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Oral presentations / European Geriatric Medicine 6S1 (2015) S5
–
S31
trials), care facilities(n = 17 studies), hospital (acute, sub-acute
and rehabilitation) (n = 15 trials). We developed clinical questions
for each intervention and each setting. Strong recommendations
(n = 4) were formulated, based on moderate quality evidence,
for exercise (group, home-based, Tai Chi), and home safety
modification and provision of personal mobility aids, to prevent
falls in community-dwelling older adults. Moreover, moderate
quality of evidence allowed to strongly recommend multifactorial
interventions (n = 3) in all 3 settings. One clinical question,
regarding knowledge/education,with moderate quality evidence,
had a strong recommendation against. Twenty-two clinical
questions had low/very low quality of evidence and weak
recommendations for (n = 4) and against (n = 18).
Conclusions:
Overall, the panel developed 29 recommendations for
the delivery of non-pharmacological interventions to prevent falls
in older adults in 3 different settings.
O-004
Impact of blood pressure lowering treatment on frailty in
the HYpertension in the Very Elderly Trial (HYVET)
N. Beckett
1
, J. Warwick
2
, K. Rockwood
3
, A. Mitnitski
3
, L. Thijs
4
,
C. Bulpitt
2
, P. Ruth
2
1
Guys and St Thomas’ NHS Foundation Trust, London, England;
2
Imperial College London, London, England;
3
Dalhousie University,
Halifax, Canada;
4
University of Leuven, Leuven, Belgium
Objective:
Treating hypertension with antihypertensive medication
has been shown to reduce cardiovascular events and mortality in
older adults. Whether this transfers to a reduction of frailty is
unknown. We assessed the impact of antihypertensive treatment
on frailty in those aged 80 or more with hypertension as assessed
by the frailty index (FI) in HYVET.
Methods:
Participants in HYVET were randomised 1:1 to
active treatment (indapamide sustained release (SR) 1.5mg +/−
perindopril 2–4mg) or matching placebo. The FI was calculated
at entry and on annual visits and based on fifty-seven potential
deficits (same variables used at entry and annual visits). The FI
did not include incident non-fatal cardiovascular events. Impact of
active treatment on FI at 2 years was assessed using a 2-part model
based on 1,665 participants with logistic regression to estimate
risk of death and Poisson regression to model frailty (FI). Analyses
were carried out using FI with and without patient reported side-
effect data. Analyses were adjusted for age, sex, and region of
recruitment.
Results:
The mean increase in FI over 24-months was 1.53 (95% CI
0.97–2.10) in the placebo group and 0.79 (95% CI 0.26–1.32) in the
active treatment group (p = 0.06, ttest). Initial results suggest this
pattern is likely to remain when side-effects are included in the
FI. Exploration using the 2-part model to take account of mortality
over the 2-year period further supports this.
Conclusions:
Initial findings suggest that the antihypertensive
treatment employed in HYVET did not have an adverse effect on
frailty and may even be beneficial.
O-005
ADAMO: validation of an algorithm for automatic monitor
of physical activity in elderly population
L.C. Feletti
1
, G. Zia
1
, D. Sacchetto
1
, D. Magistro
2
, G. Boccia
3
,
M. Ivaldi
3
, A. Rainoldi
3
1
Caretek s.r.l., Torino, Italy;
2
School of Electronics, Loughborough
University, UK;
3
SUISM
–
Centro Servizi University of Turin, Torino,
Italy
Objectives:
ADAMO is a care watch from Caretek S.r.l. embedding
an algorithm for the measurement of physical activity in elderly
population. Its design has been carried out on behalf of the SPRINTT
project, 9th Call IMI 2013. The aim of this study was to assess the
accuracy in steps detection during various activity performed by
elderly subjects.
Methods:
Sixteen subjects (aged 68–91) wore the device on
both wrists performing in random order the following activities:
walking at slow, normal, and fast self-paced speeds; Timed Up
and Go Test (TUG); ascending and descending stairs; step test.
The criterion measure was the number of manually counted steps;
absolute percent error scores were calculated as: %Error = [(ADAMO
taken steps − manually taken steps)/(manually taken steps)]
×
100.
Intra-class correlation coefficients (ICC) were also calculated.
Results:
ADAMO care watch demonstrated high accuracy (the
former value) and high ICC (the latter) in walking activities and
step test: slow walking (−1.5%; 0.95); normal walking (−1.6%; 0.97);
fast walking (−6.5%; 0.95); TUG (−1.8%; 0.90); step test (−5.5%; 0.95).
Under the stairs conditions ADAMO showed a slightly higher error:
ascending stairs (15.5%; 0.81); descending stairs (13.0%; 0.96).
Conclusions:
On the base of these finding it is possible to claim that
the ADAMO care watch demonstrated highly accurate measurement
of steps in all activities, particularly in slow and very slow walking
speeds. Hence we support the inclusion of ADAMO care watch
in clinical and free living applications measuring steps of elderly
persons with slow or extremely slow walking speed pace.
O-006
International normative data for grip strength across the life
course: a systematic review and meta-analysis
R. Dodds
1
, H. Syddall
2
, R. Cooper
3
, D. Kuh
3
, C. Cooper
2
, A.A. Sayer
2
1
MRC Lifecourse Epidemiology Unity, University of Southampton,
Southampon, United Kingdom;
2
MRC Lifecourse Epidemiology Unit,
University of Southampton, Southampton, UK, Southampton, United
Kingdom;
3
MRC Unit for Lifelong Health and Ageing at UCL, London,
UK, London, United Kingdom
Background:
Weak grip strength is a key component of sarcopenia
and is associated with subsequent disability and mortality. We
recently established life course normative data for grip strength in
Great Britain, but it is unclear whether the cut-points for weak grip
strength we derived are suitable for use in other settings.
Objective:
To investigate differences in grip strength by world
region using our data as a reference standard.
Methods:
We searched MEDLINE and EMBASE for papers reporting
items of normative data for grip strength. We extracted each
normative data item and converted it on to a Z-score scale relative
to our British centiles. We performed metaregression in STATA
version 13 to pool Z-scores and compare them by world region.
Results:
Our search returned 806 abstracts and 60 met inclusion
criteria. All UN regions were represented although most papers
(n = 43) were in developed regions. We extracted 730 items relating
to 95,625 grip strength observations. The pattern of results was
similar to our British centiles in terms of periods across the life
course and gender differences. Normative data from developed
regions were similar to our British centiles whereas those from
developing regions were clearly lower, with pooled Z-scores of 0.12
(95% CI: 0.07, 0.17) and −0.86 (95% CI: −0.95, −0.77), respectively.
Conclusions:
Normative data from developed regions were similar
to that described in our British centiles, whereas those from
developing regions were clearly lower. This supports the use of
our British centiles and cut-points in consensus definitions for
sarcopenia and frailty across developed settings.