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be considered in potentially unvaccinated elderly with infected
wounds.
P-463
Alcohol consumption and risk of dementia up to 27 years later
in a large, population-based sample: The HUNT study, Norway
E. Melbye Langballe
1,2
, H. Ask
1
, J. Holmen
3
, E. Stordal
4,5
,
I. Saltvedt
5,6
, G. Selbaek
2,7,10
, A. Fiksesaunet
8
, S. Bergh
7
, P. Nafstad
9,11
,
K. Tambs
1
1
Division of Mental Health, Norwegian Institute of Public Health,
Oslo, Norway;
2
Norwegian National Advisory Unit on Ageing and
Health, Vestfold Hospital Trust, Tønsberg, Norway;
3
HUNT Research
Centre, Department of Public Health and General Practice, Norwegian
University of Science and Technology (NTNU), Levanger, Norway;
4
Namsos Hospital, Nord-Trøndelag Health Trust, Namsos, Norway;
5
Department of Neuroscience, Norwegian University of Science and
Technology (NTNU), Trondheim, Norway;
6
Department of Geriatrics,
St Olav Hospital, University Hospital of Trondheim, Trondheim,
Norway;
7
Centre for Old Age Psychiatric Research, Innlandet Hospital
Trust, Ottestad, Norway;
8
Levanger Hospital, Nord-Trøndelag Health
Trust, Levanger, Norway;
9
Institute of Health and Society, University
of Oslo, Oslo, Norway;
10
Akershus University Hospital, Lørenskog,
Norway;
11
Division of Epidemiology, Norwegian Institute of Public
Health, Oslo, Norway
Objectives:
The relationship between alcohol consumption and
dementia risk is unclear. This investigation estimates the
association between alcohol consumption reported in a population-
based study in the mid-1980s and the risk for dementia up to 27
years later.
Methods:
The entire adult population in one Norwegian county
was invited to the Nord-Trøndelag Health Study during 1984–86
(HUNT1): 88% participated. The sample used in this study includes
HUNT1 participants born between 1905 and 1946 who completed
the questionnaire assessing alcohol consumption. A total of
40,435 individuals, of whom 1,084 have developed dementia, are
included in the analysis adjusted for age, sex, years of education,
hypertension, obesity, smoking, and symptoms of depression.
Results:
When adjusting for age and sex, and compared to
reporting consumption of alcohol 1–4 times during the last 14
days (drinking infrequently), both abstaining from alcohol and
reporting consumption of alcohol five or more times (drinking
frequently) were statistically significantly associated with increased
dementia risk with hazard ratios of 1.30 (95% CI 1.05–1.61) and 1.45
(1.11–1.90), respectively. In the fully adjusted analysis, drinking
alcohol frequently was still significantly associated with increased
dementia risk with a hazard ratio of 1.40 (1.07–1.84). However,
the association between dementia and abstaining from alcohol
was no longer significant (1.15, 0.92–1.43). Equivalent results for
Alzheimer’s disease and vascular dementia indicated the same
patterns of associations.
Conclusions:
When adjusting for other factors associated with
dementia, frequent alcohol drinking, but not abstaining from
alcohol, is associated with increased dementia risk compared to
drinking alcohol infrequently.
P-464
Drug administration in selected Icelandic nursing homes
O. Samuelsson
1
, H.T. Traustason
2
, P. Gunnarsson
2
, J.E. Jonsson
1
,
A. Gudmundsson
3
1
Landspitali University Hospital, Reykjavik, Iceland;
2
University of
Iceland Pharmacology department, Reykjavik, Iceland;
3
Landspitalinn
University Hospital, Reykjavik, Iceland
Objective:
Medication use in nursing homes is considerable and the
prevalence of dysphagia is significant, affecting the administration
of medications in their tablet form. The crushing of medications or
mixing them with food can change the quality of a drug. The aim
of this study was to investigate the status of drug administration
with special focus on the crushing of drugs.
Methods:
The study was conducted in two selected nursing homes.
The nurses were observed as they prepared and administered
the medication. The type of drug, number and if pills were split
or crushed and capsules opened was registered. The mixing of
medications with food was noted.
Results:
Participants were 73, females 49 (67%).Preparing of 1917
drugs for 522 instances of drug administrations were observed. 54%
of drugs administered during the study period were crushed and
this was common practice if the residents had problem swallowing
tablets. Coated tablets and tablets with extended release were
crushed in 61% and 39% of cases. Acid resistant coated tablets
and capsules were crushed in 54% and 29% of cases. The most
common food item for mixing medication was apple puree.
Conclusions:
The study showed that considerable amount of
resources were wasted on drugs that can be expected to become
unusable or change quality in their crushed form. Drug safety
and efficasy was thus compromized. Published recommedations for
proper drug handling and suggestions for alternative drug forms
for patients with dysphagia proved to be limited.
P-465
The relationship between physical frailty and cognitive decline
M.C. Kizilarslanoglu
1
, H.D. Varan
1
, M.K. Kilic
1
, O. Kara
1
, G. Arik
1
,
F. Sumer
1
, G. Guner
1
, M.E. Kuyumcu
1
, Y. Yesil
1
, B.B. Yavuz
1
,
M. Halil
1
, M. Cankurtaran
1
1
Hacettepe University School of Medicine, Ankara, Turkey
Objectives:
Frailty is an important statement affecting physical,
social and cognitive status of the elderly. This term has usually
referred to physical phenotype. Recently, cognitive domain of frailty
has been emphasized by the authors. In this study, we aimed to
show whether physical frailty is associated with cognitive decline
or not.
Methods:
Fried frailty index was used for the evaluation of frailty.
Five parameters (weight loss, exhaustion, weakness, slow walking
speed and low level of physical activity) were evaluated. The
patients were divided into three groups as robust if none of the
mentioned criteria was affected, pre-frail if 1 or 2 were affected
and frail if 3 or more were affected. All patients underwent
comprehensive geriatric assessment. Cognitive functions were
evaluated by using mini-mental state examination (MMSE) and
clock drawing tests (CDT).
Results:
One hundred one patients (31 robust, 43 pre-frail and
27 frail patients) (median age 73 years (min-max: 65–94) and
66.5% patients female) were included. Medians of age, gender and
co-morbidities rates were similar between groups. Activities of
daily living were more affected in frail group compared to pre-
frail and robust group (p
<
0.001). CDT score medians were similar
between robust and pre-frail group but higher than frail group (6,
6 and 3 points, respectively, p
<
0.001). Medians of MMSE test were
significantly lower in frail group (24 points, min-max: 9–30) than
pre-frail (27 points, min-max: 11–30) and robust group (29 points,
min-max: 15–30) (p
<
0.001).
Conclusions:
This study has demonstrated that cognitive decline
may be associated with physical frailty.
P-466
Factors associated with postoperative blood transfusion
requirements in Proximal Femoral Fractures-Local population
study
T. Fleming
1
, H. MacDonald
1
, T. Solanki
1
1
Taunton and Somerset NHS trust, Taunton, United Kingdom
Objectives:
Proximal femoral fractures (PFF) are associated with
high rates of blood loss requiring transfusion. The objective of
this study was to identify risk factors for transfusion in the local