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Rehabilitation, Frailty Area, E.O. Galliera Hospital, National Relevance &

High Specialization Hospital, Genoa, Italy


Aging is associated with an increased prevalence of

chronic diseases and polypharmacy, with consequent major risks of

potentially inappropriate drug prescriptions (PIPs). Aim of this study

was to evaluate the efficacy of a computer-based tool to reduce PIPs in

hospitalized older patients.


Subjects aged 65+ years admitted to the Geriatrics Unit of

the Galliera Hospital in Genoa for any acute illness were enrolled.

Therapies at admission and at discharge were collected. Then a

validated computer-based tool was used in order to detect any PIPs

according to the Screening Tool of Older People

s Prescription (STOPP)

criteria and Micromedex


system was used to detect major drug

interactions. All identified PIPs have been then discussed by the

multidisciplinary geriatric team (MGT) that included geriatricians,

pharmacist and nurses to consider possible modifications of the

potentially inappropriate drug prescriptions. In all patients the

Medication Appropriateness Index (MAI) at admission and at

discharge has been calculated.


166 patients were enrolled (mean age 87 ± 5.4 years, females

72% and males 28%) with an average number of 6 ± 2.9 drugs at

admission. Between admission and discharge the number of detected

STOPP criteria decreased by 32.7% while the number of drug

interactions decreased by 65.5%. The median value of MAI score

decreased from admission to discharge [2 (IQR 0

4) to 1 (IQR 0


respectively, (p < 0.01)].


Prescriptive appropriateness in older patients could be

improved during hospitalization by using a computerized system that

detects PIPs and the pharmacist

s involvement in the MGT.

Area: Cognitive disorders


Psychotropic drug use and mortality in old people with dementia:

a gender-sensitive analysis

J. Brännström


, G. Boström


, E. Rosendahl


, P. Nordström



H. Littbrand


, H. Lövheim


, Y. Gustafson




Department of Community

Medicine and Rehabilitation, Geriatric Medicine, Umeå University,


Department of Community Medicine and Rehabilitation, Physiotherapy,

Umeå University, Sweden (ER)


Psychotropic drugs are common among old people with

dementia, and have been associatedwith increasedmortality. Previous

studies have not investigated gender differences in this risk. This study

was conducted to analyse associations between the use of anti-

psychotics, antidepressants, and benzodiazepines and 2-year mortal-

ity in old people with dementia, and to investigate gender differences



In total,1,037 participants (74% women; mean age, 89 years)

with dementia were included from four cohort studies and followed

for 2 years. Data were collected through home visits and medical

records. Cox proportional hazard regression models were used to

analyse associations between ongoing baseline drug use and mortal-

ity. Multiple possible confounders were evaluated and adjusted for.


In fully adjusted models including data from the whole

population, no association between baseline psychotropic drug use

and increased 2-year mortality was seen. Significant gender differ-

ences were found in mortality associated with antidepressant use,

which was protective in men, but not in women (hazard ratio [HR]

0.61, 95% confidence interval [CI] 0.40

0.92 and HR 1.09, 95% CI 0.87

1.38, respectively). The interaction term for sex was significant in

analyses of benzodiazepine use, with a higher mortality risk among

men than among women.


Among old peoplewith dementia, ongoing psychotropic

drug use at baseline was not associated with increased mortality in

analyses adjusted for multiple confounders. Gender differences in

mortality risk associated with antidepressant and benzodiazepine use

were seen, highlighting the need for further investigation of the

impact of gender.


Can we influence hospital readmission for people with dementia?

C. Scampion


, A. Eltilib


, N. Cahill


, R. Robinson


, O.J. Corrado





Teaching Hospitals NHS Trust, Leeds, United Kingdom


90% of people with dementia in Leeds have at least one

other significant co-morbid medical problem. As a result they are at

great risk of frequent admission to hospital. We have undertaken an

audit to determine the health and social factors contributing to

readmission in people with dementia to try and identify potential

strategies to prevent avoidable re-admissions.


We undertook a retrospective case note audit of patients


65 years with an ICD code of dementia with 4 or more

emergency admissions to Leeds Teaching Hospitals in the year

following an initial admission in 2013. We devised an audit tool to

identify the factors contributing to each admission.


72 patients had 4 or more readmissions within a year. 14

patients were omitted due to missing data. The remaining 58 patients

were admitted a total of 264 times. 57% of admissions were to Elderly

Medicine, the mean length of stay was 11 days. The majority of

admissions were attributed to health (73%) rather than social factors.

Only 16% of admissions were from 24 hour care. Involvement of mental

health teams was poor (8% of admissions) and communication with

carers was lacking.


Contrary to our expectations, people with dementia

were readmitted to hospital principally for medical rather than social

reasons. Given the relative paucity of admissions from care homes,

their admissions may be influenced by social factors or


. Many

admissions were for relatively


medical problems potentially

lending themselves to

unplanned admission strategies

in primary



Differences in prevalence and treatment of atrial fibrillation in

dementia disorders: data from the Swedish Dementia Registry

R. Dorota, L. Bognandi, P. Cermakova, S. Ptacek, B. Winblad,

M. Eriksdotter.

Karolinska Institutet, Polish Academy of Sciences


Emerging evidence shows an association between atrial

fibrillation (AF) and dementia. Treatment for AF in patients with

dementia has been suggested to be lower than for patients without

dementia due to a higher risk of bleeding. Studies have not included all

types of dementia disorders. Aims: This study aimed to find the

prevalence of AF in different dementia disorders and to assess

prevalence of warfarin use in dementia disorders.

Material and methods:

A register based, cross-sectional study,

combining data from several registries. Patients from the Swedish

Dementia Registry (n = 29,630) within 2007

2012 were included.


In the total study cohort, prevalence of AF was 19%. AF was

more prevalent in mixed dementia (MD) (OR 1.1; 95% CI 1.0

1.3) and

vascular dementia (VD) (OR 1.3; 95% CI 1.1

1.4) and more associated

with MD and VD than Alzheimer

s disease (AD) even after adjustment

for confounders. Forty percent of individuals with AF got treated with

warfarin. Warfarin use was more associated with MD (OR 1.2; 95% CI


1.4) and VD (OR 1.3; 95% CI 1.1

1.5) than AD, after controlling for



The burden of AF is high in dementia patients. The

burden is highest in patients with MD and VD, disorders possibly

partially caused by AF. Warfarin treatment is more often associated

with MD and VD than other dementia diagnoses, probably due to a

higher risk of stroke.

Oral presentations / European Geriatric Medicine 7S1 (2016) S1