215 / 290
each other when evaluating changes in function in hospitalized
geriatric patients.
P-683
Screening for sarcopenia with the BelRAI Acute Care Instrument
B. Sol
1
, V. Bulens
1
, C. De Cock
1
, P. Peters
1
, S. Lieten
1
, I. Bautmans
1,2
,
I. Beyer
1,2
.
1
Geriatrics department, Universitair Ziekenhuis Brussel (UZ
Brussel),
2
Gerontology Department and Frailty in Ageing (FRIA) Research
Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090
Brussels, Belgium
Introduction:
Despite established consensus criteria, sarcopenia
remains underdiagnosed. Gait speed, the first screening test, is diffi-
cult to obtain in acute care settings. Predictive items from systematic
comprehensive geriatric assessment in geriatric wards might allow to
detect individuals with sarcopenia.
Methods:
Retrospective study of 155 patients admitted to the geriatric
ward of the Universitair Ziekenhuis Brussel (VUB) between December
2015 and February 2016. Sarcopenia was diagnosed using the
European Working Group on Sarcopenia in Older People (EWGSOP)
consensus criteria. Items from the BelRAI Acute Care instrument,
expected to be associated with muscle status, were compared between
patients with or without sarcopenia. Parameters with significant
results were combined in a predictive score.
Results:
120 patients had muscle mass assessment. Low muscle mass
showed a significant relationship with BelRAI items: dyspnea, scale
and CAP for communication, capability of understanding others, of
emotional expression, and incoherent speech. Gait speed could not
be assessed in 22 of the 120 patients (18.3%). Among the remaining
98 patients 14.3% were diagnosed with sarcopenia and 56.1% with
severe sarcopenia. Only 5 patients with sarcopenia were detected on
a combination of slow gait in the presence of normal strength. The
prediction of (pre-)sarcopenia based on BelRAI items, would be
correct in 78.6% of the cases, with a high sensitivity (96.5%), but very
low specificity (29.0%).
Conclusion:
The BelRAI Acute Care instrument items analyzed in this
study cohort, did not allow construction of an efficient screening tool
for sarcopenia. Gait speed has a low input in the acute setting.
P-684
Hospitalisation of older people with diabetes after admission to
emergency department: the patient journey
I. Bourdel-Marchasson, N. Andreu, M. Wegne Wabo, F. San-Galli,
B. Nicolesco-Catargi.
CHU Bordeaux, Université Bordeaux, Collège
d
’
endocrinologie
–
diabétologie
–
nutrition du Sud Ouest
Objective:
To describe in real life the older patient with diabetes
journey after unplanned hospitalisation.
Methods:
Multicenter prospective observational study (3 emergency
departments) during 6 months including patients with diabetes older
than 75 years. Inclusion criterion was hospitalisation after the emer-
gency department. Subjects were describing according to: reasons for
admission, home living, functional dependency, comorbidities, treat-
ments, care journey, and living place one month after discharge.
Results:
90 patients (85.1 y, interquartile interval Q1 ; Q3 [80 ; 90], 46
M). Among them 85.1% were home-living with care giver, familial or
professional in 48.3%. Main reasons for admission were stroke (3),
delirium (5), alteration of general condition (16), falls (11). Their health
status was poor: 18.7% were undernourished and 59.4% at risk for
malnutrition, 82.4ù were ADL dependent and 100% IADL dependent,
97.4% had macrovascular complications. The questionnaire recorded
dementia or cognitive troubles in 14.0%, renal insufficiency in 26.7%,
COPD in 3.0%, and a cancer in 17.8%. The distribution of usual anti-
diabetic treatment was: none in 18.2%, oral treatment in 55.6% and
insulin in 37.8%. During hospitalisation the treatment was stopped or
decreased in 7 subjects due to over-treating and increased in other 7
patients. During follow-up 31 patients were deceased. The mean
length of stay was 14.3 days including 43% hospital transfers.
Discharge to rehabilitation unit concerned 5 patients. One month
after discharge 2 patients were newly admitted in nursing homes.
Conclusion:
patients with diabetes with unplanned hospital admis-
sion had a very poor health status with severe comorbidity and
frequent over-treatment. They suffer of high mortality rate. This study
has benefited from financial support from SANOFI-AVENTIS France
P-685
Osteoporosis in adults with Down
’
s syndrome
A. Carfì, V. Brandi, R. Bernabei, G. Onder.
Catholic University of the
Sacred Heart, Rome, Italy
Background:
Increased life expectancy in persons with Down
Syndrome (DS) is associated with premature age-related changes. A
high prevalence of osteoporosis is reported in these subjects. It has
been hypothesized that in this special population reduced height
could lead to overdiagnosis of osteoporosis. Some authors thus suggest
to adjust the bone mineral density (BMD) for height in patients
with DS (BMD/h). Aim of the present study was to define age related
modifications in BMD of persons with DS and the prevalence of
osteoporosis in this population.
Methods:
Participants were 198 adults with DS, aged 18 or older,
assessed at the geriatric day hospital of our institution. Individuals
received a comprehensive clinical assessment, including BMD assess-
ment by DEXA. Data were compared to BMD measurements in
NHANES wave 2009
–
2010. Both BMD and BMD/h were used in the
study of the age related modifications in bone density and of the
prevalence of osteoporosis.
Results:
Mean age was 36.8 ± 11.8 years with 55.1% females. In all age
groups, when compared to NHANES subjects, DS individuals showed a
significantly lower BMD in the neck of femur; conversely, in the
lumbar spine, BMD didn
’
t differ significantly. Osteoporosis was highly
prevalent in the sample, being present in 67 (33.8%) individuals
when calculated using BMD. Importantly, when calculations were
conducted using the BMD/h adjustment, prevalence dropped to 10.6%
(21 subjects).
Conclusions:
Adults with DS show high prevalence of early onset
osteoporosis. Diagnostic criteria should be critically reviewed in this
special population.
P-686
T-cell lymphoma disguised as depression
–
a case report of
constitutional syndrome
C. Graca, R. Martins, M. Pacheco, F. Rocha, M. Moitinho, E.D. Haghighi,
J. Barata.
Hospital Vila Franca de Xira
Introduction:
Geriatric Medicine deals with the complex medical
and psychosocial problems of older adults. It has special knowledge of
the aging process and significant skills in the diagnostic, therapeutic
and preventive aspects of illness in the elderly. Case Report: We
present the case of an independent 83-year-old female with prior
history of arterial hypertension, congestive heart failure, coronary
arterial disease, hypothyroidism and dyslipidemia. She had been
assessed by different physicians for a 6 month history of unspecific
symptoms: fatigue, anorexia, involuntary weight loss, nausea, vomit-
ing, anxiety, frequent falling and generalized pain. The diagnosis of
Depressive Syndrome was assumed after an inconclusive laboratory
and radiologic assessment. She was medicated with 12 different
drugs, with no symptomatic improvement. She was finally referred
to our Geriatric Department for investigation of this constitutio-
nal syndrome. We performed a multidisciplinary evaluation and a
Comprehensive Geriatric Assessment that detected several Geriatrics
syndromes, and submitted the patient to a full complementary
diagnostic work-up, including an osteomedullary biopsy that revealed
T-cell lymphoma. She was referred urgently to a hematologist.
Conclusion:
In response to the rapidly aging population, Geriatric
Medicine has emerged as an area of Medicine focusing on the
treatment of disease and disability in later life. The constitutional
syndrome in elderly patients often is correlated to psychiatric diseases,
Poster presentations / European Geriatric Medicine 7S1 (2016) S29
–
S259
S209