European Geriatric Medicine - Supplement 1 - Volume 6

S24

Oral presentations / European Geriatric Medicine 6S1 (2015) S5

–

S31

Methods:

We organized a web-based survey among the members

of Finnish Geriatricians (n = 248). The questionnaire included

items about usage and content of CGA. Evaluated domains

were: assessment of cognition, malnutrition and functional ability,

evaluation of depression and measurement of orthostatic blood

pressure.

Results:

Altogether 121 physicians (49%) responded, and the

present analysis included 95 geriatricians performing clinical work.

Majority of the responders (94%) evaluated older patients using

CGA. Of them, 38% performed CGA to all new patients and 62%

to selected patients. Ten responders (11%) incorporated all five

domains into CGA. Other responders selected domains according

to their clinical judgment. Greater proportion of female than male

physicians included evaluation of depression (39% vs. 16%, p = 0.045)

and assessment of functional ability (48% vs. 24%, p = 0.01) always

in CGA. Those responders, who applied CGA to all new patients,

incorporated nutritional assessment (68% vs. 34%, p = 0.002) and

measurement of orthostatic blood pressure (76% vs. 54%, p = 0.04)

always into CGA more often than those who performed CGA to

selected patients only. Responders’ opinions about health care for

older people and about their own work were not associated with

the application of CGA.

Conclusions:

Majority of the responders performed CGA to

their patients. The content of CGA varied between geriatricians.

Incomplete evaluation may lead to inadequate detection of geriatric

syndromes and other problems.

O-066

Profiling of geriatric patients by using a comprehensive

geriatric assessment

J.-P. Steinmetz

, J. Schrauf

2,3

, D. Ferring

, C. Federspiel

Department of Research and Development, Zitha Senior and Centre

for Memory and Mobility, Luxembourg, Luxembourg;

University of

Luxembourg, Luxembourg;

ZithaSenior Research & Development,

Walferdange, Luxembourg;

University of Luxembourg, Walferdange,

Luxembourg;

ZithaSenior, Center for Memory and Mobility,

ZithaKlinik, Luxembourg, Luxembourg

Introduction:

Long-term care patients generally demonstrate a

dependency in activities of daily living and are characterized

by a high prevalence of cognitive and emotional dysfunctions.

The organization and the provision of individualized and patient-

centred care are limited by the complexity of the clinical

heterogeneity of the geriatric sample. With the present research

we aim at reducing the heterogeneity in our sample by regrouping

patients into several different subsamples by their respective

clinical profile.

Methods:

A total of 391 patients (mean age: 85.0, SD=7.1

years) from 4 different long-term care institutions were assessed

using a comprehensive geriatric assessment. The assessment was

composed of measures of functional and cognitive impairment,

emotional status, grip strength, mobility, and pain. Data collection

was organized over a 6 month period.

Results:

Using cluster analysis as an exploratory data analytic tool

for organizing observed data into meaningful, yet initially unknown

groups of patients, we found four relatively homogeneous groups

of geriatric patients. The four clusters differ significantly from each

other on a number of observed parameters, suggesting that each

cluster is characterized with a different pattern of health concerns.

Conclusion:

The present research demonstrates an approach to

reduce the heterogeneity included in geriatric samples. By using the

cluster analytic approach, individuals with similar characteristics on

the respective variables are included in the same subsample. We

discuss how the identified profiles may serve the clinician and

other health professionals to adequately structure patient-centred

care and support.

O-067

Implementation of geriatric consultation teams (GCT) in acute

hospitals in three European countries

M. Deschodt

, V. Claes

, B. Van Grootven

, K. Van den Heede

B. Boland

, J. Flamaing

, K. Milisen

Department of Public Health and Primary Care KU Leuven and

University Hospitals Leuven, Leuven, Belgium;

Institut of Nursing

Science, University of Basel, Basel, Switzerland;

Department

of Public Health and Primary Care, KU Leuven and University

Hospitals Leuven, Leuven, Belgium;

Belgian Healthcare Knowledge

Centre, Brussels, Brussels, Belgium;

Geriatric Medicine, Cliniques

Universitaires Saint-Luc, Brussels, and Research Institute of Health

a, Louvain-la-Neuve, Belgium;

Department of Geriatric Medicine

University Hospitals Leuven and KU Leuven, Leuven, Belgium

Objective:

To understand how implementation of multidisciplinary

GCTs on non-geriatric hospital units was facilitated in the

Netherlands, France and Belgium.

Methods:

Scoping review and cross-sectional survey.

Results:

GCT implementation was supported through a Senior

Friendly Hospital (SFH) Quality Label in the Netherlands, and

legislation in France and Belgium. Forty-six (47%) hospitals in the

Netherlands were awarded the Quality Label in 2013 and 82 (83%)

had a GCT. The majority (n = 56, 68%) of the GCTs scored 75% on

the GCT criterion, a minimal standard for SFH eligibility. The Dutch

National Society for Clinical Geriatrics specifies different ways to

implement consultation-based interventions. In 2002, the Ministry

of Health in France decreed on the Geriatric Care Network (GCN)

for better elderly management, stating that the GCN should consist

out of a GCT and a geriatric unit, short-stay unit, day hospital and

rehabilitation unit. It also regulated GCT activities and provided

the possibility for out of hospital consultation. In 2011, 216 French

public acute care hospitals (31%) had a GCT. In Belgium, a Care

Program for Older Hospitalized Patients was published in 2007:

acute hospitals should have an acute geriatric hospitalization ward,

outpatient’s clinic, and day care hospital, a GCT, and an external

liaison service. Over 90% of Belgian acute hospitals have a GCT.

Structural financing for GCT activities is provided since 2013.

Conclusions:

Although a heterogeneous approach for patient

screening, assessment, and follow-up was observed, legislation and

quality labels were facilitators to promote GCT implementation on

a national level.

Delirium

O-068

Plasma melatonin levels in older hip fracture patients and

the occurrence of delirium: signs for a phase shift?

R. Scholtens

, A. De Jonghe

, B. Van Munster

, S. De Rooij

AMC, Amsterdam, Netherlands;

Netherlands;

UMCG, Amsterdam,

Netherlands;

UMCG, Groningen, Netherlands

Objective:

Delirium is characterized by circadian rhythm

disturbances. Melatonin plays a major role in maintaining circadian

rhythm. The aim of this study was to compare melatonin levels in

patients with and without delirium.

Methods:

From 2008–2012 all consecutive older hip fracture

patients who were acutely admitted to the hospital were included

in a randomized controlled trial investigating melatonin suppletion

for the prevention of delirium. Data of the placebo group of

this study were used. If patients consented to blood withdrawal

1–4 blood samples were obtained during hospitalization at 11:00

am. Delirium was assessed daily by trained staff using the

Confusion Assessment Method (CAM). At baseline demographic

data, comorbidity, cognitive and functional status were recorded.

Melatonin was measured by radio immunoassay (RIA).