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S56
Poster presentations / European Geriatric Medicine 6S1 (2015) S32
–
S156
managers or GPs from practices that declined to support the study
were asked to give their reasons.
Results:
All primary care practices in Nottingham and
Nottinghamshire were contacted (n = 145). Of those, 12 (8%)
practices agreed to support the study. Between them they identified
and sent out a total of 249 letters to potential participants. Of
these 19 (7%) people responded and only 6 (2%) met the eligibility
criteria for withdrawing antihypertensive medication. 80/133 (60%)
non responding practices gave reasons for why they did not support
the study: the most common responses were that 31 (39%) were
‘too busy’, staff changes or short staffed were cited in 11 (14%) and
“too time consuming” was cited in 7 (9%).
Conclusions:
Recruitment of a sufficiently large and representative
population for a larger trial would not be feasible in primary care
practices using these methods, due to the high workload in UK
primary care.
P-089
Is the Mini-Cog the way forward in cognitive testing?
R. Visavadia
1
, J. Ehsanullah
2
, M. Chatterjee
3
, D. McCrea
1
1
Care of the Elderly, Central Middlesex Hospital, London, United
Kingdom;
2
United Kingdom;
3
North West London Hospitals, London,
United Kingdom
Objectives:
To evaluate the value of Abbreviated Mental Test Score
(AMTS), Montreal Cognitive Assessment (MOCA) and Mini-Cog in
screening for dementia in secondary care, and to assess which test
correlated best with a bedside geriatric assessment.
Methods:
40 elderly care inpatients in a London hospital underwent
AMTS, MOCA and a Mini-Cog assessment. A consultant geriatrician
also provided a 2-minute bedside assessment. Fisher’s test was
applied to test for statistical significance between groups. Exclusion
criteria: delirium, impaired speech, sight or writing. 40 controls
subjects underwent a MOCA.
Results:
35% patients had an abnormal AMTS. All 40 patients had
a MOCA ≤26 (range 2–25). All patients with an abnormal AMTS
scored abnormally in all assessments. Of those with a normal AMTS,
69% had abnormal Mini-Cog and 46% had an abnormal bedside
assessment.
Of 40 controls, 42% had an abnormal MOCA.
83% of the patients showed correlation between the Mini-Cog and
the bedside geriatric assessment. There was a significant difference
in the bedside assessment results for patients with normal and
abnormal clock draw, (p
<
0.001) and normal and abnormal recall
(p
<
0.001).
Discussion:
The AMTS tends to over-score patients while the MOCA
under-scores. The Mini-Cog correlates best with bedside geriatric
assessment, is quicker and bypasses cultural barriers. Therefore the
MOCA and AMTS could be replaced by the Mini-Cog test when
screening for dementia in hospitals.
P-090
Should the treatment of hypertension in people with coexisting
dementia be attenuated?
T. Welsh
1
, A. Gordon
2
, J. Gladman
1
1
University of Nottingham, Nottingham, United Kingdom;
2
Nottingham
University Hospitals NHS Trust, Nottingham, United Kingdom
Objectives:
The benefits of antihypertensives may be unchanged in
people with dementia (PwD), but the incidence of antihypertensive
side effects (ASEs) may be greater and so the risk-benefit ratio for
antihypertensives in PwD is less clear. By examining the size and
nature of potential risks this study aims to inform decision making
in this group.
Methods:
181 participants with hypertension and dementia were
recruited from seven sites in the UK via memory clinics and
GP practices to an observational cohort study. After baseline
assessment participants were followed up at monthly intervals for
six months.
Results:
Data from 118 participants were available for interim
analysis: 64 (54%) female; mean age 81; residence: 99 (84%)
own homes, 19 (16%) institutional care; mean MMSE 21/30. The
majority (94, 80%) were taking ≥1 antihypertensive. 104 (88%) were
taking 4 or more medications, 23 (19%) 10 or more. Over three
months 37 (31%) saw the district nurse, 72 (61%) saw their general
practitioner, and 11 (9%) had a hospital admission. Those taking
antihypertensives were less likely to report a fall in the preceding
three months (p = 0.009) and during three months of follow
up reported less ankle-swelling (p = 0.023), anxiety/nervousness
(p = 0.005) and MI (p = 0.042).
Conclusions:
We found no evidence that participants given
antihypertensives had a higher incidence of potential ASEs than
participants not given antihypertensives. On the basis of these data
there is no reason to think that ASEs in PwD will outweigh the
potential benefits of treatment, and hence no reason to modify the
treatment of hypertension in PwD.
P-091
Relationships among chronic musculoskeletal pain, cognitive
status and body awareness in older adults
E. Baskan
1
, N. Yagci
1
, U. Cavlak
2
1
Pamukkale University, Denizli, Turkey;
2
Pamukkale University, Denizli
Objectives:
Chronic musculoskeletal pain (CMSP) is a common
health problem and it often leads disabling condition among older
adults. In addition to this, it affects cognition and body awareness.
The aim was to show the relations among chronic musculoskeletal
pain, cognitive status and body awareness in older adults.
Methods:
The sample consisted of 311 older adults (134 females;
177 males) aged 65 and over (mean age; 72.27
±
6.42 years) living
in their own homes. 263 (84.6%) reported musculoskeletal pain
(234 with lower extremity pain; 207 with spinal pain; 138 with
upper extremities pain). Pain intensity was evaluated using Visual
Analog Scale (VAS). Cognition (Hodkinson’s Abbreviated Mental
Test-HAMT) and body awareness (Body Awareness Questionnaire-
BAQ) were also evaluated.
Results:
The mean CMSP VAS score was 6.13
±
1.6 cm. The mean
HAMT score was 8.3
±
1.6. The mean BAQ score was 81.5
±
19.3.
While a significant positive mild relationship between cognitive
status and body awareness was found (r = 0.392; p = 0.0001), there
was a significant negative poor relationship between cognitive
status and CMSP score (r = −0.240; p = 0.0001). On the other hand,
a significant negative poor relationship between body awareness
and CMSP scores (r = −0.249; p = 0.0001).
Conclusions:
The results indicate that pain intensity, cognitive
status, and body awareness affect each other from poor to mild
in older adults.
The study did not have any financial support.
P-092
Integrated one-stop cognitive assessment clinic for elderly
C.Y. Yung
1
, C.C. Chan
2
, M.L. Lau
2
, Y.Y. Tam
2
1
Hong Kong Hospital Authority, Hong Kong, Hong Kong;
2
United
Christian Hospital, Kwun Tong, Hong Kong
Introduction:
Patient-centred care planning is vital to cognitively
impaired patients. Multidisciplinary approach ensures continuity
of care and unification of care goals. In a district hospital in Hong
Kong, an integrated cognitive assessment clinic was established in
2013, operating with a novel collaborative model of providing a
one-stop service to cognitively impaired patients.
Objective:
To launch an integrated one-stop service for cognitively
impaired patients by an interdisciplinary team