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

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are rarely engaged in cessation efforts. It is unclear which pharmaco-
therapy strategies are most effective in elderly.
Methods: Search performed using Mesh terms: “aged”; “smoking
cessation”. Review of systematic and narrative reviews, meta-analysis
and guidelines, published between 2011 and 2016, the age was limited
to >65 years. Data base used was: Pubmed.
Results: 1163 articles were found, and 13 were selected according
to our objective. Counselling and non-pharmacological approach
demonstrated benefices therefore smoke cessation is an effective
intervention to offer. Nicotine replacement therapy is the pharmaco-
therapy most studied in older adults. It is effective for smoking
cessation among this population. Varenicline is generally safe and well
tolerated; a study involving smokers aged 65 years and above found
that no dose adjustment was required. Bupropion can be used in
elderly smokers but at a reduced dose – 150 mg/day. Other strategies
are available: spirometer as a motivational tool and physical activity as
a coping resource, but further information is needed.
Conclusion: The studies available are insufficient to recommend a
clear strategy for smoking cessation in older adult smokers. Special
consideration needs to be given to the elderly because of such factors
as their longer smoking history, comorbidities and drug history.
Further study is needed to assess the efficacy of smoking cessation
interventions. However, family physicians should continue to advise,
encourage and support elderly smokers.
P-588
The physical capacity of community-dwelling elderly
S.W.T. Frazer 1, S.M. Jansen-Kosterink1, M.M.R. Vollenbroek-Hutten2.
1Roessingh Research and Development, 2University of Twente, Enschede,
The Netherlands
Objectives: Ageing is a dynamic process, with great diversity in
how elderly age [1,2]. Frailty is a common clinical condition which can
lead to high fall risks, disability, hospitalization and mortality [1,3,4]. A
sufficient level of physical capacity, referring to the maximal ability to
perform activities, has preventive value for frailty [1]. Physical capacity
can be expressed in different dimensions and measured both
objectively and subjectively. The aim of this study is to provide more
insight into these different dimensions and their relationship in
community-dwelling elderly.
Methods: As part of the PERSSILAA-project (FP7-ICT-610359),
community-dwelling elderly between 65 –75 years performed
several physical assessments; the SF-36 physical functioning scale
(SF-36pfs), the 4 m-walk-test, Chair-stand-test, Chair-sit-and –reach-
test, Timed-up-and-Go (TUGT) and the Two-Minute-step-test.
Results: In total, 85 elderly participated (44.7% male, average age 70.1
(SD 3.0), 77.6% robust and 22.4% frail based on the Groningen Frailty
Indicator). Concerning the different dimensions 30.6%, the partici-
pants score below the threshold for flexibility (Chair-sit-and-reach-
test), 24.7% for endurance (Two-Minute-step-test), 20% for subject-
ively judged physical capacity (SF-36pfs), 17.3% for strength (Chair-
stand-test) and balance (TUGT) and 14.1% for gait speed (4 m-walk-
test). Only 41.2% scored above threshold on all the objective physical
assessments.
Conclusion: Almost 60% of the elderly score below threshold on at
least one of the objectively assessed dimensions of physical capacity
compared to only 20% who judge their physical capacity below
threshold by themselves. It is important to measure various dimen-
sions of physical capacity in order to have a better insight and to define
personal treatment plans.
References
[1] Buckinx F., Rolland Y., Reginster J.-Y., et al., Burden of frailty in the
elderly population: perspectives for a public health challenge.
Archives of Public Health (2015); 73:19.
[2] Suzman R., Beard J.R., Boerma T., Chatterji S., Health
in an ageing world – what do we know? Lancet (2015);
385;484–486.
[3] Rodriguez-Manas L., Fried L.P., Frailty in the clinical scenario.
Lancet (2015); 385.
[4] Clegg A., Young J., Iliffe S., et al., Frailty in older people. Lancet
(2013); 381:752–762.
P-589
Empirical data of self-rated health in elderly reveal dynamical
characteristics that rank humans from resilient to frail
S.M.W. Gijzel1,2, I.A. van de Leemput2, M. Scheffer2, M. Roppolo3,4 ,
M.G.M. Olde Rikkert1, R.J.F. Melis1. 1Department of Geriatrics, Radboud
University Medical Center, Nijmegen, 2Aquatic Ecology and Water Quality
Management, Wageningen University, Wageningen, The Netherlands;
3Department of Psychology, University of Torino, Torino, Italy;
4Department of Developmental Psychology, Rijksuniversiteit of
Groningen, Groningen, The Netherlands
Introduction: Resilience is the capacity to bounce back to normal
functioning upon disturbances and its gradual deterioration during
ageing often remains unnoticed until confronted with a health
crisis. We currently still lack valid methods to dynamically measure
resilience for upcoming stressors. Research on complex dynamical
systems such as ecosystems has put forward empirical quantitative
indicators of resilience. We hypothesise that we could rank elderly
from resilient to frail by looking at differences in variance, temporal
autocorrelation and cross-correlation in three self-rated health
outcomes.
Methods: We monitored self-rated physical, mental and social health
with the use of daily visual analogue scale questions during 100 days
in 22 institutionalised elderly people above 70 years. Their frailty was
determined by the Survey of Health, Ageing and Retirement in Europe
(SHARE) frailty index.
Results: With increasing frailty on a continuous scale, the three
dynamical characteristics of subjects’ time series significantly
increased. When the group was dichotomised for frailty status, the
time series of frail elderly exhibited elevated variance in the physical
(0.02 vs. 0.006, p < 0.001) and mental domain (0.03 vs. 0.006,
p < 0.001), as well as elevated temporal autocorrelation in the physical
(0.57 vs. 0.44, p = 0.06) and mental domain (0.54 vs. 0.43, p = 0.14) as
compared to non-frail elderly. In addition, time series in the physical
and mental domains of the system were more cross-correlated in the
frail group (0.67 vs. 0.37, p < 0.001).
Conclusion: These results suggest that dynamical characteristics in
empirical data collected over time may be used to quantify resilience
in elderly.
P-590
Spatial distribution of falls prevalence in Europe: an analysis based
on SHARE database
M. Gomes1–3, S. Alves1,3,4, C. Oliveira1,3,4, E. Costa 1,2,7, M. de Fátima de
Pina1,3,5,6,8,9. 1i3S, Instituto de Investigação e Inovação em Saúde da
Universidade do Porto, 2FFUP, Faculdade de Farmácia da Universidade do
Porto, 3INEB, Instituto Nacional de Engenharia Biomédica, 4ESTSP/IPP,
Escola Superior de Tecnologias da Saúde do Porto, 5FMUP, Faculdade de
Medicina da Universidade do Porto, 6ISPUP, Instituto de Saúde Pública da
Universidade do Porto, 7UCIBIO, Portugal; 8ICICT/FIOCRUZ, 9CARTO-FEN/
UERJ, Brazil
Objectives: Our aim is to evaluate the prevalence rates of falls in older
adults in Europe.
Methods: We conducted a cross-sectional analysis using data from the
fourth wave (2011/2012) of SHARE (Survey of Health, Aging and
Retirement in Europe) database. The direct age-standardized (5-years
age groups) prevalence rates of falls in individuals ≥50 years old were
calculated for 16 European countries using the revised European
Standard Population of 2013.
Results: From the SHARE database (n = 58,489) we selected 57,056
registers of individuals ≥ 50 years old, 55.9% (n = 25,162) were women.
In this wave, 2953 individuals experienced falls in the 6 months before
the interview, with mean age for males and females 71.6 (SD11.0) vs
Poster presentations / European Geriatric Medicine 7S1 (2016) S29–S259 S184