European Geriatric Medicine - Supplement 1 - Volume 6

European Geriatric Medicine 6S1 (2015) S5–S31

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Oral presentations

Frailty and sarcopenia

O-001

Low serum creatinine levels in orthogeriatric patients and

its consequences on kidney function assessment, with relation

to possible benefits of utilizing cystatin C levels

A. Giordano

, I. Iacomelli

, A. Ungar

, A.T. Roberts

, N. Marchionni

J. Romani

Division of Geriatric Cardiology and Medicine

–

AOU Careggi, Firenze,

Italy;

Azienda Ospedaliero Universitaria Careggi, Florence, Italy;

AOU Careggi, Firenze, Italy;

Geriatric Cardiology and Medicine,

Careggi University Hospital, Florence, Florence, Italy

Introduction:

Aim of this study was to evaluate the performance

of formulas for estimation of glomerular filtration rate (GFR) –

as recommended by international guidelines – for a specific

population such as Orthogeriatrics.

Methods:

Test subjects: 571 patients of the “Traumatology and

General Orthopedics Department”, aged over 65 years with bone

fractures requiring surgical treatment.

This observational study utilized levels of creatinine and CysC

at entry and, where available, post operation. It then estimated

GFR with formulas: MDRD, CKD-EPIcreatinine, CKD-EPICysC, CKD-

EPIcreatinine-CysC, BIS-1 and BIS-2.

Results:

During hospitalization the creatinine levels diminished

from 0.97 to 0.78mg/dL (p

0.001), while CysC levels were stable

(p=ns). This happened especially in hip fracture cases (Fig.1). The

GFR calculated with formulas based on creatinine, obviously and

paradoxically, became higher as time progressed (p

0.001). The

GFR calculated with the CKD-EPICysC formula, however, remained

stable. The prevalence of chronic kidney disease changed with the

used formula: 17% with MDRD or CKD-EPIcreatinine vs 50–80%

with CKD-EPIcysC.

Population:

Average age 82.7

8.2 years; 76.7% female. Average cre-

atinine level 0.93

0.53mg/dL. Average CysC level 1.48

0.61mg/L.

74.6% hip fractures. 73% serum creatinine

1mg/dL.

Conclusions:

A high percentage of senior orthopedic patients has

low creatinine levels, which results in a significant overestimation

of the GFR when using formulas based on creatinine. In these cases

CysC is possibly a useful alternative.

O-002

Dietary animal-derived protein intake and frailty: a prospective

study in community-dweller older subjects (FRAIL Project)

A. Cella

, C. Musacchio

, E. Tavella

, R. Custureri

, A. Delrio

A.M. Mello

, C. Prete

, N. Vello

, E. Zigoura

, E. Palummeri

M. Puntoni

, S. Poli

, A. Pilotto

Galliera Hospital, Genoa, Italy;

E.O. Ospedali Galliera, Genoa,

Italy;

DISFOR

–

University of Genoa, Genoa, Italy;

Department

of OrthoGeriatrics, Rehabilitation and Stabilization, Frailty Clinic.

Ospedali Galliera, Genoa, Italy

Objectives:

It is generally accepted that malnutrition is involved

in pathophysiology of frailty. Relationship between dietary animal-

derived protein (DAP) intake and prevalence of frailty in humans

is still unclear. Using data from the FRAIL Project, a prospective

population-based observational study, we aimed at evaluating if

DAP consumption is associated with frailty in community-dwelling

adults aged 65 years and older.

Methods:

Frailty was assessed according to the Cardiovascular

Health Study (CHS) model and the FRAIL Scale. All subjects

underwent a comprehensive geriatric assessment and physical

performance tests (SPPB, Timed Up&Go Test). The DAP intake was

evaluated using specific items of the Mini Nutritional Assessment.

Results:

Among the 315 participants enrolled (mean age 78

4.5

years; 53% men) 196 claimed to eat DAP every day. These subjects

were not different in mean age, BMI and physical performance

from those with lower DAP intake. Prevalences of frailty were

11.7% and 10.8% by using CHS and FRAIL methods, respectively. A

significant negative association between DAP daily intake and frailty

has been observed both with CHS and FRAIL scale (p = 0.02 and

p = 0.002, Fisher’s exact test). Logistic regression analysis confirmed

this association both with FRAIL scale (OR = 0.38, 95% CI 0.20–

0.74, p = 0.004, adjustment for age, sex, comorbidity, polypharmacy,

Barthel index, SPPB) and with CHS score (OR = 0.62, 95% CI 0.36–

1.04, p = 0.075, adjustment for age, sex, comorbidity, Barthel index

and Timed Up&Go Test).

Conclusions:

DAP daily intake is associated with a lower prevalence

of frailty in community-dwellers older subjects, suggesting that a

dietary intervention could be useful to prevent or delay frailty.

O-003

Recommendations for non-pharmacological interventions to

prevent falls in older patients. Applying the GRADE approach.

The SENATOR project ONTOP series

A. Cherubini

, I. Abraha

, J. Rimland

, F. Trotta

, G. Dell’Aquila

V. Pierini

, R. Soiza

, A.J. Cruz-Jentoft

, D. O’Mahony

IRCCS INRCA, Italy;

Geriatrics and Geriatric Emergency Care, Italian

National Research Center on Aging (IRCCS-INRCA), Ancona, Italy;

NHS Grampian, Aberdeen, United Kingdom;

Hospital Universitario,

Ramon y Cajal, Madrid, Spain;

Department of Medicine, University

College Cork, Dublin, Ireland

Objectives:

To develop explicit and transparent recommendations

for non-pharmacological interventions to prevent falls in older

adults based on the Grading of Recommendations, Assessment,

Development and Evaluation (GRADE) approach to rating the

quality of evidence and the strength of recommendations.

Methods:

A multidisciplinary panel was constituted comprising

geriatricians, nurses and a clinical epidemiologist. The evidence

was compiled from a systematic search of reviews published from

2009 to January 2015. A Delphi method was used to establish

critical and important outcomes. The GRADE approach was used to

rate the evidence and to formulate recommendations.

Results:

The critical outcomes were fall incidence. The

non-pharmacological interventions were categorized as single

component, multiple and multifactorial interventions according

to the PROFANE taxonomy. An overview of systematic reviews

identified 59 systematic reviews in 3 settings: community (n = 120