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

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P-636
Correlations between depression and nutritional status among
hospitalized older adults
A. Rusu 1, I.M. Crăcană2, R. Stefăniu2, I. Sandu1, I.D. Alexa2. 1“Dr. C.I.
Parhon” Hospital, 2Department of Internal Medicine, University of
Medicine and Pharmacy “Grigore T. Popa”, Iaşi, Romania
Objectives: Depression and malnutrition are frequent and serious
conditions within the geriatric population. Both have multifactorial
origins and are linked to adverse outcomes.
Methods: We present a retrospective study performed on a group of
663 Romanian elderly patients aged over 65 years, whowere admitted
in an acute Geriatric Clinic from Iasi, Romania over a two year period.
In this group we analyzed the impact of depression (evaluated with
GDS scale) and malnutrition (evaluated with MNA scale) over the
demographic parameters and other geriatric syndromes.
Results: Depression and malnutrition were found in all age groups
(65–75 years old – 60.7%, respectively 70%, 75–85 years old – 72,2%,
respectively 77%, over 85 years old – 77,8% respectively 84,7%). The
data obtained showed that depression is an independent factor for
malnutrition (p < 0.05), 86,5% of those with severe depression were
malnourish or at risk of malnutrition. Conversely, malnutrition was
not a risk factor for depression; it was found in 53,7% with normal
scores of GDS.
Conclusions: Senior population has a high prevalence of depression
and malnutrition, with a significant impact on the evolution of
concomitant diseases and quality of life. Depression is an independent
risk factor for malnutrition, while poor nutritional status was found
in a large majority of normal disposition state. The correct treatment
of both these conditions is a major requirement in establishing
therapeutical approach.
P-637
Effectiveness of nutritional screening for hospitalised older people
E. Dent, R. Hubbard. The University of Queensland
Background and aims: Hospital-based nutritional screening may not
always lead to intervention. This study aimed to determine: (i) the rate
of nutritional screening in older patients hospitalised in sub-acute
care; (ii) whether nutritional screening led to appropriate dietitian
referral; and (iii) the riskof adverse outcome formalnourishedpatients.
Methods: In this clinical, prospective study of patients aged >70 years,
malnutritionwas identified using the full Mini Nutritional Assessment
(MNA), with nutritional screening performed using the MNA-short
form (MNA-SF). Anthropometric measures included Body Mass Index
(BMI) and Calf Circumference (CC).
Results: Of the 172 patients participating in the study, 53 (30.8%)
patients were malnourished and a further 84 (48.8%) patients were at
risk of malnutrition. Mean (SD) age was 85.2 (6.4 years) and 131
patients (76.2%) were female. Nutritional screening was completed for
113 (65.7%) patients. Overall, 62 (36.0%) of the total number of study
patients were seen by the dietitian, which included 26 (49%) of
malnourished patients, 27 (32%) of at-risk patients and 9 (26%) of the
well-nourished patients. No patients lost >1% of body weight during
their sub-acute care stay. Malnutrition was a risk factor for 12-month
mortality after controlling for age, gender and cognition (OR, 95%
CI = 3.01, 1.34–6.77).
Conclusions: Despite the encouraging maintenance or increase in
weight of older patients, nurse-led nutritional screening using MNA-
SF did not always lead to appropriate dietitian referral. Future research
should focus on identifying barriers and facilitators associated with
the Nutritional Care Process.
P-638
Dysphagia, creating a better team with continuity
M.C. Deza, M.M. González, I. Ferrando, C. Cánovas. Hospital Nuestra
Señora de Gracia, Zaragoza, Spain
Introduction: Improve the care of patients with dysphagia admitted
to a geriatric service.
Methodology: Creating a multidisciplinary team nurse, assistant,
occupational therapist, nutritionist, physician geriatrician and medical
residents. Monthly meetings since 2014, with sharing of clinical
experience. Surveys dysphagia diets.
Results: In 2014–2015: We have developed an “Information leaflet” for
caregivers and a “poster warning” about risks placed on the headboard
of the bed. It has been assigned nurse performing dysphagia MECV-V
test when required. At discharge, the caregiver delivery of “road food
recommendations”. They have identified the products most pleasing
to patients and have developed strategies to improve the taste and
presentation of the preparations. Delivery has begun small teaspoons
allowing better dosing volumes. 2016: There have been training
sessions for health workers and caregivers, pending continue to be
made monthly.
Conclusion: We have initiated improvement strategies for patients
with dysphagia directed to your usual caregiver and staff. Improving
the taste and presentation of diets in our hospital for the patient
means a stimulus, to be a more attractive and less monotonous diet.
For Caregivers and staff improved knowledge will mean greater safety
in patient management. We believe that the approach must be
multidisciplinary dysphagia and that will mean a higher quality care.
P-639
Prevalence of malnutrition in a cohort of 509 patients with acute
hip fracture. Importance of a comprehensive assessment
M. Díaz de Bustamante1, J.I. González-Montalvo1–3, T. Alarcón1–3,
R. Menéndez-Colino1,2, R. Ramírez-Martín 1, A. Otero2–4. 1Geriatrics
Department, Hospital Universitario La Paz, 2La Paz Universitary Research
Institute, IdiPAZ, Madrid, 3RETICEF, 4Preventive Medicine Department,
Universidad Autónoma de Madrid, Madrid, Spain
Objectives: Malnutrition is very frequent in acute hip fracture (HF)
patients. Studies often include small cohorts and use different criteria
so their data arewidely different, there is no consensus. The aim of this
study was to determine, in a large cohort of patients with hip fracture,
the prevalence of malnutrition in a comprehensive sense, including
the frequency of protein-energy malnutrition, vitamin D deficiency
and sarcopenia.
Methods: A one-year consecutive sample of patients admitted with a
fragility HF in a 1,300 bed public university hospital were assessed in
the first 72 h since admission. Clinical, functional, cognitive, and
analytic variables were included. Calorie malnutrition (Body mass
Index –BMI– <22 Kg/m2), protein malnutrition (serum total protein
level <6.5 g/dL or albumin <3.5 g/dL), Vitamin D deficiency (serum 25-
OH-Vitamin D <30 ng/dL) and sarcopenia (low muscle mass plus low
grip strength) were considered.
Results: Five hundred and nine HF patients were included. Mean age
was 85.6 ± 6.9 years and 79.2% were women. One hundred and three
(20.9%) patients had a BMI <22 Kg/m2. Four hundred and nine patients
(80.4%) had protein malnutrition. Eighty seven (17.1%) patients had
both calorie and protein malnutrition. Serum Vitamin D was <30 ng/
mL in 466 (93%). Prevalence of sarcopenia was 17.1%.
Conclusion: Protein malnutrition and Vitamin D deficiency are the
rule in acute HF patients. Calorie malnutrition and sarcopenia are also
frequent. The nutritional assessment in these patients should include
these aspects together.
P-640
Impact of nutritional status in outcome of older patients admitted
in an Internal Medicine ward at 6 and 12 months follow-up
S. Velho1, S. Duque2,3, M.J. Serpa4, I. Carvalho1, R. Silva1, A. Ferreira1,
V. Teixeira1, S. Moço1, C. Inácio1, D. Sarabando1, Á. Chipepo4, F. Araújo4,
J. Pimenta da Graça4. 1Nutrition and Dietetics Department, Hospital
Beatriz Ângelo, Loures, 2Internal Medicine Department, Centro Hospitalar
de Lisboa Ocidental, Hospital São Francisco Xavier, 3Unidade
Universitária de Geriatria, Faculdade de Medicina, Universidade de
Lisboa, Lisboa, 4Internal Medicine Department, Hospital Beatriz Ângelo,
Loures, Portugal
Poster presentations / European Geriatric Medicine 7S1 (2016) S29–S259 S197