European Geriatric Medicine - Supplement 1 - Volume 6 - September 2015

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Poster presentations / European Geriatric Medicine 6S1 (2015) S32–S156 S65
P-122
Longer duration of Parkinson’s disease is associated with
reduced prevalence of hypertension
D.L. Vetrano1 , V. Brandi2, M.S. Pisciotta1 , M.R. Lo Monaco3 ,
A. Laudisio4 , G. Onder5, R. Bernabei5 , G. Zuccala1
1Catholic University – Rome, Rome, Italy; 2Italy; 3 Universit`a Cattolica
del Sacro Cuore, Roma, Italy; 4 Campus Biomedico – Rome, Rome,
Italy; 5 Catholic University of the Sacred Heart, Rome, Italy
Objectives: Contrasting evidence suggests that Parkinson’s
Disease (PD) patients present with lower cardio-metabolic risk
than the general population, and that lower blood pressure
levels are associated with reduced risk of incident PD.
Indeed, PD is characterized by an abnormal blood pressure
control (cardiovascular dysautonomia) that makes treatment of
hypertension challenging in such patients. The aim of the present
study was to assess the prevalence of hypertension according to
the duration of PD.
Methods: Two-hundred-three consecutive PD patients, referred
to a geriatric day hospital, underwent comprehensive clinical
evaluation. Diagnosis of hypertension and pharmacological
treatment were assessed. The odds of suffering from hypertension
were obtained for tertiles (TZ) of PD duration.
Results: Among participants (mean age 73 ±8 years; 37% women;
median PD duration 4 [IQR 1.5–6.2] years), 120 (59%) had
hypertension. The prevalence of hypertension declined across
increasing tertiles of disease duration (TZ1 75%, TZ2 61%, TZ3
46%; p = 0.005). Similarly, prevalent use of antihypertensive agents
decreased. After adjusting for potential confounders, patients in
TZ2 and TZ3 were less likely (TZ2 OR 0.45, 95% CI 0.20–0.98; TZ3
OR 0.27 95% CI 0.11–0.63) to suffer from hypertension as compared
with those in TZ1.
Conclusions: The present study suggests that the likelihood of
suffering from hypertension might decrease along the course of PD.
Further longitudinal studies should assess the pathophysiology of
this phenomenon, as well as the impact of reduced blood pressure
levels on the survival and functional ability of patients with PD.
P-123
Elderly patients with hip fracture and inappropriate drug use –
testing the STOPP-2 vs the STOPP-1 criteria
M. Hadi1 , A.H. Ranhoff2 , K.K. Viktil3
1School of Pharmacy, University of Oslo, Oslo, Norway;
2Diakonhjemmet Hospital, Oslo, Norway; 3 Diakonhjemmet Hospital
Pharmacy, and School of Pharmacy, University of Oslo, Oslo, Norway
Objective: To investigate the extent of inappropriate prescribing to
elderly patients admitted with hip fracture, and further, to assess
the revised STOPP-2 (Screening Tool of Older People’s Potentially
Inappropriate Prescriptions) versus the original STOPP-1 criteria
with special focus on drugs with risk of falls (DF).
Method: Prospective study at the orthogeriatric unit, Diakonhjem-
met Hospital. Patients ≥65 years hospitalized and operated for
hip fractures in the period October 2014 to January 2015 were
consecutively included. Medication reconciliation was performed
to verify the drug list at admission. The drugs were recorded
according to the ATC (Anatomic Therapeutic Chemical) system.
Relevant clinical data were recorded from the patient record to
assess if the drugs belonged to a STOPP criterion or not.
Results: A total of 105 patients, mean age 85.5 years (range
65–101), 75.2% female, were included. According to the STOPP-2
criteria 77.1% of the patients had at least one inappropriate drug at
admission versus 62.9% of the patients according to the STOPP-1,
p < 0.05. Drugs for the nervous system (ATC N), and cardiovascular
drugs (ATC C), were the most frequent drugs identified in STOPP-2
and not in STOPP-1. With regard to the specific DF listed in STOPP-2,
53.3% of the patients had at least one of these drugs, and 36.2%
according to the STOPP-1, p< 0.05.
Conclusion: Nearly 80% of the elderly patients hospitalized with hip
fracture used inappropriate drugs according to STOPP-2. STOPP-2
revealed significant more DF than STOPP-1 and would be an
important tool in clinical practice.
Comprehensive geriatric assessment
P-125
Daily practicalities and challenges of elderly-care medicine
in a busy NHS district general hospital
M. Anwar1, A. Jakupaj1 , A. Sharma 1
1Luton and Dunstable Hospital, Luton, United Kingdom
Bed pressures in NHS hospitals are rising yearly on elderly-care
wards, leading to out-of hour transfers and the need for better
streamlining of the discharge process. Elderly-care wards have
negative perceptions attached to them and patients there are
often deemed as ‘bed-blockers’. We aimed to assess the daily
practicalities and challenges faced by staff and patients by collecting
data for all patients transferred and cared for on an elderly-care
ward in a busy district general hospital in the UK. Ward admissions
were monitored for 60 days between February and April, and
patients followed up for 3 months.
A total of 106 patients were cared for, 69 female (mean age 86.6)
and 37 male (mean age 85.3). 71% of patients were moved to the
ward out of normal working hours. A consultant had reviewed 80
(75.5%) patients prior to transfer. The mean and median length of
stay was 20.7 and 16 days respectively. Urosepsis (20%), Pneumonia
(17%) and fall (7%) were the most common discharge diagnosis.
Readmission rate was 18.9% in the following 3 months. We found
no correlation between age and readmission.
In conclusion we found that we need to improve continuity of
care and transfers out of hours. We recommend development
of the same standard of care for every elderly care ward which
includes: prioritising discharges with early morning discharges,
quicker access for specialty input, investigations and planning end
of life care. We proved that the role of an early comprehensive
Geriatric assessment is crucial in implementing best practice.
P-126
Ortho-Geriatrics out the Hip Fracture. A description of 2,484
orthopaedic patients requested to Geriatric Team over 20 years
F. Argentina1 , P. Condorhuaman1, M. Oviedo Briones1,
T. Salgado1, R. Men ´endez1, T. Alarcon1 , J. D´ıez-Sebasti ´an1,
J.I. Gonz ´alez-Montalvo1
1Hospital Universitario La Paz, Madrid, Spain
Objective: To describe the patients’ characteristics and the
destination at discharge of the orthopaedic patients requested to
geriatrics in a 1,100 bed university hospital; and to determine the
convenience of geriatric follow-up in them.
Methods: This is a descriptive study of patients over 65 years
of age admitted to the orthopaedic unit from January 1995
to December 2014 and requested to a Geriatric Team. Hip
fracture patients were excluded. Geriatric management included
comprehensive assessment, clinical monitoring and medical
treatment as necessary. Barthel Index (BI), Red Cross Mental Scale
(RCMs) and Pfeiffer’s Questionnaire (SPMSQ) were used.
Results: We analyzed 2,484 patients. Mean age was 81.3 years and
77.3% were women. Mean hospital stay was 16.4 days (±14.6 days)
and mean time from admission until geriatric request was 4.9
days (±9.7). Among them, 1,593 (64%) patients needed a clinical
follow-up until discharge. Previous median BI was 90 (IQR 70–
100), mean RCMs was 0.7 (±1.1). At admission median BI was 25
(IQR 5–40) and RCMs was 1 (±1.6). Mean SPMSQ was 3.2 (±3.1).
The most frequent diagnoses were prosthesis implant or revision