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S54
Poster presentations / European Geriatric Medicine 6S1 (2015) S32
–
S156
P-081
Characteristics of nursing home residents with extreme vocally
disruptive behavior: a part of the WAALBED III Study
A. Rouwenhorst
1
, D. Gerritsen
2
, M. Smalbrugge
2
, R. Wetzels
3
,
H. Bor
4
, S. Zuidema
2
, R. Koopmans
2
1
Department of Primary and Community Care, Radboud University
Medical Center, Nijmegen, Lieren, Netherlands;
2
Netherlands;
3
Department of Primary and Community Care, Radboud University
Medical Center, Nijmegen, Nijmegen, Netherlands;
4
1Department of
Primary and Community Care, Radboud University Medical Center,
Nijmegen, Nijmegen, Netherlands
Objective:
Although vocally disruptive behavior (VDB) is a common
feature in nursing home residents with dementia and some have
extreme VDB, hardly any literature about the characteristics of these
residents is available. The Waalbed III study explores the prevalence
and characteristics of this group and the current presentation will
show the differences of residents with extreme vocally disruptive
behavior as compared to those without extreme VDB.
Methods:
Data of four studies in nursing home patients with
dementia was combined into one dataset of 2076 residents: the
Waalbed-I study (cross-sectional study, n = 1332), the Waalbed-II
study (longitudinal; n = 290), the Dementia Care Mapping study
(randomized controlled trial; n = 318), and GRIP on challenging
behavior (randomized controlled trial; n= 659). Residents with
extreme VDB were defined as those having a score of 6 or 7 on the
CMAI-items ‘screaming’ and/or ‘making strange noises’ compared
to residents without VDB, i.e. having a CMAI total score of 1 on
both items.
Results:
In the extreme VDB group (n = 239), mean age was lower
(81.5 years vs. 82.9, p = 0.01), duration of stay was longer (34.2
months vs. 26.6, p = 0.00) and severity of dementia was different
(p = 0.00), with more residents in Global Deterioration Scale (GDS)
stage 7 and less in GDS 4, 5 and 6 compared to residents without
VDB. The prevalence of psychotropic drug use was higher in the
extreme VDB group (73.7% vs. 59.8%, p = 0.00).
Conclusion:
When comparing a group of nursing home residents
with dementia having extreme VDB to a group without VDB several
important differences emerge.
P-082
Validity of consent in patients over 75 on an acute general
medicine unit undergoing procedures and contrast imaging
J. Rudnay
1
, I. Haeusler
1
, S. Pendlebury
2
1
Oxford University Hospitals Trust, Oxford, United Kingdom;
2
Stroke Prevention Research Unit, Nuffield Department of Clinical
Neurosciences, Oxford, United Kingdom
Objectives:
UK guidelines recommend routine cognitive screening
for older people (
>
75 years) admitted as an emergency to the
general hospital. These data should inform the need for capacity
assessment in patients undergoing procedures for which formal
written informed consent or discussion of risk/benefit is required.
We therefore undertook an audit to determine the number of older
patients undergoing a procedure who had a cognitive test and the
nature of the consent process in those with cognitive impairment.
Methods:
A consecutive sample of notes from current acute
medicine patients aged
>
75 years were reviewed over two days
in February 2015. The number undergoing procedures requiring
consent or contrast CT scans was recorded together with the
abbreviated mental test score (AMTS/10, AMTS
<
8 = abnormal)
and consent documentation.
Results:
Among 105 patients, 30 underwent procedures and/or
contrast CT scans. 21/30 had a documented AMTS, 11 of which
were low. Twelve patients underwent procedures; 5 of these had
abnormal AMTS but standard consent, with no documentation
of capacity. Documented consent was missing in 2 cases (AMTS
normal n = 1; AMTS missing n = 1). Discussion of the risk of acute
kidney injury was not documented prior to any of 26 contrast
scans in 22 patients, of whom 7 had low AMTS and 8 had no AMTS
documented. Two patients had a subsequent eGFR reduction of
≥25%.
Conclusion:
Although a majority of older acute medicine patients
undergoing procedures had had a cognitive test, these results were
not used to inform the consent process, resulting in suboptimal
consent in many cases.
P-083
Effects of acetylcholinesterase inhibitors on nutritional status
in elderly patients with dementia: a 6 month follow-up study
P. Soysal
1
, A.T. Isik
2
1
Center for Aging Brain and Dementia, Department of Geriatric
Medicine, Dokuz Eylul University, Izmir, Turkey;
2
Center for Aging
Brain and Dementia, Department of Geriatric Medicine, Dokuz Eylul
University, Facul, Izmir, Turkey
Objectives:
Nutritional status is one of the factors that affect
disease progression, morbidity and mortality in elderly patients
with dementia. The present study aimed to evaluate effect of
acetylcholinesterase inhibitor (AchEI) therapy on nutritional status
and food intake in the elderly.
Methods:
Newly diagnosed patients with dementia, who
underwent comprehensive geriatric assessment (CGA) and followed
at regular intervals, were retrospectively evaluated. A total of 116
patients, who began to receive AchEI therapy and have completed 6-
month follow-up period under this treatment, were enrolled in the
study. Socio-demographic characteristics and data on comorbidity,
polypharmacy, cognitive function, depression, activities of daily
living and nutritional status (weight, Body Mass Index (BMI), Mini
Nutritional Assessment (MNA)-Short Form) were recorded.
Results:
The mean age of the patients was 78.0
±
8.9 years. There
was no significant difference between baseline and 6-month
BMI, weight and MNA scores of dementia patients that received
AchEI therapy (p
>
0.05). With regard to the relation between
changes in BMI, weight and MNA on the 6th month versus
baseline, and donepezil, rivastigmine and galantamine therapies,
no difference was determined (p
>
0.05). However, a change in
favor of improvement was observed in food intake (kappa: 0.377).
It was determined that donepezil and galantamine therapies did
not significantly influence food intake, but rivastigmine patch did
positively (p
<
0.05).
Conclusion:
AchEI therapy has no unfavorable effect on nutritional
status in elderly, but food intake is likely to be improved in those
treated with rivastigmine patch.
P-084
Relationship between the Four Square Step Test and cognitive
function in community-dwelling older women
N. Tomiyama
1
, R. Hasegawa
2
1
Seijoh University, Tokai, Japan;
2
Chubu University, Kasugai, Aichi,
Japan
Introduction:
Previous research has reported that the Four Square
Step Test (FSST) was easily to scored, quickly administered and
required little space and no special equipment as a dynamic
balance test. At the same time, the FSST is demanding remembering
sequence. Thus, the FSST may be associated with cognitive function
and may be useful to assess it in older adults. The purpose of
this study was to examine the relationship between the FSST and
cognitive function in community-dwelling older women.
Methods:
Seventy-three community-dwelling older women (mean
age of 72.4
±
4.9 years) performed the FSST and cognitive function
testing using Test Your Memory (TYM). The FSST was measured
not only by completed time; step start time for each square was
also calculated by recorded video camera. Pearson’s correlation
coefficient was used to investigate the relationship between the