European Geriatric Medicine - Supplement 1 - Volume 6

Poster presentations / European Geriatric Medicine 6S1 (2015) S32

–

S156

S153

Results:

The lying SBP and SDP were respectively 136

21 and

14mmHg in the 100 patients (85

5 years, 58% women;

7.7

4 medications, DDD: V 1.0, N 0.74). In standing position, SBP

declined (mean

SD 12

17mmHg), decreasing in 77 patients. In

SBP multivariate model (adjusted r

: 93%), the blood pressure

decline was significantly (p

0.05) and positively correlated with

age, diabetes, history of falls, and number of medications, but not

with the DDD of any of the nine medication classes. DBP also

declined in orthostatism (11

5mmHg), decreasing in 74 patients.

In the DBP multivariate model (adjusted r

: 87%), the decline was

significantly (p

0.05) and positively correlated with age, diabetes,

stroke and anemia, but again not with the DDD of any medication

class.

Conclusion:

The lack of correlation between the medication dosage

and the orthostatic decline in blood pressure is an argument against

their causal association in geriatric inpatients.

P-450

Prevalence of depressive symptoms in elderly people: Example

of a suburban and a rural region in Manisa, Turkey

B. Cengiz ¨Ozyurt

Celal Bayar University and Ege University Elderly Health, Manisa,

Turkey

Objectives:

The aim of this study is to determine the prevalence

of depressive symptoms in two different settlement regions (rural

and suburban) of Manisa and evaluate the potential risk factors.

Methods:

The population of this cross-sectional study was 2,040

elderly individuals who were leaving at the region of two randomly

selected primary medical services (one at rural area, other at

suburban area) in March 2013. The sample size was calculated

using the software of Epi info 7.0; thereby, 340 geriatric individuals

were enrolled. Each individual was randomly selected from his/her

registration at the administrative office of Manisa Public Health. All

data were collected by face-to-face interview and a standardized

questionnaire form, that involved sociodemographic characteristics,

Katz index and Depression scale for geriatrics, was used. The

rate of participation was 97.9% (n = 333). The study activities were

approved by the Celal Bayar University Institutional Review Board.

All data were evaluated using descriptive analysis, chi square test

and multivariate analysis.

Results:

The mean age of the study group was 71.8

5.4. The

majority of individuals (77.5%) had a chronic disease for which

continuous drug administration was required, 51.1% was women,

34.2% was graduated from elementary school and 17.7% was living

alone. The prevalence of depressive symptoms was 38.7% (suburban

area 44.6%, rural area 36.2%, p

0.05).

Conclusion:

Multivariate analysis demonstrated that the risk of

depression is significantly high in individuals who were living

alone, had no education, need of support during daily activities,

experienced an adverse event lately and exposed to mistreatment.

P-451

Electroconvulsive therapy for comorbid major depressive

disorder with dementia

N. Denewet

, J. Kengni Tameze

, S. Higuet

CHU Charleroi, ULB, Uccle, Belgium;

CHU Charleroi, ULB, Lodelinsart,

Belgium

Objectives:

We report the case of a 74-year-old patient, treated

by electroconvulsive therapy (ECT) for a severe and treatment-

resistant psychiatric disorder. We review some studies about ECT

and its efficacy for elderly patients with depression, bipolar disorder

and psychosis

Methods:

A caucasian woman, living at home with her partner,

with a history of major depressive disorder and suspected Lewy

bodies dementia, initially presented a recurrent depressive state

non-responsive to antidepressant drug therapy. She displayed

opposing attitude, anorexia and parkinsonism. Tomodensitometry

imaging revealed some microangiopathic lesions in the brain, and

electroencephalogram showed seizures.

Results:

Diagnosis of acute catatonia was confirmed by a

psychiatrist. Leviracetam therapy was started along with enteral

nutrition. Benzodiazepines failed and the patient was dying. After

nine ECT sessions, the patient woke up, started eating and walked

a few steps, but cognitive disorders increased with hallucinations

and disorientation. Institutionalization was finally planned, with

only antidepressive drug therapy. ECT can be life saving for older

adults who exhibit symptoms of acute catatonia.

Conclusions:

Elderly patients have a lower tolerance to medication

due to age-associated pharmacokinetic changes and increased

sensitivity to psychotropic medications, such as anticholinergic

and orthostatic hypotensive side effects. Otherwise they have

higher rates of neuropsychiatric comorbidities. ECT can be effective

in treating neuropsychiatric conditions, such as catatonia and

parkinsonism. Benzodiazepines are used as first-line treatment

for mild-to-moderate catatonia. Some authors also have suggested

alternative medications such as midazolam, memantine, topiramate

and amantadine. Most patients experience some adverse cognitive

effects during and after a course of ECT.

P-452

Depression and pain: Prevalence, medication and comorbidity

in long-term care residents

P. Frisch

, J.-P. Steinmetz

, E. Bourkel

, L. Frantzen

, C. Theisen-

Flies

, C. Federspiel

Department of Research and Development and ZithaSenior and

University of Luxembourg, Luxembourg, Luxembourg;

Department

of Research and Development, Zitha Senior and Centre for Memory

and Mobility, Luxembourg, Luxembourg;

Department of Research

and Development, ZithaSenior and Center for memory and

mobility, Luxembourg, Luxembourg;

Department of Research and

Development, ZithaSenior, Luxembourg, Luxembourg;

Department of

Research and Development, ZithaSenior, University of Luxembourg,

Luxembourg, Luxembourg;

ZithaSenior, Center for memory and

mobility, ZithaKlinik, Luxembourg, Luxembourg

Objectives:

Depression and pain are common conditions in long-

term care residents and often occur together. The study investigates

(1) the prevalence of depressive symptoms, antidepressive

treatments, experienced pain, the prevalence and type of antalgic

treatments and (2) the relationship between depression and pain

in long-term residents in Luxembourg.

Methods:

The study sample consisted of 194 residents (age 47–

102). Exclusion criteria were an MMSE

16. Medical charts were

examined retrospectively. We assessed age, gender, MMSE, current

antidepressive and chronic pain medication, the emotional status

using the GDS5, and pain experience using the DoloPlus scale.

Results:

In total, 39.7% of the patients were treated with pain

medication and 51% of all long-term residents were treated with

antidepressants. A total 38.1% were classified as depressed with the

recommended GDS5 cut-off ≥2. Interestingly, 16.5% of the depressed

residents were without appropriate antidepressant treatment. We

found furthermore that depressed patients with a GDS5 ≥2 scored

significantly higher in the DoloPlus scale (p = 0.01), required a

higher number of different pain relievers (p = 0.03) and were treated

with more potent antalgics (p = 0.02) than patients with a GDS5

Conclusions:

Pain and depression are very common in long-

term care residents and clearly influence one another. Despite

this knowledge, depression is often under-diagnosed in geriatric

patients and the present findings suggest that depressed patients

experience more pain and require a quantitatively and qualitatively

different pain therapy than non-depressed patients. Special

attention in long-term care residents should be allocated to

depressive symptoms and pain expressions.