98 / 210
S90
Poster presentations / European Geriatric Medicine 6S1 (2015) S32
–
S156
levels and physical performance among acute care setting geriatric
patients.
Methods:
Acute care setting patients aged ≥75 were proposed
to participate to the FALL-A-SLEEP Study since March 2015.
Patients with severe cognitive impairment, short life expectancy or
bedridden were excluded. 25(OH)D levels were measured. Handgrip
strength and short physical performance battery (SPPB including
gait speed, chair stand and balance) were performed in a stabilized
medical condition.
Results:
Complete evaluation was available for 17 patients (mean
age 84.9, 12 women, mean body mass index 21.7 kg/m
2
). For
patients never fell, only women. Among fallers (recurrent falls), a
half spent more than one hour on the ground after falling and 58%
cannot get up alone after falling. 54% had traumatic falls. Handgrip
strength and SPPB were not statistically different between fallers
and non-fallers. Balance scores between fallers and non-fallers
are nearly significant (3/4 vs 1.6/4, p = 0.07). 25(OH)D levels were
significantly lower in fallers (36.8 ng/ml vs 22.2 ng/ml, p = 0.04) and
among patients with SPPB≤8 (22.3 vs 39.3 ng/ml, p = 0.048).
Conclusions:
There is an association between 25(OH)D and falls
and between 25(OH)D and physical performance, probably mostly
due to the impact on balance. More data are needed to confirm
these results and the inclusion is still ongoing in the FALL-A-SLEEP
Study.
P-219
High-protein oral nutritional supplements improve leg muscle
quality in sarcopenic, malnourished adults
J. Cramer
1
, A.J. Cruz-Jentoft
2
, M. Hickson
3
, F. Landi
4
, M. Zamboni
5
,
S. Pereira
6
, D. Hustead
6
, V. Mustad
7
1
University Nebraska Lincoln, Lincoln, United States of America;
2
Hospital Universitario, Madrid, Spain;
3
Imperial Hospital NHS Trust,
London, United Kingdom;
4
Catholic University of Sacred Hearth,
Rome, Italy;
5
University of Verona, Italy;
6
Abbott Nutrition, Columbus,
United States of America;
7
Abbott, Columbus, United States of America
This study evaluated high-protein nutritional supplements with
and without CaHMB on muscle quality (MQ) in sarcopenic,
malnourished adults. Participants (65+ years, n = 330) malnourished
by subjective global assessment and sarcopenic by EWGSOP
were randomized: Control (14 g protein; 160 IU vitamin D) or
Experimental (20 g protein; 500 IU vitamin D3; 1.5 g CaHMB) twice
daily. MQ was calculated (isokinetic leg strength, Nm
÷
leg lean
mass (DXA, kg) at baseline, 12, and 24 weeks. Subgroups were
evaluated: severe sarcopenia (low muscle mass, low grip strength
[
<
30 kg men;
<
20 kg women], and low gait speed [
<
0.8m
·
s
−1
]) and
sarcopenia (low muscle mass, normal gait or normal grip strength).
Evaluable data from n = 216 are presented as median change from
baseline (25%, 75% interquartile range). MQ improved in both
groups (p ≤ 0.05) over 24 weeks (+0.42 [−0.5, 1.3], Experimental;
+0.42 [−0.5, 1.8], Control), with no treatment differences. Severe
sarcopenia comprised ~44% of this sample; MQ was lower in
those with severe sarcopenia, with no treatment differences in
MQ improvements. MQ increased in sarcopenic individuals at
12 weeks, Experimental
>
Control (ns, p = 0.06), with significant
treatment differences (Experimental: +0.89 [−0.05, 1.53]; Control:
+0.31 [−0.71, 0.73] p = 0.02] in subjects with normal grip only.
Sarcopenic, but not severely sarcopenic, participants improved MQ
after consuming a supplement with CaHMB compared to a Control
supplement for 12 weeks. Although prevalence of severe sarcopenia
is low (≤2.9%, Dam et al., J Gerontol A Biol Sci Med Sci 2014;
69: 584–590), severity should be considered for muscle-related
outcomes during nutrition-only interventions.
P-220
Prognostic factors related to functional recovery after hip
fracture
M. Neira
1
, P. Lopez Doriga
2
, E. Arias
3
, J.F. Gomez Cerezo
4
, R. Bielza
3
1
H. Infanta Sofia, Geriatric Unit, Madrid, Spain;
2
Hospital La Fuenfr´ıa,
Madrid, Spain;
3
H. Infanta Sofia, Madrid, Spain;
4
H. Infanta Sof´ıa,
Madrid, Spain
Aim:
To identify variables related to functional recovery after hip
fracture in elderly people.
Methods:
This prospective observational study included patients
who were admitted to Infanta Sofia’s hospital for hip fracture
surgery from April to September 2014. Functional status (Barthel
Index), mental status (Cruz Roja Index) and grip strength were
evaluated at the time of admission. Multivariate regression analysis
was used to evaluate the independent relationship between
functional status 3 months after discharge and clinical variables.
Results:
The mean age of hip fracture subjects was 85.5
±
0.7 years.
Out of 93 subjects, 74 were women and 19 were men. Women were
significantly older than men. Barthel Index score was 66.7
±
3.1 on
average. Moderate to severe cognitive impairment (Cruz Roja Index
≥3) was present in 33.3%. The mean grip strength was 10.5
±
0.6,
being higher in men than in women. Grip strength was directly
related to age and previous functional status. Mortality was 14.2%
and those who died had lower Barthel Index scores prior to hip
fracture.
Barthel Index score three months after hip fracture was 50.3
±
3.9 on
average. We observed significant associations between functional
status three months after discharge and age, previous functional
status, mental status and grip strength. After multiple logistic
regression, only associations with age, previous functional status
and mental status remained significant.
Conclusions:
Hip fracture has a significant impact on functional
status and mortality among elders. Factors related to functional
recovery are age, previous functional status and cognitive status.
The authors have no financial support from commercial parties.
P-221
Frailty syndrome among older patients with post-traumatic
stress disorder
A. Parnicka
1
, K. Piotrowicz
2
, J. Walczewska
1
, M. Mielima˛ka
1
,
K. Basista
1
, A. Skalska
2
, K. Rutkowski
3
, T. Grodzicki
2
1
Department of Internal Medicine and Gerontology, Jagiellonian
University Medical College, Krak´ow, Poland;
2
Poland;
3
Jagiellonian
University Medical College, Krak´ow, Poland
Objective:
To assess frailty syndrome in elderly people with post
traumatic stress disorder (PTSD).
Methods:
The study included outpatients ≥60 years old with PTSD
who had been deported during the World War II or born on exile
in the Soviet Union. PTSD was diagnosed according to the criteria
of DSM-IV. To asses frailty we used two scales: the Canadian
Study of Health and Aging Clinical Frailty Scale (CSHA-CFS) and
the Cardiovascular Health Survey frailty definition (Frail-CSH).
Results:
The group included 68 patients (55.9% men); mean age:
70.4
±
6.8 years (min.-max.: 60–88 years). 61.8% of the patients
were pre-frail, 20.6% were frail, with the frail-CSH definition. There
was a trend toward higher frequency of frailty in women (30%
vs 13.2% in men, p = 0.088). More than half of the respondents
reported exhaustion, 23.5% weight loss, and 16.2% low activity
level; 62.3% presented weakness and 9.2% impaired mobility on
physical examination. According to the CSHA-CFS, 29.4% of all
respondents were mildly frail, 8.8% moderately frail, 1.5% severely
frail, 25% apparently vulnerable, 23.5% well, with treated comorbid
disease, 10.3% well, without active disease, and only 1.5% very fit.
There was a significant correlation between the results of the CSHA-
CFS and the muscle strength (r = −0.35, p
<
0.01) and the results of
the Timed Up and Go test (r = 0.506, p
<
0.001).