European Geriatric Medicine - Supplement 1 - Volume 6

S26

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

–

S31

observed daily recording incident delirium, subtypes of delirium,

use of pshychoactive medication, adverse outcomes, length of stay

and discharge destination.

Results:

Out of 262 patients, 119 (45.5%) developed delirium

(median age +SD of 87.1+6.1; 69.4% women), being delirium

hyperactive in 27.7% hypoactive in 29.4% and mixed in 42.9%

of cases. Patients with hypoactive delirium showed increased

mortality and institutionalization at hospital discharge (p 0.055),

worse functional status (p 0.011) but less use of physical restraints

(p 0.002). Patients with hyperactive delirium were more likely

to receive neuroleptic medication (p

0.001), to have history of

delirium (p 0.045), and to present falls and injurious behaviour

that interfered with the treatment (p 0.021) however the duration

of the syndrome was shorter (p 0.050).

Conclusions:

In this study, incidence of delirium was high. Mixed

delirium was the most common subtype. Hypoactive delirium

was significantly associated with poor functional status, greater

mortality and less return home. Strategies to prevent and early

manage delirium, according to subtypes, might be evaluated to

prevent undesirable outcomes and measures such as neuroleptic

medications and physical restraints.

Psychiatric symptoms and illnesses

O-073

Association of depressive symptoms with circadian blood

pressure alterations in Parkinson’s disease

D.L. Vetrano

, M.S. Pisciotta

, V. Brandi

, M.R. Lo Monaco

A. Laudisio

, D. Fusco

, G. Onder

, R. Bernabei

, G. Zuccala

Catholic University

–

Rome, Rome, Italy;

Italy;

Universit`a Cattolica

del Sacro Cuore, Roma, Italy;

Campus Biomedico

–

Rome, Rome,

Italy;

Catholic University of the Sacred Heart, Rome, Italy

Objectives:

To assess whether among patients with Parkinson’s

disease depression, a common non-motor symptom associated with

reduced survival, is associated with cardiovascular dysautonomia.

Methods:

One-hundred-twenty-five subjects with PD consecutively

admitted to a geriatric day hospital were enrolled. All participants

underwent comprehensive evaluation, fasting blood sampling

and 24-hour ambulatory blood pressure monitoring. The percent

reduction in nocturnal blood pressure (dipping) was calculated.

Depressive symptoms were assessed through the 15-item Geriatric

Depression Scale (GDS); a score ≥5 identified moderate to severe

symptoms.

Results:

Within the study sample (mean age 72.7

7.8 years, 32%

women) 61 subjects (49%) presented with a GDS score ≥5. When

compared with other participants, subjects with a GDS score ≥5

had reduced adjusted levels of systolic (−2.6

2.7% vs 4.7

2.5%;

p = 0.003) and diastolic dipping (0.6

2.8% vs 7.4

2.6%; p = 0.007).

After adjusting for potential confounders, depressive symptoms

were associated with reduced systolic (OR 0.94; 95% CI 0.89; 0.98)

and diastolic dipping (OR 0.94; 95% CI 0.90; 0.99).

Conclusion:

Depressive symptoms are prevalent, and inde-

pendently associated with cardiovascular dysautonomia among

patients with Parkinson’s disease. This might explain the

remarkable incidence of sudden death, as well as the association

of depressive symptoms with reduced survival reported in

these patients. The finding of depressive symptoms in subjects

with Parkinson’s disease should therefore prompt assessment of

cardiovascular autonomic function.

O-074

Antidepressant use and cognitive decline in elderly people

I. Carriere

, A. Farre

, J. Norton

, M. Wyart

, P. Noize

, K. Peres

A. Fourrier-Reglat

, M.L. Ancelin

Inserm, U1061, Montpellier, France;

CHU, Nimes, Nimes, France;

Inserm, U657, Bordeaux, France;

Inserm, U897, Bordeaux, France

Objectives:

To prospectively examine the association between

antidepressant use and cognitive decline in community-dwelling

elderly people.

Methods:

The sample included 4210 non-demented participants

(40.3% men) of the 3-city cohort aged 65 and over and followed-up

during 10 years. Baseline antidepressants were grouped into three

classes: the non-selective monoamine reuptake inhibitors (TCA

class), the selective serotonin reuptake inhibitor and the serotonin

and noradrenaline reuptake inhibitor (SSRI and SNRI class) and the

other antidepressants. A battery of tests assessed different cognitive

domains at each examination: Isaacs Set Test for verbal fluency,

Benton’s Test for visual memory, Trail Making Tests A and B (TMT-

A and TMT-B) for psychomotor speed and executive function and

the Mini Mental State Examination for global cognitive function.

Longitudinal associations were analyzed using linear mixed models

(LMM) and LMM with latent processes.

Results:

After adjustment for demographic and behavioral factors,

physical comorbidities, disabilities, apolipoprotein E genotype,

other psychotropic drugs, anxiety, sleep disorders and depressive

symptoms antidepressant use was only associated with baseline

lower cognitive performances but not with a cognitive decline over

time. At baseline compared to non-users, the SSRI or SNRI users

had lower Isaacs scores (−3 word, p = 0.0006) and were slower on

TMT-B (+9 seconds, p = 0.02). The TCA users were slower on both

TMT-A (+8 seconds, p = 0.02) and TMT-B (+22 seconds, p = 0.003).

Conclusion:

Our findings suggest antidepressants are not a risk

factor for cognitive decline after multiple adjustments; the question

remains whether the loss observed at baseline occurred before or

at the moment of treatment initiation.

Geriatrics in organ disease

O-075

Burden of comorbidity of older subjects on dialysis: the QiN

registry

G. von Gersdorff

, M.C. Polidori

, M. Schaller

, K. Rascher

W. Pommer

, G. Roehrig

Dpt II INternal Medicine University Hospital of Cologne, Cologne,

Germany;

University of Cologne, Cologne, Germany;

KfH Curatorium

for Dialysis and Kidney Transplantation, Neu-Isenburg, Germany;

Ageing Clinical Research, Dpt II INternal Medicine, University

Hospital of Cologne, Cologne, Germany

One of the growing healthcare problems of elderly subjects is

chronic kidney disease. A substantial proportion of these require

thrice weekly dialysis, which is associated with a significant disease

burden. Most dialysis units are currently poorly prepared to deal

with geriatric syndromes. This analysis was done to describe

characteristics of incident dialysis patients aged 80 years or older

in Germany.

The Curatorium for Dialysis and Kidney Transplantation (KfH)

comprises 191 nephrology clinics across Germany covering the

needs of ca. 25% of the whole German dialysis population; KfH has

established a quality registry (Qualit¨at in der Nephrologie; QiN),

which regularly analyzes and reports clinical and epidemiological

characteristics of the dialyzed population. In this retrospective

cohort study, patients initiating dialysis aged 65–79 or ≥80 years,

respectively, were analyzed in the period 2007–2013.