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Poster presentations / European Geriatric Medicine 6S1 (2015) S32
–
S156
S51
P-071
Retrospective study of comorbidities and prescripction in
psychogeriatric patients (2012–2014)
M. Hernandez
1
, C. Mestres
1
, J. Junyent
1
, D. Quera
1
1
Grup Mutuam, Barcelona, Spain
Objectives:
Patients admitted in a Psychogeriatric Unit of Long-
term care institutions have common characteristics: cognitive
impairment, behavioral and psychological symptoms of dementia,
balance disorders, polypharmacy and comorbidities. Thus, the
purpose was to review the population characteristics in order to
establish improvements in our healthcare.
Methods:
Retrospective observational study 2012–2014. Data in
the electronic medical records were reviewed. Study variables:
demographic data, cognitive impairment and tests, comorbidities
and drugs at admission. Exclusion criteria: Patients without
cognitive impairment, length of stay under 7 days, palliative or
previous psychiatric pathology.
Results:
Included 85 patients (51% women). Average age 84.27
years old. Mean length of stay 69 days. Mean (MMSE) 15: moderate
cognitive impairment. Mean Barthel Index 35: severe-moderate
dependence. At admission, 76% polymedicated (8.8 drugs/patient
(2–20 drugs)).
Dementia: 38% not completed study, 30.6% Alzheimer, 17.6%
Vascular, 4.7% secondary Parkinson disease, others 7.1% and Mixed
dementia 1.2%.
Comorbidity: aggression/agitation 85.5%, ischemic heart disease
22.4%, hypertension 31.8%, diabetes 24.7%, chronic obstructive
pulmonary disease 4.7%, arrhythmia 23.5%, heart failure 9.4%,
cerebrovascular disease 23%, renal impairment 7.1%.
Medication: 88% had psychoactive drugs and 70% more than one.
Distribution: 56% antipsychotic, 25% benzodiazepines and 19%
antidepressants. Of whom 29% had more than 1 benzodiazepine,
19% more than 1 antidepressant and 44% more than 1
antipsychotic.
Conclusions:
Risk reduction should include multidisciplinary team
involvement at admission and follow-up. Medication review is an
essential component of comprehensive risk assessment.
A guideline has been developed for medications assessment that
includes recommendations to discontinue medications, decrease
dosage and reduced risk treatments in dementia patients.
P-072
Self-rated and caregiver-rated quality of life in Alzheimer’s
disease: 5-year prospective ALSOVA cohort study
K. Hongisto
1
, S. V¨a¨at¨ainen
2
, J. Martikainen
2
, I. Hallikainen
3
,
T. V¨alim¨aki
4
, S. Hartikainen
5
, J. Suhonen
6
, A. Koivisto
7
1
University of Eastern Finland, Institute of Public Health and
Clinical Nutrition,Geriatrics, Kuopio, Finland;
2
Pharmacoeconomics &
Outcomes Research Unit, School of Pharmacy, University of Eastern
Finland, Kuopio, Finland;
3
) School of Educational Sciences and
Psychology, University of Eastern Finland, Kuopio, Finland, Kuopio,
Finland;
4
Department of Nursing Science, University of Eastern
Finland, Kuopio, Finland., Kuopio, Finland;
5
Kuopio Research Centre
of Geriatric Care, School of Pharmacy, University of Eastern Finland,
Kuopio, Kuopio, Finland;
6
Department of Neurology, Al-Ahli Hospital,
MOLDE, Qatar;
7
NeuroCentre, Neurology, Kuopio University Hospital,
Kuopio, Finland, Kuopio, Finland
Objective:
Examine and compare self-and caregiver-rated measures
of Quality of Life (QoL) in relation to disease progression in patients
with very mild or mild Alzheimer’s disease (AD) and at what disease
stage patient’s ability to respond to QoL questionnaires with or
without assistance begins to diminish.
Methods:
236 patients with very mild or mild AD and their family
caregivers from three Finnish hospital districts participated in this
prospective, longitudinal study with five years of follow-up.
Three patient-reported wellbeing and life satisfaction instruments
were used to assess health-related QoL – a generic 15D, the Quality
of Life in Alzheimer’s Disease (QoL-AD), and the Visual Analogue
Scale (VAS) as well as one caregiver-rated assessment of patient QoL
(QoL-AD). AD severity was evaluated with the Clinical Dementia
Rating Scale – Sum of Boxes (CDR-SOB).
Results:
All self- and caregiver-rated QoL estimates correlated with
AD severity. The self- and caregiver-rated QoL scores began to
diverge even with very mild cognitive impairment after CDR-
SOB reached 4, value that corresponds with a Mini-Mental State
Examination (MMSE) score of 25–30. Patients also began to need
assistance in responding to questionnaires at very early stages of
AD (CDR-SOB 4–6). Furthermore, their ability to respond to QoL-
questionnaires with or without assistance declined after CDR-SOB
reached 11 points, value that correlated with an early moderate
stage of AD and MMSE 11–20.
Conclusions:
It is challenging to assess QoL in patients with AD,
because even at very early stages of AD, patients have difficulty
comprehending or communicating their health status.
P-073
The prevalence, determinants and long term effects of
resilience in family caregivers of persons with dementia.
A longitudinal analysis of multiple studies
K. Joling
1
, G. Windle
2
, R.-M. Dr ¨oes
3
, F. Meiland
3
, H. Van Hout
4
,
J. MacNeil Vroomen
5
, P. van de Ven
3
, E. Moniz-Cook
6
, B. Woods
2
1
VU University medical center, Amsterdam, Netherlands;
2
Bangor
University, Bangor, United Kingdom;
3
VUmc, Amsterdam, Netherlands;
4
Netherlands;
5
AMC, Amsterdam, Netherlands;
6
University of Hull,
Hull, United Kingdom
Objective:
Although caring for a person with dementia can
be stressful, some carers appear to experience few negative
consequences to their well-being. This could be interpreted as a
sign of resilience. This study aimed to (1) examine how many
carers demonstrate resilience, (2) identify determinants of their
resilience, and (3) test to what extent resilience is related to carers’
health outcomes over time.
Methods:
Data were derived from four longitudinal studies
including 1,311 family caregivers of community-dwelling persons
with dementia. Caregivers’ resilience was defined as having
relatively low levels of care distress in the face of high
care demands at baseline. High care demands included caring
for a relative with severe dementia, problems with self-care,
and/or behavioural problems. Regression analyses were performed
to identify significant determinants of resilience and test its
relationship with caregivers’ health over time.
Results:
Between 29 to 61% of all caregivers demonstrated high
resilience levels for each adversity. Cohabiting status, patient
gender, a good quality of the carer-patient relationship, sense of
competence, mastery, use of day care, carer mental health and
quality of life were significant determinants of resilience across
samples. Baseline resilience was not significantly related to changes
in carers’ mental health or quality of life over time.
Conclusion:
Resilience in carers was present across multiple
studies, even if operationalized in different ways. Results point to
the importance of the carer (mental) health and the quality of the
caregiver-care recipient relationship since these factors emerged
frequently as determinants of caregivers’ resilience.