HATICE) – an ongoing randomised controlled trial
N. Coley 1 , S. Andrieu 1 , F. Mangialasche 2 , M. Barbera 3 ,C. Beishuizen 4 , C. Brayne 5 , W.A. van Gool 6 , J. Guillemont 7 ,S. Jongstra 6 , E.P. Moll van Charante 8 , T. van Middelaar 6 , L. van
Wanrooij 6 , M. Hoevenaar-Blom 6 , T. Ngandu 9 , B. van de Groep 10 ,Y. Meiller 11 , H. Soininen 3 , M. Kivipelto 12 , E. Richard 13 . 1 INSERM,
University of Toulouse UMR1027; Department of Epidemiology andPublic Health, Toulouse University Hospital, Toulouse, France; 2 Aging
Research Center, Karolinska Institutet/Stockholm University,
Stockholm, Sweden; 3 Institute of Clinical Medicine/Neurology,
University of Eastern Finland, Kuopio, Finland; 4 Department of
Neurology, Academic Medical Center, University of Amsterdam;
Department of General Practice, Academic Medical Centre, Universityof Amsterdam, Amsterdam, The Netherlands; 5 Department of Public
Health and Primary Care, Cambridge Institute of Public Health,
University of Cambridge, United Kingdom; 6 Department of Neurology,
Academic Medical Center, University of Amsterdam, Amsterdam, The
Netherlands; 7 INSERM, University of Toulouse UMR1027, Toulouse,
France; 8 Department of General Practice, Academic Medical Centre,
University of Amsterdam, Amsterdam, The Netherlands; 9 Chronic
Disease Prevention Unit, National Institute for Health and Welfare,Helsinki, Finland; 10 Vital Health Software, Ede, The Netherlands;
11 Department of Information and Operations Management, ESCP
Europe, Paris, France; 12 Institute of Clinical Medicine/Neurology,
University of Eastern Finland, Kuopio, Finland;Chronic Disease
Prevention Unit, National Institute for Health and Welfare, Helsinki,
Finland; Division of Clinical Geriatrics, Department of Neurobiology,
Care Sciences and Society, Karolinska Institutet, and Karolinska
University Hospital, Stockholm, Sweden; 13 Department of Neurology,
Academic Medical Center, University of Amsterdam, Amsterdam;
Department of Neurology, Donders Institute for Brain, Cognition and
Behavior, Radboud University Medical Center, Nijmegen, The
Netherlands
Background: Cardiovascular disease (CVD) and dementia share
several risk factors. It is unknown whether treatment of thelatter reduces the risk of dementia. eHealth offers opportunities
for large-scale delivery of prevention programs encouraging selfmanagement of risk factors. We aim to investigate whether amulti-domain internet intervention to optimise self-managementof cardiovascular risk (CVR) factors can reduce the risk of CVD,
cognitive decline and dementia.
Methods: We developed and currently test in the Netherlands,
Finland and France an internet intervention in a multi-centre,
prospective, randomised, open-label blinded endpoint trial with
18-months intervention in persons aged 65 and older with increased CVR. The intervention group uses an interactive internet
platform with coach support to stimulate a healthy lifestyle. The
control group has access to a static platform. Primary outcome is acomposite score of systolic blood pressure, low-density-lipoprotein
and body mass index. Main secondary outcomes include effect on
CVR factors, incident CVD, mortality, cognitive functioning, moodand cost-effectiveness.
Results: Between March 2015 and September 2016 we recruited
2725 persons. Median age is 69, 40% has higher education and
30% has a history of CVD. During the ﬁrst 12 months of the trial,
adherence to the intervention was good with over 50% logging in atleast 5 times per 3 months. Follow-up will end in January 2018.
Conclusions: A large multi-national trial using an internet intervention to improve CVR proﬁle is feasible. Whether this leads toa reduced risk of CVD and dementia is under investigation. Final
results are expected in mid 2018.

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P-559
Heart structure and function in centenarians: preliminary
results of Moscow Centenarian study
Y. Kotovskaya 1 , O. Tkacheva 2 , N. Runikhina 2 , D. Akasheva 3 ,N. Sharashkina 2 , V. Ostapenko 2 , S. Boytsov 3 . 1 RUDN University,
Pirogov Russian National Research Medical University - Russian
Clinical and Research Center of Gerontology, Moscow, RussianFederation; 2 Pirogov Russian National Research Medical University Russian Clinical and Research Center of Gerontology, Moscow, RussianFederation; 3 National Center of Preventive Medicine, Moscow, RussianFederation
Objective: Centenarians are still represent an underinvestigatedpopulation. There is large body of data on heart structure andfunction changes with ageing, but very few data available for centenarians. The aim of the Moscow Centenarian Study (NCT02876809)
was to perform complex evaluation of centenarians living in
Moscow. Preliminary results of echocardiograhy are reported in thisabstract.
Methods: Echocardiography was performed with a portable device
In 64 (8 male) aged from 97 to 105 years. Medical history including
history of arterial hypertension, myocardial infarction, heart failureand current treatment was collected during interview with centenarians, their relatives/ carers and from medical notes if available.
Aorta diameter, left atrium size and volume index (LAVI), systolicand diastolic dimensions and volumes of left ventricle (LV), LV massindex (LVMI), ejection fraction (EF) were evaluated. LV hypertrophy
was diagnosed if LVMI was >95 g/m2 in females or >115 g/m2
in males, concentric LV geometry if relative wall thickness (RWT)>0,42. LV-arterial coupling was calculated as Ea/Ees, Ea=end systolic pressure (ESP)/stroke volume, Ees=ESP/end systolic LV volume.
Ea/Ees 0,5–1,2 was considered as optimal. The data are presented
as Mean+SD Results. Mean aortic root diameter was 3,5±0,34 cm
and in 8 (12,5%) subjects exceeded 3,8 cm. Mean LAVI was 41,8+14,3
ml/m2 and was moderately-to-severe abnormal (>42 ml/m2 ) in 28(43,75%) subjects. Normal LVMI and RWT was found in 13 (20,3%)
centenarians. Concentric LV remodeling was observed in 15 (23,4%),concentric LVH 24 (37,5%), eccentric LVH in 12 (18,7%). Two subjects
had EF <40% (history of MI in both), 62 subjects had EF >50%.
Structural abnormalities typical for heart failure with preserved EF(LV end diastolic volume <97 ml/m2 and LAVI>34 ml/m2 or LVH)
was observed in 46 (71,9%) centenarians. Ea/Ees <0,5 was observedin 11 (17,2%) subjects, and Ea/Ees>1,2 - in 2 (3,1%) subjects.
Conclusion: LV structure of centenarians is characterized by concentric LV geometry in 50,9%. Despite high prevalence of the heart
structure typical for heart failure with preserved EF majority ofcentenarians have normal values Ea/Ees.
P-560
Hip fracture in older age caused by a decline of cognitive andcardiovascular functions
R. Csanády-Leitner 1 , H.K. Lackner 1 , W. Maurer-Ertl 2 , F.J. Seibert 2 .
1 Dept. Phys., Med. Univ. Graz, Austria; 2 Dept. Orth. & Trauma Surg.,Med. Univ. Graz, Austria
Introduction: Health status is positive related to cognitive andcardiovascular functions in older age. A decline of this performancelead to hip fractures often triggered by falls. Evaluating the potential differences between patients of femoral fracture (FF) andcoxarthrosis surgery (CS) cognitive and cardiovascular functions
including fall analyses were studied.
Methods: Men and women according to hip replacement due toFF after falls and CS recruited at the Medical Clinic Centre Graz
were investigated from October 2016 till May 2017. Testing time
was between the third and tenth day after surgery. Data were collected, following a special timeline and circadian rhythms, using a

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cognitive performance battery (CPB) – Stroop Test. Continuous ECG
recordings during performance were conducted associated withdata collection in BMI, wade circumference, fear and frequency offalls.
Results: 86 patients between 60–85 years with FF (n=25), CS (n=36)
and control group (n=25), mean age+SD=73.1±7.0 years were tested.
Results of CPB indicated signiﬁcant differences in the FF group compared to the other groups testing the interference of Stroop Test,
H(2)=25.995, p<0.00 as well as heart rate variability parameters likeaverage RR (ms), H(2)=15.149, p<0.001. Furthermore frequency andfear of falls were signiﬁcant higher, BMI and wade circumference
signiﬁcant lower in the FF group.
Conclusions: Results of this pilot study show signiﬁcant differencesamong the groups related to cognitive and cardiovascular functions.
Based on these preliminary ﬁndings we are encouraged to test morepatients detecting potential distinctions to lower risk of falls andfractures in the future.
P-561
Human longevity – Are we ready to go for it?
K. Piotrowicz 1 , J. Baran 1 , K. Bierau 2 , A. Chan 2 , T. Grodzicki 1 .
1 Jagiellonian University Medical College, Kraków, Poland; 2 Percuros,

Leiden, Netherlands
Introduction: Secret of longevity in humans is a burning but stillunanswered question.
Methods: CHARMED Project, designed as a Research and Innovative
Staff Exchange (RISE), intends to characterize a green microenvironment of the small community of the Marches Region in Italy(Nemi town), and study its impact on health and well-being ofolder adults as a way forward for health tourism dedicated to andtailored for old people. 4-step scientiﬁc research is expected: 1) To
characterize local ecosystem of Nemi (the climate, air quality, noiselevels and ﬂora- with the use of, inter alia, optical spectroscopy and
UV-Vis and NIR spectrometers) and its impact on health and qualityof life of elderly people from the local community (the customized
questionnaires, salivary and blood samples for immune status andstress monitoring, function and blood tests); 2) To analyze target
population of elderly visitors to Nemi and to identify their speciﬁc
needs (health analytics, oxidative stress markers and immune components); 3) To implement landscaping and urban infrastructurechanges, as well as social and therapeutic horticulture, food lessons
and dietary counseling, and physical exercises personalized forelderly visitors; 4). To analyze the economic impact of implemented
strategies and to calculate health cost beneﬁts.
Results and conclusions: We aim to achieve an innovative transfer
of knowledge and interactions between academic experts as well
as different organizations from non-proﬁt, public and industry,
to create an inventive social-economic infrastructure for health
tourism based upon environmental-impacting factors for improving
the physical and psychological well-being of older individuals.
Acknowledgements: The CHARMED project is funded by the European Commission under the Marie Sklodowska Curie Actions RISE
program from 2017 to 2020.
P-562
Impact of environmental modiﬁcations on the quality of life ofresidents with dementia
D. Curto 1 , P. Cano 1 , C. Garcia 1 , J.F. Tomas 2 , M. Cuesta 2 . 1 Sanitas
Mayores Sanitas ELA-Bupa; 2 Sanitas ELA-Bupa
Introduction: An ongoing initiative which carries out transformations and adaptations of spaces in our care homes so thatthese areas increasingly respond to the necessities and functional,
environmental and comfort requirements of residents living withdementia, their families, as well as the people who work in them.

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Methods: Many improvements have been carried out in many carehomes, some small, others more ambitious, from refurbishments ofbedrooms, bathrooms, dining rooms and lounges to the creation of
new areas such as terraces, bathrooms, staff rooms and adaptationsof dementia ﬂoors.
Results: Dementia care means a continued reformulating global
model, to adapt dementia ﬂoors to the necessities of our residents with dementia, covering: the adaptation of the physicalenvironment in common areas, corridors, creation of Snoezelen
rooms (multisensory rooms), bathrooms and bedrooms. A pilot
programme in a care home in the dementia ﬂoor has undergone
the following changes:• Adaptation of the corridors (materials, lighting etc).
• Elimination of the nurses’ station, (tablets are now used for thiscontrol), in order to create a rest point simulating a natural spacewith benches to rest on and also to receive therapies, as wellas having natural sounds emanating from inbuilt speakers at all
times. The pillars are decorated in such a way as to simulate
trees and on touch seem real – they even have moss interspersedwith the bark.
• Concealment of elements which are susceptible to generatingstressful situations, like lift doors and emergency exits.
Conclusions: An environmental refurbishment centered on the dementia residents needs results in a reductions of critical incidents(falls, severe consequences, a reductions od psychoactive drugs)
that allows a better care and an improvement of quality of life ofresidents.
P-563
Investigation of cognitive function in the oldest-old using ACE-III
Y. Eguchi, N. Hirose, H. Niimura, Y. Arai, M. Mimura. Keio University
School of Medicine, Tokyo, Japan
Introduction: Though ageing is the greatest risk factor for the
onset of dementia, some of the oldest-old have comparatively wellpreserved cognitive function and appear capable of performing
complex tasks. We used Addenbrooke’s Cognitive Examination-III(ACE-III) to investigate cognitive function in the oldest-old, which
has not been fully elucidated.
Methods: ACE-III was administered to community-living oldest-old(aged 90 years and centenarians) who consented to participate.
Results: Participants were eleven subjects in their 90s, with a mean
age of 93.2 years (range, 92–95 years) and 7 centenarians, witha mean age of 106.6 years (range, 105–108 years). The 90s group
scored high on the mini-mental state examination, conﬁrming theabsence of dementia. The mean total ACE-III score of the 90s group
was 88.1, which was above the cut-off score indicating dementia;that of the centenarians was 51.9, which was below the cut-off
score. All subjects were able to perform visual counting (a visuospatial subtest involving counting the number of black dots without
pointing), with a mean correct response rate of 95.8%.
Conclusions: The scores on the ﬁve cognitive domains of ACE-III
in the 90s group indicated almost an intact cognitive functioning
except for ﬂuency and memory, and in centenarians, an overall
decline with a particularly marked decrease in memory. Only visualcounting had a high correct response rate, suggesting that the visualﬁeld of the oldest-old was relatively unaffected by ageing and brain
degeneration. This study showed details of cognitive function in theoldest-old using ACE-III.
P-564
Is it feasible to evaluate ageing process by creating a single
health metric? The ATHLOS Project approach
G. Soulis 1 , F.F. Caballero 2 , A. Sánchez-Niubó 3 , J.L. Ayuso-Mateos 2 ,J.M. Haro 3 , S. Chatterji 4 , D. Panagiotakos 1 . 1 Department of Nutrition

and Dietetics, School of Health Science and Education, Harokopio
University, Athens, Greece; 2 Department of Psychiatry, Universidad
Autónoma de Madrid, Madrid, Spain; 3 Parc Sanitari Sant Joan de Déu,
Barcelona, Spain; 4 Information, Evidence and Research, World HealthOrganization, Geneva, Switzerland
Introduction: Ageing is a complex phenomenon that is unique foreach individual. It can be viewed as a continuous accumulation of
diseases, but it can also be approached in a more comprehensive
way taking into account the dimensions that are included in thehealth quantiﬁcation approach, as proposed by WHO.
Methods: We used a two-stage factor analysis approach in 11,906
participants from the English Longitudinal Study of Ageing (ELSA),
which included 45 items that ﬁt with the proposed minimal genericset of variables deﬁned in the WHO International Classiﬁcationof Functioning (ICF). Evidence for a general factor underlying
ﬁrst-order factor were obtained. Then, a Bayesian multilevel Item
Response Theory (IRT) approach was applied to create the healthmetric using the ﬁrst six waves of the study.
Results: A single metric was developed, where variables of functioning, mobility, senrorineural, emotional and cognitive aspects
have been proved to be the most important. The ﬁve ﬁrst-orderfactors extracted explained a 63.1% of the total variance.
Conclusions: Although these variables are not new for geriatricians,
since some of them are already evaluated during the Comprehensive
Geriatric Assessment, the current work revealed that it is feasible
to create a health metric based on a broader conceptualization ofhealth characteristics. This can also be useful since it can help toquantify the effects of clinical and public health interventions andcredibly evaluate their impact in the ageing process.
P-566
Lifestyle-Integrated Exercise Interventions delivered by use of
ICT or an instructor - PreventIT Feasbility RCT
K. Taraldsen 1 , M. Schwenk 2 , J. van Ancum 3 , S. Mellone 4 ,E. Boulton 5 , A. Zacchi 6 , C. Todd 5 , W. Zhang 7 , A. Maier 3 , C. Becker 2 ,R. Bergquist 1 , B. Vereijken 1 , J.L. Helbostad 1 . 1 NTNU, Norway; 2 RBK,
Germany; 3 VU, The Netherlands; 4 UiB, Italy; 5 UoM, UK; 6 Doxee, Italy;
7 EPFL, Switzerland
Introduction: The European population is rapidly ageing. Physical activity (PA) can improve health and function and reduce
disability at old age. Older adults are at risk of being inactive,
and activity declines signiﬁcantly at time of retirement. To beable to reach recommended activity levels, behavioural change isneeded. The PreventIT consortium has adapted an existing lifestyleintervention programme to home-dwelling young older adults who
are recently retired (aLiFE). Furthermore, we have transferred theaLiFE programme to a mobile health application system based on
smartphones and smartwatches, called eLiFE. The aim of the study
is to investigate whether it is feasible to have young older adults
between 61–70 years perform the aLiFE and eLiFE versus a control
group.
Methods: This is an ongoing multi-centre randomised feasibility
trial with three sites, Trondheim, Amsterdam, and Stuttgart. Eligible
people are invited to take part in a three-armed feasibility RCT,with two behaviour change programmes (aLiFE and eLiFE) focusing
on muscle strength, balance, and PA, and a “usual care” control
group who receive generic activity advice Each site will include
participants until 60 at each site are randomised.
Results: 9500 invitation letters have been distributed. 250 people have undergone risk assessment. At present 63 participants
have been randomised, and the ﬁrst participants have started theintervention.
Conclusions: Adherence and delivery of PA interventions are achallenge. In this trial we will get more knowledge about thePoster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

feasibility of two newly developed home-based interventions for a
relatively young and healthy group of older adults.
P-567
Oxidative stress and ageing
S.D. Brincat 1 , A. Brincat 2 , T. Hunter 3 . 1 Mater Dei Hospital, Msida,
Malta; 2 Sir Anthony Mamo Oncology Centre, Msida, Malta;
3 University of Malta, Msida, Malta
Introduction: Nowadays, life expectancy has substantially increased due to advances in public health, medicine and nutrition.
Ageing results from the accumulation of multiple deleterious
changes predisposing the individual to diseases and eventuallydeath.
Aim: To understand the physiological process of ageing with particular reference to the role of oxidative stress as proposed by the Free
Radical Theory of Ageing.
Methodology: A literature review was conducted to unveil the insights of the mechanisms of ageing. A number of theories have been
proposed to suggest the physiology underlying this phenomenon.
This study focused on The Free Radical Theory of Ageing since it isconsidered as the most prevalent theory to elucidate the molecularmechanism of ageing.
Results: The Free Radical Theory of Ageing identiﬁes free radicals as
the cause of time-related changes attributed to ageing. Multicellular organisms necessitate high energy levels to drive the biologicalprocesses making the cell dependent on oxidative phosphorylation.
This produces a wide range of radical and non-radical oxidants
which are responsible for cellular damage. Damage to both nuclear
and mitochondrial DNA induced by free radicals includes nitration,
deamination of bases, deletion of purines and damage to DNA repair
system. In order to cope with the bombardment of reactive oxygen
species, cells have developed an antioxidant system composed ofenzymatic and non-enzymatic components as a defence mechanism
to maintain a redox state and safeguard against the toxic effects
resulting from oxidative stress.
Conclusion: The Free Radical Theory stood the test of time as it isfundamental for the on-going research on ageing and lays fertile
area for future research. This revolution in understanding the bodily
response to oxidative stress leads to therapeutic and pharmacologic interventions to retard the development and progression ofage-related conditions.
P-568
Participation in and adherence to an internet-based
multidomain trial for the prevention of cardiovascular diseaseand cognitive decline in French, Finnish and Dutch older adults:
data from the ACCEPT-HATICE ancillary study
N. Coley 1 , J. Guillemont 2 , A. Rosenberg 3 , T. van Middelaar 4 ,M. Barbera 3 , H. Soininen 3 , E. Richard 4 , M. Kivipelto 5 , S. Andrieu 6 .
1 INSERM-Univeristy of Toulouse UMR1027/CHU Toulouse, Toulouse,
France; 2 INSERM-University of Toulouse UMR1027, Toulouse, France;
3 Institute of Clinical Medicine/Neurology, University of Eastern
Finland, Kuopio 70211, Finland; 4 Department of Neurology, Donders
Institute for Brain, Cognition and Behavior, Radboud University
Medical Center, 6525 GA Nijmegen, The Netherlands; Department of
Neurology, Academic Medical Center, University of Amsterdam, PO Box
22660, 1100 DD, Amsterdam, The Netherlands; 5 Center for Alzheimer
Research, Karolinska Institutet, Stockholm 14157, Sweden; Institute ofClinical Medicine/Neurology, University of Eastern Finland, Kuopio
70211, Finland; Chronic Disease Prevention Unit, National Institute for
Health and Welfare, Helsinki 00271, Finland; Center for Alzheimer
Research, Karolinska Institutet, Stockholm 14157, Sweden; 6 INSERMUniversity of Toulouse UMR1027/CHU Toulouse, Toulouse, France
Introduction: We compared reasons for participating in an eHealthS203

prevention trial, and adherence to the intervention in older adults
from Finland (FI), France (FR) and the Netherlands (NL).
Methods: The 18-month “Healthy Ageing Through Internet Counselling in the Elderly” (HATICE) trial is testing an internet-based
lifestyle intervention, with coach support, for prevention of cardiovascular disease and cognitive decline in 2725 European participants aged ≥65 years with cardiovascular risk factors/disease.
For the ACCEPT-HATICE ancillary study, 341 participants completed
an online questionnaire at the time of recruitment to explore
determinants of participation.
Results: Participants from the three countries differed by age [median 67 (FI), 70 (FR) and 69 (NL) years, p<0.001], social support[median score (/12, higher scores represent more social support):
11 (FI), 9 (FR), 9 (NL), p=0.003], and locus of control [median“powerful others” external locus of control score (/12, higher scoresindicate greater attribution of health to healthcare professionals):
7 (FI), 9 (FR), 8 (NL), p<0.001]. 51% of French participants statedthat contributing to scientiﬁc progress was their main reason forparticipating, compared to 23% and 37% of Finnish and Dutch
participants, respectively, while 24% of Finnish participants statedthat receiving better medical care was their main reason for participating, compared to 11% and 13% of French and Dutch participants(p=0.009). Adherence to the intervention also differed between
countries [proportion of subjects logging in ≥10 times in the ﬁrst 6
months: 60% (FI), 79% (FR), 65% (NL), p=0.030].
Conclusions: Reasons for participation and intervention adherence
differed by country, probably due to differences in participant characteristics, cultural factors, recruitment methods, and healthcare
systems.
P-569
Physical and mental determinants related to the ﬁrst fall in
healthy old people
S. Gillain 1 , M. Boutaayamou 2 , C. Schwartz 3 , N. Dardenne 4 ,O. Brüls 3 , O. Bruyère 5 , J.-L. Croisier 6 , E. Salmon 7 , G. Garraux 7 ,J. Petermans 1 . 1 Geriatric Department, University Hospital of Liège,
Belgium; 2 INTELSIG Laboratory, Department of Electrical Engineeringand Computer Science, University of Liège, Belgium; 3 Laboratory of
Human Motion Analysis - LAMH, University of Liège, Belgium; 4 Public
Health Department, University of Liège, Belgium; 5 Research Unit in
Public Health, Epidemiology and Health Economics, University of Liege,
Belgium; 6 Science of Motricity Department, University of Liège,
Belgium; 7 Neurology Department, University Hospital of Liège,
Belgium
Introduction: Falls and their consequences are a public healthproblem. To discern people those at risk to experiment a ﬁrst fall isa key issue. The objective of this work is to highlight the physical ormental determinants of falls in healthy old people.
Methods: 105 healthy community-dwelling old people, without fall
history, were recruited in a 2-years longitudinal study and screened
for autonomy, fear of falling, visual impairment, co-morbidities,
drugs, physical activities, nutritional status, body composition, grip
strength, physical performances, mood and cognitive disorders andgait parameters. Falls incidence was measured every 3-month bya phone contact. SAS statistical package (version 9.4) was used.
Fallers and non- fallers were compared by one-way analysis ofvariance (ANOVA) or by the Kruskal-Wallis test for quantitative
parameters and by a chi-squared test for qualitative parameters.
Results were considered statistically signiﬁcant for p<0.05.
Results: At the end of the 2-years follow-up 35 people experienced
at least one fall. The incidence of falls was associated with lower
IADL (instrumental activities daily living) score (p=0.014), lower
SPPB (short physical performance battery) score (p=0.015), lower
fast walking speed (p=0.035), lower step length in comfortable
walking condition (p=0.035) and lower step length in fast walking

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condition (p=0.01) at inclusion in faller people. Age, sex, drugs,
co-morbidities, visual impairment, mood and cognitive status were
not signiﬁcantly different between the groups (p>0.05).
Conclusion: At inclusion and before the ﬁrst fall, fallers and nonfallers showed different physical characteristics and daily activities.
Multivariate analysis will be assessed to build an explicative model.
P-570
Prevention of balance loss and frailty
J.P. Farcy, J.B. Cook. Nymbl Science, USA
Introduction: Nymbl Science deﬁnes and measures a personalized“balance index” which incorporates both physical balance and cognitive impact on balance, then recommends speciﬁc, customized
treatment to improve perception, cognition and action in order toprevent balance loss and frailty.
Method: The balance index is made of 2 numbers, each from 0 to100. The ﬁrst evaluates postural stability and strength, the second
evaluates cognition in performing “double tasks” (e.g. counting
backward or playing a video-game while maintaining a postureduring a given time). Each of double tasks reinforces the effect of
the other in order to both strengthen the musculoskeletal systemand simultaneously engage the brain to stimulate brain plasticity.
Nymbl uses a smart phone’s internal motion sensors plus an external sensor worn at the ankle. The Nymbl mobile app directs
the tests, analyses sensor’s data, guides personalized training, andcommunicates data to the Cloud for further followup.
Results: Preliminary studies on a cohort of volunteers indicatesexcellent results based on signiﬁcant improvement of balance index
numbers after only 21 days of training. Full validation study isunderway at the Imperial College of London led by Professor Alison
McGregor.
Conclusion: Assuming that balance control is pivotal to maintaining and improving quality of life, an innovative concept such as thisone presented by Nymbl Science is remarkable and signiﬁcant toprevent falls and improve function and neurocognition.
P-571
Psychological predictors and consequences of hearing healthbehaviors in older adults
M. Marquet 1 , A.L. Chasteen 2 , J.E. Plaks 2 , L. Balasubramaniam 2 .
1 University of Liège, Liège, Belgium; 2 University of Toronto, Toronto,
CanadaIntroduction: Hearing loss is a common chronic condition affecting
older adults in Western populations [1,2]. Even if older adults could
beneﬁt from hearing aid use, they are reluctant to wear them[1]. The purpose of the present study was twofold: a) to examine
whether older adults’ implicit theories regarding the modiﬁabilityof abilities in general would predict their hearing health behaviors;and (b) to assess consequences of these behaviors on subjective
aging.
Methods: One hundred and sixty-three older adults (Mean age=68.62, SD =5.40) completed, among other questionnaires, questions assessing their implicit theories of ability (i.e., seeing generalabilities as ﬁxed vs. improvable with effort [3]) and their subjectiveage (i.e., felt age, do age, look age, and interest age [4]). They also
reported their perceptions of the beneﬁts of various hearing healthbehaviors for slowing the effects of aging (i.e., getting their hearing
tested and using hearing aids) as well as their intentions to engage
in those behaviors.
Results: We found that the more older people considered thatabilities are alterable, the more they perceived hearing health behaviors as being beneﬁcial, which in turn increased their intentions
to engage in these behaviors. Also, the greater their intentions, theyounger subjective age they reported.

Conclusions: These relationships between implicit theories, hearing
health behaviors, and subjective age are particularly important totake into account. Indeed, neglecting hearing problems and experiencing an older subjective age may have detrimental health-related
outcomes over time [5, 6].
References:[1] Feder, K., Michaud, D., Ramage-Morin, P., McNamee, J., & Beauregard, Y. (2015). Prevalence of hearing loss among Canadians
aged 20 to 79: Audiometric results from the 2012/2013 Canadian
Health Measures Survey. Health Reports, 26(7), 18–25.
[2] Lin, F. R., Thorpe, R., Gordon-Salant, S., & Ferrucci, L. (2011).
Hearing loss prevalence and risk factors among older adults
in the United States. The Journals of Gerontology, Series A:
Biological Sciences and Medical Sciences, 66(5), 582–590. doi:
doi:10.1093/gerona/glr002[3] Dweck, C. S. (1999). Self-theories: Their role in motivation, personality, and development. Philadephia, PA: Psychology Press.
[4] Kastenbaum, R., Derbin, V., Sabatini, P., & Artt, S. (1972). “Theages of me”: Toward personal and interpersonal deﬁnitions offunctional aging. The International Journal of Aging and Human
Development, 3(2), 197–211.
[5] Bainbridge, K. E., & Wallhagen, M. I. (2014). Hearing loss
in an aging American population: Extent, impact, and management. Annual Review of Public Health, 35, 139–152. doi:
10.1146/annurev-publhealth-032013–182510[6] Kotter-Grühn, D., Kornadt, A. E., & Stephan, Y. (2015). Looking
beyond chronological age: Current knowledge and future directions in the study of subjective age. Gerontology, 62(1), 86–93.
doi: 10.1159/000438671
P-572
Regular exercise is associated with greater physical performancein elderly adults
A.L. Demoux 1 , N. Capony 2 . 1 Department of Geriatrics, Public
Hospital of Marseille, North Hospital, 13015 Marseille; 2 Department ofGeriatrics, Public Hospital Of Marseille, North Hospital
Introduction: The positive effect of physical training in healthyelderly people is well documented, however there is little understanding of the aspects of performance contributing to this beneﬁt.
The aim of this study was to evaluate the impact of regular physical activity on muscle strength, and potentially related functional
ability in elderly.
Methods: Fifty-eight (31 men, 27 women) non-disabled communitydwellers aged from 75 to 90 years were consecutively enrolled ingeneral practitioners cabinets. They underwent a comprehensive
geriatric assessment including physical activity questionnaire especially designed for the elderly, physical function by Short Physical
Performance Battery (SPPB), and hand grip strength.
Results: A ccording to the “Questionnaire d’Activité Physique pourles Personnes Âgées” (QAPPA), a group of exercisers (18 men and 11
women) and a group of non-exercisers (13 men and 16 women), theformer presenting higher volumes and levels of physical activity,
were identiﬁed. The two groups were similar for age, BMI, numberof daily treatments, and number of previous falls; non-exercisers
were likely more smokers and under anti-depressive treatment. The
univariate analysis showed that high level of physical activity wassigniﬁcantly associated with a better nutritional status, lower Fried
frailty score, faster mean walk speed, higher hand grip strength,
and higher SPPB. However, only SPPB was signiﬁcantly associatedwith physical activity in multivariate analysis (p<0.001).
Conclusions: This study showed that regular moderate-intensity
training is independently associated with an improvement in physical performance in non-disabled community-dwellers aged>75 yrs,
suggesting a lower risk of falling.

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

P-573
Relationships between functional physical ﬁtness cardiovascularvariables and quality of life in elderly
D. Pietko Da Cunha. Universidade de Coimbra
Introduction: The performance of daily activities is crucial to thequality of life in old age, and physical ﬁtness gets signiﬁcant impact
in this context. Cardiovascular variables are very important formorbidity and mortality in the generalpopulation, with particular
relevance to the geriatric age group. The challengenowadays is tounderstand the factors that inﬂuence the quality of life, for thehumanbeing to live longer without losing autonomy.
Objectives: To study the relationship between functional ﬁtness,anthropometric, hemodynamic and blood variables and quality oflife. Furthermore, toinvestigate how these variables predict qualityof life of elderly people.
Materials and methods: Twenty participants over 60 years oldfrom thegeriatric ambulatory of city of Cachoeirinha, in Brazil, had
physical ﬁtness tests forelderly people and had blood pressure (BP)and body mass index (BMI) measured. They had blood test to determinate lipid and glucose proﬁles. The quality of life wasassessedwith the SF-36v2. Multivariate analysis of techniques of varianceand linearregression were also used.
Results: Participants with normal glucose levels had lower BMI(p<0.05) than pre-diabetics and diabetics participants. The older
adults with normaltriglycerides levels showed lower systolic anddiastolic blood pressure (p<0.05). Age, sex and BMI explained
31.4% of the SF-36v2. Including systolic blood pressurein the model
explanation raised to 43.6% the R2, increasing progressively to
53.8% when lower limbs strength was considered and to 64.7% withvariable aerobicresistance.
Conclusion: BMI and BP, particularly systolic, cause great impact
on generaland cardiovascular morbidity, as well as in the qualityof life for seniors. The lowerlimb strength and aerobic endurance
affect decisively their quality of life. The maintenance and optimization of these physical parameters positively impact thefunctional
autonomy, and the level of independence of the elderly population.
P-574
Renal ageing and glycation: implication of RAGE
T. Teissier 1 , V. Quersin 2 , V. Gnemmi 3 , F. Delguste 2 , N. Grossin 2 ,M. Daroux 2 , F. Tessier 2 , M. Frimat 4 , E. Boulanger 2 . 1 University ofLille, Inserm, Regional University Hospital Center of Lille, U995 – Liric– Lille Inﬂammation Research International Center; 2 University of Lille,
Inserm, Regional University Hospital Center of Lille, U995 – Liric – Lille
Inﬂammation Research International Center, Lille, France;
3 Anatomopathology Department, Regional University Hospital Centerof Lille, Lille, France; 4 University of Lille, Inserm, Regional University
Hospital Center of Lille, U995 – Liric – Lille Inﬂammation ResearchInternational Center, Nephrology Department, Lille, France
Introduction: Endogenous advanced glycation end-products (AGEs)
are well-studied, especially for their effect on inﬂammation andﬁbrosis and possibly on ageing. Nonetheless, these effects have yet
to be described for dietary AGE (dAGE). Here, we study whether a
prolonged exposure to the dAGE carboxymethyl lysine (CML) caninﬂuence ageing in kidneys and whether the receptor for AGEs
(RAGE) is a modulator of this process.
Methods: Wild-type (WT) and RAGE−/− male C57Bl/6 mice werefed with a control-diet (BSA) or a CML-rich diet (200 μg CML/gof food) for 18 months. Renal function markers were measured
and histological analyzes were performed to assess kidney ageing. Kidney amyloidosis was analyzed by staining, immunostaining
and electronic microscopy. Immunohistochemistry was used tocharacterize amyloidosis and localize CML.
Results: We showed a RAGE-dependent production of CML into

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kidneys of WT CML mice when compared to RAGE−/− CML mice,with a predominant tubular and endothelial localization. Immunohistochemistry analyzes revealed amyloid deposits involving
apolipoprotein A-II (APoAII). RAGE−/− mice were signiﬁcantly protected against CML-induced sclerosis (p<0.05), tubular atrophy(p<0.05) and ApoAII amyloidosis (p<0.01) when compared to WT
CML mice. There is a positive linear correlation between sclerosis
score and ApoAII amyloidosis score (r=0.92).
Conclusion: We suggest that dCML may induce RAGE-dependantﬁbrosis, sclerosis and amyloidosis in mice kidneys, aggravating
renal ageing. Our data also show a dCML-induced CML production
pathway that involves RAGE. Further studies are needed to conﬁrm
these data and determine speciﬁc signaling pathways.
P-575
Results from a geriatric fall clinic – reduced sensibility andelectromyographically identiﬁed polyneuropathy
L. Blok Madsen, A. Güzel, H.E. Andersen. Geriatric Section, Medical
Department, Glostrup hospital
Introduction: Reduced sensibility is a well-known risk factor for
falling and electromyographically (EMG) identiﬁed polyneuropathy(PN) is proven to be strongly associated with falls. This study
reports data from a Danish geriatric fall clinic and aims to see howcommon reduced sensibility and EMG veriﬁed PN is among elderly
fall patients.
Materials and methods: Referred fall patients underwent a standardized multidisciplinary quantitative assessment program. Vibratory sensibility was tested with biothesiometry and tactile sensibility using a monoﬁlament. Persons referred to EMG underwent a
standard neurophysiological EMG.
Results: 162 patients were referred throughout 2015. 123 gave informed consent and were included.79 women (64,2%) and 44 men(35,8%), mean age 76,9. Reduced vibration sensibility was found in
74 (60,2%), reduced tactile sensitivity in 31 (25,2%). 27 (22%) had
reduced tactile as well as vibratory sensibility. Two of them had
already EMG diagnosed PN. Totally 40 of the patients with reduced
sensibility were further examined with EMG. Polyneuropathy wereveriﬁed in 18 (45% of the EMG examined). Totally the frequency of
EMG identiﬁed polyneuropathy in the study population was 14,6%.
Conclusion: This study shows that reduced sensibility is very
common in a geriatric fall population. The results suggest thatpolyneuropathy is a frequent condition among geriatric fall patientsthat perhaps should be given more attention in geriatric fall assessment in terms of further examinations i.e. EMG and blood samples
to identify potential causes.
P-576
Screening for age-related eye diseases – the impact of costs
L. Martin. School of Health, Care & Social Welfare, Mälardalen
University
Introduction: Screening for age-related eye diseases can successfully be performed by optometrists via tele ophthalmology.
However, in some countries the screening visit has to be paid by
the old person themselves. The out-of-pocket cost may deter somefrom presenting for examination. In other countries the screening
is free of charge which might lead to that a wider range of people
might attend, many of which do not need to be examined, leading
to a “noise” in the system. The aim of the current study was toevaluate the effect of a temporary lowering the out-of-pocket costfor screening examinations for age-related eye diseases.
Methods: During a 2 month campaign with reduced prises for eye
examinations, 218 people attended. Demographic data, as well as
the proportion of referrals were compared to all examinations inthe same setting during the year before as well as to the total

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number of the examinations in the country-wide screening system(n=39 517).
Results: The persons examined during the campaign were significantly (p=0.0004) older both compared to the examined persons
at the same setting the year before and to the total number inthe country. No differences were seen in gender, or the proportionof foreign-born persons. The proportions of ﬁrst-time visits andreferrals were not signiﬁcantly different between the two samples.
Conclusion: Reduced price attracted somewhat older customers
but no difference in morbidity was observed.
P-577
Self-eﬃcacy, gerotranscendence and positive personality traits
help in preventing frailty and maintaining a high level ofwell-being among the oldest-old in Japan: The Arakawa 95+
study
H. Kida 1 , H. Niimura 1 , Y. Eguchi 1 , W. Nishimura 1 , M. Takayama 2 ,M. Mimura 1 . 1 Keio University School of Medicine, Tokyo, Japan; 2 Keio
University School of Science and Technology, Tokyo, Japan
Introduction: Japan is fast becoming a super-aged society, and its
oldest-old population is expected to increase even as the whole
population will decrease in next 30 to 40 years. Therefore, it isimportant to ascertain whether the oldest-old will continue tolive with a high level of well-being and enjoy successful ageing
in a residential district. In general, people tend to become closed,
sceptical and introverted with ageing. It is linked with frailty, thatis decrease in walking ability, easy fatigability and weight loss. Past
study reported that preventing frailty helped the oldest-old live alife with high level of well-being. In this study, we aimed to identify
factors for preventing frailty among the oldest-old by examining
the relationship between frailty, self-eﬃcacy, gerotranscendence
and personality characteristics.
Methods: Subjects are all the oldest-old residents, aged 95 years
or older, live in Arakawa ward of Tokyo. Of 542 eligible subjects,
168 (31%) answered the questionnaire survey, 40 provided moredetailed responses to the questionnaire survey, and 26 accepted
visiting investigations.
Results: Inability to walk 400 meters was related with awareness of forgetfulness, low frequency of meetings with people, lowfrequency of going out, low self-eﬃcacy and low extraversion.
In addition, easy fatigability was correlated with neuroticism andinversely correlated with gerotranscendence and agreeableness.
Conclusions: Our study suggested that formation of self-eﬃcacy,
gerotranscendence and positive personality traits helped prevent
frailty and contributed to acquisition of a high level of well-being
among the oldest-old in Japan.
P-578
Sleep quality of elderly people living in their homes
E. Bagriacik, Ü.D. Yılmaz. Near East University Faculty of Health
Sciences, Nursing Department, Nicosia, Turkish Republic of Northern
CyprusIntroduction: Because of the positive results in the ﬁeld of technology and health, human life has been prolonged and life expectancy
from birth has been reported to be 75 years. Sleep is the most basic
daily life activity with its physiological, psychological and social
aspects affecting human health. Sleep has become important in thegrowing elderly population as it is important in all age groups.
Methods: A literature search (2000–2017) was carried out, using
MEDLINE, Pub Med, Science direct, Scopus, Cochrane library, Turkish Medical Index and related institutional websites. Key words
included “Elderly”, “Sleep quality”, “Sleep problems”.
Results: The prevalence of sleep disturbance is up to 35% in those
aged 60 years and over, 50% in 65 years and over. The causes of

sleep problems in the elderly; loss of melatonin secretion, lossof consciousness, loneliness, rest homes and retirement. In termsof quantity-quality of sleep problems of elderly individuals; slow
wave, decrease in eﬃciency, phase shift and increase in divisions.
When sleep problems are examined; drowsiness, persistence ofdiﬃculty, early waking and daytime drowsiness.
Conclusions: The consequences of sleep disturbance; daytime
sleepiness, fatigue, depression, anxiety, irritability, increased pain
sensitivity, muscle tremors, immune suppression, decreased mental function, health and functional impairment. As a result, it isobserved that elderly people live more insomnia and this affects
healthy aging adversely. Holistic approach should be promoted byputting the evaluation of sleep qualities of elderly individuals into
routine applications.
P-579
Studying prognostic factors in people over 90 years
R. Quílez, V. Guerrero, R. Sander, A. Narvión, A.C. Sanjoaquín,
J. Galindo. H. Sagrado Corazón Jesús, Huesca, Spain
Introduction: Several studies show that age itself is not an independent factor in survival; however, we usually limit the use ofdiagnostic and therapeutic resources in people over 90 years. The
lack of studies in these patients makes the usual scales not suitablein this population.
Objectives: Analyze the prognostic survival parameters and characteristics in people over 90 years.
Methods: A prospective longitudinal cohort study with people fromthe outpatient clinic over 90 years during 2015 and 2016 in Huesca.
Analytical data, comorbidity, admissions, ER attending, primary carevisiting and drug assessments were recollected. Statistical analysis
was done with SPSS 23.
Results: A total of 288 patients. Average age: 94.5. 70.8% were
women. Mean Barthel index: 70. Charlson index 2.7. Mortality per
year: 18.7%. Comorbidities: HTA 78.5%, DM 29.2%, dyslipidemia 45%,
heart failure 23.6%, stroke 18%, ischemic heart disease 13.5%, cancer
22%, anemia: 35.7%, renal failure 64.2%. Drug number: 6.7. Numberof admissions per year 0.5. Emergency care admission in a year 1.
Primary care visits per year 5.6. We found an increase in mortality
rate trough a year in people with anemia (p<0.001), low albumin
levels (p=0.03), male gender (p=0.03), high RDW, (p=0.001), kidney
impairment veriﬁed by HUGE formula (p=0.003), suffering cancer(p=0.003) or CHF (p=0.001).
Conclusions:• In this study, we didn’t ﬁnd a direct relationship in mortality
between having a high Charlson index in people over 90 years.
• The amplitude in red cell distribution [1], could be useful asa prognostic factor in elderly people. With patients with renal
impairment, applying the HUGE2 formula can be helpful
References:[1] M. Olivares Jara,E. Santas Olmeda,G. Miñana Escrivà,P. Palau
Sampio,P. Merlos Díaz,J. Sanchis Forés Ancho de distribución eritrocitaria y riesgo de mortalidad en pacientes con insuﬁciencia
cardiaca aguda Med Clin (Barc), 140 (2013), pp. 433–438[2] Heras M, Fernández-Reyes MJ, Guerrero MT, Sánchez R. Evaluación de la función renal en el anciano con la fórmula HUGE.
Rev Esp Geriatr Gerontol. 2013;48:94–95
P-580
Telemonitoring to improve nutritional status and physicalactivity in older adults: a process and effect evaluation
M.N. van Doorn-van Atten, A. Haveman-Nies, J.H.M. de Vries,
C.P.G.M. de Groot. Wageningen University, the Netherlands
Introduction: An optimal nutritional status and physical activity
are essential for successful aging. However, more than 40% of thePoster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

European older adults are at risk of malnutrition and physicalactivity levels decline with age. As health care resources are scarce,
increasing attention is being paid to novel technologies that support
healthy ageing. This study aims to evaluate an intervention directed
at telemonitoring of nutritional status and physical activity among
Dutch community-dwelling older adults.
Methods: In 2016 and 2017, a non-randomized controlled study
was conducted among 217 older adults (65+). The six-month intervention comprised telemonitoring of nutritional status, bodyweight, appetite, diet quality, and physical activity, feedback via
a television channel, and when necessary guidance by a nurse ordietician. The control group received usual care. Outcome measures
were nutritional status, diet quality (measured as compliance tothe Dutch dietary guidelines and scored on a scale from 0–10),
quality of life, functional status, physical performance, behavioural
determinants, and process indicators.
Results: Preliminary analyses showed signiﬁcant improvements indiet quality. The scores for intake of vegetables improved (1.6, 95%
conﬁdence interval (CI): 0.8–2.4), as well as for intake of fruits (1.1,
95% CI: 0.6–1.7), dietary ﬁbre (1.1, 95% CI: 0.7–1.4), and protein(1.2, 95% CI: 0.1–2.3). More insights into the effectiveness of thetelemonitoring intervention will follow.
Conclusions: This study will show the feasibility and effectivenessof a telemonitoring intervention concerning nutrition and physicalactivity in community-dwelling older adults, thereby contributing
to the knowledge on how technology can assist in healthy ageing.
P-581
Telomere length and telomere attrition in chronic oxidative
stress and inﬂammation
S. Toupance 1 , I. Tzanetakou 2 , M. Chahine 3 , P. Konstantopoulos 2 ,S. Gautier 4 , M. Korou 2 , C. Lakomy 1 , I. Doulamis 2 , C. Labat 1 ,A. Gkogkos 2 , N. Settembre 4 , T. Moussallem 5 , K. Perreas 6 ,L. Frimat 4 , P. Yared 5 , E. Menenakos 6 , J. Hubert 4 , M. Vasiloglou 6 ,S. Malikov 4 , R. Asmar 3 , D. Perrea 2 , A. Benetos 1 . 1 INSERM UMRS
1116, Université de Lorraine, Nancy, France; 2 Laboratory for
Experimental Surgery and Surgical Research “N S Christeas”, Universityof Athens, Greece; 3 Foundation-Medical Research Institutes, Beirut,
Lebanon; 4 CHRU de Nancy, Université de Lorraine, Nancy, France;
5 Lebanese University, Faculty of Medical Sciences, Hadath, Lebanon;
6 Medical School of Athens, National and Kapodistrian University ofAthens, Greece
Introduction: Short telomere length (TL) is associated withatherosclerotic cardiovascular diseases (ACVD) and increased mortality. Inﬂammation and oxidative stress are believed to play a
key role in telomere attrition and could explain the association
between short TL and ACVD. The objective was to measure TL inskeletal muscle (MTL), which serves as a proxy of TL at birth, andin leukocytes (LTL) in three situations of increased oxidative stressand inﬂammation: ACVD, severe renal failure (SRF: clearance<30
ml/min) and morbid obesity (MO: BMI>40 kg/m2 ). The LTL/MTL
ratio represents life-long telomere attrition.
Methods: MTL and LTL were measured by Southern blot in samples from 158 individuals (42 women) undergoing surgery (France,
n=71; Greece, n=52; and Lebanon, n=35). Four groups were enrolled:
control (CTL, n=44), ACVD (n=62), SRF (n=47) and MO (n=34).
Results: In all subjects, MTL was longer than LTL. LTL and LTL/MTL
were shorter in ACVD patients (p<0.01, p<0.05 respectively vs CTL).
No differences were observed between the groups of MO and SRF
and the CTL.
Conclusions: This study conﬁrms the presence of shorter telomeresin ACVD patients. By contrast, in two other situations with highchronic oxidative stress and inﬂammation, TL and TL attrition
were not affected. We suggest that shorter telomeres observed insubjects with atherosclerotic disease are not the result of increased

S207

telomere attrition by oxidative stress and inﬂammation but might
rather antecede the clinical manifestation of the disease.
P-583
The “Centre for Memory and Mobility” in Luxembourg –A comprehensive approach to prevent age-associated memory
and mobility declines
E. Bourkel 1 , C. Federspiel 2 , J.-P. Steinmetz 2 . 1 Centre for memory andmobility, Luxembourg; 2 Centre for memory and mobility, Luxembourg;
ZithaSenior, Research & Development, Luxembourg
The “Centre for Memory and Mobility” located in Luxembourg
City opened its doors in September 2015 and addresses people
aged 60 years and older. A team composed of medical doctors,
physiotherapists, occupational therapists, psychologists and social
workers provides primary and secondary preventive healthcare
programmes. On the patient’s ﬁrst visit, the medical backgroundand social key parameters (e.g., living situation, dependency) are
assessed in a personal counselling interview. In a second step,therapists assess general cognitive functioning, balance, strength,
gait performances and vital parameters. The assessed information
guides the individual composition of the suitable intervention
programme (mobility and/or cognitive training) for each patient.
Interventions generally consist of 6, 12 or 18 weeks lasting mobility
and/or cognitive training programmes, which can be attended onceor twice a week. Patients are evaluated weekly during multidisciplinary staff meetings. After completion of their individualized
training programme, the therapists re-evaluate mobility and cognitive parameters and discuss the effects of the training as well assuitable further interventions with the patients. Individual physiotherapy, psychological or social counselling, and neuropsychologicaldiagnostics complement the Centre’s healthcare offer. To date,
133 patients have completed cognitive and mobility training programmes with positive results (see Bourkel, Steinmetz & Federspiel,
2016; Federspiel, Bourkel & Steinmetz, 2016). With the present
work, we demonstrate the necessity and more importantly, thefeasibility of a highly qualiﬁed structured preventive healthcare
offer.
P-584
The HATICE trial in France: focus on the recruitment from a
prevention centre
N. Coley 1 , J. Guillemont 2 , F. Martin 3 , S. Andrieu 1 . 1 INSERM,
University of Toulouse UMR1027; Department of Epidemiology andPublic Health, Toulouse University Hospital, Toulouse, France;
2 INSERM, University of Toulouse UMR1027, Toulouse, France; 3 Ageing
Well Prevention Centre Agirc/Arrco: Cedip, Toulouse, France
Background: The Healthy Ageing Through Internet Counselling in
the Elderly (HATICE) trial aims to investigate whether a multidomain internet intervention to optimise self-management ofcardiovascular risk (CVR) factors can reduce the risk of cardiovascular disease, cognitive decline and dementia. The 18-month trial isintended for persons aged 65 and older with increased CVR. It runsin the Netherlands, Finland and France. In France, half of the 368
participants were recruited from a prevention centre (Cedip). We
explored the recruitment process among this speciﬁc populationand examined to what extent Internet is a barrier to participation.
Methods: In France, Cedip participants were recruited among beneﬁciaries aged 65 and older via 2 channels: 1. beneﬁciaries coming
to Cedip for their prevention check-up were invited to participate
in the HATICE trial if considered eligible; 2. a self-completion
questionnaire to assess main eligibility criteria was sent to 6591
beneﬁciaries who had attended a prevention check-up since 2012;
eligible persons were then invited by phone to participate in thetrial.

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Results: A mong the 1027 persons preselected via channel 1,
82.2% were not eligible. Main reasons for non-eligibility were low
CVR (60.1%) and Internet illiteracy (23.3%). In the 3359 questionnaires that were returned (response rate: 51.0%), non-eligibility wascertain for 52.2%, of whom 83.4% had low CVR and 39.5% had
insuﬃcient Internet skills. Acceptation rates before prescreening
was 55.9% in channel 1 and 56.0% in channel 2.
Conclusions: Internet was an important barrier to participation in
the HATICE trial in France, though not the main one.
P-585
The inﬂuence of cognitive and mobility training programmes on
cognitive functioning among healthy elderly people and people
with MCI
E. Bourkel 1 , G. Hubsch 1 , C. Federspiel 2 , J.-P. Steinmetz 2 . 1 Centre forMemory and Mobility, Luxembourg; 2 Centre for Memory and Mobility,
Luxembourg; ZithaSenior, Research & Development, Luxembourg
Cognitive and mobility training have a positive inﬂuence on cognitive functioning both in healthy elderly people and in people
with mild cognitive impairment. The aim of this study is to further
clarify the effect of a 12 week mobility and/or cognitive intervention
on cognitive performances in healthy elderly people and mildly
cognitively impaired people. The mobility and cognitive training
were both conducted in small groups (maximum eight participants)
which were homogeneous concerning the participants’ respective
cognitive and mobility capacities. The participants attended thecognitive training sessions once a week and the mobility training
sessions at least once a week. In the cognitive intervention, mainly
attention, memory strategies, cognitive ﬂexibility, and language
were trained. The mobility intervention mainly focussed on the
training of general mobility, balance, coordination, gait stability, endurance, muscular strength, torso muscles and spine ﬂexibility. The
participants (N=63, age range = 58–92 years) either partook (1) in
only a cognitive training programme, (2) in only a mobility training
programme, or (3) in a combination of a mobility and a cognitive
programme. The participants’ cognitive abilities were assessed before and after the training programmes. Cognitive screening andattention tests were used. The effects of the interventions in thethree groups are compared. The discussion of the ﬁndings focuseson the effects of the interventions and highlights the importance offacilitating structured cognitive and mobility training programmes
for both healthy elderly people and people with mild cognitive
impairment.
P-586
The prevalence of xerosis among older people living in thecommunity and its inﬂuence on quality of life
J. Knasiene 1 , V. Jievaltaite 2 , M. Jaras 2 . 1 Lithuanian University of
Health Sciences, Academy of Medicine, Department of Geriatrics,
Kaunas, Lithuania; 2 Lithuanian University of Health Sciences, Academyof Medicine, Kaunas, Lithuania
Introduction: Xerosis is one of the most common complaints ofolder people, often remains undiagnosed. Identiﬁcation of risk
factors and the most common clinical manifestations would help
to timely recognize and treat xerosis, and to avoid its inﬂuence on
quality of life.
Methods: Analytical cross-sectional study was performed. Questionnaire survey of older people (n=83, age 69,26±3,98 years),
living in the community, was conducted by using the originalquestionnaire, developed by researchers.
Results: 58.1% of all surveyed currently experience xerosis withduration 8.29±6.373 months. A statistically signiﬁcant risk factor for
development of xerosis was usage of statins (p=0,048). The respondents most often complained about dry skin in face (26.8%), palms(20.6%), calves (18.6%), forearms (13.4%). 57.1% of the respondents
complained about dry skin ﬂaking, 51% - dry skin redness, 47.9% dry skin cracks, 55.1%-dry itching skin, 22.4% – pain, 83.7% felt uncomfortable because of their skin. Dry skin disturbed in householdchores for 30.6% of the respondents, inﬂuenced the choice of clothes(36.7%) and leisure activities (49%), disturbed sports activities for
28.6% of the respondents.
Conclusions: Xerosis is prevalent among 58,1% of older people,
living in the community. Usage of statins has statistically signiﬁcant
inﬂuence on appearance of xerosis (p<0,05). Xerosis is usually
localized in the skin of face, back of the head, palms, calves, forearms. Flaking, redness, cracking, itching and pain occurs together
with xerosis. Xerosis inﬂuences the choice of clothes, leisure time,
sports, household chores. Older people feel uncomfortable becauseof xerosis.
P-587
Trajectories of health-related quality of life (HRQoL) domains
among older businessmen
A. Urtamo 1 , K. Pitkälä 1 , H. Kautiainen 1 , T. Strandberg 2 . 1 University
of Helsinki, Department of General Practice and Primary Health Care,and Helsinki University Central Hospital, Unit of Primary Health Care,
Helsinki, Finland; 2 University of Helsinki, Clinicum, and Helsinki
University Hospital, Helsinki, Finland, and University of Oulu, Center
for Life Course Health Research, Oulu, Finland
Introduction: Health-related quality of life (HRQoL) has been used
to assess healthy and functional ageing. Previous studies indicatethat the stability in the trajectory of good physical functioning
is associated with an optimal ageing. However, the trajectories ofother HRQoL domains are less clear. We studied these trajectories
in a 15-year follow-up among older businessmen.
Methods: This is a longitudinal study of the Helsinki Businessmen
Study (HBS) cohort (born in 1919–34). HRQoL was assessed with
the RAND-36 (SF-36) instrument in the years 2000 (n=1871), 2003
(n=1273), 2007 (n=1043), 2010 (n=911), and 2015 (n=497). RAND36 includes 8 domains: Physical functioning (PF), Role physical(RP), Vitality (VT), Mental health (MH), Role mental (RM), Social
functioning (SF), Bodily pain (BP), and General health (GH). These
domains can be further condensed to Physical component summary(PCS), and Mental component summary (MCS). The linearity andstatistical signiﬁcances were analysed using NCSS software.
Results: We found that the trajectory of PF, an indicator of mobility
disability, decreased linearly with increasing age. In contrast to PF,
the scores of other domains of HRQoL ﬁrst remained similar or evenincreased between years 2000 and 2003, and decreased linearlyﬁrst after that. Similar trends were seen in the summary scores PCS
and MCS.
Conclusions: Our study reveals variations in the trajectories of
HRQoL domains in old age, especially between PF and other domains. These differences should be considered when HRQoL isrelated to healthy and functional ageing, and when summary scoresof HRQoL are used.
P-588
Transition to long-term care by the elderly – Evaluation of thephenomena in Central Portugal (a research protocol)
H. Neves 1 , V. Parola 1 , A. Coelho 1 , E. Santos 1 , J. Tavares 1 ,S. Pereira 2 , M. Almeida 3 , S. Duarte 3 , A. Cavaleiro 3 , M. Cordeiro 3 ,I. Gil 3 , J. Apóstolo 1 . 1 Health Sciences Research Unit: Nursing, Nursing
School of Coimbra, Portugal; Centre for Evidence-Based Practice: aJoanna Briggs Institute Centre of Excellence, Portugal; 2 Nursing Schoolof Coimbra, Portugal; 3 Health Sciences Research Unit: Nursing, Nursing
School of Coimbra, Portugal
Introduction: The number of elders in Long Term Care Facilities

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247(LTCF) has been increasing signiﬁcantly. In 2014, over 75000 elders
lived in LTCF in Portugal. It is known that the increase in life
expectancy, impact of work obligations in family support, increased
comorbidities, and self-care needs are some of the reasons forthis need of change from home to LTCF. However there is a lackof knowledge about how this transition is experienced by thispopulation, and the potential impact in their lives.
Methods: A qualitative study, based on Meleis’ Transition Theory,
will be carried out in ten LTCF in Central Portugal, in elderly
without history of cognitive impairment, and willing to participate
in the study. Data will be collected using individual semi-structured
interviews, and content analysis will be performed.
Results: Data collected from the interviews will allow us to understand how the transition process occurred/is occurring, which
factors inﬂuence this process and consequences in the life experiences of the elderly.
Conclusions: This research will provide insight of how the transition process is occurring in the elderly, allowing a better understanding of this phenomenon. It is expected that the data collected
will potentially allow for the development of nursing interventions
that may optimize the transition process.
P-589
Who uses exercise in later life?
E. Clift 1 , H. Roberts 2 , A. Sayer 3 , A. Rogers 4 . 1 Health Education
England, NIHR CLAHRC, Wessex; 2 Academic Geriatric Medicine
University of Southampton, NIHR CLAHRC Wessex; 3 Academic
Geriatric Medicine University of Southampton, NIHR Newcastle
Biomedical Research Centre, Newcastle upon Tyne Hospitals NHSFoundation Trust and Newcastle University; 4 NIHR CLAHRC Wessex,
University of Southampton Health Sciences
Introduction: Living longer brings the challenge of ageing well.
Enabling older people to increase exercise and activity can improvehealth and social outcomes, functional ability, engagement withlocal community resources and quality of life. A key challenge isto reverse the trend for older people who reduce their activity by
50% from age 60 to 85 and to promote exercise alongside everyday
community living. This study explores the lived experience of older
people and their exercise practice in one English city.
Methods: An ethnographically informed approach was used tounderstand the local contexts. We undertook focus groups, withparticipants in local exercise classes, and non-exercise participants.
The data was enriched with ﬁeld notes and observations of theclasses. Further focus groups and 1:1 interviews were undertakenwith exercise providers, clinicians and service commissioners.
Results: Key themes identiﬁed relate to the charisma and capabilityof the instructor to tailor exercise to individual needs, familiarity
and accessibility of the group, and social engagement with fellow
participants. Non-exercise participants articulated the process of
dis-engagement as they grow older. Clinicians were unaware of
local provision, and unable to signpost older people appropriately. Exercise providers struggled to access routine referral routes.
Commissioners understood barriers, but were disconnected fromaspirational opportunities and the lived experience of service users.
Conclusions: Understanding local context, culture and older people’s priorities is key for engagement in exercise. Clinicians andproviders should develop awareness of local opportunities andtheir value to older people, to increase referral options that areappropriate and acceptable.

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Area: Oral and dental health

P-590
Association of functioning and nutrition with oral health andhygiene among old home care clients
E. Tuuliainen 1 , K. Autonen-Honkonen 2 , A. Nihtilä 3 ,K. Komulainen 1 , I. Nykänen 4 , S. Hartikainen 5 , R. Ahonen 6 ,M. Tiihonen 7 , L. Suominen 3 . 1 Institute of Dentistry, University ofEastern Finland, Kuopio, Finland; 2 Institute of Dentistry, University ofEastern Finland, Kuopio, Finland, Public Health Center, Oral HealthCare Services, City of Äänekoski, Finland; 3 Institute of Dentistry,
University of Eastern Finland, Kuopio, Finland, Department of Oral andMaxillofacial Surgery, Kuopio University Hospital, Kuopio, Finland;
4 Kuopio Research Centre of Geriatric Care, School of Pharmacy, Facultyof Health Sciences, University of Eastern Finland, Institute of Public
Health and Clinical Nutrition, Faculty of Health Sciences, University ofEastern Finland, Kuopio, Finland; 5 Kuopio Research Centre of GeriatricCare, School of Pharmacy, Faculty of Health Sciences, University ofEastern Finland, Kuopio, Finland; 6 School of Pharmacy, University ofEastern Finland, Kuopio, Finland; 7 Kuopio Research Centre of GeriatricCare, School of Pharmacy, Faculty of Health Sciences, University ofEastern Finland
Introduction: Vulnerable older people living at home are at increased risk of compromised oral health and hygiene. The aim of
this study was to describe oral health and hygiene in a group of
old home care clients and investigate how functional ability andnutrition are associated with them.
Methods: This study is a part of a multidisciplinary intervention
study of 269 home care clients aged ≥75 years, living in Eastern andCentral Finland. The data was collected using structured interviews
to measure ability to function in activities of daily living (ADL),
instrumental activities of daily living (IADL), comorbidity (Functional Comorbidity Index, FCI), depression (Geriatric Depression
Scale, GDS-15), cognitive function (Mini Mental State Examination,
MMSE), nutritional status (Mini Nutritional Assessment, MNA) andnumbers of drugs used. The study included an interview of oral
health and clinical oral examination.
Results: The majority of participants were at least moderately
dependent on support for activities of daily living (ADL). The
participants had, on average, 8.4 teeth. Dental plaque was detected
in 77%, bleeding on probing in 84% and dental caries in 30%. In
multivariate analyses, low functioning in activities of daily living
was statistically signiﬁcantly associated with occurrence of dental
plaque (OR =0.95, 95% CI: 0.9–1.0). Lower functional ability, lower
numbers of remaining teeth and higher amount of plaque wereassociated with bleeding on probing.
Conclusions: The results of this study suggest that functional ability is on important determinant of oral health and hygiene amongolder home care clients.
P-591
Promoting oral health and oral hygiene in a geriatric nursing
home – A pilot
I. Dolhaniuk, V. Moser-Siegmeth, C. Dorner, S. Hämmerle, A. Terzic,
U. Tarnawski, D. Metzenbauer, C. Fida, M. Patsch. Haus derBarmherzigkeit
The number of older people having their own teeth is rising.
According to studies, oral health (OH) has great impact on health.
The aim of the project is to achieve the best possible oral and dental
hygiene. It is designed as an intervention study and carried out
in a nursing home for one year. At the beginning the oral healthstatus of the residents (n=77) was assessed with a quantitative

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questionnaire. Also a survey with the nursing staff (n=36) regarding
OH knowledge and performance-rating was conducted. As interventions we implemented a special OH-training for the nurses,
utilised a guideline and offer professional dental hygiene. Resultsof the residents self-assessment show that 86% rate their OH as
good. Less than 10% report diﬃculties while speaking or eating.
Similar results can be found within the external assessment, where
the majority (70–95%) was assessed as healthy.Within the nurse
self-assessment, 67% rate their knowledge of oral care as good. Only
15% rated it as suﬃcient. Almost all respondents (94%) conﬁrmed
the importance of oral care. In order to improve the OH status,
regular dental examinations, followed by trainings are stated. The
results show a positive result both in the self-assessment and in
the external assessment of the residents. On the part of the nurses,
a high value towards the topic, as well as a consistently positive
assessment of the abilities and the OH health status of the residents.
P-593
Telemedicine and programmed oral surgery in a
Odontogeriatrics Program
M.V. Mejía Ramírez de Arellano, B. Garmendia Prieto, C. Alcaraz
López, P.R. Saenz, J. Gómez Pavón. HCCR. Hospital Central de la Cruz
Roja, San José y Santa Adela. Madrid, Spain
Introduction: The objetive is to deﬁne the development of ourOdontogeriatrics program along last 2 Years.
Methods: 19 patients from our Institutionalised, Home Visiting
and Acute Geriatrics care programs. Patients are checked by thedentist thanks to telemedicine and he chooses the treatment:
programmed oral surgery in our hospital or in other one. We
have included patients since 2015 to the present. We have collectedsocio-demographic, clinical, mental (Mental Red Cross -MRC-Index),
functional (Physical Red Cross -PRC- and Barthel -BI- Indices), geriatric syndromes, polifarmacy (>6 drugs), comorbidity (Charlson
Index), surgical risk (ASA Index), and surgical activity performedfeatures.
Results: One patient was rejected due to a deep vein trhombosis.
Final N=18 (84% women, mean age 83.84±7.32 years). Patients
proﬁle: 68% severely dependent (MRC 4–5), 53% moderate-severe
dementia (MRC >3), 74% polypharmacy, 26% high comorbidity(Charlson >3) and 57.89% high surgical risk ASA IV). The mostfrequent treatment has been complete dental pieces extraction or
root remains retained extraction which had had frequent infections(57.89%) or severe complications (26.31%). Mean surgical delay was
9.33 days. The most frequent surgical complication was hemorrhage(15.79%). Mean number of extracted dental pieces was 6.38 (range
2 to 13 pieces).
Conclusions: Severe functional and cognitive dependence, highpolypharmacy, high comorbidity and high surgical risk patients are
the most beneﬁted from the odontogeriatrics program.
P-594
The association of oral complaints with mental disorders inolder patients
A. Kossioni 1 , G. Kossionis 2 . 1 School of Dentistry, National andKapodistrian University of Athens, Greece; 2 “Dromokaition” Psychiatric
Hospital, Attica, Greece
Introduction: Psychiatric diseases, and particularly depression,anxiety and personality disorders, as well as psychiatric medications, have been associated with various self-reported oral
complaints. The aim of this study was to investigate any variation in
subjective oral complaints between older people with and without
mental disorders.
Methods: An interview was performed in a group of older patientswith mental disorders, with a mean age of 71.9 years residing

in a psychogeriatric ward and in a group of dental school patients without mental disease with a mean age of 70.2 years. The
patients with mental illness were diagnosed for mood disorders,
psychotic disorders, dementia, and other mental diseases. Descriptive statistics were performed, and chi-square and Mann-Whitney
tests investigated any signiﬁcant variation between variables.
Results: The non-mentally ill patients suffered more frequently
from hypertension and cardiopathy, but received fewer medications(P<0.05). The prevalence of xerostomia in patients with mental
disorders was 46.7%, burning mouth 22.7%, oral malodor 21.3% anddysgeusia 25.4%. The prevalence of these symptoms in people without mental disorders was 33.8%, 0%, 10.8% and 2.7% respectively.
The differences between groups were statistically signiﬁcant: xerostomia (P=0.049), burning mouth (P≤0.001), oral malodor (P=0.028)
and dysgeusia (P≤0.001).
Conclusions: Dysgeusia, burning mouth and oral malodor selfperceptions were more frequent in older people with mental
diseases; therefore, their prognostic value requires further investigation. The variation in xerostomia complaints between groups was
marginal, as people without mental illness also suffered from general diseases associated with xerostomia (ie. diabetes) or received
xerostomic medications (ie. for hypertension).
P-595
The effect of individually tailored dietary and oral healthcounselling among older home care clients on xerostomia
A. Nihtilä, K. Komulainen, E. Tuuliainen, I. Nykänen, S. Hartikainen,
A.L. Suominen. Facuty of Health Sciences, University of Eastern
Finland, Finland
Introduction: A subjective feeling of dry mouth (xerostomia) is
common among older adults and affects their quality of life,
nutrition and oral health. Medical conditions, polypharmacy anddehydration are often found behind xerostomia. The aim of thisstudy was to examine the effectiveness of a tailored dietary andoral health intervention among home care clients aged 75 years or
over.
Methods: This intervention study is part of a population –based
Nutrition, Oral Health and Medication (NutOrMed) study. Intervention group comprised 141 patients (84,3±5,5 years) and control
group 108 (84,6±5,8 years). Home care nurses, nutritionists, dental
hygienists and pharmacists carried out in-home interviews before
a tailored intervention. Individual counselling on dry mouth care
was given to all those suffering occasionally or continuously fromxerostomia (n=80, 56,8%) including advice on topical therapies. Nutritional intervention included instructions to all with malnutrion
or at risk of malnutrion (MNA score <24, n=120, 86,8%) on increasing the number of meals and energy and protein intake as wellas liquid intake. 91,2% (n=73) of those suffering from xerostomia
received both interventions.
Results: In the intervention group xerostomia decreased (7,1%)
and liquid intake (21,6%) and eating fruits or vegetables (10,0%)increased. In the control group xerostomia increased by 2,8%, liquid
intake decreased (5,4%) and eating fruit and vegetables slightly
increased (2,1%).
Conclusions: The interventions reduced xerostomia most likely
due to dietary changes. Comprehensive management of xerostomia
including nutritional advice is important as topical therapies alone
are often not enough.

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

Area: Pharmacology

P-596
AGITE – a medication self-management and adherence in theelderly questionnaire
H. Neves 1 , M. Almeida 2 , S. Duarte 2 , V. Parola 1 , A. Coelho 1 , I. Gil 2 ,J. Apóstolo 1 . 1 Health Sciences Research Unit: Nursing, Nursing Schoolof Coimbra, Portugal; Centre for Evidence-Based Practice: a Joanna
Briggs Institute Centre of Excellence, Portugal; 2 Health Sciences
Research Unit: Nursing, Nursing School of Coimbra, Portugal
Introduction: Complex medication regimes are a reality for manyolder adults (OA). This requires the use of inner competences toallow for higher levels of adherence and self-care-management
regarding medication. Health professionals require knowledge ofthese self-management and adherence behaviors to optimize andimprove quality-of-life. The use of a questionnaire could prove to
be a tool that systematize data collection with impact in the offer
adequate interventions.
Methods: A systematic review of literature was developed to obtain the main categories that inﬂuence medication adherence andself-management. Afterwards, a questionnaire with open-ended
questions was administered to twenty OA. Content analysis was
performed by a group of experts in the area, leading to the development of nineteen closed-ended questions with a Likert scale
approach for the scaling of responses. The questionnaire was named
AGITE. After application of the ﬁnal questionnaire to 128 elders in
day centers in Central Portugal, exploratory factorial analysis (EFA)
and internal consistency (IC) were performed.
Results: From the EFA, using varimax rotation, three main dimensions emerged: “Engagement”, “Neglect” and “External Inﬂuences”.
Higher scores of “Engagement” indicate a responsible attitude
towards self-management and adherence, while higher scores of“Neglect” tendency to cease medication without professional advice. People with high scores of “External inﬂuences” tend to follow
medication without assuming control of the process. Overall thequestionnaire dimensions demonstrate questionable to acceptable
IC (0,6<α<0,8).
Conclusions: AGITE requires further testing to understand its clinical validity and potential to aid in adapting nursing interventions tothe self-management and adherence proﬁle.
P-597
An approach towards internationalization and computerizationof the FORTA (Fit fOR The Aged) list
F. Pazan, M. Wehling. Clinical Pharmacology, Medical Faculty
Mannheim, Heidelberg University
Older people are the main recipients of drugs in many regions of theworld. Numerous studies have demonstrated that a large division ofolder people is the “target” of inappropriate drug therapy. The reason is that for most of the medications there is hardly any evidence
regarding eﬃcacy and safety in the elderly. Furthermore, the presence of multimorbidity and as a result polypharmacy aggravates
this issue. To effectively address this problem and to increase theappropriateness and quality of drug treatment in older people, ourgroup has developed a clinical tool called the FORTA List. Wehlingoriginally created FORTA, and the FORTA List was validated by 20
experts in a Delphi consensus procedure and updated in 2016. In
addition, we evaluated FORTA’s utility in a pilot clinical trial and ina randomized controlled prospective trial. These two trials revealed
that FORTA signiﬁcantly (p<0.001) improves the quality of drug
treatment, and even some secondary endpoints (e.g. total numberof ADRs) of our studies were improved. Based on these results,

S211

we conducted a consensus validation of country-speciﬁc FORTA
Lists in the UK, France, Poland, Italy, Spain, Nordic countries andNetherlands. Here, we used a self-developed algorithm to select top
experts in the ﬁeld of geriatrics with high experience in clinicalpharmacotherapy. 46 experts agreed to take part in our study. The
results of this study will be used to develop a European FORTA
List and an application (FORTA-App) which will help to increase its
international and clinical applicability.
P-598
An audit of non steroidal anti-inﬂammatory drug (NSAID)
prescribing to high risk patient populations
L. Daly 1 , M. O’Mahony 2 . 1 Ballinasloe Specialist Training Scheme inGeneral Practice, Ireland; 2 Glasson Health Centre, Ireland
Introduction: NSAIDs are associated with known morbidity/mortality, particularly in High Risk patient populations, such as theelderly. Prescribing should be both carefully considered and monitored. Studies have shown 1/3 of adverse drug reactions (ADRs)
requiring hospital admission may be attributable to NSAIDs. This
Audit assessed prescribing in an Irish General Practice, and compared results to a 2015 National Audit of NSAID prescribing performed in Wales (similar patient cohort). Data gathered included:
Among patients receiving repeat prescriptions for NSAIDs:• Percentage considered “High Risk” for an ADR, this included all
patients aged over 65.
• Rate of PPI co prescription.
• Percentage that had an eGFR documented in their records.
Methods: Healthcare Software, SOCRATES, was used to collect dataof patients who received more than one prescription for NSAIDs
in the period 01/07/2015 to 01/07/2016. Data was analysed using
Microsoft Excel and basic statistical analysis.
Results: 43 patients received more than one prescription for an
NSAID. 60% of those had at least one factor that categorised themas “High Risk”. 58% of patients had a PPI co-prescribed and 77% had
a recorded eGFR. These ﬁgures were higher than those found in the
All Wales National Audit (46 and 56% respectively).
Conclusion: The overall positive ﬁndings in this Audit are likely
attributable to repeat prescribing being performed solely by one
doctor. This shows how important continuity of care, and knowledge of patients, is to optimise prescribing practice in patients withmultiple co morbidities, or who are at High Risk of an ADR.
P-599
Analysis of remaining Potentially Inappropriate Medications(PIM) after revaluation of drug prescriptions in geriatric unit
P. Gibert, L. Maljean, A. Grevy, P. Bedouch, G. Gavazzi. CHU Grenoble
Alpes
Introduction: Revaluation of drug prescriptions in geriatric units
leads to improve the quality of prescription with the decrease of thenumber of Potentially Inappropriate Medications (PIM). But evenafter revaluation by a multidisciplinary team, some PIM still remain
in prescriptions. The aim of this study is to analyze the remaining
PIM at discharge in a geriatric unit.
Methods: We performed a 4-month prospective study of drug prescriptions of patients hospitalized in a geriatric unit of our hospital.
Patients with PIM in their prescription at admission and for whom
medication conciliation at discharge was performed were included.
Results: A total of 35 patients were included. At admission, 273
drugs were prescribed and 96 PIM identiﬁed (median of 8 drugs
and 2 PIM per patient). After revaluation, 31 of these PIM (32.3%)
remained at discharge. Among these PIM, 15 were psychotropic
drugs (12 benzodiazepines and 2 antidepressants, 1 neuroleptic
with failure to withdrawal), 8 proton pump inhibitors (PPI), 6
antiplatelet agents (APA) with no evidence-based clinical indication

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Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

and 2 antihypertensive drugs in old fallers. Benzodiazepines had
short half-life without withdrawal planned for all of them. PPI
were continued for patients with concomitant anticoagulant or
APA (n=6). APA were mainly kept for patients with cardiovascular history such as hypertension or arrhythmia (n=5). For allof these patients, explanations or guidance were rarely found in
hospitalization reports.
Conclusions: Most of PIM are stopped but the beneﬁt-risk balanceof the remaining PIM is most of the time diﬃcult to evaluate. Theirpursuit has to be justiﬁed and their future communicated to generalpractitioners.
P-600
Anticholinergic burden – A review of available scales andassociated outcomes
T.J. Welsh 1 , V. Van de Wardt 2 , A.L. Gordon 3 , J.R.F. Gladman 4 .
1 Research Institute for the Care of Older People; Royal United Hospital
Bath NHS Foundation Trust; University of Bristol; 2 University of
Nottingham; 3 University of Nottingham; Derby Teaching Hospitals
NHS Foundation Trust; 4 University of Nottingham; Collaboration for
Leadership in Applied Health Research and Care (CLAHRC) East
Midlands; NIHR Nottingham Biomedical Research Centre
Introduction: Cumulative anticholinergic exposure (anticholinergic
burden) is associated with a number of adverse outcomes. An
agreed approach to describing anticholinergic burden is neededin order to conduct research in this area. This review reports theresults of a systematic approach to identify anticholinergic burden
scales, the context in which they have been used and the outcomes
linked with them.
Methods: The Medline, Embase, CINAHL and PsycINFO databases
were searched for systematic reviews describing the use of anticholinergic burden scales. Abstracts and titles were then reviewed
with eligible articles read in full. The ﬁnal selection of studies wasthen analysed and appraised.
Results: Five reviews were identiﬁed for analysis which described
18 anticholinergic burden scales. Comparison of these scales
showed variation in their derivation, content and quantiﬁcationof anticholinergic activity. The Anticholinergic Risk Scale was used
more frequently in care homes and hospital settings while the Drug
Burden Index was the most commonly used scale in communityand database studies. Association between anticholinergic burden
and outcomes varied by scale and study - falls and hospitalisation
were consistently found to associate with anticholinergic burden
while mortality, delirium, physical function and cognition were not.
Conclusions: Anticholinergic burden scales vary in their derivation,
content and association with outcomes. This review has shown thatthe concept of anticholinergic burden has been variably describedand inconsistently deﬁned using a number of scales with different
content and quantiﬁcation. The association between adverse outcomes and anticholinergic burden varies between indices and has
not been conclusively established.
P-601
Antidepressant use in the elderly and users’ risk proﬁles:baseline characteristics of a German claims-based cohort
F.E. Pisa, B. Kollhorst, J. Reinold, T. Schink, U. Haug. Leibniz Institutefor Prevention Research and Epidemiology – BIPS
Background: Antidepressants (ATDs) are a useful therapeutic toolin late-life depression and prescribed off-label for pain or sleep
disturbances. They are frequently used in the elderly, but balancing
the risks and beneﬁts in these patients is challenging. The safety
proﬁles of individual ATDs need to be considered in combination
with the patients’ risk proﬁles. However, patient populations have
hardly been described in this regard.

Objective: This study aimed to assess patient characteristics, useof individual ATDs, co-medications and pre-existing diagnoses
relevant to potential adverse events in elderly users of ATDs.
Methods: Population-based cohort study of elderly aged ≥65 years
with a ﬁrst prescription for an ATD during 2005–2014, basedon claims data of the German Pharmacoepidemiological Research
Database (GePaRD). Pre-existing diagnoses and co-medications
were assessed any time before starting treatment.
Results: The cohort included 763,723 new users of ATDs (69.5%
women, median age 73 years; interquartile range (IQR): 68–79).
Treatment was most frequently started with Amitriptyline (19.9%),
Citalopram and Opipramol (16.0%), Mirtazapine (15.2%), Doxepin(8.1%). Before starting treatment, patients took a median of 7 (IQR:
4–10) differResults: The cohort included 763,723 new users of ATDs
(69.5% women, median age 73 years; interquartile range (IQR):
68–79). Treatment was most frequently started with Amitriptyline(19.9%), Citalopram and Opipramol (16.0%) Mirtazapine (15.2%),
Doxepin (8.1%). Before starting treatment, patients took a median of
7 (IQR: 4–10) different medications, 51.1% had Charlson Comorbidity index >2, 49% prior cardio- and 34.3% cerebro-vascular disease,
79.7% hypertension, 31.1% diabetes, 7.5% prior hip fracture.
Conclusions: Risk factors for adverse outcomes, co-morbidity andco-medications were common. This highlights the need for a careful risk-beneﬁt assessment and the consideration of the individual
agents’ safety proﬁles when prescribing ATDs in the elderly. ent
medications, 51.1% had Charlson Comorbidity index >2, 49% priorcardio- and 34.3% cerebro-vascular disease, 79.7% hypertension,
31.1% diabetes, 7.5% prior hip fracture.
Conclusions: Risk factors for adverse outcomes, co-morbidity andco-medications were common. This highlights the need for a careful risk-beneﬁt assessment and the consideration of the individual
agents’ safety proﬁles when prescribing ATDs in the elderly.
P-602
Bone mineral density changes in postmenopausal women after a
2-year treatment course of bisphosphonates
D. Sladkeviciene, A. Mastaviciute, M. Tamulaitiene, V. Alekna.
Vilnius University, Faculty of Medicine, Vilnius, Lithuania
Introduction: Osteoporosis is a disease characterized by a loss ofbone mass with alterations of the bone tissue’s microarchitecture
resulting increased bone fragility and risk of fracture. Bisphosphonates are the most commonly used agents for osteoporosis.
Methods: A retrospective cross-sectional study was performed in
The National Osteoporosis Center based in Vilnius and included
47 women aged 51 years and older. Exclusion criteria were malignancies, secondary osteoporosis. Written informed consent was
obtained from each participant. DXA was used to measure hip andlumbar bone mineral density (BMD) (iDXA, GE Lunar, USA). BMD
was measured twice: at the beginning of treatment and after 2 years± 6 months. All participants answered face-to-face questionnaires
addressing medications use after 2 years ± 6 months.
Results: The total of 47 postmenopausal women were investigatedin the ﬁrst visit: the youngest was 51 years and the oldest was 84
years old and the average BMD was 0.781 g/cm3 ±0.0131. In thesecond visit was measured BMD after 2 years use of bisphosphonate
treatment course and the average BMD was 0.84 g/cm3 ±0.082.
There was a signiﬁcant difference between the ﬁrst test and thesecond test results (p<0.001). Hip BMD for 32 of 47 women wasmeasured above the least signiﬁcant change (5%) and the mean was
13.59%.
Conclusions: The preliminary data of our study showed BMD
statistical signiﬁcant changes after two years of bisphosphonates
treatment.

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

P-603
Cerebrovascular accident related to the use of tranexamic acid:
A case report
L. Maljean, P. Gibert, C. Brun, A. Grevy, G. Gavazzi. CHU Grenoble
Alpes
Introduction: Tranexamic acid is an old drug (1986) mainly used
in ﬁrst intention for menorrhagia. It was recently reassessed by
French Haute Autorité de Santé who suggests that it represents
a high medical beneﬁt. However, no study was performed in theolder population. We report the case of a 91 years old woman, who
was hospitalized for a stroke few weeks after the prescription oftranexamic acid for menorrhagia (500mg three times per day) in acontext of uterine tumor.
Discussion: Thromboembolic event is a known but rare side effectof this drug (0.01 to 0.1%). Before prescribing tranexamic acid,prescribers have to ensure the absence of thromboembolic risk
factors before using it. However, older patients often are at highrisk of thromboembolic factor, age itself being a risk factor. Thispatient already had 4 risks factors and had aspirin as cardiovascularprevention. Aspirin could have been stopped before trying the useof tranexamic acid. Another issue is the adaptation of the drug
dosage to renal function. According to the legal mentions, thedosage must be adapted depending on the serum creatinine values
and not on the renal clearance as it is usually recommended in thispopulation.
Conclusion: For these reasons, prescribers should very carefully
think and reject all other option before the use of tranexamic acidin older individuals.
P-604
Comparison of drug therapy on nursing home admission andat six months with the application of STOPP/START criteria
version 2
S.H. Sveinsson 1 , P. Gunnarsson 1 , O. Samuelsson 2 , H. Hansdottir 3 ,A. Gudmundsson 2 . 1 University of Iceland Pharmacology Department,
Reykjavik, Iceland; 2 University Hospital of Iceland GeriatricDepartment, Reykjavik, Iceland; 3 Mörk Nursing Home, Reykjavik,
IcelandIntroduction: Nursing home residents are frail with multiple comorbidities requiring the use of many drugs, increasing the riskof potentially inappropriate prescribing. The STOPP/START criteria were developed to identify such errors, where STOPP detects
potentially inappropriate medications (PIMs) and START potential
prescribing omissions (PPOs). The aim of the study was to evaluate
drug therapy in two nursing homes in Reykjavik, with the application of the STOPP/START (version 2) criteria, on admission and at
six months.
Methods: The study was retrospective. Included were residents
admitted after January 1, 2013 that remained in the nursing homes
for at least six months. Data collected included information about
drug therapy, diagnosis, selected blood laboratory values and theresident’s state of health according to selected Resident Assessment
Instrument (RAI) variables.
Results: In nursing home A (n=88), the prevalence of residents with
PIM were 94.3% both on admission and at six months, and the
proportion of PIMs per total number of medications were 28.2%
and 27.3%, respectively. In nursing home B (n=55), the prevalence ofresidents with PIM on admission and at six months were 90.9% and96.4%, respectively, and the proportion of PIMs per total numberof medications were 30.3% and 36.8%, respectively. The number of
medications and PIMs were positively correlated at both time points
in nursing homes A and B. Cognitive impairment was negatively
correlated with the number of PIMs at six months in nursing home
A and on admission in nursing home B. In nursing home A, theS213

prevalence of residents with PPO on admission and at six months
were 73.9% and 68.2%, respectively, and in nursing home B, 85.5%
and 90.9%, respectively. The most common STOPP criteria used was
not a registered indication.
Conclusion: According to STOPP/START both PIMs and PPOs werehighly prevalent both on admission and at six months in both
nursing homes. Inadequare documentaion of diagnoses was common. Better documentation and regular medication reviews using
STOPP/START criteria, could be useful to reduce the high prevalence
PIMs.
P-605
Comparison of three score methods for predicting the risk ofadverse drug reaction in older people in intermediate term careinstitutions
P. Amoros 1 , L. Puerta 1 , A. Agustí 1 , B. Llagostera 1 , C. Mestres 2 ,M. Hernandez 3 . 1 Pharmacist Grup Mutuam, Barcelona, Spain; 2 Dean
Facultat de Ciències de la Salut Blanquerna (Univeristat Ramon Llull),
Barcelona, Spain; 3 Pharmacy Director Grup Mutuam, Barcelona, Spain
Introduction: In the last years, different risk scores to evaluate therisk of adverse drug reactions (ADR) in geriatric patients have been
proposed. The risk screening is an important tool for pharmacists
working in long term care institutions, in order to focus theirinterventions. We have assessed different tools to determine which
will be more appropriate in our setting.
Methods/Setting: Three intermediate long term care institutions.
Design: Observational cross-sectional study.GerontoNet, BADRI and
ADE Geriatric Risk Score, were applied using the electronic clinicalrecord to all inpatients. Palliative patients were excluded.Data wererecorded and evaluated using Microsoft Excel 2013® .
Results: A total of 248 patients were included.GerontoNet: 5(medium level of risk) was the most frequent score. Items ofcomorbidities and ≥8 drugs were the most habitual. BADRI: Scores
1, 2 and 3 had similar frequency (low-medium risk). Comorbidities
and length of stay ≥12 days were those most prevalent. ADE
Geriatric Risk Score: The higher frequency was in the range 2–5
score (medium risk). Use of anticoagulants since <3 months and
7–9 of drugs were the predominant risk factors.
Conclusions: The three methods gave results of medium risk of
ADR in our patients. Comorbidies and a high number of drugs are
determinant factors, been always present in our patients. In our
setting GerontoNet had limitations due to search for previous ADR
information. A prospective study will be managed using BADRI and
ADE Geriatric Risk Score.
P-606
Computerised medication analysis designed to minimise
inappropriate prescribing in older hospitalised patients:a systematic review
K. Dalton 1 , G. O’Brien 1 , D. O’Mahony 2 , S. Byrne 1 . 1 School of
Pharmacy, University College Cork, Cork, Ireland; 2 Department ofGeriatric Medicine, Cork University Hospital, Cork, Ireland and Schoolof Medicine, University College Cork, Cork, Ireland
Introduction: Prescribing medications for complex multi-morbid
older patients is a challenging process. Computerised interventions
have been suggested as an effective strategy to reduce potentiallyinappropriate prescribing (PIP) in this patient group. This systematic review examined the evidence of eﬃcacy of computerisedinterventions designed to reduce PIP in hospitalised older adults.
Methods: A comprehensive electronic literature search was conducted using 8 databases from inception to end of March 2017.
Studies were included if they were controlled trials (randomised
or non-randomised) of computerised interventions which aimed toreduce PIP in hospitalised older adults (≥65 years).

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Results: A total of 594 records were identiﬁed after duplicates were
removed. Eight studies met the inclusion criteria - two randomised
controlled trials, two interrupted time series studies, and four
pre/post intervention studies. Studies were mostly at a low risk ofbias. The acceptance rates of computer-generated recommendations
ranged from 29% to 95% in the studies that assessed this outcome.
The majority of studies showed either a signiﬁcant reduction in
the proportion of patients prescribed a potentially inappropriate
medicine (PIM), or a reduction in PIMs ordered compared to control
patients (p<0.05).
Conclusions: This systematic review concludes that computerised
medication review interventions are associated with a signiﬁcantreduction in PIP in hospitalised older adults. However, the majority
of included studies only focused on a limited number of PIMs.
Further studies are required that utilise robust validated software
engines capable of targeting a wider range of PIP instances, andthat can result in clinically signiﬁcant improvements in patient
outcomes.
P-607
Consensus validation of the POSAMINO (POtentially Serious
Alcohol Medication INteractions in Older adults) criteria
A. Holton 1 , P. Gallagher 1 , C. Ryan 1 , T. Fahey 2 , G. Cousins 1 . 1 Schoolof Pharmacy, Royal College of Surgeons, 111 St Stephen’s Green, Dublin
2, Ireland; 2 HRB Centre for Primary Care Research, Royal College ofSurgeons in Ireland, 123 St. Stephens Green, Dublin 2, Ireland
Objectives: Older adults experience a disproportionate burden of
alcohol-related harm. [1] Our objective was to develop an explicit
list of potentially serious alcohol-medication interactions for use inolder adults.
Methods: A systematic review, supplemented by a review of drug
compendia and clinical guidance documents, was conducted to
identify medications with the potential to interact with alcohol. The
Project Steering Group (PSG) reviewed each criterion, resulting in an
inventory of 52 potentially serious alcohol-medication interactions.
BNF black dot warnings (n=8) were included in the ﬁnal criteria
as they represent “potentially serious” interactions. The remaining
44 criteria underwent a two-round Delphi process using an expert
panel of 19 healthcare professionals from the UK and Ireland. Usingan online questionnaire, panellists were asked to rate their agreement with each criterion, using a 5-point likert scale. Consensus
was determined using the median response, interquartile range andcomments.
Results: Thirteen criteria were accepted in round one. Following areview of comments, nine criteria were removed and eight additional criteria were developed for the second round. The remaining
30 criteria went to round-two, with 17 criteria reaching consensus,
providing a ﬁnal list of 38 potentially serious alcohol-medicationinteractions; central nervous system (n=15), cardiovascular (n=9),
endocrine (n=5), musculoskeletal (n=3), infections (n=3), malignant disease and immunosuppression (n=2) and respiratory system(n=1).
Conclusions: POSAMINO is the ﬁrst set of explicit potentially serious alcohol-medication interactions for use in older adults. These
criteria will facilitate the risk stratiﬁcation of older adults at the
point of prescribing.
References:[1] Wadd S, Papadopoulos C. Drinking behaviour and alcoholrelated harm amongst older adults: analysis of existing UK
datasets. BMC Res. Notes. 2014;7:741.

P-608
Cooperation between geriatricians and general practitioners for
improved pharmacotherapy in home-dwelling elderly people
receiving polypharmacy – the COOP Study: study protocol
R. Romskaug 1 , T.B. Wyller 1 , E. Molden 2 , J. Straand 3 , H. Kersten 4 ,E. Skovlund 5 , K.H. Pitkälä 6 . 1 Department of Geriatric Medicine,
Institute of Clinical Medicine, University of Oslo, Oslo, Norway; 2 Schoolof Pharmacy, University of Oslo, Oslo, Norway and Center for
Psychopharmacology, Diakonhjemmet Hospital, Oslo, Norway;
3 Department of General Practice, Institute of Health and Society,
University of Oslo, Oslo, Norway; 4 Department of Research andDevelopment, Telemark Hospital Trust, Tønsberg, Norway and Schoolof Pharmacy, University of Oslo, Oslo, Norway and Norwegian National
Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg,
Norway; 5 Department of Public Health and General Practice, NTNU,
Trondheim, Norway and Mental and Physical Health, NorwegianInstitute of Public Health, Oslo, Norway; 6 Department of General
Practice, University of Helsinki, Helsinki, Finland and Unit of Primary
Health Care, Helsinki University Hospital, Helsinki, Finland
Background: Polypharmacy and inappropriate drug use is associated with negative health outcomes among older people. Various
interventions for improving drug treatment have been evaluated,but the majority of studies are limited by the use of surrogate
outcomes or sub-optimal design. Thus, the potential for clinicallysigniﬁcant improvements from different interventions is still unclear. The main objective of this study is therefore to evaluate theeffect upon patient relevant endpoints of a cooperation between
geriatricians and general practitioners on complex drug regimens
in home-dwelling elderly people.
Methods: This is a cluster randomised, controlled trial wheregeneral practitioners participate with patients from their lists. The
patients must be 70 years or older, use at least seven different
medications and have their medications administered by the homenursing service. We plan to recruit 200 patients, with randomisation at physician level. The intervention consists of three parts:
1) geriatric assessment of the patient, combined with a thoroughreview of their medications; 2) a meeting between the geriatrician
and general practitioner, where the two physicians combine theircompetence and knowledge and discuss the drug list systematically; 3) clinical follow-up, depending on the medication changes
that have been done. The patients are assessed at baseline, 16
and 24 weeks, and the primary outcome measure is health-related
quality of life according to the 15D instrument.
Discussion: Our choice of patient relevant outcome measures will
hopefully provide new knowledge on the potential for clinicalimprovements after performing comprehensive medication reviewsin home-dwelling elderly people receiving polypharmacy.
P-609
Development of national guidelines on the practice of crushing
and/or opening solid dosage forms
L. Bernard 1 , A. Lepelletier 2 , C. Bezel 3 , M. Dambrine 4 , C. Devos 5 ,E. Divoux 6 , J. Doucet 7 , P. Gibert 8 , M. Legrand 9 , D. Monzat 10 ,R. Puech 11 , R. Ratiney 12 , E. Rémy 10 , H. Richard 13 , J. Rocquain 14 ,A. Terrier-Lenglet 15 , R. Varin 16 , P. Cestac 17 , C. Mouchoux 18 .
1 Université Clermont Auvergne, CHU Clermont-Ferrand, CNRS, SIGMA
Clermont, ICCF, Clermont-Ferrand, France; 2 Service Pharmacie,
Hôtel-Dieu (site PTMC), CHU de Nantes, Nantes, France; 3 CH Le Vigan,
Pharmacie, Le Vigan, France; 4 Institut de Pharmacie, CHRU de Lille,
Lille, France; 5 CH Armentières, Service Pharmacie, Armentières,France; 6 Service Pharmacie, Centre Hospitalier de Lunéville, Luneville,
France; 7 Département de médecine interne-gériatrie-thérapeutique,
CHU de Rouen, Rouen, France; 8 Pôle Pharmacie, CHU de Grenoble,
Grenoble, France; 9 CHU Reims, Pôle Pharmacie Pharmacovigilance,Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

Reims, France; 10 OMéDIT Haute-Normandie, CHU de Rouen, Rouen,
France; 11 Service Pharmacie, CH Lamballe, Groupe HospitalierGériatrique du Penthièvre, Lamballe, France; 12 Service Pharmacie,
Hôpital René-Muret, Sevran, France; 13 Pôle Pharmacie CHU Carémeau,Nîmes, France; 14 CH Aubagne, Pôle Pharmacie, Aubagne, France;
15 CHU Amiens, Pharmacie, Amiens, France; 16 Pôle Pharmacie, HôpitalCharles-Nicolle, CHU de Rouen, Rouen, France; 17 Pôle Pharmacie CHU
de Toulouse, Toulouse, France; 18 Pharmacie, Hôpital des Charpennes,
Hospices civils de Lyon, Villeurbanne, France
Introduction: Many elderly patients are unable to swallow tablets
or capsules in their original form. Therefore, there is a growing
practice of crushing or opening these medications in order to ease
their administration to patients. However, this practice is at riskof drug ineﬃcacy or toxicity for both the patients or the nursing
staffs. In the absence of widely available and consensual guidelines,
we developed harmonized national guidelines for the practice ofcrushing tablets or opening capsules for oral administration.
Methods: The Gerontology Study Group of the French Society
for Clinical Pharmacy (SFPC), deﬁned the guidelines speciﬁcations
for each medication (drug name, dosage form, recommendationof opening or crushing. The data was collected from medication databases and pharmaceutical companies, and pooled in astandardized grid which was reviewed and validated by the group.
Results: This guideline was ﬁrst published in the form of asimple electronic tool widely accessible via the SFPC web site(http://sfpc.eu/fr/) and easy to use by health-care professionals. It
includes 3 parts: (1) an instruction manual on how to ﬁnd andread data about the desired drug, (2) general good practices forthe preparation and the administration of crushed medications,and (3) the entire list of chemicals along with information about
the possibility of crushing or opening. Secondly, the guide was
optimized into a dynamic databasis for easier and more eﬃcientuse.
Conclusions: The guide developed by our working group is a
simple, accessible and dynamic tool, suitable for current practice. It
integrates well with the management of elderly patients’ medical
care.
P-610
Differences between drugs related problems in aged andmiddle-aged patients: analysis of pharmacists medication orderreview during 8 years
F. Gervais, T. Novais, J. Bonhomme, L. Bourguignon, B. Charpiat,
C. Darcissac, S. Dini, X. Dode, S. Goutelle, B. Mandy, L. Malet,
S. Parat, C. Pivot, C. Mouchoux. GT “Pharmacie clinique adaptée à lapersonne âgée”, Hospices Civils de Lyon, Lyon, France
Introduction: Involvement of clinical pharmacists to identify andcorrect Drugs Related Problems (DRP) through pharmaceuticalinterventions (PI) is supported by literature, underlying positive
patient outcomes and improvement of care. Identifying speciﬁc
DRPs and PIs occurring in aged patients compared to middle-aged
patients should help to better manage at-risk patients. This study
aimed to analyses differences in DRPs during medication orderreview between patients aged ≥75 and patients aged 18–75.
Methods: A retrospective analysis on DRPs documented at the
French university hospital of Lyon - 8 hospitals - into a dedicated module of the French Society of Clinical Pharmacy website(Act-IP® ), was conducted from beginning of 2008 to end of 2015.
Results: A total of 56241 DRPs were registered: 19071 among aged
patient and 37170 among patient aged 18–75. A supratherapeutic
dosage of benzodiazepines (4.03%) was the most frequent DRP in
aged people. Compared to middle-aged, aged patients were, inparticular, signiﬁcantly associated with 1) type of DRPs: Non Conformity of the drug choice to guidelines (OR=1.693, 95% CI [1.520–

S215

1.887]), adverse drug reaction (OR=1.532, 95% CI [1.408–1.667]);2) drug class: Cardiac therapy (OR=5.257, 95% CI [3.404–8.119]),
Antithrombotic agents (OR=3.059, 95% [2.003–4.671]).
Conclusion: The medication review by pharmacists allows detecting DRPs effectively. This study highlights some directions that
could be taken to improve prevention of DRP among aged patients:
speciﬁc training to medical team, targeted information on safe drug
use and a closer collaboration between physicians and pharmacists.
P-611
Do the recommended doses of drugs depend on the equation
used to estimate glomerular ﬁltration rate in acute geriatric careunits?
F. Guerville, S. Duc, C. Roubaud-Baudron, N. Salles,
I. Bourdel-Marchasson, M. Rainfray. Gerontology Department,
Bordeaux University Hospital, Bordeaux, France
Introduction: There is no consensus about the most appropriate
equation for estimated glomerular ﬁltration rate (eGFR) in theelderly, especially for drug dose adjustment. In those patients,
the agreement is low between Cockcroft-Gault equation eGFR
(eGFR-CG) and Chronic Kidney Disease Epidemiology Collaboration
equation eGFR (eGFR-CKDEPI). In a geriatric population, we investigated the proportion and characteristics of patients receiving drugs
whose recommended prescription differs according to the equation
used to estimate GFR, and the drugs involved.
Methods: Patients admitted in acute geriatric care units of our
hospital were retrospectively screened. Drugs prescribed duringhospitalization were recorded. Doses and contra-indications recommended according to adjustment on eGFR-CG and eGFR-CKDEPI
were compared.
Results: Among 100 patients included, 31% received at least one
drug with a recommended prescription discordance: 20% received
at least one drug whose recommended dose was different between
eGFR-CG or eGFR-CKDEPI adjustment, 4% received a drug with arelative contra-indication according to only eGFR-CG or eGFR-CKDEPI, 7% received both. Recommended prescription discordance wasindependently associated with an older age and a lower weight.
Main drugs involved were benzodiazepines, anticoagulants andanti-infective drugs, prescribed to respectively 17%, 13% and 7%
patients.
Conclusions: In this acute geriatric care units population, drug recommended dose adjustment was frequently discordant according to
the equation used to estimate GFR, especially for benzodiazepines,
anticoagulants and anti-infective drugs. Cautious prescription isneeded in very elderly, thin patients. Further prospective studies
are needed to improve guidelines for drug dose adjustment tokidney function in older patients, focusing on those therapeutic
categories.
P-612
Drug induced erythroderma: A case report
S. Ponnambath, A. Miller, S. Helliar, R. Hinton, F. Rickard, A. Manley,
L. Jefferson. University Hospitals Bristol NHS Foundation Trust, Bristol,
United Kingdom
Case report: A 89 year old man of Chinese origin was admittedwith fever, poor mobility, severe, widespread skin rash and generalised pain. His past medical history included hypertension, COPD,
chronic kidney disease and gout diagnosed several months previously and treated with allopurinol. His other medications included
furosemide, lansoprazole and bisoprolol. On examination he had awidespread, erythematous, desquamating rash from head to toe.
Blood tests revealed acute kidney injury with raised inﬂammatory
markers. The working diagnosis was erythrodermic rash probably
secondary to allopurinol, sepsis of unclear source and acute kidney

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injury due to dehydration. He was commenced on intravenous
antibiotics and ﬂuids. Allopurinol was stopped as a suspected culprit drug. Renal ultrasound and CT imaging of kidneys, ureter andbladder were unremarkable. He was reviewed by the Dermatologist
same day and skin biopsy was performed. They felt the rash wasmost likely secondary to drug rash or Sezary syndrome. His CRP andrenal functions continued to deteriorate. The skin biopsy results
were consistent with a drug reaction.
Conclusion: Allopurinol is a widely prescribed gout treatment,
and it is known to cause erythroderma. Although typically a welltolerated medication, it may result in severe complications, andhigher doses should be used with particular caution in the context
of chronic kidney disease.
P-613
Drug therapy among the elderly in nursing homes: analysis
using the STOPP criteria version 2
I.E. Jondottir 1 , P. Gunnarsson 1 , O. Samuelsson 2 , H. Hansdottir 3 ,A. Gudmundsson 2 . 1 University of Iceland, Dept. of Pharmacology,
Reykjavik, Iceland; 2 University Hospital Iceland, Dept. of Geriatrics,
Reykjavik, Iceland; 3 Mörk Nursing Home, Reykjavik, Iceland
Introduction: The aim of this study was to use the STOPP criteria
version 2 to analyse potentially inappropriate medicine use in two
selected Icelandic nursing homes.
Methods: The study was a cross sectional study. Total number ofresidents included from the two care homes was 216. Data wascollected over 8 weeks. Data collected were; age, sex, treatment
goals, length of stay, number, type and lenght ot use of medications, diagnoses reported in medical records, blood test results andfunctional parameters according to selected RAI instrument scores(ADL, CHESS and CPS scores).
Results: The results showed that 95,4% of the residents were prescribed potentially inappropriate medications. The most common
reasons were no registered indication, medications prescribed for
too long or medications that were potentially inappropriate forthis population (for example antipsychotics, benzodiazepines andz-sleeping medicines). Inadequate documentation of diagnoses wascommon.
Conclusions: The STOPP criteria might be helpful to detect Potentially inappropriate medicications in Icelandic nursing homes.
Improved documentation of indications would make the STOPP
criteria more speciﬁc and their use might be helpful to optimize
quality of drug prescribing.
P-615
Eﬃcacy of venous compression on symptomatology oforthostatic hypotension and blood pressure in patients aged
75 years and over: a prospective multicenter case/control study
S. Krypciak 1 , L. Corsin 1 , A. Durand 1 , F. Canouï-Poitrine 2 ,E. Paillaud 1 . 1 Henri Mondor Hospital - APHP. Department of Internal
Medecine and Geriatrics, Créteil, France; 2 Henri Mondor Hospital APHP. Department of Public Health, Créteil, France
Introduction: Orthostatic hypotension is common and increases
with aging. It has important consequences on the morbidity, mortality and autonomy of elderly patients. The compression stockings arepart of the recommendations to combat orthostatic hypotension,but few studies have been carried out.
Method: A prospective, multicenter case/control study was conducted in the geriatric departments of 2 hospitals with the aimof demonstrating the eﬃcacy of class II compression stockings on
symptoms and blood pressure in orthostatic hypotension. Patients’histories, treatments and physical characteristics were investigatedto ﬁnd predictive factors for good or poor response to compression
stockings.

Results: 213 patients were tested and 38.5% of patients experienced
orthostatic hypotension. After 48 hours of corrective measures, only
35 patients were able to beneﬁt from orthostatic hypotension tests
without and with compression stockings and have been analyzed.
This study shows an improvement in the symptoms of orthostatic
hypotension when taken as a whole (p=0.02) but not independently. There was also a decrease in the blood pressure drop witha signiﬁcant difference (p<0.008) in favor of the effectiveness ofthe compression stockings. Diabetes and beta-blockers are factors
leading to a lower response of compression stockings.
Conclusion: These data should strengthen our convictions in orderto improve therapeutic education among patients. However, studiesof larger scale and against placebo are still necessary to conclude to
the effectiveness of the stockings.
P-616
Evaluation of the impact of the schedule of the drug taking on
the ingestas of seniors hospitalized in after-care andrehabilitation
L. Maljean, P. Gibert, A. Grevy, N. Zerhouni, S. Lumal, G. Gavazzi.
CHU Grenoble Alpes
Introduction: Fight against undernutrition is an important stake inthe older population. Moreover, polypharmacy represents a wellknown risk of undernutrition. Traditionally, drugs are administered
before the meal,. However, it has already been proposed to administrate the drugs after the meal in order to increase the amount offood ingested. The goal of this study is to evaluate the impact of theschedule of drug taking on the ingestas.
Methods: It is an observational study on patients hospitalized inrehabilitation in the Grenoble-Alpes university hospital. The ingestas has been evaluated by the weight of food ingested (in grams)
and the patient’s view was requested.
Results: Fifty-ﬁve meals were evaluated. The results show thatscheduling the administration of drugs after the meal increased theamount of food ingested by 9.4% for the breakfast and 15.4% for the
supper. it is interesting to note that none of the patients refused totake their drugs after the meal.Moreover, some patients explainedthat the administration of drugs before the meal resulted in anappetite loss, especially nutritional supplement and sachets.
Conclusions: This observational study shows that the schedule ofdrug taking is an interesting lead in the ﬁght against undernutritionof older individuals. It is however quite diﬃcult to set up in
short-care geriatric unit. Studies on feasibility and eﬃciency in alarger population are required.
P-617
Factors determining the use of anticoagulant therapy ingeriatric patients with atrial ﬁbrillation – retrospective analysis
A. Kasiukiewicz, Z.B. Wojszel. Department of Geriatrics, Medical
University of Białystok, Bialystok, Poland
Introduction: Atrial ﬁbrillation (FA) is a common disease in geriatric patients. The patients are at high risk of ischemic stroke but
also at risk of severe bleeding during anticoagulation.
Methods: Retrospective analysis of patients hospitalized in the
Department of Geriatrics in the period 01.09.2014–30.04.2015. Information on anticoagulant therapy before and after discharge andthe patients’ functional status were collected. Based on available
data, the risk of ischemic stroke (CHA2DS2VASc scale) and the riskof bleeding (HAS-BLED scale) were determined.
Results: 427 patients were hospitalized during the period of thestudy (mean age 81.6±6.75 years, 85% of patients over 85, 78% of
women). Among them, 98 patients with FA (22.95% of the population) were reported. Mean CHA2DS2VASc scale was 5.03±1.39 pts(min value - 3 pts) and HAS-BLED was 2.33±0.83 pts. Antithrombotic

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

agents were used in 58.16% of patients before admission and in
71,43% at discharge. Anticoagulation was discontinued in 6.12% andstarted in 19.39% patients. There were no statistically signiﬁcantdifferences in CHA2DS2VASc and HAS-BLED scales between patients treated with anticoagulants and without treatment, whereas
patients left without antithrombotic prophylaxis were more likely
to be at risk of falls and orthostatic hypotension, malnutrition, andoften lived alone.
Conclusions: FA geriatric patients, despite high risk of ischemic
stroke, are often under-treated with anticoagulation. This is often
associated with “geriatric” risk factors for the adverse effects ofanticoagulant therapy.
P-618
General practionners collaboration for pharmacist-led
medication review
S. Qassemi 1 , N. Tesquet 1 , F. Eyvrard 1 , L. Rouch 2 , C. Mccambridge 1 ,P. Cestac 2 . 1 Department of Pharmacy, Purpan Hospital, Toulouse
University Hospitals, Toulouse, France; 2 Department of Pharmacy,
Purpan Hospital, INSERM UMR 1027 Toulouse University Hospitals,
Toulouse, France
Introduction: To identify potentially inappropriate prescriptions
and reduce iatrogenic events, different actions may be proposed.
Among them, a structured medication review (MR) can be provide
by french pharmacist in collaboration with general practitioner.
MR is supported by a professional Network for the Community
Pharmacy (REIPO) structured around the city of Toulouse (Occitaniearea, France). The main objective of this study is to identify the
impediments and the levers to the implementation of a pharmacist
led MR in primary care.
Methods: A national questionnaire was sent to 8939 pharmacies
via the LGPI software of pharmagest. The survey was conducted,
during a two week period from April 7–22, 2017.
Results: The main barrier identiﬁed was the fear of physicians
non-adherence for 69.7% of pharmacists interviewed (n=276/396).
However, 71.5% (n=283/396) of them think that they can identify physician with whom they could collaborate. The second
obstacle identiﬁed was the human resources lack, 52% of pharmacists (n=205/396). Then there was the lack of ﬁnancial means(n=163/396), the fear of poor patient adhesion (n=153/396), andthe lack of knowledge about elderly therapeutic optimization(n=108/396). From the perspective of the pharmacists interviewed,
the main advantage is an improvement in the patient’s medication
management (90.7%, n=359/396).
Conclusion: In view of the main obstacle, the REIPO is alreadyworking closely with representative of general practitioners. It
offers a wide range of training for health professionals wishing
to upgrade their skills in the optimization of therapeutics of theelderly. The REIPO aim is to bring together the largest number ofpharmacists in order to be able to deploy the MR in collaboration
with physicians.
P-619
GPs’ continuation and acceptance of medication change at
sectorial transitions of geriatric patients – A qualitativeinterview study
A.G. Strehlau 1 , A.B. Almarsdottir 2 , J. Søndergaard 3 , J.U. Rosholm 1 .
1 Dept. of Ger. Med., Odense Univesity Hospital, Denmark; 2 Universityof Copehangen, Denmark; 3 University of Southern Denmark
Background: Follow-up in general practice on the medical prescriptions initiated during hospitalization is often perceived to beinadequate, leading to unintended drug interaction and over orunder dosage of medication. But only little is known about the GPs’view on the patients transition from the hospital to general practice.

S217

Objective: We conducted a qualitative interview study to understand the GPs’ views on medication changes for their patients byhospital physicians in a geriatric ward, and the GPs’ actions after
discharge.Setting: Ten general practitioners in Denmark.
Methods: Qualitative semi-structured interviews using a phenomenological approach.
Results: The GPs’ primary reason for discontinuity was miscommunication, but there was a multiplum of factors including delayeddischarged letters involved. The general practitioners did not ingeneral express disagreement with the changes made in hospital.
There is a great variation in the GPs’ way to handle medication
changes etc.
Conclusion: The reason for poor continuity of medication changes
in sector transition are primarily caused by procedural errors in
the follow-up of the patient after discharge, and by insuﬃcient
communication between the primary sector and the hospital.
P-620
Health status of the patients exposed to low-dose versus
high-dose carbon disulﬁdeH. Cho 1 , J.E. Oh 2 , Y.G. Lee 3 , C.Y. Cho 1 . 1 Department of Family
Medicine, Soonchunhyang University Hospital, Soonchunhyang
University, Seoul, Korea; 2 Department of Family Medicine,
Soonchunhyang University Hospital, Soonchunhyang University,
Cheonan-City, Korea; 3 Department of Physical Medicine andRehabilitation, Soonchunhyang University Hospital, Soonchunhyang
University, Seoul, Korea
Introduction: The purpose of this study is to garner useful information through a comparative analysis of health status between
the low-dose and the high-dose carbon disulﬁde (CS2) exposed
patients.
Methods: The low-dose exposed group was deﬁned as those exposed under 5 ppm (CS2 time weighted average concentration),and the high-dose exposed group was deﬁned as those exposed 5
ppm and over. Study subjects were 663 workers of Wonjin Rayon
Co., Ltd. located in South Korea. Multiple logistic regression analysis
was used in this study.
Results: The high-dose exposed patients were more vulnerable toanxiety, felt higher level of depression, showed decreased cognitive
function, and had diﬃculty to prepare food, compared with the
low-dose exposed patients. The high-dose exposed patients lagged
behind the low-dose exposed patient in total sleeping time andquality of sleep.
Conclusions: The vulnerability of the high-dose exposed patients interms of mood, mental and sleep health needs to be acknowledged
as the various characteristics of the individual that appears according to CS2 exposure. A variety of disease prevention and healthpromotion programs that focus on the health status of the patientsneed to be personalized and put them into practice.
P-621
Iatrogenic alerts in elderly patients with hip fracture in a
dedicated orthogeriatric care pathway
L. Zerah 1 , T. Lamy 2 , J. Cohen-Bittan 2 , R. Haddad 1 , C. Villain 1 ,M. Verny 3 , H. Vallet 1 . 1 Unit of Peri-Operative Geriatric care, Groupe
Hospitalier (GH) Pitié-Salpêtrière, Assistance Publique-Hôpitaux deParis (APHP), Paris, France; Sorbonne University, University Pierre andMarie Curie (UPMC) Paris 06, University Hospital Department Fight
Aging and Stress (DHU FAST), Paris, France; 2 Unit of Peri-Operative
Geriatric care, Groupe Hospitalier (GH) Pitié-Salpêtrière, Assistance
Publique-Hôpitaux de Paris (APHP), Paris, France; 3 Unit of PeriOperative Geriatric care, Groupe Hospitalier (GH) Pitié-Salpêtrière,
Assistance Publique-Hôpitaux de Paris (APHP), Paris, France; Sorbonne
University, University Pierre and Marie Curie (UPMC) Paris 06,

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University Hospital Department Fight Aging and Stress (DHU FAST),
Paris, France 3. Centre National de la Recherche Scientiﬁque (CNRS),
UMR 8256
Introduction: Elderly people are at risk of repeated hospitalizations, some being drug-related and preventable. In 2011, French
experts (Haute Autorité de Santé (HAS)) selected 5 “iatrogenic
alerts” (IAs), from the existing sets of explicit criteria, to assess
the appropriateness of medication in elderly patients. We aimed to
examine IAs evolution before and after HAS’ publication in patientswith hip fracture, particularly prone to drug related problems,managed in a dedicated orthogeriatric care pathway.
Methods: A retrospective study with time series analysis was set
up to analyze the prevalence of IAs between 2 periods: 2009–2012
and 2012–2015. All patients (>70 years) admitted after hip fracture
surgery into a dedicated unit of perioperative geriatric care were
included. IAs were deﬁned as: (1) long half-life benzodiazepine(BZD); (2) antipsychotic drug (APD); (3) co-prescription of 3 psychotropic drugs or more (PD), (4) co-prescription of 2 diuretics ormore (DIU) and (5) co-prescription of 4 antihypertensive drugs ormore (AHD).
Results: 495 patients (86±6 years) were included and 20% of themhad an IAs’ prescription (N=101) with a prevalence of: 2% for DIU,
3% for APD in patients with dementia, 4% for AHD, 6% for BZD and
6% for PD. Only the prevalence of APD in patients with dementia
had decreased between 2012–2015 vs 2009–2012 (respectively: 2%
vs 5%, p=0.03).
Conclusion: The prevalence of IA in our population was low. Afterthe publication of HAS’ recommendations on IAs in the elderly only
APD prescriptions decreased.
P-622
Improving Medication Prescription in the Context of Advanced
Care Planning for Patients Receiving Nursing Home Care
(IMPETUS): Study protocol of a cluster randomized controlled
trial
C.A.M. Pouw 1 , M.S. Smalbrugge 1 , J.G. Hugtenburg 2 , R.J. van
Marum 1 , C.M.P.M. Hertogh 1 . 1 Department of General Practice andElderly Care Medicine, Amsterdam Public Health research institute, VU
University Medical Center, Amsterdam, The Netherlands; 2 Departmentof Clinical Pharmacology and Pharmacy, VU University Medical Center,
Amsterdam, The Netherlands
Introduction: Nursing home (NH) residents in the Netherlands
have a limited life expectancy (mean survival 1.5–2 years) andsuffer from the combined burden of advanced disease, functional
impairment and severe care dependency. it is increasingly recognized that prescribing for these patients is better guided by ageriatric-palliative care (GPC) approach, with a focus on quality oflife, comfort and medication-safety rather than on life extension.
However, current prescribing practice lags behind: inappropriateprescribing is highly prevalent among NH residents. This study aims
to align medication prescription with GPC goals in NH residents,
by means of an Advance Care Planning with multidisciplinary
medication review intervention.
Methods: A cluster randomized controlled trial will be performed
in 2×20 long term care wards of University Aﬃliated NH, including
480 patients. NH patients are eligible if they wish GPC or have an
indication based on their life-expectancy (≤1.5–2 years). The intervention consists of biannual structured multidisciplinary medication reviews followed by ACP discussions with patients/surrogates,
compared to usual care. Primary outcome measures are medication
appropriateness. Secondary outcomes are falls, hospitalizations,mortality, quality of life and patient/surrogate satisfaction withinvolvement in decision-making. A qualitative process analysis will
also be performed.

Expected results: This study is expected to increase appropriateness of medication prescription (reduction of chronic and preventive medication, increase prescriptions for symptom management)
without increase in mortality, hospital admissions, or adverse effects. We expect no negative effect on quality of life, and a positiveeffect on patient/surrogate satisfaction in decision-making.
P-623
Inappropriate drug prescriptions: Comparison of three tools foraiding drug prescriptions in the elderly
L. Godaert 1 , S. Dechavigny 1 , M. Dramé 2 , J.-L. Fanon 1 . 1 University
Hospital of Martinique, Martinique, France; 2 University of Reims,
Champagne-Ardennes, France
Aim: To compare the proportion of prescriptions containing atleast one inappropriate drug, as identiﬁed using three tools for
optimizing drug prescriptions in the elderly.
Methods: Cross-sectional, observational study based on the analysis
of prescriptions of patients discharged between 1 September and 31
October 2014 in a short-stay geriatrics unit at the Louis Domerguede Trinité Hospital in Martinique (France). Each prescription was
analysed using 3 tools, namely one for general medicine (Vidal©
drug dictionary) and two tools speciﬁcally designed for geriatrics(the Laroche list of potentially inappropriate medications, and the
STOPP-START toolkit). The number of prescriptions containing atleast one inappropriate medication was recorded as evaluated witheach tool. These prescriptions were then compared to investigate
whether the two geriatric tools identiﬁed the same prescriptions as
being inappropriate.
Results: In total, 53 prescriptions were analysed. The male-female
sex ratio was 0.70. The average age of the patients was 84.5±6.2
years. Analysis according to the Vidal© drug dictionary identiﬁed
the greatest number of inappropriate prescriptions (28.3% of allprescriptions). The proportion of prescriptions containing at least
one inappropriate drug was lower with the two tools speciﬁc togeriatrics (11% for the Laroche list and 7.5% for the STOPP START
method).
Conclusion: The general medicine Vidal© drug dictionary identiﬁed more inappropriate prescriptions than the tools speciﬁcallydesigned for geriatrics. The tools for aiding drug prescriptions in
the elderly identiﬁed different drugs as being inappropriate.
P-624
Inter-rater reliability of STOPPFrail [Screening Tool of Older
Persons Prescriptions in Frail adults with limited life
expectancy] criteria amongst 12 physicians
A.H. Lavan, D. O’Mahony, P. Gallagher. Cork University Hospital andUniversity College Cork
Introduction: STOPPFrail is an explicit tool, developed by Delphi technique, to assist physicians with deprescribing medicationsin frailer older adults with limited life expectancy. The aim of
this study was to evaluate the inter-rater reliability of applying
STOPPFrail amongst physicians.
Methods: Twenty datasets were collated. The datasets comprised
frail multi-morbid patients with a mean age of 79.3 (SD 5.68)
years, a median number of 7 (IQR4–8) conditions and a medianof 9 (IQR 7–11) medications. Two of the STOPPFrail originators
reached complete agreement (Gold standard [GS]) in terms of theprescribing appropriateness for each case according to STOPPFrail.
Of 181 prescribed medications, 91 were deemed inappropriate by
GS assessment. Twelve physicians (3 Consultant Geriatricians, 3Geriatric Medicine trainees, 3 General Practitioners and 3 Palliative
Care physicians) independently applied the STOPPFrail tool to thedatasets.
Results: Eighteen of twenty cases met STOPPFrail inclusion crite-

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

ria. These were correctly identiﬁed by 9 physicians: 3 physicianscorrectly included at least 16 of the 20 cases. The median kappa
co-eﬃcient between raters and the GS was 0.75 (IQR 0.73–0.83).
Consultant Geriatricians stopped on average 8 more medications
than others, 94 vrs 86, p=0.005. It took physicians on average 2.7(SD 0.94) minutes to apply STOPPPFrail to each case.
Conclusions: The inter-rater reliability of STOPPFrail criteria is goodwhen tested between physicians practising in different specialties.
P-625
Investigation of prescribing and utilization practices forinjectable iron in the geriatric services of a university hospital
centerA. Tanty, P. Gibert, M. Baudrant, A. Grevy, P. Bedouch, G. Gavazzi.
CHU Grenoble Alpes
Introduction: The management of martial deﬁciency, is an important and frequent issue in the hospital management of geriatricpopulation. Currently two specialties of injectable iron are mainly
used (iron sucrose and carboxymaltose). There are no consensus
references detailing in which situations to use one or the otherof these 2 specialties. The aim of this study is to analyze thepractices of use of injectable iron within the geriatric services of
our university hospital center.
Methods: Retrospective observational study, including all the patients of 3 geriatric units. The data collection was made froma computerized extraction of injectable iron prescriptions over a
period of one month, from December 1, 2016 to December 31, 2016.
Results: 26 patients were included. The mean age was 87.7 years[±5.5 years]. The average length of stay was 23.8 days [±15.6 days].
Patients in the sucrose group received on average 120 mg [±45mg] iron vs 1000 mg [±223 mg] on average for the carboxymaltose
iron group. In total, 54% (n=14) of the prescribed martial balances
investigations were adapted according to the frenche Haute Autoritéde Santé recommendations. Overall, 77% (n=20) of patients who
received injectable iron had a martial deﬁciency.
Conclusion: This study shows an important difference in termsof iron dose received according to the prescribed specialty. Thebalance of anemia is not always well done before iron prescription. These results have to be conﬁrmed but improvement in the
management of martial deﬁciency is needed.
P-626
ITP in the elderly over 75 years: Epidemiological, clinical,
biological and therapeutics characteristics. About a retrospective
study
A. Toumi 1 , J.-L. Pennaforte 2 , N. Kadri 3 , J. Doucet 3 , E. Andres 4 .
1 Hospital of Troyes; 2 University Hospital of Reims; 3 University
Hospital of Rouen; 4 University Hospital of Strasbourg
Introduction: Idiopathic thrombocytopenic purpura (ITP) can also
occur in the elderly over 75 years. At present, there are no speciﬁcdata on the care of subjects aged 75 and over.
Methods: This is a retrospective study, focusing on a population ofsubjects above age 75, and having been previously diagnosed with
ITP, by the Department of Internal Medicine University Hospital of
Reims. The collection period spans the years between 2009 and2015.
Results: Fifteen patients were enrolled. The average age of diagnosis
was 83.9 years, females representing 11 cases (73.3%). The initialclinical presentation is dominated by a signiﬁcant medical historyof hemorrhagic bleeding. We note the presence of autoimmune
diseases, previous diagnosis of ITP, including one case bullous
dermatosis autoimmune, a case of autoimmune hemolytic anemia,
and scleroderma. Two haematologic malignancies (cutaneous lymphoma, LLC) were also observed. A diagnosis of systemic lupus was

S219

raised concomitantly. After the diagnosis of ITP, vasculitis ANCA
was observed (in the suites). During the diagnostic phase, themean platelet count was 14,46G/l. one case of Evans syndrome wasdiagnosed. The ﬁrst line of treatment is based on oral corticosteroid
therapy for 14 of the cases. We observed: a month, in order toobtain a complete response for 9 patients, a partial response in
3 patients, 2 patients failed to respond; At 6 months, a complete
response for 0 patients and recurrence for all patients was recorded.
Polyvalent immunoglobulins have not been successful for patients,
collected either alone or combined with corticosteroid therapy; aswell as for platelet transfusions. Splenectomy was performed for asingle patient with recurrence observed after 6 months. Alternative
treatments used include: mycophenolate mofetil, in a case of partial
response, dapsone for 2 patients with partial responses (with hepatic adverse events occurring after 2 years of its introduction), thecellcept for 2 patients, with a partial response for one patient, anda failure for the other (associated with adverse effects such dysuria
and gastric heaviness), danazol for one patient with failed results,
eltrombopag used for a single patient with adverse events that led
to his stopping. Rituximab had been used for 3 patients with acomplete response for one patient and a partial response in theother two. Romiplostim was used for one patient with a complete
response following the use of Rituximab, which had provided apartial response for this patient. We incurred a loss of 5 patients.
We noted one death within 1 month of the initial charge.
Conclusion: Large-scale studies should be conducted in this age
population, in order to standardize these practices.
P-627
Low-dose pregabalin causes tremor in an old patient: A casereportL. Maljean, P. Gibert, A. Grevy, M. Mallaret, G. Gavazzi. CHU
Grenoble Alpes
Introduction: Neuropathic pain is a common issue in the elderlycare. The current recommendations are tricyclic antidepressant(amitriptyline) or selective serotonin reuptake Inhibitor (Duloxetine) or antiepileptic (gabapentin, pregabalin). However, theserecommendations are quite large and there are no speciﬁc guidelines for the older patients. The initial choice of the drug isoften made based on prescriber’s habits and reevaluated based on
tolerance.
Methods: We are reporting a case, notiﬁed to the pharmacovigilance, of tremor caused by low dose pregabalin.
Discussion: The patient, man, 86 years old, was hospitalized for
myeloma. He presented neuropathic pain on the left leg. A treatment by pregabalin 50mg twice a day was introduced which wasquite effective. The doses of pregalabin were adapted with the renal
clearance of the patient (38 ml/min). Seven days later, important
tremors at rest appeared. The tremors quickly and spontaneously
improved after the stop of pregabalin. The pharmacovigilance
concluded by the imputability of pregabalin in the tremors.
Conclusion: This case shows that pregabalin can causes adverse effect even at a lower dose than recommended. The treatment should
be introduced at the lower dose possible and increase regarding theeﬃciency. Also, given the lack of speciﬁc recommendations, speciﬁcstudies in the older population should be performed.
P-628
Medical treatment in frail elderly heart failure patients
M. Brockhusen 1 , E. Nielsen 1 , S. Arnspang 2 , J.-U. Rosholm 3 .
1 Medical Student, University of Southern Denmark, Odense, Denmark;2 University of Southern Denmark, Odense, Debmark; 3 Department ofGeriatric Medicine, Odense University Hospital, Odense, Denmark
Background: Many elderly suffer from heart failure along with

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other concomitant diseases. The existing pharmacological guidelines for treating heart failure are based on studies where frail
elderly often are excluded. The concomitants diseases result in
polypharmacy if the guidelines for all patient’s diseases are followed and therefore prioritization between the recommended
drugs is desirable.
Objectives: To determine whether guideline recommended pharmacological treatment of chronic heart failure can be adjusted toa frail elderly population including prioritization between recommended drugs.
Methods: A systematic search in the PubMed and EMBASE
databases was conducted using relevant search-terms; rendering 7039 hits. Studies were included only if they focused on
pharmacological treatment of heart failure in frail elderly patients.
No original studies matched the inclusion criteria, whereas threereviews matched.
Results: None of the reviews presented clear pharmacological
guidelines. They all stated that the treatment of frail, elderly heart
failure patients needs to be individualized taking concomitantdiseases, current medication and patient expectations into account.
Some recommendations could be laid down:• In any episode of congestion patients should be treated with
diuretics.
• ACE-inhibitors are indicated in all systolic heart failure patients.
• Beta-blockers may be added to the treatment if tolerated.
• Digoxin is only indicated if the patient remains symptomatic.
Conclusion: This study revealed that guideline recommended treatment can be used in a frail elderly population, if tolerated and when
taking concomitant diseases and treatments into account. Diuretics
is the most important drug for the elderly heart failure patients.
P-629
Medication appropriateness for elderly nursing home residents
with a limited life expectancy: A Delphi consensus study
C.A.M. Pouw 1 , M.S. Smalbrugge 1 , J.G. Hugtenburg 2 , R.J. van
Marum 1 , C.M.P.M. Hertogh 1 . 1 Department of General Practice andElderly Care Medicine, Amsterdam Public Health research institute, VU
University Medical Center, Amsterdam, The Netherlands; 2 Departmentof Clinical Pharmacology and Pharmacy, VU University Medical Center,
Amsterdam, The Netherlands
Introduction: Dutch nursing home (NH) residents are generally(very) old. They suffer from multi-morbidity and often use a large
number of drugs. Medication inappropriateness is highly prevalent
in this group. The Screening Tool to Alert to Right Treatment(START) and Screening Tool of Older Persons’ Prescriptions (STOPP)
are commonly used tools to enable physicians to assess medication
appropriateness. However, these criteria may not be applicable forfrail elderly with a limited life expectancy. The aim of this Delphi
study is to adjust the current START/STOPP to these patients.
Methods: An online Delphi study, based on the 2015 START/STOPP
criteria [1]. We invited international pharmacists/clinical pharmacologists, geriatricians, elderly care physicians and generalpractitioners with expertise on the subject. In the ﬁrst round, we
ask for each medication group whether the expert considers it
appropriate to start this in our target patients, and if not, whether
they would stop it (on 4-point Likert Scales). Consensus is deﬁned as ≥70% of the participants answering (very)inappropriate or(very)appropriate. Participants are also asked to offer suggestions
to adjust the STOPP.
Results: 23 international experts agreed to participate in the study.
The ﬁrst round is currently in process, ﬁnal results are to be
expected in August 2017.
Conclusions: We expect to need three rounds. The results will
be used to develop adjusted START/STOPP criteria which will beapplied in a cluster randomized controlled trial aimed at increas-

ing the appropriateness of medication in NH residents in the
Netherlands with a limited life expectancy (1.5–2 years).
References:[1] O’Mahony D, O’Sullivan D, Byrne S, et al. STOPP/START criteria for potentially inappropriate prescribing in older people:
Version 2. Age and Ageing 2015
P-630
Medication management and adherence – A diagnostic study ofan elderly population in central Portugal
H. Neves 1 , M. Almeida 2 , S. Duarte 2 , V. Parola 1 , A. Coelho 1 , I. Gil 2 ,J. Apóstolo 1 . 1 Health Sciences Research Unit: Nursing, Nursing Schoolof Coimbra, Portugal; Centre for Evidence-Based Practice: a Joanna
Briggs Institute Centre of Excellence, Portugal; 2 Health Sciences
Research Unit: Nursing, Nursing School of Coimbra, Portugal
Introduction: With ageing a multitude of problems may arrive,
either due to genetic predisposition, lifestyle habits or other problems, that lead to the need of medication, requiring the need to
implement strategies by the elderly and their families, to improvemedication management and adherence. As such, it is importantto understand their knowledge, diﬃculties and strategies used, todevelop nursing interventions targeting this phenomenon.
Methods: A descriptive study was developed in elders who use daycenters, in Coimbra-Portugal. Data collection was obtained througha questionnaire with 4 open-ended questions and 26 close-ended
questions.
Results: From the questionnaire’s application, 128 answers wereobtained. Regarding risk factors, 24,4% failed at least one question
regarding spatial and/or temporal orientation, 76,4% had visualdeﬁcits, 35,8% lived alone, and 21,8% did not know how to read or
write. As for adherence, 88,6% considered important taking their
medication daily, and 79,7% believe in its beneﬁts in their life quality. Interestingly, 15,4% admitted taking non-prescribed medication,with 35,0% using natural products. Diﬃculties mentioned were“forgetfulness” or memory loss (37,4%). When asked to prepare apill, 9,8% were incapable of preparing, and 7,3% showed diﬃculties.
The most commonly mentioned strategies for adherence were
pillboxes with separators (31,7%) and asking for another person’s
support/help.
Conclusions: This study shows memory loss, and sensorial or cognitive impairments are diﬃculties that need to be considered whenaddressing this phenomenon. Also, pillboxes’ use and capacitationof the caregiver are strategies that need to be considered whendeveloping interventions regarding medication management andadherence.
P-631
Medication reconciliation in elderly cancer patients treated withchemotherapy
A.-L. Couderc 1 , F. Correard 2 , C. Tabélé 2 , S. Levillain 1 , R. Brun 3 ,A. Daumas 4 , P. Bertault-Peres 3 , P. Villani 1 , S. Honoré 2 . 1 Service deMédecine Interne, Gériatrie et Thérapeutique, Hôpital Sainte
Marguerite, AP-HM, Marseille, France; 2 Pharmacie, Hôpital Timone,
AP-HM, Marseille, France; 3 Pharmacie, Hôpital Sainte Marguerite,
AP-HM, Marseille, France; 4 Médecine Interne et Thérapeutique
Post-Urgences, Hôpital Timone, AP-HM, Marseille, France
Introduction: Medication reconciliation (MedRec) is considered to
be an important strategy for increasing the safety of medication use.
However, few studies have been carried out showing the effect of amultidisciplinary approach and MedRec program in elderly cancer
patients. The objective is to measure the effect of an oncogeriatricapproach integrating MedRec program on elderly cancer patientstreated with chemotherapy.
Methods: A monocentric prospective study was implemented toPoster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

evaluate the overall survival, rate of readmission hospital andadmission emergency at 1st, 2nd, 3rd month, acceptance rate of
dosage drug and inappropriate medication.
Results: From 01/01/2017 to 04/03/2017, 79 patients were received
in oncogeriatrics day hospital; mean age was 81.9±4.7. Howeverdata could be analyzed only for the ﬁrst 38 patients. Death rate
was 5.3%. Among the other 36 patients, 23 received chemotherapy, 6 were under active surveillance, 3 received palliative care,radiotherapy was applied for 2 patients, 1 patient had surgery,and 1 had another treatment. Readmission hospital rate was 23.7%
and admittance to emergency was 21% for the ﬁrst 3 months.
Acceptance rate of dosage drug modiﬁcation was 10/26, since data
are not available for 10 patients. Chemotherapy adaptation was
carried out in 18.2% of cases. Out of 22 patients with chemotherapy,
63.7% are still performing their chemotherapy, 13.6% completed it
and 22.7% prematurely stopped it. Data will be available only by 6months.
Conclusions: Increasing number of older patients (frail population)with cancer it could be incorporate “pharmaco-geriatric-speciﬁc”
evaluations to reduce inappropriate medications, use of health careresources and adverse events.
P-632
Optimization of drug treatment by using FORTA: Results fromthe FORTAMED study
F. Pazan 1 , H. Burkhardt 2 , H. Frohnhofen 3 , C. Weiss 4 , C. Throm 5 ,A. Kuhn-Thiel 6 , M. Wehling 1 . 1 Clinical Pharmacology, Medical
Faculty Mannheim, Heidelberg University; 2 University Hospital
Mannheim, Heidelberg University; 3 University Witten-Herdecke,
Faculty of Health, Department of Medicine; 4 Medical Faculty
Mannheim, Heidelberg University, Department of Medical Statistics,
Biomathematics and Information Processing; 5 Agaplesion Markus
Krankenhaus, Department of Cardiology and Angiology, Frankfurt am
Main; 6 MEDIAN Klinik Sonnenwende, Bad Duerkheim
Clinical studies on the eﬃcacy and safety of drugs often do notinclude older people. Thus, there is a lack of data as to the appropriateness of numerous drug treatments in this vulnerable group.
Indeed, these facts often turn the drug therapy of older people
into a “ﬁeld experiment”. To address this problem, the FORTA
classiﬁcation (A: Absolutely; B: Beneﬁcial; C: Careful; D: Don’t) was
proposed as a clinical aid for physicians. The FORTA List was developed in a Delphi process. To evaluate the effectiveness of FORTA we
conducted a prospective randomized controlled trial in hospitalized
elderly patients. Nearly half of our patients received standard careand the other half received standard care plus the FORTA method. In
this study, we separately assessed changes of drug prescriptions at
the anatomical-therapeutic-chemical system (ATC) level for elevenimportant diagnoses and compared over- and undertreatment rates
between the groups. At the individual drug/drug group level, eightitems (e.g. loop diuretics to treat arterial hypertension) were significantly altered by FORTA when use changes between admission anddischarge were compared between groups. Furthermore, FORTA
also signiﬁcantly improved undertreatment (e.g. ACE inhibitors
or statins to treat coronary heart disease) or overtreatment (e.g.
thiazides to treat heart failure) for seventeen drugs/drug groups.
Based on this trial, FORTA is the ﬁrst combined positive/negative
labelling approach at the individual drug level which is effective
in reducing inappropriate prescribing and certainly ameliorates the
drug treatment of older people.
P-633
Phenobarbital related confusion, dysarthria and ataxia
C. Michael. Christie Hospital NHS Foundation Trust, Manchester, UK
An 83 years old male was admitted following a fall; he had tried

S221

to stand up off a stool, turned, fell and was unable to weight bear.
X-ray showed fracture left neck of femur.His wife said that he has
been confused, walking with a sway “like a drunk” with numerous
falls in the last six months and his speech was slurred. Past medical
history included atrial ﬁbrillation and myocardial infarction. He
had epilepsy - the last seizure was several years ago. He was on
Warfarin, Bisoprolol 2.5mg once daily, Phenobarbital 30mg in themorning, 30mg in the afternoon and 60 mg nocte and Primidone
250mg three times daily. On examination he was slow to respond.
His pulse was 70 and blood pressure 95/50, He had tachypnea andfever. Both his CRP and WCC were high. Diagnosis: The admitting
team attributed the falls and his slow response to phenobarbital
and primidone side effects. He also had a chest infection.Treatment:
Antibiotic was started for the chest infection. The team decided togradually reduce phenobarbital and primidone and ultimately replace these with newer antiepileptics. Five days later the confusion
improved and the patient was more alert and rapid to respond. His
wife and family noticed the marked difference and the therapist
said “he is a different man”.
Discussion: Primidone is a structural analogue to phenobarbital andis metabolized to phenobarbital. The side effects of phenobarbital
include hypotension, drowsiness, lethargy, ataxia and hallucination.
Decades ago phenobarbital and primidone were sometimes coprescribed. Currently it is rare to prescribe these two medications
together. It could be a challenge to reduce or stop one of them,especially if the patient has been ﬁt free. If indicated, reduction
or discontinuation should be done cautiously and slowly and by aspecialist.
Conclusion:• Side effects of drugs need to be considered in the differential
diagnosis of confusion and falls especially in the elderly.
• It is important to remember that primidone is metabolized tophenobarbital.
P-634
Polypharmacy among oldest-olds from the island of Sardinia:
preliminary results
P. Mannoni 1 , G. Luciano 1 , M. Biggio 1 , A. Errigo 2 , G. Pes 1 .
1 Department of Clinical and Experimental Medicine, Sassari, Italy;
2 Azienda Ospedaliero-Universitaria, Sassari, Italy

Introduction: Populations characterized by exceptional longevity
have become a useful model to understand the aging process
and the occurrence of age-related diseases. In 2000, a hot-spot of
population longevity was identiﬁed in 6 villages in the mountainarea of the Sardinia island, Italy, where the highest life expectancy
in the world has been recorded. In the present study, a cohortof 50 nonagenarians living in these villages was interviewed toinvestigate health status, physical performance, and the use of
medicaments.
Method: The frequency of common chronic illnesses, in correlation
with the main pharmacological treatments, has been evaluated.
Results: The frequency of chronic disorders were: arthrosis (19.8%),
hypertension (19.2%), diabetes (11.2%), osteoporosis (5.2%), stroke(5.2%), cardiovascular disease (4.3%), cancer (2.6%). These subjects
had been treated mostly with the following class of drugs: nonsteroidal anti-inﬂammatory drugs (17.3%), ACE-inhibitors (17.3%),
acetylsalicylic acid and other antiplatelet drugs (13.3%), metformin(12.0%), loop diuretics (8.0%), calcium and vitamin D (8.0%), calcium
antagonists (5.3%), beta-blockers (4.0%), thiazides diuretics (4.0%),
bisphosphonates (4.0%), proton-pump inhibitors (2.7%), insulin(2.7%), angiotensin-II receptor blockers (1.3%).
Conclusions: Although these are preliminary results from an ongoing survey, we have observed that 56% of study participants
including oldest-old healthy people and oldest-olds with several
diseases have never been treated with any medicament. The other

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Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

44% of oldest-olds were treated with pharmacological therapy.
Thus, we may conclude that even though these elderly subjects
display age-related diseases, frequently untreated, they can attainadvanced age, likely due to exposure to potential favorable factors
shared by the population.
P-635
Polypharmacy, drug-drug interactions and anticholinergic loadin HIV-infected elderly patients compared to uninfected ones
F. Spagnoli 1 , P. Magro 2 , E. Focà 3 , A. Marengoni 4 , N. Gabbiadini 5 ,G. Romanelli 4 , F. Castelli 3 . 1 Post-graduate school in Geriatrics,
University of Brescia, Brescia, Italy; 2 Post-graduate school in Infectious
Diseases, University of Brescia, Brescia, Italy; 3 University Department
of Infectious and Tropical Diseases, University of Brescia, Brescia, Italy;
4 Department of clinical and experimental sciences, University of
Brescia, Brescia, Italy; 5 Medical School, University of Brescia, Italy
Aim: To evaluate polypharmacy, potentially serious drug-drug interactions (DDIs) and anticholinergic burden in older people withand without HIV infection.
Methods: Two samples of 65+ year-old Italian persons were investigated; 225 were HIV positive outpatients and 200 HIV negative
community-living people. Number and type of drug prescriptions
were collected. Polypharmacy was deﬁned as the co-prescription of
5+ drugs; potentially serious DDIs were identiﬁed by a validated
computerized prescription support system; the anticholinergic load
was calculated according to the Anticolinergic Cognitive Burden
Scale.
Results: The mean number of prescribed drugs was higher in HIV+
persons compared to the HIV- ones (6.1 vs 4.8;p<0.001), as well as
the prevalence of polypharmacy (73.3% vs 48.5%, p<0.001). Despite
the mean number of potentially serious DDIs did not signiﬁcantly
differ between the two samples, the percentage of persons with atleast one potentially serious drug-drug interaction was higher in the
HIV+ sample compared to the HIV- one (73.3% vs 48.5%, p<0.001).
On the other hand, the mean anticholinergic load was lower in HIV+
persons (0.15 vs 0.59, p<0.001). In multivariate analysis, adjusted
for age and gender, HIV infection was independently associatedwith polypharmacy (OR=4.0; 95% CI: 2,4–6,7), at least one potentially serious drug-drug interaction (OR=1.9; 95% CI: 1,1–3,2) and alower anticholinergic load (OR=0.28; 95% CI: 0,17–0,46).
Conclusions: Despite anticholinergic load was lower among HIVpatients, HIV infected patients had a higher burden of polypharmacy and a higher risk of potentially serious drug-drug interactions.
P-636
Prevalence of potentially inappropriate medication (PIMs)
according to STOPPFrail (Screening Tool of Older Persons
Prescriptions in Frail Adults with Limited Life Expectancy) in anolder frailer cohort with a limited life expectancy
A.H. Lavan, P. Gallagher, D. O’Mahony. Cork University Hospital andUniversity College Cork
Introduction: STOPPFrail is an explicit tool, developed by Delphi
technique, to assist physicians with deprescribing medications inolder frailer patients with limited life expectancy. The objective of
this research was to identify potentially inappropriate medications(PIMs) according to STOPPFrail in a representative population.
Methods: Comprehensive multi-disciplinary applications for nursing home placement, between January and June 2016, were retrospectively reviewed. Each application comprised detailed data regarding diagnosis, medications, function and cognition. STOPPFrailcriteria were applied where appropriate.
Results: 464 assessments were analysed. 38 were excluded because of incomplete information. STOPPFrail was applied to 274(64.3%) patients; 152 patients did not meet STOPPFrail inclusion

criteria. The STOPPFrial group were older (84 (SD 7) vs 77 (SD13) years, p<0.001), had 1 more medical condition (7 (SD 2) vs
6 (SD 2), p<0.001), were more dependent (Barthel 8 (SD 4.29) vs
12 (SD 4), p<0.001) and more likely to have dementia (73.4% vs42.8%, p<0.001). There was no difference in the median number of
medications between the groups; 8 (IQR 5–10.5) vs 7 (IQR 5–10),
p=0.490. STOPPFrail identiﬁed 894 PIMs in 247 patients (90%); a
median of 3 per patient. The most common PIMs were medications
without indication (66%), nutritional supplements (40%), high dose
proton pump inhibitors (32%), lipid-lowering therapies (29%) andneuroleptics (25%).
Conclusions: PIMs are commonly prescribed for frailer older
patients with limited life expectancy in whom nursing homeadmission is deemed appropriate. 90% of such patients were prescribed at least one PIM. Application of STOPPFrail criteria to thiscohort has the potential to optimise medication use.
P-637
Proton pump inhibitor use and risk of hip fractures amongcommunity-dwelling persons with Alzheimer’s disease –A nested case-control study
S. Torvinen-Kiiskinen 1 , A.-M. Tolppanen 2 , M. Koponen 1 ,A. Tanskanen 3 , J. Tiihonen 4 , S. Hartikainen 5 , H. Taipale 6 . 1 Kuopio
Research Centre of Geriatric Care, University of Eastern Finland,
Kuopio, Finland; School of Pharmacy, University of Eastern Finland,
Kuopio, Finland; 2 School of Pharmacy, University of Eastern Finland,
Kuopio, Finland; Research Centre for Comparative Effectiveness andPatient Safety (RECEPS), University of Eastern Finland, Kuopio, Finland;
3 Department of Clinical Neuroscience, Karolinska Institutet, Stockholm,
Sweden; Department of Forensic Psychiatry, Niuvanniemi Hospital,
University of Eastern Finland, Kuopio, Finland; National Institute for
Health and Welfare, Helsinki; 4 Department of Clinical Neuroscience,
Karolinska Institutet, Stockholm, Sweden; Department of Forensic
Psychiatry, Niuvanniemi Hospital, University of Eastern Finland,
Kuopio, Finland; 5 Kuopio Research Centre of Geriatric Care, Universityof Eastern Finland, Kuopio, Finland; School of Pharmacy, University ofEastern Finland, Kuopio, Finland; Department of Psychiatry, Kuopio
University Hospital, Kuopio, Finland; 6 Kuopio Research Centre ofGeriatric Care, University of Eastern Finland, Kuopio, Finland; School of
Pharmacy, University of Eastern Finland, Kuopio, Finland; Departmentof Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
Introduction: Hip fractures are major health concern among older
persons with Alzheimer’s disease (AD), who usually use many
concomitant drugs for several diseases. Objective of this study was
to investigate whether the use of proton pump inhibitor (PPI) is
associated with risk of hip fractures among community-dwellingpersons with AD.
Methods: In this nested case-control study, we included 4,224(mean age 84.1) community-dwelling persons with AD, who encountered hip fracture, from nationwide MEDALZ cohort. For each
hip fracture-case at the date of hip fracture, 16,852 controls (meanage 84.0) without hip fracture were matched. We investigated PPI
use at the index date and during 10 years before. Conditional
logistic regression was used to investigate the association between
PPI use and hip fracture.
Results: PPI use at the index date was associated with an increased
risk of hip fracture (adjusted OR 1.12, 95% CI: 1.02–1.23). The risk
was increased in short-term use (<1 year) from the index date(adjusted OR 1.29, 95% CI: 1.14–1.45). No association was foundbetween longer duration of use (>1 year), or cumulative use andrisk of hip fractures.
Conclusions: PPI use was modestly associated with an increased
risk of hip fracture among persons with AD. The risk was evident
in short-term use but no association was found for long-term
use. Thus, our ﬁndings do not support previous assumptions that

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

long-term PPI use would be associated with an increased risk of hip
fractures.
P-638
Signiﬁcant reduction in anticholinergic burden on an acutefrailty unit
B.A.S. Wildblood 1 , L. Clow 1 , A.M. Mohan 1 , C.A. Adams 1 ,T.J. Welsh 1,2,3 . 1 Royal United Hospital Bath NHS Foundation Trust,Bath, UK; 2 University of Bristol, Bristol, UK; 3 Research Institute for theCare of Older People, Bath, UK
Introduction: A number of commonly used medications have mild
anticholinergic activity of which practising clinicians may not beroutinely aware. The cumulative effect of multiple such medications, known as anticholinergic burden, has been associated withadverse events such as falls, hospitalisation and increased mortality.
Interventions that reduce anticholinergic burden may therefore be
beneﬁcial. This project formed part of a quality improvement cycle
aiming to reduce anticholinergic burden on an acute frailty unit.
The ﬁrst stage in this process was to quantify the impact of current
practice on anticholinergic burden and this is reported here.
Methods: A retrospective review was completed of the ﬁrst 100
admissions to the acute frailty unit in February 2017. Medication on
admission and discharge was recorded. The Anticholinergic Cognitive Burden Scale was used to quantify and compare anticholinergic
burden on admission and discharge.
Results: Data was available from 86 admissions. Mean age 83 (SD7.5), 63% female. 57 (66%) were taking at least one anticholinergic medication. At discharge the total number of medicationsprescribed remained unchanged while the total number of medications with anticholinergic properties was reduced from 101 to
79. The anticholinergic cognitive burden score was signiﬁcantly
reduced from median 1 (0–3) to 1 (0–2) P=0.04.
Conclusions: Medication review within the acute frailty unit significantly reduced median anticholinergic burden but left a proportionof people still on medications with anticholinergic properties. A
more targeted approach to reducing anticholinergic burden may be
more effective and these data will aid the development of suitableinterventions.
P-639
The effect of drug adjustment on hospitalized patients and its
examination
Y. Yoshioka, S. Harada, K. Shibasaki, A. Sampei, M. Yakabe,
A. Yonenaga, K. Toyoshima, T. Kojima, M. Ishii, Y. Kameyama,
Y. Yamaguchi, T. Urano, S. Ogawa, M. Akishita. Department ofGeriatric Medicine, Graduate School of Medicine, The University ofTokyo, Tokyo, Japan
Introduction: Polypharmacy is known to cause various disadvantages in hospitalized patients. Therefore, we have tried to reduce
the number of medications during hospitalization while carefulmonitoring.
Methods: We analyzed 253 patients, discharged from the geriatricward in the University of Tokyo Hospital, from April 2016 to March2017. We counted the number of medications on admission and atdischarge. We divided the patients into three groups; patients withincreased, the same and decreased number of oral medications atdischarge. In those groups, we assessed the basic characteristics,
comorbidities, and the number and types of medications.
Results: We collected 253 patients (111 men and 142 women), aged
from 52 to 97 (82 on average). They were taking 7 medications on
admission and it was signiﬁcantly decreased to 6 at discharge on
average. Out of them, the number of oral medications was increased
in 21% (53/253), the same in 33% (83/253) and decreased in 46%(117/253). 23 patients were able to reduce 5 or more drugs, up to

S223

15 drugs. Among patients with reduced number of medications atdischarge, the mean number of discontinued drugs was 3.
Conclusions: In our inpatient services, we succeeded in reducing the average number of one medicine during hospitalization.
Patients who were hospitalized for emergency could be reduced
more medicine than expected patients. In addition, the decreasein cardiovascular drugs and peptic ulcer therapeutic drugs wasconspicuous. We assume that the review after hospitalization of
hypertension and gastrointestinal diseases and so on result in drug
reduction.
P-640
The impact of age on the incidence of adverse drug events(ADEs) causing hospitalisation in cancer patients
A.H. Lavan 1 , D. O’Mahony 1 , D. O’Mahony 2 , P. Gallagher 1 . 1 Cork
University Hospital and University College Cork; 2 Cork University
Hospital
Introduction: Over 60% of all cancers are diagnosed in patients’≥65 years, many of whom have other co-morbidities. Multi-morbid
people with polypharmacy have a high risk of adverse drug events(ADEs). The aim of this study was to ascertain the incidence of ADEs
causing hospitalisation in older cancer patients and compare themto the non-cancer older population [1–3].
Methods: This prospective observational study included adults(≥16 years) admitted under a specialist tertiary oncology service. The proportion of patients experiencing a probable/certain
non-trivial ADE, according to WHO-UMC causality assessment [4],causing/contributing signiﬁcantly to acute admission was recorded.
Results: 265 participants participated; 54% female. 52.5% ≥65years, 35.5% ≥70 years and 7.5% ≥80 years. The median age was
66 (IQR57–72). Older adults, compared to younger adults, hadsigniﬁcantly more comorbidities, median 8 (IRQ5–10) vs 5 (IR 3–6),
p<0.001, and took more medications, 7 (IQR4–10) vs 4 (IQR2–7),
p=0.026. The most common cancers were breast (18.5%), lung(18.5%) and colorectal (9.1%).82 patients (30.9%) were affected by
ADEs, in whom 74 caused/or contributed signiﬁcantly to admission.
ADE occurrence had no signiﬁcant relationship to age (p=0.960),
gender (p=0.399), length of stay (p=0.537) or number of daily
drugs (p=0.533). ADE incidence was similar in older and younger
adults for both non-cancer drugs (14.4% vs 9.5%, p=0.141) andcancer-speciﬁc drugs (13.7% vs 15.9%, p=0.469). The most commonly reported ADEs were neutropenia with associated infectionin 23%, nausea/vomiting in 18.9% and major constipation in 17.6%.
Conclusions: Approximately 1 in 4 acute admissions in adult cancer
patients are ADE-related. ADEs are caused by non-cancer drugs as
frequently as cancer speciﬁc treatments in both older and younger
adults. Older cancer patients experience ADEs at similar frequency
to their younger counterparts. The ADE rates reported here for older
cancer patients are higher than those previously reported in thegeneral acute population.
References:[1] Lazarou J, Pomeranz BH, Corey PN. Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective
studies. Jama. 1998; 279(15): 1200–5.
[2] Pirmohamed M, James S, Meakin S, Green C, et al. Adverse drug
reactions as cause of admission to hospital: prospective analysis
of 18 820 patients. Bmj. 2004; 329(7456): 15–9.
[3] Wiffen P, Gill M, Edwards J, Moore A. Adverse drug reactions
in hospital patients. A systematic review of the prospective andretrospective studies. Bandolier Extra Evidence Based Healthcare. 2002.
[4] WHO. World Health Organization (WHO), Uppsala Monitoring Centre. The use of the WHO-UMC system for standardized case causality assessment. Available at: http://www.whoumc.org/graphics/4409.pdf.

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Area: Pre and post operative care

P-641
A change for a restrictive transfusion regimen in a hip fracture
care pathway is associated with a shift of transfusion to rehab
units. The UPOG-TRF2 study
L. Dourthe 1 , L. Zerah 1 , A. Gioanni 1 , J. Cohen-Bittan 1 , R. Haddad 1 ,M. Verny 1 , M. Raux 1 , A. Mézière 2 , B. Riou 1 , F. Khiami 1 , H. Vallet 1 ,J. Boddaert 1 . 1 Pitié Salpêtrière; 2 Charles Foix
Introduction: A restrictive transfusion strategy for elderly patientswith hip fracture (HF) is safe and reduces cardiovascular outcomes,
but it may postpone transfusion to rehabilitation units. We hypothesized that a change of transfusion regimen from a liberal to a
restrictive regimen may cause a shift of transfusion to rehab units.
Material and methods: A retrospective analysis of a time series
analysis of consecutive patients >70 years admitted for a HF to our
UPOG, comparing a liberal transfusion regimen (LR) (Goal: hb level≥10 g.dL-1, 1st period) to a restrictive regimen (RR) (Goal: hb level≥8 g.dL-1 or transfusions according to symptoms, 2nd period). Alltransfusions from ED/OR to UPOG and rehab units were reported
and compared according to transfusion regimen.
Results: 667 patients were included (86 y/o, CIRS 52 9 [6–12]),193 in the LR group, 474 in the RR group. 396 patients (59%)
were transfused for a total of 1003 red pack cells (RPC). In liberal
regimen, 133 patients (69%) were transfused with 386 RPC (mean
2 per patients and 2.9 per transfused patient), 64 (33%) in ED/OR,
96 (50%) in UPOG, and 18 (9%) in rehab. In restrictive regimen, 263(55%) with 617 RPC (mean 1.3 per patients and 2.3 per transfused
patient), 105 (22%) in ED/OR, 222 (47%) in UPOG, and 87 (18%) in
rehab.
Conclusion: Despite a transfusion shift to rehab units, a change
for a RR is associated with a reduction of total transfusion during
management of HF.
P-642
A post-surgical review of operative debridement of sacral
pressure ulcers
S. Wozniak, K. Khan, K. Haag, J. Coleman. Sinai Hospital of Baltimore,
Geriatric Surgery
Background: Pressure ulcers frequently found in the older population are associated with signiﬁcant morbidity and mortality.
Reviewing the literature, a limited number of studies exist reviewing 30 day post-operative occurrences in patients undergoing
surgical debridement of decubitus ulcers.
Aim: The aim of this review is to better understand post surgicalcomplications in older patients undergoing surgical debridement ofdecubitus ulcers.
Methods: Operative records were reviewed from 2012 to 2016 at
a community based hospital. Records were reviewed for quantity
and type of post-operative occurrences. Individual post-operative
occurrences were reviewed with regard to patient age, gender, degree of sacral ulcer, and pre-existing co-morbidities. Further records
were reviewed to ensure comparability in terms of debridement
technique.
Results: The mean age of the patients was 64.1 years of age.
Intra-operative anesthesia used: general 86.1%, monitored anesthesia care/IV sedation 12.7%, and local 1.3%, with an average surgicalduration totaling 28 minutes. Mean hospital length of stay was
8 days with 80% of patients alive at 30 days. Upon quantifying
post-operative occurrences it was found 61% (43/70) patients had
no post operative occurrences, 20% (14/70) had 1 post-operative occurrence, 10% (7/70) had 2 post-operative occurrences, 5.7% (4/70)

had 3 post-operative occurrences and 2% (2/70) had 4 or more
post-operative occurrences.
Conclusions: Higher post-operative occurrences were found withpatients who had larger wounds or wounds with an active infection
and a greater number of pre-surgical co-morbidities.
P-643
Association between anesthetic drugs and postoperativedelirium in elderly patients with hip fracture in a dedicatedorthogeriatric care pathway
L. Zerah 1 , T. Lamy 2 , J. Cohen-Bittan 2 , A. Gioanni 2 , M. Raux 3 ,A. Mézière 4 , B. Riou 5 , H. Vallet 1 , J. Boddaert 6 . 1 Unit of PeriOperative Geriatric care, Groupe Hospitalier (GH) Pitié-Salpêtrière,
Assistance Publique-Hôpitaux de Paris (APHP), Paris; Sorbonne
University, University Pierre and Marie Curie (UPMC) Paris 06,
University Hospital Department Fight Aging and Stress (DHU FAST),
Paris, France; 2 Unit of Peri-Operative Geriatric care, Groupe Hospitalier(GH) Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (APHP),
Paris, France; 3 Sorbonne University, University Pierre and Marie Curie(UPMC) Paris 06, University Hospital Department Fight Aging andStress (DHU FAST), Paris; Departments of Anesthesiology and CriticalCare, GH Pitié-Salpêtrière, APHP, Paris, France; 4 Department of
Rehabilitation, GH Charles Foix, APHP, Ivry sur Seine, France;
5 Sorbonne University, University Pierre and Marie Curie (UPMC) Paris
06, University Hospital Department Fight Aging and Stress (DHU
FAST), Paris; Departments of Emergency Medicine and Surgery, GH
Pitié-Salpêtrière, APHP, Paris, France; 6 Unit of Peri-Operative Geriatriccare, Groupe Hospitalier (GH) Pitié-Salpêtrière, Assistance PubliqueHôpitaux de Paris (APHP), Paris, France; Sorbonne University,
University Pierre and Marie Curie (UPMC) Paris 06, University Hospital
Department Fight Aging and Stress (DHU FAST), Paris, France 6. Centre
National de la Recherche Scientiﬁque (CNRS), UMR 8256
Introduction: Postoperative delirium (POD) is one of the mostcommon complications after hip fracture surgery and is associatedwith a worse prognosis. The impact of anesthetic drugs on theincidence of POD has not yet been evaluated. Our main objective
was to compare patients with or without POD with regard to drugs
they received during anesthesia.
Methods: Between 2009 and 2016, all patients (>70 years) admitted after hip fracture surgery into a dedicated unit of peri-operative
geriatric care were included.
Results: We included 559 patients: mean age: 86±6 years, 429(77%) females, CIRS 52: 9 [6–12], ADL: 5 [3–6], number of drugs
per day: 5 [3–8], length of stay: 11 [9–15] days. 220 patients(39%) suffered from POD after the surgery. We found no difference between the 2 groups with regard to drugs they received
during anesthesia: cardiovascular drugs (atropine, prostigmine,ephedrine, neosynephrine, noradrenalin), induction and maintenance drugs (curare, sufentanyl, remifentanyl, propofol, etomidate,midazolam), anti-nausea drugs (corticoids, droleptan, ondansetron),antalgic drugs (paracetamol, tramadol, nefopam, nonsteroidal antiinﬂammatory drugs, ketamine, morphine) or blood transfusion.
Patients with POD were more likely to have dementia (59% vs 26%,
p<0.001), anemia (98% vs 95%, p=0.05), swallowing disorders (56%vs 26%, p<0.001), bladder retention (30% vs 22%, p=0.04) and stool
impaction (50 vs 37%, p=0.004) than others.
Conclusion: In comparison with comorbidities and acute complications, anesthetic drugs regimen may not inﬂuence occurrence of
POD in a dedicated geriatric care pathway.

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

P-644
Association between cognitive status and outcomes in elderly
patients with hip fracture in a dedicated orthogeriatric carepathway
L. Zerah 1 , J. Cohen-Bittan 2 , M. Raux 3 , A. Mézière 4 , C. Tourette 5 ,C. Neri 5 , M. Verny 6 , B. Riou 7 , F. Khiami 8 , J. Boddaert 6 . 1 Unit ofPeri-Operative Geriatric care, Groupe Hospitalier (GH)Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (APHP), Paris,
France; Sorbonne University, University Pierre and Marie Curie(UPMC) Paris 06, University Hospital Department Fight Aging andStress (DHU FAST), Paris, France; 2 Unit of Peri-Operative Geriatric care,Groupe Hospitalier (GH) Pitié-Salpêtrière, Assistance
Publique-Hôpitaux de Paris (APHP), Paris, France; 3 Sorbonne
University, University Pierre and Marie Curie (UPMC) Paris 06,
University Hospital Department Fight Aging and Stress (DHU FAST),
Paris, France; Departments of Anesthesiology and Critical Care, GH
Pitié-Salpêtrière, APHP, Paris, France; 4 Department of Rehabilitation,
GH Charles Foix, APHP, Ivry sur Seine, France; 5 Sorbonne University,
University Pierre and Marie Curie (UPMC) Paris 06, University Hospital
Department Fight Aging and Stress (DHU FAST), Paris, France; Centre
National de la Recherche Scientiﬁque (CNRS), UMR 8256; 6 Unit ofPeri-Operative Geriatric care, Groupe Hospitalier (GH)Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (APHP), Paris,
France; Sorbonne University, University Pierre and Marie Curie(UPMC) Paris 06, University Hospital Department Fight Aging andStress (DHU FAST), Paris, France; Centre National de la Recherche
Scientiﬁque (CNRS), UMR 8256; 7 Sorbonne University, University
Pierre and Marie Curie (UPMC) Paris 06, University Hospital
Department Fight Aging and Stress (DHU FAST), Paris, France;
Departments of Emergency Medicine and Surgery, GH Pitié-Salpêtrière,
APHP, Paris, France; 8 Sorbonne University, University Pierre and Marie
Curie (UPMC) Paris 06, University Hospital Department Fight Agingand Stress (DHU FAST), Paris, France; Departments of Orthopedic
Surgery and Trauma, GH Pitié-Salpêtrière, APHP, Paris, France
Introduction: Dementia is associated with a worse prognosis of hip
fracture, but the impact of a dedicated geriatric care pathway on the
prognosis of these patients has not been evaluated. According to the
cognitive status before surgery, our main objective was to compare
mortality rate at 6 months; secondary outcomes were to compare
in-hospital complications, the risk of new institutionalization andthe ability to walk at 6 months.
Methods: Between 2009 and 2015, all patients (>70 years) admitted after hip fracture surgery into a dedicated unit of peri-operative
geriatric care were included: patients with dementia (DP), without
dementia (NDP) and with cognitive status not determined (CSND).
Data are expressed as Hazard Ratio (HR) for multivariate cox analysis or Odds Ratio (OR) for multivariate logistic regression analysis
and their 95% conﬁdence interval (CI).
Results: We included 650 patients (86±6 years): 168 DP, 400
NDP and 82 CSND. After adjustment for age, sex, comorbidities,
polypharmacy, pre-fracture autonomy, time-to-surgery and delirium, there were no signiﬁcant differences for 6-month mortality(DP vs NDP: HR=0.7 [0.4–1.2], DP vs CSND: HR=0.6 [0.3–1.4], CSND
vs NDP: HR=0.8 [0.4–1.7]); but DP and CSND were more likely tobe newly institutionalized after 6 months compared to NDP (ORDP=2.6 [1.4–4.9], p=0.003, OR CSND=2.9 [1.4–6.1], p=0.004). 92% of
population was walking after 6 months (63% with assistance): nodifference was found between the 3 groups.
Conclusion: In a dedicated geriatric care pathway, DP and CSND
undergoing hip surgery have the same 6-month mortality andwalking ability as NDP.

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P-645
Causes and consequences of surgical delay in older patients withhip fracture
S. Fernández-Villaseca 1 , L. García-Cabrera 2 , B. Montero-Errasquín 1 ,M.N. Vaquero Pinto 1 , C. Miret Corchado 3 , M.L. Álvarez Nebreda 1 ,A.J. Cruz-Jentoft 1 . 1 Hospital Ramón y Cajal, Madrid, Spain; 2 Hospital
Hestia Madrid, Madrid, Spain; 3 Fundación Jiménez Díaz, Madrid, Spain
Introduction: The clinical consequences of surgical delay in older
patients with hip fracture are controversial. We studied the clinicaland survival differences in older patients admitted with a hip
fracture according to the surgical delay and the reason of suchdelay.
Methods: Prospective observational study of all. All patients >79
years admitted with a hip fracture in an Orthogeriatrics Unit in 14
months, followed for 18 months. Subjects were classiﬁed in two
groups: early surgery (≤48 hours from admission) and surgicaldelay (>48 hours).
Results: 468 surgeries, 33.1% with surgical delay (preoperative
length of stay 5.3±2.1days vs 1.0±0.9 in early surgery). No differences in age, gender, functional and cognitive status or type offracture between groups were found. The early surgery group had
better nutritional status (MNA-SF: 10.8±2.8 vs 10.1±2.7, p=0.015),
used fewer drugs (5.9±3.4 vs 7.2±3.6, p<0.001), polypharmacy(52.9% vs 68.2%, p=0.001), less clopidogrel (1.3% vs 12.8%, p<0.001)
and coumadin (7.1% vs 20.4%, p<0.001), had a shorter length ofstay (11.5±6.1 vs 15.6±6.7 days, p<0.001) and lower surgical risk
(ASA score 2.5±0.6 vs 2.8±0.6, p<0.001). The surgical delay group
had more medical complications [(81.2% vs 69.7%, p=0.005; themost frequent urinary infection (30.4% vs 20.6%, p=0.026)] without
differences in surgical complications or in-hospital mortality. No
differences in mortality at 1, 3, 6 and 12 months after surgery
were found. Main reasons of surgical delay were: high INR 25.6%,
clopidogrel 13.1%, operating room not available 36.7%, the latest
was associated with higher mortality at 1 (6.7% vs 1.8%, p=0.05), 3(13.5% vs 4.5%, p=0.012), 6 (21.8% vs 8.9%, p=0.004) and 12 months(33.2% vs 16.1%, p=0.001) and higher perioperative heart failure(15.0% vs 7.1%, p=0.042).
Conclusions: One third of our patients with hip fracture had asurgical delay, mainly due to coagulation disorders and unavailability of an operating room. Surgical risk, medical complications andlength of stay were lower in those with early surgery.
P-646
Characteristics of elderly orthopedic patients’ careÜ.D. Yılmaz, N. Bayraktar. Near East University Faculty of Health
Sciences, Nursing Department, Nicosia, Turkish Republic of Northern
CyprusIntroduction: As a result of increases in life expectancy, the world
population is getting older and the proportion of the elderly in the
total population has been increasing rapidly. During the twentiethcentury, life expectancy at birth increased from 48 to 74 years formales and from 51 to 79 years for females. The aging of the population brings signiﬁcant health problems. The number of elderly
patients undergoing orthopedic surgery has been also increasing
due to changes in muscle and skeletal system with aging. This review provides an overview to relevant literature on characteristics
of elderly orthopedic patients’ care.
Methods: A literature search (2000–2017) was carried out, using
MEDLINE, Pub Med, Science direct, Scopus, Cochrane library, Turkish Medical Index and related institutional websites. Key words
included “Older adults”, “Elderly”, “Orthopedic patient”, “Nursingcare”.
Results: Elderly orthopedic patients have many insuﬃciency andchanges in the system and diseases. Development of anesthesia,

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surgical techniques and perioperative care decreased perioperative
mortality in the elderly group, mortality rate; 2.2% in the 60–69 age
group, 2.9% in the 70–79 age group and 5.8–6.2% in the 80 and overage group. The main purpose in the care of the orthopedic elder
is; preventing or minimizing complications, and maintaining thehealth of the patient at the highest level.
Conclusions: For effective treatment and care for the elderly,comprehensive evaluation of age-related changes, existing chronic
diseases and the risks of orthopedic surgery should be performed
and care should be planned.
P-647
Characteristics of the patients with hip fracture admitted to the
Public Hospitals of Castilla y León, Spain
S. Jiménez Mola 1 , P. Sáez López 2 , A. Muñoz Pascual 3 , J. Idoate Gil 4 ,E. Martín Pérez 5 , A. González Ramírez 6 , N. Pereira de Castro 7 .
1 Complejo asistencial Universitario de León, León. Spain; 2 Complejo
Asistencial de Ávila, Ävila. Spain; 3 Complejo Asistencial de Segovia.
segovia. Spain; 4 Complejo Asistencial Universitario de León, León.
Spain; 5 Hospital San Juan de Dios, León. Spain; 6 Complejo Asistencial
Universitario de Salamanca. Spain; 7 Complejo Asistencial de Burgos.
Spain
Introduction: Hip fractures are a prevalent fragility fracture secondary to osteoporosis that involves high morbidity and mortality.
Hip fracture registries are a good way to improve knowledge about
this condition and its quality of care. The aim of this study is
to describe the characteristics of the patients with hip fracture
admitted to the Public Hospitals of Castilla y León during a periodof time, and to analyze the variables that inﬂuence their hospitalstay.
Method: The Castilla y León orthogeriatric work group elaborated
a common register to collect data of hip fractures. Patients 75 andolder hospitalized with hip fractures in the 13 public hospitals in
the Community during November 2014 and October and November
2015 were included in the study. It is a multicentric, prospective andobservational study in which clinical, functional, social variables,
and in-hospital mortality, were collected.
Results: A total of 776 patients with a mean age of 86±6 wereanalyzed, 79% women. 33.4% were living in a nursing home prior to
fracture. 93% underwent surgery. The surgical delay was 4±2.8 days,
and the average hospital stay was 10±4.7 days. Only 9.5% received
general anesthesia. The 66.5% of the patients had medical complications: 35.5% developed delirium, and 55.5% required a transfusion.
4.6% died during hospitalization. The average pre-surgical stay was
related to the overall stay (p<0.001).
Conclusions: Hip fracture registers constitute an essential tool forevaluating the process and for improving the treatment quality ofthese patients.
P-648
Comparison of cemented augmented PFNA and Gamma nail III
in hip fracture surgery in elderly patients
L. Zerah 1 , R. Dayan 2 , A. Morvan 2 , J. Cohen-Bittan 3 , H. Vallet 3 ,M. Raux 4 , B. Riou 5 , A. Mézière 6 , J. Boddaert 1 , F. Khiami 7 . 1 Unit ofPeri-Operative Geriatric care, Hôpitaux universitaires
Pitié-Salpêtrière-Charles Foix. DHU FAST, Assistance Publique Hôpitauxde Paris (APHP), Paris, France; Sorbonne University, University Pierre
and Marie Curie (UPMC) Paris 06, University Hospital, Paris, France;
2 Department of Orthopedic Surgery and Trauma, Hôpitaux
Universitaires Pitié Salpêtrière - Charles Foix, AP-HP, Paris, France;
3 Unit of Peri-Operative Geriatric care, Hôpitaux universitaires
Pitié-Salpêtrière-Charles Foix. DHU FAST, Assistance Publique Hôpitauxde Paris (APHP), Paris, France; 4 Sorbonne University, University Pierre
and Marie Curie (UPMC) Paris 06, University Hospital, Paris, France;

Department of Anesthesiology and Critical Care. Hôpitaux
Universitaires Pitié Salpêtrière-Charles Foix, AP-HP, Paris, France;
5 Sorbonne University, University Pierre and Marie Curie (UPMC) Paris
06, University Hospital, Paris, France; Department of Emergency
Medicine and Surgery, Hôpitaux Universitaires Pitié Salpêtrière Charles Foix, APHP, Paris, France; 6 Rehabiliation Geriatric Department.
Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, AP-HP, Paris,
France; 7 Sorbonne University, University Pierre and Marie Curie(UPMC) Paris 06, University Hospital, Paris, France; Department ofOrthopedic Surgery and Trauma, Hôpitaux Universitaires PitiéSalpêtrière - Charles Foix, AP-HP, Paris, France
Introduction: A stable ﬁxation to allow immediate mobilizationof elderly patients with full weight-bearing after hip fracture (HF)
surgery is a challenge. The cement augmentation of the Proximal
Femoral Nail Antirotation (PFNA) is a new internal ﬁxation technique that causes minimum bone loss in femoral head and neck.
We aim to demonstrate that cement augmentation of the PFNA wasassociated with a reduction of lateral blade migration.
Material and methods: All patients >70 y/o admitted for intertrochanteric HF to our emergency department were included
from 2009 to 2016. Clinical and biological data were prospectively
collected, including a 6-month follow-up. Comparison of patientstreated with cement augmentation of the PFNA (PFNA group) andGamma Nail III (GN group). Medical charts, with X-ray radiography ±CTscan were reviewed by 3 orthopedic surgeons to assess diagnosisof orthopedic complication. The primary endpoint was lateral blade
migration. Secondary endpoint was in-hospital 6-month mortality.
Results: Monocentric retrospective study, 271 elderly were included: 57 (PFNA) and 214 (GN) patients. The two groups werecomparable for age, sex and comorbidities. A lateral blade migration was reported in 12 patients (GN group) and 1 patient (PFNA
group)(5.6 vs 1.7%, p=0.389 respectively). No complications relatedwith cement augmentation were observed.
Conclusion: We observed no difference of lateral blade migration
outcome in elderly patients admitted with an intertrochantericfracture during a 6 month post-operative follow-up. Further studies
are needed to determine the interest of cement augmentation of
the PFNA.
P-649
Effect of heterogeneity of weight status on all-cause mortality inolder adults: a study on type 2 diabetes patients undergoing
subtotal gastrectomy for cancer
Y. Kwon 1 , K.J. Kim 1 , Y.-G. Park 2 , S. Park 1 , K.-H. Cho 1 . 1 Korea
University College of Medicine, Seoul, Republic of Korea; 2 The Catholic
University of Korea, Seoul, Republic of Korea
Introduction: The survival beneﬁt of excess body weight acrossvarious subpopulation groups remains controversial. We assessed
the effect of weight status on all-cause mortality among type 2
diabetes patients undergoing subtotal gastrectomy for cancer.
Methods: This was a retrospective study conducted to examine
the medical charts of 210 patients with type 2 diabetes treated
at two university hospitals. All patients had undergone subtotal
gastrectomy for cancer between January 1993 and December 2012.
Participants were classiﬁed as either normal weight (BMI: 18.5–
24.99 kg/m2 ) or overweight/obese (BMI: ≥25 kg/m2 ). Weighted
Cox proportional hazard regression models using inverse probability weighting were constructed to adjust the differences between
groups.
Results: The mortality rate for the entire study population was
27.3% after a median follow-up duration of 7.5 years (interquartile
range, 4.5–9.3 years; maximum, 15.3 years). The overweight/obese
group had a signiﬁcantly lower risk of all-cause mortality (hazard
ratio, 0.46; 95% conﬁdence interval, 0.38–0.62; p0=0.001) comparedPoster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

to the normal weight group. The overweight/obese group was
associated with lower all-cause mortality in patients <65 years ofage (p=0.01 for interaction) with a possible association in patientswith a diabetes duration <5 years (p=0.07 for interaction).
Conclusions: A signiﬁcantly lower all-cause mortality was observed in the overweight/obese group of patients with type 2
diabetes compared to the normal weight group after undergoing
subtotal gastrectomy for cancer, although the signiﬁcance was not
maintained in the subgroup of patients ≥65 years of age.
P-650
Emergency laparotomy in the older patient. Perioperative careof older people admitted to general surgery – Salford General
Surgery (POPS-SG)
M. Rowles, A. Gomez-Quintanilla, A. Vilches-Moraga, J. Fox, M. Tan,
A. Paracha, M. Moatari, L. Miguel-Alhambra, A. Price. Ageing andComplex Medicine Directorate, Salford Royal NHS Foundation Trust
Objectives: The purpose of our study was to describe the characteristics and clinical outcomes of a cohort of elderly patients
undergoing emergency laparotomy and elderly care in reach input
Methods: We carried out a prospective non-randomised study ofpatients 75 or older admitted to general surgical wards following an
emergency laparotomy. All individuals underwent comprehensive
geriatric assessment, targeted multidisciplinary interventions andtimely discharge planning.
Results: Between 08/09/2014 and 28/02/2017 we reviewed 81
emergency laparotomy patients. Average age of 82.5±5.0, 5, 53.1%
females, 45.7% ASA class I-II, 3.7% lived in residential home, 85.2%
and 54.3% were independent for basic and instrumental ADLs
respectively, 70.4% mobilised with no aids or a cane, 11.1% cognitively intact and 89.7% continent. On discharge fewer patients wereindependent in basic ADLs (p 0.004) but there were no other signiﬁcant differences in functional status. Patients presented 5.2±3.0
comorbidities. Hypertension (65.4%), ischemic heart disease (27.2%)
and atrial ﬁbrillation (24.7%) were the most frequent. Average
medications on admission were 7.7±4.2. Anaemia (44.4%), delirium(32.1%), acute renal injury (29.6%) and constipation (24.7%) werethe most common complications and only 6 patients (7.4%) werecomplication-free. Mean length of stay was 21.8±19.6, 4.9% were in
hospital at 60 days, in- hospital mortality was 8.6%, observed 30 and
90 day mortality (after surgery) were 6.2% and 13.6% respectively
and 30-day readmission 9.5%.
Conclusions: Older persons undergoing emergency laparotomy
present signiﬁcant comorbidity, polypharmacy, and high morbimortality. We advocate global assessment and management by
multiprofessional teams experienced in care of the older patient.
P-651
Geriatric depression in pre-operative older patients withmeningiomas
V. Giannouli. School of Medicine, Aristotle University of Thessaloniki,
GreeceIntroduction: The aim of this study is to examine if pre-operative
older patients with meningiomas show differences in their depression levels when compared with healthy controls and patients withother types of chronic diseases.
Methods: Twenty-three pre-operative patients (11 females, 12
males) with meningiomas in various brain regions (8 right, 7 left
and 8 bilateral,) and of various sizes participated in the study.
Their mean age was 68.60 years (SD = 12.26, range 31–77), level of
education 9.47 years (SD = 3.82) and time since the ﬁrst signs ofpossible brain disease (headaches, fatigue, fainting) were 4.21 years(SD = 2.19). A control group of 20 healthy participants with similar
demographics was examined (mean age = 69.25, mean education =S227

11 years) and a group of 19 patients with different types of chronic
diseases were also examined (mean age = 69.10, mean education =12 years). All three groups of participants completed the GeriatricDepression Scale (GDS).
Results: Results revealed that pre-operative older patients sufferingfrom meningiomas report a higher total score in GDS with more
symptoms of depression when compared with older patients who
suffer from other types of chronic diseases and healthy older
controls.
Conclusions: Future studies should clarify the possible factors that
affect and differentiate the depressive symptomatology in patientswith meningiomas.
P-652
Hip fracture outcomes in patients with Parkinson’s disease
R. Lisk, H. Watters, K. Yeong. Orthogeriatrics Department, Ashford &St. Peter’s NHS Foundation Trust, Chertsey, UK
Objectives: Patients with idiopathic Parkinson’s disease (PD) are ata high risk for fracture, tend to have a longer hospital stay andunlikely to return home within 30 days [1]. The aim of this audit
was to establish if outcomes from hip fracture in people with PD
can be improved with targeted interventions.
Methods: A PD sticker was created to highlight PD patients on theboard round. We devised a PD Hip Fracture checklist which ensured:
1) Clinic letter printed on arrival2) PD medications prescribed andgiven on time3) Lying and standing blood pressure measurement4)
Bowel care with regular laxatives and suppositories.PD medications
were made available on the ward, with a poster reminder on the
drug trolley & drug cupboard where the PD meds are kept. PD
patients were prioritised by the therapists and regular educationalsessions for staff.
Results: 28 PD patients pre-intervention (Dec 2012–14) were lessindependently mobile pre-operation (21.4%) compared to 808 nonPD (48.3%). Hence home to home after operation was only 28.5%
with higher length of stay (LOS) of 26.1 days compared to non-PD
patients which was 58.1% and 21 days respectively.Following the intervention (May 2015–16), home to home after operation improved
to 40.9% with lower LOS of 15 days compared to non-PD patients
which was 59.6% and 15.2 days respectively.
Conclusions: Targeted interventions improved outcomes for PD patients with hip fracture. Cost-effective interventions such as there
are essential to reduce the burden of hospitalisation for patients,
carers and healthcare systems.
References:[1] Measuring the burden and mortality of hospitalisation in
Parkinson’s disease: A cross-sectional analysis of the English
Hospital Episodes Statistics database 2009–2013 Vincent Low,
Yoav Ben-Shlomo, Elena Coward, Suzanne Fletcher, Richard
Walker, Carl E. Clarke
P-653
Hip fracture patients: survival versus mortality
A. Michael 1 , N. Obiechina 2 , Z. Hussain 1 , R. Bansal 1 . 1 Russells Hall
Hospital, Dudley, UK; 2 Queen’s Hospital, Burton on Trent, UK
Introduction: The in hospital mortality rate of hip fracture ranges
between 2.7% to 15% in different studies.
Aim: To study the differences between hip fracture patients who
survived and those who died during hospitalisation.
Methods: Retrospective analysis of the medical records of all hip
fracture patients admitted in one-year period in a UK teaching
hospital. Demographics, residence, ASA score, mobility and time tosurgery data were collected, downloaded on excel and analysed.
Results: 527 patients were admitted in the study period and 59 diedas inpatients (11.2%). 6 patient notes were not available. 48 had an

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operation and 5 were treated conservatively.33/370 (9%) of womenand 26/157 (17%) of men died. 44/417 (11%) of patients admitted
from their own home died compared to 10/63 (16%) of those fromresidential care and 5/21 (24%) of those who had the fracture in
hospital. None of the 4 patients with ASA 1 died, 5/118 (4%) of
ASA 2 patients died, compared to 35/333 (11%) of ASA 3 patientsand 13/51 (26%) of ASA 4 patients. 15/197 (8%) who were mobile
without aids died, compared to 16/150 (11%) who were mobile with
one aid and 15/86 (17%) who were mobile with two aids. However
just 1/10 (10%) of those with no functional mobility died.37/407(9%) of patients operated upon within 36 hours died, compared to
16/97 (16%) of those who had the operation after 36 hours. 6/23
(26%) of those who had no operation died. The documented causeof death in 2/3 of the patients was chest infection.
Conclusion:• Men have higher inpatient mortality than women.
• Patients from nursing homes had a higher in hospital mortality
than those living in their own homes.
• The higher the ASA score the higher the inpatient mortality.
• The poorer the mobility the higher the inpatient mortality.
• The more delayed the surgery after 36 hours the higher the
mortalityP-654
Hip fractures: What I wish you had told me
L. McCluskey 1 , V. Patel 1 , J. Yeung 1 , A. Simons 2 . 1 University ofBirmingham, Birmingham, United Kingdom; 2 Heartlands Hospital,
Birmingham, United Kingdom
Introduction: Hip fractures are associated with signiﬁcant cost,
distress, morbidity and mortality, with 10% of patients dying within
30 days (1). Patients approach hip fracture repair with expectations about their outcomes. Evidence shows that pre-operative
expectations predict important post-operative outcomes; including
healing time, quality of life and functional improvement (2). A
key to addressing these surgical expectations is physician–patientcommunication. This project was a service evaluation of our service
and the need for a hip fracture booklet to improve communication.
Methods: A service evaluation was carried on post-operative hip
fracture patients at a large teaching hospital. Surveys were distributed and collected over a 1-month period. The aim was todetermine: i) if patients wanted more information about theircare; ii) common themes patients would like to have known about
in relation to their care; iii) if patients would like to receive an
information booklet about their care. A booklet was then designed
and a focus group held to discuss it prior to implementation.
Results: i) 67% of the patients and relatives surveyed wanted toreceive more information about their care. ii) Common themes
included; What anaesthetic will I have? Will I be asleep? When will
I walk again? What physiotherapy will I get? What is the timescaleof hospital admission? iii) 100% of patient and relatives surveyed
wanted a hip fracture booklet.
Conclusions:• There is a need for the implication of a hip fracture booklet into
our practice.
• Interestingly patients at the focus group requested that Advance
Care Planning was included.
References:[1] Scheier MF, Matthews KA, Owens JF et al. Dispositional optimism and recovery from coronary artery bypass surgery:the beneﬁcial effects on physical and psychological well-being.
Journal of Personality and Social Psychology, 1989; 57: 1024–
1040.
[2] Mahomed NN, Liang MH, Cook EF et al. The important of patient
expectations in predicting functional outcomes after total joint
arthroplasty. Journal of Rheumatology, 2002; 29: 1273–1279.

P-655
Identiﬁcation of frail elderly in need of intensive caremonitoring after hip fracture surgery using the ISAR score
A.V. Silven 1 , L.M.A. de Vries 2 , J. Steens 2 , J.O. Daal 1 . 1 Department ofClinical Geriatrics, Westfriesgasthuis, Hoorn, The Netherlands;
2 Department of Orthopedic Surgery, Westfriesgasthuis, Hoorn, The
Netherlands
Background: Patients with hip fractures are often frail elderly.
Guidelines suggest close postoperative monitoring to minimise therisk of complications. In our hospital, frail elderly are therefore
closely monitored at the Intensive Care Unit (ICU). Since there areno validated tools to identify frail elderly in need of ICU monitoring,
we use a modiﬁed version of the Identiﬁcation of Seniors At Risk
(ISAR) [1]. This study evaluated the use of the modiﬁed ISAR scoreas a predictor of necessary ICU admission in frail elderly after hip
fracture surgery.
Methods: We retrospectively collected data of all patients aged ≥70
years with hip fractures who underwent surgery followed by ICU
monitoring in the Westfriesgasthuis hospital in 2015 and 2016. We
analysed the ability of ISAR outcome for each patient to predict a
necessary ICU admission, deﬁned as one or more of the followinginterventions: administration of vasopressors, >6L oxygen/min, any
form of rate control for heart rates <40 or >150 bpm, ≥4L IV
crystalloid infusion within 24h and/or >4 units of blood within 24h.
Results: 186 patients were included in this study. Overall, 47.8%
of ICU admissions were categorised as necessary. Accuracy of the
ISAR score to predict a necessary ICU admission was analysed using
the ROC curve. The area under the curve (AUC) was 0.506, which
represents a worthless accuracy.
Conclusions: The modiﬁed ISAR score is not able to predict necessary IC admissions in elderly patients after hip fracture surgery
and is therefore not recommended as a preoperative screening
tool [1.] Identiﬁcation of Seniors At Risk-10 score, as used in the
Westfriesgasthuis hospital, Hoorn, The Netherlands1. Does the patient regularly need help in daily household activities like cooking,ﬁnancial administration, preparing medication, etc.? (iADL) 2. Does
the patient regularly need help in taking care of his or herself(getting dressed, personal hygiene, etc.)? (ADL) 3. Has the patient
recently been contacting his/her family physician more often, or has
he/she been hospitalised for one or more nights during the past six
months? 4. In general, does the patient have problems in hearing or
seeing? 5. In general, does the patient have problems with his/her
memory? 6. Is the patient feeling down or depressive? 7. Does thepatient use more than three different medications? 8. Does thepatient have problems in mobility, or has he or she experienced
one or more falls during the past six months? 9. Has the patient
lost weight during the past six months, or does the patient havediﬃculties eating or drinking? 10. Has the patient had an episodeof confusion during a previous illness or hospital admission?
P-656
Idiopathic normal pressure hydrocephalus in elderly: response
to shunting and predictors of response taking into accountfrailty and Alzheimer LCS ﬂuid biomarkers
L. Joly 1 , M.-J. Fourriere 2 , V. Bourdaire 2 , A. Kearney-Schwartz 2 ,I. Gantois 2 , C. Armand Malaplate 2 , T. Jonveaux 2 , O. Klein 2 ,A. Besozzi 2 , A. Benetos 2 . 1 CHRU de Nancy France, INSERM U1116,
Université de Lorraine, Nancy, France; 2 CHRU de Nancy, France
There are currently no European guidelines for the managementof normal pressure hydrocephalus (HPN) in the elderly, on the
one hand because of the diﬃculty of establishing a very precise nosological framework, and on the other hand because of
the lack of large-scale randomized studies in this area. In 2015,
the American Academy of Neurology developped a report of thePoster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

guideline development on the study of the international literature
on idiopathic normal pressure hydrocephalus and its response toshunting and predictors of response with a view to standardizingcare. Obviously, these guidelines didn’t take into account the elderly
patient’s frailty, the presence of cognitive disorders and the valueof degenerative cerebro spinal ﬂuid biomarkers. The aim of ourstudy is to propose, according to the data of the international
litterature, a mode of evaluation and management of the elderly
patient suspected of HPN in collaboration with the different interlocutors that the patient will meet in his journey of care, and frailty
characterization. We have prospectively recruited elederly patientsover 65 years of age suspected of HPN in Nancy Lorraine Memory
Hospital Center. All participants were submitted to a broad clinicaland neuropsychological evaluation. Frailty was evaluated according
to the Fried criteria. Cerebrospinal ﬂuid analysis for Alzheimer’s
disease biomarkers was systematically analyzed. The main objective was to obtain more reliable answers in terms of diagnosis andsurgical decision, of re-educative and neuropsychological follow-up
of the elderly with standardized assessment.
P-657
Immediate and very long term results of colorectal cancer
treatment in the elderly
M. Vigara 1 , C. Cerdán 2 , P. Gil 1 , A. Viloria 1 , J. Cerdán 2 . 1 Hospital
Clinico San Carlos; 2 Clinica Santa ElenaIntroduction: More than 50% of Colorectal Cancer occurs in patients over 70 years old, and its prevalence will increase in the next
decades, in line with the increase in life expectancy. The aim of
this work is to determine both, inmediate postoperative results andlong-term oncologic results in ancient patients electively operated
on colorectal cancer.
Material and methods: A single centre retrospective study of patients undergoing elective surgery for colorectal cancer, between
January-1991 and December-2012. The follow-up period ranges
from 3 to 25 years. Frequencies of the different qualitative variables
were studied with the Chi-square test. Long-term survival was
analyzed using the Kaplan Meier and Log Rank method.
Results: 1031 patients, 571 males (55.4%), aged between 70 and
100 years, divided into ﬁve groups: 70–74, 75–79, 80–84, 85–89
and> =90 years. Potentially curative surgery was performed in
883 (85.6%). Palliative care: 137 (13.3%). Unresectable tumor: 44(4.3%). From the 1031 patients just 32 required reoperation (4.3%).
Evisceration happened in 28 (3.8%), hemoperitoneum in 8 (1%) andanastomotic leak in 23 (3.5%). Global 30 day mortality was 1.8%; 0,1, 1.6, 1.7 and 11.8% by age groups. Overall 5-year survival: 76.6%. By
age group: 82%, 80.5%, 71%, 69% and 57.4%, respectively.
Conclusions: 1. In our experience, with adequate pre- and postoperative care, the results obtained in the elderly are comparable toyoung patients, except those older than 90 years. 2. Age is not alimit to carry out an appropriate treatment in the elderly.
P-658
Impact of comprehensive geriatric care in trauma service on thelenght of stay (LOS) in elderly patients over 75 years old withfemoral neck fracture (FNF)
F. Leborgne 1 , F.-H. Brunschwig 2 , C. Dahan 1 , E. Clais 1 , C. Rambaud 1 ,M. Sanchez 1 , J.M. Turpin 1 , E. Ferrer 1 , R. Boulahssass 3 , C. Arlaud 1 ,G. Sacco 1 , O. Guérin 4 , I. Bereder 1 . 1 EMG CHU de Nice; 2 SSR
orthogériatrique CHU de Nice; 3 UCOG PACA EST CHU de Nice; 4 EMG
CHU de Nice, FHU
Introduction: In 2016, at University Hospital of Nice (UHN), a
collaboration between orthopedics surgeons and geriatricians wascreated in order to improve outcomes for older patients witha model of care “routine geriatric consultation within a trauma

S229

service”. We decided to measure the impact of the development of
the orthogeriatric program on the LOS in trauma service.
Methods: Starting February 2016, the Mobile Geriatric Team (MGT)
assessed each day in trauma service of UHN (42 beds) all patientsover 75 years-old with a operated FNF. The MGT made a contribution to geriatric expertise (perioperatory analgesia adapted toelderly, personalized and comprehensive advices to limit geriatrics
decompensations) and to short the LOS in trauma service (and thus
shortening the time for hospitalization in rehabilitation care).
Results: Three hundred and ninety-one patients were been evaluated by the MGT (average age of 87). The average LOS in trauma
service decreased from 9,98 to 7,01 days in 2016. This contributed
to decrease orientation towards others hospitals to urgent surgery
and to increase the number of elderly patients over 75 years-old
operated for FNF to 40%.
Conclusion: The daily passage of MGT decreased from 3 days theaverage LOS in trauma service in frail patients over 75 years-old
with FNF by faster transition in rehabilitation care.
P-659
Improving venous thromboembolism risk assessment andprophylaxis prescription in fracture neck of femur patients
I. Gunawardena, S. Gorgievska, R. Rajakunjaram, D. Nelson. Norfolk
and Norwich University Hospital, United Kingdom
Introduction: In the absence of any prophylaxis, the rates ofvenography-assessed total and proximal Deep Vein Thrombosis(DVT) after hip fracture are 50% and 27% respectively in the 3months after surgery. The incidence of fatal Pulmonary Embolism(PE) ranges from 1.4% to 7.5%. Best practice standards in keepingwith NICE guidelines 1) All patients should undergo a Thrombosis
Risk assessment (TRA) on admission to hospital2) Low Molecular
Weight Heparin (LMWH) should be prescribed to all patients inwhom it is indicated, according to the TRA. 3) Pharmacologicalvenous thromboembolism (VTE) prophylaxis should be started atadmission for all neck of femur (NOF) fractures. 4) Pharmacological
VTE prophylaxis should be stopped 12 hours before surgery. 5)
Pharmacological VTE prophylaxis should be restarted 6–12 hours
after surgery.
Methods: Clinical practice was measured using a convective sampling method before and after the introduction of electronicprescribing (EP).
Results: Clinical practice showed a signiﬁcant improvement after
introduction of EP particularly with regards to TRA on admission,
which increased from 83% to 100%. The prescription of VTE prophylaxis after surgery improved from 46% to 73%. Recommendations
and actions EP has improved clinical practice in VTE risk assessment
and prophylaxis prescription. However, there is room for improvement. Regular education and staff awareness programmes need to
be implemented to further improve patient care.
P-660
Indications for medical review in older surgical patients:
the need for geriatricians in perioperative medicine
L. Koizia, A. Koizia, M. Sbai, G. Peck, D. Shipway. St Mary’s Hospital,
Paddington, United Kingdom
Introduction: The ageing demographics of European populations
are well-recognised. Increasing numbers of older patients areadmitted under acute general surgery. Data from national UK
audits have demonstrated poorer outcomes for older surgical patients. Frailty, multi-morbidity and ageing physiology correlate withincreased complications, morbidity and mortality. Perioperative
geriatric liaison services can improve outcomes, but limited data
have been published to describe indications for review and patientcomplexity. Data are required to emphasise the need for geriatri-

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Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

cians in perioperative liaison, and support the expansion of geriatric
surgical liaison internationally.
Method: Indications for review were prospectively collected inpatients referred to a geriatric surgical liaison service. Data werecategorised according to medical diagnoses and intervention.
Results: Over nine-months, 233 inpatient liaison reviews wereconducted. Interventions included: high dependency review (24%);
optimisation of ﬂuid balance (20%); treatment of cardiac complications (16%); delirium management (16%); treatment of respiratorycomplications (15%); discharge planning (48%); complex communication (30%). Patients required multiple interventions to aid their
management (mean 2.43 interventions per patient).
Conclusions: Indications for medical review in older surgical patients are diverse. Many patients suffer numerous complications
affecting multiple organ systems. Under conventional services,
these patients may have required numerous specialty referrals.
The geriatrician’s skillset combines acute internal medicine withknowledge of the geriatric syndromes, rehabilitation and dischargeplanning. These data illustrate that the needs of older surgicalpatients cannot be met by surgeons or anaesthetists alone. Geriatricians need to expand their role in perioperative medicine to meetthe needs of the ageing surgical population.
P-661
Interventions in frail elderly patients with severe aortic stenosis,
possible candidates for implementation of aortic valve
transcatheter (TAVI)C. Roqueta 1 , B. Vaquerizo 2 , M.I. Martínez-Fernández 1 , N. Farre 2 ,A. Sánchez-Carpintero 2 , N. Leiva 1 , S. Burcet 1 , M. Cladellas 2 ,R. Miralles 3 , O. Vázquez 1 . 1 Geriatric Medicine Department, Parc de
Salut Mar. Centre Fòrum. Hospital del Mar. Barcelona; 2 Department of
Cardiology. Parc de Salut Mar. Hospital del Mar. Barcelona; 3 GeriatricMedicine Department. Parc de Salut Mar. Hospital del Mar. Barcelona
Aim: To describe interventions in elderly frail patients with severe
aortic stenosis.
Patients and methods: Prospective and descriptive study of patients evaluated by geriatrician for detection and interventionof frailty (to assess the possibility of TAVI indication). Demographic variables (age, sex), functional [Barthel index (BI), Lawton
index (LI)], cognitive [Mini-Mental State of Examination of Folstein (MMSE)] and nutritional status [Mini-Nutritional Assessment
abbreviate (MNA)] were registered. Short Physical Performance Battery (SPPB) was performed and stratiﬁed (0–3, 4–6, 7–9 and 10–12).
Walking aids, levels of vitamin D (25-hydroxy) and polypharmacy
review. Geriatric interventions performed: recommendations forphysical exercise, request for a physical rehabilitation program, nutritional recommendations or enteral supplementation, adequacyof walking aids, polypharmacy revision and vitamin D supplementation.
Results: Forty-ﬁve patients (62.22% women); mean age: 82.62±6.09
years. Mean of the parameters evaluated: IB: 94.00±10.97; IL: 5.02±
2.08; MMSE: 26.06±3.40 y SPPB: 6.88±2.69. SPPB categorized: 0–3
points: 3 (6.67%), 4–6 points: 18 (40%), 7–9 points: 15 (33.33%);
10–12 points: 9 (20%). MNA abbreviate: 33 (73.33%) good nutrition(12–14 points), 12 (26.67%) with risk of malnutrition (8–11 points).
Intervention was performed in 17 (37.78%) patients: 13 (28.89%)
physical exercise recommendations, 6 (13.33%) physical rehabilitation program, 13 (28.89%) nutritional recommendations or enteralsupplementation, 6 (13.33%) adequacy of walking aids, 12 (26.67%)
polypharmacy reduction and 20 (44.44%) supplementation withvitamin D.
Conclusions: Evaluated patients had a well preserved functionaland cognitive status, and abnormal scores in the SPPB, suggestive offrailty. Intervention was performed in one-third of the patients. The
most prevalent intervention was oral vitamin D supplementation.

P-662
Is there a requirement for Geriatrician input in emergency
surgical patients not undergoing surgery?
E. Howie, A. Crees, N. Bashir. Musgrove Park Hospital, Taunton, UK
Introduction: Older adults are commonly admitted under the careof surgeons with pathology not requiring surgery or for conservative management. We sought to evaluate the geriatric syndromes
amongst this group and whether there is a role for Geriatrician
input in their management.
Methods: A pilot service was provided by a Consultant Geriatrician/Specialist Registrar to older adults aged over 70 years admitted
acutely to General Surgery between November 2016 - January 2017.
Prospective data was obtained from direct patient assessment,
medical notes and computer records. A proforma and databasewere completed for each patient, recording the geriatric syndromes
identiﬁed and outcomes, including length of stay (LOS).
Results: 129 patients (mean age 81.5 years) total were reviewed. 35
patients required operations and 94 patients did not - within thisgroup 13 patients had other, non-surgical procedures. Patients undergoing surgery were younger (78 years vs 83 years) and less frail(Clinical frailty score 3.3 vs 4.5). In patients not undergoing surgery,the main issues identiﬁed were new medical diagnosis (26%), falls(22.3%), malnutrition (18%) and delirium (highest incidence in thoseundergoing non-surgical procedures: 15.4% vs 8.6%). The average
LOS was highest in the operative group (n=15 days).
Conclusions: The majority of older patients acutely admitted under the care of the surgeons do not undergo surgery. There are
signiﬁcant geriatric syndromes amongst this group, with patients
undergoing non-operative procedures being particularly vulnerable. There is a clear role for Geriatricians in identifying issues andimproving the management of these older surgical adults.
P-663
OPAL service reduces readmission and complication rates inGeneral Surgery
M. Rahman 1 , L. Priestner 1 , A. Watson 2 , W. Baraza 3 . 1 Department ofGeneral Surgery, University Hospital South Manchester, UK;
2 University Hospital South Manchester, UK; 3 Department of General
Surgert, University Hospital South Manchester, UK
Introduction: The poor care of older patients, has been highlighted
in recent publications such as the National Conﬁdential Enquiry
into patient Outcome and Death (NCEPOD). Our general surgicalservice has employed a Consultant Physician with an interest in the
perioperative care of older people (OPAL). We aimed to evaluate the
new service.
Method: We performed a review of all general surgery patients
aged above 75 years who were admitted to our unit in the 6months before (Cohort A, n=188) and 6 months after (Cohort B,
n=225) the OPAL service began. Fit patients over 75 were not seenby the OPAL service routinely. Those seen were frail, had poorcognitive function, poor mobility or complex comorbidities.Primary
outcomes measured were the readmission rate and the incidence of
post-operative complications. Secondary outcomes measured werelength of stay and patient mortality.
Results: The two cohorts were well matched. The readmission andcomplication rates were reduced in Cohort B (14.9% vs 7.1% and19.1% vs 11.1% respectively, p<0.05). There was no difference inlength of stay or mortality between the groups.
Conclusion: Regular input from a specialist OPAL physician reduces
the complication and readmission rate in elective and emergency
surgical patients.

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

P-664
Outcomes in older patients discharged from acute surgery tointermediate care
M. Dos Santos, M. Tan, J. Fox, A. Vilches-Moraga. Department of
Ageing and Complex Medicine, Salford Royal NHS Foundation Trust,
Salford, United Kingdom
Background: Intermediate care (IMC) is widely utilised to help
older people regain independence after a hospital stay. We describe
outcomes in older patients discharged from an acute surgical ward
to IMC.
Methods: We identiﬁed all patients discharged to IMC from anacute surgical ward between September 2014 and September 2016
and conducted a retrospective case note audit. All patients had
been assessed by our Perioperative Care of Older People Undergoing
Surgery - General Surgery (Salford POPS-GS) in-reach service whilea hospital inpatient.
Results: Within the study period, 29 older people with a mean ageof 85.4±5.7 years were discharged to IMC. Most were females (73%).
Multimorbidity (6.3±3.3 chronic illnesses), polypharmacy (7.6±3.5
medications), functional impairment (76% dependent for ADLs) and
impaired mobility (only 8% mobilised with no aids or a stick) were
the norm.Median length of stay in IMC was 24 days (3–67 days).
While 9 patents (36%) were readmitted to hospital, there were no
deaths. Continence and mobility were both shown to improve following an IMC stay. On admission, 24% of patients were incontinent
and 89% were immobile or required a zimmer frame or crutches tomobilise. These ﬁgures improved to 11% and 68% respectively ondischarge.30-days after discharge from IMC, 8 patients (30%) had
been readmitted to hospital, while 2 patients (7%) had died. Noneof the cohort lived in residential care on admission, but 2 patients(7%) were discharged to a care home.
Conclusions: Functional abilities can improve in an IMC setting inolder surgical patients discharged from hospital. Readmission rates
are high both from IMC units and after discharge home, perhaps
reﬂecting the frail nature of the cohort discharged there.
P-665
Perineal repair for full thickness rectal prolapse in the elderly
I. Katsoulis 1 , I. Karaitianos 2 . 1 Department of Surgical Oncology, St.
Savvas Cancer Hospital, Athens, Greece; 2 Department of Surgical
Oncology, St Savvas Cancer Hospital, Athens, Greece
Introduction: Full thickness rectal prolapse has an incidence of 1%
among elderly people and is most common in females. Predisposing
factors are old age, multiparity, hysterectomy, chronic dyschesia
and deﬁciency of the pelvic ﬂoor musculature. Both abdominaland perineal procedures have been used for the repair of thiscondition. Although there are no evidence-based guidelines for the
optimal surgical method, repair through the perineum is consideredappropriate for elderly people or patients with co- morbidities dueto the low risk for complications and faster recovery.
Methods: We retrospectively studied the records of 9 elderly patients with full thickness rectal prolapse who were treated with aperineal operative procedure.
Results: This case series consisted of 9 females with an averageage of 76 years (range 67–98). Six patients were treated with Delorme repair and 3 with Altemeier rectosigmoidectomy combinedwith levatorplasty. In three patients, who were deemed unsuitablefor general anaesthesia, surgery was performed under regional
anaesthesia. The average hospital stay was 2 days (range 1–4).
There were no perioperative complications. One patient, 6 months
after a Delorme procedure, developed a partial recurrence of therectal prolapse which was subsequently repaired with an Altemeier
procedure. On follow-up, faecal continence was satisfactory in all
patients.

S231

Conclusion: Perineal procedures are safe and eﬃcient for thetreatment of full thickness rectal prolapse in the elderly.
P-666
Perioperative complications and hip fracture mortality
A. Michael 1 , N. Obiechina 2 , Z. Hussain 1 , M. Waites 1 . 1 Russells Hall
Hospital, Dudley, UK; 2 Queen’s Hospital, Burton on Trent, UK
Introduction: Hip fracture is an orthopaedic and medical emergency with high in hospital mortality.
Aim: To study the intra and postoperative complications in hip
fracture patients who died during hospitalisation.
Methods: Retrospective analysis of the medical records of all hip
fracture patients admitted in one-year period in a UK teaching
hospital. Demographics, intra and postoperative complications data
were collected, downloaded on excel and analysed.
Results: 527 patients were admitted in the study period and 59
died as inpatients (11.2%). 6 patient notes were not available so
53 patients were studied. 48 had an operation and 5 were treatedconservatively.37/48 (77%) of patients who died had intraoperativecomplications; the most common was hypotension in 32/48 (67%)
of patients. 32/48 (67%) had postoperative chest infection. 27/48(56%) developed postoperative confusion. 12/48 (25%) had postoperative UTI. 11/48 (23%) had postoperative LVF. 6/48 13%) had
clinical evidence of ﬂuid overload The mean perioperative eGFR
decline was 14%. 5/48 (10%) had perioperative stage 1 acute kidney
injury (AKI), 2/48 (4%) had stage 2 AKI and 1/48 (2%) had stage 3
AKI. The mean perioperative haemoglobin loss was 16 gm/L (14%).
34/48 (71%) had other post operative complications17/48 (35%) had
complications after being declared medically ﬁt for discharge, mostcommonly chest infection 11/17 (65%)
Conclusion:• Intra and postoperative complications are common in hip fracture patients who died during hospitalisation.
• 3/4 of patients who died had intraoperative complications.
• The postoperative complications were mainly medical. 2/3 ofpatients had chest infection, more than half had postoperative
confusion, 1/4 had UTI, nearly a 1/4 had LVF and 1in 8 had ﬂuid
overload. 16% had acute kidney injury.
• 1/3 of patients had the complications after being medically ﬁt
for discharge.
P-667
Postoperative haematoma on RIVAROXABAN: 2 case reports
T. Parent 1 , L. Maljean 1 , C. Bioteau 1 , G. Gavazzi 1 , J. Tonetti 2 ,G. Kerschbaumer 2 , O. Seurat 2 , S. Drevet 1 . 1 Clinique universitaire demédecine gériatrique, CHU Grenoble Alpes, Grenoble, France;
2 Traumatologie, CHU Grenoble Alpes, Grenoble, France
The use of Non-vitamin K antagonist oral anticoagulants (NOACs)
is increasing rapidly and is now recommended in preference tovitamine K antagonist (VKA) in atrial ﬁbrillation. The prevalence ofgeriatric traumatology is increasing and perioperative period is associated with a higher bleeding risk. We report two cases reported
to pharmacovigilance. Case 1: Mr C, 85 years old, hospitalized
for an loosening of the left Cotyloidal implant, on RIVAROXABAN(Atrial ﬁbrillation, clearence 92ml/min). Bridging using LMWH andsurgery on day 2. RIVAROXABAN reinitiated without bridging on
day 5 after surgery. Onset of a large postoperative haematoma
progressively getting worse with anemia (decreased hemoglobinfrom 124 to 98g/L) Case 2 Ms D, 89 years old, hospitalized for aleft THA periprosthectic fracture, on RIVAROXABAN (Atrial ﬁbrillation, clearence 35ml/min with adapted posology). Bridging withCALCIPARINE (not overdosed) and surgery on day 8. RIVAROXABAN
reinitiated without bridging on day 5 after surgery. Onset of a large
postoperative haematoma progressively getting worse with anemia

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Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247(decreased hemoglobin from 106 to 89g/L) secondarily superinfected with a need of surgical debridement. A retrostrospective
study has found a small but signiﬁcative increased risk of bleeding
following the procedure with RIVAROXABAN in comparaison to
VKA. Perioperative Guidelines exist for the management of NOACs
in scheduled surgery or for emergency invasive procedures. Actually, there is no recommendation for post operative re-processing.
Based on our elderly clinical experience, frailed or dependent,
we wonder on this theme as far as this population has a higher
thrombosis risk. Haemorrhagic complications has to be reduced
without increasing thromboembolic events. When NOACs should
be reinitiated and may bridging be considered? Declaration to pharmacovigilance department is needed to optimize the use of NOACs
in real life.Few recommendations for the invasive non-programmed
procedures exist and they are based on expert opinion. Guidelines
should be clariﬁed with prospective studies. Caution is needed
for the perioperative management of NOACs especially in geriatrictraumatology.
P-668
Post-operative hypoxemia and in-hospital complications ofgeriatric patients admitted in Unit of Peri-Operative Geriatriccare after hip fracture surgery
L. Dourthe 1 , L. Zerah 2 , H. Vallet 2 , A. Gioanni 1 , A. Mézière 3 ,R. Haddad 4 , M. Doulazmi 5 , J. Cohen-Bittan 1 , J. Boddaert 2 ,K. Kinugawa 6 . 1 Unit of Peri-Operative Geriatric Care, GeriatricDepartment, Hôpitaux universitaires Pitié-Salpêtrière-Charles Foix.
DHU FAST, Assistance Publique Hôpitaux de Paris (APHP), Paris,
France; 2 Unit of Peri-Operative Geriatric Care, Geriatric Department,
Hôpitaux universitaires Pitié-Salpêtrière-Charles Foix. DHU FAST,
Assistance Publique Hôpitaux de Paris (APHP), Paris, France; Sorbonne
University, University Pierre and Marie Curie (UPMC) Paris 06,
University Hospital, Paris, France; 3 Geriatric Rehabilitation Unit,
Hôpitaux universitaires Pitié-Salpêtrière-Charles Foix. DHU FAST,
Assistance Publique Hôpitaux de Paris (APHP), Paris, France; 4 Unit ofPeri-Operative Geriatric Care, Geriatric Department, Hôpitaux
universitaires Pitié-Salpêtrière-Charles Foix. DHU FAST, Assistance
Publique Hôpitaux de Paris (APHP), Paris, France; Neuro-Urology
Clinical Research Group (GREEN), Rothschild Hospital, Neurorehabilitation department, 5 rue Santerre, Paris, France; 5 CNRS, UMR
8256 Biological Adaptation and Aging, University Pierre and Marie
Curie (UPMC) Paris 06, Paris, France; 6 Sorbonne University, University
Pierre and Marie Curie (UPMC) Paris 06, University Hospital, Paris,
France; CNRS, UMR 8256 Biological Adaptation and Aging, University
Pierre and Marie Curie (UPMC) Paris 06, Paris, France 6. Functional
Exploration Unit, Hôpitaux universitaires Pitié-Salpêtrière-Charles
Foix. DHU FAST, Assistance Publique Hôpitaux de Paris (APHP), Paris,
FranceIntroduction: Delirium is a common complication following hip
fracture surgery (HFS) in older people. Postoperative hypoxia has
also been associated with delirium, but not speciﬁcally in geriatricpatients. We tested the hypothesis that post-operative hypoxia isassociated with in-hospital complications in patients with HFS.
Methods: Patients hospitalized in orthogeriatric unit after HFS weremonitored for SpO2 with a pulse oximeter continuously up to 16h,
covering one night. In-hospital complications were recorded in all
patients.
Results: 46 patients with a mean age of 86±6 years old, anda mean oxymetry recording of 850,6±669 min (14hrs) were included in the analysis. Twenty-six patients presented a severe
post-operative hypoxemia (time spent with SpO2<90% more than20%) and 20 patients not (mean SpO2 at 88,3±7,0% vs 93,9±2,3%respectively; p<0.001). There was no signiﬁcant difference between
groups for age, gender, comorbidity (CIRS 52), physical status score(ASA), dementia, alcoholism, denutrition, depression, dehydrata-

tion, medication use (e.g benzodiazepine/hypnotics/morphine), average length of stay, mean oxymetry recording time. Hypoxemic
patients signiﬁcantly suffered more COPD (19% vs 0%; p=0,038),
and were taking more diuretics and IEC/sartan medication. Amongin-hospital complications, delirium was more present in hypoxemic
patients (46% vs 15%; p=0,025), but falls, swallowing diﬃculty,
aspiration pneumonia, infections, heart failure, cardiac ischemia,
anemia and transfusions were not signiﬁcantly different.
Conclusion: Preliminary data showed that post-operative hypoxia
is associated with delirium in older patients in orthogeriatricunit after HFS. Further inclusions are ongoing and a clinical trial
testing the beneﬁt of oxygen therapy in preventing delirium is inperspective.
P-669
Predicting in-hospital mortality in older surgical patients:
a prospective cohort study of non-elective admissions
A. Paracha, A. Vilches-Moraga, J. Fox, A. Gomez-Quintanilla, M. Tan,
M. Moatari, L. Miguel-Alhambra, M. Rowles, A. Price. Ageing andComplex Medicine Directorate, Salford Royal NHS Foundation Trust,
Salford, United Kingdom
Objectives: Patients admitted as emergencies account for 80% of
all in-hospital surgical mortality. Half of patients undergoing emergency general surgical procedures are old. We examine risk factors
predicting in hospital mortality in older acute surgical patients.
Methods: All general surgical patients aged 75 years or older
admitted non-electively between 9th September 2014 and 28th
February 2017. The primary outcome measure was in-patient mortality. Univariate and Multivariate logistic regression analyses were
undertaken to identify factors predicting in-hospital mortality.
Results: 577 patients were included in the study, mean age 82.9±5.7
years (56.2% female). The majority were living at home or withcarers (92.9%) at the time of admission although 21.4% of patientswere dependent for basic activities of daily living (ADLs). 76.6%
of patients were managed non-operatively. Female sex (p<0.031),
nursing home residence (p<0.001), dependence ADLs (p<0.001),
cognitive impairment (p<0.001), restricted mobility (p 0.001) andurinary incontinence (p<0.001) were predictors of in-hospital mortality. Multivariate analysis: ASA class III-IV (OR 6.54 CI 1.50–28.47),
dependence for basic ADLs (OR 2.63 CI 1.25–5.52), heart failure(OR 2.57 CI 1.19–5.54), and cognitive impairment (OR 2.54 CI
1.02–5.01).Type of treatment intervention, number of medications
and number of co-morbidities were not predictive of in-hospitalmortality (p>0.05).
Conclusions: This study highlights the predictive role of functional
status, dependence and cognitive impairment when risk assessing
older surgical patients presenting with acute surgical conditions.
Accurate risk stratiﬁcation requires global assessment by teams
experienced in care of the older patient rather than the traditional
focus on comorbidities.
P-670
Prediction of postoperative mortality in elderly patients withhip fracture: are speciﬁc and geriatric scores better than generalscores?
H. Vallet 1 , N. Na 2 , Y. Le Manach 3 , M. Raux 4 , J. Cohen-Bittan 5 ,A. Mézière 6 , F. Khiami 7 , B. Riou 8 , J. Boddaert 1 . 1 Unit of PeriOperative Geriatric care, Groupe Hospitalier (GH) Pitié-Salpêtrière,
Department Fight Aging and Stress (DHU FAST), Assistance PubliqueHôpitaux de Paris (APHP), Paris, France; Sorbonne University,
University Pierre and Marie Curie (UPMC) Paris 06, University
Hospital, Paris, France; 2 Departments of Emergency Medicine andSurgery, GH Pitié-Salpêtrière, APHP, Paris, France; 3 Departments ofAnesthesia & Clinical Epidemiology and Biostatistics, Michael DeGrootePoster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

School of Medicine, Faculty of Health Sciences, McMaster University,
Hamilton, Canada; 4 Sorbonne University, University Pierre and Marie
Curie (UPMC) Paris 06, University Hospital, Paris, France; Departmentsof Anesthesiology and Critical Care, GH Pitié-Salpêtrière, APHP, Paris,
France; 5 Unit of Peri-Operative Geriatric care, Groupe Hospitalier (GH)Pitié-Salpêtrière, Department Fight Aging and Stress (DHU FAST),
Assistance Publique-Hôpitaux de Paris (APHP), Paris, France;
6 Department of Rehabilitation, GH Charles Foix, APHP, Ivry sur Seine,France; 7 Departments of Orthopedic Surgery and Trauma, GH PitiéSalpêtrière, APHP, Paris, France; Sorbonne University, University Pierre
and Marie Curie (UPMC) Paris 06, University Hospital, Paris, France;
8 Sorbonne University, University Pierre and Marie Curie (UPMC) Paris
06, University Hospital, Paris, France; Departments of Emergency
Medicine and Surgery, GH Pitié-Salpêtrière, APHP, Paris, France
Background: Elderly patients with hip fracture are at high riskof mortality. An accurate prediction of postoperative mortality isimportant for communicating information, in guiding decisionmaking, and management. We tested the hypothesis that speciﬁc or
geriatric scores predict postoperative mortality better than generalscores in this frail population.
Methods: Consecutive elderly patients (>75 years) admitted to our
dedicated geriatric post-operative unit after hip fracture surgery
were included and followed up over 6 month. The following
scores were calculated: the American Society of Anesthesiology(ASA) score, PreOperative Score to predict PostOperative Mortality(POSPOM) score, Cumulative Illness Rating Scale (CIRS), Charlson
score, and Nottingham Hip Fracture Score (NHFS).
Results: 508 patients were included (age 86±7 years). The 30-day
and 6-month mortality rates were 4.1% (95% conﬁdence interval(CI): 2.7–6.3%) and 14.4% (95% CI: 11.6–17.8%), respectively. For
6-month mortality, the area under the receiver operating curve(ROCAUC) was not signiﬁcantly different between scores. The predictive characteristics of these scores were relatively poor as shownby the highest recorded values of ROCAUC (0.67 for CIRS) andpositive likelihood ratio (2.06 for POSPOM) and high proportions ofpatients identiﬁed as intermediate risk ranging from 37.4% for CIRS
to 77.5% for Charlson score. Similar results were obtained when
considering 30-day mortality.
Conclusion: In elderly patients with hip fracture, speciﬁc andgeriatric scores are not better than general scores in predicting
6-month mortality. All these scores performed poorly, suggestingthat preoperative characteristics may not be crucial in identifying
mortality risks in this frail population.
P-671
Preoperative identiﬁcation of frail elderly with hip fractures:
Which patients need postoperative intensive care monitoring?
A.V. Silven 1 , L.M.A. de Vries 2 , J.O. Daal 1 , J. Steens 2 . 1 Department ofClinical Geriatrics, Westfriesgasthuis, Hoorn, The Netherlands;
2 Department of Orthopedic Surgery, Westfriesgasthuis, Hoorn, The
Netherlands
Introduction: Recent guidelines advise intensive postoperative
monitoring of frail elderly patients after hip fracture surgery. In our
hospital, all patients aged ≥70 years with hip fractures are screened
for frailty at the emergency department, to decide on postoperative
admission to the Intensive Care Unit (ICU). In some patients though,there is no need for intensive monitoring. Therefore, it is importantto establish critical factors for admittance. The objective of thisstudy was to identify preoperative patient speciﬁc characteristics,
which can predict clinically necessary ICU admission following hip
fracture surgery in patients aged ≥70 years.
Methods: We retrospectively collected data of all patients aged
≥70 years with hip fractures who underwent surgery followed by
ICU monitoring in the Westfriesgasthuis hospital in 2015 and 2016.

S233

Patient characteristics were related to necessary ICU admission.
This was deﬁned as one or more of the following: administrationof vasopressors, >6L oxygen/min, any form of rate control for heart
rates <40 or >150 bpm, ≥4L IV crystalloid infusion within 24h
and/or >4 units of blood within 24h.
Results: 186 patients were included in this study. Overall, 47.8%of all ICU admissions were categorised as necessary. Preoperative
characteristics signiﬁcantly associated with an increased risk ofnecessary ICU admission were cardiac disease (odds ratio (OR) 2.30;
95% conﬁdence interval (CI) 1.03–5.15; p=0.04) and age (OR 1.11; CI
1.04–1.19; p<0.01).
Conclusions: Higher age and the presence of any form of cardiac
disease predict a higher chance of necessary ICU monitoring inelderly patients after hip fracture surgery.
P-672
Pressure ulcers are associated with six month mortality inelderly patients with hip fracture managed in orthogeriatriccare pathway
H. Vallet, J. Cohen-Bittan, M. Raux, A. Mézière, M. Verny, B. Riou,
F. Khiami, J. Boddaert. Groupe Hospitalier (GH) Pitié-Salpêtrière –Charles Foix, Assistance Publique-Hôpitaux de Paris (APHP), Paris –Ivry sur Seine, France
Pressure ulcers (PU) in hip fracture are associated with pooroutcomes. Orthogeriatric management reduces PU incidence in
hip fracture in the elderly. However, remaining factors and prognostic associated with PU in hip fracture patients managed inorthogeriatric care pathway are unknown. The objectives were
to determine the prognostic of PU in the hip fracture in UPOG,
and their associated factor. From June 2009 to April 2015, allconsecutive patients, >70 years old, with hip fracture admitted toan Unit for Post-Operative Geriatric Care (UPOG) were screened.
Patients were included if they were hospitalized for hip fracture
and were excluded in presence of pathological fracture or if they
were already hospitalized at the time of the fracture. In our unit,
orthogeriatric principles are implemented, including a multicomponent intervention to improve PU prevention and management.
Patients were followed until 6 months after discharge. 567 patientswere included, with an overall 14,4% 6-month mortality (95% CI:
11.6–17.8%). Of these, 67 patients (12%) experienced at least one PU.
Despite orthogeriatric management, PUs were signiﬁcantly associated with a low albumin level (RR 0.90, 95% CI:0.84–0.96; p=0.003)
and history of atrial ﬁbrillation (RR 1.91, 95% CI:1.05–3.46, p=0.033),
coronary artery disease (RR 2.16, 95% CI:1.17–3.99; p=0.014) anddiabetes (RR 2.33, 95% CI:1.14–4.75; p=0.02). PU was associatedwith 6 month mortality (RR 2.38, 95% CI: 1.31–4.32, p=0.044). In
elderly patients with hip fracture managed in an orthogeriatriccare pathway, PU remained associated with poorly modiﬁable risk
factors and long term mortality.
P-673
Procalcitonin and C-reactive protein for diagnosing sepsis inelderly patients after orthopedic surgery
H. Vallet 1 , C. Chenevier-Gobeaux 2 , J. Cohen-Bittan 3 , P. Ray 4 ,G. Gavazzi 5 , A. Breining 6 , L. Epelboin 7 , M. Verny 8 , B. Riou 9 ,F. Khiami 10 , J. Boddaert 11 . 1 Unit of Peri-Operative Geriatric Care,
Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix. DHU FAST,
Assistance Publique Hôpitaux de Paris (APHP), Paris, France; Sorbonne
Universités, UPMC Paris 6, Paris, France; 2 Clinical Chemistry
Laboratory, Hôpitaux Universitaires Paris Centre (HUPC), APHP, Paris,
France; 3 Unit of Peri-Operative Geriatric Care, Hôpitaux Universitaires
Pitié-Salpêtrière-Charles Foix. DHU FAST, Assistance Publique Hôpitauxde Paris (APHP), Paris, France; 4 Sorbonne Universités, UPMC Paris 6,
Paris, France; Department of Emergency Medicine, Groupe Hospitalo-

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Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

Universitaire de l’Est parisien, site Tenon, APHP, Paris, France; 5 Clinicof Geriatrics, CHU de Grenoble, Grenoble, France; 6 Sorbonne
Universités, UPMC Paris 6, Paris, France; Department of Geriatrics,
Groupe Hospitalier Pitié Salpêtrière-Charles Foix, APHP, DHU FAST,
Paris, France; 7 Department of Infectious and Tropical Diseases, Centre
Hospitalier Andrée Rosemon, Université de la Guyane, Institut Pasteurde La Guyane et Centre d’Investigation Clinique CIC Antilles-Guyane
Inserm 1424, Guyane Française, France; 8 Unit of Peri-Operative
Geriatric Care, Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix.
DHU FAST, Assistance Publique Hôpitaux de Paris (APHP), Paris,
France; Sorbonne Universités, UPMC Paris 6, Paris, France; UMR CNRS
8256, Paris, France; 9 Sorbonne Universités, UPMC Paris 6, Paris,
France; Department of Emergency Medicine and Surgery, Hôpitaux
Universitaires Pitié Salpêtrière-Charles Foix, APHP, Paris, France; UMR
INSERM 1166, IHU ICAN, Paris, France; 10 Sorbonne Universités, UPMC
Paris 6, Paris, France; Department of Orthopedic Surgery and Trauma,
Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, APHP, Paris,
France; 11 Unit of Peri-Operative Geriatric Care, Hôpitaux Universitaires
Pitié-Salpêtrière-Charles Foix. DHU FAST, Assistance Publique Hôpitauxde Paris (APHP), Paris, France; Sorbonne Universités, UPMC Paris 6,
Paris, France; UMR CNRS 8256, Paris, France; Department ofEmergency Medicine and Surgery, Hôpitaux Universitaires PitiéSalpêtrière-Charles Foix, APHP, Paris, France

Methods: Monocentric retrospective study of data prospectively
collected between 2009 and 2014. Inclusion of consecutive patients >75 y/o, admitted in unit of perioperative geriatric (UPOG)
care with HF or MFP. Data included comorbidities, Injury Severity
Score score (ISS), trauma mechanism, complications, and 6-monthfollow-up for death, walk recovery or new institutionalization. The
primary endpoint was 6-month mortality.
Results: 606 patients were included (age 86±6 y/o, CIRS 9 [6–12],
ADL 5.5 [3.5–6], home living 75%), 522 with HF and 54 with MFP. HF
patients were older (86±6 vs 84±5 y/o, p=0.001), had more comorbid conditions (CIRS 9 [6–12] vs. 7 [4–10], p=0.004) and dementia(40 vs 11%, p<0.001). ISS score was higher in MFP patients (9 [9–9]
vs 9 [8–17], p<0.001). After 6-months, there was no difference formortality between HF and MFP patients (respectively 16 vs 8%,
p=0.15), but walking recovery was more frequent in HF patients(53% vs. 37%, p=0.03) and admission to new institution was lessfrequent (4% vs. 15%, p=0.03).
Conclusion: The weight of comorbid conditions could counteract
the initial severity of lesions in elderly patients with trauma.

Introduction: In the ﬁeld of surgery in elderly patients, biomarkers
may be of interest for diagnosis of infection, but data are scarce. We
aimed to analyze the diagnostic performance of infection of procalcitonin (PCT) compared to C-reactive protein (CRP) in orthopedic
surgery for elderly patients.
Methods: From July 2009 to July 2013, all patients admitted to ourperioperative geriatric unit after trauma surgery were included in
the study. Patients were excluded in presence of preoperative infection or antibiotics distribution, or if PCT was not measured. Clinicaland biological data were prospectively collected. Medical charts
were reviewed by 3 experts to assess bacterial sepsis diagnosis.
Areas under the curve (AUC) and 90%-speciﬁcity thresholds wereanalyzed for PCT and CRP crude levels and their relative variations.
Results: Two hundred twenty-nine out of 527 patients were retained for the analysis (median (IQR) age 86 (81–90) y/o, CIRS 9(7–12), ADL 5.5 (3.5–6.0), hip fracture 75%), of which 40 had bacterial infection (23 pneumopathy, 8 urinary tract infection, mediandelay 2 days after admission). For bacterial infection diagnosis,
AUCs were 0.64 95% CI [0.57–0.70] for PCT crude levels, 0.65
[0.59–0.71] for PCT relative variations, 0.68 [0.61–0.74] for CRP
crude levels, and 0.70 [0.64–0.76] for CRP relative variations. Ninety
percent speciﬁcity thresholds were 0.75μ g/L for PCT crude levels,+62% for PCT variations, 222mg/L for CRP crude levels, and +111%
for CRP variations.
Conclusions: Diagnostic values of PCT and CRP were low after
trauma surgery in elderly patients. Relative variations of thesebiomarkers may be more informative than crude levels.

A. Breining 1 , H. Vallet 2 , L. Zerah 2 , A. Gioanni 2 , N. Hammoudi 3 ,J. Cohen-Bittan 1 , M. Verny 2 , A. Mézière 4 , F. Khiami 5 , B. Riou 6 ,J. Boddaert 2 . 1 Unit of Peri-Operative Geriatric Care, GeriatricDepartment, Hôpitaux universitaires Pitié-Salpêtrière-Charles Foix.
DHU FAST, Assistance Publique Hôpitaux de Paris (APHP), Paris,
France; 2 Unit of Peri-Operative Geriatric Care, Geriatric Department,
Hôpitaux universitaires Pitié-Salpêtrière-Charles Foix. DHU FAST,
Assistance Publique Hôpitaux de Paris (APHP), Paris; Sorbonne
University, University Pierre and Marie Curie (UPMC) Paris 06,
University Hospital, Paris, France; 3 Department of Cardiology,
Hôpitaux universitaires Pitié-Salpêtrière-Charles Foix, AP-HP, Paris,
France; 4 Rehabiliation Geriatric Department, Hôpitaux Universitaires
Pitié Salpêtrière-Charles Foix, AP-HP, Paris, France; 5 Department ofOrthopedic Surgery and Trauma, Hôpitaux Universitaires PitiéSalpêtrière - Charles Foix, AP-HP, Paris; Sorbonne University,
University Pierre and Marie Curie (UPMC) Paris 06, University
Hospital, Paris, France; 6 Department of Emergency Medicine andSurgery, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, APHP,
Paris; Sorbonne University, University Pierre and Marie Curie (UPMC)
Paris 06, University Hospital, Paris, France

P-674
Prognosis of trauma elderly patients with hip fracture vsmultiple fractures or polytrauma in a dedicated geriatric carepathway
A. Gioanni. 2. Unit of Peri-Operative Geriatric care, geriatricdepartment, Hôpitaux universitaires Pitié-Salpêtrière-Charles Foix.
DHU FAST, Assistance Publique Hôpitaux de Paris (APHP), Paris, France
Introduction: Prognosis of trauma elderly patients is due to severity of initial lesions, but the weight of multimorbidity, as reported
in patients with hip fracture (HF), is less known. We aimed tocompare phenotypes of morbidities and outcomes of elderly patients admitted with HF vs multiple fractures or polytrauma (MFP)
managed in a dedicated care pathway.

P-675
Prognostic value of fragmented QRS in elderly patients with hip
fracture in a dedicated geriatric care pathway

Introduction: Fragmented QRS (fQRS) are due to terminal conduction delay after myocardial infarction, and are associated withcoronary artery disease in younger patients. We aimed to describe
electrocardiograms (ECG) before and after hip fracture surgery inelderly patients and to evaluate prognostic value of fQRS duringhospitalization.
Patients and methods: Monocentric retrospective study, all consecutive patients >75 years with a hip fracture were enrolled. Clinical,
ECG, biological data and outcomes were prospectively collected.
Presence of fQRS was determined before surgery, and repeated ECG
were analysed. Each 12-lead ECG was analysed by 3 independent
readers. The primary end point was a composite criteria deﬁned as
in-hospital cardiovascular complication (arrhythmia, heart failure,
acute coronary syndrome, troponin elevation).
Results: A total of 185 patients were enrolled. Before surgery, 91%of the patient were in sinus rhythm and 8% had atrial ﬁbrillation.
Twenty nine percent of the patients had a fQRS and 15% a J wave.
During their stay in the geriatric post operative unit, cardiac andarrhytmics event occurred in 56% of the patients: 28% presented
supraventricular extra-systoles, 21% ventricular extra-systoles, 11%paroxystic atrial ﬁbrillation. Acute coronary syndrome (with andwithout ST-elevation) were observed in 7% of the patient. New

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

fQRS appeared in 9% of the patient. Pre-operative fQRS were notassociated with any postoperative cardiovascular outcome whereas
pre-operative Q wave was associated ACS (regression coeﬃcient
0.31, p=0.04)
Conclusion: fQRS are a frequent pattern in elderly’s ECG, but are
not associated with in-hospital cardiovascular outcome after hip
surgery.
P-676
Quality improvement project – Is there a need for an inpatient
falls management pathway?
A. Malik, R. Malik, E. Paling, A. Simons. Birmingham Heartlands
Hospital, Heart of England Foundation Trust, Birmingham, United
Kingdom
Introduction: Patients who present to hospital via the emergency
services with a NOF fracture have an integrated care pathway which
outlines quality standards. There is no pathway for patients who
sustain these fractures as an inpatient. We identiﬁed patients who
sustained a NOF as an inpatient and compared their pathway tothose presenting to A&E with a suspected NOF.
Methods: We included all NOFs in the trust (Heart of England Foundation Trust) sustained as an inpatient in 2016 (1st January-31st
December). We reviewed the time taken for doctor to review, timeto analgesia, time to x-ray, time to theatre, time to Ortho-geriatric
review and 30 day mortality. Data was collected from electronic
records and case notes.
Results: 13 patients sustained a NOF fracture as an inpatient in thepast 12 months. 38% were reviewed within 1 hour of the fall. No
patients received analgesia within 30 minutes, and no patients had
an x-ray within 1 hour, 11/13 patients were managed surgically.
Mortality at 30 days was 30% compared with 7% for outpatient NOFs.
Conclusion: A separate pathway for patients who sustain NOFs as
inpatients is required, to identify those with serious injury, ensure
prompt analgesia, x-ray and a quicker transit to theatre. Mortality
rates for inpatient NOF’s are higher as the patients have more
medical problems and are often unwell at the time of falling.
P-677
Simpliﬁed comprehensive geriatric assessment in older surgicalpatients admitted to General Surgery. Salford POPS-GS
M. Tan, A. Gomez-Quintanilla, A. Vilches-Moraga, J. Fox,
L. Miguel-Alhambra, M. Moatari, A. Paracha, M. Rowles, A. Price,
M. Dos Santos. Ageing and Complex Medicine Directorate, Salford
Royal NHS Foundation Trust, Salford, United Kingdom
Objectives: Half of patients undergoing emergency general surgicaladmission are old. We examined variations in housing, mobility,
cognition, functional status, continence and medications on admission compared to discharge, and between different treatmentgroups.
Methods: All general surgical patients aged 75 years or older
admitted non-electively between 9th September 2014 and 28th
February 2017 and reviewed by our in-reach service.
Results: 577 patients were included in the study, mean age 82.9±5.7
years, 56.2% female. 23.4% (135) underwent surgery, 17% (102) nonsurgical procedure and 58.9% (340) medical management. The
majority were living at home or with carers (92.9%) at the time ofadmission although 21.4% of patients were dependent for basic activities of daily living (ADLs). Patients managed medically presented
more cognitive impairment (21.5% vs 16.7% vs 13.3% - p 0.034), weremore dependent for basic (26.3% vs 16.7% vs 12.6% – p 0.002) andinstrumental ADLs (51.2% vs 52% vs 43.6% – p 0.001), less mobile(69.7% vs 65.5% vs 81.7% p 0.043) and took more medications (8.7
vs 8.6 vs 7.4 – p 0.012). There were no other signiﬁcant differences.
Admission vs discharge more patients were independent for basic

S235

ADLs (73.7%–83.3%–87.4% vs 73.3%–84%–77.6% p<0.001), less mobile (65.5%–72.5%–75.6% vs 63.3%–70%–68.3% p<0.001) and took
fewer medications (8.7–8.6–7.4 vs 8.1–8.2–7 p<0.001). There wereno other signiﬁcant differences.
Conclusions: Patients undergoing surgical interventions and procedures were more independent, mobile and took fewer medications
compared to those managed medically. Patients became less mobile and more dependent after hospitalisation in the medical andsurgical intervention groups but not those undergoing procedures.
P-678
The ﬁrst 7 months of an Orthogeriatric Unit in a general hospital– a new model of care towards outcome improvement?
A. Santos 1 , L. Costa 1 , C. Claudino 1 , R. Costa 1 , S. Gomes 1 ,S. Duque 1,3 , J.G. Consciência 2 , L. Campos 1 . 1 Orthogeriatric Unit,
Internal Medicine Department, São Francisco Xavier Hospital,
Occidental Lisbon Hospital Center; 2 Orthogeriatric Unit, Orthopedics
Department, Occidental Lisbon Hospital Center; 3 University Geriatric
Unit, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
Introduction: Hip fracture (HF) frequently occurs in elderly, due
to high risk of falls and osteoporosis. Multimorbidity and geriatricsyndromes result in high vulnerability to perioperative complications, which can increase perioperative morbimortality, impair
gait rehabilitation and decrease quality of life. Several evidence
has been published showing that co-management by orthopedics
and medical specialties, performing routine medical assessment
based on comprehensive geriatric assessment, can improve patients
outcomes. Our goal is to analyse the ﬁrst 7 months of a new
Orthogeriatric unit that was opened grounded on potential beneﬁtof this model of care.
Methods: Retrospective study of elderly admitted in an Orthogeriatric Unit due to HF (also including fractures associated to prosthesis) between June and December 2016 through hospital record
analysis.
Results: 134 patients admitted, only 11 were not assessed by thegeriatric team. Average age 83.87 years, 78.4% females, 42% widowed, 31% married, 79% living at home. Average baseline Barthelscore 80.3, normal gait in 55%, average Cumulative Illness Rating Scale Geriatrics 7.45, cognitive impairment in 29%, 96% wereadmitted from the emergency department. Most frequent typesof fractures were: intracapsular (n=71), intertrocantheric (n=38)
and subtrocantheric (n=13). Surgical intervention was performedin average 4.2 days after admission, average length of stay (LOS)
was 16.7 days and 10 patients died. Most frequent perioperativecomplications were: pain (87%), anemia (82%), delirium (34%).
Conclusions: There is a trend to improvement of LOS and time tosurgery, comparing to the previous 17 months of standard care (LOS
19.6 days, 5.4 days).
P-679
What do Greek students and professionals know about the timea person with dementia is in need of palliative care?
V. Giannouli, N. Syrmos. School of Medicine, Aristotle University ofThessaloniki, Greece
Introduction: There is scarce research about the beliefs of university students and professionals in the social, medical and otherscience ﬁelds in Greece regarding the need of the elders with adiagnosis of dementia for palliative care. The objective of this study
is to explore when students and professionals living and working in
Greece, consider a person with dementia in need of palliative care.
Methods: A questionnaire based on an existing case-vignette by
van Riet Paap et al. (2015) was used. One hundred seventy-ﬁve
participants from Greece (147 women; 158 not having a relative diagnosed with dementia; 29 student nurses, 34 professional

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Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

nurses, 52 psychology students, 22 professional psychologists, and38 students of non-relevant sciences; M age = 27.72, SD age =9.61; and for the 55 professionals M years of professional working
experience = 11.76, SD years of professional working experience =6.50) participated voluntarily in this study.
Results: Open responses to the “when” question revealed six categories: after her diagnosis/after the ﬁrst symptoms; when she andher family cannot cope; at the advance of symptoms; all the time;
when she behaves aggressively; I am not sure/there is no speciﬁc
point. Professional status, age, and ﬁeld of studies were not foundto be signiﬁcant predictors, and thus did not contribute to theparticipants’ answers regarding the start of palliative care.
Conclusions: Professional-student status and relevancy of subject
do not predict opinions of Greek participants for the proposed time
point of considering a person with dementia in need of palliative
care.

Area: Psychiatric symptoms and illnesses

P-680
Antipsychotics use in the elderly and users’ risk proﬁles:baseline characteristics of a German claims-based cohort
J. Reinold, B. Kollhorst, T. Schink, U. Haug, F.E. Pisa. Leibniz Institutefor Prevention Research and Epidemiology – BIPS, Germany
Background: Antipsychotics are indicated for the treatment of psychotic disturbances. In the elderly they are frequently used in otherindications, such as neuropsychiatric symptoms of dementia. However, balancing risks and beneﬁts in these patients is challenging.
Safety proﬁles of individual antipsychotics need to be considered
in combination with the patients’ risk proﬁles. However, patient
populations have hardly been described before.
Objective: This study aims to describe patient characteristics, comorbidities and concomitant medications as well as preexisting
conditions associated with adverse outcomes in elderly new usersof antipsychotics.
Methods: Cohort study including patients aged ≥65 years witha ﬁrst prescription for antipsychotics during 2005–2014, basedon claims data of the German Pharmaco-epidemiological Research
Database (GePaRD).
Results: 415,948 patients were included, 70.3% women, median age
80 years (interquartile range (IQR): 73–85). Treatment was mostfrequently started with Melperone (29.3%), Risperidone (13.4%) and
Sulpiride (11.3%), in 3.6% of patients with >1 antipsychotic. Before
starting treatment patients took a median of 8 (IQR: 5–11) different
medications, 62.7% had Charlson Comorbidity index >2. 37.3% of
patients had a diagnosis of dementia, and 85.3% a diagnosis related
to pain. 58.3% of patients had a history of cardiovascular and 45.0%
of cerebrovascular disease.
Conclusions: In this cohort of elderly antipsychotics users,
polypharmacy, risk factors for adverse outcomes and comorbidities,
especially dementia, were common at baseline. Risks and beneﬁts
of an antipsychotics treatment have to be carefully weighed in thispopulation.
P-681
Can we prevent the risk of escaping of old residents? The needfor a speciﬁc tool
S. Bonin-Guillaume 1 , E. Jouve 2 , E. Poulin 2 , V. Bertrand 3 ,T. Bautrand 4 . 1 Assistance Publique Hopitaux De Marseille; Aix
Marseille Université; 2 Assistance Publique Hopitaux de Marseille;
3 EHPAD Korian Loubiere; 4 EHPAD Le Domaine de La Source
Introduction: Residents’ escape episodes or elopement occur even

if most of the nursing homes (NH) have set up speciﬁc devices
to prevent from this risk. Escaping is associated to a high burdenof the caregivers and is often underreported. Currently there isa lack of a clear deﬁnition of escaping often included in otherbehavioral symptoms of dementia (BPSD) such as wandering, motor disturbance or agitation. Aim: describe the characteristics ofescapers.
Method: Exploratory retrospective descriptive study. Population:
NH residents with an escape episode reported to local authority
between 2008 and 2009. Assessment: semi guided interview by anindependent healthworker with the medical and nursing staffs.
Results: 9 NH volunteered to participate with 42 elopement records
analyzed. Mean age was 78.7 years old (56–96); 63% over 80 y.o.;
60% males; 54% of the residents had severe disability. Most but
not all of the them had dementia (23/42); 58% had previously
experienced a similar episode; BPSD were often reported out of
which 2 cases of apathy. Environmental factors were also reported
such as recent admission to the NH (<6 months: 69%); living in asingle room (54%), family visits (77%) particularly when more than
twice a week (44%); 34% resided in a speciﬁc Alzheimer Unit.
Conclusion: A speciﬁc tool to assess the risk of escaping wouldemphasize patient centered-care and help to develop personalized
devices. After reaching a pluridisciplinary consensual deﬁnition,such a tool has been developed and its validation is ongoing with
the ESCAPE Study.
P-682
Elderly diabetic patients: inﬂuence of anxiety and depression on
adherence to medication
R. Mendes 1 , M. Cunha 1 , S. Martins 2 , L. Fernandes 3 . 1 Department ofInternal Medicine. São João Hospital Centre/CHSJ, Porto; 2 Center for
Health Technology and Services Research/CINTESIS, UP. Department ofClinical Neurosciences and Mental Health. Faculty of Medicine,
University of Porto; 3 Department of Clinical Neurosciences and Mental
Health. CINTESIS. Faculty of Medicine, University of Porto. Clinic of
Psychiatry and Mental Health, CHSJ, PortoIntroduction: The prevalence of diabetes is growing worldwide,
particularly in the elderly [1]. In diabetic patients, anxiety anddepression are highly prevalent, which plays a negative role inmedication adherence, as well as in metabolic control [2,3]. This
study aims to analyze the association in elderly diabetic patients between symptoms of anxiety/depression and medication
adherence.
Methods: This cross-sectional study was carried out in an outpatient department of Internal Medicine Service (CHSJ-Porto), withelderly patients (≥65 years) that had been diagnosed with diabetes. Patients were excluded if they were unable to communicate.
Symptoms of anxiety/depression were assessed with the Hospital
Anxiety and Depression Scale/HADS. Medication adherence wastreated as a categorical variable (non-adherent, partially adherent,
adherent).
Results: Overall 94 patients were included, mostly female (53.2%),
married (63.8%) and with a mean age of 75.2 (sd=6.7) and mean
education of 3.3 years (sd=2.0). Patients had on average 5.9 (sd=1.7)
comorbidities and took 8.8 (sd=2.3) medications daily. In thissample, 30% of patients were non- or partially adherent. Basedon HADS, 16.1% of patients presented depression and 25.8% anxiety. Signiﬁcant differences between the three groups were foundin anxiety and depression scores, both being higher among the
non-adherent patient group, compared to the adherent and to thepartially adherent groups (anxiety: median = 8 vs. 6,4, respectively,
H=8.860, p=0.012; depression: median = 6 vs. 3,2, respectively,
H=6.043, p=0.049).
Conclusions: The present ﬁndings of this association between
symptoms of anxiety/depression and medication adherence, cor-

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

roborate those from previous studies. This research points to theimportance of early identiﬁcation and adequate treatment in orderto enhance medication adherence.
References:[1] Centers for Disease Control and Prevention. National Diabetes
Fact Sheet: General Information and National Estimates on
Diabetes in the United States, 2011. Atlanta, Georgia, U.S. Department of Health and Human Services, Centers for Disease
Control and Prevention, 2011[2] Nouwen A, Winkley K, Twisk J, Lloyd CE, Peyrot M, Ismail K,
Pouwer F. European Depression in Diabetes (EDID) ResearchConsortium Type 2 diabetes mellitus as a risk factor for the
onset of depression: a systematic review and meta-analysis.
Diabetologia 2010;53:2480–2486.
[3] Capoccia K, Odegard PS, Letassy N. Medication adherence withdiabetes medication: a systematic review of the literature. The
Diabetes Educator 2016;42(1):34–71.
P-683
Elderly patients with syncope or falls showed high prevalence of
psychiatric symptoms
J.J. Walgers, S.C. de Ruiter, T. Germans, M.G. Kat, J.H. Ruiter,
R.W.M.M. Jansen. Northwest Clinics, Alkmaar, the Netherlands
Introduction: The prevalence of psychiatric symptoms has hardly
been investigated in elderly patients with syncope. The aim of thisstudy is to investigate the prevalence of psychiatric symptoms inpatients 65 years or older with syncope in comparison with older
patients with falls.
Methods: This observational cohort study included patients aged
65 years or older with at least one syncope or unexplained fall
and who were evaluated at the fall and syncope day clinic. Primary
outcomes were the prevalence of depressive and anxiety symptoms
that were reported in the medical history. The secondary outcome
was the use of psychotropic medication, Geriatric Depression Scale,and Patient Health Questionnaire.
Results: 378 patients were included with a mean age of 79.7±6.5(SD) years; 194 patients with syncope and 184 patients with falls.
Patients with syncope had more depressive symptoms than fallpatients (33% vs. 23%, P=0.05). Sadness occurred signiﬁcantly more
often in the syncope group (P=0.05). No other signiﬁcant differenceswere observed between syncope and fall groups. Anxiety symptoms
were common in both syncope and fall group (20% vs. 19%, P=0.79).
Also, we found a high prevalence of benzodiazepine use (22% vs.
16%, P=0.15) and antidepressants use (17% vs. 15%, P=0.63) in bothsyncope and fall groups.
Conclusions: Elderly patients with syncope or unexplained falls
often have psychiatric symptoms and frequently use psychotropic
medication. Elderly patients with syncope experience more depressive symptoms than elderly patients with falls. Therefore, elderly
patients with syncope should also be evaluated for psychiatric
symptoms.
P-684
Fear of falling, functional activity, and psychotropic medications
in elderly patients with syncope or falls
J.J. Walgers, S.C. de Ruiter, T. Germans, M.G. Kat, J.H. Ruiter,
R.W.M.M. Jansen. Northwest clinics, Alkmaar, the Netherlands
Introduction: Fear of falling (FOF) is common in elderly patientswith syncope or falls. The aim of this study is to investigate which
factors are associated with FOF.
Methods: We evaluated FOF in patients aged ≥65 years, who experienced at least one syncope or fall. Main outcomes were the use ofpsychotropic medication, functional activity, and the prevalence of
psychiatric symptoms.

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Results: 378 patients were included with a mean age of 79.7 (SD6.5) years; 256 patients with FOF and 122 patients without FOF(non-FOF). The prevalence of FOF was 68% in patients with syncope
and 67% in patients with falls (P=0.89). Compared with non-FOF
patients, patients with FOF used more antidepressants (P=0.03) andbenzodiazepines (P=0.00). FOF patients scored worse than non-FOF
patients on the handgrip strength test (19.3±8.4 vs. 22.6±10.2,
P=0.01), as a measure of functional activity. FOF was associated withmore depressive symptoms (P=0.01) compared with non-FOF. The
multivariate analysis showed no independent risk factor for FOF.
Conclusions: Two-third of elderly patients with syncope or falls
have FOF, which seems to be associated with high use of antidepressants and benzodiazepines, decline in functional activity,and more depressive symptoms compared with non-FOF patients.
However, none of these variables were an independent risk factor
for FOF. Physicians taking care of older patients with syncope orfalls should be aware of the high prevalence of FOF, with theassociated functional decline, depressive symptoms, and high useof psychotropic medications.
P-685
Frailty evaluation in aging adults with autism spectrum disorderand intellectual disability (EFAAR study)
S. Miot 1,2,3 , S. Crepiat 2 , S. Couderc 2 , E. Pernon 2 , V. Gonnier 2 ,C. Jeandel 3 , A. Baghdadli 2,4 . 1 CNRS UMR 8246, INSERM UMR-S 1130,
Sorbonne Universités, Université Pierre et Marie Curie Paris 06, Institut
de Biologie Paris-Seine (IBS), UM119 Neuroscience Paris Seine (NPS),
Paris, France; 2 Centre de gérontologie clinique Antonin-Balmès, CHRU
Montpellier, Montpellier, France; 3 Centre de Ressources Autisme,Département de Psychiatrie de l’Enfant et de l’Adolescent, CHRU
Montpellier, Montpellier, France; 4 Centre de Recherche en
Epidemiologie et Santé des Populations (CESP), Paris-Saclay University,
Paris-Sud University, UVSQ, APHP, Paris, France
Few data are available about aging with autism spectrum disorders(ASD). Nevertheless a premature frailty is suspected. In general
population, two models are used for frailty screening: the Fried’s
phenotypic model and the Rockwood’s cumulative model. This later
allows to calculating the frailty index (FI), which depends only onage. The principal aim of our monocentric and prospective study
is to determine if FI is age-dependent in over age 20 and living
in medico-social institutions of Languedoc-Roussillon adults withADS and intellectual disability (ASD-ID). Secondary objectives areto evaluate the frailty prevalence and to verify the FI validity for
fall, hospitalisation and death prediction in this population. At thetime of enrolment, FI is calculated from 103 clinic and biologicalvariables. In addition, ASD severity, adaptive and intellectual functioning, somatic and psychiatric comorbidities, and treatments areevaluated. The fall, hospitalisation and death occurrence is thencollected each year during 5 years. Here we present preliminary
results. To date, 23 patients aged from 21 to 62 years are included.
The FI depends signiﬁcantly on the age and ASD severity interaction.
No frail patient is detected by the Fried’s model, when 21.7% aredeﬁned frail with the Rockwood’s model. As described in people
with ID, the synergy of age and disease severity seems to inﬂuence
the ASD-ID patient frailty. These results need to be conﬁrmed in abigger cohort. By follow-up our patients during 5 years, we hope topropose at term a new frailty phenotypic model adapted to people
with ASD-ID.
P-686
Management of residual symptoms and psychotropic
medication side-effects among older or soon-to-be-old adults
with chronic mental illness
K.C. Chan 1 , D.W.L. Lai 2 , S.S.W. Yau 3 . 1 The Chinese University Of Hong

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Kong, Hong Kong, China; 2 The Hong Kong Polytechnic University, Hong
Kong, China; 3 New Life Psychiatric Rehabilitation Association, Hong
Kong, China
Background: Individuals with persistent mental illness are notspared from the issue of aging. However there have been few studies which focus on the aging experience of this group of individuals,
particularly the issues of residual symptoms and medication sideeffects as these individuals age. Therefore it is the purpose of thispresentation to explore these issues through qualitative study thattargets this speciﬁc population group.
Methods: 61 individuals, aged 41 to 75 with chronic mental illness, were recruited from different mental health programs toparticipate in qualitative interviews. Interviews were audio-taped
and transcribed. Narratives generated were subsequently examinedusing thematic analysis. Qualitative data from participants of the 3
age groups namely: mid-age (40–49); soon-to-be-old (50–59); andolder adults (≥60) were compared with respect to their experienceof residual symptoms and side-effects of psychotropic medications.
Results: Of the 61 interviewed, 31 were males, majority sufferedfrom schizophrenia or other psychotic disorders (n=46). Residual
symptoms common to all groups were rumination, anxiety, sleep
problem and delusional ideations. Medication side-effects shared
among the 3 groups included fatigue, drowsiness, weight gain andextra-pyramidal symptoms and appeared to be better tolerated
in the older-adult group. The residual symptoms and medication
side-effects tended to exacerbate the chronic physical conditions or
arouse related apprehension in the oldest group, while their impact
on the younger groups was often manifested as interference withthe engagement in exercise, social, educational and wage-making
activities.
Conclusion: Successful aging strategies should encompass the variation in residual symptoms and medication side-effects experienced
during aging.
P-687
Prevalence of depressive symptoms in elderly people in Manisa,
TurkeyB. Cengiz Özyurt 1 , M. Serifhan 2 . 1 Celal Bayar University Faculty of
Medicine Public Health Department, Manisa, Turkey; 2 Sehzadeler
Community Health Center, Manisa, Turkey
Objectives: The aim of this study is to determine the prevalence ofdepressive symptoms in elderly population in Manisa and evaluate
the potential risk factors.
Methods: The population of this cross-sectional study was 17760
elderly individuals who were living at the region of community
health center in March-April 2017. The sample size was calculatedusing the software of Epi info 7.0; thereby, 546 geriatric individuals
were enrolled. Each individual was randomly selected from his/her
registration at the administrative oﬃce of Manisa Public HealthDirectory. All data were collected by face-to-face interview. A standardized questionnaire form, that is involved sociodemographic
characteristics, Katz index and, Depression scale for geriatrics, wasused. The rate of participation was 97.8% (n=534). The study activities were approved by the Celal Bayar University Institutional
Review Board. All data was evaluated using descriptive analysis
and chi square test. Logistic regression was used for multivariate
analysis.
Results: The mean age of the study group was 72.70±6.35. The majority of individuals (78.6%) had a chronic disease which continuous
drug administration was required, 56.3% was women, 44.3% was
graduated from elementary school and 19.6% was living alone. The
prevalence of depressive symptoms was 32.8%
Conclusion: Multivariate analysis demonstrated that the risk of depression is signiﬁcantly high in individuals who were living alone,need of support during daily activities, said that they perceived
their health worse according to previous year, abused in the past
year, insuﬃcient income and past psychiatric illness history.
P-689
Seven-year outcome of depression in elderly high-altituderesidents in Ladakh, India
M. Ishikawa, G. Yamanaka, A. Endo, J. Kizuki, T. Kawabe, H. Sakura.
Tokyo Women’s Medical University Medical Center East, Tokyo, Japan
Background: Studies have reported a positive association between
suicide rate and altitude, suggesting a relationship between hypoxia and depression. Previously we reported that the prevalenceof depression in high-altitude residents in Ladakh was low. This
study aimed to analyze the clinical course of residents diagnosed
with depression in a clinical interview during our previous healthcheckup in Ladakh.
Methods: The participants were two residents diagnosed withdepression during our health checkup of 114 residents in Domkhar,
Ladakh in 2009. Their 7-year outcome was analyzed through home
visits. The interview was conducted in English with a local interpreter. The Religious Commitment Inventory-10 was used as anindex of religious devotion. The Multidimensional Scale of Perceived
Social Support was used as an index of social support and level ofwell-being was assessed using visual analog scale.
Results: The two residents diagnosed with depression achieved
spontaneous remission without treatment. The interviews focusedon religious devotion and social support. Both residents had strong
religious devotion and were satisﬁed with their relationship withother residents. With regard to subjective quality of life, bothresidents were highly satisﬁed with the relationship they had with
their family and friends. They reported that praying, listening toa priest’s lecture, and visiting a religious facility made them feelbetter.
Conclusion: The results suggest that deep religious devotion andsocial support are helpful in defending against development ofdepression. One limitation of this study is that only two residents
were included; thus, quantitative studies are required to clarify thisissue.
P-690
The association between apathy and decline of physicalfunctioning in depressed and non-depressed older persons
during 2-years of follow-up
M.J. Henstra 1 , T.C Feenstra 2 , N. van der Velde 1,3 , R.C. van derMast 4 , H. Comijs 2 , M.L. Stek 2 , D. Rhebergen 2 . 1 Academic Medical
Center, Amsterdam, The Netherlands; 2 GGZ inGeest, Amsterdam, The
Netherlands; 3 Erasmus University Medical Centre Rotterdam, The
Netherlands; 4 Leiden University Medical Center, Leiden, The
Netherlands
Background: In older persons, both apathy and depression (which
frequently co-occurs with apathy) have been associated with poor
physical functioning, a major health concern. We investigated theassociation between apathy and physical functioning in older persons without manifest dementia and whether this association is
modiﬁed by depression.
Methods: We used data of 380 older persons (with and without depression) participating the Netherlands Study of Depression in Older
Persons, with baseline-scores on the Apathy Scale and baselineand 2-year follow-up-scores on at least one measure of physicalfunctioning, including International Physical Activities Questionnaire (IPAQ, self-reported), WHO-Disability Assessment Schedule (WHO-DASII mobility-subset, self-reported), walking-speed or
handgrip-strength. Multivariable linear regression analyses were
performed to examine the association between apathy at baselinePoster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

and physical functioning at 2-year follow-up. We also investigatedeffect-modiﬁcation by sex, age, and depression.
Results: Cross-sectionally, persons with higher baseline Apathy
Scale-scores performed signiﬁcantly worse on all measures of physical functioning. Longitudinally, higher baseline Apathy Scale-scores
were associated with higher delta-scores on the IPAQ (B=−59.81)
in the basic model, and higher delta-scores on the WHO-DASII(B=0.09) in all models. Apathy was not associated with higher
delta-scores for walking speed or handgrip strength. Furthermore,sex, age, and depression did not modify any association.
Conclusion: In a Dutch cohort of older persons without manifest
dementia, apathy was associated with more decline in self-reported,
but not in objective physical functioning. Sex, age, and depression
did not modify these associations. Maybe, in older persons withapathy, subjective decline precedes decline in physical performance
tests.
P-691
The association between apathy and recurrent falling in a Dutch
cohort of older individuals visiting a fall clinic
M. Henstra, C.M. Houbolt, L. Seppala, A. Scheffer, S. de Rooij, N. vander Velde. Academic Medical Center, Amsterdam, The Netherlands
Background: Apathy, a common and disabling behavioral syndromein older individuals, has been associated with impaired physicalperformance and executive dysfunction. They share a pathophysiological pathway and the latter are both risk-factors for falling. Thiscross-sectional study examines the association between apathy andfallrisk in a cohort of 243 Dutch outpatients aged ≥65 years visiting
a fall-clinic after a fall.
Methods: Information on the number of falls and recurrent falling
was derived from the CAREFALL Triage Instrument. Multivariable
regression and negative binomial regression analyses were used
to assess Odds Ratio’s (ORs) and Incidence Rate Ratio’s (IRRs) andtheir 95% Conﬁdential Intervals (CI95) for the association between
apathy and recurrent falling (≥2 falls in the past 12 months) andnumber of falls respectively.
Results: Apathy was independently associated with recurrent
falling in patients aged 65–75 years: OR 2.8 (CI95 1.1–7.4). The
number of falls in the past 12 months was 46% higher in patientswith apathy than in patients without apathy after adjustment for
confounders (IRR 1.46 (CI95 1.0–2.1)).
Conclusion: In a Dutch population of older outpatients visiting afall-clinic, apathy was associated with recurrent falling in patients
aged 65–75 years and the number of falls. Hypothetically, apathy isespecially relevant in relation to falling in the “youngest old” andmaybe potential interventions modifying apathy should be targetedat this age group. Further research is necessary to elucidate thediagnostic accuracy of apathy as a risk-factor for recurrent fallingand its potential role in fall-prevention strategies.
P-692
The associations between depressive state and well-being inelderly women
A. Cernovas 1 , V. Alekna 1 , M. Tamulaitiene 2 , M. Fabijonavicius 1 ,I. Serbentaite 1 , G. Sadauskaite 1 . 1 Faculty of Medicine of Vilnius
University, Vilnius, Lithuania; 2 Faculty of Medicine of Vilnius
University, Vilnius, Lithuania; National Osteoporosis Center, Vilnius,
Lithuania
Objective: The aim of study was to investigate the associations
between depressive state and well-being in elderly women.
Subjects and methods: The cross-sectional study was performedon Lithuanian community dwelling women aged 60 years and older.
The exclusion criteria were musculoskeletal or nervous system diseases or conditions that could restrict mobility. Data were collected

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by a survey consisted of sociodemographic questions and four
speciﬁc questionnaires. Depression state was measured by Center
for Epidemiologic Studies Depression Scale (CESD). Well-being wasmeasured using: Control, Autonomy, Pleasure, and Self-realization(CASP-19), Satisfaction with Life Scale (SWLS) and The Positive
and Negative Affect Schedule (PANAS). Correlation was determinedusing Spearman correlation coeﬃcient.
Results: The study was performed on 161 women. Mean age ofstudy sample was 69.9±5.1 years; the youngest woman was 60 years
old, the oldest one – 84 years old. Average of special questionnaires
scores were: CESD – 15.0±6.9; CASP-19 – 37.2±9.6; PANAS positive
affect – 34.6±6.4, PANAS negative affect – 21.4±6.2, SWLS – 25.1±4.5.
Our ﬁndings suggest that CESD score correlated with CASP-19 score(r=-0.36, p=0.03) and separately with three of CASP-19 domainscores: control (r=-0.38, p=0.02), autonomy (r=-0.36, p=0.02), andself-realization (r=-0.44, p=0.004). Correlation with pleasure domain was not found, as well as correlation with positive subscaleof PANAS scores. Further analysis showed CESD score correlation
between and SWLS (r=-0.42, p=0.01) and PANAS negative affectsubscale (p=0.002; r=0.48) scores.
Conclusions: Our study showed that depressive state was associated with well-being: negatively with CASP-19 and SWLS andpositively with and PANAS negative affect subscale.
P-693
The relationship between depression and perceived social
support among community-dwelling elderly in Ladakh, India
A. Endo, M. Ishikawa, J. Kizuki, T. Kawabe, G. Yamanaka, H. Sakura.
Department of Medicine, Tokyo Women’s Medical University Medical
Center East, Tokyo, Japan
Introduction: Recent studies have reported a positive correlation
between altitude and suicide rate. Suicide rate is known to besigniﬁcantly associated with depression. According to our past
study inLadakh, India, despite its location at a 12,000 feet highaltitude, the depression rate was lowamong community-dwellingelderly. The purpose of the present study was to investigate therelationship between depression rate and perceived social support andreligiosity among theelderly in Ladakh.
Methods: A total of 88 community-dwelling elderly aged 64.1(± 12.6) years living in Domkharvalley, Ladakh, participated inthis study. All participants underwent a medical check-up, andwereinterviewed using the Multidimensional Scale of Perceived
Social Support (MSPSS), GeriatricDepression Scale (GDS), Religions
Commitment Inventory-10 (RCI-10), and Visual Analog Scale (VAS)
for subjective quality of life. We compared variables including age,sex, marital status, education levels, number of housemates andchildren, MSPSS, RCI-10, and VAS between theDepression group(GDS >6) and No Depression (GDS 6) group.
Results: The perceived social support from family and signiﬁcantothers were lower in theDepression group. There were no significant differences between the two groups in total MSPSSscores,
social support from friends, or RCI-10 scores.
Conclusions: The No Depression group perceived more social support from family and signiﬁcantothers than the Depression group.
People in Ladakh are devout Buddhists and have survived theharshenvironment of the high altitude by helping each other. This social
background could haveinﬂuenced the low depression rate despite ahigh altitude.

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Area: Urology and continence management

P-694
Association of urinary incontinence with geriatric syndromes incommunity-dwelling highly functional people aged 65 and over
M. Kotsani 1 , G. Soulis 2 , A. Achimastos 2 , I. Georgiopoulos 2 .
1 HE.S.S.R.A. Hellenic Society for the Study and Research of Aging andAristotle University of Thessaloniki, 2nd Department of Internal
Medicine, Hippokratio Hospital of Thessaloniki, Thessaloniki, Greece;
2 HE.S.S.R.A. Hellenic Society for the Study and Research of Aging,
GreeceIntroduction: We investigated the prevalence of urinary incontinence (UI) and its association with common geriatric syndromes(GS), in a Greek community-dwelling population, aged ≥65 years.
Methods: Secondary database analysis of a cross-sectional study.
Results: We studied 402 persons (54.7% women), mean age 73.7(±5.8) years. UI was reported by 42.3% of them; 34.4% as occasional
accidents and 7.9% as a permanent phenomenon. People with UI
in comparison to those without, were more likely to: be women(74.7 vs 40.1%, p<0.001), take more drugs (6.8±3.1 vs 5.7±3.2,
p<0.001), present more chronic comorbidities (4.4±1.9 vs 3.7±2.0,
p<0.001), lower MMSE scores (26.9±3.0 vs 27.7±2.2, p=0.001),
higher 15-items’ Geriatric Depression Scores (4.8±3.4 vs 3.5±3.1,
p<0.001), higher disability in Global Disability Scale (27.7±15.3
vs 21.3±14.0, p<0.001), slower 3 meters’ Timed-Up-and-Go (TUG)
performance (11.5±3.5 vs 10.6±3.7sec, p<0.001), fall history (74.9 vs
56.9% p<0.001), higher pain levels (35.3 vs 62.5% with no, 44.7 vs26.7% with low and 20.0 vs 10.8% with high pain levels, p<0.001)
and globally more coexisting GS (2.3±1.3 vs 1.6±1.2, p<0.001), but
did not differ in age (73.8±5.6 vs 73.7±6, p=0.807). They were also
more likely to report anxiety and sleep problems (70.6 vs 53.9%,
p=0.001) and lower self-rating health status (54.1 vs 64.7% in thehigh-ranking category, p=0.007). Neither diabetes nor diuretics,
taken by 190 (47.3%) individuals, were associated with UI. Results
remained similar after adjustment for sex, except for TUG test
(p=0.313).
Conclusions: UI is highly prevalent even in relatively youngcommunity-dwelling populations and is associated with various
other GS, which could all incur a negative impact on a person’sfunctional status. Clinical awareness is required when assessing
older adults with UI, since it could only be the tip of the iceberg.
P-695
Eﬃcacy of transcutaneous posterior tibial nerve stimulation inolder patients with overactive bladder syndrome
R. Haddad 1 , C. Hentzen 2 , G. Amarenco 2 , G. Robain 1 , GRAPPPAGroup (Research Group on Pelviperineology of the Elderly).
1 Rothschild Hospital, Sorbonne University, UPMC Univ Paris 06, AP-HP,
GRC 01, Group of Clinical Research in Neuro-Urology (GREEN); 2 Tenon
Hospital, Sorbonne University, UPMC Univ Paris 06, AP-HP, GRC 02,
Group of Clinical Research in Neuro-Urology (GREEN), Paris, France
Introduction: The main objective of this study is to determine
the eﬃcacy of transcutaneous posterior tibial nerve stimulation(TPTNS) in older patients with overactive bladder (OAB) syndrome.
The secondary objective is to look for predictive factors of eﬃcacy
of this treatment.
Methods: All patients aged over 65 years with OAB syndrome forwhich TPTNS was introduced between 2010 and 2016 in 2 neurourology centers were included. Age, gender, etiology of OAB, urinary
symptoms and detrusor overactivity (DO) were retrospectively collected. The main outcome was eﬃcacy of TPTNS (i.e. purchase of
the device between 3 and 6 months). Association between patientcharacteristics and eﬃcacy was examined in logistic regression
models.
Results: A total of 271 patients were included (mean age 74.2 years;
63.8% of women), of whom 50.8% had neurogenic OAB (44.9% withparkinsonian syndromes). 75.6% had urinary incontinence and DO
was found on urodynamic studies for 145 patients. The overall
eﬃcacy was 45.8%. None of the factors tested were signiﬁcantly
predictive of eﬃcacy, especially age (≥75 years, p=0.54), stress urinary incontinence (p=0.48) and DO (p=0.39), whether neurogenic
or not, except a center effect (p=0.03). This was not sustained after
adjustment for age and DO.
Conclusion: TPTNS is an effective treatment in older patientswith OAB syndrome. No predictive factors of eﬃcacy were found,especially age and DO. If a center effect has been found, the placeof TPTNS in OAB management (ﬁrst line vs failure of a previous
treatment) is under study.
P-696
Indication change from appropriate to inappropriate use ofurinary catheters between medical and surgical hospitalized
elderly patients
C.-M. Chang 1 , F.-W. Hu 2 , C.-H. Tsai 3 , C.-H. Chen 4 . 1 Division ofGeriatrics and Gerontology, Department of Internal Medicine, National
Cheng Kung University Hospital; Institute of Gerontology, Departmentof Medicine, National Cheng Kung University, Tainan, Taiwan;
2 Department of Nursing, National Cheng Kung University Hospital,
Tainan, Taiwan; 3 Department of Nursing, College of Medicine, Tzu Chi
University, Hualien, Taiwan; 4 Department of Nursing, Chang Jung
Christian University, Tainan, Taiwan
Introduction: Urinary catheterization is a commonly used procedure in hospital setting but may lead to complications. Our study
was to compare risk factors between medical and surgical hospitalized elderly patients with or without change of appropriateness ofurinary catheters.
Methods: From October 1, 2012 to October 31, 2013, hospitalized
patients aged ≥65 years, with appropriate use of urinary catheters
placed within 24 hours of hospitalization, were enrolled. Data
were collected from medical records and standardized interviews
with patients or surrogates. Indications for urinary catheters wereassessed every day and inappropriate use was considered if nomore indication existed.
Results: A total of 198 patients with appropriate use of urinary
catheters was observed. Indication change from appropriate to
inappropriate use of urinary catheters occurred in 36 (38.7%) of
medical patients and 71 (67.6%) of surgical patients. Univariate
analysis showed that the change to inappropriate use occurred
more often among medical patients with higher comorbidities, forconvenience by caregivers and by patients, while it occurred more
often among surgical patients who were female, with cognitive impairment, ADL impairment, higher comorbidities, for convenienceby caregivers and by patients, for comfort by patients, and lessdocumentation for urinary catheters. Multiple logistic regression
showed that the change to inappropriate use occurred more often
among medical patients with higher comorbidities, and among
surgical patients for comfort by patients.
Conclusion: There is higher rate of change from appropriate to
inappropriate use of urinary catheters among surgical elderly patients. Education to caregivers and patients, and monitoring thechanging indications and different risks among medical and surgicalinpatients might be helpful.

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

P-697
Patient reported urinary incontinence and quality of life afterradical prostatectomy
J. Aurelian 1 , A. Capisizu 2 , S.M. Aurelian 2 , V. Jinga 2 , P. Armean 2 .
1 University of Medicine and Pharmacy “Carol Davila” Department ofUrology, Bucharest, Romania; 2 University of Medicine and Pharmacy“Carol Davila”, Bucharest, Romania
Introduction: Radical prostatectomy remains the best treatment
for localized and locally advanced prostate cancer, but complications like urinary incontinence and erectile dysfunction may alter
the surgical outcomes and decrease the quality of life of prostatecancer patients. The objective of the study was to assess the impact
of radical prostatectomy on urinary continence and quality of life
after radical prostatectomy for prostate cancer.
Methods: We carried out a prospective study in “Prof. Dr. Th.
Burghele” Clinical Hospital, Department of Urology. The study took
place between 2015 - 2016 and we evaluated 134 patients diagnosed with prostate cancer in localized or locally advanced stage
with the use of two questionnaires – QLQ-C30 and QLQ-PR25 preand post radical prostatectomy. We divided the patients in 2 groups:
a preoperative group and a postoperative group that underwent
radical prostatectomy. The age distribution of the two groups was:for the preoperative group the mean was 63.52 years, and for the
postoperative group the mean was 66.23 years.
Results: In operated patients over 65 years, the urinary symptoms
were more severe compared to unoperated patients (p<0.005).
After radical prostatectomy, 30.6% of patients have accused thepresence of urinary incontinence. Urinary incontinence frequency
was higher in patients over 65 years (38.1%), compared to patients
below 65 years (23.2%). Overall health status scale scores (QLQC30) decreases postoperatively, representing a decrease of overall
health.
Conclusions: Quality of life was seen as impaired by patientstreated with radical prostatectomy. Age over 65 years brings
reduced functionality and louder symptoms after radical prostatectomy, urinary incontinence being a disturbing complication.
P-698
Quality of life among elderly women with urinary incontinence
G. Jievaltiene 1 , J. Knasiene 2 , V. Jievaltaite 3 , M. Jaras 3 . 1 Lithuanian
University of Health Sciences, Department of General Surgery, Kaunas
Clinical Hospital; 2 Lithuanian University of Health Sciences,
Department of Geriatrics; 3 Lithuanian University of Health Sciences,
Faculty of Medicine, Kaunas Clinical Hospital
Introduction: Urinary incontinence (UI) is a health problem prevalent in various age groups [1]. Due to anatomical and physiologicalpeculiarities, it is more common in women and inﬂuences various
aspects of quality of life [3,2]. Women still do not want to talk about
UI and it causes that this problem often remains undiagnosed [4].
Methods: Women aged 65 years and more were surveyed. The original questionnaires were used with permissions: SF-36v2 – genericquestionnaire of quality of life; I-QOL – speciﬁc questionnaire ofquality of life. Statistical calculations were performed by using IBM
SPSS 23.0 software package.
Results:: 127 women participated in the study. Answers of SF-36v2
questionnaire showed that the mean of quality of life was 45 pts.
The lowest scores were observed in subscales General Health (30pts), Vitality (40 pts), and Bodily Pains (42 pts). Meanwhile Physical
Functioning and Emotional Roles had highest scores (respectively58 and 51 pts). Women with UI had statistically signiﬁcantly poorer
quality of life than other elderly women. I-QOL questionnaire revealed that the total quality of life was 71 pts on average. The
best measured component was related with psychosocial impacts(75 pts) while avoidance behaviors and social embarrassment were

S241

scored lower (68–69 pts). Comparative analysis of women with UI
versus without UI revealed that the former group had statisticallysigniﬁcantly lower quality of life.
Conclusion: Quality of life among elderly women with UI is lower
than among other women. Also, study showed that UI is associatedwith quality of life aspects.
References:[1] Damián J, Pastor-Barriuso R, García López FJ, de Pedro-Cuesta J.
Urinary incontinence and mortality among older adults residing
in care homes. J Adv Nurs. 2017 Mar;73(3):688–699.
[2] Dumoulin C, Tang A, Pontbriand-Drolet S, Madill SJ, Morin
M. Pelvic ﬂoor morphometry: a predictor of success of pelvic
ﬂoor muscle training for women with stress and mixed urinary
incontinence. Int Urogynecol J. 2017 Jan 12.
[3] Santini S, Andersson G, Lamura G. Impact of incontinence on thequality of life of caregivers of older persons with incontinence:
A qualitative study in four European countries. Arch Gerontol
Geriatr. 2016 Mar-Apr;63:92–101.
[4] Di Rosa M, Lamura G. The impact of incontinence management
on informal caregivers’ quality of life. Aging Clin Exp Res. 2016
Feb;28(1):89–97.
P-699
The use of a urinary tract management protocol in an integrated
hip fracture unit to reduce urinary tract infections
Sin Yue, Jeanice Ker, Mallya Jagadish Ullal, Su Su, Wen Qi Mok, Pok
Ling Yiap, Lee Hoon Yu, Siew Ming, Meliza Lim, Ai Ling Hong. Khoo
Teck Puat Hospital, Singapore
Introduction: Globally, the incidence of Urinary Tract Infections(UTI) in hip fracture elderly is 23%-25%. UTI increases the risk ofdelirium, associated with an increased length of hospitalisation andis a common cause of readmission from community hospital. A
comprehensive nurse-led urinary tract management protocol was
introduced in the integrated Hip Fracture Unit (HFU) to reduceincidences of UTIs in elderly patients with hip fractures during theperi-operative period.
Methods: Firstly, a nurse-initiated protocol instead of a doctordriven approach was introduced to prevent catheter-associated UTI(CAUTI). Nurses will remove patients’ indwelling urinary catheter(IDC) on the morning of 2nd post-operation day. To avoid reinsertion of IDC, nurses will initiate routine intermittent catheterisation(IMC) instead should trial-off-catheter failed. Additionally, high risk
male patients will be administered PO Tamsulosin for a period of
not more than 7 days to reduce their risk of post-operative urinary
retention. Furthermore, all patients will undergo routine blood andurine tests to assess their risk of kidney injury, with intravenous
hydration initiated as appropriate.
Results: Of the 357 hip fracture patients from January to December
2016, there were 58 cases of UTI (16%) of which 5 cases were CAUTI(1.4%). The readmission rate from community hospital was 1.4%
(5 cases) while the incidence rate of delirium is also signiﬁcantly
lower compared to international data.
Conclusions: UTI is a common complication of hip fracture. A comprehensive nurse-led multidisciplinary urinary tract management
protocol has successfully reduced the incidence of UTI especially
CAUTI among our HFU patients hence preventing related complications.
P-700
Urinary catheter use and care in the acute hospital setting:a point prevalence study
D. McCartan, A. Fallon, C. MacMahon, R. Collins, S. Kennelly.
Tallaght Hospital
Background: Urinary catheters (UC) are associated with poor out-

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Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

comes in hospitalised older adults including infection, delirium, andtrauma. We sought to determine the point prevalence of UC use andto review the process employed for both the decision to catheterise
and ongoing care thereafter. A basic nursing UC bundle is available,
but there is no other resource to direct clinical decisions regarding
UCs.
Method: In a single day all admitted patients in a tertiary university
teaching hospital were screened for the presence of an in-dwelling
UC. Clinical, nursing, ED and peri-operative notes were reviewed forevidence of clinical indication, catheter care records, and review ofongoing clinical need with view towards timely removal. Patientsin critical care units were excluded.
Results: 56 of 386 eligible patients had an indwelling catheter witha point prevalence of 14.5%. 75% (42/56) of whom were aged ≥65
years, and 64% (36/56) were male. 86% (48/56) were newly inserted
on current admission, with seven inserted due to brain and spinal
injuries. In 14% (9/56) there was no indication recorded, with otherindications including urinary retention 19.6% (11/56) or as partof haemodynamic stabilisation protocol 12.5% (7/56). Only 14.5%(7/48) of those with newly inserted UC had a trial-without-catheter(TWOC) and of these only 4 had formal urology input.96% (54/56)
had a complete nursing catheter care bundle.
Conclusion: Limitations in UC care were identiﬁed. Inconsistency
in medical record keeping regarding both decision to catheterise
and of review regarding early removal could be targeted with anappropriate protocol to prompt earlier TWOC, urology input when
warranted.
P-701
Urinary incontinence in aged women: Prevalence and risk
factors
G. Jievaltiene 1 , J. Knasiene 2 , V. Jievaltaite 3 , M. Jaras 3 . 1 Lithuanian
University of Health Science, Department of General Surgery, Kaunas
Clinical Hospital, Kaunas, Lithuania; 2 Lithuanian University of Health
Science, Department of Geriatrics, Kaunas Clinical Hospital, Kaunas,
Lithuania; 3 Lithuanian University of Health Science, Faculty of
Medicine, Kaunas Clinical Hospital, Kaunas, Lithuania
Introduction: Urinary incontinence (UI) is a health problem prevalent in various age groups [1,4]. Based on scientiﬁc literature,incontinence is more common in women and the prevalence of itis over 30% [2,3]. There is still no effective predictive assessment
framework for UI and more research is needed [4].
Methods: Elderly women who visited the general practitioner weresurveyed. The original questionnaires were used: MMSE – minimental state examination, used for evaluation of cognitive function;
GDS – geriatric depression scale, used for evaluation of depressiveness. Also, we asked elderly women their demographic data andthem physical health. Statistical calculations were performed byusing IBM SPSS 23.0 software package.
Results: 127 women participated in the study and mean age ofparticipants was 76.6±7.50 years. The most common diseases werearterial hypertension (84%), urinary incontinence (77%), constipation (53%), and cardiac arrhythmia (48%). Study participants’ mean
body mass index (BMI) was 28.0±6.95 kg/m2 (range 19–79). Morethan half (55%) of responders had no cognitive dysfunction, 21%
had mild, 13% – moderate, and 11% – severe cognitive impairment.
78% of elderly women had certain level of depression (32% mildlydepressed and 46% severely depressed), while 22% of women
had no depression. Average GDS score was 9.6±4.01. The results
demonstrated that the associated factors with UI (P<0.05) werecognitive impairment (OR=7.36), depressiveness (OR=3.62), historyof gynecologic surgery (OR=3.53) and constipation (OR=3.22).
Conclusion: Prevalence of urinary incontinence in elderly women
visiting the general practitioner is 77%. The main factor associatedwith urinary incontinence is cognitive impairment.

References:[1] Damián J, Pastor-Barriuso R, García López FJ, de Pedro-Cuesta J.
Urinary incontinence and mortality among older adults residing
in care homes. J Adv Nurs. 2017 Mar;73(3):688–699.
[2] Dumoulin C, Tang A, Pontbriand-Drolet S, Madill SJ, Morin
M. Pelvic ﬂoor morphometry: a predictor of success of pelvic
ﬂoor muscle training for women with stress and mixed urinary
incontinence. Int Urogynecol J. 2017 Jan 12.
[3] Di Rosa M, Lamura G. The impact of incontinence management
on informal caregivers’ quality of life. Aging Clin Exp Res. 2016
Feb;28(1):89–97.
[4] Troko J, Bach F, Toozs-Hobson P. Predicting urinary incontinencein women in later life: A systematic review. Maturitas. 2016
Dec;94:110–116.
P-702
Urinary incontinence predicts the onset of cognitive impairment
N. Veronese 1 , M. Noale 1 , E. Musacchio 2 , L. Sartori 2 , G. Crepaldi 1 .
1 National Research Council, Padova, Italy; 2 University of Padova,
Padova, Italy
Introduction: Urinary incontinence is a common condition in theelderly, particularly in demented people. However, if urinary incontinence could predict the onset of poor cognitive status is poorly
known.
Methods: Data was gathered from the Progetto Veneto Anziani(Pro.V.A) dataset, a longitudinally assessed cohort of communitydwelling older people in Italy. The mean follow-up period was
4.4 years. Urinary incontinence was deﬁned through self-reported
questions regarding the activities of daily living. Cognitive impairment was assessed through mini-mental state examination (MMSE)
using a score of less 24/30.
Results: In total 1,414 people were included, of them 540 (=38.2%)
suffers from urinary incontinence. At baseline, participants withurinary incontinence were signiﬁcantly older, females and had alower MMSE score (27.1±1.8 vs. 27.3±1.7, p<0.0001). During followup, participants with urinary incontinence had a signiﬁcant greater
decrease in MMSE (−2.29±5.19 vs. −1.38±4.19, p<0.0001) than those
without this condition. Subjects with urinary incontinence had asigniﬁcant increased odd of cognitive impairment at follow-up compared to those without (Odds Ratio (OR)=1.17; 95% CI: 1.06–1.29,
p=0.001), after adjusting for 13 potential baseline confounders.
Conclusions: Urinary incontinence is a common condition in theelderly and seems to increase the onset of poor cognitive status.
Greater awareness is required for physicians to screen/investigate
this population at potential higher risk of poor cognitive status.
P-703
Urinary retention in older patients with lower urinary tract
symptoms: prevalence, associated factors and impact onmanagement
R. Haddad 1 , B. Peyronnet 2 , M. Mezzadri 3 , G. Robain 1 ,G. Amarenco 4 , GRAPPPA Group (Research Group on
Pelviperineology of the Elderly). 1 Rothschild Hospital, Sorbonne
University, UPMC Univ Paris 06, AP-HP, GRC 01, Group of ClinicalResearch in Neuro-Urology (GREEN), Paris, France; 2 Pontchaillou
Hospital, University Hospital of Rennes, Rennes, France; 3 Lariboisière
University Hospital, Paris Diderot University, AP-HP, Paris, France;
4 Tenon Hospital, Sorbonne University, UPMC Univ Paris 06, AP-HP,
GRC 01, Neuro-Urology Clinical Research Group (GREEN), Paris, France
Introduction: The objectives are to determine the prevalence ofurinary retention (UR) in older patients with lower urinary tract
symptoms (LUTS), as well as factors associated with UR and impactof UR screening in the management of LUTS.
Methods: A cross-sectional multicentric study included all patients

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

over 65 years with LUTS. A comprehensive geriatric evaluationand screening of UR (i.e. uroﬂowmetry with post void residual
volume (PVR) measurement) were performed. UR was considered
as a continuous or a binary variable (i.e. PVR ≥100 mL). Associations between characteristics of patients and UR were examined inregression models. Impact of UR screening was evaluated by thepercentage of modiﬁcation of initial management.
Results: A total of 25 patients were included (mean age 82.1±5.8
years, 88% women). The main complaint was urge urinary incontinence (32%). LUTS were severe in 48% of cases and 56% of patientsused pads. Prevalence of UR was 16% and mean PVR was 49.7±100.1
mL. No association was found between UR and type of LUTS.
There was an association between MMSE (p=0.02), undernutrition(p=0.046) and UR, that was not sustained on multivariate analysis.
Screening of UR led to modiﬁcation of the initial management in 2
cases.
Conclusion: UR is not uncommon in symptomatic older patients,
but was not associated with type of LUTS. No determinants of UR
were found in this preliminary analysis. Finally, screening of UR led
to a modiﬁcation of management in less than 10% of cases.
P-704
What are uro-geriatric factors that impact decision making in
the elderly, with a refractory urinary retention, after amultidisciplinary team board?
C. Rambaud 1 , M. Durand 2 , S. Gonfrier 1 , C. Arlaud 1 , M. Sanchez 1 ,B. Tibi 3 , R. Prader 3 , G. Sacco 1 , O. Guérin 4 . 1 Geriatrics Department,
University Hospital of Nice, France; 2 Department of Urology,
University Hospital of Nice, INSERM, U1189, ONCO-THAI, Lille, France;
3 Department of Urology, University Hospital of Nice, France;
4 Geriatrics Department, University Hospital of Nice, IRCAN - Universityof Nice, Sophia-Antipolis INSERM U1081 - CNRS UMR 7284, France
Introduction: The indwelling urinary catheter (IUC) is over usedon the elderly, with a risk of complications. Alternative treatments
exist but underused due to diﬃculties of decision making. The aimof the study is to analyze factors that inﬂuence decision-making
by a multidisciplinary team board, after a comprehensive geriatricassessment (CGA), in the elderly with a refractory urinary retention.
Methods: A standardized multidisciplinary team board was established for patients, over 70 y, with a refractory urinary retention,over a 1-Year period in 2016. Decision making for each patient wasmade after a CGA. Uro-geriatric and demographic clinical data werecollected. We collected the alternative technics and their respective
success rates (deﬁned by the lack of urinary retention at 7 days).
Results: Ninety-seven were enrolled with a mean age of 87 y with
37% of women. Alternative technics was offered in 58,8% (n=57),
including 30 catheter withdrawals, 13 thermo-expandable intraprostatic stents, 15 prostatic photovaporizations. The global successrates of alternative technics were 93% (n=53). In univariate analyzes,
predictive factors of IUC were neurologic comorbidities (HR: 3.1[1.6–7.7], p=0.014), an important dependence (ADL <2) (HR: 5.5[2.2–14], p<0,001) and an older age (HR: 1.1 [1.1–1.2], p=0.017).
In multivariate analyzes, the factor was the dependence (ADL <2)(HR: 5 [1.9–12.9], p=0.001). Compare to photovaporizations of theprostate, incontinentation’s surgeries were signiﬁcantly proposedfor older patients (86 y vs 81,4 y, p=0,026), more dependent (ADL<2, 83.3% vs 13.3%, p<0.001), with neuroleptic treatments (50% vs
13.3%, p=0.038) and a risk to tear off the catheter (83.3% vs 20%,
p=0.001).
Conclusion: Dependence appears to be an important factor inﬂuencing decision making in the elderly with urinary retention. A
multidisciplinary analysis offers a better chance to screen patientsand propose a personalized treatments adapted to their proﬁle.

S243

Area: Geriatrics in organ disease

P-705
Acute heart failure in elderly patients: clinical characteristics
and prognosis. Realworld evidence from ATHENA registry
A. Herbst 1 , F. Orso 2 , A. Pratesi 3 , S. Parlapiano 1 , A.C. Baroncini 2 ,A. Lo Forte 2 , C. Ghiara 2 , E. Carrassi 1 , G. Biagioni 1 , F. Fedeli 1 ,M.L. Di Meo 2 , N. Marchionni 4 , L. Gabbani 5 , M. Di Bari 2 , A. Ungar 2 ,S. Baldasseroni 2 . 1 University of Florence, Florence, Italy; 2 GeriatricIntensive Care Unit, Careggi University Hospital, Florence, Italy;
3 Department of Experimental and Clinical Medicine, University of
Florence, Florence, Italy; 4 Division of General Cardiology, Careggi
University Hospital, Florence, Italy; 5 Department of Medicine andGeriatrics, Careggi University Hospital, Florence, Italy
Introduction: Clinical registries and clinical trials do not represent
completely the “real world” of acute heart failure (AHF) in theelderly because of selection bias. Our purpose was to compare theclinical characteristics and prognosis of elderly patients hospitalised
for AHF in cardiology, internal medicine and geriatrics.
Methods: Data derived from the ATHENA retrospective observational study which included elderly patients (≥65 years) admitted
for AHF to the Emergency department (ED) of a tertiary University
teaching-hospital and transferred to the above described settings ofcare in the period 01.12.2014–01.12.2015.
Results: 342 patients were enlisted: 17.8% from cardiology, 17.3%
from geriatrics and 64.9% from internal medicine. Mean age was
83.7 years, resulting higher in geriatrics (86.9 years) versus internal medicine (83.6 years) and cardiology (81.0 years), P=0.001.
Females were 54.1%, without statistically signiﬁcant differences
between the three settings. Patients with HFpEF were 61.0% andpredominated in geriatrics (62.5%) and internal medicine (65.0)
compared to cardiology (49.1%), P=0.116. In-hospital mortality was
7.3% and it was higher in cardiology and geriatrics (11.0%) compared
to internal medicine (5.0%), (P=0.075). The analysis of independent predictors of in-hospital mortality showed the relationshipbetween age and mortality (OR=1.18 CI=1.05–1.32, P=0.002) andthe reverse relationship with the systolic blood pressure at the ED
entry (OR=0.96, CI=0.94–0.99, P=0.011); in-hospital mortality wassigniﬁcantly lower in patients hospitalized in cardiology (OR=0.32,
CI=0.12–0.87, P=0.025).
Conclusions: Elderly patients with AHF are signiﬁcantly different
in terms of clinical characteristics and prognosis according to thedifferent settings of care.

Late Breaking Abstracts – Poster presentations

LB-006
Age-related variations of skeletal muscle mass and strength
among Italian and Taiwanese community-dwellers: results from
the Milan-EXPO Survey and the I-Lan Longitudinal Aging Study
F. Landi 1 , M. Tosato 1 , A.-C. Hwang 2,3 , L.-K. Chen 2,3 , L.-N. Peng 2,3 ,R. Calvani 1 , A. Picca 1 , E. Marzetti 1 , R. Bernabei 1 . 1 Department ofGeriatrics, Neurosciences and Orthopedics, Catholic University of the
Sacred Heart, Rome, Italy; 2 Aging and Health Research Center,
National Yang Ming University, Taipei, Taiwan; 3 Center for Geriatrics
and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
Background: Age- and gender-speciﬁc curves of muscle mass andstrength, using data from large samples of community-dweller
people, need to be better established and so are possible differencesamong ethnic groups. The aims of the present study were toS244

Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

analyze age- and gender-speciﬁc changes in measures of muscle
and strength among community-living persons and to identify
differences between Caucasian and Asiatic individuals.
Methods: The Italian survey (“Longevity Check-up”), conductedduring EXPO 2015 in Milan, consisted of a population assessment
aimed at evaluating the prevalence of speciﬁc health metrics inpersons outside of a conventional research setting (n=1924), with a
special focus on muscle mass and strength. The Taiwanese survey
used the ﬁrst-wave sampling from the I-Lan Longitudinal Aging
Study (ILAS) collected from August 2011 to August 2013 (n=1839).
Muscle mass was estimated by using calf circumference of thedominant side. Muscle strength was determined through handgrip
strength testing.
Results: The mean age of the 1924 Italian participants was 62.5±8.3
years, of whom 1031 (53.6%) were women. Similarly, the mean
age of the Taiwanese sample was 63.9±9.3 years with 966 (52.5%)
women. Overall, cross-sectional observations suggest that calf
circumference decline with age in both genders. The calf circumference was signiﬁcantly greater among Italian participants comparedwith Taiwanese people in all age groups. A similar effect of age
was observed for muscle strength. As for calf circumference, muscle
strength was signiﬁcantly greater among Italian persons relative to
Taiwanese participants.
Conclusions: Muscle mass and strength curves for Caucasian and
Asiatic people may be used to derive reference values for subsequent use in research and clinical settings. In particular, theanalyses of trajectories of muscle parameters may help identify
cutoffs for estimating risk of adverse events as well as the optimal
timing for intervening.
LB-007
Risk factors for fall screening for identifying population at riskof prolonged length of stay
O. Dang 1 , J. Bernard 2 . 1 Acute Geriatric Care Unit, Hôpital Rothschild –Paris, France; 2 DSAS, Paris, France
Introduction: Fall is a frequent event among the elderly and thehospitalisation rate increases with age. Many risk factors for fall
have been identiﬁed [1] and the risk of fall itself increases with thenumber of factors [2]. In our study, we stated the hypothesis thatthe number of risk factors for fall increases the length of stay.
Method: Retrospective study over a year including hospitalised
patients after a fall in an acute geriatric care unit in Paris. 10
risk factors for fall were selected. First the lenght of stay andthe number of risk factors for fall were analysed using a linear
regression method. Secondly each individual risk factor, the main
etiology of fall and the complications after fall were studied.
Results: 171 stays were analysed. The mean length of stay was
33.2 days. Cumulative risk factors for fall (p=0.016), a tumoral
cause of fall (p=0.038), complications of fall (p=0.001) and delayedcomplications after fall (p=3×10–3 ) increased the length of stay.
Conclusion: Early screening of risk factors for fall for each patient
hospitalised after a fall can help to identify a population at riskof prolonged stay. Speciﬁc interventions aimed to this population
could prevent recurrent hospitalisations and falls, and prolonged
stays.
References:[1] Rubenstein LZ, Josephson KR. The epidemiology of falls andsyncope. Clin Geriatr Med 2002.
[2] Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among
elderly persons living in the community. N Engl J Med 1988.

LB-008
Effects of transcranial magnetic stimulation on Alzheimer’s
diseaseM. Budak, L. Hanoğlu. Istanbul Medipol University, Department of
Neurology
Alzheimer’s disease (AD) is a neurodegenerative disease associated with a gradual regression in cognitive function. Transcranial
Magnetic Stimulation (TMS) is an alternative treatment that canbe used in addition to pharmacological treatment. We aimed toinvestigate the effect of the repeated TMS (rTMS) in addition topharmacological treatment in AD.
Eighteen patients aged 60 years and older with AD were includedin the study and separated to 2 groups. In TMS group (n=10) 20 Hz
rTMS was applied to the bilateral Dorsolateral Prefrontal Cortex for
consecutive 5 days a week for 2 weeks. In control group (n=8) only
pharmacological treatment was applied. Individuals were evaluatedfor neuropsychiatric and behavioral status, cognition, depression,level of physical activity, quality of life and functional changes ofbrain before and after treatment.
Statistically signiﬁcant difference was found in attention, executivefunctions, behavioral status, level of physical activity and qualityof life in the TMS group; in memory and behavioral status in
the control group (p<0.05). We found that rTMS treatment was
effective on Default Mode Network, Executive Control Network andDorsal Attention Network.
Our ﬁndings showed that therapeutic methods that appear tobe an alternative in AD are in fact inﬂuenced by different areasof the cognitive and behavioral proﬁle. In conclusion, our study
showed that high frequency rTMS treatment in addition to pharmacological treatment may produce effective treatment against thedisease. In AD, detailed studies are needed to better understandthe destruction of cognitive functions and functional changes in thebrain.
LB-009Dental care utilization in patients with different types ofdementia: a longitudinal nationwide study of 58,037 individuals
M. Eriksdotter, S.-M. Fereshtehnejad, S. Garcia-Ptacek, D. Religa,
J. Holmer, K. Buhlin, G. Sandborgh Englund. Department of
Neurobiology, Care Sciences and Society (NVS), Division of Clinical
Geriatrics, Karolinska Institute, Stockholm, Sweden
Introduction: Dementia may be associated with discontinuationof regular dental checkups, which in turn results in poorer oral
health. We aimed to investigate the trend of change in dental careutilization and its contributing factors in older people before andafter being diagnosed with different types of dementia.
Methods: In this cohort study, data on 58037 individuals withdementia was obtained and merged from the Swedish Dementia
Registry (SveDem) and the Swedish Dental Health Register during
2007–2015. Onset age, type of dementia, medications, living status
and mortality were recorded. Cognitive status was assessed using mini mental state examination (MMSE) at baseline and eachfollow-up visit. Longitudinal year-by-year panel data on dental careutilization, type of operation and number of remained teeth was
prepared 3-years prior to 3-years after dementia diagnosis.
Results: Following dementia diagnosis, rate of dental care visits
signiﬁcantly declined from 1.5 to 0.9 per year (p<0.001). After multivariate adjustments, individuals with mixed dementia, dementia
with Lewy bodies, Parkinson’s disease dementia and those withfaster cognitive impairment had signiﬁcantly higher rate of decline
in dental care utilization (all p<0.05). Vascular dementia and lower
baseline MMSE score were signiﬁcant predictors of faster loss ofteeth.
Conclusions: Dental care utilization markedly declines followingPoster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

dementia diagnosis in geriatric population. The reduction is more
prominent in those with rapid progressive cognitive impairment
and the ones with extra frailty burden. Caregivers and healthcare workers should facilitate adequate dental care for frail older
individuals with dementia.
LB-010The mortality determinants of sarcopenia and comorbidities in
hospitalized geriatric patients
S. Lamers 1 , R. Degerickx 1 , S. Perkisas 2 . 1 School of Medicine,
University of Antwerp, Antwerp, Belgium; 2 University Centre for
Geriatrics, ZNA (Ziekenhuis Netwerk Antwerp), Antwerpen, Belgium
Objectives: This study sought to determine the inﬂuence of muscle
mass, muscle strength, physical performance, nutritional status andtwo speciﬁc comorbidities – heart failure and orthopedic surgery –on the four years mortality risk of hospitalized geriatric patients.
Design: A retrospective cohort study.
Setting: During hospitalization of the included geriatric patients,
the determinants of sarcopenia were measured and the nutritional
status was surveyed.
Participants: All patients hospitalized at the geriatric department of
the Saint-Elisabeth hospital in Antwerp (Belgium) from 01/08/2012
until 31/01/2013 were included. No patients were excluded. A totalof 302 subject were obtained.
Measurements: The muscle mass was measured by a computed
tomography (CT) scan of both upper legs. The muscle strength
was obtained by measuring the handgrip strength using a Jamar dynamometer. The physical performance was measured by
performing the Short Physical Performance Battery (SPPB). The
nutritional risk status was surveyed by using a questionnaire,
i.e. the Mini-Nutritional Assessment – Short Form (MNA-SF). The
comorbidities were obtained later through research of medical
records.
Results: The variables gender (HR=0.609; 95% CI: 0.442–0.838),
nutritional status (HR=2.953; 95% CI: 1.924–4.531), muscle mass
(HR=0.443; 95% CI: 0.251–0.780), muscle strength (HR=0.215; CI
95% 0.079–0.587), physical performance (HR=0.407; 95% CI: 0.237–
0.702) and heart failure (HR=1.440; 95% CI: 1.022–2.029) have beenshown to be signiﬁcant in determining the 4 years mortality risk in
hospitalized geriatric patients. Age and orthopedic surgery had no
signiﬁcant relation with mortality.
Conclusion: The determinants which have the greatest prognostic
value in predicting the four years mortality risk were gender,
nutritional status and physical performance.
LB-011
Which speciﬁc executive functions are predictors of functional
decline in community-dwelling older adults?
E. Verreckt 1 , S. Agrigoroaei 2 , M. de Saint Hubert 1 ,D. Schoevaerdts 1 . 1 Service de médecine gériatrique, CHU UcL Namur,site Godinne, Yvoir, Belgique; 2 Psychological Sciences ResearchInstitute, Université Catholique de Louvain, Louvain-La-Neuve,
BelgiqueIntroduction: The relationship between executive functions andgait speed, fall risk and functional decline (FD) is emerging in the
medical literature. Previous studies have underlined the importanceof controlling automatic behavior, planning appropriate behavior
and initiating goal-directed behaviors in health management likefall prevention. In our study, we aim to link speciﬁc executivefunctions, such as inhibition, planning, spontaneous and reactive
ﬂexibility and working memory, to the risk of FD.
Methods: A prospective cohort of community-dwelling older adults
was screened for frailty (Fried criteria) at baseline and assessed
for FD after a 6 months period. All participants completed a

S245

neurocognitive evaluation including 5 executive processes anda comprehensive geriatric assessment (CGA) including mobility
scales (timed get-up and go test, short physical performancebattery, handgrip and performance oriented mobility assessment
scale).
Results: A total of 99 old subjects (mean age: 81.6 years) was
included. Using a hierarchic multiple regression analysis, the model
showed a signiﬁcant association between frailty indicators and FD.
When executive function indicators were introduced in the model,
errors in inhibition and planning time were shown to be signiﬁcantrisk factors of FD. These results remained unchanged when mobility
scales were introduced as covariates.
Conclusions: We conclude that executive functions including inhibition and planning time, which are closely related to the control
of automatic behavior and the planning of goal-directed behavior,
are potential risk factors for FD. We suggest that implementing ascreening tool of those executive functions in CGA could help in theprevention of FD.
LB-012
Optimization of polypharmacy in geriatric patients using aclinical decision support system
F. van den Hanenberg, V.D. Poetsema, J.J.M.A. Hendrikx, J. vanCampen, M.C. Meulendijk, J. Tichelaar, M.A. van Agtmael,
C.J.P.W. Keijsers. The Netherlands
Background: Polypharmacy is a known risk factor for potentiallyinappropriate prescribing. Recently there is an increasing interestin clinical decision support systems (CDSS) as a computer tool for
improving polypharmacy. A randomised controlled trial in Ireland
showed that a structured review of medication supported by a
CDSS can improve the appropriateness of medication regimens andreduces the incidence of adverse drug reactions in older hospitalised patients. However, so far no attention has been devoted
to patients admitted to a geriatric department. This is relevant
because polypharmacy is highly prevalent in this population.
Objective: The objective of this study was to evaluate the impact ofa CDSS, with the START-STOPP criteria as main content. Endpoints
were 1) appropriateness of prescribing, and 2) acceptance rate ofrecommendations.
Methods: a multicentre prospective study comparing the use of
a CDSS with usual care was performed in patients at the geriatric department of two non-academic teaching hospitals in the
Netherlands. Patients were included from January till May 2017.
Medication appropriateness was assessed with the Medication
Appropriateness Index (MAI).
Results: 125 patients with a median age of 83 years were reviewed.
In both the usual care and intervention group MAI scores weresigniﬁcantly declined at discharge. This effect was signiﬁcantly
larger in the intervention group. MAI scores at discharge between
the usual care group and the intervention group were respectively
9.95±6.70 and 7.26±5.07. The CDSS created 193 recommendationsof which 71 START, 45 STOPP and 77 interactions. 31.6% of therecommendations were accepted.
Conclusion: This study showed that a CDSS used for optimising
polypharmacy does have additional value in a setting of a geriatricdepartment. However the usual care at a geriatric department
already improves the appropriateness of prescribing substantially.
LB-013
A frailty intervention therapy team (FITT) pilot led by health andsocial care professionals (HSCP) in a Teaching Hospital
A. Ryan 1 , C. O’Mahony 2 , G. Forde 3 , J. Kirwan 4 , L. Keaskin 5 ,A. Casey 1 , V. Nelson 2 , D. Danaher 3 , H. Coetzee 4 , M. McKiernan 5 ,U. Cunningham 6 . 1 Medical Social Work Department; 2 Occupational

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Poster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

Therapy Department; 3 Physiotherapy Department; 4 Speech andLanguage Therapy Department; 5 Department of Clinical Nutrition andDietetics; 6 Chair of Health & Social Care Professions Directorate, Mater
Misericordiae University Hospital, Dublin, Ireland
Introduction: Frail older people have a longer length of hospital
stay and have worse outcomes from their inpatient stay [1]. The
aim of the initiative was to identify frail older people admitted to
the Mater Misericordiae University Hospital and to develop an assessment service at the “front door” to enable a Multi-Disciplinary
Team (MDT) consensus to ensure best possible care for the patient.
Methods: FITT was made up of 5 HSCPs - Dietetics, Medical Social
Work, Physiotherapy, Occupational Therapy and Speech & Language Therapy for the pilot from March-May 2017. FITT identiﬁed
patients >75 years old using the local FITT Common Screening
Tool including Rockwood Clinical Frailty Scale [2]. Patients received
intensive early MDT intervention. Daily FITT “huddles” discussed
patient intervention and discharge planning with HSCPs completinginterdisciplinary treatments as required. On the patient’s 8th day
in hospital, FITT reviewed the patient’s care and discussed theinterventions required to expedite discharge.
Results: 107 patients were accepted by FITT (Mean age 85 years,
SD=6.5 years). 69% of patients assessed and treated by FITT required
the input of 3 HSCP disciplines or more, with 29% requiring all 5
disciplines. The mean Length of Stay (LOS) for patients assessed,
treated and discharged by FITT was 7.7 days. This was shorter thanthe LOS for patients in same age category not treated by FITT in thesame time period (15 days).
Conclusions: “Front Door” identiﬁcation of frail older people andintensive early MDT intervention may reduce the length of hospital
stay for these patients who have complex multidisciplinary needs.
References:[1] Eeles EM, White SV, O’Mahony SM, Bayer AJ, Hubbard RE. The
impact of frailty and delirium on mortality in older inpatients.
Age Ageing. 2012;41(3):412–6. [PubMed][2] Rockwood K, Song X, MacKnight C, Bergman H, Hogan DB,
McDowell I, Mitnitski A. A global clinical measure of ﬁtness andfrailty in elderly people. CMAJ. 2005;173(5):489–95.
LB-014High degree of BMI misclassiﬁcation of malnutrition among
Swedish elderly population: Age-adjusted height estimation
using knee height and demi-span
N.N. Gavriilidou. Lund University, Sweden
The degree of misclassiﬁcation of obesity and undernutrition among
elders owing to inaccurate height measurements is investigated using height predicted by knee height (KH) and demi-span equations.
Cross-sectional investigation was done among a random heterogeneous sample from ﬁve municipalities in Southern Sweden from ageneral population study ’Good Aging in Skåne’ (GÅS). The sample
comprised two groups: Group 1 (KH) including 2839 GÅS baseline
participants aged 60–93 years with a valid KH measurement; andGroup 2 (demi-span) including 2871 GÅS follow-up examination
participants (1573 baseline; 1298 new), aged 60–99 years, with avalid demi-span measurement. Participation rate was 80%. Height,
weight, KH and demi-span were measured. KH and demi-spanequations were formulated using linear regression analysis among
participants aged 60–64 years as reference. Body mass index (BMI)
was calculated in kg/m2 . The results obtained were: Undernutrition
prevalences in men and women were 3.9 and 8.6% by KH, comparedwith 2.4 and 5.4% by standard BMI, and more pronounced for all
women aged 85+ years (21% vs. 11.3%). The corresponding value in
women aged 85+ years by demi-span was 16.5% vs. 10% by standard
BMI. Obesity prevalences in men and women were 17.5 and 14.6% by
KH, compared with 19.0 and 20.03% by standard BMI. Values among

women aged 85+ years were 3.7% vs. 10.4% by KH and 6.5% vs. 12.7%
by demi-span compared with the standard. In conclusion, there
is an age-related misclassiﬁcation of undernutrition and obesity
attributed to inaccurate height estimation among the elderly. This
could affect the management of patients at true risk. We therefore
propose using KH- and demispan-based formulae to address thisissue.

Comparison between standard BMI and BMI predicted by knee height (KH) (i) anddemispan (DS) (ii) based equations.

Recent publications[1] Gavriilidou NN, Pihlsgård M, Elmståhl S. Anthropometric reference data for elderly Swedes and its disease-related pattern.
Eur J Clin Nutr 2015;69(9):1066–75.
[2] Gavriilidis G, Gavriilidou NN, Pettersson E, Renhammar E, Balkfors A, Östergren PO. Empowerment evaluation of a Swedish
gender equity plan. Glob Health Action 2014;7:23710.
LB-015Can doctors identify older patients at risk of medication-related
harm at hospital discharge?
N. Parekh 1 , J.M. Stevenson 2 , R. Schiff 3 , J.G. Davies 2 , S. Bremner 4 ,T. van der Cammen 5 , C. Rajkumar 1 , K. Ali 1 , on behalf of the PRIME
Study Group. 1 Department of Elderly Medicine, Brighton and Sussex
Medical School, Brighton UK; 2 Institute of Pharmaceutical Science,King’s College London, London UK; 3 Department of Ageing and Health,
Guy’s and St. Thomas’ NHS Foundation Trust, London UK;
4 Department of Primary Care, Brighton and Sussex Medical School,
Brighton UK; 5 Department of Industrial Design, Delft University ofTechnology, Delft, Netherlands
Introduction: Medication-related harm (MRH) is the most common
adverse event following hospital discharge affecting 18–37% of older
patients [1,2]. At the point of discharge, hospital doctors prescribe
patients’ medications and share care plans with primary care.
We explored whether hospital doctors can predict which patients
post-discharge are likely to experience MRH requiring healthcare.
Methods: The methods for this multicentre prospective cohort
study have been published [3]. Patients 65 years or above wererecruited at hospital discharge from ﬁve teaching hospitals inSouth England between September 2013 and November 2015. A
questionnaire was used to collect data from doctors about theirprediction of whether patients might experience MRH requiring
healthcare, and their degree of conﬁdence in this prediction (little
or no conﬁdence to virtually certain). Research pharmacists collected hospital readmission and GP record data, and conducted apatient/carer telephone interview to establish if MRH occurred overan eight-week follow-up period.
Results: Data for 1066 patients were analysed; median age
82.0 years (IQR, 75.6–87.0), 58.1% female. The median discharge
medicines per patient was 9 (IQR, 7–12). Most predictions (88%)
were made by junior doctors (<5 years’ clinical experience). In
the eight-week follow-up period, 315 patients (29.5%) experienced
MRH requiring healthcare. Using logistic regression, there was no
relationship between doctors’ predictions and future incidence ofPoster presentations / European Geriatric Medicine 8S1 (2017) S40–S247

MRH (OR 1.10, 95% CI: 0.82–1.46, p=0.53), irrespective of the doctors’ level of clinical experience. However, when doctors were more
conﬁdent in their MRH prediction, it was more likely to be accurate(p<0.01).
Conclusions: Discharging doctors cannot predict MRH requiring
healthcare in older people being discharged from hospital.
References:[1] Forster AJ, Murff HJ, Peterson JF, Gandhi TK, Bates DW. The
incidence and severity of adverse events affecting patients after
discharge from the hospital. Ann Intern Med 2003;138:161–7.
[2] Garcia-Caballos M, Ramos-Diaz F, Jimenez-Moleon Juan J,
Bueno-Cavanillas A. Drug-related problems in older people
after hospital discharge and interventions to reduce them. Age
Ageing 2010;39:430.
[3] Stevenson J, Parekh N, Ali K, Timeyin J, Bremner S, Van Der
Cammen T, et al. Protocol for a Prospective (P) study to develop
a model to stratify the risk (RI) of medication (M) related harmin hospitalized elderly (E) patients in the UK (The PRIME study).
BMC Geriatr 2016;16:22. doi:10.1186/s12877–016–0191–8.
LB-016
Eﬃcacy of subcutaneous route for antibiotic infusion in elderly
patients
O. Duems, S.N. Yarlequé. Hospital de Granollers, Barcelona, Spain
Introduction: Subcutaneous (SC) has been described as an eﬃcientand safe route for drug administration with potential beneﬁts inelderly population. The aim of this study was to describe ourexperience with SC antibiotics in elderlies with an acute infectious
process, diﬃcult venous access, oral intolerance and limitation oftherapeutic effort.
Methods: Retrospective study of patients hospitalized in an acutegeriatric unit, that required SC antibiotics from 01/2012–12/2016.
We recollect data from patient, infectious process, antibiotic used,
local/systemic effects and clinical/parametric outcomes.
Results: 368 patients received SC antibiotics, mean age 86.6±6.7,
women (64.7%), Barthel 39.7±26.2; Cognitive impairment in 71.5%
and 31.3% institutionalized. A total of 2446 SC infusions were made,Ceftriaxone (68.4%), Ertapenem (20.7%) and Amikacin (10.9%) witha mean duration of 6.65±4.97 days. The infection focus were respiratory, urinary and biliary tract (48.5, 42.9 and 6.8% respectively).
A low proportion of adverse effects (2.7%) were observed, being
the principal local edema or erythema at infusion site, mostly
associated with Amikacin in relation to infusion rate and diluent
used (D5%W>NS0.9%). The clinical cure rate/improvement was high(82.3%), with a signiﬁcant decrease in acute phase reactants (PCR
and Leukocytosis). In 12.2% of patients the clinical course requireda change of therapeutic approach to the intravenous route.

S247

Conclusions: Antibiotics administrated by SC route are well tolerated, with a high percentage of clinical/parametrical resolution andminimum local adverse effects. This study supports SC route as avalid approach in the treatment of infectious processes in patientswith poor venous accesses and oral intolerance.
LB-017The disease burden of pertussis in older adults: systematic
literature review
X. Li 1 , P. Atanasov 2 , D. Avramioti 2 , J. Fu 2 , N. Demarteau 1 ,W. Kandeil 1 . 1 GSK, Wavre, Belgium; 2 Amaris, London, UK or Toronto,
CanadaIntroduction: Pertussis is a highly contagious respiratory infection causing considerable morbidity and mortality. Despite highvaccination coverage against pertussis in infants worldwide, recommendations for vaccination of adults over 50 years-of-age (50+) arelimited. This review aimed at understanding the burden of pertussis
in this population.
Methods: A systematic literature review was conducted to identify
published studies reporting epidemiological and economic dataon pertussis in adults 50+. PICOS framework was used focusing
on adults 50+; no restriction on intervention and comparator;
observational, cost-of-illness and economic studies. Structured
queries were run in MEDLINE, MEDLINE-IN-PROCESS, EMBASE, andCochrane library with time span from 2006 to September 2016.
Results: Forty-nine epidemiological studies (39 from industrialised
countries) and 15 reviews were retrieved. The incidence of pertussis
varied widely from <1 to 464 (adjusted for under-reporting) per
100,000 population, lower in industrialised countries comparedwith non-industrialised countries. A trend towards increase in
number of cases in all age groups was observed over time. A higher
incidence in dedicated studies than in notiﬁed cases from registries
was noted, suggesting under-recognition and under-reporting.
Six economic studies were identiﬁed from four countries (US,Spain, the Netherlands and Poland). The direct and indirect medical
resource utilization was captured with large variations. Overall,
pertussis was considered to incur high burden to the health caresystem.
Key conclusions: Despite large variations in estimates, the burdenof pertussis may be larger than reported, thus, this urges for
additional studies to reach a consensus on vaccination strategies in
50+ population.
Funding: GlaxoSmithKline Biologicals SA
Disclosures: ND, WK and XL declare they are employed by the
GSK group of companies; ND holds shares in the GSK group ofcompanies. DA, JF and PA received payment for the performed
analysis through their institution.

European Geriatric Medicine 8S1 (2017) S249–S268

Author Index
Aarden, J., S59 (P-068), S163 (P-426)
Aarden, J.J., S162 (P-422)
Abraha, I., S112 (P-247)
Abramaviciute, A., S121 (P-279)
Acar, F., S23 (O-071)
Achimastos, A., S240 (P-694)
Adam, S., S43 (P-013), S116 (P-261)
Adams, C., S144 (P-360)
Adams, C.A., S223 (P-638)
Addante, F., S17 (O-053)
Advinha, A.M., S75 (P-126)
Agogbua, C., S95 (P-193), S151 (P-387)
Agrigoroaei, S., S245 (LB-011)
Agustí, A., S213 (P-605)
Aharoni, M., S185 (P-507)
Ahmadpour, M., S168 (P-445)
Ahmed, B., S72 (P-116)
Ahonen, R., S209 (P-590)
Ahonkhai, A., S151 (P-387)
Akasheva, D., S201 (P-559)
Akasheva, D.U., S200 (P-557)
Akbar, S., S31 (O-096), S135 (P-328)
Akcicek, F., S108 (P-238), S126 (P-298),
S162 (P-423), S164 (P-431)
Akin, S., S135 (P-327), S138 (P-339)
Akishita, M., S4 (O-010), S32 (O-102),
S100 (P-210), S110 (P-244),
S223 (P-639)
Al Hamad, H., S25 (O-076)
Al Harrach, M.M., S135 (P-329)
Al Obaidili, M., S25 (O-076)
Al Sulaiti, E., S25 (O-076)
Alarcón, T., S22 (O-069), S72 (P-114),
S81 (P-145), S167 (P-442)
Albaret, G., S44 (P-014)
Albéniz, J., S99 (P-208), S109 (P-240),
S178 (P-482), S186 (P-509)
Albrand, G., S5 (O-013)
Alcala Manchado, P., S119 (P-274)
Alcaraz López, C., S151 (P-385),
S210 (P-593)
Alekna, V., S132 (P-319), S171 (P-457),
S179 (P-486), S185 (P-506),
S212 (P-602), S239 (P-692)
Alen, I., S176 (P-474)
Alessandro, M., S84 (P-158)
Alexa, I.D., S61 (P-078), S68 (P-101),
S70 (P-106), S177 (P-478)
Alexander, K., S79 (P-140), S117 (P-267)
Alfano, C., S47 (P-027), S86 (P-163),
S112 (P-249)

Alg, G., S117 (P-266)
Algun, Z.C., S172 (P-461)
Ali, A., S152 (P-388)
Ali, K., S39 (LB-004), S246 (LB-015)
Ali, S., S176 (P-473)
Ali, Z., S42 (P-009), S93 (P-187)
Aliaga, B., S80 (P-144)
Alla, F., S34 (O-107)
Allain, T., S163 (P-427)
Allard Saint-Albin, L., S1 (O-002)
Allepaerts, S., S123 (P-287), S126 (P-299)
Almarsdottir, A.B., S217 (P-619)
Almeida, A.F., S158 (P-411)
Almeida, M., S26 (O-081), S57 (P-061,
P-062), S77 (P-133), S120 (P-276),
S208 (P-588), S211 (P-596),
S220 (P-630)
Aloisi, G., S88 (P-169)
Alonso, E., S92 (P-182)
Alonso Seco, M., S164 (P-429)
Álvarez Nebreda, M.L., S225 (P-645)
Alves, R., S122 (P-282), S127 (P-300, P-301)
Amadeo, B., S139 (P-343)
Amaral, R., S30 (O-095), S150 (P-383)
Amarenco, G., S240 (P-695), S242 (P-703)
Amin, K., S151 (P-387)
Amiot, C., S198 (P-550)
Ammendola, M., S83 (P-153)
Amoros, P., S213 (P-605)
Amranie, A., S198 (P-550)
Amu Ruiz, F., S146 (P-368)
Amu Ruiz, F.A., S63 (P-082)
Andersen, H.E., S109 (P-239), S205 (P-575)
Andersen, L.H., S69 (P-105)
Andersen, S., S131 (P-313)
Andersen-Ranberg, K., S10 (O-031)
Andres, E., S96 (P-199), S219 (P-626)
Andrieu, S., S13 (O-038), S24 (O-075),
S48 (P-031), S113 (P-252), S129 (P-308),
S200 (P-558), S203 (P-568),
S207 (P-584)
Andringa, K., S71 (P-110)
Andrusca, A., S72 (P-116)
Ang, Y.H., S11 (O-032)
Angleitner, C., S169 (P-449)
Ankri, J., S113 (P-252)
Annoni, G., S84 (P-158)
Annweiler, C., S122 (P-283), S130 (P-309)
Anten, S., S89 (P-172), S147 (P-373),
S158 (P-409)
Antikainen, R., S11 (O-033)

Antikainen, R.L., S108 (P-237)
Antoine, V., S58 (P-065), S63 (P-083),
S74 (P-123), S83 (P-152), S189 (P-520)
Antonietti, A., S198 (P-549)
Antonio, M., S74 (P-120)
Antunes, M., S122 (P-282), S127 (P-300,
P-301), S185 (P-504)
Aparicio, T., S5 (O-013), S127 (P-303)
Apóstolo, J., S26 (O-081), S57 (P-061,
P-062), S77 (P-133), S120 (P-276),
S208 (P-588), S211 (P-596),
S220 (P-630)
Appelboom, G., S105 (P-228)
Aquilina, N., S157 (P-408)
Arai, H., S109 (P-242), S110 (P-245)
Arai, T., S101 (P-216)
Arai, Y., S202 (P-563)
Araujo, M., S159 (P-413)
Araujo Ordóñez, M., S93 (P-185)
Araujo Ordoñez, M., S121 (P-280),
S163 (P-425), S164 (P-429)
Arepali, S., S38 (LB-001)
Argoullon, L., S137 (P-334), S139 (P-341)
Arık, G., S98 (P-203)
Arlaud, C., S15 (O-044), S37 (O-117),
S137 (P-336), S183 (P-498),
S189 (P-518), S229 (P-658),
S243 (P-704)
Armand Malaplate, C., S228 (P-656)
Armean, P., S241 (P-697)
Armstrong, J.J., S8 (O-025)
Arnau-Barrés, I., S188 (P-516)
Arnspang, S., S219 (P-628)
Arshad, A., S36 (O-112)
Asadi-Lari, M., S128 (P-306)
Asgassou, S., S178 (P-480)
Ashraﬁ, H., S31 (O-096), S135 (P-328)
Ashraﬁ, T., S151 (P-387)
Asil, S., S181 (P-492)
Aslan Telci, E., S172 (P-460), S173 (P-463)
Asmar, R., S207 (P-581)
Aspvik, N.P., S32 (O-101), S199 (P-556)
Atalay, O.T., S172 (P-459)
Atanasov, P., S247 (LB-017)
Atef, M., S60 (P-072)
Atli, T., S135 (P-327), S138 (P-339)
Aubert, A., S44 (P-014)
Aubouy, G., S21 (O-066)
Audureau, E., S10 (O-030), S92 (P-182)
Augusto, B., S158 (P-411)
Aukes, L., S188 (P-517)

S250

Aulló Chavez, E., S119 (P-274)
Aurelian, J., S241 (P-697)
Aurelian, S.M., S99 (P-207), S241 (P-697)
Autonen-Honkonen, K., S209 (P-590)
Avci, S., S110 (P-243)
Averty, E., S34 (O-107)
Aviv, A., S40 (P-001)
Avramioti, D., S247 (LB-017)
Ayçiçek, G., S114 (P-256)
Ayçiçek, G.Ç., S131 (P-314)
Ayçiçek, G.Ş., S98 (P-203)
Aycicek, G.S., S63 (P-084)
Aykent, B., S2 (O-005)
Aymes, B., S198 (P-550)
Ayuso-Mateos, J.L., S202 (P-564)
Azad, M., S101 (P-213)
Azeredo, Z., S83 (P-155)
Azulay, N., S137 (P-336)
Baccini, M., S51 (P-040)
Baczynska, A., S175 (P-472)
Badr, S.M., S102 (P-218)
Baeza-Monedero, M.E., S65 (P-089),
S146 (P-369)
Baghdadli, A., S237 (P-685)
Bagriacik, E., S206 (P-578)
Bahat, G., S2 (O-005), S44 (P-015),
S57 (P-063), S66 (P-092), S80 (P-143),
S82 (P-148), S84 (P-156), S97 (P-200),
S105 (P-230), S114 (P-254)
Bailey, S.-J., S65 (P-090)
Bailly, H., S155 (P-402)
Bakka, A.O., S23 (O-070)
Balardy, L., S5 (O-013)
Balassa, P., S51 (P-042)
Balasubramaniam, L., S204 (P-571)
Balcı, C., S63 (P-084), S114 (P-256),
S131 (P-314), S181 (P-492)
Baldasseroni, S., S26 (O-083), S28 (O-087,
O-090), S153 (P-394), S176 (P-476),
S243 (P-705)
Baldwin, C., S132 (P-318)
Balenovic, A., S136 (P-333)
Ballard, C., S52 (P-045)
Balyasnikova, N.A., S130 (P-311, P-312)
Banni, S., S125 (P-294)
Bansal, R., S227 (P-653)
Banu, S., S119 (P-272)
Baque, M., S154 (P-397)
Baran, J., S201 (P-561)
Barat, I., S144 (P-359)
Baraza, W., S230 (P-663)
Barba-Martín, R., S65 (P-089), S146 (P-369)
Barbera, M., S200 (P-558), S203 (P-568)
Barbieri, S., S142 (P-353)
Bargaoanou, I., S72 (P-116)
Barlesi, F., S74 (P-122)
Baroncini, A., S28 (O-090)
Baroncini, A.C., S26 (O-083), S28 (O-087),
S153 (P-394), S176 (P-476),
S243 (P-705)
Baroncini, C., S51 (P-040)
Barratt, R., S84 (P-157)
Barrett, J., S151 (P-387)
Barrios, A., S175 (P-470)
Barse, E., S103 (P-220)

Author Index / European Geriatric Medicine 8S1 (2017) S249–S268

Bartholet, S., S188 (P-515), S191 (P-528),
S193 (P-533)
Bartlett, J., S188 (P-517)
Barton, E., S162 (P-424)
Bashir, N., S230 (P-662)
Basileu, T., S34 (O-107)
Baskan, E., S78 (P-135, P-136), S172 (P-459)
Bastuji-Garin, S., S10 (O-030), S90 (P-175),
S188 (P-514)
Batista Jr, P.B., S81 (P-146)
Baudrant, M., S219 (P-625)
Bauer, J., S9 (O-027)
Bauer, J.M., S171 (P-455)
Bauhuis, R., S46 (P-022)
Bautmans, I., S101 (P-214)
Bautrand, T., S236 (P-681)
Baxter, M., S104 (P-226), S174 (P-467)
Baxter, R., S188 (P-517)
Bay, İ., S114 (P-254)
Bayle, C., S8 (O-024)
Bayraktar, N., S198 (P-551, P-552),
S225 (P-646)
Baztán Cortés, J., S152 (P-389)
Beale, J., S117 (P-266)
Beauchet, O., S122 (P-283)
Beaudart, C., S9 (O-027), S10 (O-029),
S96 (P-196), S103 (P-222), S105 (P-228)
Beck, A.M., S132 (P-318)
Becker, C., S53 (P-046), S202 (P-566)
Bedouch, P., S211 (P-599), S219 (P-625)
Beinse, G., S19 (O-059)
Beirão, S., S150 (P-384)
Beishuizen, C., S200 (P-558)
Belcher, R., S145 (P-366)
Bellarbre, F., S186 (P-508)
Bellelli, G., S54 (P-053), S84 (P-158),
S87 (P-166), S88 (P-169, P-170, P-171),
S90 (P-176)
Bellera, C., S139 (P-343)
Belmin, J., S82 (P-151), S90 (P-175)
Ben Ghorbel, I., S177 (P-479), S178 (P-483),
S181 (P-493)
Ben Salem, T., S177 (P-479), S178 (P-483),
S181 (P-493)
Bencivenga, L., S125 (P-295)
Benetos, A., S4 (O-011), S40 (P-001),
S157 (P-405), S192 (P-530),
S207 (P-581), S228 (P-656)
Benjak, T., S136 (P-333)
Bennedsen, J., S154 (P-398)
Bennett, A.M., S176 (P-473)
Benovici, J., S56 (P-060)
Berbis, J., S74 (P-122)
Bercial Velez, S., S119 (P-274)
Bereder, I., S15 (O-044), S229 (P-658)
Berg, N., S141 (P-350)
Berger, E., S142 (P-352)
Berger-Carbonne, A., S190 (P-523)
Bergh, S., S17 (O-051), S53 (P-046)
Bergland, A., S53 (P-048)
Bergmundsdóttir, S., S72 (P-115)
Bergquist, R., S202 (P-566)
Bermudez, M., S104 (P-225), S144 (P-362)
Bernabei, R., S5 (O-014), S38 (LB-001,
LB-002), S45 (P-020), S69 (P-104),
S243 (LB-006)

Bernard, J., S244 (LB-007)
Bernard, L., S214 (P-609)
Bernard, L.P., S3 (O-008)
Berrut, G., S3 (O-009), S43 (P-012),
S107 (P-235)
Bertault-Peres, P., S21 (O-065),
S220 (P-631)
Bertholon, L.A., S102 (P-218)
Bertin, H., S8 (O-023)
Bertrand, A., S8 (O-023)
Bertrand, B., S40 (P-001)
Bertrand, V., S236 (P-681)
Besozzi, A., S51 (P-042), S228 (P-656)
Betney, D., S145 (P-366)
Betti, M., S51 (P-040)
Beuscart, J.-B., S190 (P-524)
Beyer, I., S101 (P-214)
Bezel, C., S214 (P-609)
Biagioni, G., S26 (O-083), S28 (O-087,
O-090), S153 (P-394), S176 (P-476),
S243 (P-705)
Bianchi, L., S96 (P-198)
Bidó, M., S74 (P-120)
Bierau, K., S201 (P-561)
Biggio, M., S221 (P-634)
Bilge, A., S191 (P-527)
Bin-Saïd, I., S40 (P-002)
Bingol, Z., S57 (P-063)
Binici, D.N., S194 (P-536)
Bioteau, C., S231 (P-667)
Birkemose Mejer, K., S151 (P-386)
Bisceglia, P., S40 (P-003)
Bischoff-Ferrari, H.A., S153 (P-392)
Bitsikokou, A., S70 (P-109), S80 (P-141),
S182 (P-495), S187 (P-511)
Björg Jónsdóttir, A., S72 (P-115),
S76 (P-128)
Bjork Jakobsdottir, I., S76 (P-128)
Björkman, M., S122 (P-285)
Blain, H., S3 (O-008), S80 (P-144)
Blanc, F., S7 (O-022)
Blanchard, M., S134 (P-324)
Blandfort, S., S85 (P-161)
Blauw, G.J., S89 (P-172), S147 (P-373),
S158 (P-409)
Ble, A., S29 (O-092), S71 (P-112)
Ble, M., S181 (P-491)
Bleie, Ø., S179 (P-485)
Blok Madsen, L., S205 (P-575)
Blomaard, L.C., S158 (P-409)
Blomgreen, J., S152 (P-391)
Bo, M., S54 (P-053), S87 (P-166),
S88 (P-169, P-170), S90 (P-176)
Boddaert, J., S16 (O-050), S22 (O-068),
S24 (O-074), S35 (O-111), S152 (P-390),
S154 (P-397), S156 (P-403),
S182 (P-496), S224 (P-641, P-643),
S225 (P-644), S226 (P-648),
S232 (P-668, P-670), S233 (P-672,
P-673), S234 (P-675)
Boelle, P.-Y., S16 (O-050)
Boer, A.-K., S80 (P-142)
Boersma, F., S16 (O-047)
Boersma, W.G., S193 (P-532)
Boi, R., S85 (P-159)
Bolayır, B., S131 (P-314)

Author Index / European Geriatric Medicine 8S1 (2017) S249–S268

Bologna, E., S198 (P-549)
Boncey, K., S117 (P-266)
Bonhomme, J., S147 (P-370), S215 (P-610)
Boni, S., S180 (P-488), S184 (P-503)
Bonin-Guillaume, S., S20 (O-062),
S26 (O-082), S236 (P-681)
Bonnave, C., S187 (P-512)
Bonnefoy, M., S33 (O-105), S44 (P-016),
S53 (P-050), S147 (P-370),
S179 (P-484), S183 (P-497)
Bonnel, L., S54 (P-052)
Bonnet, F., S191 (P-526)
Bonnet-Zamponi, D., S16 (O-050)
Bonneville, A., S139 (P-341)
Boqué, C., S74 (P-120)
Bor, H., S43 (P-011)
Borchiellini, D., S72 (P-113)
Bordage, M., S82 (P-149)
Bordne, S., S171 (P-456)
Borghi, C., S180 (P-488)
Boriani, G., S180 (P-488)
Borizovski, E., S51 (P-041)
Borkowska, J., S127 (P-302)
Bornheim, S., S103 (P-222)
Bosch, J., S59 (P-068), S163 (P-426)
Bosch, J.A., S162 (P-422)
Bosmans, J., S30 (O-093), S31 (O-098)
Bossers, W.J., S55 (P-054)
Bossert, I., S47 (P-027)
Boström, A.-M., S100 (P-211)
Boubakri, C., S3 (O-008)
Boucekine, M., S74 (P-122)
Bouchaert, P., S2 (O-006)
Boucherie, Q., S20 (O-062)
Boudaoud, S., S135 (P-329)
Bouﬁ, M., S40 (P-001)
Bouillet, T., S108 (P-236)
Bouksani-Kacher, Z., S90 (P-175)
Boulahssass, R., S5 (O-013), S15 (O-044),
S72 (P-113), S76 (P-127), S183 (P-498),
S229 (P-658)
Boulanger, E., S40 (P-002), S66 (P-094),
S205 (P-574)
Boully, C., S146 (P-367), S159 (P-412)
Boulton, E., S202 (P-566)
Bourdaire, V., S228 (P-656)
Bourdel-Marchasson, I., S1 (O-002),
S103 (P-220), S132 (P-317),
S191 (P-526), S215 (P-611)
Bourdin, N., S140 (P-346)
Bourguignon, L., S215 (P-610)
Bourkel, E., S207 (P-583), S208 (P-585)
Bourry, S., S5 (O-016)
Boussat, B., S35 (O-110)
Boutaayamou, M., S203 (P-569)
Bouteloup, V., S7 (O-022)
Bovatekin, S., S66 (P-092), S80 (P-143),
S82 (P-148)
Bowen, J., S117 (P-266)
Bowman, K., S27 (O-085), S71 (P-112)
Boytsov, S., S201 (P-559)
Boytsov, S.A., S200 (P-557)
Bracco, A., S142 (P-353)
Brailova, N.V., S200 (P-557)
Brain, E., S5 (O-013)
Braunstein, D., S26 (O-082)

Brayne, C., S200 (P-558)Brazão, S., S186 (P-510)
Brazier, J., S162 (P-424)
Bredahl Sørensen, M., S160 (P-417)
Breilh, D., S191 (P-526)
Breining, A., S22 (O-068), S187 (P-513),
S233 (P-673), S234 (P-675)
Bremner, S., S246 (LB-015)
Bresnitz, E., S188 (P-517)
Bricard-Pacaud, V., S133 (P-321)
Briem, K., S27 (O-086)
Briggs, R., S27 (O-084), S194 (P-538)
Brincat, A., S106 (P-233), S203 (P-567)
Brincat, S.D., S106 (P-233), S124 (P-291),
S203 (P-567)
Brites, L., S143 (P-358)
Brockhusen, M., S219 (P-628)
Broczek, K., S170 (P-452)
Brodsky, A., S183 (P-500)
Broussier, A., S59 (P-069)
Brouwer, C., S16 (O-047)
Brovold, T., S53 (P-048)
Brown, A., S98 (P-204)
Brüls, O., S203 (P-569)
Brun, C., S213 (P-603)
Brun, R., S220 (P-631)
Brunet, T., S1 (O-001), S78 (P-137)
Brunois, T., S101 (P-215), S115 (P-257)
Brunschwig, F.-H., S229 (P-658)
Brunschwing, F.H., S15 (O-044)
Bruyère, O., S9 (O-027), S10 (O-029),
S96 (P-196), S101 (P-215), S103 (P-222),
S105 (P-228), S115 (P-257), S123 (P-287,
P-288), S126 (P-299), S203 (P-569)
Brzozowska, A., S70 (P-107), S113 (P-253)
Brzozowska, M., S137 (P-335)
Bucher Sandbakk, S., S199 (P-556)
Buckinx, F., S9 (O-027), S101 (P-215),
S115 (P-257), S123 (P-287, P-288),
S126 (P-299)
Bucy, L., S137 (P-334)
Budak, M., S244 (LB-008)
Bugeja, V., S157 (P-408)
Buhlin, K., S244 (LB-009)
Bukowska-Strakova, K., S99 (P-206)
Bula, C., S38 (LB-003)
Bulgaresi, M., S49 (P-035)
Bulut, E., S55 (P-055)
Burbano, P., S9 (O-026)
Burcet, S., S74 (P-121), S86 (P-162),
S230 (P-661)
Burdorf, A., S33 (O-103)
Bureau, M.-L., S2 (O-004), S186 (P-508)
Burkhardt, H., S148 (P-376), S221 (P-632)
Bushiri, R., S61 (P-077)
Buttery, A.K., S52 (P-045)
Buurman, B., S59 (P-068), S163 (P-426)
Buurman, B.M., S162 (P-422)
Büyükgök, D., S57 (P-063)
Byrne, S., S213 (P-606)
Bywalec, R., S196 (P-542)
Caamaño-Selma, O., S146 (P-369)
Caballero, B., S104 (P-225)
Caballero, F.F., S202 (P-564)
Cabezas Alfonso, P., S23 (O-072)

S251

Cabradilla, J., S143 (P-356)
Cadilhac, A.-C., S146 (P-367)
Caiano-Gil, P., S93 (P-186)
Caillard, L., S146 (P-367), S159 (P-412)
Caillet, P., S5 (O-013), S19 (O-059)
Çalışkan, H., S63 (P-084), S114 (P-256),
S131 (P-314)
Calle, A., S169 (P-448)
Calleja-Agius, J., S106 (P-233)
Calvani, R., S38 (LB-001, LB-002),
S243 (LB-006)
Calvo, E., S169 (P-448)
Cámara, B., S144 (P-362)
Campanini, M., S87 (P-166), S88 (P-169,
P-170), S90 (P-176)
Campos, L., S159 (P-415), S235 (P-678)
Can, B., S98 (P-203)
Canepa, E., S83 (P-154)
Canha, C., S125 (P-293)
Cankurtaran, M., S55 (P-055), S63 (P-084),
S98 (P-203), S114 (P-256), S131 (P-314),
S138 (P-339), S181 (P-492)
Cano, P., S32 (O-100), S48 (P-029),
S201 (P-562)
Canouï-Poitrine, F., S10 (O-030),
S19 (O-059), S59 (P-069), S92 (P-182),
S216 (P-615)
Cantegreil-Kallen, I., S45 (P-019),
S51 (P-039)
Cantet, C., S48 (P-031)
Capelle, H., S21 (O-065)
Capisizu, A., S99 (P-207), S241 (P-697)
Capony, N., S204 (P-572)
Carbonell, N., S156 (P-403)
Cardoso, D., S26 (O-081), S57 (P-061,
P-062), S120 (P-276)
Cariot, M.-A., S92 (P-182)
Carola, E., S180 (P-490)
Carpena-Ruiz, M., S94 (P-189)
Carrassi, E., S26 (O-083), S28 (O-087),
S176 (P-476), S243 (P-705)
Carrillo Garcia, P., S76 (P-129), S94 (P-191)
Carrizo, G., S13 (O-040)
Carroll, N., S22 (O-067)
Carta, G., S125 (P-294)
Cartei, A., S91 (P-178)
Carvahlo-Verlinde, M., S19 (O-059)
Carvalho, A., S16 (O-048), S125 (P-293),
S180 (P-489), S186 (P-510)
Casas-Herrero, A., S146 (P-368)
Cascavilla, L., S17 (O-053), S40 (P-003)
Caserotti, P., S115 (P-258)
Casey, A., S245 (LB-013)
Cassar, C., S124 (P-291)
Castagna, A., S55 (P-056), S83 (P-153)
Castañeda-Pastor, A., S146 (P-369)
Castelli, F., S222 (P-635)
Castro, J., S175 (P-470)
Castro, S., S127 (P-300, P-301)
Catheline, G., S103 (P-220)
Cattagni, T., S107 (P-235)
Cauley, J.A., S121 (P-281)
Caunes, P., S21 (O-065)
Caupenne, A., S2 (O-004), S34 (O-108)
Cavaleiro, A., S26 (O-081), S57 (P-061,
P-062), S77 (P-133), S208 (P-588)

S252

Cavallini, M.C., S51 (P-040)
Cavallo, F., S164 (P-430 )Cavlak, U., S78 (P-136)
Cawthon, P.M., S121 (P-281)
Cazanave, C., S187 (P-513), S191 (P-526)
Ceccoﬁglio, A., S54 (P-053), S91 (P-178)
Ceda, G.P., S130 (P-310)
Cederbom, S., S167 (P-441)
Cederholm, T., S9 (O-027)
Cekok, K., S82 (P-150), S106 (P-232),
S168 (P-447), S171 (P-458)
Cella, A., S85 (P-159)
Cempron-Cutamora, J., S196 (P-543)
Cengiz, M., S110 (P-243)
Cengiz Özyurt, B., S164 (P-433),
S238 (P-687)
Centeno, D., S113 (P-253)
Ceravolo, M.J., S86 (P-163)
Cerdán, C., S229 (P-657)
Cerdán, J., S229 (P-657)
Cerfon, M.-A., S147 (P-370)
Cerhan, J., S41 (P-004)
Cermakova, P., S67 (P-096)
Cernovas, A., S185 (P-506), S239 (P-692)
Cesa-Bianchi, G., S198 (P-549)
Cesa-Bianchi, M., S198 (P-549)
Cesari, M., S9 (O-027), S24 (O-075),
S113 (P-252)
Cestac, P., S214 (P-609), S217 (P-618)
Chabéne, I., S46 (P-023), S68 (P-099),
S155 (P-401), S161 (P-421)
Chabert, A., S179 (P-484)
Chahine, M., S207 (P-581)
Chalﬁne, C., S24 (O-074)
Chan, A., S201 (P-561)
Chan, D., S151 (P-387)
Chan, K.A., S25 (O-077)
Chan, K.C., S237 (P-686)
Chandra, A., S9 (O-028)
Chang, C.-M., S240 (P-696)
Chang, M., S27 (O-086), S91 (P-181)
Chang Gudjonsson, M., S129 (P-307)
Chanoine, S., S17 (O-052)
Chapelet, G., S3 (O-009)
Chappelow, I., S36 (O-112)
Charpentier, A., S190 (P-524)
Charpiat, B., S215 (P-610)
Charrié, A., S183 (P-497)
Chassagne, P., S82 (P-149)
Chasteen, A.L., S204 (P-571)
Chatterji, S., S202 (P-564)
Chauvelier, S., S13 (O-039)
Chen, C.-H., S240 (P-696)
Chen, D., S41 (P-005)
Chen, L.-K., S243 (LB-006)
Chen, L.L., S99 (P-209)
Chen, Y., S188 (P-517)
Chêne, G., S7 (O-022)
Chenevier-Gobeaux, C., S233 (P-673)
Cheng, C.-H., S55 (P-057)
Cheng, X.W., S98 (P-205)
Cherubini, A., S5 (O-014), S9 (O-027),
S84 (P-158), S87 (P-166), S88 (P-169,
P-170), S90 (P-176), S112 (P-247)
Chevallereau, G., S122 (P-283),
S130 (P-309)

Author Index / European Geriatric Medicine 8S1 (2017) S249–S268

Chew, E., S174 (P-469)
Chia, D., S68 (P-102)
Chia, L., S68 (P-102)
Chikh, K., S183 (P-497)
Chikusu, C., S3 (O-007)
Chlebus, M., S137 (P-335)
Chmiel, W., S31 (O-096), S135 (P-328)
Cho, C.Y., S124 (P-290), S217 (P-620)
Cho, H., S217 (P-620)
Cho, J., S191 (P-525)
Cho, K.-H., S41 (P-006), S42 (P-007),
S54 (P-051), S61 (P-076), S226 (P-649)
Cho, Y.J., S124 (P-290)
Choi, H.S., S191 (P-525)
Choi, K., S113 (P-250)
Chokry, B., S34 (O-107)
Choonara, H., S31 (O-096), S135 (P-328)
Choukroun, C., S63 (P-083)
Chouteau, J., S35 (O-110)
Christensen, M.G., S109 (P-239)
Christiaens, L., S186 (P-508)
Chudek, J., S70 (P-107), S170 (P-452)
Chuzeville, M., S34 (O-107)
Ciarambino, G., S175 (P-471)
Cicek, M., S41 (P-004)
Cini, E., S136 (P-331)
Cipriani, M.C., S45 (P-020)
Cladellas, M., S74 (P-121), S181 (P-491),
S230 (P-661)
Claeys, T., S141 (P-349)
Clais, E., S15 (O-044), S76 (P-127),
S229 (P-658)
Clantau, M.D., S165 (P-437), S168 (P-446)
Claudino, C., S235 (P-678)
Clift, E., S209 (P-589)
Clot-Faybesse, P., S67 (P-098)
Clow, L., S223 (P-638)
Cobbaert, K., S187 (P-512)
Coelho, A., S26 (O-081), S57 (P-061, P-062),
S77 (P-133), S120 (P-276), S208 (P-588),
S211 (P-596), S220 (P-630)
Coetzee, H., S245 (LB-013)
Cohen, A., S13 (O-039)
Cohen Bittan, J., S24 (O-074)
Cohen-Bittan, J., S22 (O-068), S35 (O-111),
S152 (P-390), S154 (P-397),
S182 (P-496), S217 (P-621),
S224 (P-641, P-643), S225 (P-644),
S226 (P-648), S232 (P-668, P-670),
S233 (P-672, P-673), S234 (P-675)
Colas, M., S5 (O-016)
Coleman, J., S224 (P-642)
Coley, N., S48 (P-031), S200 (P-558),
S203 (P-568), S207 (P-584)
Colizzi, E., S100 (P-212)
Collins, R., S27 (O-084), S241 (P-700)
Colloca, G., S45 (P-020)
Comijs, H., S238 (P-690)
Comte, B., S113 (P-253), S126 (P-297),
S128 (P-304)
Concu, D., S123 (P-286)
Condorhuamán Alvarado, P., S192 (P-531)
Condorhuamán Alvarado, P.Y.,
S167 (P-442)
Consciência, J.G., S235 (P-678)
Constantin, G.I., S78 (P-134)

Constantinovici, M., S168 (P-446),
S173 (P-464)
Conte, M., S125 (P-295)
Conterno, E., S142 (P-353)
Contreras Escamez, B., S29 (O-091)
Cook, J.B., S204 (P-570)
Cooper, C., S9 (O-027)
Copelli, S., S30 (O-094)
Coppolino, G., S55 (P-056)
Corbi, G., S125 (P-295)
Cordeiro, M., S77 (P-133), S208 (P-588)
Cornu, C., S43 (P-012), S107 (P-235)
Correa-Pérez, A., S112 (P-247)
Correard, F., S220 (P-631)
Corsin, L., S216 (P-615)
Corvol, A., S44 (P-017), S92 (P-183),
S116 (P-261), S134 (P-324)
Costa, L., S159 (P-415), S235 (P-678)
Costa, R., S186 (P-510), S235 (P-678)
Costa, S., S125 (P-293)
Costelloe, H., S95 (P-193)
Cotch, M.F., S115 (P-258)
Coto, A., S104 (P-225)
Cotton, P., S145 (P-365), S154 (P-396),
S163 (P-428)
Couderc, A.-L., S5 (O-013), S74 (P-122),
S198 (P-550), S220 (P-631)
Couderc, S., S237 (P-685)
Coughlan, T., S27 (O-084)
Coureau, G., S139 (P-343)
Courjon, J., S189 (P-518)
Cousins, G., S16 (O-049), S214 (P-607)
Couturier, C., S43 (P-012), S107 (P-235)
Crees, A., S230 (P-662)
Crepaldi, G., S242 (P-702)
Crepiat, S., S237 (P-685)
Cressot, V., S191 (P-526)
Creswell, B., S118 (P-270)
Cretel, E., S74 (P-122)
Cristancho-Lacroix, V., S51 (P-039)
Cristina, A., S158 (P-411)
Cristini, C., S198 (P-549)
Cristofori, G., S152 (P-389)
Croisier, J.-L., S115 (P-257), S203 (P-569)
Cruz-Jentoft, A., S1 (O-001), S78 (P-137)
Cruz-Jentoft, A.J., S9 (O-027), S94 (P-189),
S99 (P-208), S109 (P-240),
S178 (P-482), S186 (P-509),
S225 (P-645)
Csanády-Leitner, R., S201 (P-560)
Cudennec, T., S5 (O-013)
Cuesta, M., S201 (P-562)
Cuesta Triana, F., S28 (O-089)
Cunha, M., S236 (P-682)
Cunningham, U., S245 (LB-013)
Curé, H., S180 (P-490)
Curgunlu, A., S135 (P-327), S138 (P-339)
Curtin, D., S12 (O-034)
Curto, D., S32 (O-100), S48 (P-029),
S201 (P-562)
Curto i Prieto, D., S119 (P-274)
Curto-Prieto, D., S66 (P-093)
Custureri, R., S1 (O-001)
Cuvelier, C., S192 (P-530)
Cuzzoni, G., S47 (P-027), S86 (P-163),
S112 (P-249)

Author Index / European Geriatric Medicine 8S1 (2017) S249–S268

Czech, M., S137 (P-335)
D’Agostino, M., S40 (P-003)
D’Onofrio, G., S17 (O-053), S40 (P-003),
S164 (P-430 ), S175 (P-471)
D’Ouince, V., S46 (P-024)
D’Souza, O., S72 (P-116)
Da Silva, S., S178 (P-480)
Daal, J.O., S228 (P-655), S233 (P-671)
Dabbabi, M., S48 (P-030)
Daeschner, M., S52 (P-044)
Dagnelie, P.C., S125 (P-296)
Dahan, C., S229 (P-658)
Dahl, A., S18 (O-056)
Dahly, D., S145 (P-364)
Dalla Costa, C., S142 (P-353)
Dalton, K., S213 (P-606)
Daly, L., S211 (P-598)
Daly, O., S50 (P-037)
Dambrine, M., S214 (P-609)
Damnee, S., S8 (O-024), S56 (P-060)
Damsgaard, E.M., S2 (O-003), S62 (P-080),
S69 (P-105), S85 (P-161), S133 (P-320),
S144 (P-359), S155 (P-400)
Damulevičienė, G., S143 (P-355)
Danaher, D., S245 (LB-013)
Danet-Lamasou, M., S103 (P-220)
Dang, O., S244 (LB-007)
Danielsen, M.B., S131 (P-313)
Dapp, U., S32 (O-099), S58 (P-066),
S81 (P-147)
Daragjati, J., S1 (O-001), S78 (P-137)
Darcissac, C., S215 (P-610)
Dardenne, N., S203 (P-569)
Dario, P., S164 (P-430 )Daroux, M., S205 (P-574)
Dascalescu, R., S99 (P-207)
Daszkiewicz, M., S196 (P-542)
Daubmann, A., S81 (P-147)
Daumas, A., S21 (O-065), S220 (P-631)
Dauphinot, V., S7 (O-022)
David, J.P., S10 (O-030), S59 (P-069)
Davidson, P., S168 (P-445)
Davies, J.G., S39 (LB-004), S246 (LB-015)
Dawids, S.G., S154 (P-398)
Dawson, H., S194 (P-535)
Dayan, R., S226 (P-648)
Dayangac, H.I., S191 (P-527)
De Bock, R., S95 (P-194)
de Brouwer, E., S25 (O-078)
De Chassey Parzy, A., S51 (P-041)
De Craen, A., S37 (O-116)
De Decker, L., S3 (O-009), S5 (O-013)
de Gelder, J., S89 (P-172), S147 (P-373),
S158 (P-409)
de Groot, A.J., S167 (P-444)
de Groot, B., S89 (P-172), S147 (P-373),
S158 (P-409)
de Groot, C.P.G.M., S206 (P-580)
de Jaegere, P., S23 (O-071)
de Klijn, F.H., S55 (P-054)
de La Sayette, V., S52 (P-044)
de la Tribonnière, X., S80 (P-144)
De Luxan, B., S104 (P-225)
De Petris, M., S175 (P-471)
de Ronde-Tillmans, M., S23 (O-071)

de Rooij, S., S239 (P-691)
de Rooij, S.E.J.A., S115 (P-259)
de Ruiter, S.C., S237 (P-683, P-684)
de Saint Hubert, M., S245 (LB-011)
de Saint-Hubert, M., S21 (O-066)
De Souto Barreto, P., S129 (P-308)
de Thézy, A., S191 (P-526)
de Valk, M., S12 (O-037)
de Vet, R., S122 (P-284)
de Vries, J.H.M., S206 (P-580)
de Vries, L.M.A., S228 (P-655),
S233 (P-671)
de Wazieres, B., S33 (O-105), S58 (P-065),
S74 (P-123), S83 (P-152), S189 (P-520)
Debray, M., S33 (O-105)
Dechavigny, S., S218 (P-623)
Declercq, A., S30 (O-093), S31 (O-098)
Deeg, D.J.H., S8 (O-025)
Deger, B., S164 (P-431), S190 (P-522)
Degerickx, R., S245 (LB-010)
Degryse, J.-M., S21 (O-066)
Deidda, M., S178 (P-480)
del Carmen Morales Ballesteros, M.,
S62 (P-081)
Del Rosario Evangelista Cabrera, L.,
S23 (O-072), S28 (O-089), S103 (P-223)
Delabriere, I., S190 (P-524)
Delalande, G., S74 (P-122)
Delamarre-Damier, F., S133 (P-321)
Delandsheere, L., S96 (P-196), S105 (P-228)
Delavar, A., S178 (P-481)
Delbari, A., S128 (P-306)
Delespierre, T., S67 (P-098)
Delgado, J., S29 (O-092), S71 (P-112)
Delguste, F., S205 (P-574)
Deligne, J., S16 (O-050)
Dell’Aquila, G., S5 (O-014)
Delrio, A., S85 (P-159)
Delrue, N., S18 (O-055), S62 (P-079)
Delva, F., S139 (P-343)
Demange, M., S45 (P-019), S51 (P-039)
Demarteau, N., S247 (LB-017)
Demény, A.K., S152 (P-391)
Demir, R., S97 (P-200)
Demirdag, F., S110 (P-243)
Demonchy, E., S189 (P-518)
Demoux, A.L., S204 (P-572)
Demurtas, A., S125 (P-294)
Denig, P., S19 (O-058), S21 (O-064)
Deniz, O., S97 (P-201), S113 (P-251),
S195 (P-541), S196 (P-544)
Denormandie, P., S138 (P-337),
S199 (P-554)
Depla, M., S52 (P-043)
Derajinski, A., S196 (P-545)
Derrett, S., S182 (P-494)
Dervaux, B., S142 (P-352)
Deschamps, T., S43 (P-012)
Deschodt, M., S187 (P-512)
Desfour, H., S80 (P-144)
Deveney, M.E., S176 (P-473)
Devizzi, L., S45 (P-020)
Devlin, M., S91 (P-179)
Devos, C., S214 (P-609)
Di Bari, M., S26 (O-083), S28 (O-087,
O-090), S51 (P-040), S153 (P-394),

S253

S176 (P-476), S184 (P-503),
S243 (P-705)
Di Capua, B., S45 (P-020)
Di Castri, A., S189 (P-520)
Di Meo, M.L., S26 (O-083), S28 (O-087,
O-090), S153 (P-394), S176 (P-476),
S243 (P-705)
Di Pede, P., S45 (P-020)
Di Santo, S., S84 (P-158), S88 (P-169,
P-170), S90 (P-176)
Di Santo, S.G., S87 (P-166)
Diallo, K., S192 (P-530)
Didaskalou, A., S70 (P-109), S182 (P-495),
S187 (P-511)
Diederich, H., S148 (P-376)
Diekmann, R., S171 (P-455)
Dierckx de Casterlé, B., S6 (O-018),
S14 (O-042)
Dieudonné, B., S52 (P-044)
Diez-Suarez, L.A., S60 (P-074), S70 (P-108),
S118 (P-269)
Dikmen, B.T., S198 (P-551)
Dikmen, O., S191 (P-527)
Dillen, L., S87 (P-167)
Dimitrijevic, Z., S69 (P-103)
Dineros, C., S153 (P-395)
Dinesen, B., S151 (P-386)
Dini, S., S215 (P-610)
Dinsmore, J., S139 (P-340)
Dipanda, M., S178 (P-480)
Disse, E., S183 (P-497)
Divoux, E., S214 (P-609)
Djabelkhir, L., S56 (P-060)
Dodart, J., S51 (P-041)
Dode, X., S215 (P-610)
Doğan, H., S66 (P-092)
Doğrul, R.T., S98 (P-203), S114 (P-256),
S131 (P-314), S181 (P-492)
Dogrul, R.T., S63 (P-084)
Dolhaniuk, I., S209 (P-591)
Donadio-Andréi, S., S183 (P-497)
Donniacono, D., S153 (P-393)
Dore, M.P., S125 (P-294)
Dorléans, F., S191 (P-528)
Dorner, C., S209 (P-591)
Dos Santos, M., S231 (P-664), S235 (P-677)
Doucet, J., S96 (P-199), S107 (P-234),
S160 (P-418), S214 (P-609),
S219 (P-626)
Doulamis, I., S207 (P-581)
Doulazmi, M., S232 (P-668)
Doupagne, G., S123 (P-287, P-288),
S126 (P-299)
Dourthe, L., S24 (O-074), S35 (O-111),
S224 (P-641), S232 (P-668)
Doutel Haghighi, E., S136 (P-332)
Doventas, A., S110 (P-243)
Doyle, J., S139 (P-340)
Draisma, S., S31 (O-098)
Dramé, M., S1 (O-002), S183 (P-499),
S188 (P-515), S191 (P-528),
S193 (P-533), S218 (P-623)
Drame, M., S107 (P-234)
Dreier, R., S109 (P-239)
Drevet, S., S33 (O-105), S36 (O-113),
S231 (P-667)

S254

Druesne, L., S82 (P-149)
Du Boullay, H., S183 (P-497)
Duarte, S., S26 (O-081), S30 (O-095),
S57 (P-061, P-062), S77 (P-133),
S120 (P-276), S150 (P-383),
S208 (P-588), S211 (P-596),
S220 (P-630)
Dubois, B., S7 (O-022), S8 (O-023)
Duc, S., S187 (P-513), S215 (P-611)
Duchemann, B., S127 (P-303)
Dudinskaya, E.N., S200 (P-557)
Duems, O., S247 (LB-016)
Duems Noriega, O., S71 (P-111)
Duffau, P., S187 (P-513)
Dufouil, C., S7 (O-022)
Dufour, I., S142 (P-352)
Duhautois, J., S54 (P-052)
Dundar, P., S164 (P-433)
Dupont, J.C., S142 (P-352)
Duque, S., S159 (P-415), S235 (P-678)
Durand, A., S216 (P-615)
Durand, M., S37 (O-117), S72 (P-113),
S189 (P-518), S243 (P-704)
Durmazoglu, S., S2 (O-005)
Duron, E., S13 (O-039)
Durrieu, J., S191 (P-526)
Duval, G., S122 (P-283), S130 (P-309)
Dye, D., S35 (O-110)
Ebihara, T., S184 (P-502)
Egbert, A., S1 (O-001)
Egberts, A., S78 (P-137)
Egert, S., S171 (P-455)
Eguchi, Y., S197 (P-548), S202 (P-563),
S206 (P-577)
Eide, L.S.P., S179 (P-485)
Eira, J.J., S30 (O-095), S150 (P-383)
Eiríksdóttir, G., S50 (P-038), S115 (P-258),
S129 (P-307)
Ekdahl, A.W., S100 (P-211)
Ekmann, A., S152 (P-391)
El Faquir, N., S23 (O-071)
Elbi, H., S190 (P-522), S191 (P-527)
Elhani, I., S161 (P-419)
Elian, V., S99 (P-207)
Eliseeva, T.A., S130 (P-311, P-312)
Ellis, H., S72 (P-116)
Elskamp, A.B.M., S73 (P-117)
Elstgeest, L., S122 (P-284)
Endo, A., S238 (P-689), S239 (P-693)
Enduliri, S., S169 (P-450), S176 (P-473)
Enfedaque, M.B., S9 (O-026)
Engberg, H., S10 (O-031)
Engedal, K., S17 (O-051)
Engelbert, R., S59 (P-068), S163 (P-426)
Engelbert, R.H.H., S162 (P-422)
Epelboin, L., S233 (P-673)
Erbaş, B., S55 (P-055)
Ercelebi, D.C., S110 (P-243)
Erdincler, D.S., S110 (P-243), S135 (P-327)
Erdoğan, T., S80 (P-143), S114 (P-254)
Erdoğan, T.O., S102 (P-219)
Ergun, E.L., S55 (P-055)
Eriksdotter, M., S15 (O-046), S29 (O-091),
S67 (P-096), S244 (LB-009)
Ernst, C., S34 (O-107)

Author Index / European Geriatric Medicine 8S1 (2017) S249–S268

Erpelding, M.-L., S4 (O-011), S34 (O-107)
Errigo, A., S123 (P-286), S125 (P-294),
S221 (P-634)
Eschwege, P., S40 (P-001)
Escolante Melich, A., S177 (P-477)
Esme, M., S63 (P-084), S181 (P-492)
Etheridge, Z., S117 (P-266)
Eto, M., S100 (P-210)
Eusebi, P., S5 (O-014)
Evans, J., S41 (P-004)
Evans, L., S96 (P-197)
Eyvrard, F., S217 (P-618)
Fabijonavicius, M., S239 (P-692)
Fadayevatan, R., S128 (P-306)
Faes, M.C., S73 (P-117), S136 (P-330 )Fagerström, C., S194 (P-537)
Fahey, T., S16 (O-049), S214 (P-607)
Failla, A., S175 (P-471)
Fain, O., S182 (P-496)
Falandry, C., S44 (P-016), S53 (P-050),
S147 (P-370), S179 (P-484),
S183 (P-497)
Fallon, A., S27 (O-084), S165 (P-436),
S241 (P-700)
Fallot, J., S37 (O-117)
Fan, C.W., S176 (P-473)
Fancellu, A., S123 (P-286)
Fanon, J.-L., S1 (O-002), S191 (P-528),
S193 (P-533), S218 (P-623)
Fantino, B., S53 (P-050), S122 (P-283)
Fantino, F., S53 (P-050)
Fantoni, E., S59 (P-070)
Farcy, J.P., S204 (P-570)
Farina, L., S45 (P-020)
Farjon, C., S51 (P-041)
Farrant, C., S153 (P-395)
Farre, N., S74 (P-121), S181 (P-491),
S230 (P-661)
Farriols, C., S56 (P-058)
Fastbom, J., S15 (O-046), S67 (P-096)
Fauchier, T., S2 (O-006)
Faunanie, M., S80 (P-144)
Favary, C., S7 (O-022)
Fdez-Montalbán, P., S99 (P-208),
S109 (P-240), S178 (P-482),
S186 (P-509)
Fedecostante, M., S5 (O-014)
Fedeli, F., S26 (O-083), S28 (O-090),
S153 (P-394), S176 (P-476),
S243 (P-705)
Federspiel, C., S207 (P-583), S208 (P-585)
Fedyuk, I., S153 (P-393)
Feeney-Beckett, J., S25 (O-080)
Feenstra, T.C, S238 (P-690)
Feizi, S.T., S154 (P-398)
Fenaux, P., S182 (P-496)
Fereshtehnejad, S.-M., S244 (LB-009)
Fernandes, C., S158 (P-411)
Fernandes, L., S236 (P-682)
Fernandes, R., S93 (P-186)
Fernández, M., S144 (P-362)
Fernandez, M., S104 (P-225)
Fernández, R., S192 (P-531)
Fernández Arana, L., S28 (O-089),
S103 (P-223)

Fernandez Arana, L., S93 (P-188)
Fernández Ibáñez, J.M., S62 (P-081)
Fernández-Villaseca, S., S225 (P-645)
Ferrara, N., S84 (P-158), S87 (P-166),
S88 (P-169, P-170, P-171), S90 (P-176),
S125 (P-295)
Ferrari, A., S84 (P-158), S88 (P-171)
Ferreira, C., S186 (P-510)
Ferreira, D., S176 (P-474), S180 (P-489)
Ferreira, I., S159 (P-415)
Ferreira, J., S158 (P-411)
Ferreira, M., S176 (P-474)
Ferrer, E., S15 (O-044), S137 (P-336),
S229 (P-658)
Ferri, A., S83 (P-154)
Ferrucci, L., S38 (LB-001), S71 (P-112)
Fida, C., S140 (P-347), S141 (P-348),
S209 (P-591)
Figueiredo, I., S122 (P-282), S127 (P-300,
P-301)
Fimognari, F., S88 (P-169, P-170),
S90 (P-176)
Fimognari, F.L., S87 (P-166)
Finne-Soveri, H., S20 (O-061), S30 (O-093),
S31 (O-098)
Fiorini, L., S164 (P-430 )Firbank, M.J., S52 (P-044)
Fireman, B., S188 (P-517)
Firtina, M., S138 (P-339)
Fisher, D., S50 (P-038)
Fitzpatrick, D., S116 (P-263), S140 (P-344)
Flamaing, J., S187 (P-512)
Flecher, X., S40 (P-001)
Floch, P., S44 (P-014)
Focà, E., S222 (P-635)
Fodil, M., S5 (O-016)
Fogteloo, A.J., S158 (P-409)
Fogteloo, J., S89 (P-172)
Fonseca, J., S180 (P-489)
Fontecha, B., S153 (P-393)
Foo, W.C., S99 (P-209)
Forde, G., S245 (LB-013)
Forde-Johnston, C., S117 (P-266)
Forestier, E., S34 (O-107)
Forman, D.E., S179 (P-485)
Foroughan, M., S128 (P-306)
Fort, A., S181 (P-491)
Fortuna, V., S73 (P-119)
Fossaert, R., S140 (P-346)
Fossey-Diaz, V., S5 (O-013)
Fourriere, M.-J., S228 (P-656)
Fox, J., S34 (O-106), S152 (P-388),
S227 (P-650), S231 (P-664),
S232 (P-669), S235 (P-677)
Fradin, C., S40 (P-002)
Franceschi, C., S113 (P-253)
François, E., S15 (O-044), S76 (P-127)
François-Joubert, A., S183 (P-497)
Franek, E., S137 (P-335)
Franks, K., S91 (P-179)
Franse, C., S33 (O-103)
Franse, C.B., S111 (P-246)
Fratiglioni, L., S11 (O-033), S12 (O-035),
S18 (O-056)
Freiberger, E., S102 (P-217)
Frey, A., S138 (P-338)

Author Index / European Geriatric Medicine 8S1 (2017) S249–S268

Freyer, G., S180 (P-490)
Frih, M., S48 (P-030)
Frimat, L., S40 (P-001), S207 (P-581)
Frimat, M., S205 (P-574)
Frohnhofen, H., S221 (P-632)
Fu, J., S247 (LB-017)
Fuchino, K., S49 (P-032)
Fujita, K., S179 (P-487)
Fumagalli, S., S180 (P-488), S184 (P-503)
Funatsu, N., S179 (P-487)
Fure, B., S167 (P-443)
Fusco, D., S45 (P-020)
Gabbani, L., S26 (O-083), S28 (O-087,
O-090), S153 (P-394), S176 (P-476),
S243 (P-705)
Gabbiadini, N., S222 (P-635)
Gabriel, G., S132 (P-316)
Gade Holdensen, A., S90 (P-177)
Gagesch, M., S153 (P-392)
Gaha, L., S46 (P-023), S68 (P-099),
S149 (P-377), S161 (P-421)
Gaillat, J., S35 (O-109)
Gaillemin, O., S31 (O-096), S135 (P-328)
Galindo, J., S36 (O-114), S206 (P-579)
Gallagher, P., S12 (O-034), S16 (O-049),
S214 (P-607), S218 (P-624),
S222 (P-636), S223 (P-640)
Gallais, J.-L., S35 (O-109)
Gallini, A., S13 (O-038)
Gallofré, M., S175 (P-470)
Galvadà, R., S175 (P-470)
Galvin, A., S139 (P-343)
Gambal, M.-C., S140 (P-347), S141 (P-348)
Gamon, L., S80 (P-144)
Gangai, N., S117 (P-267)
Ganne, N., S127 (P-303)
Gantois, I., S228 (P-656)
Gantz, D., S192 (P-529)
Garay Airaghi, V., S28 (O-089),
S103 (P-223)
García, B., S144 (P-362)
García, C., S32 (O-100)
Garcia, C., S48 (P-029), S201 (P-562)
Garcia Alonso, C.M., S119 (P-274)
García de Viedma, R., S140 (P-345)
Garcia Fernandez, C., S17 (O-053)
García Tercero, E., S93 (P-185),
S121 (P-280), S163 (P-425),
S164 (P-429), S177 (P-477)
Garcia Tercero, E., S159 (P-413)
García Tercero, R.M., S121 (P-280),
S163 (P-425), S164 (P-429)
García-Alonso, C., S66 (P-093)
García-Cabrera, L., S225 (P-645)
García-Martín, B., S146 (P-369)
García-Molina, J., S174 (P-468)
Garcia-Ptacek, S., S29 (O-091),
S244 (LB-009)
Gardarsdottir, H., S21 (O-064)
Gardette, V., S13 (O-038)
Gareri, P., S55 (P-056), S83 (P-153)
Garmendia Prieto, B., S210 (P-593)
Garms-Homolová, V., S30 (O-093),
S31 (O-098)
Garraux, G., S203 (P-569)

Gaspar, E., S143 (P-358)
Gatignol, A., S22 (O-067)
Gauchez, A.-S., S183 (P-497)
Gaudreau, P., S126 (P-297), S128 (P-304)
Gauthier, J., S178 (P-480)
Gautier, S., S4 (O-011), S40 (P-001),
S207 (P-581)
Gavazzi, G., S17 (O-052), S34 (O-107,
O-108), S35 (O-109, O-110),
S36 (O-113), S60 (P-073), S190 (P-523),
S192 (P-529), S211 (P-599),
S213 (P-603), S216 (P-616), S219 (P-625,
P-627), S231 (P-667), S233 (P-673)
Gavriilidou, N.N., S246 (LB-014)
Geirsdottir, O.G., S27 (O-086), S91 (P-181),
S129 (P-307), S132 (P-318)
Genc, A., S82 (P-150), S106 (P-232),
S168 (P-447), S171 (P-458)
Geniere Nigra, S., S86 (P-163), S112 (P-249)
Gentile, S., S88 (P-170)
Gentilini, A., S123 (P-286)
Genton, L., S132 (P-316)
Gentric, A., S116 (P-261)
Georgiopoulos, I., S240 (P-694)
Gérard, A.-L., S182 (P-496)
Germans, T., S237 (P-683, P-684)
Geronimi, L., S189 (P-520)
Gerridzen, I., S52 (P-043)
Gerrits, H.L., S167 (P-444)
Gerritsen, D., S12 (O-037)
Gerritsen, D.L., S4 (O-012), S43 (P-011)
Gervais, F., S15 (O-045), S215 (P-610)
Gheorghievici, G., S165 (P-437)
Ghesquiere, B., S187 (P-512)
Ghiara, C., S26 (O-083), S28 (O-087,
O-090), S89 (P-174), S153 (P-394),
S176 (P-476), S243 (P-705)
Giannini, I., S180 (P-488), S184 (P-503)
Giannouli, V., S116 (P-260), S227 (P-651),
S235 (P-679)
Gibert, P., S17 (O-052), S60 (P-073),
S211 (P-599), S213 (P-603),
S214 (P-609), S216 (P-616),
S219 (P-625, P-627)
Gil, I., S77 (P-133), S208 (P-588),
S211 (P-596), S220 (P-630)
Gil, P., S229 (P-657)
Gil Gregorio, P., S76 (P-129), S93 (P-188)
Gilbert, T., S44 (P-016)
Gillain, S., S203 (P-569)
Gillibrand, N., S141 (P-351)
Gineste, Y., S7 (O-020)
Ginting, M.L., S11 (O-032)
Gioanni, A., S24 (O-074), S35 (O-111),
S109 (P-241), S152 (P-390),
S154 (P-397), S156 (P-403),
S182 (P-496), S224 (P-641, P-643),
S232 (P-668), S234 (P-674, P-675)
Gionti, L., S130 (P-310)
Giordano, A., S49 (P-035)
Girard, J., S103 (P-220)
Girardi, C., S157 (P-406)
Gislason, T., S132 (P-318)
Giuliani, F., S164 (P-430 ), S175 (P-471)
Gkogkos, A., S207 (P-581)
Gladman, J.R.F., S212 (P-600)

S255

Gnemmi, V., S205 (P-574)
Gnerre, P., S88 (P-171)
Gnjidic, D., S19 (O-058)
Godaert, L., S1 (O-002), S183 (P-499),
S188 (P-515), S191 (P-528),
S193 (P-533), S218 (P-623)
Godard-Sebillotte, C., S1 (O-002)
Goede, V., S138 (P-338)
Goh, K.H.R., S174 (P-469)
Goisser, S., S129 (P-308)
Göker, B., S97 (P-201), S113 (P-251),
S195 (P-541), S196 (P-544)
Gold, G., S132 (P-316)
Golmard, J.-L., S52 (P-044)
Gomes, J.F., S176 (P-474)
Gomes, S., S235 (P-678)
Gomez Bruinewoud, I.V., S136 (P-330 )Gómez Pavón, J., S151 (P-385),
S210 (P-593)
Gomez-Quintanilla, A., S34 (O-106),
S227 (P-650), S232 (P-669),
S235 (P-677)
Gonçalves, M., S143 (P-358)
Gonfrier, S., S15 (O-044), S37 (O-117),
S72 (P-113), S76 (P-127), S137 (P-336),
S183 (P-498), S243 (P-704)
Gonnier, V., S237 (P-685)
Gonthier, R., S33 (O-105)
González, M., S184 (P-501)
González, M.N., S56 (P-059)
González Becerra, M., S151 (P-385)
Gonzalez Glaria, B., S146 (P-368)
González Montalvo, J.I., S22 (O-069)
Gonzalez Montalvo, J.I., S167 (P-442)
González Navajas, C., S117 (P-264)
González Ramírez, A., S226 (P-647)
González-Montalvo, J.I., S72 (P-114),
S81 (P-145)
González-Rodríguez, S., S94 (P-189)
González-Villaumbrosía, C., S65 (P-089),
S146 (P-369)
Gonzalo Lazaro, M., S146 (P-368)
Gonzalvo Cirac, B., S66 (P-093)
Gordillo Villegas, A., S38 (LB-002)
Gordon, A.L., S212 (P-600)
Gorgievska, S., S229 (P-659)
Gorus, E., S101 (P-214)
Gosch, M., S86 (P-165)
Gotor, P., S167 (P-442)
Goudzwaard, J., S23 (O-071)
Gourmelon, R., S183 (P-497)
Goutelle, S., S215 (P-610)
Goyal, D., S117 (P-266)
Grácio, J., S53 (P-049)
Grados, M., S192 (P-531)
Graf, C., S132 (P-316)
Granbo, R., S49 (P-034)
Gravina, C., S17 (O-053), S40 (P-003)
Grech, M., S95 (P-192)
Grech, M.J., S124 (P-291)
Greco, A., S1 (O-001), S17 (O-053),
S41 (P-003), S78 (P-137), S164 (P-430 ),S175 (P-471)
Greffard, S., S52 (P-044)
Gregersen, M., S2 (O-003), S62 (P-080),

S256

S69 (P-105), S85 (P-161), S144 (P-359),
S155 (P-400), S160 (P-417)
Greib, C., S191 (P-526)
Greillier, L., S74 (P-122)
Grétarsdóttir, E.Þ, S76 (P-128)
Grevy, A., S60 (P-073), S211 (P-599),
S213 (P-603), S216 (P-616),
S219 (P-625, P-627)
Groc, Y., S196 (P-545)
Grodzicki, T., S12 (O-036), S67 (P-097),
S68 (P-100), S99 (P-206), S201 (P-561)
Grossin, N., S205 (P-574)
Gruner, H., S122 (P-282), S127 (P-300,
P-301), S185 (P-504)
Gryglewska, B., S12 (O-036), S68 (P-100),
S131 (P-315)
Gryllaki, M., S157 (P-405)
Gual, N., S9 (O-026)
Guðmundsdóttir, E.E., S76 (P-128)Guðnason, V., S50 (P-038), S115 (P-258),
S129 (P-307)
Gudmundsson, A., S213 (P-604),
S216 (P-613)
Guerber, F., S35 (O-110)
Guérin, O., S15 (O-044), S37 (O-117),
S72 (P-113), S76 (P-127), S180 (P-490),
S183 (P-498), S189 (P-518),
S229 (P-658), S243 (P-704)
Guerrero, V., S36 (O-114), S206 (P-579)
Güerri-Fernández, R., S188 (P-516)
Guerriero, F., S30 (O-094), S47 (P-027),
S112 (P-249)
Guerrreiro Castro, S., S185 (P-504)
Guerville, F., S215 (P-611)
Guery, B., S190 (P-524)
Guglielmo, M., S45 (P-020)
Guiard, R., S34 (O-107)
Guigay, J., S15 (O-044)
Guillemin, F., S4 (O-011)
Guillemont, J., S200 (P-558), S203 (P-568),
S207 (P-584)
Guimarães Consciência, J., S159 (P-415)
Guinet, F., S155 (P-402)
Guiso, N., S35 (O-109)
Gunawardena, I., S229 (P-659)
Güner, G., S98 (P-203)
Gunnarsdottir, I., S129 (P-307),
S132 (P-318)
Gunnarsson, P., S213 (P-604), S216 (P-613)
Gurkas, S., S44 (P-015)
Gusev, I.A., S130 (P-311)
Gustavsson, L., S199 (P-555)
Gutiérrez-Valencia, M., S63 (P-082),
S146 (P-368)
Guyonnet, S., S129 (P-308)
Güzel, A., S205 (P-575)
Guzman, G., S104 (P-225), S144 (P-362)
Haag, K., S224 (P-642)
Haaning Rasmussen, N., S176 (P-475)
Haaverstad, R., S179 (P-485)
Habchi, H., S107 (P-234)
Haberkorn, G., S153 (P-392)
Habert, M.-O., S8 (O-023)
Hache, G., S21 (O-065)
Haddad, R., S24 (O-074), S35 (O-111),

Author Index / European Geriatric Medicine 8S1 (2017) S249–S268

S217 (P-621), S224 (P-641),
S232 (P-668), S240 (P-695),
S242 (P-703)
Hadley, G., S117 (P-266)
Haenen, E., S158 (P-409)
Hagberg, G., S167 (P-443)
Haghighi, E., S77 (P-131)
Haider, R., S105 (P-227)
Hajebrahimi, F., S172 (P-461)
Halil, M., S55 (P-055), S63 (P-084),
S98 (P-203), S114 (P-256), S131 (P-314),
S135 (P-327), S181 (P-492)
Halldorsson Thorhallur, I., S115 (P-258)
Hallsworth, C., S117 (P-266)
Hamdi, M.S., S177 (P-479), S181 (P-493)
Hamdi Mohamed, S., S178 (P-483)
Hamilton, W., S29 (O-092)
Hamina, A., S6 (O-017)
Hammami, M., S48 (P-030)
Hammami, S., S46 (P-023), S48 (P-030),
S68 (P-099), S149 (P-377),
S155 (P-401), S161 (P-421)
Hammas, K., S92 (P-183)
Hämmerle, S., S209 (P-591)
Hammoudi, N., S234 (P-675)
Han, J., S116 (P-262)
Han, K., S61 (P-076)
Han, Y., S71 (P-112)
Hanaire, H., S13 (O-038)
Hanley, M., S152 (P-388)
Hannigan, C., S139 (P-340)
Hanoğlu, L., S244 (LB-008)
Hanon, O., S7 (O-022), S13 (O-039),
S159 (P-412)
Hansdóttir, H., S50 (P-038)
Hansdottir, H., S213 (P-604), S216 (P-613)
Hansen, J., S188 (P-517)
Hanssen, S.A.J., S43 (P-011)
Haque, K., S151 (P-387)
Harada, S., S4 (O-010), S110 (P-244),
S223 (P-639)
Harchowal, J., S39 (LB-004)
Hardy, C., S117 (P-266)
Harmer, J., S71 (P-110)
Harnie, J., S107 (P-235)
Haro, J.M., S202 (P-564)
Harris, T., S115 (P-258)
Harris, T.B., S121 (P-281), S129 (P-307)
Hartikainen, S., S6 (O-017, O-019),
S7 (O-021), S14 (O-043), S33 (O-104),
S209 (P-590), S210 (P-595),
S222 (P-637)
Hasegawa, H., S184 (P-502)
Hassan, L., S199 (P-553)
Haug, U., S212 (P-601), S236 (P-680)
Haution-Bitker, M., S44 (P-016),
S53 (P-050), S147 (P-370)
Haveman-Nies, A., S206 (P-580)
Hayakawa, M., S179 (P-487)
Hebesberger, D., S140 (P-347),
S141 (P-348)
Heckerman, D., S38 (LB-001)
Heczko, P., S68 (P-100)
Hegge, H.H.M., S115 (P-259)
Heiland, E.G., S12 (O-035)
Hein, A., S171 (P-455)

Heirman, P., S141 (P-350)
Helbostad, J.L., S53 (P-046), S202 (P-566)
Helliar, S., S215 (P-612)
Helmer, C., S139 (P-343)
Helvik, A.S., S17 (O-051)
Hendrikx, J.J.M.A., S245 (LB-012)
Henley, W., S29 (O-092), S71 (P-112)
Henneberg Pedersen, S.G., S10 (O-031)
Henrard, S., S21 (O-066)
Henstra, M., S239 (P-691)
Henstra, M.J., S238 (P-690)
Hentzen, C., S240 (P-695)
Héquette-Ruz, R., S190 (P-524)
Herbaud, S., S92 (P-182)
Herbst, A., S26 (O-083), S28 (O-087,
O-090), S153 (P-394), S176 (P-476),
S243 (P-705)
Herghelegiu, A.M., S61 (P-078),
S68 (P-101), S70 (P-106)
Heringhaus, C., S89 (P-172)
Hermann, F., S132 (P-316)
Hernandez, D., S38 (LB-001)
Hernández, L., S99 (P-208), S109 (P-240)
Hernandez, L., S186 (P-509)
Hernandez, M., S9 (O-026), S213 (P-605)
Hernandorena, I., S13 (O-039)
Herr, M., S113 (P-252)
Herrera, C., S144 (P-362)
Herrero, A.C., S63 (P-082)
Hertogh, C., S52 (P-043)
Hertogh, C.M.P.M., S120 (P-277),
S167 (P-444), S218 (P-622),
S220 (P-629)
Hesse, S., S5 (O-015), S47 (P-025),
S60 (P-071), S193 (P-534)
Hesseberg, K., S53 (P-048)
Hewitt, J., S96 (P-197)
Hiesmayr, M.J., S128 (P-305)
Hilmer, S., S19 (O-058), S21 (O-064)
Hindrich, S., S133 (P-322)
Hinton, R., S91 (P-179), S145 (P-366),
S162 (P-424), S163 (P-427),
S215 (P-612)
Hirayama, R., S95 (P-195)
Hirose, N., S202 (P-563)
Hjaltadóttir, I., S72 (P-115), S76 (P-128)
Hjaltadottir, I., S115 (P-258)
Hodson, J., S36 (O-112)
Hoee, R., S81 (P-147)
Hoevenaar-Blom, M., S200 (P-558)
Hofmann, A., S86 (P-165)
Holikova, S., S42 (P-009), S93 (P-187)
Holmer, J., S244 (LB-009)
Holmerová, I., S116 (P-263)
Holmes, C., S163 (P-427)
Holmes, K., S199 (P-553)
Holst Pedersen, L., S144 (P-359)
Holton, A., S16 (O-049), S214 (P-607)
Honda, M., S7 (O-020), S50 (P-036)
Hong, Ai Ling, S241 (P-699)
Hong, H.P., S191 (P-525)
Honoré, S., S21 (O-065), S220 (P-631)
Hood, C., S148 (P-375)
Hood, K., S103 (P-220)
Hood, V., S101 (P-213)
Hoogendijk, E.O., S8 (O-025)

Author Index / European Geriatric Medicine 8S1 (2017) S249–S268

Hooper, C., S95 (P-193)
Hopanci, D., S108 (P-238)
Hopper, A., S52 (P-045)
Horesh, N., S185 (P-507)
Horgan, N.F., S145 (P-364)
Hørlyck, C., S101 (P-213)
Horpibulsuk, J., S124 (P-292)
Houbolt, C.M., S239 (P-691)
Houman, M.H., S177 (P-479), S178 (P-483),
S181 (P-493)
Howe, A., S31 (O-096)
Howe, A.P., S135 (P-328)
Howie, E., S230 (P-662)
Hu, F.-W., S240 (P-696)
Hubert, J., S40 (P-001), S207 (P-581)
Hubsch, G., S208 (P-585)
Hue, S., S188 (P-514)
Hufthammer, K.O., S179 (P-485)
Hugtenburg, J.G., S218 (P-622),
S220 (P-629)
Huić, M., S136 (P-333)
Huisman, M., S8 (O-025), S19 (O-058),
S21 (O-064)
Humbert, M., S14 (O-041)
Hunter, T., S203 (P-567)
Hupli, M., S105 (P-229)
Hussain, Z., S227 (P-653), S231 (P-666)
Hussein, Z., S117 (P-266)
Huvent, D., S54 (P-052)
Hwang, A.-C., S243 (LB-006)
Hyatt, R., S152 (P-388)
Hyernard, C., S187 (P-513)
Hylen Ranhoff, A., S179 (P-485)
Hyne, S., S120 (P-278)
Iacomelli, I., S91 (P-178)
Ibrahim, E., S140 (P-344)
Ibrahim, K., S104 (P-226), S175 (P-472)
Idiri, H., S54 (P-052)
Idoate Gil, J., S79 (P-138), S86 (P-164),
S226 (P-647)
Igeta, Y., S19 (O-057)
Ihle-Hansen, H., S167 (P-443)
Ikeda, Y., S179 (P-487)
İlhan, B., S66 (P-092), S80 (P-143),
S82 (P-148), S102 (P-219)
İliaz, R., S57 (P-063)
Ilnitski, A., S75 (P-124), S119 (P-271)
Imai, M., S19 (O-057)
Imrani, L., S135 (P-329)
Ingadottir, A.R., S132 (P-318)
Ingebrigtsen, J.E., S32 (O-101),
S199 (P-556)
Ingrand, I., S34 (O-108)
Ingrand, P., S34 (O-108), S186 (P-508)
Inoue, A., S98 (P-205)
Inzitari, M., S9 (O-026), S13 (O-040),
S169 (P-448), S175 (P-470)
Irving, R., S145 (P-365), S154 (P-396)
Isaykina, O.Y., S200 (P-557)
Ishibashi-Ueda, H., S179 (P-487)
Ishii, M., S4 (O-010), S110 (P-244),
S223 (P-639)
Ishii, T., S49 (P-032)
Ishikawa, M., S238 (P-689), S239 (P-693)
Ishitake, T., S77 (P-132)

S257

Ito, M., S7 (O-020), S95 (P-195)
Iwasaki, Y., S179 (P-487)
Izquierdo, M., S63 (P-082), S146 (P-368)
Izumi, H., S149 (P-378), S156 (P-404),
S157 (P-407)

Jukema, W., S37 (O-116)
Jung, D.Y., S79 (P-139)
Junot, C., S126 (P-297)
Justo, D., S185 (P-507)
Jyväkorpi, S., S122 (P-285)

Jacob, A., S98 (P-204)
Jacobs, A., S139 (P-340)
Jacobsen, W., S58 (P-066)
Jacyna, A., S137 (P-335)
Jadawji, C., S73 (P-118)
Jailany, H., S13 (O-039)
Jakavonyte-Akstiniene, A., S61 (P-075)
Jakovljević, D., S20 (O-061)
Jakupaj, A., S195 (P-539)
Jamet, A., S2 (O-004, O-006)
Janavičiūtė, A., S143 (P-355)
Jansen, R.W.M.M., S237 (P-683, P-684)
Janssens, W., S20 (O-060)
Janus, S., S17 (O-051)
Jaracz, K., S75 (P-125)
Jaramaviciene, M., S179 (P-486)
Jaramavicius, J., S179 (P-486)
Jaramillo Hidalgo, J., S151 (P-385)
Jaras, M., S208 (P-586), S241 (P-698),
S242 (P-701)
Jarzebowski, W., S82 (P-151)
Jaussent, A., S3 (O-008)
Jay, S., S165 (P-434, P-435)
Jeandel, C., S237 (P-685)
Jefferson, L., S215 (P-612)
Jelovcak, M., S140 (P-347), S141 (P-348)
Jensen, K., S62 (P-080)
Jeon, H.H., S185 (P-505)
Jeon, T.J., S185 (P-505)
Jetha, N., S153 (P-395)
Jievaltaite, V., S208 (P-586), S241 (P-698),
S242 (P-701)
Jievaltiene, G., S241 (P-698), S242 (P-701)
Jiménez Mola, S., S79 (P-138), S86 (P-164),
S226 (P-647)
Jinga, V., S241 (P-697)
Joachim, C., S183 (P-499)
Jobzs, N., S153 (P-395)
Johansen, A., S118 (P-270)
Johnell, K., S29 (O-091), S67 (P-096)
Johnston, M., S22 (O-067)
Joling, K., S31 (O-098), S52 (P-043)
Joly, L., S228 (P-656)
Jondottir, I.E., S216 (P-613)
Jones, G., S50 (P-037)
Jongjol, P., S124 (P-292)
Jongstra, S., S200 (P-558)
Jónsdóttir, M.K., S50 (P-038)
Jónsson, P., S31 (O-098)
Jónsson, P.V., S30 (O-093), S50 (P-038)
Jonsson, P.V., S27 (O-086)
Jonveaux, T., S228 (P-656)
Jordhøy, M.S., S23 (O-070)
Jørgensen, B.B., S155 (P-400)
Jørgensen, M., S10 (O-031)
Jørgensen, M.G., S131 (P-313)
Josseran, L., S67 (P-098)
Jouanny, P., S178 (P-480)
Jouve, E., S236 (P-681)
Jubeau, M., S107 (P-235)

Kääriä, S., S105 (P-229)
Kabeshova, A., S122 (P-283)
Kadri, N., S96 (P-199), S107 (P-234),
S160 (P-418), S219 (P-626)
Kahraman, T., S82 (P-150), S106 (P-232),
S168 (P-447), S171 (P-458)
Kakhki, A.D., S168 (P-445), S178 (P-481)
Kalikawe, R., S61 (P-077)
Kalinin, G.A., S130 (P-311, P-312)
Kalisvaart, C.J., S87 (P-168), S142 (P-354)
Kalisvaart, I., S87 (P-168)
Kalliakmanis, A., S70 (P-109), S80 (P-141),
S182 (P-495), S187 (P-511)
Kaltenbach, G., S170 (P-453)
Kameyama, Y., S4 (O-010), S110 (P-244),
S223 (P-639)
Kamienski, P., S77 (P-130)
Kamp, E., S91 (P-180)
Kanazu, S., S189 (P-521)
Kandeil, W., S247 (LB-017)
Kania, L., S137 (P-335)
Kanters, T., S125 (P-296)
Kantoch, A., S68 (P-100)
Kara, Ö., S98 (P-203)
Kara, Z., S110 (P-243)
Karabulut, E., S114 (P-256)
Karaitianos, I., S231 (P-665)
Karakulak, E.A., S55 (P-055)
Karan, M.A., S2 (O-005), S44 (P-015),
S57 (P-063), S66 (P-092), S80 (P-143),
S82 (P-148), S84 (P-156), S97 (P-200),
S102 (P-219), S105 (P-230),
S114 (P-254), S135 (P-327),
S138 (P-339)
Karasahin, O., S194 (P-536)
Kåreholt, I., S29 (O-091), S91 (P-181)
Kark, J.D., S40 (P-001)
Kärmeniemi, P., S105 (P-229)
Karoubi, E., S142 (P-352)
Karssemeijer, E.G.A., S43 (P-010),
S55 (P-054)
Kashtanova, D., S195 (P-540), S197 (P-547)
Kasiukiewicz, A., S216 (P-617)
Kat, M.G., S237 (P-683, P-684)
Katsoras, A., S70 (P-109), S80 (P-141),
S182 (P-495), S187 (P-511)
Katsoulis, I., S231 (P-665)
Kaufmann, E., S86 (P-165)
Kautiainen, H., S18 (O-054), S208 (P-587)
Kawabe, T., S238 (P-689), S239 (P-693)
Kaya, S., S97 (P-201), S113 (P-251),
S195 (P-541), S196 (P-544)
Kazanavičius, E., S143 (P-355)
Kearney-Schwartz, A., S137 (P-334),
S157 (P-405), S228 (P-656)
Keaskin, L., S245 (LB-013)
Kechida, M., S155 (P-401)
Keelan, R., S84 (P-157), S147 (P-371)
Keijsers, C.J.P.W., S245 (LB-012)

S258

Keinänen-Kiukaanniemi, S.M.,
S108 (P-237)
Keller, D.I., S153 (P-392)
Kelly, J., S165 (P-434, P-435)
Kemmler, W., S102 (P-217)
Kennelly, S., S27 (O-084), S140 (P-344),
S241 (P-700)
Kennelly, S.P., S165 (P-436)
Kenny, R.A., S25 (O-080)
Kent, L., S31 (O-096), S135 (P-328)
Ker, Sin Yue, Jeanice, S241 (P-699)
Kerebel-Bucovaz, D.A., S21 (O-065)
Kerhervé, H., S45 (P-019)
Kerherve, H., S8 (O-024), S56 (P-060)
Kerif, M., S160 (P-418)
Kerschbaumer, G., S231 (P-667)
Kersten, H., S214 (P-608)
Keskinoglu, P., S82 (P-150), S106 (P-232),
S168 (P-447), S171 (P-458)
Kessler, M., S40 (P-001)
Kestenbaum, S., S162 (P-424)
Khan, A., S25 (O-076)
Khan, K., S224 (P-642)
Khedher, M., S178 (P-483), S181 (P-493)
Khiami, F., S22 (O-068), S35 (O-111),
S224 (P-641), S225 (P-644),
S226 (P-648), S232 (P-670),
S233 (P-672, P-673), S234 (P-675)
Khoo, J.K.C., S11 (O-032)
Kida, H., S197 (P-548), S206 (P-577)
Kilaite, J., S132 (P-319)
Kilavuz, A., S108 (P-238)
Kilbane, L., S27 (O-084), S165 (P-436)
Kılıç, C., S2 (O-005), S66 (P-092),
S80 (P-143), S82 (P-148), S97 (P-200),
S102 (P-219), S105 (P-230),
S114 (P-254)
Kılıç, M.K., S98 (P-203), S181 (P-492)
Kim, D., S191 (P-525)
Kim, E., S191 (P-525)
Kim, H.J., S54 (P-051)
Kim, J., S41 (P-006), S42 (P-007),
S166 (P-439)
Kim, J.H., S185 (P-505)
Kim, K.J., S226 (P-649)
Kim, M., S114 (P-255)
Kim, S., S114 (P-255)
Kim, S.H., S124 (P-290)
Kim, Y., S41 (P-006), S42 (P-007)
Kim, Y.H., S61 (P-076)
Kimura, M., S40 (P-001)
Kinirons, M., S52 (P-045)
Kinowski, J.-M., S63 (P-083)
Kinugawa, K., S24 (O-074), S135 (P-329),
S232 (P-668)
Kirbiyik, F., S135 (P-327)
Kirk, H., S162 (P-424)
Kirwan, J., S245 (LB-013)
Kivipelto, M., S11 (O-033), S48 (P-031),
S200 (P-558), S203 (P-568)
Kıyan, E., S57 (P-063)
Kızılarslanoğlu, C., S98 (P-203),
S114 (P-256)
Kızılarslanoğlu, M.C., S97 (P-201),
S113 (P-251), S181 (P-492),
S195 (P-541), S196 (P-544)

Author Index / European Geriatric Medicine 8S1 (2017) S249–S268

Kizuki, J., S238 (P-689), S239 (P-693)
Klein, N., S188 (P-517)
Klein, O., S228 (P-656)
Klii, R., S155 (P-401)
Klop, H.G., S158 (P-409)
Kluonaitis, K., S185 (P-506)
Knašienė, J., S143 (P-355)
Knasiene, J., S121 (P-279), S158 (P-410),
S208 (P-586), S241 (P-698),
S242 (P-701)
Kob, R., S102 (P-217)
Kobayashi, N., S77 (P-132)
Kobeh, D., S191 (P-526)
Kocak, F.O.K., S162 (P-423)
Kocaturk, C., S135 (P-327), S138 (P-339)
Kochtali, I., S155 (P-401)
Koda, H., S166 (P-438)
Kodavali, K., S120 (P-278)
Koiranen, M.J., S108 (P-237)
Koivukangas, M.M., S108 (P-237)
Koizia, A., S229 (P-660)
Koizia, L., S229 (P-660)
Kojima, T., S4 (O-010), S100 (P-210),
S110 (P-244), S223 (P-639)
Kolaric, B., S73 (P-119), S136 (P-333)
Koldestam, A., S199 (P-555)
Kollhorst, B., S212 (P-601), S236 (P-680)
Komici, K., S125 (P-295)
Komulainen, K., S33 (O-104), S209 (P-590),
S210 (P-595)
Kondova, D., S143 (P-357), S145 (P-363)
Koning, H., S16 (O-047)
Köninger, T.W., S138 (P-338)
Konstantopoulos, P., S207 (P-581)
Koopmans, R., S12 (O-037)
Koopmans, R.T.C.M., S43 (P-011),
S46 (P-022)
Koponen, M., S14 (O-043), S222 (P-637)
Korc-Grodzicki, B., S79 (P-140),
S117 (P-267)
Korfage, I., S33 (O-103)
Korou, M., S207 (P-581)
Korshun, E., S75 (P-124)
Kossioni, A., S210 (P-594)
Kossionis, G., S210 (P-594)
Kotovskaya, Y., S47 (P-026), S195 (P-540),
S197 (P-546, P-547), S201 (P-559)
Kotsani, M., S157 (P-405), S240 (P-694)
Kozaki, K., S184 (P-502)
Kozdron, E., S170 (P-452)
Kozma, A., S61 (P-078), S68 (P-101),
S70 (P-106), S177 (P-478)
Krakowski, I., S180 (P-490)
Kremer, A., S185 (P-507)
Krief, H., S38 (LB-003)
Krolak-Salmon, P., S7 (O-022)
Kropińska, S., S75 (P-125)
Kruglikova, A.S., S200 (P-557)
Krypciak, S., S216 (P-615)
Kuchel, G.A., S71 (P-112)
Küçükdağlı, P., S80 (P-143), S82 (P-148)
Kucukdagli, P., S84 (P-156), S102 (P-219),
S114 (P-254)
Kuczewski, E., S183 (P-497)
Kuhn-Thiel, A., S221 (P-632)
Kuiper, J., S139 (P-340)

Kuiper, K.K.J., S179 (P-485)
Kukkonen-Harjula, K., S105 (P-229)
Kullmann, B., S47 (P-025), S60 (P-071)
Kung, A., S164 (P-430 )Kunvik, S., S39 (LB-005)
Kuo, R.N.-C., S25 (O-077)
Kupina, L.M., S130 (P-312)
Kuraishi, Y., S149 (P-378), S156 (P-404),
S157 (P-407)
Kurylowicz, A., S127 (P-302)
Kuzuya, M., S98 (P-205)
Kwak, S.H., S191 (P-525)
Kwon, Y., S41 (P-006), S42 (P-007),
S54 (P-051), S61 (P-076), S226 (P-649)
Kwon, Y.-J., S54 (P-051)
La Carpia, D., S45 (P-020)
Laakkonen, M.-L., S18 (O-054)
Laatikainen, T., S11 (O-033)
Labarias, C., S189 (P-520)
Labat, C., S4 (O-011), S40 (P-001),
S207 (P-581)
Labouree, F., S146 (P-367), S159 (P-412)
Lachani, D., S145 (P-363)
Lackner, H.K., S201 (P-560)
Ladikou, E.E., S73 (P-118)
Lafargue, A., S191 (P-526)
Lafargue, S., S133 (P-321)
Lafferty, J., S117 (P-266)
Lafuente, C., S82 (P-151)
Lafuente-Lafuente, C., S90 (P-175)
Lagarde, L., S20 (O-062)
Lai, C.-L., S25 (O-077)
Lai, D.W.L., S237 (P-686)
Lai, M.-S., S25 (O-077)
Lakkappa, B., S120 (P-278)
Lakomy, C., S207 (P-581)
Lambert, M., S187 (P-513)
Lamers, S., S245 (LB-010)
Lamloum, M., S177 (P-479), S178 (P-483),
S181 (P-493)
Lamoth, C., S19 (O-058)
Lamy, T., S217 (P-621), S224 (P-643)
Lanciego, C., S121 (P-280)
Landaluce Pelligra, V., S93 (P-185),
S121 (P-280), S159 (P-413),
S163 (P-425), S164 (P-429),
S177 (P-477)
Landelle, C., S192 (P-529)
Landi, F., S9 (O-027), S38 (LB-001),
S96 (P-198), S243 (LB-006)
Lang, T., S115 (P-258)
Langellotto, A., S54 (P-053)
Langenfeld, S., S189 (P-519)
Langørgen, J., S179 (P-485)
Lapeña Montero, T., S151 (P-385)
Laport, N., S141 (P-350)
Laranjeira, C., S83 (P-155)
Lardy, B., S36 (O-113)
Larissa, G., S157 (P-406)
Larsen, T., S151 (P-386)
Lasserre, R., S8 (O-024)
Latchezar, T., S58 (P-067)
Latini, E., S51 (P-040)
Lauda, M., S34 (O-108)
Launer, L., S115 (P-258)

Author Index / European Geriatric Medicine 8S1 (2017) S249–S268

Launer, L.J., S129 (P-307)
Laurain, M.-C., S34 (O-107)
Laurent, M., S10 (O-030), S92 (P-182)
Lauretani, F., S100 (P-212), S130 (P-310)
Lauriola, M., S40 (P-003)
Lauritzen, T., S2 (O-003)
Lavan, A.H., S218 (P-624), S222 (P-636),
S223 (P-640)
Lavikainen, P., S6 (O-017), S14 (O-043)
Lawn, L., S65 (P-091)
Lawrence, R.M., S52 (P-045)
Layé, S., S44 (P-014)
Le borgne, P., S170 (P-453)
Le Guern, R., S190 (P-524)
Le Guillou, C., S189 (P-520)
Le Manach, Y., S22 (O-068), S232 (P-670)
Leal-Seabra, F., S93 (P-186)
Leborgne, F., S15 (O-044), S76 (P-127),
S229 (P-658)
Lebreton, V., S133 (P-321)
Lecardonnel, C., S44 (P-016), S53 (P-050)
Lechevallier, E., S74 (P-122)
Lee, A., S151 (P-386)
Lee, C.P., S68 (P-102)
Lee, J., S120 (P-275)
Lee, J.A., S116 (P-262)
Lee, S., S191 (P-525)
Lee, Y.G., S124 (P-290), S217 (P-620)
Leeuwenburgh, C., S38 (LB-002)
Legeron, R., S191 (P-526)
Legrand, M., S214 (P-609)
Leguelinel-Blache, G., S63 (P-083)
Lehours, P., S44 (P-014)
Lehtisalo, J., S11 (O-033), S48 (P-031)
Leissing-Desprez, C., S59 (P-069)
Leitão, S., S186 (P-510)
Leiva, N., S45 (P-021), S56 (P-058),
S74 (P-121), S86 (P-162), S230 (P-661)
Lenaerts, C., S101 (P-215), S115 (P-257)
Lenoir, H., S51 (P-039)
Lenta, E., S142 (P-353)
Lenuzza, N., S128 (P-304)
Lenzen, M., S23 (O-071)
Leo, P., S175 (P-471)
Lepelletier, A., S214 (P-609)
Leperre-Desplanques, A., S16 (O-050),
S58 (P-067)
Lepetit, K., S135 (P-329)
Lepetitcorps, H., S90 (P-175)
Lesauskaitė, V., S143 (P-355)
Lescure, P., S161 (P-419)
Leshabari, K., S61 (P-077)
Leskinen, M.R., S108 (P-237)
Lestrat, Y., S190 (P-523)
Lethby, M., S153 (P-395)
Letty, A., S67 (P-098), S138 (P-337),
S199 (P-554)
Levet, S., S192 (P-529)
Levillain, S., S220 (P-631)
Levy, M., S8 (O-023)
Levy, V., S108 (P-236), S127 (P-303)
Levy, Y., S188 (P-514)
Lewden-Bernadac, B., S133 (P-321)
Lewis, E., S188 (P-517)
Lewis, K., S151 (P-387)
Lewis, S., S96 (P-197)

Leycuras, T., S40 (P-002)
Lezza, A.M.S., S38 (LB-002)
Li, J., S41 (P-005)
Li, X., S247 (LB-017)
Liesa, G., S9 (O-026)
Lieutier, F., S189 (P-518)
Lim, S., S174 (P-467)
Lim, Siew Ming, Meliza, S241 (P-699)
Limosani, R., S164 (P-430 )Lindner, K., S196 (P-542)
Linley-Adams, L., S50 (P-037)
Linschooten, J.O., S125 (P-296)
Liperoti, R., S45 (P-020), S69 (P-104)
Lisk, C., S120 (P-275)
Lisk, R., S3 (O-007), S24 (O-073),
S65 (P-091), S227 (P-652)
Litke, R., S40 (P-002), S66 (P-094)
Liu, C., S11 (O-032)
Liu, C.-L., S25 (O-077)
Liuu, E., S2 (O-004, O-006), S186 (P-508)
Lizard, G., S48 (P-030)
Llagostera, B., S213 (P-605)
Lo Forte, A., S26 (O-083), S28 (O-087,
O-090), S153 (P-394), S176 (P-476),
S243 (P-705)
Locquet, M., S10 (O-029), S96 (P-196),
S103 (P-222), S105 (P-228)
Loiez, C., S190 (P-524)
Lombardini, F., S169 (P-448)
Lopes, M.J., S75 (P-126)
Lopes, P., S176 (P-474), S180 (P-489)
López López, K., S79 (P-138), S86 (P-164)Lopez Sáez De Asteasu, M., S63 (P-082),
S146 (P-368)
López Viñas, M., S79 (P-138), S86 (P-164)
López-Liria, R., S66 (P-095), S174 (P-468)
Lorenzi, C., S49 (P-035)
Los, F., S117 (P-266)
Louchart de la Chapelle, S., S5 (O-015),
S47 (P-025), S60 (P-071), S193 (P-534)
Lourenço, F., S122 (P-282), S127 (P-301),
S185 (P-504)
Lovett, N., S117 (P-266)
Lozano, C., S178 (P-482)
Lozano-Montoya, I., S112 (P-247)
Lozano-Pino, G., S149 (P-379)
Luciano, G., S221 (P-634)
Lucke, J., S89 (P-172)
Lucke, J.A., S147 (P-373), S158 (P-409)
Lueje Alonso, E., S28 (O-089), S93 (P-188),
S103 (P-223)
Luiking, Y., S112 (P-248)
Lukic, M., S73 (P-119), S136 (P-333)
Lumal, S., S216 (P-616)
Lupo, J., S192 (P-529)
Lwin, Z.M., S119 (P-272)
Lyan, B., S113 (P-253)
Lyngholm Soerensen, G., S151 (P-386)
Machut, A., S190 (P-523)
Macijauskiene, J., S61 (P-075)
MacMahon, C., S241 (P-700)
Macni, J., S183 (P-499)
Madsen Fredholm, L., S90 (P-177)
Maggi, S., S9 (O-027), S16 (O-048),
S83 (P-154)

S259

Maggio, M., S100 (P-212), S130 (P-310)
Magro, P., S222 (P-635)
Mahmoudi, R., S102 (P-218), S183 (P-499)
Maier, A., S87 (P-168), S202 (P-566)
Maietti, E., S96 (P-198)
Maigre, O., S44 (P-017)
Mäkelä, M., S20 (O-061)
Malet, L., S215 (P-610)
Malik, A., S235 (P-676)
Malik, N.A., S103 (P-221)
Malik, R., S235 (P-676)
Malik, R.A., S25 (O-076)
Malikov, S., S40 (P-001), S207 (P-581)
Maljean, L., S211 (P-599), S213 (P-603),
S216 (P-616), S219 (P-627),
S231 (P-667)
Mallaret, M., S17 (O-052), S219 (P-627)
Mallaret, M.-R., S192 (P-529)
Maltaric, M., S73 (P-119), S136 (P-333)
Mamun, K., S99 (P-209)
Manca, C., S125 (P-294)
Manchipa, J.C., S159 (P-413)
Manciaux, M.A., S139 (P-341)
Mancini, A., S125 (P-295)
Manckoundia, P., S178 (P-480)
Mandujano Valencia, J., S47 (P-028)
Mandy, B., S215 (P-610)
Manfredi, L., S83 (P-153)
Mangiacotti, A., S1 (O-001), S17 (O-053),
S40 (P-003), S78 (P-137)
Mangialasche, F., S200 (P-558)
Mangoni, A.A., S1 (O-001), S78 (P-137)
Mankowski, R., S38 (LB-002)
Manley, A., S215 (P-612)
Manna, R., S117 (P-267)
Mannoni, P., S221 (P-634)
Mansour, S., S119 (P-272)
Mantovani, M., S100 (P-212)
Marasigan, E., S143 (P-356)
Marchionni, N., S26 (O-083), S28 (O-087,
O-090), S176 (P-476), S180 (P-488),
S184 (P-503), S243 (P-705)
Marco, E., S169 (P-451)
Marengoni, A., S11 (O-033), S87 (P-166),
S88 (P-169, P-170), S90 (P-176),
S222 (P-635)
Marescotti, R., S7 (O-020)
Mariadas, P., S10 (O-031)
Marin, F., S135 (P-329)
Marinho, C., S46 (P-024)
Markevičiūtė, U., S143 (P-355)
Marks, M., S188 (P-517)
Marques, P., S77 (P-131), S136 (P-332)
Marquet, M., S204 (P-571)
Marseglia, A., S18 (O-056)
Marsh, S., S118 (P-270)
Martella, L., S49 (P-035)
Martí, J., S181 (P-491)
Martin, A., S58 (P-065), S74 (P-123),
S83 (P-152), S189 (P-520)
Martin, E., S9 (O-026)
Martin, F., S116 (P-263), S207 (P-584)
Martin, F.C., S52 (P-045)
Martin, I., S178 (P-480)
Martin, L., S205 (P-576)
Martin Maestre, I., S167 (P-442)

S260

Martín Pérez, E., S79 (P-138), S86 (P-164),
S226 (P-647)
Martín Rodríguez, L.M., S140 (P-345)
Martin Sánchez, F.J., S93 (P-188)
Martin-Marero, C., S153 (P-395)
Martínez, N., S175 (P-470)
Martínez Maroto, T., S93 (P-185),
S121 (P-280), S163 (P-425),
S164 (P-429)
Martinez Maroto, T., S159 (P-413)
Martínez Rivas, J.J., S71 (P-111)
Martínez-Fernández, M.I., S45 (P-021),
S56 (P-058), S74 (P-121), S86 (P-162),
S181 (P-491), S230 (P-661)
Martínez-Fuerte, R., S64 (P-087),
S123 (P-289)
Martinez-Fuerte, R., S60 (P-074),
S63 (P-085), S64 (P-086, P-088),
S70 (P-108), S92 (P-184), S118 (P-269),
S150 (P-382)
Martínez-Peromingo, J., S65 (P-089),
S146 (P-369)
Martinez-Velilla, N., S63 (P-082),
S146 (P-368)
Martini, F., S69 (P-104)
Martins, M., S159 (P-415)
Martins, R., S77 (P-131)
Martins, S., S236 (P-682)
Martone, A.M., S54 (P-053)
Marttini Abarca, J., S76 (P-129),
S93 (P-188), S94 (P-191)
Maruno, H., S19 (O-057)
Marzetti, E., S38 (LB-001, LB-002),
S243 (LB-006)
Mas-Stachurska, A., S181 (P-491)
Masanet, E., S8 (O-024)
Mases, A., S181 (P-491)
Masoli, J., S71 (P-112)
Masoli, J.A., S29 (O-092)
Massias, J., S92 (P-182)
Masson, C., S192 (P-529)
Mastaviciute, A., S132 (P-319),
S179 (P-486), S212 (P-602)
Masud, T., S101 (P-213), S119 (P-272),
S151 (P-386)
Matchar, D.B., S11 (O-032)
Matelot, D., S58 (P-065), S74 (P-123),
S83 (P-152), S189 (P-520)
Mateus, J.E., S150 (P-384), S176 (P-474),
S180 (P-489)
Mather, S., S141 (P-351)
Mathoulin-Pélissier, S., S5 (O-013),
S139 (P-343)
Mathur, A., S73 (P-118), S135 (P-326)
Matía Martín, P., S28 (O-089)
Matijevic-Hlatki, S., S136 (P-333)
Matovelle, P., S72 (P-114), S81 (P-145)
Matsumoto, M., S179 (P-487)
Mattace-Raso, F., S1 (O-001), S23 (O-071),
S33 (O-103), S78 (P-137)
Matteucci, P., S45 (P-020)
Matthews, I., S194 (P-535)
Matthews, R., S119 (P-273)
Mattiuzzo, E., S112 (P-249)
Maurer-Ertl, W., S201 (P-560)
Mavura, N., S61 (P-077)

Author Index / European Geriatric Medicine 8S1 (2017) S249–S268

May, C., S104 (P-226)
Mayan, H., S185 (P-507)
Mazen, E., S178 (P-480)
Mazya, A.L., S100 (P-211)
Mazzola, P., S84 (P-158)
Mazzone, A., S84 (P-158), S87 (P-166),
S88 (P-169, P-170), S90 (P-176)
Mccambridge, C., S217 (P-618)
Mccann, C., S153 (P-395)
McCartan, D., S194 (P-538), S241 (P-700)
McCarthy, F., S169 (P-450), S176 (P-473)
McCluskey, L., S228 (P-654)
McCullagh, R., S145 (P-364)
McDonnell, S., S41 (P-004)
Mcgrath, C., S95 (P-193)
McKiernan, M., S245 (LB-013)
Meadows, L., S72 (P-116)
Medzeviciute, V., S158 (P-410)
Mégraud, F., S44 (P-014)
Mehedi, F., S145 (P-363)
Meiland, F.J., S167 (P-444)
Meiller, Y., S200 (P-558)
Mejía Ramírez de Arellano, M.V.,
S210 (P-593)
Mekhinini, S., S3 (O-008)
Meldgaard, P., S62 (P-080)
Melis, R.J.F., S111 (P-246)
Mello, A.M., S51 (P-040)
Mellone, S., S202 (P-566)
Melzer, D., S27 (O-085), S29 (O-092),
S71 (P-112)
Mendes, A., S8 (O-023), S132 (P-316)
Mendes, R., S236 (P-682)
Menenakos, E., S207 (P-581)
Menendez Colino, R., S22 (O-069)
Menéndez-Colino, R., S72 (P-114),
S81 (P-145)
Mengoni, M., S51 (P-040)
Menozzi, L., S49 (P-035)
Mensah, K., S179 (P-484)
Mercalli, F., S30 (O-094)
Merchant, R.A., S45 (P-018)
Mercie, P., S187 (P-513)
Merello, A., S109 (P-240), S186 (P-509)
Mergy, J., S186 (P-508)
Meroni, F., S157 (P-406)
Mertens, C., S5 (O-013)
Mertens, D., S187 (P-512)
Mesas, M., S169 (P-448)
Meschi, T., S100 (P-212), S130 (P-310)
Meseri, R., S108 (P-238)
Mesfar, R., S155 (P-401)
Mesri, K., S158 (P-409)
Messouak, S., S155 (P-402)
Mestres, C., S213 (P-605)
Metti, A., S13 (O-040)
Metzenbauer, D., S209 (P-591)
Meulendijk, M.C., S245 (LB-012)
Meyer, M., S170 (P-453)
Meyer, O., S153 (P-392)
Mézière, A., S22 (O-068), S24 (O-074),
S35 (O-111), S154 (P-397), S224 (P-641,
P-643), S225 (P-644), S226 (P-648),
S232 (P-668, P-670), S233 (P-672),
S234 (P-675)
Mezzadri, M., S242 (P-703)

Mhalla, A., S46 (P-023), S68 (P-099),
S149 (P-377), S161 (P-421)
Micallef, A., S95 (P-192)
Micallef, J., S20 (O-062), S26 (O-082)
Michael, A., S227 (P-653), S231 (P-666)
Michael, C., S221 (P-633)
Michalkova, H., S1 (O-001), S78 (P-137),
S104 (P-224)
Michel, A., S82 (P-149)
Michelena, M., S178 (P-482)
Migeot, V., S2 (O-006)
Migliasso, P., S5 (O-015)
Migliorini, M., S180 (P-488), S184 (P-503)
Miguel-Alhambra, L., S34 (O-106),
S227 (P-650), S232 (P-669),
S235 (P-677)
Mijnarends, D., S112 (P-248)
Milho, J., S136 (P-332)
Milisen, K., S6 (O-018), S14 (O-042)
Millan, R., S181 (P-491)
Miller, A., S91 (P-179), S145 (P-366),
S162 (P-424), S163 (P-427),
S215 (P-612)
Miller, C., S145 (P-365), S154 (P-396),
S163 (P-428)
Mimura, M., S197 (P-548), S202 (P-563),
S206 (P-577)
Mínguez-Blasco, P., S169 (P-451)
Miot, S., S237 (P-685)
Miralles, R., S45 (P-021), S56 (P-058),
S74 (P-121), S86 (P-162), S188 (P-516),
S230 (P-661)
Miret, C., S1 (O-001), S78 (P-137),
S186 (P-509)
Miret Corchado, C., S225 (P-645)
Missotten, P., S43 (P-013), S116 (P-261)
Mitic, B., S69 (P-103)
Mitoiu, B., S165 (P-437)
Mitoiu Brindusa, I., S168 (P-446),
S173 (P-464)
Mitsui, Y., S149 (P-378), S156 (P-404),
S157 (P-407)
Miyazaki, J., S166 (P-438)
Mkhitaryan, E., S47 (P-026)
Moatari, M., S34 (O-106), S227 (P-650),
S232 (P-669), S235 (P-677)
Mohan, A.M., S223 (P-638)
Mok, Wen Qi, S241 (P-699)
Molden, E., S214 (P-608)
Moll van Charante, E.P., S200 (P-558)
Mondain, V., S189 (P-518)
Monéger, N., S191 (P-526)
Monnerie, S., S126 (P-297), S128 (P-304)
Monnet, C., S8 (O-024), S142 (P-352)
Montagu, A., S117 (P-266)
Monteiro, P., S93 (P-186)
Montero, B., S99 (P-208), S109 (P-240)
Montero-Errasquín, B., S225 (P-645)
Montorsi, M., S87 (P-166), S88 (P-169,
P-170), S90 (P-176)
Monzat, D., S214 (P-609)
Mooijaart, S., S37 (O-116), S89 (P-172)
Mooijaart, S.P., S147 (P-373), S158 (P-409)
Moorchilot, R., S101 (P-213)
Mora, L., S52 (P-044)

Author Index / European Geriatric Medicine 8S1 (2017) S249–S268

Mora Fernández, J., S23 (O-072),
S103 (P-223)
Morais, J., S126 (P-297), S128 (P-304)
Moral-Cuesta, D., S72 (P-114), S81 (P-145)
Morandi, A., S87 (P-166), S88 (P-169,
P-170), S90 (P-176)
Morelli, S., S85 (P-159)
Moreno, P.A., S134 (P-323)
Moreno Collado, A.M., S140 (P-345)
Mori, K., S19 (O-057)
Morisco, C., S125 (P-295)
Morisot, A., S47 (P-025), S60 (P-071),
S193 (P-534)
Morton, T., S95 (P-193)
Morvan, A., S226 (P-648)
Moser-Siegmeth, V., S140 (P-347),
S141 (P-348), S209 (P-591)
Moss, N., S50 (P-037)
Mossakowska, M., S127 (P-302),
S170 (P-452)
Mossello, E., S51 (P-040), S84 (P-158),
S87 (P-166), S88 (P-169, P-170),
S89 (P-174), S90 (P-176)
Motte, C., S137 (P-334)
Mouchoux, C., S7 (O-022), S15 (O-045),
S214 (P-609), S215 (P-610)
Mourey, L., S5 (O-013)
Mouro, A., S26 (O-081), S57 (P-062)
Moussallem, T., S207 (P-581)
Mphumuhila, B., S61 (P-077)
Mravak, S., S73 (P-119), S136 (P-333)
Mucci, E., S91 (P-180)
Mukherjee, C., S105 (P-227)
Mulders, A., S46 (P-022)
Muniesa, J.M., S169 (P-451)
Muniz, R.C., S117 (P-267)
Muñoz Pascual, A., S226 (P-647)
Murakami, Y., S189 (P-521)
Muratli, S., S102 (P-219), S105 (P-230)
Muredda, L., S125 (P-294)
Murphy, E., S139 (P-340)
Murru, E., S125 (P-294)
Musacchio, C., S1 (O-001), S78 (P-137)
Musacchio, E., S242 (P-702)
Mussi, C., S54 (P-053)
Na, N., S232 (P-670)
Nacu, R.M., S61 (P-078), S68 (P-101),
S70 (P-106), S177 (P-478)
Naess, H., S167 (P-443)
Nagase, D., S149 (P-378), S156 (P-404),
S157 (P-407)
Nagel, V., S81 (P-147)
Nahornyj, E., S53 (P-050)
Najioullah, F., S188 (P-515), S191 (P-528),
S193 (P-533)
Nakai, T., S110 (P-245)
Nalbant, S., S138 (P-339)
Nalls, M., S38 (LB-001)
Nannini, F., S198 (P-549)
Narendran, J., S118 (P-270)
Narici, M., S100 (P-212)
Nartea, R., S165 (P-437), S168 (P-446),
S173 (P-464)
Narvión, A., S36 (O-114), S206 (P-579)
Nascimento, A.L.A., S81 (P-146)

Nath, J., S36 (O-112)
Natori, K., S149 (P-378), S156 (P-404),
S157 (P-407)
Naturel, J., S34 (O-107)
Nauleau, M., S133 (P-321)
Nauman, J., S32 (O-101)
Navas-Clemente, I., S65 (P-089)
Negers, A., S156 (P-403)
Nel, L., S163 (P-427)
Nelson, D., S229 (P-659)
Nelson, V., S245 (LB-013)
Neri, C., S225 (P-644)
Neri, L., S142 (P-353)
Nesbakken, A., S23 (O-070)
Neumann, L., S32 (O-099), S58 (P-066),
S81 (P-147)
Neves, H., S26 (O-081), S57 (P-061, P-062),
S77 (P-133), S120 (P-276), S158 (P-411),
S208 (P-588), S211 (P-596),
S220 (P-630)
Newman, A.B., S13 (O-040)
Newton-Boerjan, M., S80 (P-142)
Ng, S.E., S45 (P-018)
Ngandu, D.L., S151 (P-387)
Ngandu, T., S11 (O-033), S48 (P-031),
S200 (P-558)
Nghiem, D., S5 (O-016), S82 (P-151)
Ngueyon Sime, W., S34 (O-107)
Nguyen, J.-M., S8 (O-024)
Nguyen, M.H., S99 (P-209)
Nica, A.S., S165 (P-437), S168 (P-446),
S173 (P-464)
Nicosia, F., S54 (P-053)
Nidh, N., S147 (P-371)
Nielsen, E., S219 (P-628)
Nigro, F.M., S89 (P-174)
Nihtilä, A., S33 (O-104), S209 (P-590),
S210 (P-595)
Niimura, H., S197 (P-548), S202 (P-563),
S206 (P-577)
Nijboer, H., S97 (P-202)
Niranjan, K., S95 (P-193)
Nishimura, W., S197 (P-548), S206 (P-577)
Nishiwaki, Y., S189 (P-521)
Nizigiyimana, D., S192 (P-529)
Noale, M., S242 (P-702)
Nonnonhou, V., S102 (P-218)
Nordrehaug, J.E., S179 (P-485)
Norekvål, T.M., S179 (P-485)
Noro, G., S54 (P-053)
Nourhashemi, F., S13 (O-038)
Nouvenne, A., S100 (P-212)
Novais, T., S15 (O-045), S215 (P-610)
Novella, J.-L., S102 (P-218), S183 (P-499)
Novella, J.L., S34 (O-107)
Numata, T., S110 (P-245)
Nunes, C., S75 (P-126)
Nygaard, H., S152 (P-391)
Nygård, S., S167 (P-441)
Nykänen, I., S33 (O-104), S209 (P-590),
S210 (P-595)
O’Brien, G., S213 (P-606)
O’Donnell, D., S12 (O-034)
O’Mahony, C., S245 (LB-013)
O’Mahony, D., S12 (O-034), S112 (P-247),

S261

S213 (P-606), S218 (P-624),
S222 (P-636), S223 (P-640)
O’Mahony, M., S211 (P-598)
O’Neill, D., S27 (O-084), S116 (P-263),
S140 (P-344), S194 (P-538)
O’Riordan, S., S144 (P-361), S148 (P-374)
O’Sullivan, R., S3 (O-007)
Oba, M., S189 (P-521)
Obara, T., S184 (P-502)
Öbekli, T., S82 (P-148)
Obiechina, N., S227 (P-653), S231 (P-666)
Ogasawara, S., S98 (P-205)
Ogawa, K., S77 (P-132)
Ogawa, S., S4 (O-010), S32 (O-102),
S100 (P-210), S110 (P-244),
S223 (P-639)
Ogita, M., S110 (P-245)Oğuz, K.K., S55 (P-055)
Oh, J.E., S124 (P-290), S217 (P-620)
Öhman, H., S18 (O-054)
Ohta-Ogo, K., S179 (P-487)
Okamura, H., S49 (P-032)
Okura, M., S110 (P-245)
Olde Rikkert, M.G.M., S43 (P-010),
S49 (P-033), S55 (P-054)
Oldham, L., S141 (P-351)
Olding, L., S194 (P-535)
Oliveira, A., S93 (P-186)
Oliveira, D., S150 (P-384)
Oliveira-Martins, S., S75 (P-126)
Oliven, A., S183 (P-500)
Oliven, R., S183 (P-500)
Ollivier, J., S191 (P-526)
Olson, J., S41 (P-004)
Olszanecka-Glinianowicz, M., S70 (P-107),
S127 (P-302)
Olthof, M.R., S121 (P-281)
Ommundsen, N., S23 (O-070)
Onder, G., S5 (O-014), S30 (O-093),
S31 (O-098), S69 (P-104)
Ong, P.S., S68 (P-102)
Oñoro-Algar, C., S65 (P-089), S146 (P-369)
Onwuteaka-Philipsen, B.D., S8 (O-025)
Oostendorp-Lange, A., S147 (P-373)
Oosterbaan, L., S71 (P-110)
Opris, S., S78 (P-134)
Oren, M., S84 (P-156)
Orso, F., S26 (O-083), S28 (O-087, O-090),
S153 (P-394), S176 (P-476),
S243 (P-705)
Ortés-Gómez, R., S149 (P-379)
Ørum, M., S62 (P-080)
Osman, S., S25 (O-076)
Ostapenko, V., S47 (P-026), S195 (P-540),
S197 (P-547), S201 (P-559)
Ostiz, F., S169 (P-451)
Osuafor, C.N., S169 (P-450), S176 (P-473)
Oswald, L., S193 (P-532)
Otero, A., S72 (P-114)
Otero Puime, A., S22 (O-069)
Oubaya, N., S10 (O-030), S92 (P-182)
Ouchi, Y., S19 (O-057)
Oude Voshaar, R., S12 (O-037)
Oviedo Briones, M., S94 (P-191),
S192 (P-531)
Owczarek, A., S70 (P-107)

S262Özbek, H., S172 (P-461)
Ozdener, A., S126 (P-298)Özkaya, H., S66 (P-092)
Özsürekci, C., S114 (P-256), S131 (P-314)
Ozsurekci, C., S63 (P-084)
Oztop, M., S78 (P-136), S172 (P-460),
S173 (P-463)
Ozturk, G.B., S102 (P-219)
Ozturk, Z.A., S135 (P-327), S138 (P-339)
Pac, A., S67 (P-097)
Paccalin, M., S1 (O-001), S2 (O-004,
O-006), S33 (O-105), S34 (O-107,
O-108), S78 (P-137), S186 (P-508)
Packer, E.J.S., S179 (P-485)
Padeletti, L., S180 (P-488)
Pagkalinawan, M., S3 (O-007)
Paillaud, E., S5 (O-013), S10 (O-030),
S19 (O-059), S92 (P-182), S108 (P-236),
S127 (P-303), S188 (P-514),
S216 (P-615)
Paille, M., S3 (O-009)
Pais Ribeiro, J., S57 (P-064)
Paixão-Dias, V., S93 (P-186)
Paleń, J., S12 (O-036)
Palermo, M., S125 (P-294)
Palicio, C., S74 (P-120), S184 (P-501)
Paling, E., S235 (P-676)
Paltineanu, B., S166 (P-440), S172 (P-462),
S173 (P-465, P-466)
Pamoukdjian, F., S5 (O-013), S108 (P-236),
S127 (P-303)
Panagiotakos, D., S202 (P-564)
Panagoda, W.K., S103 (P-221)
Panarra, A., S122 (P-282), S127 (P-300,
P-301)
Pang, W.Y., S103 (P-221)
Panza, F., S17 (O-053), S40 (P-003)
Paoli, M., S51 (P-040)
Paolillo, C., S88 (P-171)
Paquay, L., S6 (O-018), S14 (O-042)
Paquot, N., S123 (P-287, P-288),
S126 (P-299)
Paracha, A., S34 (O-106), S227 (P-650),
S232 (P-669), S235 (P-677)
Parat, S., S147 (P-370), S215 (P-610)
Pardal, S., S159 (P-415)
Pardal-De la Mano, E., S149 (P-379)
Parekh, N., S39 (LB-004), S246 (LB-015)
Parent, T., S231 (P-667)
Park, J.Y., S185 (P-505)
Park, S., S42 (P-007), S226 (P-649)
Park, Y.-G., S54 (P-051), S61 (P-076),
S226 (P-649)
Park, Y.-H., S79 (P-139)
Parkinson, E., S85 (P-160)
Parlapiano, S., S26 (O-083), S28 (O-087,
O-090), S153 (P-394), S176 (P-476),
S243 (P-705)
Parnicka, A., S131 (P-315)
Parola, V., S26 (O-081), S57 (P-061, P-062),
S77 (P-133), S120 (P-276), S208 (P-588),
S211 (P-596), S220 (P-630)
Parrilo, E.F., S81 (P-146)
Partington, L., S145 (P-365), S154 (P-396),
S163 (P-428)

Author Index / European Geriatric Medicine 8S1 (2017) S249–S268

Pasquier, F., S7 (O-022), S54 (P-052)
Passadori, Y., S196 (P-545)
Pastor de Blas, M., S140 (P-345)
Patel, H.P., S104 (P-226)
Patel, R., S145 (P-366)
Patel, V., S228 (P-654)
Patry, C., S34 (O-107)
Patsch, M., S209 (P-591)
Paulmier, B., S47 (P-025)
Pautas, E., S90 (P-175)
Pavón, F.J.G., S184 (P-501)
Pawlaczyk, M., S75 (P-125)
Payette, H., S126 (P-297), S128 (P-304)
Payoux, P., S24 (O-075)
Pazan, F., S211 (P-597), S221 (P-632)
Pearson, G.M.E., S182 (P-494)
Pech, P., S80 (P-144)
Peck, G., S229 (P-660)
Pedersen, N., S18 (O-056)
Pedersen, P.U., S133 (P-320)
Pedlar, C., S117 (P-266)
Pedragosa, À., S188 (P-516)
Pedrazzoni, M., S100 (P-212)
Pedro, L., S57 (P-064)
Pedro, N., S186 (P-510)
Pedro Monfort, C., S121 (P-280)
Peetermans, W., S187 (P-512)
Peiffer, S., S152 (P-390)
Peltone, M., S11 (O-033)
Pena, C., S166 (P-440), S172 (P-462),
S173 (P-465, P-466)
Penco, I., S87 (P-166), S88 (P-169, P-170),
S90 (P-176)
Penes, O.N., S68 (P-101), S70 (P-106)
Peng, L.-N., S243 (LB-006)
Pennaforte, J.-L., S219 (P-626)
Pensart, L., S170 (P-454)
Perdomo Ramirez, B., S94 (P-191)
Pereira, S., S77 (P-133), S208 (P-588)
Pereira de Castro, N., S226 (P-647)
Pereira Sousa, J., S161 (P-420)
Pérez, L.M., S175 (P-470)
Perez, L.M., S9 (O-026), S13 (O-040)
Pérez-Rodríguez, R., S134 (P-323)
Pergeline, S., S133 (P-321)
Perkisas, S., S245 (LB-010)
Pernon, E., S237 (P-685)
Perrea, D., S207 (P-581)
Perreas, K., S207 (P-581)
Perret-Guillaume, C., S51 (P-042),
S137 (P-334), S192 (P-530)
Perticone, F., S87 (P-166), S88 (P-169,
P-170, P-171), S90 (P-176)
Perttila, N., S18 (O-054)
Pes, G., S123 (P-286), S125 (P-294),
S221 (P-634)
Pesce, A., S5 (O-015), S47 (P-025),
S60 (P-071), S193 (P-534)
Peschiera, S., S175 (P-471)
Pétéra, M., S113 (P-253)
Petermans, J., S10 (O-029), S101 (P-215),
S105 (P-228), S115 (P-257),
S123 (P-288), S126 (P-299),
S203 (P-569)
Peters, R., S108 (P-237)
Petit, C., S141 (P-350)

Petrovic, M., S101 (P-214)
Peyronnet, B., S242 (P-703)
Philippe, A.S., S26 (O-082)
Philp, I., S75 (P-125)
Phyu, C., S145 (P-363)
Picca, A., S38 (LB-001, LB-002),
S243 (LB-006)
Pickles, T., S103 (P-220)
Picot, M.-C., S3 (O-008), S80 (P-144)
Pierre, M., S161 (P-419)
Piers, R., S20 (O-060), S87 (P-167),
S95 (P-194)
Pietko Da Cunha, D., S205 (P-573)
Pietruszka, B., S113 (P-253)
Pilotto, A., S1 (O-001), S78 (P-137),
S83 (P-154), S85 (P-159), S186 (P-508)
Pimentel, J., S150 (P-384)
Pinganaud, G., S191 (P-526)
Pinheiro, J.P., S57 (P-064)
Pino, M., S45 (P-019), S51 (P-039),
S142 (P-352)
Pinquier, D., S35 (O-109)
Piot, J., S8 (O-024)
Piotrowicz, K., S67 (P-097), S99 (P-206),
S201 (P-561)
Piper, K.S., S109 (P-239)
Pisa, F.E., S212 (P-601), S236 (P-680)
Pitkälä, K., S105 (P-229), S122 (P-285),
S208 (P-587)
Pitkälä, K.H., S18 (O-054), S214 (P-608)
Pivot, C., S15 (O-045), S215 (P-610)
Plagnol, A., S18 (O-055), S62 (P-079)
Plaks, J.E., S204 (P-571)
Plokhova, E.V., S200 (P-557)
Plonquet, A., S188 (P-514)
Pociumban, M., S90 (P-175)
Poetsema, V.D., S245 (LB-012)
Poisson-Salomon, A.-S., S5 (O-016)
Pokrovskaya, M.S., S200 (P-557)
Polet, K., S47 (P-025), S60 (P-071)
Polidori, M.C., S1 (O-001), S78 (P-137),
S83 (P-154)
Politis, A., S58 (P-067)
Pomata, M., S85 (P-159)
Ponce-Leão, P., S94 (P-190)
Ponirakis, G., S25 (O-076)
Ponnambath, S., S91 (P-179), S145 (P-366),
S162 (P-424), S163 (P-427),
S215 (P-612)
Poon, M.H., S101 (P-213), S119 (P-272)
Popek, I., S73 (P-119), S136 (P-333)
Porasso, P., S5 (O-015)
Porras, M.I., S56 (P-059)
Porras, T., S56 (P-059)
Porrino, P., S88 (P-169)
Porta Gonzalez, L.A., S163 (P-425)
Porto, J., S176 (P-474), S180 (P-489)
Potier, A., S137 (P-334), S139 (P-341)
Potier, F., S21 (O-066)
Potpara, T., S184 (P-503)
Poulin, E., S236 (P-681)
Pouw, C.A.M., S218 (P-622), S220 (P-629)
Prada, A.G., S61 (P-078), S68 (P-101),
S70 (P-106), S177 (P-478)
Prada, G.I., S61 (P-078), S68 (P-101),
S70 (P-106), S177 (P-478)

Author Index / European Geriatric Medicine 8S1 (2017) S249–S268

Prader, R., S243 (P-704)
Pradhan, S., S141 (P-351)
Prashchayeu, K., S75 (P-124)
Pratesi, A., S26 (O-083), S28 (O-087,
O-090), S153 (P-394), S176 (P-476),
S243 (P-705)
Predavec, S., S73 (P-119), S136 (P-333)
Preskey, R., S145 (P-366)
Pressel, E., S152 (P-391)
Price, A., S34 (O-106), S227 (P-650),
S232 (P-669), S235 (P-677)
Priestner, L., S230 (P-663)
Priner, M., S34 (O-108)
Provenzano, S., S125 (P-295)
Prud’homme, J., S92 (P-183), S116 (P-261)
Prytek, B., S140 (P-347), S141 (P-348)
Puech, R., S214 (P-609)
Puerta, L., S213 (P-605)
Puerto del Antonio, M., S94 (P-189)
Puffet, E., S117 (P-266)
Puisieux, F., S54 (P-052), S66 (P-094),
S190 (P-524)
Pujos-Guillot, E., S113 (P-253),
S126 (P-297), S128 (P-304)
Pulcini, C., S192 (P-530)
Puntoni, M., S1 (O-001), S78 (P-137)
Pupo, S., S180 (P-488), S184 (P-503)
Puranen, T., S28 (O-088), S122 (P-285)
Purkis, A., S174 (P-467)
Puzianowska-Kuznicka, M., S127 (P-302),
S137 (P-335)
Pykhtina, V.S., S200 (P-557)
Qassemi, S., S217 (P-618)
Qin, L., S111 (P-246)
Qiu, C., S12 (O-035)
Queipo, R., S22 (O-069), S81 (P-145)
Quersin, V., S205 (P-574)
Quiles, M., S192 (P-531)
Quílez, R., S36 (O-114), S206 (P-579)
Quinn, S., S165 (P-436)
Quiñones Huayna, K.L., S23 (O-072)
Raat, H., S33 (O-103), S111 (P-246)
Rabilloud, M., S53 (P-050), S183 (P-497)
Rafanelli, M., S54 (P-053), S91 (P-178)
Raffaelli, C., S137 (P-336)
Raffort, N., S80 (P-144)
Raftery, J., S39 (LB-004)
Ragkou, A., S70 (P-109), S80 (P-141),
S182 (P-495), S187 (P-511)
Rahbek, K., S85 (P-161)
Rahman, M., S230 (P-663)
Rahman, P.A., S9 (O-028)
Rai, S., S144 (P-361)
Rainer, T., S96 (P-197)
Rainfray, M., S139 (P-343), S187 (P-513),
S215 (P-611)
Raivio, M., S18 (O-054)
Rajakunjaram, R., S229 (P-659)
Rajcoomar, N., S42 (P-009), S93 (P-187),
S105 (P-227)
Rajkumar, C., S39 (LB-004), S246 (LB-015)
Ramadan, M., S25 (O-076)
Rambaud, C., S15 (O-044), S37 (O-117),
S72 (P-113), S76 (P-127), S183 (P-498),

S189 (P-518), S229 (P-658),
S243 (P-704)
Rambaud, J., S3 (O-008)
Ramel, A., S27 (O-086), S91 (P-181),
S132 (P-318)
Ramirez Martin, R., S22 (O-069)
Ramírez Peñaherrera, J., S140 (P-345)
Ramírez-Fuentes, C., S169 (P-451)
Ramos, A.R., S93 (P-186)
Rananja, H., S13 (O-039)
Rashedi, V., S128 (P-306)
Ratiney, R., S214 (P-609)
Raux, M., S22 (O-068), S35 (O-111),
S154 (P-397), S224 (P-641, P-643),
S225 (P-644), S226 (P-648),
S232 (P-670), S233 (P-672)
Ray, P., S233 (P-673)
Razou, R., S46 (P-024)
Rebillard, Y., S17 (O-052)
Redondo González, O., S62 (P-081)
Reginster, J.-Y., S9 (O-027), S10 (O-029),
S96 (P-196), S101 (P-215), S103 (P-222),
S105 (P-228), S115 (P-257)
Rego Figueiredo, I., S185 (P-504)
Regueme, S., S103 (P-220)
Reichardt, L., S59 (P-068), S163 (P-426)
Reichardt, L.A., S162 (P-422)
Reig, L., S153 (P-393)
Reimers, M., S15 (O-046)
Reinold, J., S212 (P-601), S236 (P-680)
Reitter, D., S19 (O-059)
Rejdak, K., S58 (P-067)
Religa, D., S29 (O-091), S67 (P-096),
S244 (LB-009)
Rémy, E., S214 (P-609)
Renaud, I., S94 (P-190)
Renedo, J.A., S146 (P-368)
Rengo, G., S125 (P-295)
Renzi, F., S175 (P-471)
Resano, C., S48 (P-029)
Retornaz, F., S5 (O-013)
Retur, N., S189 (P-518)
Revnic, C.R., S166 (P-440), S172 (P-462),
S173 (P-465, P-466)
Revnic, F., S166 (P-440), S172 (P-462),
S173 (P-465, P-466)
Reyes, K., S3 (O-007)
Rezigue, H., S5 (O-016)
Rhebergen, D., S21 (O-064), S238 (P-690)
Ribas, N., S181 (P-491)
Ricciardi, F., S175 (P-471)
Riccio, D., S54 (P-053)
Ricevuti, G., S30 (O-094), S47 (P-027),
S86 (P-163), S88 (P-171), S112 (P-249)
Richard, E., S200 (P-558), S203 (P-568)
Richard, H., S63 (P-083), S214 (P-609)
Rickard, F., S91 (P-179), S145 (P-366),
S162 (P-424), S163 (P-427),
S215 (P-612)
Rico, A., S192 (P-531)
Rietjens, J., S33 (O-103)
Rietjens, J.A.C., S111 (P-246)
Rietkerk, W., S4 (O-012)
Rigaud, A.-S., S8 (O-024), S13 (O-039),
S45 (P-019), S51 (P-039), S56 (P-060)
Rigaud, A.S., S142 (P-352)

S263

Riley, J., S117 (P-266)
Rios German, P., S22 (O-069)
Riou, B., S22 (O-068), S35 (O-111),
S154 (P-397), S224 (P-641, P-643),
S225 (P-644), S226 (P-648),
S232 (P-670), S233 (P-672, P-673),
S234 (P-675)
Rioufol, C., S147 (P-370)
Ripamonti, C.I., S45 (P-020)
Riva, E., S198 (P-549)
Rivas, Z., S184 (P-501)
Rivas García, Z., S152 (P-389)
Rivasi, G., S49 (P-035), S54 (P-053),
S91 (P-178)
Rizzoli, R., S9 (O-027)
Rizzuto, D., S11 (O-033), S12 (O-035)
Robain, G., S240 (P-695), S242 (P-703)
Roberts, H., S175 (P-472), S209 (P-589)
Roberts, H.C., S104 (P-226), S174 (P-467)
Robles-Barrena, I., S65 (P-089)
Roca, F., S82 (P-149)
Rocamora-Pérez, P., S66 (P-095),
S174 (P-468)
Rocca, M., S83 (P-153)
Roch, B., S26 (O-082)
Rochaix, L., S142 (P-352)
Rockwood, K., S8 (O-025)
Rocquain, J., S214 (P-609)
Rodríguez, E., S99 (P-208)
Rodríguez-Mañas, L., S134 (P-323)
Rodriguez-Mañas, L., S103 (P-220)
Rogers, A., S174 (P-467), S209 (P-589)
Rogowski, O., S185 (P-507)
Roh, Y.-K., S54 (P-051), S61 (P-076)
Rohleder, N., S102 (P-217)
Rohn, C., S81 (P-147)
Rollod-Trad, F., S5 (O-013)
Rollone, M., S112 (P-249)
Rolph, G., S153 (P-395)
Romanelli, G., S222 (P-635)
Romskaug, R., S214 (P-608)
Ronconi, D., S69 (P-104)
Rondeau, V., S139 (P-343)
Ronﬂe, E., S20 (O-062)
Ronin, C., S183 (P-497)
Roodenburg, A.J.C., S125 (P-296)
Roqué, M., S169 (P-448)
Roqueta, C., S45 (P-021), S56 (P-058),
S74 (P-121), S86 (P-162), S181 (P-491),
S230 (P-661)
Rosano, C., S13 (O-040)
Rosenberg, A., S203 (P-568)
Rosholm, J.-U., S151 (P-386), S219 (P-628)
Rosholm, J.U., S217 (P-619)
Rossi, P.M., S40 (P-001)
Rosso, A.L., S13 (O-040)
Rostagno, C., S91 (P-178)
Rostoft, S., S23 (O-070)
Roubaud-Baudron, C., S34 (O-107),
S44 (P-014), S187 (P-513), S191 (P-526),
S215 (P-611)
Rouch, L., S217 (P-618)
Roussel, J.C., S3 (O-009)
Rowles, M., S34 (O-106), S227 (P-650),
S232 (P-669), S235 (P-677)
Rozier, L., S50 (P-037)

S264

Rubbieri, G., S51 (P-040)
Ruberto, C., S55 (P-056)
Rubin, S.M., S121 (P-281)
Rudel, B., S12 (O-036)
Ruff, N., S95 (P-193)
Ruggieri, M.P., S88 (P-171)
Ruiter, J.H., S237 (P-683, P-684)
Ruiz, S., S181 (P-491)
Runikhina, N., S47 (P-026), S195 (P-540),
S197 (P-547), S201 (P-559)
Ruotolo, G., S55 (P-056)
Ruths, S., S17 (O-051)
Rutkowski, D., S137 (P-335)
Ruxton, K., S1 (O-001), S78 (P-137)
Ruzafa, E., S169 (P-448)
Ryan, A., S245 (LB-013)
Ryan, C., S214 (P-607)
Rydwik, E., S53 (P-048)
Ryg, J., S10 (O-031), S151 (P-386)
Rygaert, X., S115 (P-257)
Ryu, E., S41 (P-004)
Ryznarova, I., S104 (P-224)
Saad, R., S91 (P-180)
Saavedra, O., S144 (P-362)
Sabet, D.N., S142 (P-353)
Sable-Morita, S., S109 (P-242)
Sacco, F., S184 (P-503)
Sacco, G., S15 (O-044), S37 (O-117),
S229 (P-658), S243 (P-704)
Sadauskaite, G., S239 (P-692)
Saddier, P., S188 (P-517)
Sadoul, N., S40 (P-001)
Saeedi, Z.A., S178 (P-481)
Saenz, P.R., S210 (P-593)
Sáez López, P., S79 (P-138), S86 (P-164),
S226 (P-647)
Saez Pomares, M., S119 (P-274)
Sağır, A., S181 (P-492)
Sagot, C., S52 (P-044)
Sahimi, S.N.M., S169 (P-450)
Şahin, S., S108 (P-238), S117 (P-265),
S138 (P-339), S162 (P-423),
S194 (P-536)
Şahutoğlu, S., S117 (P-265)
Saiki, T., S166 (P-438)Saint Jean, O., S46 (P-024)
Saiz, A.B., S52 (P-045)
Saja, D., S15 (O-044), S76 (P-127)
Sajko, D., S73 (P-119)
Saka, B., S135 (P-327), S138 (P-339)
Saka, F., S80 (P-143)
Sakura, H., S238 (P-689), S239 (P-693)
Salancı, B.V., S55 (P-055)
Salas, J., S175 (P-470)
Salatino, C., S31 (O-097)
Saldanha, M., S122 (P-282), S127 (P-300,
P-301)
Salido, L., S178 (P-482)
Salles, N., S44 (P-014), S140 (P-346),
S215 (P-611)
Salmon, E., S203 (P-569)
Salonoja, M., S39 (LB-005)
Saltvedt, I., S53 (P-046)
Šaltytė Benth, J., S17 (O-051)
Samaranayaka, A., S182 (P-494)

Author Index / European Geriatric Medicine 8S1 (2017) S249–S268

Sambuchi, M., S51 (P-041)
Sampaio, C., S94 (P-190)
Sampei, A., S4 (O-010), S110 (P-244),
S223 (P-639)
Samuelsson, O., S116 (P-263),
S213 (P-604), S216 (P-613)
Sancarlo, D., S17 (O-053), S40 (P-003),
S164 (P-430 ), S175 (P-471)
Sánchez, E., S99 (P-208), S109 (P-240)
Sanchez, E., S178 (P-482), S186 (P-509)
Sanchez, M., S15 (O-044), S37 (O-117),
S72 (P-113), S76 (P-127), S229 (P-658),
S243 (P-704)
Sanchez, M.-A., S138 (P-337)
Sanchez, S., S138 (P-337), S199 (P-554)
Sánchez Mingo, C., S140 (P-345)
Sánchez-Carpintero, A., S74 (P-121),
S181 (P-491), S230 (P-661)
Sánchez-Niubó, A., S202 (P-564)
Sánchez-Rodríguez, D., S169 (P-451)
Sandborgh Englund, G., S244 (LB-009)
Sander, R., S36 (O-114), S206 (P-579)
Sandin Wranker, L., S194 (P-537)
Sanjoaquín, A., S36 (O-114)
Sanjoaquín, A.C., S206 (P-579)
Santoni, F., S189 (P-520)
Santoro, A., S113 (P-253)
Santos, A., S159 (P-415), S235 (P-678)
Santos, E., S77 (P-133), S208 (P-588)
Santos, L., S186 (P-510)
Santos, M., S161 (P-420)
Santos-Eggimann, B., S38 (LB-003)
Santoso, A.M.M., S49 (P-033)
Sanz-González, N., S63 (P-085),
S64 (P-086, P-087, P-088), S70 (P-108),
S92 (P-184), S118 (P-269), S123 (P-289),
S150 (P-382)
Sarac, F., S108 (P-238), S126 (P-298),
S164 (P-431)
Sarfraz, S., S118 (P-268)
Sarin, P., S147 (P-371)
Sarraf, S., S79 (P-140)
Sartori, L., S242 (P-702)
Sati, L., S51 (P-040)
Sauer, J., S52 (P-045)
Saugbjerg Weng, H., S160 (P-417)
Savarieau, H., S7 (O-022)
Savas, S., S126 (P-298), S135 (P-327),
S164 (P-431)
Savikko, N., S18 (O-054)
Sayer, A., S209 (P-589)
Sayer, A.A., S9 (O-027), S104 (P-226),
S174 (P-467), S175 (P-472)
Sbai, M., S229 (P-660)
Scardia, A., S180 (P-488), S184 (P-503)
Schaap, L., S19 (O-058), S21 (O-064)
Schaap, L.A., S121 (P-281)
Schambach, C., S34 (O-107)
Schaufel, M.A., S179 (P-485)
Scheepmans, K., S6 (O-018), S14 (O-042)
Scheffer, A., S239 (P-691)
Scheper, J., S16 (O-047)
Schiff, R., S39 (LB-004), S246 (LB-015)
Schiﬁno, N., S112 (P-249)
Schindler, K., S128 (P-305)
Schink, T., S212 (P-601), S236 (P-680)

Schmidt, A.-S., S138 (P-338)
Schmitt, E., S170 (P-453)
Schneider, S., S103 (P-222)
Schnell, C., S196 (P-545)
Schoenenberger, A.W., S179 (P-485)
Schoevaerdts, D., S245 (LB-011)
Scholes, D., S22 (O-067)
Schollum, J.B.W., S182 (P-494)
Schols, J., S112 (P-248)
Schoon, Y., S147 (P-372), S149 (P-380),
S155 (P-399), S160 (P-416)
Schroyen, S., S43 (P-013)
Schulz, R.-J., S138 (P-338), S171 (P-456)
Schwartz, C., S203 (P-569)
Schwenk, M., S202 (P-566)
Sebbane, G., S127 (P-303)
Seematter-Bagnoud, L., S38 (LB-003)
Segaux, L., S59 (P-069)
Seget, J., S104 (P-224)
Segura-Luján, M.I., S66 (P-095)
Seibert, F.J., S201 (P-560)
Seiger, Å., S15 (O-046)
Sekeroz, S., S173 (P-463)
Selbaek, G., S17 (O-051), S58 (P-067)
Selbæk, G., S53 (P-046)
Selby, N., S65 (P-091)
Selton Sulty, C., S34 (O-107)
Sendín-Martín, V., S65 (P-089)
Seppala, L., S239 (P-691)
Serbentaite, I., S239 (P-692)
Serifhan, M., S238 (P-687)
Seripa, D., S17 (O-053), S41 (P-003)
Serrat, R., S181 (P-491)
Settembre, N., S40 (P-001), S207 (P-581)
Seurat, O., S231 (P-667)
Seux, M.-L., S13 (O-039)
Sezgin, G., S135 (P-327)
Sgrilli, F., S49 (P-035)
Shaﬁq, S., S95 (P-193)
Shah, H., S98 (P-204)
Shah, K., S117 (P-266)
Shah, P., S152 (P-388)
Shahpar, K., S119 (P-272)
Shahrokni, A., S79 (P-140)
Sharashkina, N., S47 (P-026), S195 (P-540),
S197 (P-547), S201 (P-559)
Sharashkina, N.V., S200 (P-557)
Sharif, A., S36 (O-112)
Sherlock, M., S140 (P-344)
Sherrington, K., S117 (P-266)
Shibasaki, K., S4 (O-010), S32 (O-102),
S110 (P-244), S223 (P-639)
Shibuya, A., S149 (P-378), S156 (P-404),
S157 (P-407)
Shimada, C., S50 (P-036), S95 (P-195)
Shin, H.S., S124 (P-290)
Shipway, D., S229 (P-660)
Shuaib, A., S25 (O-076)
Shueb, A., S42 (P-008)
Sieber, C., S9 (O-027), S102 (P-217)
Sieber, C.C., S128 (P-305)
Sierra-Martinez, I., S60 (P-074),
S70 (P-108), S118 (P-269)
Sierra-Martínez, L., S60 (P-074),
S63 (P-085), S64 (P-086, P-087, P-088),

Author Index / European Geriatric Medicine 8S1 (2017) S249–S268

S70 (P-108), S92 (P-184), S118 (P-269),
S123 (P-289), S150 (P-382)
Sifré, E., S44 (P-014)
Siggeirsdottir, K., S115 (P-258)
Sigurdarsdottir, S.H., S91 (P-181)
Sigurdsson, G., S115 (P-258)
Sigurþórsdóttir, I., S76 (P-128)
Silva, C., S180 (P-489)
Silveira Jr, S.A.D., S81 (P-146)
Silven, A.V., S228 (P-655), S233 (P-671)
Simão, A., S125 (P-293)Simões, M., S150 (P-384)
Simonato, M., S1 (O-001), S78 (P-137)
Simoni, D., S51 (P-040)
Simons, A., S228 (P-654), S235 (P-676)
Şimşek, H., S108 (P-238), S117 (P-265),
S162 (P-423)
Sinclair, A.J., S103 (P-220)
Sipilä, S., S105 (P-229)
Sir, Ö., S147 (P-372), S149 (P-380),
S155 (P-399), S160 (P-416)
Sirlin, X., S196 (P-545)
Sivapragasam, N.R., S11 (O-032)
Skaar, E., S179 (P-485)
Skalska, A., S67 (P-097), S99 (P-206),
S127 (P-302)
Skarsem Reitlo, L., S199 (P-556)
Skovlund, E., S23 (O-070), S214 (P-608)
Skuladottir, S.S., S115 (P-258)
Skvortsov, D.A., S200 (P-557)
Sladkeviciene, D., S212 (P-602)
Slaets, J.P.J., S4 (O-012)
Slankamenac, K., S153 (P-392)
Sliwczynski, A., S137 (P-335)
Slusarczyk, P., S170 (P-452)
Smalbrugge, M., S43 (P-011), S71 (P-110)
Smalbrugge, M.S., S218 (P-622),
S220 (P-629)
Smit, J., S30 (O-093)
Smit, R.A.J., S158 (P-409)
Smith, C., S38 (LB-003)
Smith, S., S139 (P-340)
Smith-Ravin, J., S183 (P-499)
Snowdon, C., S148 (P-375)
Sobieszczańska, M., S196 (P-542)
Socorro, A., S184 (P-501)
Socorro García, A., S152 (P-389)
Sogut, C., S164 (P-433)
Soini, H., S122 (P-285)
Soininen, H., S11 (O-033), S200 (P-558),
S203 (P-568)
Soiza, R.L., S112 (P-247)
Sola Mateos, A., S63 (P-082)
Solano, J.J., S104 (P-225), S144 (P-362)
Solinas, G., S189 (P-520)
Solmi, M., S16 (O-048)
Somme, D., S92 (P-183), S116 (P-261)
Somri, M., S183 (P-500)
Son, Y.W., S185 (P-505)
Søndergaard, J., S217 (P-619)
Sonneveld, P., S71 (P-110)
Soria Perdomo, F.J., S117 (P-264),
S140 (P-345)
Soriano, G., S129 (P-308)
Soriteau, L., S80 (P-144)
Sost, G., S34 (O-107)Šostar, Z., S73 (P-119), S136 (P-333)
Soto, L., S9 (O-026)
Soubeyran, P., S5 (O-013), S139 (P-343),
S180 (P-490)
Soulis, G., S202 (P-564), S240 (P-694)
Sousa, J., S158 (P-411)
Soussan, M., S108 (P-236)
Spagnoli, F., S222 (P-635)
Spanjers, K.R., S115 (P-259)
Spanu, M.A., S123 (P-286)
Spencer, C., S3 (O-007)
Spensley, K., S89 (P-173)
Spildooren, J., S170 (P-454)
Spitz, E., S51 (P-042)
Staus, V., S140 (P-347), S141 (P-348)
Steens, J., S228 (P-655), S233 (P-671)
Steingrimsdottir, L., S115 (P-258)
Steinmetz, J.-P., S207 (P-583), S208 (P-585)
Stek, M.L., S238 (P-690)
Stensvold, D., S32 (O-101), S199 (P-556)
Stevenson, J.M., S39 (LB-004),
S246 (LB-015)
Stevenson, K., S3 (O-007)
Stiers, L., S170 (P-454)
Stock, L., S195 (P-539)
Storlie, C.B., S9 (O-028)
Straand, J., S214 (P-608)
Strach, M., S99 (P-206)
Strain, W.D., S29 (O-092)
Strandberg, T., S11 (O-033), S18 (O-054),
S122 (P-285), S208 (P-587)
Strandberg, T.E., S108 (P-237)
Stratton, E., S163 (P-427)
Strazhesko, I.D., S200 (P-557)
Strehlau, A.G., S217 (P-619)
Streicher, M., S128 (P-305)
Strike, G., S174 (P-467)
Strotmeyer, E.S., S121 (P-281)
Stubbs, B., S16 (O-048)
Studenski, S., S13 (O-040)
Studzińska, D., S12 (O-036)
Stukas, R., S185 (P-506)
Su, Su, S241 (P-699)
Subhan, Z., S118 (P-270)
Suetta, C., S109 (P-239)
Sugiura, S., S109 (P-242)
Sui Seng, X., S96 (P-199)
Suikkanen, S., S105 (P-229)
Sulicka-Grodzicka, J., S99 (P-206)
Sümer, F., S63 (P-084), S98 (P-203),
S114 (P-256), S131 (P-314),
S181 (P-492)
Sumru Savas, E., S108 (P-238)
Sund, R., S14 (O-043)
Suominen, A.L., S210 (P-595)
Suominen, L., S209 (P-590)
Suominen, M., S28 (O-088), S122 (P-285)
Suominen, M.H., S39 (LB-005)
Suppiah, M., S120 (P-278)
Suwalska, A., S31 (O-097), S75 (P-125)
Sveinsson, S.H., S213 (P-604)
Sweeting, M., S105 (P-227)
Swiat, M., S70 (P-107)
Swietalsky, I., S140 (P-347), S141 (P-348)
Syrmos, N., S116 (P-260), S235 (P-679)
Szummer, K., S67 (P-096)

S265

Szybalska, A., S127 (P-302), S170 (P-452)
Tabélé, C., S220 (P-631)
Tagliaferri, S., S130 (P-310)
Tahir, S., S42 (P-009), S93 (P-187)
Taipale, H., S6 (O-017, O-019), S7 (O-021),
S14 (O-043), S222 (P-637)
Takahashi, A., S166 (P-438)
Takahashi, P.Y., S9 (O-028)
Takayama, M., S197 (P-548), S206 (P-577)
Talarska, D., S75 (P-125)
Tam, J., S91 (P-179)
Tamosiunaite, K., S171 (P-457)
Tamulaitiene, M., S132 (P-319),
S171 (P-457), S179 (P-486),
S185 (P-506), S212 (P-602),
S239 (P-692)
Tamulaityte-Morozoviene, I., S171 (P-457)
Tan, F.Y.H., S103 (P-221)
Tan, M., S34 (O-106), S227 (P-650),
S231 (P-664), S232 (P-669),
S235 (P-677)
Tan, X., S199 (P-556)
Tanderup, A., S151 (P-386)
Tang, N., S174 (P-469)
Tanikawa, T., S109 (P-242)
Tanskanen, A., S6 (O-017, O-019),
S7 (O-021), S14 (O-043), S222 (P-637)
Tanty, A., S219 (P-625)
Tapiainen, V., S6 (O-019)
Tapus, A., S31 (O-097)
Taraldsen, K., S53 (P-046), S202 (P-566)
Tariga, J.A., S196 (P-543)
Tarnawski, U., S209 (P-591)
Tasar, P.T., S194 (P-536)
Tasci, I., S135 (P-327), S138 (P-339)
Tasic, D., S69 (P-103)
Tasic, K., S69 (P-103)
Tavares, J., S53 (P-049), S77 (P-133),
S208 (P-588)
Taxis, K., S16 (O-047), S19 (O-058),
S21 (O-064)
Tay, T., S199 (P-553)
Taylor, J., S152 (P-388), S199 (P-553)
Teichert, M., S19 (O-058)
Teissier, T., S205 (P-574)
Tellem, R., S159 (P-414)
Temprado, J.-J., S198 (P-550)
Tenli, E., S117 (P-265)
Terpstra, L., S193 (P-532)
Terpstra, P., S193 (P-532)
Terrier-Lenglet, A., S214 (P-609)
Terzic, A., S209 (P-591)
Tesi, F., S54 (P-053)
Tesquet, N., S217 (P-618)
Tessier, D., S132 (P-317)
Tessier, F., S205 (P-574)
Tessier, S., S26 (O-082)
Tew, C.W., S11 (O-032)
Tezenas du Montcel, S., S8 (O-023)
Thabut, D., S156 (P-403)
Thébeau, A.-C., S132 (P-317)
Theotoka, D., S70 (P-109), S80 (P-141),
S182 (P-495), S187 (P-511)
Theou, O., S8 (O-025)
Thévenot, E., S126 (P-297), S128 (P-304)

S266

Thibodeau, S., S41 (P-004)
Thiel, E., S140 (P-346), S191 (P-526)
Thingstad, P., S53 (P-046)
Thivolet, C., S183 (P-497)
Thomas, C., S156 (P-403)
Thomas-Hermet, E., S59 (P-069)
Thommessen, B., S167 (P-443)
Thompson, S., S117 (P-266)
Thomson, A., S85 (P-160), S145 (P-365),
S154 (P-396), S163 (P-428)
Thomson, A.M., S119 (P-273)
Thönes, J., S138 (P-338)
Thorsdottir, I., S27 (O-086)
Thorsteinsdottir, T., S76 (P-128)
Throm, C., S221 (P-632)
Tibi, B., S243 (P-704)
Tichelaar, J., S245 (LB-012)
Ticinesi, A., S100 (P-212), S130 (P-310)
Tiihonen, J., S6 (O-017, O-019), S7 (O-021),
S14 (O-043), S222 (P-637)
Tiihonen, M., S7 (O-021), S209 (P-590)
Tilvis, R., S18 (O-054)
Timmons, S., S145 (P-364)
Timperley, J., S22 (O-067)
Timur, O., S194 (P-536)
Tkacheva, O., S47 (P-026), S195 (P-540),
S197 (P-546, P-547), S201 (P-559)
Tkacheva, O.N., S200 (P-557)
Tobella, L., S9 (O-026)
Tobis, S., S31 (O-097), S75 (P-125)
Todd, C., S202 (P-566)
Toh, P., S91 (P-179)
Tokuda, H., S109 (P-242)
Tolppanen, A.-M., S6 (O-017, O-019),
S7 (O-021), S14 (O-043), S222 (P-637)
Tolu, F., S125 (P-294)
Tomas, J.F., S32 (O-100), S48 (P-029),
S201 (P-562)
Tomasovic-Mrcela, N., S73 (P-119),
S136 (P-333)
Tomasson, G., S76 (P-128)
Tomek-Roksandic, S., S73 (P-119),
S136 (P-333)
Tommasino, C., S88 (P-171)
Tonetti, J., S231 (P-667)
Tong, A., S95 (P-193)
Tonon, E., S54 (P-053)
Topçu, Y., S80 (P-143)
Topcu, Y., S82 (P-148), S102 (P-219),
S114 (P-254)
Topinkova, E., S1 (O-001), S78 (P-137),
S104 (P-224)
Topolyanskaya, S.V., S130 (P-311, P-312)
Torbahn, G., S128 (P-305)
Torriglia, D., S85 (P-159)
Torrini, M., S89 (P-174)Tortù, V., S91 (P-178)
Torvinen-Kiiskinen, S., S222 (P-637)
Tosato, M., S243 (LB-006)
Tosun, P., S135 (P-327), S138 (P-339)
Touborg Lassen, A., S151 (P-386)
Toumi, A., S219 (P-626)
Toupance, S., S40 (P-001), S207 (P-581)
Tourais Martins, R., S136 (P-332)
Tourani, J.-M., S2 (O-006)
Tourette, C., S225 (P-644)

Author Index / European Geriatric Medicine 8S1 (2017) S249–S268

Tournier Louvel, S., S134 (P-325)
Tournigand, C., S19 (O-059)
Tournoij, I.P.B., S97 (P-202)
Toyoda, K., S179 (P-487)
Toyoshima, K., S4 (O-010), S110 (P-244),
S223 (P-639)
Trabucchi, M., S84 (P-158), S87 (P-166),
S88 (P-169, P-170, P-171), S90 (P-176)
Travers, E., S176 (P-473)
Traynor, B.J., S38 (LB-001)
Tricerri, F., S85 (P-159)
Triﬁro’, G., S47 (P-027)
Trimarco, B., S125 (P-295)
Trivalle, C., S5 (O-016)
Trochu, J.N., S3 (O-009)
Trottier, L., S132 (P-317)
Tsai, C.-H., S240 (P-696)
Tsam, L., S89 (P-173)
Tsang, C., S144 (P-361)
Tufan, A., S57 (P-063), S66 (P-092),
S82 (P-148), S105 (P-230),
S135 (P-327), S138 (P-339)
Tuomilehto, J., S11 (O-033)
Turpin, J.M., S15 (O-044), S76 (P-127),
S137 (P-336), S183 (P-498),
S229 (P-658)
Tuuliainen, E., S209 (P-590), S210 (P-595)
Twisk, J., S16 (O-047)
Tzanetakou, I., S207 (P-581)
Ubero, S., S45 (P-021), S86 (P-162)
Uchida, Y., S109 (P-242)
Udina, C., S13 (O-040), S169 (P-448)
Uematsu, A., S166 (P-438)
Ugut, B.O., S82 (P-150), S106 (P-232),
S168 (P-447), S171 (P-458)
Uittenbroek, J.R., S4 (O-012)
Ullal, Mallya Jagadish, S241 (P-699)
Ungar, A., S26 (O-083), S28 (O-087, O-090),
S49 (P-035), S54 (P-053), S91 (P-178),
S153 (P-394), S176 (P-476),
S243 (P-705)
Urano, T., S4 (O-010), S110 (P-244),
S223 (P-639)
Urbano, M., S17 (O-053), S40 (P-003)
Ursin, M.H., S167 (P-443)
Urtamo, A., S208 (P-587)
Uyar, M., S108 (P-238)
Vakulenko, O.N., S130 (P-311, P-312)
Valance, A., S139 (P-341)
Valdés Aragonés, M., S134 (P-323)
Valero, M., S53 (P-050), S179 (P-484)
Valéro, S., S2 (O-004, O-006)
Vallet, H., S22 (O-068), S24 (O-074),
S35 (O-111), S152 (P-390),
S154 (P-397), S156 (P-403),
S217 (P-621), S224 (P-641, P-643),
S226 (P-648), S232 (P-668, P-670),
S233 (P-672, P-673), S234 (P-675)
Valve, R., S39 (LB-005)
Valverde-Moyar, M.V., S94 (P-189)
van Agtmael, M.A., S245 (LB-012)
van Ancum, J., S202 (P-566)
van Beeck, E., S33 (O-103)
van Berkel, J., S71 (P-110)

Van Campen, J., S19 (O-058), S21 (O-064)
van Campen, J., S245 (LB-012)
van de Groep, B., S200 (P-558)
Van de Wardt, V., S212 (P-600)
van den Brink, A., S12 (O-037)
van den Hanenberg, F., S245 (LB-012)
Van Den Noortgate, N., S87 (P-167),
S95 (P-194), S101 (P-214)
van der Cammen, T., S246 (LB-015)
van der Heide, A., S33 (O-103)
van der Linden, C., S80 (P-142)
van der Linden, C.M.J., S97 (P-202)
van der Mast, R.C., S238 (P-690)
Van Der Meer, H., S16 (O-047),
S19 (O-058), S21 (O-064)
van der Roest, H., S30 (O-093)
van der Schaaf, M., S59 (P-068),
S162 (P-422), S163 (P-426)
van der Veer, S., S199 (P-553)
van der Velde, N., S238 (P-690),
S239 (P-691)
van Deudekom, F.J., S147 (P-373)
van Doorn-van Atten, M.N., S206 (P-580)
van Eenoo, L., S30 (O-093)
Van Eslande, L., S137 (P-336)
Van Gansbeke, H., S6 (O-018)
van Gool, W.A., S200 (P-558)
van Grieken, A., S33 (O-103), S111 (P-246)
van Heuvelen, M.J.G., S55 (P-054)
van Hout, H., S30 (O-093)
Van Humbeeck, L., S87 (P-167)
van Lenthe, F., S58 (P-066)
van Lier, L., S30 (O-093)
van Marum, R.J., S218 (P-622),
S220 (P-629)
van Middelaar, T., S200 (P-558),
S203 (P-568)
van Mieghem, N., S23 (O-071)
van Seben, R., S59 (P-068), S162 (P-422),
S163 (P-426)
van Spijker, G.J., S49 (P-033)
van Wanrooij, L., S200 (P-558)
Vanacore, N., S58 (P-067)
Vanbrabant, K., S6 (O-018)
Vandennoortgate, N., S20 (O-060)
Vaquerizo, B., S74 (P-121), S181 (P-491),
S230 (P-661)
Vaquero Pinto, M.N., S225 (P-645)
Varan, H.D., S97 (P-201), S98 (P-203),
S113 (P-251), S181 (P-492),
S195 (P-541), S196 (P-544)
Varin, R., S214 (P-609)
Varli, M., S135 (P-327), S138 (P-339)
Vasilakis, N., S144 (P-361), S148 (P-374)
Vasiloglou, M., S207 (P-581)
Vaz, R., S159 (P-415)
Vaz Marques, P., S30 (O-095), S150 (P-383)
Vázquez, O., S45 (P-021), S56 (P-058),
S74 (P-121), S86 (P-162), S181 (P-491),
S230 (P-661)
Veenhuizen, R., S52 (P-043)
Vega-Ramírez, F.A., S66 (P-095),
S174 (P-468)
Veiga Nunes, L., S53 (P-049)
Velasco, R., S72 (P-114), S81 (P-145),
S167 (P-442)

Author Index / European Geriatric Medicine 8S1 (2017) S249–S268

Velasco Guzman de Lazaro, R., S22 (O-069)
Veldwijk-Rouwenhorst, A.E., S43 (P-011)
Vella, A., S95 (P-192), S124 (P-291)
Vella-Azzopardi, R., S101 (P-214)
Vellani, C., S47 (P-027)
Vellas, B., S7 (O-022), S9 (O-027),
S24 (O-075), S48 (P-031), S113 (P-252),
S129 (P-308)
Vello, N., S85 (P-159)
Venturini, L., S30 (O-094), S47 (P-027),
S86 (P-163), S112 (P-249)
Venturini, S., S89 (P-174)
Verdejo, J.C., S56 (P-059)
Verdejo-Bravo, C., S94 (P-189)
Vereijken, B., S202 (P-566)
Verghese, J., S13 (O-040)
Verhaegen, J., S187 (P-512)
Verho, J., S28 (O-088)
Verhulst, S., S40 (P-001)
Vérin, E., S82 (P-149)
Veríssimo, M., S143 (P-358), S176 (P-474)
Veríssimo, M.T., S125 (P-293),
S150 (P-384), S180 (P-489)
Veríssimo, R., S93 (P-186)
Veríssimo, T., S186 (P-510)
Verlaan, S., S112 (P-248)
Vermeiren, S., S101 (P-214)
Verny, M., S16 (O-050), S22 (O-068),
S24 (O-074), S35 (O-111), S52 (P-044),
S152 (P-390), S154 (P-397),
S156 (P-403), S182 (P-496),
S217 (P-621), S224 (P-641),
S225 (P-644), S233 (P-672, P-673),
S234 (P-675)
Veronese, N., S83 (P-154), S242 (P-702)
Veronique-Baudin, J., S183 (P-499)
Verreckt, E., S245 (LB-011)
Verschuur, E., S52 (P-043)
Vicarelli, L., S51 (P-040)
Vidal, J.-S., S13 (O-039)
Videau, M.-N., S191 (P-526)
Vieira Alves, R., S185 (P-504)
Vigara, M., S229 (P-657)
Vigara Garcia, M., S76 (P-129)
Viglino, G., S142 (P-353)
Vignoles, A., S44 (P-016), S147 (P-370),
S183 (P-497)
Viken, H., S32 (O-101), S199 (P-556)
Vilches-Moraga, A., S31 (O-096),
S34 (O-106), S135 (P-328),
S227 (P-650), S231 (P-664),
S232 (P-669), S235 (P-677)
Villain, C., S35 (O-111), S217 (P-621)
Villalba-Lancho, E., S149 (P-379)
Villani, P., S21 (O-065), S74 (P-122),
S198 (P-550), S220 (P-631)
Viloria, A., S229 (P-657)
Vincent, C., S47 (P-025)
Vinding, K.L., S10 (O-031)
Vintrou, M., S198 (P-550)
Visser, D., S167 (P-444)
Visser, M., S121 (P-281), S122 (P-284),
S129 (P-307)
Vogel, T., S170 (P-453)
Voinea, S., S166 (P-440), S172 (P-462),
S173 (P-465, P-466)

Volkert, D., S128 (P-305)
Volpato, S., S96 (P-198)
von Euler, M., S29 (O-091)
von Heideken Wågert, P., S167 (P-441)
von Koch, L., S29 (O-091)
von Renteln-Kruse, W., S32 (O-099),
S58 (P-066), S81 (P-147)
Vororbjova, N., S197 (P-546)
Voukelatou, P., S70 (P-109), S80 (P-141),
S182 (P-495), S187 (P-511)
Vreeswijk, R., S87 (P-168), S142 (P-354)
Vrettos, I., S70 (P-109), S80 (P-141),
S182 (P-495), S187 (P-511)
Vygodin, V.A., S200 (P-557)
Wagstaff, J., S65 (P-091)
Waites, M., S231 (P-666)
Wajda, J., S70 (P-107)
Wakui, T., S95 (P-195)
Walgers, J.J., S237 (P-683, P-684)
Walicka, M., S137 (P-335)
Walker, D., S151 (P-387)
Walker, R.J., S182 (P-494)
Wallace, M., S112 (P-248)
Wan, M.Q., S68 (P-102)
Wang, P.-N., S55 (P-057)
Wang, R., S12 (O-035)
Ware, C., S56 (P-060)
Wargny, M., S13 (O-038)
Watanabe, A., S189 (P-521)
Watelet, S., S44 (P-016)
Watson, A., S230 (P-663)
Wattel, E.M., S167 (P-444)
Watters, H., S227 (P-652)
Watts, P., S3 (O-007)
Weber, J., S123 (P-287, P-288),
S126 (P-299)
Weekes, E., S132 (P-318)
Wehling, M., S211 (P-597), S221 (P-632)
Weiss, C., S221 (P-632)
Wejse, M.R., S152 (P-391)
Welkie, B., S41 (P-004)
Welmer, A.-K., S12 (O-035)
Welsh, S., S71 (P-112)
Welsh, T.J., S65 (P-090), S144 (P-360),
S212 (P-600), S223 (P-638)
Weninger, M., S140 (P-347), S141 (P-348)
Wentworth, L., S165 (P-434, P-435)
Westendorp, R., S37 (O-116)
Wheeler, S., S117 (P-266)
Wieczorowska-Tobis, K., S127 (P-302)
Wijnhoven, H., S122 (P-284)
Wijsman, L., S37 (O-116)
Wildblood, B.A.S., S223 (P-638)
Wilkinson, P., S65 (P-091)
Wilks, O., S89 (P-173)
Williams, J., S165 (P-434, P-435)
Williams, J.C., S139 (P-342)
Williams, J.W.E., S139 (P-342)
Williams, M.E., S139 (P-342)
Winblad, B., S67 (P-096)
Wind, P., S127 (P-303)
Windsor, J., S148 (P-374)
Wisløff, U., S32 (O-101), S199 (P-556)
Wizner, B., S131 (P-315)
Wójkowska-Mach, J., S131 (P-315)

S267

Wojkowska-Mach, J., S68 (P-100)
Wojnarowska, M., S12 (O-036)
Wojszel, Z.B., S216 (P-617)
Wojzischke, J., S171 (P-455)
Wolak-Thierry, A., S102 (P-218)
Won, C.W., S106 (P-231), S114 (P-255)
Wong, C.H., S11 (O-032)
Wong, L.L.B., S45 (P-018)
Wood, I., S194 (P-535)
Wouters, H., S16 (O-047), S19 (O-058),
S21 (O-064)
Wozniak, S., S224 (P-642)
Wright, J., S91 (P-180)
Wright, S., S50 (P-037)
Wu, Y.-H., S56 (P-060)
Würzl, D., S140 (P-347), S141 (P-348)
Wyller, T.B., S23 (O-070), S214 (P-608)
Wynia, K., S4 (O-012)
Xérès, S., S135 (P-329)
Xu, W., S18 (O-056)
Yactayo, S., S188 (P-515)
Yağcı, N., S78 (P-135, P-136), S172 (P-459)
Yagci, N., S172 (P-460), S173 (P-463)
Yakabe, M., S4 (O-010), S110 (P-244),
S223 (P-639)
Yamada, S., S32 (O-102)
Yamada, Y., S100 (P-210)
Yamaguchi, Y., S4 (O-010), S110 (P-244),
S223 (P-639)
Yamamoto, H., S77 (P-132)
Yamamoto, M., S110 (P-245)
Yamanaka, G., S238 (P-689), S239 (P-693)
Yang, Y.-Y., S25 (O-077)
Yared, P., S207 (P-581)
Yarlequé, S.N., S247 (LB-016)
Yau, S.S.W., S237 (P-686)
Yavuz, B., S181 (P-492)
Yavuz, B.B., S55 (P-055), S63 (P-084),
S98 (P-203), S114 (P-256), S131 (P-314),
S181 (P-492)
Yavuzer, H., S110 (P-243), S138 (P-339)
Yavuzer, S., S110 (P-243)
Yeong, K., S24 (O-073), S227 (P-652)
Yeung, J., S228 (P-654)
Yiap, Pok Ling, S241 (P-699)
Yıldırım, F., S194 (P-536)
Yilmaz, A., S172 (P-459)
Yilmaz, O., S2 (O-005), S44 (P-015),
S80 (P-143), S82 (P-148), S84 (P-156),
S102 (P-219), S114 (P-254)
Yılmaz, Ü.D., S198 (P-552), S206 (P-578),
S225 (P-646)
Yip, K., S31 (O-096), S135 (P-328)
Yonenaga, A., S4 (O-010), S110 (P-244),
S223 (P-639)
Yong, A.L.T., S119 (P-273)
Yoong, D.Y., S143 (P-356)
Yoshioka, Y., S4 (O-010), S110 (P-244),
S223 (P-639)
Yu, Lee Hoon, S241 (P-699)
Yuruyen, M., S110 (P-243)
Zacchi, A., S202 (P-566)

S268

Zambon, A., S87 (P-166), S88 (P-170),
S90 (P-176)
Zambon Ferraresi, F., S63 (P-082),
S146 (P-368)
Zamﬁrescu, A., S99 (P-207)
Zandi, M., S168 (P-445)
Zank, S., S171 (P-456)
Zarrouk, A., S48 (P-030)
Zasadzka, E., S75 (P-125)
Zech, A., S81 (P-147)
Zekry, D., S132 (P-316)

Author Index / European Geriatric Medicine 8S1 (2017) S249–S268

Zelek, L., S108 (P-236), S127 (P-303)
Zerah, L., S16 (O-050), S24 (O-074),
S35 (O-111), S152 (P-390), S154 (P-397),
S156 (P-403), S182 (P-496),
S217 (P-621), S224 (P-641, P-643),
S225 (P-644), S226 (P-648),
S232 (P-668), S234 (P-675)
Zerhouni, N., S216 (P-616)
Zhang, W., S202 (P-566)
Zheng, H., S41 (P-005)
Zhu, A., S41 (P-005)

Zilinskiene, R., S121 (P-279)
Zintchouk, D., S2 (O-003)
Zirabe, V., S137 (P-334)
Zirk-Sadowski, J., S29 (O-092)
Zirnhelt, J., S34 (O-107)
Zisko, N., S32 (O-101)
Zubillaga, A.C., S63 (P-082)
Zuidema, S., S16 (O-047), S17 (O-051)
Zuidema, S.U., S4 (O-012), S43 (P-011)
Zupanic, E., S29 (O-091)
Zwijnenburg, D., S142 (P-354)