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participants were randomized to

home visit




(TG), or

control group

(CG). The intervention was

individualized nutritional counseling one, two, and four weeks after

discharge. The risk of readmission was analysed as intention-to-treat

(ITT) and as per-protocol (PP) using the Cox proportional hazard

regression model.


208 patients were randomized (HV = 73, TG = 68, CG = 67) and

included in the ITT-analysis. HV had a lower risk of readmission to

hospital compared to CG (HR = 0.4; 95% CI: 0.2

0.9, p = 0.03). No

difference was detected between TG and CG (HR = 0.6, 95% CI: 0.3


p = 0.18). 166 patients completed the full intervention and were

included in the PP-analysis (HV = 53, TG = 46, CG = 67). HV had a lower

risk of readmission to hospital compared to CG (HR = 0.1; 95% CI: 0.03

0.6, p < 0.01). TG had also lower risk of readmission compared to CG

(HR = 0.2, 95% CI: 0.07

0.8, p = 0.02).


Individualized nutritional follow-up performed as home

visits reduces readmission to hospital 30 after discharge in malnour-

ished geriatric patients who live alone. Nutritional counselling

performed over the telephone can reduce readmission to hospital,

but only among patients who receive the full intervention.


Adults 70

89 with heart disease, lung disease or diabetes mellitus

have an antibody response comparable to healthy adults 70


after receiving 23-valent pneumococcal polysaccharide vaccine

K. Kawakami


, H. Kishino


, S. Kanazu


, N. Toshimizu


, R. Yokokawa



K. Takahashi


, M. Kohn


, L. Musey




Nagasaki Kawatana Medical Center,


MSD K. K., Tokyo, Japan;


MSD, West Point, USA


Many countries recommend that adults with chronic

disease be vaccinated with pneumococcal polysaccharide vaccine

(PPSV23) because of their increased risk for pneumococcal disease. To

explore the immunogenicity of PPSV23 in these patients we examined

antibody responses in adults age 70

89 with chronic disease after

primary vaccination and revaccination compared to healthy adults in

this same age group.


We measured serotype-specific IgG geometric mean

concentrations (GMC, 14 serotypes) and opsonophagocytic activity

titers (OPA, 6 serotypes) 4 weeks after vaccination in a community-

based cohort vaccinated >=5 years earlier (N = 161) or never vaccinated

(N = 81) with PPSV23.


For each serotype the GMC and OPA titers did not differ

significantly between each of the groups with co-morbid conditions

and the group without any of those conditions, with the exception of

significantly higher GMC titers against serotype 7F in the revaccination

groups with lung disease and heart disease, and serotype 3 in the

revaccination group with heart disease. The GMC also were not

significantly different between those with 0, 1 and 2

3 of these


Key conclusions:

GMC and OPA responses to PPSV23 vaccination and

revaccination in older patients with heart disease, lung disease or

diabetes mellitus were not significantly different from older patients

without these conditions, even if they had more than one of these

condition or if they had been previously vaccinated. These results

support the recommendation to vaccinate these patients at increased

risk with PPSV23.


Norovirus disease leads to higher healthcare usage in older adults

with chronic medical conditions

T. Verstraeten


, B. Jiang


, H. Bogaerts


, J.G. Weil





Pharmacovigilance and Epidemiology Services, Leuven, Belgium;



Development Center Americas, Inc., Deerfield, Illinois, USA;



Pharmaceuticals International AG, Zurich, Switzerland


Global estimates suggest that each year norovirus

infections cause over 200,000 deaths and US$65 billion in costs,

mostly affecting elderly adults and young children. It is also estimated

that over 80% of US adults over 65 years suffer from at least one chronic

medical condition. We assessed the impact of norovirus acute

gastroenteritis (NGE) on health care utilization by US adults with a

range of chronic underlying conditions.


We performed a retrospective cohort study using

MarketScan data from 2002 to 2013, comparing rates of emergency

department visits, outpatient visits and hospitalizations for NGE

among patients with chronic conditions (renal, cardiovascular,

respiratory, immunocompromising, gastrointestinal, hepatic/pancre-

atic and neurological conditions and diabetes) with a healthy age-

matched population. We estimated the rates of these outcomes due to

NGE using an indirect modeling approach, stratified by 65

74, 75


and 85+ year-old age groups.


82.2% of elderly adults had one or more chronic condition.

Hospitalization rates for NGE were higher in all-risk groups compared

with otherwise healthy subjects. Highest rates were observed among

those with renal conditions (23.9

40.3 episodes per 10,000 person-

years across the increasing age groups) and chronic gastro-intestinal

conditions (12.6

62.8 episodes per 10,000 person-years), compared to


11.5 episodes per 10,000 person-years among those without

chronic conditions. Outpatient visits for NGE were also increased in

persons with chronic gastrointestinal or immunocompromising



Norovirus gastroenteritis leads to significantly higher

rates of healthcare utilization in older adults with a chronic medical

condition compared with otherwise healthy older adults.


Ageing with HIV: a huge challenge due to a high prevalence of

chronic comorbidities in a French population over 75

C. Allavena, C. Bernaud, F. Delamarre-Damier, S. Lariven, M.A. Valantin,

T. Ferry, L. Cuzin, A. Naqvi, A. Cabié, M. Hanf, F. Raffi.

DatAIDS study

group and AGREE FRANCE


HIV-infected adults on successful antiretroviral therapy

(ART) are expected to have close to normal lifespans, but will

increasingly develop age-associated comorbidities. Few data are

available in a geriatric HIV population.


From the DatAIDS cohort, we selected patients with at least

one visit since 2004 and aged over 75 at the latest visit (geriatric

group). Their characteristics and comorbidities were described at the

censoring date (01/09/2014) and compared with the elderly popula-

tion, aged 50 to 75 (elderly group).


Characteristics of the 430 patients over 75 were as follow:

median age 78 years, 72% male, 37% homosexual contamination, 9%

hepatitis B or C co-infected, BMI < 18 in 22%, 34% at CDC stage C (AIDS),

with a median age at HIV diagnosis of 62 years (age > 75 at diagnosis in

8%) and a median duration of HIV infection of 17 years. Median nadir

CD4 and current CD4 were 144 and 494/mm


, respectively; 98% of the

subjects were on ART, virologically controlled in 89%. Most frequent

comorbidities were diabetes 22.3%, hypertension 42.3%, dyslipidemia

27.9%, cardiovascular disease 20.7%, neoplasia 22.6%, renal failure 14%

and depression 15.1%. The geriatric group had significantly more

frequent comorbidities than the elderly group: 40.2% vs. 24.7% had 2 or

3 comorbidities and 14% vs. 4.3% had more than 4 comorbidities (all

p < 0.05).


Comorbidities dramatically increased in the geriatric HIV

population. New strategies are required for providing integrated HIV

and geriatric care to meet the long term and complex needs of older

HIV adults and to deal with drug-drug interactions.


Light physical activity predicts longevity in the Swedish older


M. Rennemark, J.S. Berglund, C. Jogreus.

Blekinge Institute of Technology


Physical activity gains health. It is positively related to

cognitive functions, good sleeping habits, muscle strength and

cardiovascular functions. In older ages, light physical activity is most

gainful. Since longevity is multi-determined, physical activity habits

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