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were related to longevity taking multiple potential confounders into
account in this study.
Methods:
The sample was drawn from the Swedish National study on
Aging and Care (SNAC), which includes representative data on Swedish
inhabitants aged 60 to 96 years. The participants (N = 6,986) were
followed from 2002 to 2011. Data was collected including age, physical
activity, bodymass index (BMI), muscle strength, smoking, living alone
or not, household economy, education, and cognition. Cox regression
analyses were performed in order to estimate the relative risk of dying,
given differences in physical activity, all included variables taken into
account.
Results:
During the follow up period, 4,447 participants (64%)
survived. Light physical activity were the strongest predictor of
survival, decreasing the relative risk of death with 21% (P < .001. 95%
CI = 0.74
–
0.93). Other significant predictors were muscle strength,
which decreased the relative risk with 19% (P < .05. 95%CI = 1.04
–
1.35)
and smoking, increasing the relative risk with 11% (P < .001. 95%
CI = 0.86
–
0.95). In addition, higher age decreased the relative risk of
death with 2% for each year of age (P < .001.95%CI = 1.02
–
1.03).
Key conclusions:
Physical activity is an important predictor of
longevity in an older population. Even as low activity level as 3
times every month seem to be protective.
O-051
A healthy lifestyle in old age and prospective change in four
domains of functioning
H.A.H. Wijnhoven
1
, M. Visser
1,2
, H.C. Comijs
2
, F.G.C.F. Thomése
1
,
J.W.R. Twisk
2
, D.J.H. Deeg
2
.
1
VU University Amsterdam,
2
VU University
Medical Center, Amsterdam, the Netherlands
Introduction:
Healthy lifestyle is considered an important tool
to prevent chronic conditions and institutionalization in older
adults. The associations between a healthy lifestyle in old age,
according to official, international recommendations, and long-term
decline in physical, psychological, cognitive, and social functioning
were studied.
Methods:
A population-based sample of 3,107 Dutch men and women
aged 55
–
85 years at baseline (1992/1993), participants of the
Longitudinal Aging Study Amsterdam, was used with five follow-up
examinations covering 17 years. Lifestyle score, based on smoking
status, alcohol consumption, physical activity and BMI, ranged from 0
(unhealthy) to 4 (healthy). The outcomes included gait speed (m/s),
depressive symptoms (CESD score), cognitive status (MMSE score) and
social contacts (number of social network members with at least
monthly contact). Linear mixed-models with a 3-year time lag were
used to test the associations.
Results:
Persons with an overall healthy lifestyle had a 9.9% slower rate
of decline in gait speed (0.04 m/s (95% CI 0.02, 0.05)), 11.3% slower rate
of increase in depressive symptoms (
−
1.11 (
−
1.80,
−
0.43)), a 2.1%
slower rate of decline in cognitive functioning (0.56 (0.30, 0.82)), and a
5.8% slower rate of decline in social contacts (0.68 (0.05, 1.31)) as
compared to persons with no or one healthy lifestyle factor.
Key conclusions:
A healthy lifestyle benefits physical, psychological,
cognitive and social functioning up to very old age.
Area: Comprehensive geriatric assessment and
organ disease
O-052
Comprehensive geriatric assessment for prevention of delirium
post hip fracture: a systematic review of randomised controlled
trials
V. Henderson
1
, L. Shields
1
, R. Caslake
1
.
1
Department of Medicine for the
Elderly, Aberdeen Royal Infirmary, Aberdeen, UK
Introduction:
Hip fracture is common, affecting 70,000 people
annually in the UK [1]. The clinical course is often complicated by
delirium, which is associated with poorer outcomes [2,3]. A systematic
review of the evidence was performed to assess comprehensive
geriatric assessment (CGA) for prevention of delirium in this
population.
Methods:
MEDLINE, EMBASE, CINAHL and psychINFO databases were
searched to identify randomised controlled trials with CGA (defined
pre-search) as an intervention and occurrence of delirium as a primary
or secondary outcome. Papers were screened by two investigators.
Reference lists from full text articles were reviewed. Length of stay,
delirium severity, institutionalisation, long term cognition and
mortality were pre-defined as secondary outcomes. Duration of
delirium was included as an outcome post hoc.
Results:
Four trials (three European, one US; 973 participants) were
identified. Two assessed ward based interventions and two team
based.
There was a significant reduction in delirium overall (relative risk (RR)
0.81; 95% confidence interval (CI) 0.69
–
0.94). Post hoc subgroup
analysis found this effect to be preserved in the team based
intervention group (RR 0.77; 95%CI 0.61
–
0.98), but not the ward
based group.
No significant effect was observed on any secondary outcome.
Key conclusions:
This is the first systematic review on this topic and
demonstrates that CGA reduces the incidence of delirium post hip
fracture. This is in keeping with results of non-RCTs and trials in other
populations. In contrast to one previous review [4], team based
interventions appeared superior but it is likely that heterogeneity in
interventions impacted on this.
References
[1] National Institute for Health and Clinical Excellence.
Management
of hip fracture in adults commissioning guide
. CG124. London 2012
[2] Holmes JD, House AO. Psychiatric illness in hip fracture.
Age and
Ageing
2000;29(6):537
–
46.
[3] McCusker J, Cole M, Abrahamowicz M, Primeau F, Belzile E.
Delirium predicts 12-month mortality.
Archives of Internal
Medicine
2002;162(4):457
–
63.
[4] Ellis G, Whitehead MA, Robinson D, O
’
Neill D, Langhorne P.
Comprehensive geriatric assessment for older adults admitted to
hospital: meta-analysis of randomised controlled trials.
BMJ
2011;343:d6553.
O-053
Transcatheter aortic valve implantation registry with
comprehensive geriatric assessment
G. Mannarino
1
, N. van der Velde
2
, M.-P. Thibodeau
3
, J. Baan
4
, M. van
Mourik
2
, J.B. Masson
3
, M.M. Vis
4
, P. Bramlage
5
, J. Kurucova
6
,
M. Thoenes
6
, J.-P. Michel
7
, A. Schoenenberger
8
, A. Ungar
1
.
1
Unit of
Geriatric Cardiology and Medicine, University of Florence, Italy;
2
Internal
Medicine, Section of Geriatric Medicine, Academic Medical Center,
Amsterdam, Netherlands;
3
University of Montreal, CHUM-Hopital Notre-
Dame, Montréal, Canada;
4
Cardiology, Academic Medical Center,
Amsterdam, Netherlands;
5
Institute for Pharmacology und Preventive
Medicine, Cloppenburg, Germany;
6
Edwards Lifesciences, Nyon,
Switzerland;
7
Geneva Medical School and University Hospitals,
Switzerland;
8
Geriatrie Universität Bern, Inselspital, Bern, Schweiz
Objectives:
Transcatheter aortic valve implantation (TAVI) has
become a viable alternative to surgical aortic valve implantation in
high-risk and inoperable patients. Procedural results and medium
term outcomes are, however, strongly affected by the overall health
state of an individual patient and this is not sufficiently covered by a
standardized cardiology assessment. For this reason we aimed to
investigate the impact of a comprehensive geriatric assessment (CGA)
on the accuracy of the prognosis and the clinical benefits of TAVI in this
population.
Oral presentations / European Geriatric Medicine 7S1 (2016) S1
–
S27
S15