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

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Methods: One hundred and twelve smoking elderly subjects in
Denizli/Turkey were included into the study. The Fagerström
Nicotine Dependence Scale (FNDS) was used to assess nicotine
dependence and the PAL of subjects was assessed by using
International Physical Activity Questionnaire (IPAQ).
Results: The average age of subjects was 70.08 ± 7.89 year and the
average duration and amount of smoking was 16.89 ± 4.32 packet/
years. Thirty-eight subjects (33.92%) had high nicotine dependence
(FNDS score ≥ 5) and 74 subjects (66.08%) had low to moderate
dependence (FNDS score < 4). The average PAL of subjects was found as
2,374.32 ± 311.76 MET-minute/weeks (low level of physical activity).
When the PAL of subjects were compared according to their nicotine
dependence, there was a significant difference between high nicotine
dependent (PAL: 1,024.76 ± 135.67) and low to moderate dependent
subjects (PAL: 2,649.23 ± 234.56) (p < 0.05).
Conclusions: In the results of this study the PAL of smoking elderly
subjects were lower in the high nicotine dependent group. We think
that high nicotine dependency may be related to depression which
also can be a reason for lower PAL. Further researches are needed.
O-032
Is there a geriatric patient hidden behind the spousal caregiver?
F. Potier1,2, G. Aubouy1, J. Degryse2, M. de Saint-Hubert1,2. 1Department
of Geriatrics, CHU Université Catholique de Louvain, Namur, 2Institute of
Health and Society, Université Catholique de Louvain, Brussels, Belgium
Background: Evidence suggests that providing care for a disabled
elderly may represent a risk for the health of the caregiver (decreased
immunity, hypertension, depression). In this context, health assess-
ment of old caregivers is important.
Methods: Community-dwelling spousal caregivers of old patients
were recruited, mainly by the geriatric outpatient clinic. Data collected
were: mini nutritional assessment-short Form (MNA-SF), short
physical performance battery (SPPB), frailty phenotype (Fried),
geriatric depression scale (GDS-15) and clock test.
Results: Among 80 caregivers, 44 were women’ s, mean age and
Charlson comorbidity index were respectively 79.6 ± 5.4 and
0.79 ± 0.98. Among care-receiver (mean age 81.4 ± 5.2) 81% had
cognitive impairment. Caregivers were at risk of frailty in 60% of
cases and at risk of malnutrition in 33% of cases. 62% had low or
intermediate physical performance (<9). 31% of caregivers were at risk
of depression and 25% took antidepressive drugs. Half of the caregivers
had a pathologic clock test.
Conclusions: One third of spousal caregivers of disabled elderly are at
risk for malnutrition and depression, two-thirds at risk of frailty.
Caregivers should benefit from screenings to prevent health problems
so that old patients can stay home longer with good quality of life.
O-033
Association of atypical femoral fracture and osteonecrosis of the
jaw in bisphosphonate users
A. Correa-Pérez1, C. Sánchez-Castellano1, I. Lozano-Montoya1,
E. Delgado-Silveira 2, A. Cruz-Jentoft1. 1Geriatrics Department, Hospital
Univeristario Ramón y Cajal, 2Pharmacy Department, Hospital
Univeristario Ramón y Cajal
Introduction: Treatment with bisphosphonates is associatedwith two
serious adverse drug reactions (ADRs): atypical femoral fracture (AFF)
and osteonecrosis of the jaw (OJ). Both complications in the same
patient are unusual. Our purpose is to describe some cases of patients
diagnosed with AFF and OJ after bisphosphonates treatment and to
estimate the prevalence of these ADRs in the population treated with
bisphosphonates attending our hospital between 2011 and 2015.
Methods: A retrospective search of patients was conducted by
combining the terms (in Spanish): atypical fracture, diaphysary
fracture, external cortical fracture, femur, jaw, maxilar, osteonecrosis,
biphosphonates. In order to make an estimation of the prevalence of
both ADRs, the number of patients on bisphosphonates from the
hospital catchment area was obtained from the Madrid health
authority database.
Results: Four women were diagnosed with AFF (mean age 68.3). One
of them (25%) had AFF in both femurs. Two of them (50%) were also
diagnosed with OJ, whose diagnoses of both conditions were
separated by a few days. A fifth patient was diagnosed with OJ and
swollen cortical subcapital fracture (not declared as atypical) of the
femur. Out of the total number of patients treated with bispho-
sphonates (13,666), a prevalence of 0.029% was estimated for AFF and
of 0.39% for OJ. Prevalence of both concomitant ADRs was 0.014%.
Conclusions: Half of the patients treated with bisphosphonates
diagnosed with AFF also presented OJ. Despite the prevalence of AFF
and OJ being very low, they are very serious ADRs. Whenever patients
are diagnosed with one of these conditions, it seems wise to
discontinue bisphosphonate treatment and to start a close follow-up.
O-034
Relationship between drugs with anticholinergic properties and
functional and cognitive status in elderly: results from the CRIME
Study
G. Brombo1, L. Bianchi1, F. Malacarne1, A. Corsonello2, A. Cherubini3,
C. Ruggiero4, G. Onder5, S. Volpato1. 1Department of Medical Sciences,
University of Ferrara, 2Unit of Geriatric Pharmacoepidemiology, Research
Hospital of Cosenza, INRCA, 3Department of Geriatrics, Research Hospital
of Ancona, INRCA, Italy; 4Department of Medicine, Institute of
Gerontology and Geriatrics, University of Perugia, 5Research Center on
Aging, Catholic University of Sacred Heart, Rome, Italy
Objectives: Medications with anticholinergic properties, although
widely used, may negatively affect cognitive and functional status in
older patients. We investigated the relationship between use of these
drugs and cognitive and functional impairment in a sample of Italian
older hospitalized patients.
Methods: Cross-sectional and longitudinal analysis of 1,123 elderly
enrolled in CRIME study. Cognitive performance and functional status
were evaluated at hospital discharge and over the follow-up (3, 6, 12
months) using the MMSE score and 5 basic ADLs, respectively. We
assessed anticholinergic burden with Anticholinergic Burden (ACB)
and Anticholinergic Risk Scale (ARS).
Results: Mean age of study population was 81 ± 7.5 years, 33.9% had
ACB = 1 and 31% ACB ≥ 2. When compared, ACB and ARS classifications
showed a moderate correlation (Spearman’s rho = 0.39). Adjusting for
potential confounders, there were significant associations between
MMSE score at discharge with both home (ACB ≥ 2: β =− 1.85,
p = 0.002; ARS≥ 1: β = −2.42, p < 0.001) and hospital therapy
(ACB ≥ 2: β = −1.25, p = 0.041; ARS ≥ 1: β = −1.83, p = 0.001). Similarly,
there were significant relations between likelihood of disability with
home and hospital anticholinergic burden, respectively for ACB≥ 2 O.
R. = 1.69 (95%C.I.: 1.10–2.57) and 2.15 (95%C.I.: 1.40–3.32) and for
ARS ≥ 1 O.R. = 3.29 (95%C.I.: 2.05– 5.27) and 2.06 (95%C.I.: 1.39–3.06).
Higher anticholinergic burden (ARS ≥ 1) was significantly associated
with a steeper monthly decline in MMSE score over time (p = 0.042);
similarly patients with ACB ≥ 1 were at higher risk of new disability
over the follow-up (O.R. = 2.09, 95%C.I.: 1.09–4.01).
Conclusion: Use of drugs with anticholinergic properties in elderly is
independently associated with cognitive and functional decline,
suggesting the need of particular care in their prescription in patients
assuming complex polypharmacotherapy.
O-035
Usefulness of a computer-based tool to reduce inappropriate drug
prescriptions in hospitalized older patients
M. Rossi1, C. Musacchio2, A. Cericola1, E. Ferelli1, V. Arena1, F. Calautti1,
F. Filauro1, E. Zaninoni1, S. Garaboldi2, E. Zigoura2, R. Custureri2,
M. Pomata2, C. Prete2, C.E.A. Fraguglia1, A. Pilotto2. 1Pharmacy Unit, E.O.
Galliera Hospital, National Relevance & High Specialization Hospital,
2Geriatrics Unit, Department of Geriatric Care, OrthoGeriatrics and
Oral presentations / European Geriatric Medicine 7S1 (2016) S1–S27 S10