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Poster presentations / European Geriatric Medicine 6S1 (2015) S32
–
S156
S47
objectives, level of cognitive functionality, or guided neuropsycho-
logical exploring. We have designed a telerehabilitation innovative
system that faces the clinical and technological challenges.
Method:
The initial and final evaluations have been carried out
after an intervention period of 6 months.
The target population was 115 persons at the beginning and 63 at
the end, from which 25 (X=81, 38 years) lived in elderly population
residences and 38 (X=77, 13 years) in the community. The cognitive
profile was classified in 4 levels.
The satisfaction was evaluated with validated questionnaires
analyze telemedicine programs according to the Model for
Assessment of Telemedicine Application and the levels of life
quality according to the health questionnaire EUROQOL 5D.
Results:
The average cognitive level of the residential population
was 1.72 and in the community, 2.50. The final level was 1.80 and
2.47, respectively.
The satisfaction degree was considered to be excellent in 60% and
good in 40%. The tool was considered to be recommendable in 80%.
In the life quality of the residential population, 68% had a mobility
issue, and 42% presented pain; meanwhile, in the communal
population, 33% had a mobility issue and 42% presented pain.
Conclusions:
•
Excellent acceptance of the tool
•
Usefulness of the tool to increase the life quality, without
affecting the self-care
•
Decelerate the cognitive impairment in residential population.
Minor improvement.
P-057
Association between left ventricular diastolic function and
cognitive performance in adults with Down syndrome
A. Carfì
1
, D.L. Vetrano
2
, V. Brandi
2
, F. Fiore
1
, D. Mascia
1
, S. Di Tella
1
,
R. Bernabei
2
, G. Onder
2
1
Department of Geriatrics
–
Catholic University of the Sacred Heart,
Rome, Italy;
2
Italy
Objectives:
Down syndrome(DS) is characterized by high rates
of early-onset age-related disorders and in particular persons
with this condition are at high risk of experiencing Alzheimer
disease(AD). Subjects with DS are also known for very low
prevalence rates of cardiovascular disease, but attention is growing
on increased prevalence of left ventricular diastolic dysfunction in
adults with DS. Interestingly, studies on AD are now investigating
the relationship between heart and brain function. Aim of the
present study is to evaluate the association between left ventricular
diastolic dysfunction and cognitive impairment in adults with DS.
Methods:
We enrolled 27 adults with DS followed at the Day
Hospital of Geriatrics at the Policlinico Gemelli, Universit `a Cattolica
del Sacro Cuore in Rome. Left ventricular diastolic function was
evaluated through echocardiography with measurement of trans
mitral flow and Tissue Doppler Imaging (TDI). Diastolic dysfunction
was defined as an E/e
>
8. Cognitive impairment was evaluated
with Raven Matrices and Wechsler Adult Intelligence Scale(WAIS)
including verbal scale and performance scale.
Results:
In our sample (mean age 37.1
±
9.2 years; 78% females),
14 (52%) subjects showed diastolic dysfunction with a mean score
in Raven matrices and WAIS scales (verbal and performance) of
respectively 12.8
±
5.6, 9.1
±
4.1 and 8.9
±
4.2. After correction for
age and gender, participants with diastolic dysfunction showed
lower scores in the three cognitive performance scales as compared
with those without diastolic dysfunction and: Raven matrices
10.8
±
1.1 vs. 15.8
±
1.4 (p = 0.011); WAIS verbal scale 7.5
±
0.7 vs.
10.1
±
0.7 (p = 0.017); WAIS performance scale 7.8
±
1.0 vs. 9.8
±
1.0
(p = 0.190).
Conclusions:
Left ventricular diastolic dysfunction is independently
associated with reduced cognitive performance in adult subjects
with DS.
P-058
A better diagnostic differentiation between mild and major
NCD when measuring everyday functioning
E. Cornelis
1
, E. Gorus
2
, I. Bautmans
3
, I. Beyer
1
, P. De Vriendt
3
1
Universitair Ziekenhuis Brussel, Jette, Belgium;
2
Vrije Universiteit
Brussel, Jette, Belgium;
3
Belgium
Objectives:
According to DSM-V, differentiation between mild and
major neurocognitive disorders (NCD) – or mild cognitive impair-
ment (MCI) and dementia – is based on the preservation of everyday
functioning. However, no established standards exist for measuring
functional limitations for diagnostic purposes. Therefore, an eval-
uation for basic (b-) and instrumental (i-) activities of daily living
(ADL) has been developed which assesses individualized functional
impairment by distinguishing underlying causes of limitation.
Expressed as percentages, it distinguishes a Global (DI), Cognitive
(CDI) and Physical Disability Index (PDI) for both b- and i-ADL.
Methods:
The (construct and discriminative) validity and inter-
rater reliability was evaluated in 154 community dwelling older
persons (mean age 79.8; SD
±
7.0), classified based upon a standard
clinical evaluation as cognitively healthy (CH; n = 47) (controls),
Mild Cognitive Impairment (MCI; n = 43) (mild NCD) and mild to
moderate Alzheimer’s Disease (AD; n = 64) (major NCD). Separately,
the new evaluation was administered.
Results:
The CDI showed accurate differentiation (p
<
0.05) with a
mean b-ADL-CDI of 0.0% for CH, 2.8% (SD
±
7.1) for MCI and 8.9%
(SD
±
11.3) for AD, and a mean i-ADL-CDI of 1.8% for CH (SD
±
5.7),
21.3% for MCI (SD
±
19.7) and 50.9% for AD (SD
±
22.8). The DI and
PDI were only different between CH and patients (p
<
0.001). ROC
curves showed satisfactory results for DI and CDI of both b- and
i-ADL, with an AUC ranging 0.687 to 0.992. Inter-rater reliability
for all indices showed an ICC ranging 0.944 to 0.994.
Conclusions:
By distinguishing causes of limitations, evaluation of
everyday functioning allows an accurate diagnostic classification in
NCD.
P-059
Creativity in Alzheimer’s Disease
C. Cristini
University of Brescia, Brescia, Italy
Objectives:
In Alzheimer’s Disease, despite limited brain activity, it
may still to express creativity.
Methods:
We have examined some examples of creativity and
dementia reported in scientific documents and several patients
with Alzheimer’s Disease, living in nursing home, that have
expressed their creativity by many paintings.
Results:
In old age, Immanuel Kant presents signs of cognitive
decline. He appears to be aware of his disorder, expressing the
pain of changes, the need to secure environmental and emotional
reference points. His decline continues relentlessly, but he keeps
his style, his cultural achievements, his feelings of gratitude,
understanding and affection.
Cary Smith Henderson, a professor of history, writes his journal,
expressing his experience with Alzheimer’s disease. In advanced
stages of the disease, he is able to grasp the meaning of situations
and relationships; despite the difficulties and communication
problems, he continues to have feelings and ideas that he would
like to share with others.
William Utermohlen, a painter, stricken by Alzheimer’s disease,
continued to compose portraits following the inexorable
progression of his decay; he has witnessed the decline of his
cognitive functions, maintaining until the end a kind of artistic
core. Utermohlen seems aware – at least in emotional terms – of
what is happening to him.
Many institutionalized elderly people express their creativity, their
emotion, their thought drawing and painting. Sometimes their
interesting works recall portraits of famous painters.