European Geriatric Medicine - Supplement 1 - Volume 6

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

–

S156

S155

30%. In every case, there was a change of the general state; extra-

cellular dehydration in 70%, urinary disorders in 33%, abdominal

meteorism in 33% an hypothyroidism in one case, bedsores in 25%,

relapse of an infectious in 25%, and confusions in 50%. A care of

nursing,nutrition and antidepressor was established. The evolution

was marked by 3 deaths and the improvement of the state at 13

other patients.

Discussion:

Slipping syndrome is a severe affection causing death

in the majority of the cases. It is important to know how to detect

it and especially to prevent it.

P-457

Narcolepsy in the elderly: a case report

C. Pablos Hern ´andez

, A. Gonz ´alez Ram´ırez

, J.R. S ´anchez

Marug ´an

, J.F. Jim´enez Viseu-Pi˜neiro

, C. Hern ´andez Pascual

J.M. Juli ´an Enr´ıquez

Universitary Hospital of Salamanca, Salamanca, Spain

Objectives:

Narcolepsy is a rare syndrome with a very low preva-

lence (0.04%). Main symptoms are chronic daytime sleepiness with

cataplexy (emotionally-triggered muscle weakness), hypnagogic

hallucinations (as the patient is falling asleep) and sleep paralysis

(inability to move immediately after awakening).

Methods:

77 years old woman admitted to hospital with left

pertrochanteric hip fracture, unable to remember the episode. No

traumatic brain injury associated. After surgery presents daytime

sleepiness (sleep attacks, 2–3 minutes each) and cataplexy episodes

related to pleasant emotions (iconographic material provided).

Medical History: no relevant (except arthrosis). Functional status:

Katz B, Barthel 85/100.

Results:

Polysomnography: reduced sleep efficiency and

spontaneous awakenings. REM sleep 8 minutes after sleep. Multiple

Sleep Latency Test: mean sleep latency 1.6 minutes. Sleep Efficacy

Index: 0.75. REM latency: 0.0 minutes. Blood test and drug

screening: no relevant findings, except HLA-DR2 positive haplotype.

Cranial computed tomography: no lesions detected. Final diagnosis:

Narcolepsy type 1. Treatment with sodium oxybate 2.25 g/12h, with

quickly response (cataplexy). Later on modafilin 200mg (1–0–0).

Key conclusions:

•

Narcolepsy involves the loss of hypocretin neuropeptides (orexin-

A and orexin-B) that have excitatory effects and increase the

activity of many brain regions involved in the promotion of

wakefulness.

•

The DQB1*0602 haplotype (a subtipe of DR2) is present in 95%

of patients with cataplexy. Nevertheless, environmental factors

appear to be more relevant.

•

Cataplexy can lead in elderly patients to several complications

related to falls, specially hip fracture. It is important to treat

not only narcolepsy, but also age-related risk factors for severe

lesions.

P-458

Validity and reliability of “AM SAD”, a short geriatric

depression screening tool, in Turkish elderly people

P. Soysal

, A.T. Isik

, C. Usarel

, D. Kaya

, H. Ellidokuz

G.T. Grossberg

Center for Aging Brain and Dementia, Department of Geriatric

Medicine, Dokuz Eylul University, Izmir, Turkey;

Center for Aging

Brain and Dementia, Department of Geriatric Medicine, Dokuz Eylul

University, Facul, Izmir, Turkey;

Department of Biostatistics, Dokuz

Eylul University, Faculty of Medicine, Izmir, Turkey;

Department

of Neurology & Psychiatry, St Louis University School of Medicine,

St Louis, United States of America

Objective:

Depression is a serious public health problem among the

elderly and screening for depression in the elderly for primary care

physicians is essential.The objective of this study was to evaluate

the validity and reliability of the “AM SAD” and to compare the

results with DSM-V depression criteria in Turkish elderly people.

Methods:

This study was conducted in a geriatric division of a

tertiary hospital in the west part of Turkey, Izmir. A total of

186 elderly outpatients were included in the study. Translation

from the original English version was performed according to

the standardized methods. Yesavage Geriatric Depression-15 Scale

(YGDS), and the “AM SAD” were administered following by the

Mini-Mental Status Examination (MMSE). Patients were assessed

for depression using DSM-V criteria and the results were compared

with AM SAD.

Results:

A significant correlation was established between YDGS-15

and AM SAD scores (r: 0.64, p

0.001). AM SAD had also a mild–

moderate significant correlation with DSM-V criteria that were

depressive or not (r: 0.58 and r: 0.41, respectively). With a cut-

off score of ≥2 points, the AM SAD showed sensitivity of 94%

and specificity of 78% in the detection of depression in geriatric

patients. The area under the receiver-operating characteristics curve

(95% confidence interval) for the AM SAD was 0.92 (95% CI 0.873–

0.968), p

0.001.

Conclusion:

AM SAD which has a moderate correlation with DSM-V

criteria could be useful for screening depression in Turkish elderly

patients in the primary care clinics.

P-459

Gender differences in the elderly taking antidepressants when

visiting the emergency department

N. Ortuno

, M. Suarez Linares

, G. Guzman Gutierrez

A. Raiza

, E. Gonzalez

, M.D. Ferrer

, I. Garcia

, C. Campos

M.L. Iglesias-Lepine

, B. Garcia Garcia

, J. Cobo

Corporaci´o Sanit`aria i Universit`aria Parc Taul´ı, Sabadell, Spain;

Hospital Monte Naranco, Oviedo, Spain

Objective:

To determine if there’s a difference between genders

during visits made to the Emergency Department in the population

of 65 years and older taking antidepressant medications and its

influence on the decision for hospitalization.

Material and Methods:

We included elderly patients 65 years and

older that visited the emergency department between January

and October 2012. We obtain information through interviewing

the patient and/or companion and by going through the medical

record. We gathered their socio-demographic, toxicology, medical

history (past and present) and recent medications. After calculating

the sample size and by doing randomization, we did a statistical

analysis of the data collected.

Results:

We analyze the information of 674 patients (53% women)

with a mean of 78.5 years of age. From these, 27.6% were taking an

antidepressant at the time of the Emergency Department consult,

of which 71% (p

0.001) were women. We also observed that 37.4%

of the patients that consulted the ER were taking an anxiolytic drug,

of which 67.9% were women (p

0.001). We obtained a statistically

significant difference between past medical somatic illnesses and

gender: women consulting the ER had significantly more cognitive

impairment, cardiovascular risk factors and joint disease; while

men had more lung and oncologic disease, and a significantly higher

tobacco and alcohol consumption.

Conclusions:

In the study it can be observed that women taking

antidepressants make more visits to the ER compared to men,

not having a significantly relation regarding the decision for

hospitalization. Also we saw difference between genders and their

past medical somatic diseases.