123 / 290
showing that frailty was significantly related to social vulnerability,
with greater disadvantage for older and females subjects.
Key conclusions:
Socioeconomic and lifestyle factors are associated
with frailty independently from functional impairment and low
physical activity.
P-332
Geriatric conditions are associated with potential difficulty of
walking a distance of 200
–
300 meters among older adults in
Taiwan
C.M. Chang
1,2
, H.I. Shih
3,4
, Y.T. Huang
1
, T.Y. Chao
5
, P.T. Chen
2
, C.C. Yao
6
.
1
Division of Geriatrics and Gerontology, Department of Internal Medicine,
National Cheng Kung University Hospital,
2
Institute of Gerontology,
College of Medicine, National Cheng Kung University,
3
Department of
Emergency Medicine, National Cheng Kung University Hospital,
4
Department of Public Health, College of Medicine, National Cheng Kung
University,
5
Department of Urban Planning, National Cheng Kung
University,
6
Department of Architecture, National Cheng Kung University,
Tainan, Taiwan
Objectives:
Walking a distance of 200
–
300 meters are important to
older adults for disaster prevention and independent living in the
community. While geriatric conditions are common problems in the
older adults, this study aims to examine the associations of geriatric
conditions and ability of walking a distance of 200
–
300 meters among
the elderly people in Taiwan.
Methods:
The data was collected from the Longitudinal Study on
Aging in 2007 in Taiwan. Basic characteristics, including age, gender,
years of education, living status, area of residence, institutional care,
chronic diseases, and geriatric conditions were obtained. Participants
were asked if they were able to walk a distance of 200
–
300 meters.
Geriatric conditions, including underweight, functional impairment,
falls twice or once with injury in the past year, cognitive impairment,
depressive condition were assessed.
Results:
A total of 2700 older adults aged
≥
65 years were enrolled in
this study. Multiple logistic regression analysis shows that the elderly
people with <6 years of education, chronic diseases of diabetes
mellitus, heart disease, stroke, arthritis/rheumatism, hip fracture,
osteoporosis; no habit of alcohol drinking, as well as the geriatric
conditions, including functional impairment, depressive condition,
falls twice or once with injury in the past year were associated with
difficulties in walking a long distance.
Conclusions:
To improve the walking a long distance of 200
–
300
meters, screening and managing geriatric conditions, in addition to
control chronic disease, must be considered.
P-333
Frailty is associated with long-term adverse outcome among
hospitalized older patients: a prospective cohort study in China
L.Y. Chen
1
, X.J. Chen
1
, J. Yan
1
, L.K. Chen
2,3
.
1
Zhejiang Hospital, Hangzhou,
China;
2
Aging and Health Research Center, National Yang Ming University,
3
Center for Geriatrics and Gerontology, Taipei Veterans General Hospital,
Taipei, Taiwan
Aim:
To evaluate the prognostic effect of frailty on long-term outcome
for older patients discharged from Geriatric Unit of a hospital in China.
Methods:
From Oct, 2014 to October, 2015, patients admitted to the
Geriatric Unit of Zhejiang hospital were invited for study. For all
participants, disregard of the disease for admission, they received a
comprehensive geriatric assessment and were clinically followed-up
after hospital discharge. Frailty was defined by the Clinical Frailty
Scale (CFS) and the score >4 was defined as having frailty status. The
functional status was determined at the 12-month follow-up and
functional decline was defined when the follow-up Barthel Index
was lower than the baseline Barthel Index before hospital admissions.
The composite adverse outcome was defined as the presence of
mortality or functional decline.
Results:
Overall, 150 patients (81.5 ± 7.0 years with 64% males) were
enrolled for study. Among them, 62% were living alone and 29.3%
eventually lived in the nursing homes. The main admission conditions
were cardiovascular disease, neuropsychiatric disease and infectious
diseases. Compared to non-frail patients, frail patients were signifi-
cantly older (84.4 ± 5.9 vs 79.3 ± 7.0 years, P < 0.001), more living in
nursing homes (55.4% vs 9.4%, P < 0.001), poorer in baseline functional
status (Barthel Index: 63.7 ± 22.4 vs 97.6 ± 5.5, P < 0.001 and IADL:
3.9 ± 2.2 vs 7.2 ± 1.3, P < 0.001), higher multimorbidity (CIRS-G:
11.0 ± 4.1 vs 9.6 ± 4.0, P = 0.038), longer hospital length-of-stay
(23.2 ± 13.9 vs 13.7 ± 8.0 days, P < 0.001), poorer cognitive function
(MMSE: 22.5 ± 5.9 vs 25.2 ± 3.9, P = 0.024), poorer nutritional status
(MNA-SF: 10.5 ± 2.7 vs 12.3 ± 2.0, P < 0.001), and higher CFS (5.4 ± 0.6
vs 3.4 ± 0.6). Cox proportional hazard model showed that frailty (HR:
5.59, 95% CI: 1.58
–
19.79, P = 0.008) and IADL (HR: 0.575, 95%
CI: 0.406
–
0.815, P = 0.002) were significantly associated with the
composite adverse outcome.
Conclusion:
CFS is a useful assessment instrument to predict long-
term adverse outcome among patients admitted to the Geriatric Unit,
which deserves to be a routine assessment for all geriatric inpatients.
P-334
Determinants of functional decline and entering frailty
–
results
from the Longitudinal Urban Cohort Aging Study (LUCAS)
U. Dapp
1
, L. Neumann
1
, S. Golgert
1
, B. Klugmann
1
, A. Daubmann
2
,
C. Gräfin zu Eulenburg
2
.
1
Albertinen-Haus, Centre of Geriatrics and
Gerontology, Scientific Department at the University of Hamburg,
2
Department of Medical Biometry and Epidemiology, University Medical
Center Hamburg-Eppendorf, Hamburg
Introduction:
Prevention in ageing populations is a major challenge
for public-health policy, welfare systems, healthcare providers and
payers. In the Longitudinal Urban Cohort Aging Study (LUCAS) a
functional ability (FA) index was established to screen functional
competence and development of frailty (classes ROBUST, postROBUST,
preFRAIL and FRAIL) in the community setting [1]. In this analysis, the
predictive ability of single baseline marker questions was evaluated.
Methods:
ROBUST participants in 2007 with at least one measured
follow-up until LUCAS wave 5 (2013) were eligible. The progressions to
(a) leave the ROBUST class, and separately (b) to enter the FRAIL class,
were analyzed using univariate Cox
”
cause specific hazards models.
Results:
All 820 ROBUST participants (2007) were analysed within
the six year time period. 484/820 (59.0%) participants left the ROBUST
class and 160/820 (19.5%) entered the FRAIL class. Those LUCAS FA
index risk markers depicting performance changes in walking 1km
or 500 m, climbing 10 stairs or getting into a car were significantly
predictive for (a) leaving ROBUST and (b) entering FRAIL. On the
other hand, FA index resource markers depicting moderate or
strenuous physical activity were significantly predictive for (a)
remaining ROBUST and (b) not entering FRAIL.
Key conclusions:
Well established clinical frailty markers measured
in the LUCAS FA index such as unintentional weight loss or previous
falls were inappropriate (insignificant) for predicting functional
decline (postROBUST, preFRAIL) or newly entered frailty. Multivariate
Cox
”
cause specific hazards models incl. backward selection will be
performed to confirm present results.
Funding:
LUCASIII/PROLONGHEALTH (BMBF01EL1407).
Reference
[1] Dapp U.
et al. BMC Geriatrics
2014;14:141.
P-335
Assessing the feasibility of frailty tools: a systematic literature
review
A.R. Elliott, S.P. Conroy.
University of Leicester
Background:
This literature review aimed to identify the pre-existing
evidence on the feasibility of implementing frailty identification
systems in the Emergency Department.
Methods:
Medline was searched for evidence of the feasibility of
either frailty tools specifically, or the assessment of older people, in
Poster presentations / European Geriatric Medicine 7S1 (2016) S29
–
S259
S117