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22.5–24.5) had delirium and 10.5% (95% CI 9.8–11.2) had known
dementia.
Mortality was high for older adults admitted to hospital; at 30 days
after admission 14.4% (95% CI 13.5–15.3) had died and this rose to
31.9% (95% CI 30.8–33.0) at 1 year after admission. Mortality was
significantly higher for those with any cognitive spectrum disorder:
29.8% (95% CI 27.6–32.0) at 30 days after admission and 61.5%
(95% CI 59.1–63.8) at 1 year. There was no significant difference in
mortality between the individual cognitive spectrum disorders.
Conclusions:
This data allows the prevalence and mortality of the
individual cognitive spectrum disorders to be seen in context.
Delirium is more prevalent than known dementia. Undiagnosed
dementia is common. Mortality is high. The presence of any
cognitive spectrum disorder worsens prognosis.
O-094
The association between osteoarthritis and subsequent change
in weight and muscle strength
L. Schaap
1
, N. Van Schoor
2
, D. Deeg
3
1
VU University, Amsterdam, Netherlands;
2
EMGO Institute for Health
and Care Research, Dpt. of Epidemiology and Biostatistics, Amsterdam,
Netherlands;
3
VU University Medical Center, Amsterdam, Netherlands
Objectives:
Research has shown that obesity and muscle weakness
are important risk factors for osteoarthritis. However, the conse-
quences of osteoarthritis regarding changes in weight and muscle
strength are inconclusive. The aim of this study was to investigate
the association between osteoarthritis and changes in weight and
muscle strength in a European sample of older men and women.
Methods:
Data of the European Project on OSteoArthritis (EPOSA)
were used, which includes pre-harmonized data from six European
cohort studies on older community-dwelling persons aged 65–85
years. Osteoarthritis of the knee and/or hip was defined according
to the American College of Rheumatology criteria. Weight and
handgrip strength were measured at baseline and after one year
follow-up.
Results:
Men with osteoarthritis (14.6%) had a mean weight
change of −1.1% (SD 4.0) compared to −0.5% (4.0) in men without
osteoarthritis. Mean change in grip strength was −6.7% (18.9) and
−1.2% (27.3), respectively. Women with osteoarthritis (26.2%) had
a mean weight change of −0.3% (5.0) vs. −0.5% (4.4) in women
without osteoarthritis. Grip strength change was −1.4% (33.2)
and −3.0% (27.3), respectively. Linear regression analyses adjusted
for demographics, lifestyle and morbidity showed a significant
association between osteoarthritis and loss of grip strength in men
only [B −4.55 (SE 2.31), p = 0.05]. Osteoarthritis was not associated
with change in weight in both sexes.
Discussion:
Osteoarthritis of the knee and/or hip in men is
significantly associated with one-year loss of grip strength.
Osteoarthritis disease management should focus on prevention of
muscle strength loss to prevent further deterioration of physical
functioning.
O-095
Which patients benefit from orthogeriatric treatment? Results
from the Trondheim Hip Fracture Trial
I. Saltvedt
1
, A. Prestmo
2
, J. Helbostad
3
, S. Lydersen
1
, P. Thingstad
1
,
K. Taraldsen
4
, O. Sletvold
5
1
Norwegian University of Science and Technology (NTNU), Trondheim,
Norway;
2
NTNU/St. Olavs Hospital, Trondheim, Norway;
3
Department
of Neuroscience, Norwegian University of Science and Technology,
Trondheim, Norway;
4
1 Department of Neuroscience, Norwegian
University of Science and Technology, Trondheim, Norway;
5
St. Olav
University hospital and Norwegian University of Science and
Technology (NTNU), Trondheim, Norway
Objectives:
The Trondheim Hip Fracture Trial demonstrated that
comprehensive geriatric care (CGC) in a geriatric ward gave better
mobility and function as compared to traditional orthopedic care
(OC) at four months. Objectives of this study is to investigate
whether the effect of CGC depended on the subgroups of age,
gender, type of fracture, or pre-fracture function measured by
Nottingham Extended ADL scale (NEAS).
Methods:
Home-dwelling hip fracture patients
>
70 years were
randomized to receive CGC (n = 198) or OC (n = 199). Differences
between subgroups at four months were analyzed using a linear
mixed model with interactions between treatment (CGC-OC), time,
and subgroup.
Results:
Subgroup analyses showed beneficial effect of CGC on
mobility in females, intra-capsular fractures (ICF) and patients with
pre-fracture NEAS ≥45, the effect was independent of age. CGC was
beneficial for p-ADL in patients
<
80 years, females, and patients
with pre-fracture NEAS
<
45, the effect was independent of fracture
type; beneficial effect on i-ADL was found in patients
<
80 years,
females, ICF and pre-fracture NEAS ≥45, while impact on cognition
was shown for patienst with ICF.
Conclusions:
In the present post-hoc hypothesis generating study
we found that irrespective of age, gender, type of fracture or pre-
fracture i-ADL CGC was more efficient than OC in one or more
functional outcomes. The interaction analyses suggest that patients
with the best prognosis (younger patients, patients with intra-
capsular fractures and high pre-fracture function) profited most
from CGC.
O-096
Effect of nutritional supplementation and structured physical
activity on walk capacity in mobility-limited older adults:
results from the VIVE2 study
R. Fielding
1
, D. Kirn
1
, A. Koochek
2
, K. Reid
1
, A. von Berens
3
,
T. Travison
4
, H. Zhu
4
, S. Folta
5
, J. Sacheck
5
, M. Nelson
5
, C. Liu
6
,
E. Phillips
7
, A.C. Aberg
8
, M. Nydahl
9
, T. Gustafsson
10
, T. Cederholm
3
1
Jean Mayer USDA Human Nutrition Research Center on Aging at
Tufts University, Boston, United States of America;
2
Sweden;
3
Uppsala
University, Uppsala, Sweden;
4
Hebrew SeniorLife, Boston, United
States of America;
5
Friedman School of Nutrition and Policy, Tufts
University, Boston, United States of America;
6
Section of Geriatrics,
Boston University School of Medicine, Boston, United States of
America;
7
Harvard Medical School, Boston, United States of America;
8
Geriatrics, Department of Public Health and Caring Sciences, Uppsala
University, Uppsala, Sweden;
9
Department of Food, Nutrition and
Dietetics, Uppsala University, Uppsala, Sweden;
10
Department of
Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
Objectives:
The primary objective of this study is to examine the
impact of a combined intervention of nutritional supplementation
and structured physical activity, compared to a placebo, on 400M
walk capacity in a cohort of mobility-limited older adults across
two sites (Boston, MA, USA and Stockholm, Sweden).
Methods:
Mobility-limited [Short Physical Performance Battery
(SPPB) ≤9] and vitamin D insufficient (serum 25(OH)D
≥9 & ≤24 ng/ml) older adults were recruited for this study. All
subjects participated in a physical activity program (3x/week for
24 weeks), involving walking, strength, balance, and flexibility
exercises. Subjects were randomized consume a daily nutritional
supplement (150kcal, 20g whey protein, 800IU vitamin D, 4 fl. oz.
beverage) or placebo (30kcal, non-nutritive). Primary outcome was
gait speed assessed by the 400M walk.
Results:
149 subjects were randomized into the study (mean age
77.5
±
5.4; female 46.3%; mean SPPB 7.9
±
1.2; mean vitamin D
18.7
±
6.4 ng/ml). Adherence across supplement and placebo groups
was similar for the physical activity intervention (75% and 72%,
respectively) and the study product (86% and 88%, respectively).
After the intervention period both groups demonstrated an
improvement in gait speed with no significant difference between