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

128 / 290

Conclusions: These preliminary data of FALL-A-SLEEP Study showed
that older SA patients do not present more falls and sarcopenia.
P-349
Insomnia, falls and sarcopenia in older adults: preliminary results
from the FALL-Aging- SLEEP Study
A. Monti 1,2, M. Girard-Bon3,4, M. Doulazmi3,4, R. Pham3,4,
A. Breining 1,2, E. Pautas 1,2,3, K. Kinugawa1,3,4,5. 1AP-HP, DHU FAST, GH
Pitie-Salpêtrière-Charles Foix, F-75013, Paris, 2Assistance Publique des
Hôpitaux de Paris, Acute Geriatric Care, Pitié-Salpétrière-Charles-Foix
Hospital, Ivry-Sur-Seine, 3Sorbonne Universités, UPMC University Paris 6,
4CNRS, UMR 8256 Biological Adaptation and Aging, F-75005, Paris,
5Assistance Publique des Hôpitaux de Paris, France
Objectives: Sleep disturbances increase the risk of falls among older
people. We aimed to examine prevalence of falls, sarcopenia and
several comorbidities among older patients with and without
Insomnia.
Methods: Hospitalized geriatric patients aged ≥75 were proposed
to participate to the FALL-A-SLEEP Study since March 2015. Subjective
sleep questionnaires (reported sleep duration, sleeping habits,
insomnia severity index (ISI) and drug use e.g benzodiazepine/
hypnotics), handgrip strength and short physical performance
battery (SPPB), Dual Energy X-ray absorptiometry (skeletal muscle
mass (SMI)) were performed in a stabilized medical situation.
Insomnia was defined on ICSD3 criteria.
Results: Complete evaluation was available for 64 patients (mean age
81.9, 47 women), 17 patients never fell. Between insomniacs (n = 33,
mean ISI = 10.9) and non-insomniacs (n = 31), ADL (5.32 vs 5.68,
p = 0.11), Charlson score (2.81 vs 2.03, p = 0.187) and Rockwood score
(4.44 vs 4.67, p = 0.422) were not different. Falls (76.7% vs 65.5%,
p-value = 0.344), mean SPPB score (6.57/12 vs 5.36/12, p-value =
0.164), mean handgrip (18.43kg vs 18.14, p-value = 0.778), and
sarcopenia (40% vs 37.5%, p-value = 0.655) were not statistically
different. But, falls by iatrogenic (40.74% vs 14.28%, p-value = 0.045,
OR = 4.125, CI (0.974–17.469)) were more frequent in insomniac
patients. Polymedication (more than 5 medications) were present
in 66.7% of insomniac and 51.6% of non insomniac patients. Less
insomniac patients with falls remained on the ground >1 hr (26.9% vs
57.1%, p-value = 0.036, OR = 0.276, CI (0.081–0.940)).
Conclusions: These preliminary data of FALL-A-SLEEP Study showed
that older insomniac patients do not present more falls and
sarcopenia, but they present more falls by iatrogenic origin.
P-350
Association between kidney function and frailty in community-
dwelling elderly Japanese people
H. Shimada, S. Lee, H. Makizako, T. Doi, K. Harada, S. Bae, K. Harada,
R. Hotta, K. Tsutsumimoto, D. Yoshida.
Introduction: Chronic kidney disease (CKD) and frail has received
increased attention as a leading public health problem. The aim of this
study was to evaluate the relationship between kidney function and
frailty among community-dwelling older adults.
Methods: We analyzed the cohort data from a prospective study
entitled National Center for Geriatrics and Gerontology – Study
of Geriatric Syndromes. Participants comprised 9,334 community-
dwelling older adults who were participating in the Estimated
glomerular filtration rate was determined according to creatinine
levels, and participants were classified into two categories: ≥60.0,
59 –45, <45 mL/min/1.73 m2. Frailty defined by the CHS index as
proposed by Fried et al was identified by the presence of 3 or more of
the following 5 components: weight loss, poor grip strength, reduced
energy level, slow walking speed, and low level of physical activity.
Multivariate logistic regression was used to examine the relationships
between kidney function and frailty.
Results: The results suggested that lowest kidney function were at a
greater than higher risk of being frail in comparison to highest kidney
function (OR:1.37, CI: 1.01–1.85). Furthermore, the analyses showed
an even greater increase in the risk of being frail with lower physical
activity (OR:3.98, CI:1.67– 9.47).
Conclusion: A lower level of kidney function was associated with
higher risk of being frail in community-dwelling older adults.
P-351
Creating a hospital protocol on secondary prevention
pharmacological therapy for fragility fractures in a Central London
major trauma unit
D. Li1, R. Dua1, C. Baker1, J. Stephens1, D. Shipway 1. 1Comprehensive
Oncogeriatric Surgical Liason Service, St. Mary’ s Hospital, London,
United Kingdom
Objectives: Over 300,000 patients present to hospital each year
with fragility fractures, with a cost of £2 million per year. Effective
secondary prevention including lifestyle interventions and pharma-
cological therapy improves bone mineral density therefore reducing
risk of further fractures. We aimed to assess current prescribing
behaviour and create a hospital protocol on secondary prevention
pharmacological therapy for fragility fractures in patients admitted to
a major trauma unit in a Central London tertiary hospital.
Methods: A retrospective analysis was conducted on patients dis-
charged November 2015 from the rehabilitation unit. Patient demo-
graphics, comorbidities, secondary prevention pharmacological
therapy pre- and post-discharge, and evidence of counselling of risks
were recorded. A hospital protocol was created to improve secondary
prevention prescribing behaviour. A prospective analysis was con-
ducted on patients discharged January 2016.
Results: Data is reported for 20 patients in the initial study period. 18
patients (90%) were discharged with secondary prevention pharma-
cological therapy. Data is reported for 17 patients in the second study
period. 16 patients (94%) were discharged on secondary prevention
pharmacological therapy. A significantly low proportion of patients
received counselling of the risks of bisphosphonate therapy and need
for dental follow-up (11% v 50%).
Conclusions: Between 90% and 94% patients were considered for
secondary prevention pharmacological therapy that included bispho-
sphonate therapy. Reasons for omission included cognitive impair-
ment and need for further outpatient bone health evaluation. We
identified a need to improve counseling on risk of osteonecrosis of
the jaw and created a modified neck of femur fracture checklist for
discharge.
P-352
High or low hemoglobin is not an independent risk factor for
mortality in the elderly
W. Lopez1, C. Castillo-Gallego1, A. Alfaro1, J. Carnicero1,
F.J. García-García1. 1Hospital Virgen del Valle, Toledo, Spain
Objectives: Anemia is associated with increased mortality in the
elderly. The purpose of this study is to explore the association between
anemia and mortality among old people stratified by gender.
Methods: The data was obtained from the first wave of the Toledo
study for Healthy Aging (TSHA), a population based study. The
hemoglobin levels were recorded into two dichotomous variables,
one for levels under the reference interval and another one for levels
above the reference interval (12–14 g/dL). The association between
vital status and hemoglobin levels was assessed using three Cox
proportional hazard models. The first model was the unadjusted, the
second model was adjusted by age and comorbidity and finally, the
third model was adjusted by age, Carlson Index, urea, albumin and
disability.
Results: 1,744 subjects participated, mean age of 75% and 57% women.
In women, in the first model, higher hemoglobin was associated with
lower mortality (HR 0.65, p-value 0.034); In the second model, lower
hemoglobin was associated with higher mortality (HR 1.64, p-value
0.03). In men, lower hemoglobin levels were associated with higher
mortality in both the first model (HR 2.4, p-value 0.002) and the
second model (HR 2.34, p-value 0.003) and higher hemoglobin levels
Poster presentations / European Geriatric Medicine 7S1 (2016) S29–S259 S122