European Geriatric Medicine - Supplement 1 - Volume 7 - October 2016

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Numeric Rating Scale (NRS), for patients with slight or no cognitive
impairment, and the Pain Assessment In Advanced Dementia Scale
(PAINAD) for patients with moderate-severe cognitive impairment.
The Cornell Scale for Depression in Dementia (CSDD) was used to
evaluate mood, and the Quality of Life Scale (EQ-5D) to evaluate the
quality of life.
Results: Prevalence of pain evaluated by NRS was 47.7% at T0 and
39.6% at T1, while it was 50.7% at T0 and 44.4% at T1 in patients with
cognitive impairment and evaluated by PAINAD. 42.8% of people with
pain did not receive adequate pain treatment at T0. The statistical
analysis showed that the pain was correlated with depression
symptoms assessed with CSDD (Pearson ’s chi-square: 0.000,
Cramer ’s V:0.000), and poor quality of life (Pearson’s chi-square:
0.000, Cramer’s V: 0.000).
Conclusion: Self-report tools alone are not sufficient to assess pain in
elderly people; therefore, observational tools for pain should be used
in a multidimensional assessment of pain. Chronic pain can cause
depression, and a poor quality of life if not adequately treated.
AknowledgementsCalabria: RSACasa Amica, RSA, Villa Elisabetta, Casa
Protetta S. Domenic, Casa Protetta Madonna del Rosario, Casa Famiglia
Anatello RSA Santa Maria del Monte, Casa Protetta San Pio, Casa
Protetta Villa Azzurra; Emilia Romagna: RSA Villa Giulia RSA Villa
Serena, RSAVilla Margherita, RSAVilla Sorriso, RSAVilla Ranuzzi, RSA
Villa Salus, RSA I Platani, RSA S. Anna, RSAVilla Paradiso; Lazio: RSA
Bellosgurado, RSA Santa Rufina, Anagnino Residence, RSA Colle
Cesarano, RSA Corviale; Toscana: RSA Villa Gisella, RSA Le Magnolie,
RSAVilla Michelangelo, RSA La Meridiana.
P-261
Can we decide based on age? – eldery under treatment
M. Malheiro 1, A. Felix1, C. Rodriguez1, A. Pissarra1, D. Cardoso1,
M. Miguens1, L. Fernandes1, D. Alberca1, A. Plácido1, A. Martins1.
1Medical Oncology, Centro Hospitalar Lisboa Ocidental - Hospital São
Francisco Xavier
Introduction: Last years, average life expectancy increased and cancer
is overcoming the cardiovascular disease as the main cause of death.
Decision to treat should promote life quality in this group. Thus, the
treatment of cancer in elderly becomes a challenge in clinical practice.
Objectives: Characterize patients over 85 years with advanced stage
cancer, therapeutic approach, results and complications.
Material and methods: Retrospective, observational, descriptive
study of patients aged 85 or older, with advanced stages cancers,
treated with chemotherapy (CT) or hormonotherapy (HT). Data
collected from medical records and processed using Microsoft Excel.
Results: We studied 13 patients, median age: 88 years, minimum: 85
and maximum: 101 years. Performance Status (PS): 0 –1. All female.
Most had breast cancer (84.6%; n = 11), 2 had colorectal, 1 kidney and 1
ovary. 4 patients treatedwith QT. Toxicity observed in 3 patients,1 with
pulmonary thromboembolism (grade 4) and 2 with diarrhoea (grade
3). We emphasize three cases. MPB, 101 years, female; PS 1; metastatic
breast carcinoma in 2010, with letrozole for 5 years without
complications and stable disease. MJR, 86 years, metastatic kidney
carcinoma in 2006, PS 1, treatedwith pazopanib, dose reduction due to
toxicity, partial response (remission of the lung metastases). CGPD, 86
years, PS 1, colon adenocarcinoma, treated with capecitabine (20%
dose reduction), maintaining good tolerance.
Conclusion: Age shouldn’ t limit treatment if integrated with type of
tumour ECOG PS and comorbilities. There were patients treated for 4
years, with disease stability without limiting adverse events.
P-262
A challenge in oncogeriatrics: is Rockwood frailty index an accurate
tool to predict clinical outcomes?
F. Monacelli1, C. Russo1, M. Canepa1, T.G. Casaleto 1, A. Mazzeo1,
S. Sambuceti1, R. Murialdo2, A. Nencioni1, A. Ballestrero2,
E. Romairone3, S. Scabini3, F. DeCian4, F. Boccardo5, P. Odetti1.
1IST Department of Internal Medicine and Medical Specialties Section of
Geriatric Medicine (DIMI), IRCCS University Hospital San Martino,
University of Genoa, 2IST Department of Internal Medicine and Medical
Specialties, Section of Internal Oncological Medicine (DIMI), IRCCS
University Hospital San Martino, University of Genoa, 3IRCCS University
Hospital San Martino-IST Oncological Surgery and Implantable Systems,
4IST Surgery Clinics, Department of Surgical Science and Integrated
Diagnostics (DISC), IRCCS University Hospital San Martino, University of
Genoa, 5IST Department of Internal Medicine and Medical Specialties
Section of Medical Clinical Oncology (DIMI), IRCCS University Hospital
San Martino, University of Genoa, Genoa, Italy
Objective: Comprehensive geriatric assessment (CGA) is the gold
standard for elderly assessment in oncology to predict chemotherapy
tolerance and the main clinical outcomes (survival, functional status
and quality of life). CGA is also able to stratify elderly patients accord-
ing to their biological condition (frail, pre-frail, fit). However, the
method is of specialist expertise and it is still poorly incorporated
into routine clinical practice. So far, other assessment tools did not
show adequate specificity and predictive accuracy. We aimed at
comparing different evaluation scales to assess the best predicting
oncogeriatric tool.
Methods: First visit included ECOG PS, CGA, Rockwood 40 item IF,
Short Form Health Survey-36 (QoL). Patients were assessed after 1
month for mortality, after three and six months for chemotherapy
toxicity and after 12 months for QoL, functional status, and overall
mortality.
Results: One hundred and forty-seven consecutive patients (78
females, 69 males), with solid tumor, mean age of 78 ± 1.0 years,
were enrolled from May 2015 in an Italian hospital. Respectively, 24%
of patients by ECOG PS, and 61% of patients by CGA were frail.
Interestingly, by IF, 58 patients were frail (39%), 77 pre-frail (52%) and
11 were fit 8 (9%), respectively.
The present study originally showed a significant positive correlation
between Rockwood FI and the gold standard (CGA) (n = 147; R = +0.74,
p < 0.0001). CGA unmasked several clinical problems in 108 out of
147 examined oncogeriatric patients, such as nutritional deficits (39%)
and mood disorders (46%), along with a significant percentage of post
surgical delirium (8%). To date, the overall mortality was of 11% (17/147
patients). The 30-day mortality after surgery was of 4% (2/50 pts).
Conclusions: The study results indicate a significant correlation
between CGA and Rockwood IF and address a different predictive
accuracy of IF in stratifying the pre frail patients’ category. The larger
enrolment and longitudinal observation of the study will allow
identifying the best predicting oncogeriatric tool, improving the
clinical management of the pre frail oncogeriatric patients as well.
P-263
Usefulness of the Multidimensional Prognostic Index to identify
potentially inappropriate prescriptions in hospitalized older
patients
C. Musacchio1, M. Rossi2, A.M. Mello1, A. Cericola2, E. Ferelli2, V. Arena2,
F. Calautti2, F. Filauro 2, E. Zaninoni 2, S. Garaboldi1, E. Zigoura1,
R. Custureri1, M. Pomata1, C. Prete1, C.E.A. Fraguglia2, A. Pilotto1.
1Geriatrics Unit, Department of Geriatric Care, Orthogeriatrics and
Rehabilitation, Frailty Area, Galliera Hospital, National Relevance and
High Specialization Hospital, 2Pharmacy Unit, Galliera Hospital, National
Relevance and High Specialization Hospital, Genoa, Italy
Objectives: Use of multiple drugs is associated with major risks of
potentially inappropriate drug prescriptions (PIPs). Multidimensional
Prognostic Index (MPI) is a validated prognostic tool able to identify
different mortality risk (MPI1 = low, MPI2 = moderate, MPI3 = severe)
in older subjects. The aim of this study was to evaluate whether the
MPI may be useful to identify patients with different risk of PIPs in
order to develop tailored strategies to improve drug prescriptions.
Methods: Subjects aged 65+ years admitted to the Geriatrics Unit
for any acute illness were enrolled. Therapies at admission and at
dischargewere collected. Avalidated computer-based tool was used to
detect any PIPs according to the Screening Tool of Older People’ s
Prescription criteria and Micromedex® system to detect major drug
Poster presentations / European Geriatric Medicine 7S1 (2016) S29–S259 S98