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
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
, E. Ozkaya
, G. Bahat
, C. Kilic
, F. Tufan
, S. Avc
Division of Geriatric, Department of Internal Medicine,
Faculty of Istanbul Medicine, Istanbul University,
Division of Geriatric,
Department of Internal Medicine, Faculty of Cerrahpasa Medicine,
Faculty of Istanbul Medicine, Istanbul University,
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
, 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 (
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.
Internal Medicine, Pulido Valente Hospital, Lisbon, Portugal
Poster presentations / European Geriatric Medicine 7S1 (2016) S29