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explored in frailty. Our goals were (1) to analyze the relationship

between tactile discrimination (TD) of the hand, avoidance behaviours

and attitudes towards social touch (BATST) and phenotype frailty

criteria (unintentional weight loss, self-perception of exhaustion,

decrease grip strength

GS, slow walking speed, low level of physical

activity), (2) to explore whether other variables can contribute to

explain the differences between pre-frail and frail elders.


We performed a cross sectional observational study with

181 of institutionalized elders. From the initial sample we selected 50

subjects (68

99 years) who met the inclusion/exclusion criteria.


The results showed that increasing age is related to decline

of TD of the hand (p = 0.021) and to decrease in GS (p = 0.025); women

have significantly lower level of GS (p = 0.001); TD decrease is corre-

lated with higher avoidance BATST (p = 0.000) and with lower GS

(p = 0.000); Lower GS corresponds to more avoidance BATST (p =

0.003). Hand TD also can differentiate frail and pre-frail elderly

subjects in this sample (p = 0.037).


Decreased TD of the hand may have implications on the

functionality and on interpersonal relationships. TD of the hand also

explains frailty levels in this sample. Hand TD should be used in

assessment and intervention protocols in pre-frail and frail elders.


Prevalence and evaluation of sarcopenia in patients admitted in

acute geriatric unit

S. Allepaerts


, J. Weber


, F. Buckinx


, O. Bruyère


, N. Paquot



L. Rougier


, J. Petermans




Geriatric Department, CHU of Liège,


Department of Public Health, Epidemiology and Health Economics,

University of Liège,


Support Unit in Epidemiology and Biostatistics,

University of Liège,


Department of Motricity Sciences, University of Liège,



Diabetes, Nutrition and Metabolic Diseases, CHU of Liège, Belgium


Sarcopenia is a syndrome characterized by progressive

and generalized loss of skeletal musclemass and strengthwith a risk of

adverse outcomes such as physical disability, poor quality of life

and death. Aims: To examine prevalence of sarcopenia, identify

cofactors associated to sarcopenia and determine the nutritional

needs of patients hospitalized in acute geriatric unit.


Fifty-five patients (mean age 85.6 years) were prospectively

enrolled. Sarcopenia was defined according the European Working

Group criteria. Muscle mass was measured by Bio impedance analyse,

muscle strength by handgrip strength and physical performance by

gait speed and Short Physical Performance Battery. Nutritional assess-

ment was performed by the Mini Nutritional Assessment (MNA) and

biological data. Resting energy expenditure is measured using indirect

calorimetry. Three months after discharge, deaths, readmission, falls

and institutionalization were studied.


Twenty (36.4%) patients had the diagnosis of sarcopenia.

Patients with sarcopenia tended to be older (p = 0.05), were predo-

minantly of male gender (p = 0.002), had lower body mass index

(p = 0.002), albumin and pre-albumin level (p = 0.02 and 0.03), and

displayed lower MNA (p = 0.004). No significant differences were

found with activity of daily living and energy requirements measured

by calorimetry between groups. At 3 months the rate of death, read-

mission, falls and institutionalization were similar in patients with or

without sarcopenia.


Prevalence of sarcopenia in patients hospitalized in

acute geriatric unit is likely high. Although undernutrition appears

a predominant cofactor of sarcopenia, there were no significant

differences on energy requirement and early outcomes. These results

require further investigations.


Hospitalisation for colorectal surgery or acute medical illness is

associated with weight loss in older adults

C. Welch, T.A. Jackson.

University of Birmingham


Acute sarcopenia secondary to hospitalisation is an

emerging concept affecting older adults. This is hypothesised to occur

due to a combination of muscle disuse and acute inflammatory

burden. Weight loss can be caused by sarcopenia, cachexia or

starvation, with overlap between these conditions.


A retrospective study of routinely collected electronic data

for patients aged 65 years or older across cardiac surgery, colorectal

surgery and general medical specialties was conducted at the Queen

Elizabeth Hospital Birmingham (QEHB). Patients admitted during

2015 with length of stay of two days or greater were included. Weight

measurements on admission and discharge were collected. Patients

with estimated or incomplete weights and who died during admis-

sion were excluded. Outlying measurements beyond three standard

deviations from the mean were excluded.


80 patients admitted for an elective coronary artery bypass

graft, 62 for elective colorectal surgery and 2,345 under general

medicine with an infectionwere included in analysis. Medical patients

had a mean weight loss of 0.75 kg (p = 0.00) or 0.99% (p = 0.00) and

colorectal patients a mean weight loss of 1.76 kg (p = 0.01) or 2.26%

(p = 0.01). Mean change in weight was not significant for cardio-

thoracic patients but there was a trend towards weight loss; 0.67 kg

(p = 0.061) or 0.76% (p = 0.099).


Patients admitted for an infective process under

general medicine or elective colorectal surgery lose weight between

admission and discharge; further research is needed to evaluate

the nature of the weight loss and its relationship with acute



Initiating frailty screening in primary care to identify high risk

older adults for CGA

A. Williams.

Church Street Practice


In primary care older, adults at risk of hospital admis-

sion are identified using risk stratification profiling. This approach may

fail to recognise frailty as a risk factor in hospital admission, thus

excluding patients from primary care interventions to reduce risk and

possibly avoid admission.


To trial frailty screening in primary care using validated tools

in addition to risk profiling. Enhanced screen was used to identify

vulnerable patients for comprehensive geriatric assessment and

management. four cycles PDSA cycle (Plan-Do-Study-Act Cycle) were

undertaken, Cycle 1: the primary care team identified suitable frailty

screening tools for use within their practice, Cycle 2: training of staff,

Cycle 3: testing the integrating the Frailty Assessment Tool, Cycle 4:

upscaling screening.

Findings and conclusion:

A two stage approach to frailty screening

was adopted, patients self completion PRISMA 7 [1], staff completed

the Rockwood Clinical Frailty Scale [2]. 470 assessments completed

showed that thirty-three per cent of patients were frail and 20 per cent

as pre-frail, the previous Risk Stratification Profiling identified 27 per

cent (76/279) had been flagged as frail, and no level of frailty was

recorded. As a result of the enhanced screening a dedicated frailty

clinic led by the nurse consultant was established to undertake

Comprehensive Geriatric Assessment [3] as part of the frailty pathway.

One outcome has been an increase in anticipatory care planning with

patients. Concluding, that risk profiling without frailty screening

underestimates the high risk primary care population. Managing

frailty within a primary care team requires time and resources, but can

deliver real benefits to patients and families.

AcknowledgementsDr Peter Fletcher Consultant Geriatrician for his

interest and support throughout the project. Professor Alison Metcalf

(Supervisor Kings College London) for her guidance and support

throughout the project.


[1] Raiche M

et al.

(2010). Impact of PRISMA, a coordination-type

integrated service delivery system for frail older people in Quebec

(Canada): a quasi-experimental study.

J Gerontol B Psychol Sci Soc



18. doi:


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