96 / 210
S88
Poster presentations / European Geriatric Medicine 6S1 (2015) S32
–
S156
P-211
The ‘slumpogram’: a novel radiological sign that predicts
6-month mortality in elderly hospital inpatients
A. Hollington
1
, B. Cockbain
2
, D. Fink
3
1
Royal Free NHS Foundation Trust, London, United Kingdom;
2
United
Kingdom;
3
University College Hospital, London, United Kingdom
Objectives:
Frailty describes decreased physiological reserve and
resistance to stressors. Many studies have sought to quantify frailty
but there remains no consensus assessment tool or measure.
Our retrospective observational study aims to identify frailty
and associated increased mortality risk using admission chest
radiographs.
Method:
100 hospital inpatients aged 80 and over who received
admission chest radiography were included in the study. Two
physicians assessed these for the ‘slumpogram’ sign: chest
radiographs in which the mandible overlies the lung fields.
Mortality on index admission and at 6 months, and total inpatient
bed days, were then recorded.
Results:
20 patients were ‘slumpogram’ sign positive on admission
(20/100, 20%). The ‘slumpogram’ sign positive and negative groups
had comparable mean ages: 88.30 and 86.25 years. 6-month
mortality in the positive group was significantly higher than in
the negative group: 73.7% and 28.6% respectively. Odds ratio for
6-month mortality in the presence of the ‘slumpogram’ sign was
7.00 (2.25–21.77, 95% confidence interval, p
<
0.001). There was a
55.3% increase in average total 6-month bed-stay following the
index admission for the positive group (17.7 days vs. 11.4 days).
Conclusion:
This study is the first formal description of the
‘slumpogram’ sign as an independent predictor of increased 6-
month mortality. It is a simple tool for assessing frailty in
elderly inpatients in the acute setting, providing useful prognostic
information. Alongside clinical assessment, such a tool may help to
inform end-of-life decisions, improve advanced care planning and
enable tailoring of care to individual patients.
P-212
Association of frailty and cardiometabolic risk among
community-dwelling middle-aged and elderly people
A.-C. Hwang
Center for Geriatrics and Gerontology, Taipei Veterans General
Hospital, Taipei, Taiwan
Purpose:
To evaluate the association of cardiometabolic risk and
frailty through a community-based aging cohort in Taiwan
Methods:
The data of 1839 participants (men 47.5%; mean
age 63.9
±
9.3years) was retrieved from the first-wave of the I-
Lan longitudinal cohort study, for cross-sectional analysis. The
diagnosis of frailty was based on Fried phenotype criteria.
Comparisons between cardiometabolic risk and frailty status were
done after adjustment for age, hormone parameters, functional
measurements and skeletal muscle mass. Independent association
of cardiometabolic risk and frailty status was identified through the
multivariate logistic regression model.
Results:
Adjusted for age, blood pressure, LDL-C, uric acid,
creatinine, and carotid intima media thickness were not
significantly associated with frailty. However, lower total
cholesterol and HDL-C, higher hsCRP and glycemia profiles
maintained significantly associated with frailty. For hormone
parameters, DHEA-S, IGF-1 and free androgen index were not
significantly associated with frailty after age adjustment. In
multivariate logistic regression model, abdominal obesity, HOMA-
IR and hsCRP were significantly associated with frailty, the odds
ratio for frailty was 3.57(95% confidence interval (C.I) 1.88–6.78,
p
<
0.001), 1.30(95% C.I 1.02–1.66, p = 0.032) and 1.66(95% C.I 1.10–
2.49, p = 0.016) respectively in fully adjusted model. Conversely,
higher total cholesterol was associated with lower prevalence of
frailty (OR: 0.44 (95%C.I 0.22–0.89), p = 0.023) in the final model.
Conclusion:
In this study, abdominal obesity, insulin resistance
and inflammation were significantly associated with frailty, and
the effect was independent of functional measurement and decline
of skeletal muscle mass. An integrated approach targeting at
cardiometabolic aging and frailty is needed in clinical practice.
P-213
Prevalence of frailty among outpatient falls clinic attendees
in a district general hospital
R. Impson
1
, S. Awais
1
, T. Shawis
1
1
Colchester Hospital University Foundation Trust, Colchester, Essex,
England, United Kingdom
Objectives:
The prevalence of frailty in community dwelling older
people is reported to be from 7% up to 26% in those over 85
years old (Collard et al, JAGS, 2012).Falls and fractures are common
among frail people. (Tom et al, JAGS, 2013.) The prevalence of frailty
in fallers is unknown. Our aim was to find out the prevalence of
frailty among falls clinic attendees in our hospital
Method:
85 consecutive patients attending the falls clinic between
January and August 2014 were assessed on the 5 parts of the frailty
phenotype model (Fried et al, Journal of Gerontology, 2001) 58
women and 27 Men, Average age 79 years old. No exclusions as
long as they could cognitively respond to questions with the help
of carers.
Results:
61% of patients were classified as frail, 25% as pre-frail. In
those over 80 years old prevalence of frailty rose to 73%. Women
made up 71% of the frail group. Those not frail and pre frail had
on average a greater number of falls. However histories of fracture
were more in frail group.
Conclusion:
Frailty with or without fracture is very common in
fallers attending falls clinic. Falls services should address frailty as
well as falls and fracture prevention.
P-214
Hormonal determinants of muscle strength in hospitalized
older adults: the GLISTEN study
M. Maggio
1
, F. Lauretani
2
, V. Giacomini
3
, R. Zucchelli
3
, G. Bondi
3
,
A. Fisichella
1
, M. Mantovani
1
, F. De Vita
1
, F. Corica
4
, F. Landi
5
,
G.P. Ceda
6
1
University of Parma Dpt Clinical and Experimental Medicine, Parma,
Italy;
2
Geriatrics Unit, Parma University Hospital, Parma, Italy;
3
University-Hospital Parma, Parma, Italy;
4
University of Messina,
Messina, Italy;
5
Catholic University of Sacred Hearth, Rome, Italy;
6
Italy
Objective:
To determine the relationship between anabolic
hormones, testosterone (T), insulin like growth factor-1 (IGF-1)
and vitamin D (appropriately measured) and muscle strength in
hospitalized older patients.
Methods:
The Gruppo Lavoro Italiano Sarcopenia-Trattamento,
Nutrizione (GLISTEN) designed a multicenter Study in 7 acute
Geriatric Wards of University-Hospitals to determine change in
muscle mass and strength during hospitalization. We used data
from 77 women and 75 men between October 2013 and 2014
in Parma, Messina, Ferrara, and Rome having serum available
and CGA at hospital admission and discharge. Muscle strength
was evaluated by hand-grip dynamometer. FNIH cut-off points
(26 and 16 kg for men and women) were used to define low
muscle strength. Testosterone and Vitamin D were measured by LC-
MS/MS in BRAC Laboratory, Boston, USA. The relationship between
anabolic hormones and muscle strength was tested by multivariate
regression models including age (Model 1) and age, weight, IADL,
cognitive-depressive status, multi-morbidity, hemoglobin, albumin
and WBC (Model 2).
Results:
Mean age was 85
±
6 and 79
±
6, in women and men,
respectively. T and 25-OHD3 [median (IQR)] were 21 (23) and
216 (292) ng/dL and 6.4 (6.7) and 7.3 (8.9) ng/mL, in women and