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Oral presentations / European Geriatric Medicine 6S1 (2015) S5
–
S31
S19
Results:
3901 patients were included in the study; 74.2% were
women. The mean age was 84.6 years. 82.1% and 27.9% received
influenza and pneumococcal vaccination, respectively. Overall 727
(20.71%) residents died during the 1 year follow up period. After ad-
justing for potential confounders, which included age, sex, comor-
bilities, depression and ADL, both influenza (HR = 0.75, 95% CI 0.62–
0.90) and pneumococcal vaccination (HR = 0.79, 95% CI 0.67–0.95)
were associated with a significant reduction in all cause mortality.
Conclusions:
In a population of older adult living in nursing home
influenza and pneumococcal vaccination were associated with a
reduction in all cause mortality.
Pharmacology
O-049
An approach towards optimization of long-term
pharmacotherapy of lower urinary tract symptoms (LUTS)
in elderly people
M. Wehling
1
, K. Becher
2
, D. Castro-Diaz
3
, E. Chartier-Kastler
4
,
M. Kirby
5
, A. Wagg
6
, F. Pazan
7
, M. Oelke
8
1
Medical Faculty Mannheim University Heidelberg, Mannheim,
Germany;
2
Department of Geriatrics and Early Rehabilitation, Helios
Hanseklinikum, Stralsund, Germany;
3
Departments of Urology,
University Hospital of Canary Islands, Santa Cruz de Tenerife,
Spain;
4
Department of Urology, Piti´e-Salpetri`ere Academic Hospital,
University Paris 6, Paris, France;
5
Faculty of Health & Human Sciences,
CRIPACC, University of Hertfordshire, Hertfordshire, United Kingdom;
6
Division of Geriatric Medicine, University of Alberta, Edmonton,
Canada;
7
Heidelberg University, Institute of Experimental and Clinical
Pharmacology and Toxicology, Mannheim, Germany;
8
Department of
Urology, Hannover Medical School, Hannover, Germany
The drugs used to treat lower urinary tract symptoms are among the
most prescribed medications to elderly people. Nevertheless, there
is little evidence regarding their efficacy, safety and tolerability in
elderly patients (≥65 years). As an approach towards optimization
of pharmacotherapy of LUTS, a systematic review of the literature
concerning urological drugs was performed for the most important
and frequently used oral drug products. As a result, a total number
of 16 drugs (5
a
-reductase inhibitors,
a
1-blockers, antimuscarinics,
b
3-agonists and phosphodiesterase type 5 (PDE5) inhibitors) were
chosen. For oxybutynin, both the immediate release- as well as the
extended release formulations were included. The initiators rated
the selected drugs based on evidence from the existing literature,
and the Summaries of Product Characteristics (SmPCs) according to
the FORTA (Fit fOR The Aged) classification rules for drugs chron-
ically used in the elderly (A: Absolutely; B: Beneficial; C: Careful;
D: Don’t). Finally, an international expert panel assessed the classi-
fication of these drugs in a two-step Delphi process which resulted
in three drugs being assigned to FORTA B (beneficial), 9 drugs to
FORTA C (questionable or careful) and 5 drugs to FORTA D (avoid or
don’t give). Hence, most of the selected drugs should be avoided or
used with caution in older persons and the frail elderly, in particular
the
a
1-blockers, a
b
3-agonist, a PDE5 inhibitor and most of the
antimuscarinics for which classes range from B through C to D.
O-050
Incidence of benzodiazepine and related drug use in persons
with and without Alzheimer’s disease: the MEDALZ study
L. Saarelainen
1
, H. Taipale
1
, M. Koponen
1
, A. Tanskanen
2
,
A.-M. Tolppanen
1
, J. Tiihonen
2
, S. Hartikainen
3
1
University of Eastern Finland, Kuopio, Finland;
2
Karolinska Institutet,
Stockholm, Sweden;
3
Kuopio Research Centre of Geriatric Care, School
of Pharmacy, University of Eastern Finland, Kuopio, Kuopio, Finland
Objectives:
Although frequent benzodiazepine and related drug
(BZDR) use has been reported in persons with Alzheimer’s
disease (AD), the incidence remains unknown. We investigated
the incidence of BZDR use in a cohort of persons with and without
AD during a five-year follow-up.
Methods:
The study was based on the Finnish MEDALZ (Medication
use and Alzheimer’s disease) cohort. Persons diagnosed with AD
during 2005–2011 (n = 70,718) were identified from the Special
Reimbursement Register and the comparison persons without AD
from a nationwide register including all residents. Incident use of
BZDRs, including benzodiazepines and Z-drugs, was investigated
from two years before to three years after the diagnosis of AD. Data
on BZDR use were obtained from the Prescription register.
Results:
The incidence of BZDR use was higher in persons with
AD starting from one year before the diagnosis and peaked at
six months after the diagnosis of AD (incidence rate ratio 2.5,
95% confidence interval 2.4–2.7). The use of benzodiazepines was
predominant in persons with AD and, after the diagnosis, the
incidence of benzodiazepine use remained three times higher than
in the comparison persons.
Conclusions:
Early symptomatic treatment for AD with BZDRs is
not in line with treatment guidelines. BZDR use is recommended
only if non-pharmacological and other pharmacological treatments
have not been beneficial. More caution is needed as concomitant
use of BZDRs complicates the monitoring of treatment with
antidementia drugs due to their adverse effects on cognition.
Furthermore, severe adverse drug events are associated with BZDR
use in older persons.
O-051
Systematic review and meta-analysis: What is the evidence for
oral iron supplementation in treating anaemia in older people?
H.S. Tay
1
, R. Soiza
1
1
NHS Grampian, Aberdeen, United Kingdom
Objectives:
Oral iron supplementation is used widely despite
observational studies suggesting it is ineffective. Therefore, this
systematic review determined if oral iron therapy is effective in
elderly people with iron deficiency anaemia.
Methods:
The systematic review was based on Cochrane
Collaboration methods. MEDLINE, Embase and the Cochrane
library were searched from inception up to 23rd January 2014.
Only randomised controlled trials comparing oral iron with no
iron supplementation or placebo and measuring the change in
haemoglobin levels in elderly anaemic people were included.
Length of hospitalisation, mortality and adverse effect data were
also analysed.
Results:
6163 titles were screened but only three studies
(total 440 participants, mean age 70–83 years old) met the
inclusion criteria, all in an orthopaedics setting. Just one
showed oral iron supplementation significantly raised haemoglobin
level. However, meta-analysis showed oral iron supplementation
increased haemoglobin levels more than placebo or no treatment
after 4–6 weeks of treatment (weighted mean difference 0.35 g/dL,
95% CI 0.12–0.59, p = 0.003). There were no significant differences
in adverse effects, length of hospitalisation or mortality.
Conclusions:
Oral iron raises haemoglobin levels in elderly people
with post-operative anaemia by about 0.35 g/dL after 4–6 weeks.
However, only 3 studies in an orthopaedics setting met inclusion
criteria. It remains unclear if the widespread practice of prescribing
oral iron supplements results in tangible health benefits for older
people.