European Geriatric Medicine - Supplement 1 - Volume 6

Poster presentations / European Geriatric Medicine 6S1 (2015) S32

–

S156

S67

P-130

Multidimensional geriatric assessment in the decision for

treatment of older severe aortic valve stenosis patients

V. Collas

, Y.M. Chong

, B. Paelinck

, I. Rodrigus

, T. Philipsen

C. Vrints

, M. Vandewoude

, J. Bosmans

University Antwerp, Edegem, Belgium;

Ziekenhuis Netwerk

Antwerpen Sint-Elisabeth, Antwerpen, Belgium;

Antwerp University

Hospital, Edegem, Belgium;

Belgium

Objective:

The aim of this study was to evaluate if the

multidimensional geriatric assessment could objectify the decision

for treatment (surgical aortic valve replacement, transcatheter

aortic valve implantation (TAVI) or conservative treatment) made

by the multidisciplinary heart team for older patients, with severe,

symptomatic aortic valve stenosis (AVS).

Methods:

Older patients with severe, symptomatic AVS, receiving a

treatment option by the Heart Team, underwent multidimensional

geriatric assessment. This assessment included the following

domains: (1) quality of life (EQ5D); (2) independency (Katz);

(3) nutritional state (Mini Nutritional Assessment short form

12);

(4) cognition (Mini Mental State Exam

27) and depression

(Geriatric Depression Scale

5); (5) function (gait speed) and frailty

(according to Fried). The heart team evaluated the patients and

advised treatment, independently of the results of the geriatric

assessment.

Results:

One hundred and thirteen patients with severe,

symptomatic aortic valve stenosis were included in this study. Age

was 82

5 years. The heart team advised 34, 48 and 31 patients

to surgery, TAVI and conservative treatment, respectively. Patients

referred for conservative treatment, were significantly older (85

4),

had more limitations in their daily activities (no problems: 6.5%)

and were more dependent (25.8%). More patients in this group were

at risk for depression (50.0%), undernutrition (96.7%) and impaired

cognition (90.3%), had limited functionality (0.44 (0.39–0.59) m/s)

and were more frail (61.1%).

Conclusion:

Multidimensional geriatric assessment can objectify

the multidisciplinary heart team decision in high risk older patients

with severe, symptomatic AVS.

P-131

Sympathetic neuropathy diagnosed by the heat-washout

method in fall patients

L. Gjerum, M. Midttun

Copenhagen University Hospital, Herlev, Denmark

Objectives:

The veno-arteriolar reflex (VAR) is a local sympathetic

cutaneous reflex that is expected to be missing in subjects

diagnosed with orthostatic hypotension and neuropathy. Ten

patients admitted to the Falls Clinic and diagnosed with neuropathy

were examined for the presence of orthostatic hypotension and

VAR.

Methods:

Four women, mean age 75.3 years, and 6 men, mean

age 75.8 years, were examined for the presence of the VAR with

the heat-washout method (HWM). Cutaneous blood flow rate (BFR)

was measured in the forefoot with the foot placed at heart level,

respectively 50 cm below heart level. A reduction in BFR of

30%

with the foot placed below heart level indicates that the VAR is

present. Orthostatic blood pressure was measured according to the

guidelines of the clinic.

Results:

In 6/10 patients the results of HWM and the presence of

the VAR were consistent with findings made when examining for

orthostatism. In three patients the accordance was only present in

one foot.

Conclusion:

Orthostatic hypotension indicates that an autonomic

dysfunction is present, and the lack of a VAR indicates that

the peripheral sympathetic nervous system is damaged due to

neuropathy. The presence of both increases the risk of falling. The

examination for the presence of VAR by HWM is an objective

method compared to common methods as monofilament and

biothesiometry, and is therefore useful as an alternative when

examining elderly and especially cognitively impaired patients that

find it difficult to cooperate sufficiently during examination with

the existing methods.

P-132

Increasing age has detrimental effect on balance and functional

capacity in patients with stroke

E. Goz

, A. Genc

, V. Ozturk

Dokuz Eylul University, Izmir, Turkey

Objectives:

An advanced age is a factor associated with a poorer

functional prognosis following a stroke. Individuals with stroke

have more impairment such as motor, sensory and vision deficits

resulting from their strokes than the average elderly.These deficits

can affect their balance and functional capacity and motor function.

The purpose of this study was to investigate the effect of age on

balance, functional capacity and motor function in stroke patients.

Methods:

Forty-eight sub-acute and chronic stroke patients (18

female, 30 male) participated in this study. Inclusion criteria

were ability to walk 10 meter and obtained a score ≥22 on the

Revised Standardized Mini Mental Examination Test. Subjects were

classified into two age groups; geriatric (age≥60years), non-geriatric

(age

60 years). Balance [Timed Up and Go Test (TUG)], functional

capacity [6 Minute Walk Test (6 MWT)], motor function [Stroke

Rehabilitation Assessment of Movement Measure (STREAM)] were

evaluated.

Results:

Median age with Inter Quartile Range (25–75%) was

69.0 (64.0–80.0) in 31 geriatric patients and 51.0 (44.0–55.0) in

17 non-geriatric patients. Geriatric patients had worse balance

scores than non-geriatric groups and their functional capacity and

motor function scores were lower than non-geriatric group (Mann–

Whitney U test, p

0.05).

Conclusions:

In conclusions, geriatric stroke patients have more

balance and motor problems than nongeriatric patients. Because

of these problems geriatric stroke patients are less active in their

daily life.

P-133

Lower half of leg length influenced 30 seconds chair stand

test in community-dwelling older adults

R. Hasegawa

, K. Miyoshi

, M.M. Islam

, N. Tomiyama

Chubu University, Kasugai, Aichi, Japan;

Kizawa Memorial Hospital,

Minokamo, Gifu, Japan;

Yonaha General Hospital, Kuwana, MIe,

Japan;

Japan

Objectives:

Chair stand test (CS) is to assess lower body strength.

CS is easy to perform, requires simple equipment and can be used

in various settings. Use of a fixed height chair for CS may limit

extent of the test to reflect lower body strength for each individual.

The purpose of our study was to examine the influence of lower

half of leg length (LLL) on the CS in community-dwelling older

adults.

Methods:

This study included 15 individuals (72.3

6.3 years and

86.7% of whom were female). Participants’ height and their LLL

(distance from lateral knee joint line to floor in standing) were

measured.

CS was performed according to Jones and Rikli method. Participants

rose to a fully standing position from the sitting position in a

42 cm high chair, and then returned to the fully seated position.

Performance was evaluated by number of full standing in 30

seconds.

Muscular strength of knee extension (MS) assessed using hand-

held dynamometer. Data for MS was calculated the average of both

legs.

Results:

The mean

SD of participants’ height was 150.4

7.2 cm, LLL

was 30.8

1.6 cm, CS was 22.6

6.0 times, and MS was 177.9

67.1 N.