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

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P-660
When the internist discovers the cause of the fracture
C. Macedo1, M. Gonçalves1, B. Barbosa1. 1Centro Hospitalar e
Universitário de Coimbra, Medina Interna A, Portugal
Introduction: Vitamin D deficiency is common in the elderly and
can lead to secondary hyperparathyroidism, high bone turnover, bone
loss and mineralization defects. Therefore is a risk factor for fractures
in this population.
Case report: Patient 74 years, female, inpatient in an orthopaedic unit
for a supracondylar fracture of the right humerus after a fall, waiting
for surgery. The collaboration of Internal Medicine was made because
a respiratory infection. The patient was obese and had a mastectomy
because of breast cancer. She also complains about generalized
myalgia and bone pain. In laboratory study we found a calcium of
12.9 mg/dL, creatinine of 0.88 mg/dL and FA 133 U/L. So ask for the
levels of parathormone, vitamin D and phosphates: 481 pg/mL, 4.1
ng/mL and 1.2 mg/dL respectively. We treated the hypercalcemia
with pamidronate 60 mg and we began vitamin D supplementation.
The diagnosis of secondary hyperparathyroidism due to severe
vitamin D-deficient state was made. In the cranial radiography
there is hyperosteoidosis and eroded areas compatible with high
bone turnover. The patient was laboratory studies showing that
hypercalcemia and values slightly elevated of FA was present since at
least 2013.
Conclusion: There is overwhelming evidence that vitamin D defi-
ciency and secondary hyperparathyroidism are common in the elderly.
Every physician must have this in mind because the supplementation
is an effective way of preventing vitamin D deficiency and cost-
effective in prevention of fractures in the elderly.
P-661
Nutritional status and prognostic validity of malnutrition criteria:
the FRADEA Study
M. Martínez-Reig 1, L.M. Peña-Longobardo 2, I. Aranda-Reneo 2,
J. Oliva-Moreno2, N. Barcons-Vilardell 3, P. Abizanda1. 1Geriatrics
Department of the Complejo Hospitalario Universitario de Albacete,
Albacete, 2Department of Economic Analysis and Finance, Universidad de
Castilla-La Mancha, Toledo, 3Medical Affairs Department, Nestlé Health
Science, Barcelona, Spain
Objectives: To analyze the nutritional status in the FRADEA cohort,
using the following criteria: Body Mass Index (BMI) WHO criteria,
2015 ESPEN criteria, weight loss, anorexia, and Mini Nutritional
Assessment®-Short Form (MNA ®-SF) criteria. Also to analyze the
prognostic validity of those criteria with geriatric adverse events.
Methods: Population-based prospective cohort study. 827 partici-
pants aged 70 years or older from Albacete city (Spain), stratified
by age and sex. BMI and MNA®-SF were collected at baseline (2007–
2009). Bioimpedanciometry was realized in 537 participants to
determine fat free mass index (FFMI). Follow-up visits were conducted
in 2012–2013. The prognostic validity was analyzed with chi2 and
logistic regression adjusted for age and sex.
Results: Mean age 78.6 years (Range 70– 102), 492 women (59.5%).
Mean follow-up time 1044 days (Range 115–2007). Nutritional status
was: BMI < 18.5 9 (1.1%), 18.5 –24.9 129 (15.6%), 25– 29.9 341 (41.2%),
30 –34.9 231 (27.9%), >35 92 (11.1%). 12 participants (1.5%) had
FFMI < 15 in women and <17 in men. 41 (5%) ahd a BMI < 22. Only 12
(1.5%) met 2015 ESPEN criteria. 21 (2.5%) had a MNA ® -SF between 0
and 7, 204 (24.7%) between 8 and 11, and 567 (68.6%) between 12 and
14. 136 (16.5%) presented moderate to severe anorexia and 106 (12.8%)
had lost weight in the last year. Only MNA®-SF, anorexia and weight
loss associated with hospitalization, emergency visits, mortality and
disability.
Conclusion: In the FRADEA cohort, malnutrition prevalence was low,
and only MNA ®-SF, anorexia and weight loss were associated with
hospitalization, emergency visits, mortality and incident disability
in BADL.
P-662
Fighting malnutrition in older adults: the contribution of
PERSSILAA project
A. Martins1, M. Sousa Silva1, A. Ferreira 1, L. Sousa1, C. Dias1, A.M. Matos1,
V. Cachatra1, D. Batista1, A. Turkman2, F. Turkman2, M. Antunes 2,
H.S. Costa3, T. Albuquerque 3, A. Sa. 1Centro de Química e Bioquímica,
Faculdade de Ciências, Universidade de Lisboa, Campo Grande, 2Centro de
Estatística e Aplicações, Faculdade de Ciências, Universidade de Lisboa,
Campo Grande, 1749-016 Lisboa, 3Departamento de Alimentação e
Nutrição, Instituto Nacional de Saúde Doutor Ricardo Jorge, Av. Padre
Cruz, 1649-016 Lisboa, Portugal
Nutrition plays an important role all over our life span, especially in
older adults, influencing the rate of physiologic and functional decline
with age. PERSSILAA project (PERsonalised ICT supported Service
for Independent Living and Active Ageing) developed a new service
model, to screen for and prevent frailty in older adults, covering
nutrition, physical and cognitive domains. It has been successfully
accomplished with the participation of a multidisciplinary team
from five countries, namely Portugal, Spain, Italy, Ireland, and The
Netherlands. This communication describes the work developed
within the workpackage under the leadership of the Portuguese
team, in particular regarding the creation of the innovative
NUTRIAGEING website . It is an interactive and
user-friendly website providing information, advice and simple
services focused on the nutritional status of elderly people, and
offers several modules to promote rational food habits. It is structured
around healthy eating, cooking recipes with videos, and how to growa
vegetable garden, as a source of cheap and functional food ingredients.
Helping people choosing more nutritious food will contribute to
maintain good health, will improve their cognitive function, increase
their energy levels and prevent their frailty.
Acknowledgements: This work was supported by the European
project “PERsonalised ICT supported Service for Independent Living
and Active Ageing”, FP7-ICT-2013-10, GA 610359, 2013–2016. The
authors also acknowledge the European Commission for approval of
the INOVAFUNAGEING commitment, and the sponsorship of IUPAC
and Lisbon Municipality.
P-663
Does linagliptin reduce visceral fat burden in patients with type 2
diabetes mellitus?
R. Mitsutake. Fukuoka University Chikushi Hospital, Chikushino, Japan
Objectives: Abdominal visceral fat is associated with increased risk of
diabetes and cardiovascular disease. Linagliptin belongs to dipeptidyl
pepidase-4 (DPP4) inhibitors widely accepted as the treatment of
type 2 diabetes mellitus (DM). Linagliptin has a novel xanthine based
structure, resulting in a positive effect on metabolic dysfunction, renal
and cardiovascular damage. The aim of this study was to analyze the
effect of linagliptin on visceral fat burden.
Methods: This prospective study was enrolled 8 patients (6 men,
mean 63 years, mean HbA1c 8.0%) with uncontrolled type 2 DM
without treatment of DPP4 inhibitors. We precisely analyzed abdom-
inal circumference, visceral and subcutaneous fat area (VFA and SFA)
by computed tomography at baseline and 3 months after administra-
tion of linaglipin. We also measured plasma levels of adiponectin and
leptin at the same period.
Results: There was significantly reduced in HbA1c (mean − 1.04%,
p = 0.0052). However, subcutaneous and visceral fat burden and
plasma levels of adiponectin and leptin did not show significant
changes. We divided patients into two groups, VSA-rich group
(VFA > SFA at baseline) and SFA-rich group. The difference in HbA1c
between baseline and 3months showed higher trend in VFA-rich
group, but was not statistically significant (ΔHbA1c 0.88 vs 1.20,
p = 0.5729).
Conclusions: Linagliptin demonstrates superior glucose-lowering
efficacy, while effect on visceral fat burden during follow-up period
was limited in our small population.
Poster presentations / European Geriatric Medicine 7S1 (2016) S29–S259 S203