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each other when evaluating changes in function in hospitalized

geriatric patients.


Screening for sarcopenia with the BelRAI Acute Care Instrument

B. Sol


, V. Bulens


, C. De Cock


, P. Peters


, S. Lieten


, I. Bautmans



I. Beyer




Geriatrics department, Universitair Ziekenhuis Brussel (UZ



Gerontology Department and Frailty in Ageing (FRIA) Research

Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090

Brussels, Belgium


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.


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.


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%).


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.


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




nutrition du Sud Ouest


To describe in real life the older patient with diabetes

journey after unplanned hospitalisation.


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.


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.


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


Osteoporosis in adults with Down

s syndrome

A. Carfì, V. Brandi, R. Bernabei, G. Onder.

Catholic University of the

Sacred Heart, Rome, Italy


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.


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.


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).


Adults with DS show high prevalence of early onset

osteoporosis. Diagnostic criteria should be critically reviewed in this

special population.


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


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.


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