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emergency and urgent care, between 2001 and October 2015. Markers

of feasibility included the time taken to complete an assessment;

acceptability to clinicians; and completion rates of tools.


1754 titles and abstracts were identified and reviewed by

two researchers. 47 full papers were reviewed with nine included in

the final critical review. Median CASP score was 75%, interquartile

range = 69

81. Eight of the nine papers included information on how

long an assessment took to carry out; three assessed completion rates;

and one investigated the acceptability of tool domains to clinicians.


There is a paucity of evidence of the practical application

of frailty tools and their feasibility. The most commonly assessed

feasibility marker is time taken to complete an assessment. Further

work is required to better understand the acceptability of frailty

identification to ED staff.


Assessing the feasibility of implementing frailty identification

tools in the Emergency Department

A.R. Elliott, S.P. Conroy.

University of Leicester


Identifying frailty in older people in the Emergency

Department (ED) is important as ED assessment and initial manage-

ment substantially affect outcomes. Screening tools can be used for

identification but there is relatively little evidence of their practical



A convenience sample of ED clinicians in a large teaching

hospital, employing 179 nursing and 104 medical staff, assessed four

frailty tools: clinical frailty scale (CFS), ISAR, PRISMA-7 and the Silver

Code (SC) against patient vignettes, developed from focus groups.

Assessments were timed and participants were asked about: their

opinion on the tools; whether they would use them in practice; and

how easy they were to use on a scale of 1



121 staff members were recruited, representing 36% of

nursing staff (n = 65), 53% of doctors (n = 55) and one manager. 75%

(95% CI 68

80%) of participants would use a frailty tool in future.

Proportions whowould use each tool againwere:

CFS = 75% (61


ISAR = 85% (72


PRISMA-7 = 79% (65


SC = 62% (48


Median and interquartile ranges in seconds to carry out the

assessment were:

CFS = 41 (28


ISAR = 66 (52



7 = 52 (40


SC = 54 (36

86) The silver code

s median ease of use

score was five out of five, with the rest scoring four out of five.


Implementing frailty tools in the Emergency Department

is quick, simple and acceptable. There are no significant differences

between the four tools but the silver code appears to be less acceptable

with the lowest proportion of people willing to use it and the second

longest median time to use.


Falling of eldery living in the community

M. Erarkadas


, E. Ozkaya


, G. Bahat


, C. Kilic


, F. Tufan


, S. Avc




M.A. Karan




Division of Geriatric, Department of Internal Medicine,

Faculty of Istanbul Medicine, Istanbul University,


Division of Geriatric,

Department of Internal Medicine, Faculty of Cerrahpasa Medicine,

Istanbul University,


Faculty of Istanbul Medicine, Istanbul University,

Istanbul, Turkey


The research was aimed to investigate falling prevalance

and associated factors among elders who was evaluated in Fatih

district geriatric study.

Material and methods:

Age range of 60

101 were taken into the

study. Falling has been evaluated as an existence of falling within a

year. The fragility screened with FRAIL-questionnaire, functional

capacity measurement with KATZ-Activities-of-Daily-Living-Scale

(ADL) and LAWTON-BRODY-Instrumental Activities-of-Daily Living

Scale (IADL), quality of life measurement with EQ5D-questionnaire,

cognitive status with Mini

Cog-test, depression with GDS-SF, malnu-

tritionwithMNA-SF, balance and gait with Romberg-test and postural-

instability-test, were evaluated accordingly.


204 cases (94 male

110 female) were recruited in this

research. Average age is 75.4 ± 7.3. Case of falling rate is %28.1 in all

cases(M: %25.5, F: %30.3). There was a significant difference among

falling and number of disease (p < 0.001)-number-of-drug (p = 0.003)-

fragility-score (p = 0.001), IADL (p = 0.019), EQ-5D score (p = 0.010),

depression score (p = 0.023) but there wasn

t any significant finding

among falling and age (p = 0.97), BMI (0.56), afraid of falling (p = 0.16),

VAS score (p = 0.98), power of muscle (p = 0.053), diameter of forelegg

(p = 0.60), TUG test (p = 0.96), UGS (p = 0.91), ADL score (p = 0.065, BIA

parameters (body fat, visceral tallowing, bone), CDT score (p = 0.08),

MNA score (p = 0.065, point of subjective health condition (p = 0.16)).

Among the group of falling, dementia (p = 0.003), chronic pain

(p = 0.028), dynapenia (p = 0.028), level of ambulation (p = 0.036),

fragility (p = 0.013) had a significant difference, however; gender

(p = 0.47), obesity-DSO(p = 0.69), level of education (p = 0.50), HL

(p = 0.63), existence of MN (p = 0.09), existence of DM (p = 0.07),

existence of HT (p = 0.54), UI (p = 0.48), finding of Romberg (p = 0.51),

postural instability (p = 0.38), low UGS (p = 0.84), cognitive defect

(p = 0.47, existance of depresion (p = 0.35)) didnot have a significant

difference. Falling non-releated factors in regretion analysis in last

1 year scores were; (depending variablitiy: falling/non-depending

variability: disease/number of drug/fragility/IADL/GDS-SF/Eq-5d

score/demantia/chronic pain/ existence of dynapenia): Existance of

demantia (OR = 0.29, p = 0.012) and fragilityscore (OR = 1.43, p = 0.031).


Many falling related factors were taken into account. As a

result, we think that cognitive defect and fragility are major factors

which are the related factor of falling.


Falling; Geriatric, Fragility; Cognitive defect.


Sarcopenia and nutritional status in elderly patients with fragility

hip fracture

L. Evangelista


, F. Cuesta


, P. Matía


, L. Fernández


, V. Garay


, J. Mora




Hospital Clínico San Carlos, Madrid, Spain


To describe the prevalence and main characteristics of

sarcopenia and malnutrition in hip fracture elderly patients.


Observational study. Patients aged

65 admitted with hip

fracture (September 2015

February 2016) were included. Variables:

sociodemographic, clinical, functional assessment (Barthel index-BI-,

FAC), Comorbidity (Charlson

s index-CCI-), nutritional status (BMI,

biochemical parameters, MNA), body composition by bioimpedance

analysis-BIA-, (MMI, phase angle-PA-), and muscular strength (grip

strength). EWGSOP criteria. Statistical analysis: SPSS.


74 patients were included (mean age 85.2 ± 8, women 76.7%,

lived at home 95.9%). BI 85.1 ± 13, CCI 6.71 ± 1.5. 38.4% had a

pertrochanteric fracture. Preoperative stay was 4.4 days ± 2.31, length

of stay 11 days (IQR 9

15), in-hospital mortality 6.8%. Preoperative

measures: serum albumin 3.3 mg/dL ± 0.2, IL-6 47.0 pg/mL ± 45.8, Vit

D 15.7 ng/mL ± 8.1. According to MNA score 50.7% were at risk of

malnutrition and 4.1% were undernourished. BMI 26.5 Kg/m



9.45% had sarcopenia (men 29.4%, women 3.6%), MMI 9.53 ± 2.49. Low

grip strength: men 88.2%, women 82.1%. There was association

between: severe sarcopenia and BI at discharge (



0.299, p = 0.019),

PA and BI at discharge (


= 0.0256, p = 0.029). There was no association

with mortality, co-morbidity, nutritional status, discharge destination.

There was association between: discharge destination and BI at

discharge (OR = 1.051, p = 0.002), length of stay and CCI (


= 0.098,

p = 0.004). There was no association with nutritional status, albumin,

MMI, age, gender or grip strength.


Sarcopenia was more prevalent in men than in women

with hip fracture. Severe sarcopenia was associated with the degree of

functional decline at discharge. More than half of patients were at risk

of malnutrition or undernourished.


Frailty and malnutrition

M. Freixa, A. Simões, J. Rodrigues, S. Úria, G. Silva.

Department of

Internal Medicine, Pulido Valente Hospital, Lisbon, Portugal

Poster presentations / European Geriatric Medicine 7S1 (2016) S29