European Geriatric Medicine - Supplement 1 - Volume 6 - September 2015

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S104 Poster presentations / European Geriatric Medicine 6S1 (2015) S32–S156
P-270
Influence of vitamin D deficiency in the functional recovery
in patients with hip fracture of a functional recovery unit
I. Artaza1, R. Valera1, O. San Juan1, N. Fernandez1, V. Malafarina2
1Igurco Servicios Sociosanitarios, Erandio-Bizkaia, Spain; 2Clinica Los
Manzanos, Lardero, Spain
Objective: To determine the influence of vitamin D deficit in
functional recovery in patients admitted to a unit of functional
recovery with hip fracture.
Methods: Prospective observational study of a cohort of patients
with hip fracture admitted from April 1, 2014 to 31 March 2015.
We analyze Socio-demographic data, functional status on admission
and at discharge in the unity and levels of 25 (OH) vitamin D on
admission.
Results: 59 patients (74.5% women) were admitted in our unit.
The 78% of patients had vitamin D levels <20 ng/dl and the 30.5%
<10 ng/dl. We divide the sample in 3 groups according to the level of
Vit D. A: patients with <10 ng/dl: 18, mean of age 84.6 years, length
of stay 33.2 days, Barthel admission 40.8 and 62.7 at discharge
(Heineman I.: 32.61), FAC admission 0.9 and 2.4 to discharge.
B: patients with Vit D 10 to 20 ng/dl: 28, age 82. 7 years, stay 30.4
days, Barthel 49.2 admission and 71.2 at discharge (Heineman I.:
54.42), FAC admission 1.3 and 3.1 at discharge. C: patients with
Vit D normal: 13, age 81.4 y., stay 22.7 days, Barthel admission 56.9
and 82.2 at discharge (Heineman I.: 64.06) and FAC 2.2 and 4.1 to
discharge.
Conclusions: Vitamin D deficiency is extremely prevalent among
the studied population.
In our study patients with low levels of vitamin D have more years
and more dependence levels at admission in the unit and obtain
lower functional recovery at discharge in more days of stay.
P-271
Effectiveness of an “osteopathic manipulative therapy” for
chronic low back pain in elderly: preliminary report
N. Yagci1 , U. Bas Aslan1, M. Pekesen Kurtca1
1Pamukkale University, Denizli, Turkey
Objectives: Advancing age is associated with less positive treatment
outcomes in patients with chronic low back pain (CLBP). The aim
of this preliminary study was to evaluate the effectiveness of
soft tissue mobilization treatment as an osteopathic manipulative
therapy approach in elderly patients with CLBP.
Methods: Twenty patients, aged 64 to 80 years (mean age:
70.54±5.63) with CLBP participated in this study. 58.3% (n = 14)
of the sample were female. Mean duration of low back pain
was 24.95±2.17 months. Patients received soft tissue mobilization
program, three times a week for 3 weeks. Soft tissue mobilization
program included different soft tissue mobilization techniques
such as functional massage, myofascial release, friction massage,
muscle energy techniques, neuromuscular stretching. The soft
tissue mobilization techniques are selected according to physical
examination findings of patients. Pain (Visual Analog Scale) and
disability (Roland Morris Questionnaire) assessed at pre- and post-
treatment time points.
Results: In the pre-treatment period, mean Visual Analog Scale
(VAS) and Rolland Morris (RM) scores were 7.08±2.28 (95% CI 6.12
to 8.08) and 15.70±5.87 (95% CI 13.22 to 18.18) respectively. In the
post-treatment period, mean VAS and RM scores were 2.09±1.28
(95% CI 1.55 to 2.63) and 7.37±5.82 (95% CI 4.91 to 9.83) respectively.
The reduction from the baseline scores were significantly different
for both pain and disability (p< 0.05).
Conclusions: The results of our study suggest that soft tissue
mobilization treatment has positive effect on pain and disability
in elderly patients with CLBP. The study did not have any financial
support.
P-272
Falls, gait and dual-tasking in older adults with mild cognitive
impairment: A cross-sectional study
V. Booth1 , P. Logan1, T. Masud 2, V. Hood2, V. Van Der Wardt1,
R. Taylor3, R. Harwood3
1University of Nottingham, Nottingham, United Kingdom; 2United
Kingdom; 3Nottingham University Hospitals NHS Trust, Nottingham,
United Kingdom
Objectives: Cognitive impairment has an effect on gait and falls
rates. Gait speed and step variability, particularly in a dual-task
paradigm, are considered quantifiable measures to evaluate the role
of cognition on gait. The aim was to investigate the relationship
between falls risk and gait measures in single and dual-task
conditions in older adults with mild cognitive impairment (MCI).
Methods: Falls risk [Physiological Profile Assessment (PPA);
previous 6 months fall history] and global cognition (MOCA) were
measured in a cross-sectional study of older adults with MCI (MOCA
15–25) recruited from memory and falls services (Balance and the
Mind study). Spatiotemporal gait parameters using the GAITRite
system were recorded under single task and 2 dual task conditions.
Dual-task cost was calculated for gait speed and variability.
Results: The 69 participants (mean age=80.75 years;38 women)
with MCI had an increased risk of falls (median falls in previous 6
months=1.5; mean PPA falls risk score=2.48) and poor gait pattern
(Table 1). DTC was identified during both cognitive tasks, with
verbal-fluency producing the greatest cost to gait speed (−26.99%)
and variability (step-time 53.29%, step-length 35.27%). A statistically
significant relationship between gait parameters (speed, step-time
variability and step-length variability), falls risk (p < 0.05) and global
cognition (p< 0.05) is evident.
Conclusions: Negative changes to gait pattern are evident and are
associated with an increased risk of falls and global cognition in
older adults with MCI. A DTC exceeding levels for healthy older
adults is present suggesting a benefit of such measures in falls
intervention research with this population.
P-273
Body mass index, nutrition and rehabilitation outcome in
elderly patients with cognitive impairment
I. Cardoso1 , L. Poynter1, J. Kwan2, J. Sharma 3, S. Allen1, M. Vassallo 1
1The Royal Bournemouth Hospital, Bournemouth, United Kingdom;
2University of Hong Kong, Hong Kong, Hong Kong; 3 United
Lincolnshire Hospital NHS Trust, Lincoln, United Kingdom
Background: Cognitive impairment is known to adversely affect
rehabilitation but the role of poor nutrition in the rehabilitation of
such patients needs exploring.
Methods: In a UK-based prospective cohort study in a general
rehabilitation unit for elderly patients we explored rehabilitation
outcomes in 115 patients (mean age 84.7, 70 females). We used
BMI and MUST as surrogate markers of poor nutrition. All patients
were included in an individually tailored programme comprising
one-to-one attention and group sessions. The Barthel Index (BI)
was performed on admission and discharge. Patients also had BMI,
MUST, Mini Mental State Examination (MMSE), and Carlson Co-
morbidity Index recorded.
Results: Improvement on the BI was significantly associated with
cognition (P = 0.018), BMI (P = 0.003), MUST (P = 0.001) and length
of stay (P = 0.006). Logistic regression identified MUST (P = 0.039,
CI 0.37–0.97) and in a separate analyisis, BMI (P = 0.027, CI
0.04–0.15) as independent variables that influenced rehabilitation
outcome. Patients with cognitive impairment and a high MUST or
BMI <20 kg/m2 were significantly less likely to show improvement
in BI with rehabilitation when compared to cognitively impaired
patients with low MUST or BMI ≥20 kg/m2. Cox Regression
showed the former group of patients had a slower trajectory of
improvement.