Table of Contents Table of Contents
Previous Page  134 / 290 Next Page
Show Menu
Previous Page 134 / 290 Next Page
Page Background


Patients admitted to an orthogeriatric unit who gave

informed consent for the biomarker

s study. Musclemass was assessed

using bioimpedance analysis, Janssen (J) and Masanés (M) reference

cutoff-points were used. Strengthwas assessedwith handgrip (Jamar


dynamometer). Assessment included socio-demographic data, cogni-

tive status (Pfeiffer, GDS-Reisberg), functional status (Barthel, Lawton,

FAC), nutrition (MNA, BMI), number of falls, medications. After one

year, by phone-call, mortality, functional status, cognitive status, visits

to Emergency Department (ED), hospitalizations, falls and institu-

tionalization were collected.


N = 87. Mean age:88.0 ± 4.7. Women:82.8%. Sarcopenia pre-

valence varied from 8.8%(J) to 33.7%(M). One-year-mortality: 16%.

Visits-to-ED:0.7 ± 1.1. Hospitalizations:0.2 ± 0.5. Falls:1.4 ± 1.6. No

ambulation: 38.1%. 45.7% had at least one visit to the ED, 20.5%

one or more hospitalizations. Independent for ADL 14.3%, severe

dependency 57.1%. Only 14.3% were independent in more than three

IADL. 55% had at least one fall, 15%

4 falls after discharge. In

multivariate analysis, sarcopenia was not predictive of mortality. The

only predictive factor of mortality was male gender(p = 0.012).


Sarcopenia, assessed by international (Janssen) and local

(Masanés) cutoff-points, did not predict one-year-mortality in this

small sample of patients hospitalized for the surgical treatment of a

hip fracture. This should be confirmed with a larger sample. Male

gender is a risk factor for one-year-mortality in this population.

Funded with a grant from FundaciónMutuaMadrileña


Prevalence of malnutrition in a post-acute care geriatric unit:

applying the new ESPEN definition

D. Sánchez-Rodríguez


, E. Marco


, N. Ronquillo-Moreno



R. Miralles


, O. Vázquez-Ibar


, F. Escalada


, J. Muniesa




Geriatrics Department, Parc Salut Mar,


Rehabilitation Research Unit.

Institut Hospital del Mar d

Investigacions Mèdiques (IMIM),



Autònoma de Barcelona,


Physical Medicine and Rehabilitation

Department, Parc Salut Mar,


Universitat Internacional de Catalunya,

Barcelona, Spain


The European Society of Clinical Nutrition and

Metabolism (ESPEN) recently proposed a consensus definition of

malnutrition. Using these criteria, prevalence of malnutrition in

hospitalized older diabetic and community-dwelling population

(middle-aged, geriatric outpatients, healthy old, and healthy young

individuals) has been reported. However, determining prevalence in

older deconditioned in-patients due to an acute process is needed. Our

aim is to assess malnutrition in post-acute care applying ESPEN



Eighty-eight in-patients aged

70, body mass index

(BMI < 30 Kg/m


) were included (84.1 years-old; 62% women) by

screening for malnutrition risk using Mini-Nutritional Assessment-

Short Form (MNA-SF). ESPEN definition of malnutrition, i.e. low BMI

(<18.5 kg/m


) or a combination of unintentional weight loss and

low BMI/low fat-free mass index (FFMI) was applied. Malnutrition

biochemical markers were determined.


From 88 in-patients screened as

at risk

by MNA-SF, 27

(30.7%) noticed unintentional weight loss. First option of ESPEN

criteria (BMI < 18.5 kg/m


) found a prevalence of 4.5% (4 patients);

second option, (unintentional weight loss plus low BMI), 7.9% (7

patients), and third option (unintentional weight loss plus low FFMI),

17% (15 patients). Malnourished patients according to ESPEN criteria

were 17 (19.3%). No statistical differences in biochemical markers

were found between patients with and without malnutrition.


Applying ESPEN definition, malnutrition prevalence

was 19.3% in post-acute geriatric in-patients. Combining ESPEN

malnutrition criteria, with MNA-SF as a screening tool, seem to be a

valid, reliable, and feasible instrument in post-acute care. Further

work is needed to determine implications of ESPEN consensus

among related clinical conditions such frailty, sarcopenia, and



Validity of the Kihon checklist for predicting adverse health

outcomes in the clinical setting

S. Satake


, K. Senda


, Y-J. Hong


, H. Miura


, H. Endo


, H. Arai





Center for Geriatrics and Gerontology, Obu,


Ichishi Hospital, Mie, Japan


The Kihon checklist (KCL) was developed by the

Ministry of Health, Labor, and Welfare in Japan to identify at-risk

elderly who would require support/care in community-dwellers.

However, it is obscure whether this checklist could predict adverse

health outcomes in the clinical setting. This study was conducted to

validate the ability of the KCL for predicting adverse health outcomes

in regular outpatients with chronic diseases.


Of 212 regular outpatients who had consulted with

geriatricians, 135 patients were analyzed in this study. We assessed

their physical functions, activities of daily living (ADL), comorbidity,

memory, andmood, as well as the KCL at registration. We had observed

the incidence of any adverse events, such as ADL decline, emergent

admission, moving into nursing home, or death for 2 years.


The mean age, body mass index (BMI), and Charlson

comorbidity index (CCI) were similar in the event group (n = 50) and

the non-event group (n = 85). The event group showed slower gait

speed, higher depressive score, lower cognitive score, and higher total

KCL score than the non-event group. The total KCL score had a multi-

collineality with actual measurements of physical, psychological,

and cognitive functions. Logistic regression analysis adjusted for age,

sex, BMI, and CCI showed that the classification of frailty status by

total KCL score (total KCL score

8) was significantly associated with

the incidence of adverse health outcomes (odds ratio: 3.215 [95%

confidence interval: 1.355



KCL showed a predictive ability for identifying frail

elderly patients who would have adverse health outcomes in the



Kihon Checklist (KCL), as a surrogate marker of frailty, predicts

outcomes in Japanese elder outpatients with chronic obstructive

pulmonary disease (COPD)

K. Senda, S. Satake, I. Kondo, M. Nishikawa, H. Tokuda, H. Miura,

H. Endo.

National Center for Geriatrics and Gerontology, Obu, Japan


COPD is a prevalent, preventable and treatable chronic

systemic inflammatory disease. Kihon Checklist (KCL) is a self-

administrated questionnaire for screening users of preventive care

and remains to be investigated for clinical application.


Stable COPD outpatients in National Center for Geriatrics

and Gerontology: 40 male and 3 female; 74.9+/

5.9 (65

87) years,

underwent comprehensive geriatric assessment (CGA). We followed

for 3 years with repeated annual CGA. We adopted cut-off value in

Obu Study of Health Promotion for the Elderly: walking speed

<1.0 m/s, grip strengthmale <26 kg, female <17 kg and 5% body weight

loss in 2 years.


Initial KCL was 5.2/25 +/

4.4 (0

18) and positively correlated

with Fried

s frailty (r = 0.71, p < 0.001). Of 7 frail by Fried, 5 were

KCL >8/25 (cut-off value for frailty by KCL). KCL was associated with

CGA parameters. During 3-year observation, 10 deaths (7: KCL > 4,

cut-off value for pre-frailty), 13 admissions for exacerbation of COPD

(9: KCL > 4), 13 falls (11: KCL > 4) and 16 emergency admissions (11:

KCL > 4) were observed. A frail by Fried (KCL = 16) died of suffocation

with aspiration pneumonia. Among dead 7 pre-frail, respiratory failure

(KCL = 8), 2 heart failure (6, 4), 3 cancer (6, 3,1), sepsis with pneumonia

and severe decubitus ulcer (5) were observed. A robust (KCL = 4) died

of heart failure and another (1) died of brain infarction.


KCL was concordant with Fried

s frailty criteria and

might predict outcomes in COPD patients. KCL could be a useful

evaluation tool for inter-disciplinary integrated care team.

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