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Oral presentations / European Geriatric Medicine 6S1 (2015) S5
–
S31
S9
O-014
Inverse relationship between body mass index and mortality
in older nursing home residents: a meta-analysis of 19,538
elderly subjects
N. Veronese
1
, E. Cereda
2
, M. Solmi
1
, G. Sergi
1
, E. Manzato
1
,
C. Correll
3
, S. Maggi
4
1
University of Padova, Padova, Italy;
2
Fondazione IRCCS Policlinico
San Matteo, Pavia, Italy;
3
The Zucker Hillside Hospital, Glen Oaks,
United States of America;
4
Italy
Objective:
Body mass index (BMI) and mortality in the elderly
have been related in a U-shaped or J-shaped curve with increased
risk among underweight and obese individuals. However, limited
information is available for elderly nursing home populations.
Therefore, we aimed to investigate the risk of all-cause and cause-
specific mortality in underweight, overweight and obese vs. normal
weight elderly nursing home residents.
Methods:
PubMed/EMBASE/CINAHL/SCOPUS search from database
inception until 05/31/2014 without language restrictions. All-cause
and cause-specific fully-adjusted mortality hazard ratios (HRs)
and unadjusted risk ratios (RRs) for underweight (BMI ≤18.5),
overweight (BMI 25–29.9) and obesity (BMI ≥30) relative to normal
weight (BMI 18.5–24.9) were extracted about prospective in nursing
home residents aged ≥65 years.
Results:
Out of 342 hits, 20 studies (n = 19,538, mean age=84.2
years, females=71.5%) with 5,223 deaths during 0.5–9 (median=2,
interquartile range=1, 4.75) years follow-up were meta-analyzed.
Compared to normal weight, all-cause mortality HRs were 1.41
(95% CI=1.26–1.58) for underweight, 0.85 (95% CI=0.73–0.99) for
overweight and 0.74 (95% CI=0.57–0.96) for obesity.
These findings persisted in high-quality studies and European
studies. Higher HRs for underweight and overweight were also
confirmed in Australasian studies. Underweight was a risk factor
for higher mortality due to infections [HR = 1.65 (95% CI=1.13–2.40)].
RR results corroborated primary HR results, with additionally lower
infection-related mortality in overweight and obese than normal
weight individuals.
Conclusions:
Like in the general population, underweight is
a risk factor for mortality in elderly nursing home residents.
However, uniquely, not only overweight but also obesity is
protective, which has relevant nutritional goal implications in this
population/setting.
Funding:
No funding was used for this work.
O-015
Health literacy is associated with frailty stage in
community-dwelling elderly people
S. Hidehiko
1
, S. Nishiguchi
2
, N. Fukutani
1
, D. Adachi
2
, Y. Tashiro
1
,
T. Hotta
1
, S. Morino
1
, Y. Nozaki
1
, H. Hirata
1
, M. Yamaguchi
1
,
T. Aoyama
1
1
Kyoto University, Kyoto, Japan;
2
Japan
Objectives:
Preventing the progress of frailty is important for
avoiding various adverse health outcomes. In addition, health
literacy (HL) has attracted attention as a factor associated with
health outcomes. The purpose of this study was to determine
whether HL is associated with frailty in community-dwellers,
especially focusing on frailty stage.
Methods:
We enrolled 332 community-dwellers aged 60 years and
older (mean age: 72.9
±
6.7, 253 women). We measured five domains
(slowness, weakness, exhaustion, low activity, and shrinking) of the
participants. They were classified into three stages according to
the number of affected domains: nonfrailty = 0, prefrailty = 1–2,
and frailty = 3 or greater. HL was assessed using the 14-item HL
scale (HLS-14), a 70-point scale questionnaire. First, we conducted
logistic regression analyses, in which the presence of prefrailty or
frailty (cut-off value: ≥1) was the dependent variable and HLS-14
score was the independent variable. We also conducted logistic
regression analyses, in which the presence of frailty (cut-off value:
≥3) was the dependent variable.
Results:
In the logistic regression, in which the presence of
prefrailty or frailty was the dependent variable, HLS-14 score was
independently associated with the presence of prefrailty or frailty
(odds ratio: 0.94, 95% confidence interval: 0.90–0.99, P = 0.010).
However, logistic regression, in which the presence of frailty
was the dependent variable, showed that HLS-14 score had no
association with the presence of frailty.
Conclusions:
Health literacy is associated with the early stages, but
not with the later stage of frailty.
Comorbidity and multimorbidity
O-016
Usefulness of cerebrospinal fluid tap test as a treatment for
idiopathic normal pressure hydrocephalus in the elderly: a
pilot study
V. Scortichini
1
, L. Magni
2
, M.L. Gattoni
2
, C. Nani
2
, P. Dionigi Rossi
2
,
D. Mari
2
1
IRCCS C`a Granda Ospedale Maggiore of Milan, Milan, Italy;
2
IRCCS
C`a Granda Ospedale Maggiore of Milan, Italy, Milan, Italy
Objective:
To determine the usefulness of lumbar tap test (TT)
in old people presenting with clinical signs and symptoms of
idiopathic normal pressure hydrocephalus (iNPH) not eligible for
ventriculoperitoneal shunt.
Methods:
We enrolled and prospectively followed 38 subjects
(58% male, mean age 83
±
5.6, range 70–95), admitted to the
Department of Geriatrics of Ospedale Maggiore of Milan (Italy),
from February 2011 until April 2015. They complained memory
loss, gait difficulties and urinary incontinence. They were scheduled
for repetitive tap test and evaluated at baseline, 1 week after the
procedure, and monthly thereafter, by using Barthel Index (BI),
Barthel continence, Mini-Mental State Examination (MMSE), Tinetti
balance assessment Tool, Timed Up to Go (TUG). They were followed
up for a mean time of 16.4 months.
Results:
28 patients (72.3%) showed variable grade of improvement
of their symptoms after TT. 23 of them underwent more than one
deliquoration (range 2–5).
The impact of the procedure was deeper on BI, TUG and Tinetti,
showing an improvement after every tap test. MMSE and Barthel
continence were less responsive to the tap test. In particular, MMSE
improved only after the first two procedures and Barthel continence
after the first one. Furthermore, BI, TUG and Tinetti remained
almost stable from baseline until the third tap test (mean follow
up of 10–12 months).
Conclusions:
Tap test is a suitable option for treatment of elderly
people with iNPH not eligible for surgical treatment.
O-017
Association of circadian blood pressure alterations and disease
features in Parkinson’s disease
D.L. Vetrano
1
, M.S. Pisciotta
1
, V. Brandi
2
, M.R. Lo Monaco
3
,
A. Laudisio
4
, G. Onder
5
, R. Bernabei
5
, G. Zuccala
1
1
Catholic University
–
Rome, Rome, Italy;
2
Italy;
3
Universit`a Cattolica
del Sacro Cuore, Roma, Italy;
4
Campus Biomedico
–
Rome, Rome,
Italy;
5
Catholic University of the Sacred Heart, Rome, Italy
Objectives:
Alteration of the circadian blood pressure rhythm is
a common non-motor symptom of Parkinson’s Disease (PD). It is
one of the main manifestations of cardiovascular dysautonomia in
these patients, potentially associated to several negative outcomes.
Aim of the present study is to assess which PD specific feature is
associated with higher degree of cardiovascular dysautonomia.