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

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References
1. Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in
elderly people. The Lancet. 2013, 752–62.
2. Coelho T, Paúl C, Gobbens RJJ, Fernandes L. Multidimensional
frailty and pain in community dwelling elderly. Pain Medicine
(United States). 2015.
3. Kaye AD, Baluch A, Scott JT. Pain management in the elderly
population: a review. Ochsner J. 2010;10(3):179–87.
4. Gobbens RJJ, van Assen MALM, Luijkx KG, Wijnen-Sponselee MT,
Schols JMGA. The tilburg frailty indicator: Psychometric properties.
J Am Med Dir Assoc. 2010;11(5):344–55.
5. Becker J, Schwartz C, Saris-baglama RN, Kosinski M, Bjorner JB.
Using item response theory (IRT) for developing and evaluating the
Pain Impact Questionnaire (PIQ-6TM). Pain Med. 2007;8(Suppl.3).
6. Pfeiffer E. A Short Portable Mental Status Questionnaire (SPMSQ).
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Outcomes in a multicomponent exercise programme in frail
community-dwelling individuals
I. Anton, E. Andueza, S. Raposo, X. Embil, J. Yanguas. Fundación Matia.
Hospital Ricardo Bermingham
Introduction: The purpose of this program is to examine if a super-
vised multicomponent exercise program (MEP) in frail elderly people
can improve functionality and cognitive status, as well as reduce falls.
Methods: This is a prospective intervention of 38 frail elderly
(September 2014 –March 2016). The inclusion criteria were balance
problems and/or previous falls. The exclusion criteria were to suffer
from moderate and sever dementia. MEP includes propioception,
balance (balance carpet) and strength (leg press machine) exercises
for 60 minutes, twice a week during 12 weeks. We have done pre
and post intervention assessment of functional and cognitive values.
The functional values were SPPB (short physical performance battery),
gait velocity, balance carpet, falls and maximal dynamic strength (RM)
measured in kilograms. The cognitive values were MEC (spanish
adapted version of MMSE), TMT a, TMT b and two dual cognitive tasks
(walk while name animals and walk while substracting).
Results: Of 38 elderly, average age 80, females 51%, barthel 94, lawton
5.46, affective disorders 43%, BMI 25.81, drugs number 5.11, no. of falls
6 months previous to the program 1.24, no. of falls during the program
0.30, poor sleep quality 43%, mild cognitive impairment 10%, mild
dementia 2.7%. Statistical analysis was performed with Wilcoxon
signed ranks test. We found statistical significant differences pre/post
intervention in SPPB (8.46; 9.35 p = 0.002), balance carpet (278/300;
294/300 p < 0.001), lower-body RM (34.35; 53.22) with an improve-
ment of 54%, gait velocity 6 m (0.81 m/s; 0,95 m/s p < 0.05) and no.
of falls (1.24; 0.30 p = 0.006). We didn ′t find statistical significance of
the rest of results (TMTa, TMTb, MEC and dual cognitive tasks – gait
velocity aritmetic task and gait velocity verbal task-).
Conclusions: MEP shows improvements in functional measurements,
reduce falls but not improvements in single and in dual cognitive tasks.
P-326
Evaluation of a hospital at home service in older patients with
frailty
M. Azad1, S. Rutter2, T. Masud1. 1Nottingham University Hospitals
NHS Trust, Nottingham, 2Sherwood Forest Hospitals NHS Trust,
Sutton-In-Ashfield, UK
Introduction: Emergency admissions to hospital of older people have
increased substantially over the last decade, with many of them being
frail. Simultaneously, acute hospital bed numbers have reduced
thereby putting extra pressure on services. Hospital at Home (HAH)
interventions provide active treatment by health and social care
professionals in patients ’ own homes. The aim of this study was to
evaluate the effectiveness of a HAH service in frail and non-frail older
patients.
Methods: Community dwelling older people, at risk of hospital
admission, were referred to a HAH service from a variety of community
sources. The service comprised regular assessments and appro-
priate interventions by a multidisciplinary team including a doctor.
We measured the total duration of the HAH service and the proportion
of people whose care was transferred to another setting. Frailty status
was measured using the Groningen Frailty Indicator.
Results: Forty four patients (61.4% female) were evaluated with a
mean age of 80.9 years (SD = 8.3; range = 63– 95). The mean inter-
vention time was 15.3 days (95%CI = 12.1–18.5). The proportion of
participants classified as frail were 70.5% (95%CI = 68.4–72.5%; n = 31).
The proportion of frail patients who remained at home were 71% (95%
CI = 68.1–73.8%; n = 22) compared with 76.9% (95%CI = 70.6–83.3%;
n = 10) of those without frailty [NS].
Conclusions: These data suggest that a HAH service comprising
members of a team that can deliver comprehensive geriatric assess-
ment can effectively manage older people with frailty in their own
homes. Such a service has the potential to ease demand on a pres-
surised acute hospital care system, and warrants further research.
P-327
Prevalence of sarcopenia in patients referred to a secondary care
falls clinic
K. Barnes1, B. Smeed1, R. Taylor1, E. Blackshaw1, K. Brooke-Wavell3,
A. Slee4, V. Hood2, J. Ryg5, T. Masud2. 1NUH NHS Trust, 2University of
Nottingham, Nottingham, 3Loughborough University, Loughborough,
4United Lincolnshire Hospitals NHS Trust, Lincolnshire, England,
5University of Southern Denmark, Odense, Denmark
Introduction: Sarcopenia is characterised by loss of skeletal muscle
mass and strength with evidence of adverse outcomes such as physical
disability, poor quality of life and death. Both low muscle mass and
sarcopenia are independent risk factor for falls, although there are few
data available on the prevalence of sarcopenia in fallers. This study
aimed to determine the prevalence of sarcopenia in older people
referred to a falls clinic.
Method: Consecutive patients referred to a multidisciplinary second-
ary care falls unit were recruited. Sarcopenia was diagnosed using the
European Working Group on Sarcopenia (EWGSOP) definition (both
low muscle mass and function) and cut-off points. Bio-impedance
(BIA) was employed to measure muscle mass (SMI), gait speed and
grip strength were assessed as the functional measures.
Results: Fifty-three patients (62.3% = women) were recruited. Mean
grip strength for women and men were 17.9 (SD = 5.0) and 29.9
(SD = 9.0) kg, and mean gait speeds were 0.61 (SD = 0.18) and 0.75
(SD = 0.38) m/s respectively. Six were unable to undergo BIA (2
had pacemaker, 4 unable to stand still). Mean BIA in women and men
were 7.0 (SD = 1.0) and 7.7 (SD = 1.0) kg/m2 respectively (p = 0.018).
Prevalence of sarcopenia was 41.5% (95%CI = 27.4–55.6%; n = 22).
Conclusion: Sarcopenia, as measured by BIA, is common in older
people referred to a secondary care falls clinic. BIA was simple to
perform in this setting, although further validation against gold
standard methods in this population are lacking. As nutritional and
exercise interventions for sarcopenia are now available, simple
methods for diagnosing sarcopenia in fallers should be considered.
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Preliminary results of a systematic review focusing on the
effectiveness of the interventions in preventing the progression of
frailty in older adults
E. Bobrowicz-Campos1, J. Apóstolo1, R. Cooke2, S. Santana3,
M. Marcucci4, A. Cano 5, M. Vollenbroek-Hutten6, B. D′Avanzo7,
C. Holland2. 1ESEnfC Coimbra, Portugal; 2ARCHA Aston University,
Birmingham, UK; 3DEGEI, University of Aveiro, Portugal; 4Geriatric Unit,
Fondazione IRCCS Ca” Granda Ospedale Maggiore Policlinico & DISCCO,
University of Milan, Milan, Italy; 5Dept. of Paediatrics, Obstetrics, and
Gynaecology, Universitat de Valência, Spain; 6RRD, Netherlands; 7IRCCS
Istituto Di RicercheFarmacologiche “Mario Negri”
Poster presentations / European Geriatric Medicine 7S1 (2016) S29–S259 S115