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

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Case report 1: A 61-year-old woman, without notable medical history,
was followed for 3 years for joint pain associated with an inflamma-
tory syndrome. Physical examination was normal except for blood
pressure asymmetry of upper limbs. Biology was objectifying a
biological inflammatory syndrome. Etiological explorations of this
inflammatory syndrome were negative: Chest X ray, bacterial culture
of the urine, lumber puncture, myelogram, viral serology, tumour
marker, immunological investigations and echocardiography. A thor-
acic and abdominopelvic CT showed circumferential wall thickening of
the aorta, the supraaortic and iliac arteries. An additional angiographic
had found a Takayasu ’s arteritis. Therapeutic abstention was appro-
priate and symptomatic treatment was initiated.
Case report 2: A 66-year-old woman, without notable medical history,
was admitted for impaired general condition, joint pain and fever.
Physical examination was normal except. Biology was objectifying a
biological inflammatory syndrome. Etiological explorations of this
inflammatory syndrome and fever were negative: Chest X ray, bacterial
culture of the urine, lumber puncture, myelogram, viral serology,
tumour marker, immunological investigations and echocardiography.
A thoracic and abdominopelvic CT showed circumferential wall
thickening of the aorta. An additional angiographic had found a
Takayasu ’s arteritis. Therapeutic abstention was appropriate and
symptomatic treatment was initiated.
Conclusion: Takayasu’s disease is rare in the elderly, its diagnosis is
difficult. TA should be considered in the differential diagnosis of fever
of unknown origin and chronic biological inflammatory syndrome,
especially in elderly women.
P-491
Macrocytic anemia in the elderly subject: outcome and etiological
research
B.B. Dhaou 1, Z. Aydi 1, I. Rachdi1, F. Daoud1, L. Baili1, S. Kochbati1,
F. Boussema 1. 1Internal Medicine Department, Habib Thameur Hospital,
Faculty of Medicine, Tunis, Tunisia
Objectives: Macrocytic anemia is in third position in order of
frequency of anemia in the elderly, after iron deficiency and those
related to a chronic inflammatory disease. The aim of this study is to
identify the clinical, biological and etiological profile of macrocytic
anemia in the elderly in Tunisia from hospital data.
Methods: We performed a retrospective comparative study. It has
involved 30 patients aged 65 and older hospitalized in internal
medicine department at the Habib Thameur hospital between 2005
and 2015.
Results: There were 13 women and 17 men whose mean age was 74.3
years. The anemic syndrome was less common among the elderly.
However, neuropsychiatric signs were more frequent in the study
group. The mean hemoglobin was lower in the elderly. The deficiency
origin was reported in 93.3% of cases. Vitamin B12 deficiency was the
most frequent. Macrocytic anemia in the elderly didn ′t seem very
different from that of younger patients.
Conclusion: The deficiency was the first etiology of aregenerative
macrocytic anemia in our patients so it is important to identify risk
groups, especially prevention through diet and good oral dental in our
subjects.
P-492
Relationship between blood pressure and frailty in older
hypertensive outpatients
G. Ciancio 1, A. Catalano1, G. Mandraffino2, G. Maltese3, A. Alibrandi4,
A. Crucitti 1, A. Lasco1, M. Cesari5, G. Basile1. 1Unit and School of
Geriatrics, Dept of Clin and Exp Med, University of Messina, 2Unit of
Internal Medicine, Dept of Clin and Exp Med, University of Messina,
Messina, Italy; 3Unit for Metabolic Medicine, Cardiovascular Division,
King’s College London, London, UK; 4Dept of Economics, University of
Messina, Messina, Italy; 5Institut du Vieillissement, Université de
Toulouse, Toulouse, France
Introduction: The benefits of treating hypertension in very old
patients are debated. Current guidelines on the management of
hypertension recommend, in patients aged above 80s, a systolic blood
pressure (SBP) between 140 and 159 mmHg if patients are in good
health. In this study we aimed to assess the degree of frailty in old
hypertensive outpatients and the relationship between blood pressure
and measures of frailty.
Methods: Frailty was assessed retrospectively by using a 22-item
frailty index (FI) in 56 hypertensive old outpatients treated pharma-
cologically. Patients with an FI > 0.25 were classified as frail. Cognitive
status was evaluated by using the short portable mental status
questionnaire (SPMSQ). Gait speed was evaluated over a marked
distance of 4 m.
Results: The mean age was 80 (SD 7.5) and the mean FI value was
0.37 (SD 0.14). 45 out of 56 (80%) had a FI > 0.25. Patients with
SBP≥140 mmHg had a lower FI when compared with those having
SBP < 140 mmHg (0.34 ± 0.15 vs 0.43 ± 0.11, p = 0.006). A statistically
significant inverse correlation was found between FI and SPMSQ
score (r = −0.370, p = 0.005), gait speed (r = −0.426, p = 0.001), SBP
(r = −0.319, p = 0.016), orthostatic SBP (r = −0.408, p = 0.002), ortho-
static DBP (r = − 0.299, p = 0.025), orthostatic PP (r = −0.297, p = 0.026).
Key conclusions: Our findings suggest that frail elderly hypertensive
outpatients are often over-treated and FI can be utilized in clinical
practice to identify this category of subjects. Physicians should take
into consideration the frailty status of elderly patients in the
therapeutic decision-making to prevent the consequences related to
over-treatment of hypertension.
P-493
Diseases of older people referring to elderly centers of Tehran
Darvishpoor Kakhki Ali1, Abed Saeedi Zhilla1, Delavar Ali2. 1Shahid
Beheshti University of Medical Sciences, 2Allameh Tabatabai University,
Tehran, Iran
Introduction: Aging is a natural experience which is usually
accompanied by a variety of diseases. This study was conducted to
describe the older people’s disease rate and the number of times they
refer to elderly centers in Tehran.
Methods: This descriptive study was conducted on older people above
60 years old of Jahandidegan Centers of Tehran. 400 elder persons
were selected of research centers based on stratified sampling. Self-
report socio-demographic and diseases rate questionnaires were used
for data collection. Data were analyzed with SPSS software.
Results: 300 (75%) of older people were female and 100 (25%) male
with a mean age of 67.65 (±6.38). Besides, 160 (40%) people had
heart diseases, 137 (34.3%) musculoskeletal diseases, and 83 (20.8%)
endocrine diseases. Moreover, 381 (95.2%) participants had referred to
doctors and therapeutic centers at least once during the last year.
Furthermore, 177 subjects (44.2%) were hospitalized at least once
last year.
Key conclusions: The prevalence of diseases in older people is more
than expected. Most older people refer to doctors and therapeutic
centers, which is indicative of the fact that they suffer from diseases
and need varied health services in a developing country. Tailored and
targeted strategies to improve the health status of older people are
necessary.
Keywords: Disease; Health Status; Aging.
P-494
Atrial fibrillation in seniors: data from “Slovak Atrial FIbrillation
audit in Seniors” (SAFIS)
M. Dúbrava1, F. Németh2, T. Drobná3, L. Gerlich4, S. Krčméry5.
1I. Department of Geriatrics, Bratislava, 2Department of Geriatrics, Prešov,
3Department of Geriatrics, Trenčín, 4Department of Geriatrics, Bojnice,
5II. Department of Geriatrics, Bratislava, Slovakia
Introduction: Atrial fibrillation (AF) is the most common arrhythmia
in seniors and a major risk factor for stroke. The quality of health care is
in part country-dependent. Real-life studies can help to identify weak
Poster presentations / European Geriatric Medicine 7S1 (2016) S29–S259 S159