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of these symptoms is often multifactorial. It is possible, however,
that NPH may go undiagnosed and untreated unless the diagnosis
is considered and a trial of CSF removal is performed.
Case presentations:
We discuss two patients who were referred
to our service for assessment of poor mobility. One had urinary
incontinence while the other had significant memory impairment.
Both patients had MRI brain scans showing a prominence
of the ventricular system, suspicious for NPH. Both patients
subsequently underwent TTs with removal of up to 50mls of
CSF. Simple pre and post procedure assessments demonstrated
remarkable improvements in gait speeds and cognitive function.
They subsequently were referred for CSF shunt procedures. One
patient has undergone a ventriculo-peritoneal shunt with complete
resolution of her symptoms.
Conclusion:
Performed in a day hospital setting, a CSF TT is
simple, safe and has prognostic implications in investigation of
potential normal pressure hydrocephalus. The development of a
simple standard guideline for this procedure in an outpatient or
day hospital setting is warranted.
P-111
Factors associated with orthostatic hypotension in hospitalized
elderly patients
M. Paccalin
University Hospital, Poitiers, France
Objective:
To assess the factors associated with orthostatic
hypotension (OH) in hospitalized elderly.
Design:
Prospective observational single center study.
Setting:
One French academic center.
Participants:
One hundred thirty-one patients without OH
symptoms who underwent OH testing.
Measurements:
The blood pressure was measured when patients
recovered and after a 10-minute rest while the patients were
sitting then standing at 1 and 3 minutes. Demographic data, co-
morbidities, current medications and biological parameters were
recorded.
Results:
The mean patient age was 84.3
±
7 years. The mean CIRS-G
score was 10.6
±
3.8. The OH test was performed 6.3
±
3.9 days after
admission and was positive in 39 (29.8%) patients (95% confidence
interval (CI) = 22–38) and positive at 1 minute in 87.2% of cases.
Multivariate analysis showed that OH prevalence was correlated
with diabetes (odds ratio (OR) = 4.23; 95% CI = 1.10–16.24; P = 0.03),
serum 25-hydroxyvitamin D
<
20 ng/ml (OR = 3.38; 95% CI = 1.36–
8.42; P = 0.008), use of tranquilizers (anxiolytic and hypnotic) (OR
= 2.96; 95% CI = 1.18–7.4; P = 0.02), CIRS-G score (OR = 1.15; 95% CI
= 1.01–1.31; P = 0.03) and lack of diuretics (OR = 0.20; 95% CI =
0.06–0.63; P = 0.005).
Conclusion:
In older adults OH is often misdiagnosed because
asymptomatic. As practitioners may be reluctant to perform the OH
test because of time constraints, targeting a subgroup of patients
with a higher risk of OH, should be worthwhile to prevent further
OH complications.
P-112
Anaemia in the elderly, do we diagnose them all?
E. Pedersen
1
, L. Usinger
2
1
Medical Department, Koege university Hospital, Slangerup, Denmark;
2
Medical Department Herlev Hospital, Herlev, Denmark
Objectives:
Anaemia among elderly people is correlated to
enhanced morbidity and mortality. The purpose of this study is
to examine whether elderly patients with anaemia, admitted to
an internal medical ward for any reason, starts initial diagnosis of
their anaemia during admission.
Methods:
Cross-section retrospective study of all patients above 73
admitted to Department of Internal Medicine, Glostrup university
Hospital, in 2012. Haemoglobin at admission, age and ASA-
score were registered. Information, of additional blood samples
for diagnosing anaemia, and whether follow up on these tests
was performed, were extracted from patient records. Regression
analysis, with diagnosing anaemia as dependent variable and age,
ASA and haemoglobin level as factors, was performed.
Results:
Out of 1101 patients 42% (462) were anaemic when
admitted, of these 48% (221) had blood samples taken to
characterise their anaemia. Regression analysis showed that low
haemoglobin level (p
<
0.001) and high ASA-group (p = 0.02) were
responsible for triggering investigation of patients anaemia. Age
was not. Of the 221 who started characterisation of their anaemia
only 88 where followed up with a conclusion on their blood
samples.
Conclusion:
Less than half of elderly hospitalised patients start
examination of their anaemia during admission. Less than one fifth
of the patients with anaemia ends up with an initial diagnose.
Knowing that all anaemia is correlated with enhanced morbidity
and morbidity we must make a greater effort to diagnose our
elderly patients.
Conflict of interest:
The authors have no conflicts of interest. The
study has received no financial support.
P-113
Bone mineral density in patients with stroke
V. Povoroznyuk
1
, M. Bystrytska
1
1
D.F. Chebotarev Institute of Gerontology NAMS Ukraine, Kyiv, Ukraine
Aim:
The aim of the research is to define the bone mineral density
in patients, with stroke.
Methods:
We examined 26 women with stroke and 26 healthy
women of appropriate age; 27 men with stroke and 27 healthy
men of appropriate age.
Results:
BMD of women after stroke was significantly lower
compared with BMD of women of control group on the level of
total body (Z-score = −0.02
±
0.21 vs. 0.67
±
0.21, F = 5.92, p = 0.018)
and at the distal forearm (Z-score = −0.65
±
0.24 vs. 0.45
±
0.25,
F = 9.7, p = 0.003). In men with moderate and severe it was obtained
significant differences in BMD at total body (Z-score = −0.35
±
0.25
vs. 0.59
±
0.23, F = 7.4, p = 0.09), lumbar spine (Z-score = −0.48
±
0.42
vs. 0.68
±
0.26, F = 6.0, p = 0.02), total hip (Z-score = −0.16
±
0.27 vs.
0.51
±
0.15, F = 5.4, p = 0.03), distal forearm (Z-score = −0.03
±
0.33 vs.
0.99
±
0.30, F = 4.7, p = 0.04).
Conclusion:
BMD in patients with stroke was significantly lower
than in healthy people of the same age. In women the difference
was significant at the level of the total body and distal forearm. In
men, the difference was significant only in the group of the patients
with moderate and severe paresis.
P-114
Bone mineral density in women with Parkinson’s disease
V. Povoroznyuk
1
, M. Bystrytska
1
, I. Karaban’
1
, N. Karasevych
1
1
D.F. Chebotarev Institute of Gerontology NAMS Ukraine, Kyiv, Ukraine
Aim:
The aim of the research is to define the bone mineral density
in patients with Parkinson’s disease.
Methods:
We examined 12 women with Parkinson’s disease and
12 healthy women of appropriate age (average age: 63.6
±
6.25 vs
62.2
±
6.83 years, p = 0.5). The duration of Parkinson’s disease was
at least 5 years. All patients reseived levodopa.
Results:
BMD of women with Parkinson’s disease was significantly
lower compared with BMD of women of the control group on
the level of total body (T-score = −1.86
±
1.32 vs. −0.71
±
1.48,
p
<
0.05; Z-score = −0.35
±
0.93 vs. 0.51
±
1.05, p
<
0.05), lumbar
spine (T-score = −1.56
±
1.22 vs. 0.10
±
1.63, p
<
0.05; Z-score =
−0.66
±
0.87 vs. 0.72
±
1.53, p
<
0.05) and at the distal forearm
(T-score = −1.87
±
1.32 vs. 0.71
±
1.47, p
<
0.05; Z-score = −0.51
±
1.05
vs. 0.38
±
1.22, p
<
0.05). Hip BMD was not different from control