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

205 / 290

P-644
GNRI as a complement to MNA in nutrition study
M. Freixa, A. Simões, J. Rodrigues, S. Úria, G. Silva. Department of
Internal Medicine, Pulido Valente Hospital, Lisbon, Portugal
Introduction: Geriatric Nutritional Risk Index (GNRI) identify the risk
of nutrition-related complications in elderly. Malnutrition is common
in this population, higher in those hospitalized, and is frequently
evaluated by Mini Nutritional Assessement (MNA).
Objective: Investigate the correlation between MNA and GNRI.
Methods: Cross-sectional study with 66 hospitalized elderly patients
(≥65 years) divided into two groups according to MNA-Short Form –
G1 malnourished (≤ 7; n = 11); G2 without malnutrition (>7). There
was also used anthropometric measures (bodymass index (BMI); mid-
arm muscle circumference (MUAMC) – 71% severe, 70–80% moderate
and 80–90% mild nutrition) and albumin (normal ≥ 3 g/dL). GNRI: >98
no risk, 92–98 low, 92–82 moderate, <82 severe.
Results: (1) Mean age was similar (82,2 ± 4.5 vs 83.1 ± 6.2 years;
p = 0.6). (2) G1 had lower mean MNA (5.3 ± 1.8 vs 11.9 ± 2.2; p < 0.01).
(3) G1 had lower BMI (20.05 ± 2.05 vs 25.1 ± 4.34; p < 0.01) and positive
relation with MUAMC in both groups (69,5 ± 9,3 vs 83,9 ± 14,02;
p < 0,01). (4) Higher prevalence of hypoalbuminaemia in G1 (45,5
vs 19,6%; p = 0,069). (5) Both groups had mean GNRI <98, but G1
had lowest value (80,7 ± 16,4 vs 96.72 ± 13.4; p < 0.01). (6) In G2, 15,4%
had GNRI <82 (vs 45,5%) and 9,6% between 82 and 92 (vs 27,3%;
p = 0,010).
Conclusion: Some patients classified with no malnutrition may be
at risk to develop nutrition-related complications. It is essential to
determine the GNRI in hospitalized patients, predicting complications
and planning an effective nutritional intervention.
P-645
The metabolic syndrome in very elderly
M. Freixa, A. Simões, J. Rodrigues, S. Úria, G. Silva. Department of
Internal Medicine, Pulido Valente Hospital, Lisbon, Portugal
Introduction: The metabolic syndrome (MS) is defined as a cluster of
cardiometabolic risk factors, and elderly have highest prevalence.
However, few studies have directed attention to the MS in this
population.
Objective: To evaluate metabolic syndrome in the elderly.
Methods: A retrospective observational study with analysis of 144
clinical process of patients with MS, from admission in consultation to
the last clinical evaluation. Mean follow-up time was 5,7 ± 3,6 years.
SM was defined according to the AHA/NHLB2005 criteria. We defined
two groups: G1 <80 years (n = 123, 74,1%) and G2 > 80 years.
Results: (1) In G1, males were superior (66,7 vs 42,9%;p = 0,050) while
in G2 was the female gender (57,1 vs 33,3%;p = 0,050). (2) The mean
age in G1 was 60,9 ± 10,4 years (vs 85 ± 3,8). (3) On admission, in G2
therewas a higher prevalence of dyslipidemia (100 vs 75,2%; p = 0,007),
hypertension (85,1 vs 71,4%; p = 0,127), chronic kidney disease (23,8
vs 8,3%;p = 0,05), heart failure (42,9 vs 20,7%; p = 0,049), ischemic
cardiopathy (33,3 vs 7,4%; p = 0,003), atrial fibrillation (42,9 vs 5,8%;
p < 0,001) and stroke (30 vs 8,9%; p = 0,016). (5) G2 hadworse LDL levels
(127,2 ± 85,6 vs 114,5 ± 43,1 mg/dL) and glycaemia (126,8 ± 56,1 vs
116,8 ± 42,9 mg/dL) but better triglycerides level (127,7 ± 121,5 vs
168,8 ± 127,9 mg/dL) and total colestherol (192,43 ± 48,4 vs 193,7 ±
52,2 mg/dL). In both groups, patients were overweight (BMI 30,4 ± 6,3
vs 29,6 ± 6,4). (6) During follow-up, G1 had developed more hepatic
steatosis (37,4 vs 4,8%;p = 0,002) and diabetes (20 vs 9,5%; p = 0,365).
(7) Mortality was higher in G2 (28,6vs9,8%; p = 0,027).
Conclusions: In our study, the older people have more cardiovascular
risk factors, but the younger group developed more hepatic steatosis
and diabetes. MS is a risk factor for cardiovascular morbidity, whereby
it is important to diagnose and prevent its development.
P-646
Cross-sectional analysis of fasting blood glucose and cognition in
geriatric inpatients
M. Gogol. Department of Geriatrics, Lindenbrunn Hospital,
Coppenbruegge, Germany
Background: Diabetes mellitus affecting increasingly aging persons,
alters mirco- and macrocirculation and foster ateriosclerosis, which
play a role in accelerating aging and cognitive decline. Diabetes
nowadays is recognized as a metabolic and vascular risk factor for
cognitive decline including Alzheimer’s and vascular dementia.
Purpose: To prove the hypothesis that diabetes mellitus is an
independent risk factor for cognitive decline.
Methods: Geriatric inpatients were tested in a prospective, cross-
sectional design for cognition using the Mini Mental Status
Examination (MMSE, range 0– 30 points, higher results inidcating
better cognitive function) and blood sugar day profiles. In accordance
to guidelines we used following cut-offs: normal fasting blood glucose
(NFG) < 100 mg%, impaired fasting blood glucose 100– 125 mg%,
and elevated fasting blood glucose (EFG) ≥ 126 mg%. Pearson’ s
correlation and Student’ s t-test were used for statistical calculations,
p values were set to 0.05 or lower for significance.
Results: We examined 478 consecutive geriatric inpatients with a
mean age of 78.89 ± 8.06 years (197 men (m), 77.23 ± 8.19, 287 women
(w) 81.71 ± 8.19, p = 0.000). NFG were detected in 171 (67 m, 104 w,
mean 91 ± 6.8 mg%), IFG in 208 (80 m, 128 w, mean 110.7 ± 7.3 mg%),
and EFG in 99 (49 m, 50 w, mean 153.1 ± 38.9 mg%) patients. Cognitive
testing with MMSE revealed mean scores of 22.93 ± 5.45
(m 23.25 ± 5.54, w 22.71 ± 5.39, p = 0.28). Total MMSE scores and
subscores for immediate and delayed recall as well as attention/
calculation task revealed no correlation with fasting blood glucose
levels. Pearson’s r for MMSE total was 0.0578 (m 0.0601, w 0.0558).
In stratified groups for NFG, IFG, EFG including stratification for sex we
found no significant correlation too.
Conclusion: In a cross-sectional analysis of geriatic inpatients we
revealed no correlation between fasting blood glucose levels including
stratification for NFG, IFG, and EFG and cognitive testing using the
MMSE.
P-647
Comparison of mini nutritional assessment short and long form
and serum albumin as predictors of short- and long-term hip
fracture outcomes
H. Helminen1, T. Luukkaala2, J. Saarnio3, M. Nuotio1. 1Seinäjoki Central
Hospital, Seinäjoki, 2Science Center of Pirkanmaa Hospital District,
Tampere, 3Oulu University Hospital, Oulu, Finland
Introduction: Malnutrition is common among older hip fracture
patients and associated with adverse outcomes. The aim here was
to examine Mini Nutritional Assessment short (MNA-SF) and long
form (MNA-LF) and serum albumin as predictors of mobility, living
arrangements and mortality after hip fracture.
Methods: Population-based prospective data were collected on 536
hip fracture patients aged 65 year and over. MNA-SF, MNA-LF and
serum albumin were assessed on admission. The outcomes were
declined mobility level, moving into a more assisted living accommo-
dation and mortality one month, four months and one year after the
fracture. Logistic regression analyses for mobility and living arrange-
ments with odds ratios (OR) and Cox proportional hazards model for
mortality with hazard ratios (HR) and 95%conficence intervals (CI)
were used, adjusted for age, gender, ASA grade and fracture type.
Results: All measures predicted mortality at all time-points. Both risk
of malnutrition and malnutrition as measured by the MNA-LF
predicted mobility and living arrangements within four months of
the hip fracture. At one year, risk of malnutrition predicted mobility
and malnutrition predicted living arrangements, when measured by
the MNA-LF. Malnutrition, but not risk of malnutrition, as measured by
the MNA-SF predicted significantly living arrangements at all time-
points. One-month mobility was not predicted by any of the measures.
Poster presentations / European Geriatric Medicine 7S1 (2016) S29–S259 S199