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

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2Department of Emergency Medicine, University Hospital Galway,
Newcastle road, Galway City, 3Health Research Board Clinical Research
Facility Galway, National University of Ireland, Galway, Geata an Eolais,
University Road, Galway, 4Frail Elderly Assessment Team, University
Hospital Galway, Newcastle road, Galway City, 5Centre for Gerontology
and Rehabilitation, University College Cork, St Finbarrs Hospital, Douglas
Rd, Cork City, 6PCCC, Shantalla Health Centre, Costello road, Galway City,
Ireland
Introduction: Although frailty is common among older adults pre-
senting to the Emergency Department (ED), its prevalence is not well
described.
Methods: We assessed consecutive older adults, aged >70 years,
attending a large university hospital ED, 24-hours/day for a two week
period in March 2016, for frailty using a battery of frailty measures
including the FRAIL Scale, Clinical Frailty Scale, Groningen Frailty
Indicator, Mini-Nutritional Assessment (MNA), body mass index
(BMI), Alzheimer’s disease 8 (AD8) cognitive test, the Euroqol-5D
and the Caregiver Burden Score (CBS).
Results: In all, 307 patients were available. Of these, 280 were included
with a median (interquartile) age of 78 (83 –73 = +/−10) years. Most,
53.6%, were female. The number considered globally frail by physician
assessment was 161, a point prevalence of 58%. Using the FRAIL scale
alone, the point prevalence of frailty (cut-off ≥3/5) and pre-frailty
(cut-off <3/5 but ≥1/5), was 29% and 41% respectively. Frail patients
were significantly more likely to be older (p = 0.003), have lower
MNA (p < 0.001), higher AD8 (p < 0.001), poorer Euroqol-5D scores
(p < 0.001), and a higher CBS (p = 0.01), compared to those scoring as
non-frail (pre-frail or robust). There were no differences in gender or
BMI. Pre-frail patients had significantly better MNA, AD8, Euroqol-5D
and CBS scores than frail patients but were similar in age, sex and BMI.
Conclusion: The point prevalence of frailty and pre-frailty in an Irish
university hospital ED is high. Frail and pre-frail older patients report
more cognitive impairment, are more likely to screen positive for
malnutrition, report lower quality of life and have higher caregiver
burden scores.
P-361
The relationship between frailty, functional capacity, nutritional
status and mobility in males and females aged 70 years or older
C. Kilic1, R. Demir2, G.B. Ozturk1, F. Tufan 1, N. Erten1, G. Baskent3,
M.A. Karan 1. 1Istanbul University, Istanbul Faculty of Medicine,
Department of Internal Medicine, Division of Geriatrics, 2Istanbul
University, Cardiology Institute, 3Istanbul University, Institute of Child
Health, Istanbul, Turkey University, Institute of Child Health, Istanbul,
Turkey
Objectives: In this study we aimed to investigate the relationship
between frailty, functional capacity, nutritional status and physical
mobility in males and females aged 70 years or older.
Methods: The patients were recruited from a university hospital
geriatric outpatient clinic. 183 were male (mean age: 78,9) and 277
were female (mean age: 78,2). Frailty status was assessed by FRAIL
questionnaire; functional capacity was assessed by Katz activities of
daily living (ADL) and Lawton-Brody instrumental activities of daily
living (IADL), nutritional status was assessed by mini-nutritional
assessment short form (MNA-SF), physical mobility was assessed by
timed up and go (TUG) test.
Results: When compared with the males having similar age and
body mass index; ADL (p = 0.004), nutritional status (p = 0.005) and
physical mobility (p < 0.0001) were worse and frailty was more
common (p = 0.001) in the female patients. In both males and
females, there was significant correlation between the frailty scores
and ADL scores (r = −0.37, r = −0.33; p < 0.0001), IADL scores (r = −0.42,
r = -0.50; p < 0.0001), MNA scores (r = −0.52, r = −0.50; p < 0.0001), and
physical mobility scores (r = 0.38, r = 0.43; p < 0.0001), respectively.
Conclusion: Our results suggest that in both older males and females,
frailty status is significantly associated with worse functional,
nutritional and mobility status.
P-362
The impact of ACE I/D polymorphism in sarcopenia and
osteoporosis
A. Pereira da Silva1,2,3, N. Marques 4, A. Matos1,2, Â. Gil1,2, M. Bicho1,2,
J. Gorjão-Clara3,5. 1Genetics Laboratory and Environmental Institute of
Health, Faculdade de Medicina da Universidade de Lisboa, 2Instituto
Rocha Cabral, Lisbon, 3Universitary Geriatric Unit of Faculdade de
Medicina, Universidade de Lisboa, Portugal, 4Centro Hospitalar Lisboa
Central, 5Academic Medical Center of Lisbon – North of Lisbon Hospital
Center, Lisboa, Portugal
Objectives: To evaluate, in a sample of Portuguese centenarians,
the distribution of ACE-genotypes associated with sarcopenia and
osteoporosis.
Methods: We performed an observational cross-sectional study in
a nationwide population of 253 Centenarians. Sarcopenia was
determined using a muscle mass (MM) index cutoff ≤16.7 kg/m2.
Osteoporosis was defined through estimated bone mass (BM),
according to gender and body weight. Genotyping of Angiotensin
Converting Enzyme (ACE) (rs4646994) was performed through a
high-throughput DNA Microchip platform using iPlex MassArray
system from Sequenom. PCR Malditof mass spectrometry.
Results: In our study, 230 Centenarians were genotyped (79.1%
women), being 6.5% II-genotype, 48.3% ID-genotype and 45.2%
DD-genotype. Taking in consideration the ID+DD-genotypes (vs.
II-genotype) and DD-genotypes (vs. II + ID-genotypes) we verified
significant differences in relation to the prevalence of sarcopenia
(P = 0.016) and osteoporosis (P = 0.032), respectively. In a univariate
analysis, DD-genotypes centenarians had a significant 5.02-fold
increase to have osteoporosis (95%CI [1.065–6.716], P = 0.036) and
ID + DD-genotype centenarians had a significant 2.67-fold increase
to have sarcopenia (95%CI [1.200–21.045], P = 0.027). The
ID + DD-genotypes adjusted for gender, BMI < 18.5 Kg/m2, total body
water (TBW, %), osteoporosis and age were risk factors in favor of
sarcopenia (OR = 12.63, CI95% = 1.517–105.065, P = 0.019). Whereas,
the DD-genotype adjusted for BMI < 18.5 Kg/m2, TBW, sarcopenia and
TUG-test>12s was a risk factor in favor of osteoporosis (OR = 5.12,
CI95% = 1.151–22.741, P = 0.032).
Conclusions: Multivariate-analysis for these genetic models
showed that BMI < 18.5 Kg/m2 and age were independent predictors
of sarcopenia/osteoporosis in centenarians. ACE I/D polymorphism
may be a possible marker associated to sarcopenia and osteoporosis,
being ID + DD-genotypes in favor of sarcopenia and DD-genotype in
favor of osteoporosis.
P-363
Various diagnostic criteria of frailty as predictors for falls, weight
change, quality of life, and mortality
N. Perttila1,2, K. Pitkala1, H. Kautiainen1, R. Tilvis3, T. Strandberg3,4.
1Department of General Practice and Unit of Primary Health Care,
University of Helsinki, Helsinki University Central Hospital, Helsinki,
2City of Vantaa, 3University of Oulu, Center for Life Course Health
Research, Oulu, 4University of Helsinki, Clinicum, and Helsinki University
Central Hospital, Helsinki, Finland
Objectives: Whether various criteria identify the same people as frail
and predict the same outcomes are unknown. To shed light on this
issue, we examined the cohort in the Helsinki Businessmen Study
(HBS), a long-term observational study of men born in 1919– 1934.
Methods: The three criteria compared were the modified Fried criteria
of phenotypic frailty (1) in the HBS and (2) in the Women’ s Health
Initiative Observational Study (WHI-OS), and (3) the Frailty Index (FI)
consisting of 20 criteria. We investigated how these three criteria
separated not frail, prefrail, and frail individuals, and predicted
mortality, falls, weight change, and health-related quality of life
(HRQoL, 15D instrument) during a 5-year follow-up. All three criteria
were available for 480 men, whose average age was 73 years at the
start of follow-up.
Poster presentations / European Geriatric Medicine 7S1 (2016) S29–S259 S125