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most important, followed by the disease severity, and discussion
with health care professionals. However, despite incurable diseases
and terminal conditions, 12(40.0%) patients would follow the advice
by doctors, 9(30%) wished to go home, and 5(16.7%) agreed hospice
care. ADs would be considered if life expectancy is less than 3
months in 16(53.3%) patients, 4 to 12 months in 6(20%), but
7(23.3%) would never consider ADs. Patients who were married,
high school educated, and their spouse as the main caregiver had
higher awareness of ADs. Attitude was positive among patients
with APACHE II scores ≥16 and spouse as the main caregiver.
Conclusion:
Discussion and advice of medical professionals played
an important role in decision of ADs. Education to medical
professionals and patients might be of help.
P-480
Does obesity really lower dementia risk?
B.H. Strand
1
, E. Langballe
2
, T.A. Rosness
3
, K. Engedal
4
, E. Bjertness
3
1
Norwegian Institute of Public Health/University of Oslo, Oslo,
Norway;
2
Aldring og Helse, Tønsberg, Norway;
3
University of Oslo,
Oslo, Norway;
4
Nasjonalt Kompetansesenter for Aldring og Helse, Oslo,
Norway
Objectives:
A paper by Qizilbash et al., published in Lancet Diabetes
and Endocrinology in April this year, reported that underweight in
midlife increases dementia risk, and contrasting previous research
they reported that overweight in midlife lowers dementia risk. This
study has been questioned because they considered individuals
between 40–80 years of age at BMI assessment as a single group,
mixing midlife and late-life BMI.
Methods:
For this reason, we analyzed separately the dementia risk
for three age groups at BMI assessment: 35–49, 50–69 and 70–80
years. Our data includes more than 80 000 participants in Norway
followed-up for dementia related mortality, using Cox regression,
with a maximum of 38 years of follow-up.
Results:
Two aspects of our findings need to be considered.
First, underweight both in midlife and old age was associated
with increased dementia risk. Second, the association between
overweight and dementia depended on age at BMI assessment;
when BMI was assessed in midlife there was no decreased dementia
risk, but when BMI was assessed in old age, high BMI was associated
with decreased dementia risk.
Conclusions:
Obesity involves increased health risk for several
conditions. Based on the Qizilbash paper, global news corporations
have reported that being overweight in midlife may reduce
the risk of dementia. We believe the uncertainties concerning
clinical relevance of the Qizibalsh paper findings should be noted,
particularly that other studies find no such protective effect of
midlife overweight. However, being underweight at different stages
in life seems to be associated with increased dementia risk. To gain
more knowledge about the associations between weight, dementia
and the mechanisms involved, further investigation is warranted.
P-481
Assessment and treatment of memory problems in memory
clinic setting: A study of 60 patients
N. Ahmad
1
1
Queens Hospital, Romford, United Kingdom
Aims:
To analyse the clinical assessment, diagnosis and treatment of
patients presenting with memory problems in the memory clinic
Patients and Methods:
60 consecutive patients case notes were
audited who presented to memory clinic from Jan to July 2010.
Their clinical assessment, investigations and treatment options
were noted and their mini-mental score was charted over two
years.
Results:
Patients treated with choline esterase inhibitors showed
stable MMSE over a period of two years whereas the patients who
were not treated (for variety of reasons) continue to deteriorate
rapidly.
Discussion and Results:
Treatment with anti-dementia drugs can
provide a good quality of life for elderly patients up-to a period of
two years.
P-482
The Norwegian Cognitive Impairment After Stroke study
(Nor-COAST)
I. Saltvedt
1
, T. Askim
1
, B. Indredavik
1
, T. Engstad
2
, H. Næss
3
,
H. Ihle-Hansen
4
, B. Fure
5
, M. Beyer
6
1
Norwegian University of Science and Technology (NTNU), Trondheim,
Norway;
2
University Hospital of North Norway, Tromsø, Norway;
3
Haukeland University Hospital, Bergen, Norway;
4
Vestre Viken,
Bærum Sykehus, Høvik, Norway;
5
Ullevaal University Hospital, Oslo,
Norway;
6
Oslo University Hospital, Oslo, Norway
Objectives:
After stroke more than 50 percent of the patients get
post-stroke dementia (PSD) or mild cognitive impairment (MCI).
This is an exponentially increasing patient population due to ageing
of population and decreased mortality among stroke patients. The
overall aim of The Norwegian Cognitive Impairment After Stroke
(Nor-COAST) study is to establish a research platform that will
improve competence on PSD and MCI in order to improve individual
health outcomes following a stroke.
Methods:
Nor-COAST is an ongoing descriptive cohort study with
partners from all four Norwegian health authorities. Up to 1000
patients with acute stroke admitted to one of the six participating
stroke units will be included. Data collection at baseline, discharge
from hospital, at 3 and 18 months include evaluation of cognition,
life style, physical activity, function, MRI, blood samples, activity
monitoring (active PAL), and data on pharmacological and non-
pharmacological secondary prevention.
Results:
Nor-COAST will give increased knowledge on the following
aspects of PSD / MCI: i) incidence and clinical phenotype ii)
pathogenetic factors including MRI, biomarkers and genetics
iii) importance of physical activity iv) the interaction between
secondary prevention and development of PSD/MCI v) clinical
methods that can identify risk patients.
Conclusion:
Cognitive impairment after stroke is frequently
overlooked, and we think that this study will increase competence,
and that the results obtained can be used both in clinical care and
later intervention studies.
P-483
Clinical trial for the evaluation of an adaptive robotic gait
rehabilitation system with geriatric patients
F. Feldwieser
1
, B. Wagner
1
, E. Steinhagen-Thiessen
2
1
Geriatrics Research Group, Department of Geriatric Medicine,
Charit´e
–
Universit¨atsmedizin Berlin, Berlin, Germany;
2
Research
Group on Geriatrics, Charit´e
–
Universit¨atsmedizin Berlin, Berlin,
Germany
Objectives:
The scarcity of resources in the healthcare sector
calls for alternative ways of treatment and interventions. Robotic
gait assistance systems which can be adapted to the patient’s
anatomy are one possible alternative. Project MOPASS developed
an intelligent and adaptive system for gait rehabilitation which
can help patients to train physiological gait patterns by the
provision of constant feedback to the patient. This helps to
substitute unphysiological gait patterns with more physiological
gait patterns. Additionally new therapeutic treatment intervention
will be created.
Methods:
Within a clinical trail the usability and acceptance of
the mobile robotic assisted gait rehabilitation system MOPASS was
tested from the perspective of ten geriatric patients and three
physiotherapists. Data was collected with the help of questionnaires
and guided interviews. Information on wearing comfort, operability