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

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Poster presentations / European Geriatric Medicine 6S1 (2015) S32–S156 S73
indexes for women in postmenopausal period with higher risk of
osteoporotic fracture, assessed by FRAX, independent of age.
Conclusion: Thus, low cortical indexes, measured with the
“Osteolog” workstation are reliable predictors of high fracture risk.
There is a significant correlation between low cortical indexes and
high fracture risk, assessed by FRAX.
P-154
Trabecular bone score and bone mineral density in Ukrainian
men with vertebral fractures
V. Povoroznyuk1 , A. Musiienko1 , N. Dzerovych 1
1D.F. Chebotarev Institute of Gerontology NAMS Ukraine, Kyiv, Ukraine
The aim of this study is to evaluate the trabecular bone score (TBS)
and bone mineral density (BMD) in men with osteoporotic vertebral
fractures.
Materials and Methods: We examined 243 men aged 30–89 years,
divided according to the gerontologic classification: 30–44 yrs
(n = 46), 45–59 yrs (n = 83), 60–74 yrs (n = 86), 75–89 yrs (n = 28). The
basic group consists of 52 men with osteoporotic vertebral fractures
in the anamnesis and control group – of 191 men without fractures.
The BMD of PA lumbar spine and proximal femur were measured
by the DXA method (Prodigy, GEHC Lunar, Madison, WI, USA) and
PA spine TBS were assessed by the TBS iNsight® software package
installed on our DXA machine (Med-Imaps, Pessac, France).
Results: We have observed a significantly lower TBS (L1-L4) in
the basic group (30–44 yrs: 1.083±0.187; 45–59 yrs: 1.025±0.248;
60–74 yrs: 1.084±0.170; 75–89 yrs: 0.951±0.170) as compared to
the control group (30–44 yrs: 1.276±0.121; 45–59 yrs: 1.226±0.156;
60–74 yrs: 1.150±0.175; 75–89 yrs: 1.183±0.174); F = 1.56; p < 0.001.
We also found the lower BMD of lumbar spine in the basic
group of patients – 30–44 yrs: 0.981±0.125 g/cm2 ; 45–59 yrs:
1.028± 0.184 g/cm2; 60–74 yrs: 1.014±0.158 g/cm2; 75–89 yrs:
0.970±0.183 g/cm2 (F = 1.52; p < 0.001) and of the proximal femur –
30–44 yrs: 0.854±0.149 g/cm2 ; 45–59 yrs: 0.873 ±0.139 g/cm2 ;
60–74 yrs: 0.823±0.136 g/cm2; 75–89 yrs: 0.716±0.107 g/cm2
(F = 1.10; p <0.001) compared to the control group.
Conclusion: Subjects with vertebral fractures have TBS and BMD
parameters significantly lower than the healthy men.
P-155
Implantable loop recorder: A syncope unit experience
M. Rafanelli1 , A. Ceccofiglio1 , F. Tesi1, G. Toffanello1 , V.M. Chisciotti1 ,
G. Rivasi1, N. Marchionni2, A. Ungar 3
1Geriatric Cardiology and Medicine, University of Florence and
AOU Careggi, Florence, Italy; 2Geriatric Cardiology and Medicine,
Careggi Univesrity Hospital, Florence, Florence, Italy; 3 Azienda
Ospedaliero Universitaria Careggi, Florence, Italy
Aim: To test the Implantable Loop Recorder (ILR) in syncopal
and non-syncopal transient loss of consciousness (TLoC) and in
detecting atrial fibrillation (AF) in cryptogenic stroke.
Methods: 182 patients were implanted between January 2003 and
May 2014. 81 (45%) syncope; 3 (1.6%) pseudo-syncope; 32 (18%)
epileptics; 35 (19.2%) unexplained falls; 6 (3.3%) patients with
syncope/fall; 5 (2.7%) suspected AF; 20 (11%) cryptogenic stroke.
Results: The mean age was 70±14.2 years. After a follow-up of
19±16 months, 109 patients (59.9%) relapsed. Asystole was detected
in 51.9% of the syncope, in 100% of the epileptics, in 53.9% of the
fallers, in 20% of the syncope/falls and in 33.3% of the strokes.
AF was confirmed in 80% of the suspected cases, in 66.7% of the
strokes, in 40% of those with syncope and falls. Diagnosis was
made in 70.4% of the syncope, in 59.4% of the epileptics, in 74.3% of
the fallers, in 100% of the syncope/falls, in 66.7% of the pseudo-
syncope, in 50% of the strokes and in the 100% of the suspected
AF. No arrhythmia was recorded in 64 patients, in 49 of these the
monitoring is ongoing. Pacemaker was implanted in 22.2% of the
syncope, in 18.8% of the epileptics, in the 20% of the suspected AF.
Oral anticoagulation was started in 60% of AF patients, in 20% of
the strokes, in 16.7% of the syncope and falls.
Conclusion: ILR is useful in detecting arrhythmias both in high risk
patients and in the TLoC diagnostic pathway.
P-156
Safety and tolerability of Tilt Testing and Carotid Sinus Massage
in the oldest old
G. Rivasi1 , M. Rafanelli1, G. Toffanello1 , A. Ceccofiglio1, F. Tesi1,
N. Marchionni2, A. Ungar 3
1Geriatric Cardiology and Medicine, University of Florence and
AOU Careggi, Florence, Italy; 2Geriatric Cardiology and Medicine,
Careggi Univesrity Hospital, Florence, Florence, Italy; 3Azienda
Ospedaliero Universitaria Careggi, Florence, Italy
Objectives: To evaluate the safety and tolerability of Tilt Testing (TT)
and Carotid Sinus Massage (CSM) in the oldest old (patients aged
80 and older) and in younger patients with unexplained syncope
and/or falls.
Methods: 1170 patients referred to our Syncope Unit for
unexplained syncope or falls were enrolled. 549 patients were 80 or
older and 621 were younger. TT and CSM were performed according
to the European Society of Cardiology Guidelines. Complications
were evaluated in each group. An early interruption of TT was
defined intolerance and considered as a negative response.
Results: Complications after TT were observed in 5.3% of the
older patients and in 2.4% of the younger ones (p = 0.01). Most of
the complications (88.6%) were minor, as persistent hypotension;
serious ones occurred in 2.3% of the cases. Minor complications
were the most frequent in both groups (93.1% in the older patients
and 80% in the younger ones). Orthostatic hypotension was a
predictor of complications. No complications occurred after CSM.
Intolerance was reported in 2.7% of the older patients and 1.1% of
the younger ones (p = 0.04); in most cases (68.2%), the test was
stopped because of orthostatic intolerance.
Conclusions: Complications after TT were more common in older
patients, probably due to a higher prevalence of orthostatic
hypotension. No complications occurred during CSM. Intolerance
was very low in each group, mainly due to orthostatic intolerance.
TT and CSM are safe and well tolerated in the oldest old.
P-157
Physical performance measures compare favorably with
geriatric assessment in elderly oncological patients
A.T. Roberts1, L. Biganzoli2, D. Becheri3 , G. Mottino3, E. Mossello4 ,
M. Di Bari4
1AOU Careggi, Firenze, Italy; 2Oncologia geriatica, Dipartimento
Oncologico, Prato, Prato, Italy; 3U.O. Geriatria, Prato, Italy; 4Unit of
Gerontology and Geriatric Medicine, Firenze, Italy
Objective: In oncology there is a growing interest in geriatric
assessment (GA). In a sample of older oncological patients, we
evaluated the associations between the outcome of GA tools on
one side and, on the other, the Vulnerable Elders’ Survey-13
(VES-13), Fried’s frailty phenotype and a simple index of physical
performance, combining the handgrip (HG) and walking speed
(WS), categorized as normal or abnormal.
Methods: 273 patients aged ≥70 years with solid tumors attending
the Oncology outpatient clinic in Prato, Italy, underwent a GA.
Mean values of ADLs, IADLs, GDS, MMSE, MNA and CIRS were then
compared across the three categories of the VES-13 (fit, score of
0–2; vulnerable, score of 3–6; frail, score of 7–13), Fried’s phenotype
(fit: no impairment, prefrail: 1 impairment, frail: 2+ impairments)
and according to physical performance (both HG and WS abnormal,
HG or WS abnormal, both HG and WS normal).
Results: No significant differences in ADLs, MMSE and CIRS
emerged between fit and vulnerable (according to VES-13) or fit and
pre-frail (according to Fried) patients, whereas GDS score differed