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

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Results: The majority of patients were women (86/83,5%), and both
age groups were represented at similar rates (49/47,6% at age 60–74).
The mean age at the moment of AAI implantation was 74,9 ± 5,7 years.
The mean observation time was 62,1 ± 23,3 months. Both mortality
and frequency of paroxysmal atrial fibrillation were similar in both
groups, while AAI had to be replaced with DDD significantly more
frequently in the younger age group. However, the prevalence of severe
defects of atrioventricular conduction was low in both age groups.
The mean time to the replacement was 5,6 ± 1,9 years.
Conclusions: AAI stimulation in patients 75+-year-old seems to be as
safe as in the young-old.
P-503
Outcomes in an orthogeriatrics Portuguese unit
N. Gómez 1, D. Silva1, M. Ardérius1, A. Jordão1. 1Internal Medicine
Department- Sector III, Hospital Pulido Valente- North Lisbon Hospital
Center, Lisbon, Portugal
Introduction: Pernicious anemia accounts for 80% of case of mega-
loblastic anemia. It is an autoimmune disorder with an insidious
clinical course and highly variable clinical spectrum, including
constitutional, neurological, hematological and gastrointestinal
symptoms. A systematic approach is essential for the establish-
ment of a definitive diagnosis and institution of an appropriate
treatment plan.
Case Report: A 76 year-old woman living in Portugal, with a personal
history of asthma and chronic venous insufficiency, under no chronic
medication and having regular nutritional habits, who was admitted
for investigation of a clinical picture of asthenia, anorexia, 6% of body
weight, symmetric lower limb paresthesias and cognitive impairment
with 6 months of evolution. At physical examination normal cognitive
function and pallor of the skin and mucous membranes. Laboratory
tests showed pancytopenia (WBC) of 2.10 × 109/L, with macrocytic
anemia (Hgb) 7.1 g/dL and platelets 71.000 × 109/L. Evidence of
hemolysis on peripheral blood smear, haptoglobin <8 mg/dL and
lactate dehydrogenase 1,528 U/L. Significantly, vitamin B12 was low
<108 pg/mL, and testing for parietal cell, and intrinsic factor anti-
bodies resulted positive, confirming the diagnosis of pernicious
anemia. For further investigation she underwent an upper gastro-
intestinal endoscopy, which described atrophic gastritis of the body of
the stomach, The patient began intramuscular cyanocobalamin
replacement therapy, with clinical stability and reversion of symptoms
and hematologic disturbances
Conclusion: The diagnosis of anemia in the elderly is important to
investigate and treat the underlying cause. Aging, by itself, is not a
cause of anemia. When pancytopenia exists as initial presentation, the
etiologic diagnosis is complex. Early testing should be encouraged as
the treatment is simple and procures a good prognosis.
Keywords: anemia; pernicious; megaloblastic; pancytopenia;
vitamin B12; elderly.
P-504
Cancer in elderly patients: anatomo-clinical aspects and
therapeutic strategy
S. Aloulou 1, S. Hammami2, W. Amorri2, A. Benhmida1. 1Gabes Hospital,
2CHU F Bourguiba, Faculty of Medicine, Monastir, Tunisia
Objectives: In Tunisia, we arewitnessing an increase in life expectancy
but also an incidence of cancer in the elderly population. We aim to
identify the anatomoclinical features of elderly suffering cancer in
southern Tunisia, describe the main geriatric assessment tools and
reporting published data on the general principles of the elderly care
cancer.
Methods: This is a prospective study focusing on a case study of 65
elderly suffering from cancer in the Medical Oncology Service of the
Regional Hospital of Gabes between January the 1st 2013 and October
31, 2013. All patients had evidence of cancer and input data were
proved by the SPSS 18.0 software.
Results: The average age of patients was equivalent to 75 years and 6
months (ranging from 65 to 93 years). The median was equal to 75
years. Our study consisted of 39 men and 26 women. Most of the
patients were from Gabes governorate (52%). 77% were retired people.
72% had an average financial level. The financial resources were
mainly a monthly pension for 49 patients (75%). 85% were insured
by CNAM. 50.8% were smokers, 18.5% were occasional alcoholics.
50.8% had high blood pressure, 30.8% were diabetes and 10.8% were
suffering cardiac disease. The most common types of cancer were
colorectal cancer (21.5%) and lung cancer (24.6%). In the bronchial
cancer group was the predominant epidermoid carcinoma (12 cases).
The length of consultation period ranged from 1 to 12 months (the
average of 4.5 months). The majority had a locally advanced tumor or
metastatic cancer. The tumor was classified as T3 for 38% and T4 for
49% of cases. The tumor was associated with lymph node damage in
59% of cases. 47% had metastases at the time of diagnosis and thus
classified M1. Our patients were classified according to geriatric
evaluation scale defined by Balducci with 3 classes: Autonomous
without frailty criteria (37 patients), vulnerable (20 patients) and
critical (8 patients). 29 patients (44.6%) made surgery on early-stage
cancer. 49 patients (75.4%) had received chemotherapy for palliative
stage IV disease in 49% of cases, healing in 51% of cases. 15.4% had had
x-ray therapy. Only one patient had received in adjuvant Herceptin.
The average survival time was 11 months (ranging from 3 to 22
months).
Conclusion: A close collaboration between oncologists and geriatri-
cians is needed in order to properly assess the elderly and to optimize
the therapeutic strategy. The inclusion of elderly in clinical testing is
recommended.
P-505
Is malnutrition a cardiovascular risk factor for heart rhythm
disorders in elderly?
A.I. Pâslaru1, A.C. Ilie1, I.M. Crăcană1, N. Lefter2, G.I. Prada3, I.D. Alexa1.
1Department of Internal Medicine, University of Medicine and Pharmacy
“Grigore T. Popa”, 2“Dr. C.I. Parhon” Hospital, Iaşi, 3Department of Geriatry
and Gerontology, University of Medicine and Pharmacy “Carol Davila”,
Bucuresti, Romania
Objectives: Normal ageing is associated with a higher incidence of
cardiac arrhythmias due to multiple factors: physiological changes in
cardiovascular system, the constant increase of cardiovascular risk
factors. Malnutrition is an “untraditional” but independent cardiovas-
cular risk factor for senior population, but with few data regarding the
relationship with arrhythmias.
Methods: We present a prospective, observational study on 481
patients over 65 years of age, which were divided into two groups:
with and without arrhythmias. They all underwent a geriatric
evaluation including Mini Nutritional Assessment (MNA) and
other geriatric evaluation scales. We measured serum levels of
all “traditional” risk factors; also all patiens had an ECG and
echocardiography.
Results: 66.32% patients had arrhythmias, with no significant
differences regarding gender, body mass index, smoking status.
Arrhythmias were significantly higher in patients over 75 years
(p = 0.034). There was no difference between groups regarding some
“traditional” cardiovascular risk factors and “nontraditional” risk
factors such as ventricular mass, and nutritional status. The arrhyth-
mia group had a higher level of cholesterol (p = 0.005), triglycerides
(p = 0.015), uric acid (p = 0.018) and also a significant difference
regarding inflammatory status (p = 0.017). There were no differences
regarding studied geriatric syndromes between groups.
Conclusion: The influence of traditional and nontraditional risk
factors is not the same in arrhythmias as part of cardiovas-
cular diseases. Some of them have a constant negative influence
but there are factors such as malnutrition, depression, LDL-C, and
HDL-C levels that have a smaller impact on arrhythmias in senior
population.
Poster presentations / European Geriatric Medicine 7S1 (2016) S29–S259 S162