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Oral presentations / European Geriatric Medicine 6S1 (2015) S5
–
S31
S17
O-042
Low serum vitamin K1 increases the risk of hip fractures only
at low vitamin D status. A NOREPOS study
T.E. Finnes
1
, C.M. Lofthus
2
, A.J. Søgaard
3
, G.S. Tell
4
, E.M. Apalset
4
,
C. Gjesdal
4
, G. Grimnes
5
, B. Schei
6
, R. Blomhoff
7
, S.O. Samuelsen
8
,
H.E. Meyer
3
, K. Holvik
9
1
Innlandet Hospital, trust, Hamar, Norway;
2
Oslo University Hospital,
Oslo, Norway;
3
Norwegian Institute of Public Health, Oslo, Norway;
4
University of Bergen, Bergen, Norway;
5
The Arctic University of
Norway, Tromsø, Norway;
6
Norwegian University of Science and
Technology, Trondheim, Norway;
7
University of Oslo and Oslo
University Hospital, Oslo, Norway;
8
University of Oslo and Norwegian
Institute of Public Health, Oslo, Norway;
9
Norway
Objectives:
Studies have suggested a possible additive effect of
vitamins K and D on bone. We aimed to investigate the association
of serum-vitamin K1 and subsequent hip fracture according to
vitamin D (25(OH)D) status in elderly Norwegians.
Methods:
During 1994–2001, 21,774 men and women aged 65 to 79
years attended four community based health studies. Prospective
hip fractures were identified during a median follow up of 8.2
years. The study was designed as a case cohort study. Vitamin K1
and 25(OH)D were determined in hip fracture cases with available
frozen serum samples obtained at baseline (n = 1090), and in a
randomly selected subcohort (n = 1318). Cox proportional hazards
regression with quartiles of s-vitamin K1 as main explanatory
variable was performed in stratified groups of s-25(OH)D according
to the cutoff 50 nmol/L.
Results:
In the group with s-25(OH)D ≥50 nmol/L hazard ratio
(HR) for sustaining a hip fracture in lowest versus highest quartile
of s-vitamin-K1 was 1.26 (95% CI: 0.91–1.74), adjusting for sex,
age and study site. In the group with s-25(OH)D
<
50 nmol/L the
corresponding figures were: HR: 1.81 (95% CI: 1.24–2.62), p for trend
<
0.001. After adjusting for smoking, BMI and
a
-tocopherol HR in
highest compared with lowest quartile was 1.44 (95% CI: 0.97–2.14),
p for trend 0.04.
Conclusions:
Low serum concentrations of vitamin K1 is associated
with hip fractures in elderly with s-25(OH)D
<
50 nmol/L.
This is the first population-based cohort study to report an
association between s-vitamin K1 concentrations and subsequent
hip fractures.
O-043
Does nutritional follow-up after discharge, performed as home
visit or telephone follow-up, prevent deterioration of ADL
in malnourished geriatric patients?
J. Lindegaard-Pedersen
1
, P.U. Pedersen
2
, E.M. Damsgaard
1
1
Department of Geriatrics, Aarhus University Hospital, Aarhus C,
Denmark;
2
Center of Clinical Guidelines
–
Clearinghouse, Department
of Health Science and Techonology, Aalborg, Aalborg S
Introduction:
Disease-related malnutrition affects older individuals
negatively after discharge from hospital. With shorter hospital
stays it is becoming increasingly important to initiate nutritional
interventions after discharge to prevent and postpone further
deterioration of functions.
Objective:
To compare the effect of two nutritional follow-up
intervention methods (home visits and telephone follow-ups) and
no follow-up on prevention of deterioration in ADL.
Material and Methods:
The study is a randomized clinical trial.
Inclusion criteria were malnourishment or risk of malnutrition, age
75 years and older, home-dwelling, and living alone. Patients who
suffered from terminal illnesses, cognitive impairment, and nursing
home residents were excluded. At discharge the participants were
randomized to ‘home visit’, ‘telephone follow-up’, or ‘control group’.
The intervention was individualized nutritional counseling at one,
two, and four weeks after discharge. ADL (Barthel-100 score)
was measured at discharge and eight weeks after. Data were
analyzed using Fisher’s exact test. Comparisons were made between
randomization groups in relation to participants who maintained
or improved ADL.
Results:
A total of 208 patients were randomized, but only 157
participants completed the follow-up. More participants in the
home visit group maintained or improved ADL (96%, n = 52),
compared to the telephone (75%, n = 51) and control groups (72%,
n = 54) (p
<
0.01).
Conclusion:
Nutritional follow-up after discharge, performed as
home visits, substantially reduces the risk of deterioration of
ADL in malnourished geriatric patients compared to follow-up
by telephone or no follow-up. Telephone calls appear to have no
effect.
Preserving independency has major importance when elderly who
live alone want to stay in their homes.
O-044
Dietary carboxymethyllysine induces arterial aging in a
RAGE-dependent manner in mice
N. Grossin
1
, F. Auger
1
, C. Niquet-Leridon
2
, R. Nevi `ere
1
,
A.M. Schmidt
3
, P. Jacolot
2
, F.J. Tessier
2
, E. Boulanger
1
1
Lille2 University, Lille cedex, France;
2
Insitut Polytechnique Lasalle
Beauvais, Beauvais, France;
3
New York University, New York, United
States of America
Objectives:
Advanced glycation end-products (AGEs) are endoge-
nously produced and are present in food. N
e
-carboxymethyllysine
(CML) is an endothelial activator via the receptor for AGEs (RAGE)
and is a major dietary AGE. This work investigated the effects of a
CML-enriched diet and RAGE involvement in aortic aging in mice.
Methods:
After 9 months of a control diet or CML-enriched
diets (50, 100 or 200
m
g CML/g of food), endothelium-dependent
relaxation (EDR), RAGE, vascular cell adhesion molecule-1
(VCAM-1) and sirtuin-1 (SIRT1) expression, pulse wave velocity
(PWV) and elastin disruption were measured in aortas of wild-type
or RAGE
−
/
−
male C57BL/6 mice.
Results:
Compared to the control diet, EDR was reduced in the wild-
type mice fed the CML-enriched diet (200
m
g CML/g) (66.8
±
12.26 vs
94.3
±
2.6%, p
<
0.01). RAGE and VCAM-1 (p
<
0.05) expression were
increased in the aortic wall. RAGE
−
/
−
mice were protected against
CML-enriched diet-induced endothelial dysfunction. Compared to
control diet, the CML-enriched diet (200
m
g CML/g) increased the
aortic PWV (86.6
±
41.1 vs 251.4
±
41.1 cm/s, p
<
0.05) in wild-type
animals. Elastin disruption was found to a greater extent in the
CML-fed mice (p
<
0.05). RAGE
−
/
−
mice fed the CML-enriched diet
were protected from aortic stiffening.
Conclusions:
Chronic CML ingestion induced endothelial
dysfunction and arterial stiffness and aging in a RAGE dependent
manner.
Infectious diseases and vaccines
O-045
Clostridium difficile
infection and composition of gut
microbiota in hospitalized elderly: case-control study
A. Ticinesi
1
, F. Turroni
2
, A. Nouvenne
1
, L. Mancabelli
2
, C. Milani
2
,
I. Morelli
1
, B. Prati
1
, L. Guida
1
, M. Ventura
2
, T. Meschi
1
1
Department of Clinical and Experimental Medicine, University of
Parma, Parma, Italy;
2
Laboratory of Probiogenomics, Department of
Life Sciences, University of Parma, Parma, Italy
Objectives:
To compare the composition of gut microbiota in
hospitalized elderly with and without
Clostridium difficile
infection
(CDI).
Methods:
31 patients who developed CDI during hospital
stay, 40 CDI-negative matched inpatients under antibiotic