European Geriatric Medicine - Supplement 1 - Volume 6

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

–

S156

S89

men. Medians (IQR) for IGF-1 were 65 (36) and 82 (49) ng/mL.

In Model 1, T in men (

SE 2.06

0.93, p = 0.03) and women

(1.33

0.60, p = 0.03) but not IGF-1 and Vitamin D were independent

correlates of muscle strength at hospital admission. The association

between T and muscle strength was less strong in women

(1.04

0.62, p = 0.09) and men (2.17

1.06, p = 0.04) in Model 2. At

hospital discharge 47/75 men and 65/77 women had lower muscle

strength FNIH sex criteria. FNIH hand grip “weaker” had lower T

than “normal” group (214

190 vs 307

181, p = 0.04).

Conclusions:

T is an independent correlate of muscle strength at

hospital admission in older male and female hospitalized patients.

Men in the weaker hand grip FNIH group have significantly lower T

than robust.

P-215

Evans syndrome: a rare cause of anemia in the elderly

A. Martin-Kleisch

, A.-A. Zulfiqar

, E. Lemaire

CHU Reims, Reims, France

Background:

Anemia in the elderly remains a major problem and

the causes are large and varied.

Methods:

We illustrate that problem in this clinical case.

Results:

We received a 87-year-old patient for ischemic stroke. She

had a history for hypertension treated and phlebitis. Neurological

examination showed a right pyramidal syndrome associated with

a complete right hemiplegia without facial involvement. The skin

examination showed a slight livedo in the lower limbs. Laboratory

tests showed anemia and thrombocytopenia initially not known.

Cerebral scan confirmed ischemic stroke. Given these disturbed

investigations, we have made a report showing a positive Combs

test IgG + C3d associated with a collapsed haptoglobin, increased

free bilirubin and increased Ddim`eres (

10.00mg/L). Antiplatelet

antibodies were also positive (IgG + IgM). These results confirmed a

mixed autoimmune hemolytic anemia associated with autoimmune

thrombocytopenia and going in the direction of an Evans syndrome.

An assessment of immune dysfunction has been prescribed,

including the search for lupus or antiphospholipid syndrome, which

can move in the direction of a Sneddon syndrome. Unfortunately,

it has not been possible before the sudden deterioration and death

of the patient.

Conclusions:

Dysimmune pathologies are also found in the

elderly and must be sought before symptoms suggestive for the

establishment of a cure.

P-216

Validation of “VIDA questionnaire” for assessing instrumental

activities of daily living; aspects connecting to frailty

I. Mart´ın-Lesende

, I. Vergara

, K. Vrotsou

, P. Lopetegui

, J. Nu˜nez

I. S ´anchez

, A. Bueno

, A.I. Diez

Basque Health Service

–

Osakidetza, Bilbao, Spain;

Basque Health

Service

–

Osakidetza, San Sebastian, Spain;

Basque Health Service

–

Osakidetza, Beraun, Spain

Tools assessing early stages of functional decline in

elderly people, such as instrumental-activities-of-daily-living

(IADL)questionnaires, are involved in the detection of frailty.

Objectives:

To present the VIDA questionnaire, assessing IADL in the

community health setting, and its main characteristics. To highlight

some analysis through which it connects to frailty.

Methods:

The creation/validation of this questionnaire has been

performed through several research studies: Delphi technique (to

select items), inter/intrarater reliability, exploratory factor and

known-group analysis; with some of them related to frailty:

– content validity measuring IADL (Delphi), and correlation with

similar scales (Lawton),

– concurrent validity with functional performance tests (Timed-Up-

and-Go), widely recommended nowadays in frailty detection,

– association with frailty risk factors, including low physical activity

or age.

Significance level 0.05 as required.

Results:

Finally 10 items were selected through the Delphi study,

with 3/4-point Likert for responses, maximum score 38; without

gender bias, and 4 minutes to be completed. High inter/intrarater

reliability, with intraclass correlation coefficients (ICC) of 0.94

(95% CI 0.88–0.97 p

0.0001) and 0.96 (0.93–0.98 p

0.0001),

respectively. Cronbach’s alpha 0.94. Adequate construct validity

(correlations between items

0.40).

Moderately correlated with the Timed-Up-and-Go test (ICC 0.61

0.0001).

In the known-group analysis scores fell when Lawton was wrong

0.0001), with increasing age (p = 0.0002) and decreasing

physical activity (p = 0.0001).

Lower score when ≥2 frailty factors (comorbidity, falls, recent

hospitalization, adverse social conditions, polypharmacy) coexisted

(p = 0.015).

Conclusions:

VIDA questionnaire has good characteristics as a

diagnostic test, and several analyses seem to connect to the

detection of frailty. It is in an advanced stage of validation; indeed,

it has started being used in several research projects, mainly related

to frailty.

P-217

Relation between knee joint deformity and gait in

community-dwelling elderly people

Y. Matsui

National Center for Geriatrics and Gerontology, Obu, Japan

Objectives:

To clarify the relationship between the severity of knee

deformity and gait.

Methods:

The subjects were 2,284 randomly-selected, community-

dwelling middle-aged and elderly people ≥40 years old (men 1,154,

women 1,130, mean age 60.2). They were classified into 3 groups by

knee deformity on Xp: normal, mild, and severe. Gait velocity, pitch,

and step length were examined by gait analysis at comfortable and

maximum speeds. A general linear model adjusted for age, weight,

and leg length was then used to investigate differences by severity

of knee deformity.

Results:

The velocity of gait with comfortable speed in the normal,

mild, and severe deformity groups was 85.5, 85.2, 81.7 (m/min),

respectively, in men, and 82.0, 82.4, 79.5 (m/min) in women. It

was significantly slower in the severe group than in the normal

and mild groups in both sexes (all p

0.05). In gait with maximum

speed a similar difference was seen only in women (p

0.05 and

0.01, respectively). Pitch was not significantly different between

the groups in either gait with comfortable or maximum speed.

Step length in gait with maximum speed was different between

the severe and mild groups in both sexes and between the severe

and normal groups in men (all p

0.05). Maximum step length was

significantly longer in the severe group than the normal and mild

groups in both sexes (men, all p

0.05; women, all p

0.01).

Conclusion:

Severe knee deformity affects gait velocity, mainly by

decreasing step length.

P-218

Falls, 25(OH)vitaminD and physical performance in older

adults: preliminary results from the FALL-A-SLEEP Study

A. Monti

, E. Zafindravelo

, A. Breining

, V.H. Nguyen

, E. Pautas

K. Kinugawa-Bourron

GH Piti´e-Salpˆetri`ere-Charles-Foix, Ivry-Sur-Seine, France;

Charles

Foix Hospital, Ivry sur Seine, France

Objectives:

The relation between serum 25-hydroxyvitamin D3

(25(OH)D) levels and physical performance have been well

established among women and community dwelling older adults.

We aimed to examine the association between falls, 25(OH)D