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Poster presentations / European Geriatric Medicine 6S1 (2015) S32
–
S156
After adjusting for age, the correlation coefficient between CS and
LLL was −0.74 (p = 0.002), and between CS and height was −0.40
(p = 0.16).
Conclusions:
These results indicate that when interpreting the
score for the CS for older adults with shorter LLL, the CS may
overestimate their lower body strength.
P-134
Efficacy and safety of training program concentrating on
the Garfinkel method as a tool for reducing polypharmacy
in nursing home residents
G.B. Ozturk
1
, H. Ozkaya
2
, C. Kılıc
3
, S. Muratli
4
, B. Ilhan
5
, A. Tufan
6
,
F. Tufan
3
, Z. Horasan
7
, H. Dogan
8
, N. Erten
3
, M.A. Karan
6
,
D. Garfinkel
9
1
Turkey;
2
Istanbul Metropolitan Municipality Kayı ¸sda˘gı Darulaceze
Nursing Home.kayı ¸sda˘gı/Ata ¸sehir, 902165288400, Turkey;
3
Istanbul
University, Lier Istanbul, Turkey;
4
Istanbul University Medical School,
Istanbul, Turkey;
5
Istanbul School of Medicine, Istanbul, Turkey;
6
Istanbul University, Istanbul, Turkey;
7
Kayı ¸sdagı Darulaceze Nursing
Home, Istanbul Lier, Turkey;
8
˙Istanbul City Hall, Lier Istanbul, Turkey;
9
Israel
Background:
Polypharmacy (PP) and potentially-inappropriate-
prescribing (PIM) is increasing globally in elderly. Most strategies
suggested for detecting PIMs just report numbers of PIM, with
very limited data regarding real benefits of these approaches on
elder’s health or economic outcomes. A different approach based
on ethical, clinical principles was suggested by Garfinkel. In related
two studies, substantial drug discontinuation(DD) was safe and
associated with significant-beneficial-clinical-outcomes.
Methods:
We organized a training program evaluating the-
impact-of-Garfinkel-method on health professionals. The 3 day
educational program for MDs included lectures on-the-first-
day and workshops on-the second-and-third-days concentrating
on the-Garfinkel-method. Impact-of-these-training-programs on
physicians’-prescribing-habits and functionality, nutritional-status,
depression, cognition and economics was later assessed.
Results:
The study comprised 302 elders in Kayisdagi-Darulaceze-
Nursing-Home. Follow-up time was 13-months. In 112 (37%)
elders, medications were discontinued. Mean-age was 76.1
±
10.4.
Number of medications at the beginning and at the end of
the study was 8.6
±
3 and 6.8
±
2.8, respectively. No side-effect
was reported. The results of patient evaluation before and after
the study are summarized in Table 1.There was statistically
significant improvement in activities-of-daily-living (ADL) and
Mini-nutritional-Assessment (MNA) scores (p
<
0.05, p
<
0.005;
respectively). Annual-rates-of-falls decreased very significantly
(p
<
0.001). Minimum net drug-cost-benefit-of-deprescribing was
$1130 per month and $14690 for the 13 months study period.
As the number of elderly residents in Turkey nursing homes are
around 21000, the potential minimum drug cost benefit would be
$2,500,000/year.
Conclusion:
Interactive education with Garfinkel method could be
an effective and safe way to minimize polypharmacy in nursing-
home residents.
P-135
Comprehensive geriatric assessment in practice: From the
point of patients
¸S. Durmazo˘glu
1
, B. Ilhan
2
, A. Tufan
1
, S. Muratli
3
, G. Turun ¸c
1
,
F. Tufan
4
, G. Bahat
1
, C. Kılıc
4
, N. Erten
4
, M.A. Karan
1
1
Istanbul University, Istanbul, Turkey;
2
Istanbul School of Medicine,
Istanbul, Turkey;
3
Istanbul University Medical School, Istanbul,
Turkey;
4
Istanbul University, Lier Istanbul, Turkey
Objective:
Comprehensive geriatric assessment (CGA) improves
the coordination of overall health of elderly. Because of its
‘comprehensive’ nature, patients may get tired while performing
high number of tests. Also the doctor may not be eager to perform
all components of CGA. We aimed to assess the satisfaction of
patients with performing CGA.
Methods:
We included the elders admitted to outpatient-geriatric-
clinic at February 2015 who underwent previous CGA. All subjects
were asked to fill satisfaction survey questions. A geriatric nurse
helped the patients with filling the questionnaire. Those points
were especially clarified for patients: the answers will never
influence patient’s treatment-strategy and it will be a substantial
feed-back for us. We assessed both frequency of geriatric syndromes
and the satisfaction-expectation resulting from performing major
components of CGA.
Results:
150 subjects were asked to participate and all accepted.
39 were male (26%); 111 were female (74%).Mean age was 73.6
±
6.9
years. 148/ 150 were satisfied with performing CGA. Main results
were follows: 49% had urinary incontinence. 19% declared that they
would not mention incontinence in case it was not particularly
asked. 97% of subjects were satisfied with mini mental state
examination. 98% of elders were satisfied with ‘falling test’ and
if it has never been asked, 23% of total subjects signed that they
would not mention it.
Conclusion:
Although CGA is a long and time-consuming process,
it is satisfactory for patients. It lets to identify frequently
unrecognized geriatric syndromes.
P-138
Gait and patient characteristics that discriminate fallers from
non-fallers in a geriatric population
C. Lamoth
1
, M. De Groot
2
, J. Van Campen
2
, H. van der Jagt
3
,
J.H. Beijnen
4,5
1
University Medical Centre Groningen, University of Groningen,
Groningen, Netherlands;
2
Netherlands;
3
Academic Medical Centre,
Department of Internal Medicine and Geriatrics, Amsterdam,
Netherlands;
4
Slotervaart Hospital, Department of Pharmacy &
Pharmacology, Amsterdam, Netherlands;
5
Utrecht University, Utrecht,
Netherlands
Objectives:
Walking speed and spatio-temporal gait parameters
are related to falls in community dwelling elderly. In the geriatric
population, however, walking is effected by multiple factors, such
as multi-morbidity, polypharmacy, and cognitive function. The
objectives of the present study were to model in a population
of geriatric outpatients (1) which gait characteristics discriminate
best fallers from non-fallers, and (2) examine if the sensitivity and
specificity of the model improve when other patients characteristics
were added to the model.
Methods:
Sixty-one patients (79
±
5.0 years) walked 160m at self-
selected speed while trunk accelerations were recorded. Walking
speed, mean and variability of stride parameters, and magnitude,
frequency content, smoothness of medio-lateral and anterior-
Poster presentationsior trunk acceleration signals were calculated.
Furthermore, fall incidence, cognitive functioning, comorbidities
and grip strength were registered. The two objectives were
examined using Partial Least Squares Discriminant Analyses (PLS-
DA).
Results:
Twenty-five participants (41%) reported ≥1 falls. The first
PLS-DA model (sensitivity: 54%; specificity: 72%; AUC: 0.76) showed
that stride time variability, smoothness (Harmonic Ratio) and
magnitude (Root Mean Square) of the trunk acceleration patterns
were the gait characteristics discriminating fallers form non-fallers.
The second PLS-DA model, adding other patient characteristics,
revealed improved sensitivity and specificity (78%; and: 76%;
respectively AUC: 0.88). In particular, cognitive function was an
important factor in the relationship between gait characteristics
and falling.
Conclusion:
The results may contribute to the development of
an assessment including instrumented gait analysis, together with