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Poster presentations / European Geriatric Medicine 6S1 (2015) S32
–
S156
S57
Methodology:
An interdisciplinary team comprising geriatricians,
nurses with special interest in dementia care, occupational
therapists and physiotherapists was established in 2013.
In the first consultation patients are assessed on various domains
by members of the team. Related investigations including structural
imaging are performed beforehand. Geriatricians are responsible to
establish the clinical diagnosis. In the case conference conducted at
the end of each clinic session, care planning and goals are aligned
and formulated. Anti-dementia medications were prescribed to
suitable patients. Cognitive rehabilitation including mind-body
exercise was arranged whenever appropriate. Community resources
were introduced and recommended so that patients and caregivers
could receive maximal community support.
Results:
In the recent 12 months, a total of 124 cases were attended.
71 (57.2%) were diagnosed dementia and 47 (37.9%) were mild
cognitive impairment. Among those with dementia, 47 (37.9%), 17
(13.7%) and 7 patients (5.6%) were respectively graded as mild,
moderate and severe. 31 patients (43.7%) received anti-dementia
medications, 62 patients (50%) completed cognitive rehabilitative
training, and 35 patients were recruited for Mind-Body exercise
programme.
Conclusion:
An integrated one-stop cognitive assessment clinic
could provide holistic, people-centred framework in managing
patients with cognitive impairment.
Comorbidity and multimorbidity
P-093
Impact of contact isolation on life-quality in elderly inpatients
colonized by multidrug-resistant organisms
H. Burkhardt
1
, L. T ¨umena
1
1
Universit¨atsmedizin Mannheim, Mannheim, Germany
Objectives:
Caring for patients colonized with multidrug-resistant
organisms (MRO) rises concerns about burden for life-quality
contributing to prolonged hospital treatment and impaired
outcome.
Methods:
50 elderly inpatients (age 65years and over) with
proven colonization and 50 controls matched for age, gender and
functional limitations were recruited from acute care wards of
a large university hospital. Comprehensive geriatric assessment
was performed and quality of life was assessed by the SF-12
instrument.
Results:
Median age in the case cohort was 75 years (controls
76years). With the exception of hand-grip strength (16 kg in case
cohort vs. 21 kg in controls) there were no significant differences
in geriatric assessment between both groups. Surprisingly there
were also no significant differences in quality of life between both
groups concerning the two subscales in SF-12: SF-12s 30.88 in case
groups vs. 33.61 in controls; SF-12p 46.38 in case group vs. 47.03 in
controls. Subsequent multivariate analysis in all patients revealed
also no independent and significant influence of contact-isolation
on SF-12 scores. Pain-level remained the only significant factor with
regard to the subscale SF-12s (somatic) and depression with regard
to the subscale SF-12p (psychological).
Conclusion:
Although contact-isolation is inconvenient and may
leave the patient depressed and with reduced level of life-quality,
this could not be proven in this case-control study with elderly
inpatients. Main determining factors in this setting were pain-
control and depression. However, these results should not be taken
to omit improvements in order to alleviate the consequences of
contact isolation for patients frommultimodal treatment concepts.
P-094
Venous thromboembolism in elderly people is a matter of
multimorbidity
K. Dostalova
1
, L. Kukuckova
2
, S. Moricova
3
, J. Luha
4
1
Slovak Medical University Bratislava, Bratislava, Slovakia;
2
Department of Long Term Ill, University Hospital Bratislava,
Bratislava, Slovakia;
3
Faculty of Public Health, Slovak Medical
University, Bratislava, Bratislava, Slovakia;
4
Faculty of Medicine,
Comenius University, Bratislava, Bratislava, Slovakia
Objectives:
Venous thromboembolism (VTE) occurs across
generations. With increasing age, the incidence of VTE increases
exponentially. By analysis of dispensary patients with VTE, we tried
to determine the difference between the incidence of primary and
secondary risk factors in young adults and elderly people.
Methods:
We observed risk factors in 219 (21–90 years) patients
of Outpatient Department of Angiology with VTE: family history
of VTE, malignancy, trauma, surgery, chemotherapy, radiotherapy,
travelling, immobilisation, inflammatory disease and all patients
underwent genetic analyses of inherited thrombophilia.
Results:
21.6% of seniors and 13.3% of young adults suffered
from pulmonary embolism (Fisher’s exact test with p = 0.476). We
identified recurrence of VTE in 52.3% of elderly and 28.9% of young
adults (p = 0.018). 42.2% of young adults and 28.4% of elderly in
our study group had more important thrombophilia mutations
(p = 0.336). 11.4% of elderly and 22.2% of young adults reported
VTE in relatives (p = 0.113). 34.1% elderly had malignant disease
but only 4.4% of young adults, difference is statistically significant
(p
<
0.000). 17.0% of elderly and 24.4% of young adults suffered
from VTE in the context with trauma (p = 0.589). 11.4% of elderly
and 8.9% of young adults developed a perioperative VTE (p = 0.575).
4.4% of young adults and 4.5% of elderly developed VTE regarding
to travelling, difference is not statistically significant (P = 0.426).
Conclusions:
The presence of secondary risk factors in the elderly is
more pronounced than in young adults. This fact strongly modifies
management of VTE but same way appears to be a challenge for
prevention of VTE.
P-095
Self-perception of general and oral health status and
importance of oral health among older people admitted to
a medical ward of a general hospital
S. Duque
1
, M.J. Serpa
2
, C. Braco Forte
3
, S. Velho
2
, J. Barrona
4
,
M. Sequeira
4
, F. Branco
2
, ´A. Chipepo
2
, J. Francisco J ´unior
2
, F. Pestana
Ara ´ujo
2
, J. Pimenta da Gra ¸ca
2
1
Hospital Beatriz ˆAngelo / Faculdade de Medicina de Lisboa, Lisboa,
Portugal;
2
Hospital Beatriz ˆAngelo, Lisboa, Portugal;
3
Portugal;
4
Faculdade de Medicina de Lisboa, Lisboa, Portugal
Objectives:
Although poor oral health status (OHS) in older people
is associated to physical and cognitive impairment and higher
mortality, older people tend to underestimate its importance
considering teeth loss, caries and periodontal disease inevitable
consequences of ageing. Our aim was to evaluate self-perception of
OHS of patients ≥75 years admitted in a medical ward, comparing
to self-perception of general health status (GHS).
Methods:
Cross-sectional study during 1 day. Clinical and social
characterization, including cognition, functional and nutritional
status assessment. Dental examination and questionnaire about
GHS and OHS. Statistical analysis by SPSS.
Results:
100 patients were included, average age 83.7 years,
63% males, average Cumulative Illness Rating Scale for
Geriatrics 11.2. Average Barthel score at admission 63.6. Prevalence
of cognitive impairment and malnutrition were 31% and 70%,
respectively. Average number of teeth was 6.7
±
8.4 (0, 33),
36% used oral prosthesis. Prevalence of total edentulism, caries and
periodontal disease were 46%, 24% and 21%, respectively. 27% of
patients considered their OHS better than age-matched subjects,