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S22
Oral presentations / European Geriatric Medicine 6S1 (2015) S5
–
S31
O-058
Forget me not: Understanding “Dementia” through films
K. Ali
Brighton and Sussex Medical School, Brighton, United Kingdom
Objectives:
Dementia is a significant universal health and social
challenge. Films can act as a popular, easily-accessible medium
for understanding the experience of patients with dementia and
their carers, as well as an effective training and educational
resource, promoting the delivery of compassionate, dignified care
in hospitals and care home settings. The objectives of this survey
were to identify films exploring dementia, and summarize emerging
themes.
Methods:
An internet search was undertaken using terms:
dementia, film, movie, nursing homes, care homes, older people,
over the last 10 years using Google advanced search, EMBASE, IMDB
and Pubmed.
Results:
Sixteen films were identified from five continents with
the following themes: evolving phases of dementia (denial, grief,
acceptance and eventual loss of identity: Still Alice, USA 2014,
Cairo Time, Egypt 2014, The Iron Lady, UK 2011), role reversal
of children acting as parents and interdependency (Radiator, UK
2014, Nebraska, USA 2013, Black, India 2005), rewarding aspects
of caring (A Simple Life, Hong Kong 2011, Robot and Frank, USA
2012), potential for abuse and carer burden (A Separation, Iran
2011, Coming Forth by Day, Egypt 2012), placement issues (Away
From Her, UK 2006, The Savages, USA 2007), ethical dilemmas in
feeding and end of life decisions (Amour, France, 2012, Volcano,
Finland, 2011) and the role of arts and humanities (e.g. music and
photography) in patients’ well-being (Alive inside, USA 2014, Love,
loss and laughter, Australia 2013).
Conclusions:
Films offer a rich medium for teaching and training
healthcare professionals about the complexity of dementia.
O-059
Heterogeneity of cognitive ageing in older Britons: latent class
trajectories of cognitive scores in ELSA 2002–2013
G. Tampubolon
University of Manchester, Manchester, United Kingdom
Objectives:
Healthy cognitive ageing is desired in an ageing
population, requiring tremendous demand for health resources and
social care. An effective response to this demand must recognise
the heterogeneous experiences of cognitive ageing unfolding in the
population. To capture this heterogeneity we aim to derive latent
classes of age trajectories of cognitive scores of older Britons aged
50 and over. These are then profiled in terms of sex, education and
cohort.
Methods:
From the English Longitudinal Study of Ageing 2002–
2013 (N person-year = 49,981), cognitive scores capturing memory
and executive functions are derived. We applied latent class
trajectories method where the population likely clustered into a
limited number of classes. Each class is distinct from another based
on the way cognition changes as its members age.
Results:
The method yielded four latent classes of age trajectories
of cognitive scores. One of the classes displayed an advantageous
trajectory since for its members the onset of cognitive scores
decline does not start until 60. The profile furthermore shows that
among its members women are more likely than men to belong to
this class. Cohort effect is also apparent with the Post War cohort
members likely to be found in the advantageous latent class.
Conclusion:
Cognitive ageing of older Britons can be pictured using
four age trajectories uncovered using latent class trajectory method.
Public programme to support healthy cognitive ageing should
consider the possibility of tailoring any programme accordingly.
This research is funded by the MRC and NIHR.
O-060
Social factors predict cognitive outcomes cross-sectionally,
but not longitudinally, among older Irish adults
J. McHugh
1
, R.A. Kenny
2
, B. Lawlor
3
, F. Kee
4
1
Queen’s University Belfast, Belfast, United Kingdom;
2
Ireland;
3
Trinity
College Dublin, Dublin, Ireland;
4
Queen’s University Belfast, Belfast
Objectives:
Evidence exists of an association between social factors
and cognitive functioning in later life. We wanted to investigate
whether (a) this association holds when health behaviours and
mental health status are controlled for, and (b) whether the
association is present in cross-sectional and/or longitudinal data.
Methods:
Data from 8504 older (aged 50+) participants in waves
1 and 2 of the TILDA (Irish Longitudinal Study on Ageing) dataset
were analysed using hierarchical linear regressions. Outcomes were
immediate and delayed word recall, and scores on the Mini Mental
State Examination (MMSE). Age, gender, education level, health
factors (blood pressure, waist-hip ratio, smoking and alcohol intake,
exercise, triglycerides), and mental health (depressive and anxiety
symptomatology) factors were included as covariates. Predictors
of interest were social participation, social connectedness, and
loneliness.
Results:
Controlling for covariates, social factors predicted im-
mediate recall (Loneliness
b
= −0.064, p
<
0.01; Social participation
b
= 0.045, p
<
0.01), delayed recall (Loneliness
b
= −0.08, p
<
0.01;
Social Participation
b
= 0.034, p
<
0.05) and MMSE outcomes
(Loneliness
b
= −0.064, p
<
0.01; Social Participation
b
= 0.056,
p
<
0.01), cross-sectionally, but not longitudinally. We investigated
potential reverse causality (cognition predicting change in social
factors over time) but this possibility was ruled out.
Conclusions:
There is a cross-sectional but no longitudinal
association between social participation, loneliness, and cognitive
outcomes among older Irish adults. Social factors may have a short-
term impact on cognition only, or potentially a key confound was
not considered in this analysis. Further research is warranted to
investigate other potential confounds of the association.
Comprehensive geriatric assessment
O-061
A comprehensive geriatric assessment in the emergency
department reduces admissions and length of stay
L. Wentworth
1
, S. Briggs
1
, R. Keelan
1
, S. Ashraf
1
, L. Wileman
1
,
J. Williams
1
1
University Hospital of South Manchester, Manchester, United Kingdom
Objectives:
OPAL (Older Persons Assessment and Liaison) is a
service which has been developed at the University of South
Manchester to review frail patients who present to the Emergency
Department (ED). OPAL consists of a geriatrician and therapists.
Patients undergo a Comprehensive Geriatric Assessment (CGA)
within the ED with the intention for a safe and quick discharge
to the community, referral and timely review by appropriate
community health and social services can be arranged. The aim of
OPAL is to reduce inappropriate admissions and provide increased
support to those most vulnerable.
Methods:
The outcomes of all patients were reviewed over the last
nine months since the service began.
Results:
A total of 990 patients underwent a CGA by the OPAL
team. Of these 383 were admitted, 39% conversion rate, compared
to a 66% conversion rate of age matched controls. The patients who
were admitted by the OPAL team had a shorter length of stay, 9.93
vs 10.18. The majority of patients discharged from ED were referred
to a community service
Conclusions:
Often staff in the ED do not feel confident in managing
complex and frail patients and therefore the safest option is