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

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Results: Almost 22% of study participants had diabetes; among them,
4.0% have not been previously diagnosed. The frequency of previously
diagnosed diabetes was higher, while of undiagnosed diabetes was
lower in females (p < 0.002) than in males (p = 0.029). Diabetes was
more common in younger elderly than in oldest-old aged 85+ years
(p < 0.001); however, in multivariate logistic regression analysis
(MLRA) only BMI remained an independent risk factor for diabetes
(OR = 1.12, 95%CI: [1.10 –1.13], p < 0.001). The frequency of diabetes was
higher among urban than rural dwellers (p = 0.048), it was also related
to marital status in females (p = 0.036) and to the type of work in
males (p = 0.015). MLRA showed that in females BMI (OR = 1.10, 95%CI:
[1.08– 1.12], p < 0.001) andmarital status (OR = 0.41, 95%CI: [0.18–0.94],
p = 0.035), while in males only BMI (OR = 1.15, 95%CI: [1.12 –1.18],
p < 0.001) remained an independent risk factors for diabetes.
Undiagnosed diabetes was more frequent among rural than city
dwellers (p = 0.03). In females its frequency increased as the level of
education decreased (p-for-trend 0.016) but in MLRA only BMI
(OR = 1.06, 95% CI: [1.01–1.11], p = 0.013) and place of residence
(OR = 2.75, 95% CI: [1.52–4.97], p < 0.001) remained an independent
risk factors.
Conclusions: The prevalence of diabetes in 65+ years old population
exceeds 20% but is lower in oldest-old than in younger elderly, and is
modified by socio-economic factors.
P-704
Importance of geriatric assessment in patients with aortic stenosis
candidates to valve replacement surgery
R. Mónica 1, M. Quezada 1, R. Toro2, M. Bidó3, Z. Rivas3, J. Gómez Pavón 3,
R. Ayala1. 1Department of Cardiology, Hospital Universitario Central Cruz
Roja, Madrid, 2Department of Internal Medicine, University Hospital
Puerta del Mar, Cádiz, 3Department of Geriatrics, Hospital Universitario
Central Cruz Roja, Madrid, Spain
Introduction: Aortic stenosis (AS) is a chronic and progressive disease
with a long period of clinical latency. Geriatric objective evaluation
using scales is essential to decide which treatment is the most
appropriate.
Methods: Prospective longitudinal study from June 2014 to April 2016
that included 97 over 75 years old patients with moderate or severe
AS. They underwent biomedical, functional and cognitive assessment
by different geriatric scales and transthoracic echocardiography.
Surgical risk logistics Euroscore scale mortality prediction was
quantified. The relationship between different geriatric scales, severity
of aortic stenosis and Euroscore was performed by linear simple
logistic regression and multivariable analysis.
Results: 52.6% had severe and 47.4% moderate AS. The average age was
86 y (IQR 79 – 90). 69.1%werewomen. 71% were symptomatic. Dyspnea
was the most frequent symptom followed by chest pain 3.1%. 44.4%
had been admitted for heart failure. The Euroscore mortality risk was
18.5 (SD ± 14.96). 98% of patients had a Charlson comorbidity index
(ICH) >3 and 35.1% a modified ICH > 3. 56.4% presented fragility. The
mean Barthel index was 74.1. In the multivariable logistic regression
analysis only functional class and ICH were related to predicting
mortality risk (Euroscore) β 4.69 (p < 0.01 2,45–6.94 IC) and β 4.7
(p < 0.01 CI 2.5 – 6.9).
P-705
Assessment for risk factor for adverse drug reaction in elderly
inpatients
M. Tkeya, A. Simizu, M. Takeda, H. Akasaka, N. Itoh, Y. Takami, Y. Takeya,
K. Yamamoto, K. Sugimoto, H. Rakugi. Osaka University Graduate School
of Medicine Department of Geriatric, General Internal Medicine
Introduction: Many reports show that in elderly adverse drug reaction
(ADR) is more frequency and more happens to be serious cases. So we
need to take care to prescribe medicine to elderly patients. Then
we explored the risk factor for ADR in elderly inpatients.
Methods and materials: This study included 373 consecutive elderly
inpatients(mean age 77.0 ± 7.4, male/female 165/208) from September
2013 to August 2015. We examined comprehensively frequency or the
details of ADR, prescribed medicine, comprehensive geriatric assess-
ment (CGA) and so on.
Results and conclusion: The incidence of ADR was 21% (10.4cases per
1000 inpatients-days, 22cases per 100 inpatients). As the details of
ADR, hypoglycemia, liver dysfunction and bleeding were more
frequent. As the risk medicine of ADR, oral hypoglycemic agent,
antiplatelet agent and anticoagulant went up. By single variable
analysis, we picked up the urgent hospitalization (48cases), poly-
pathia, polypharmacy (mean prescribed medicine: 7.5 kinds of
medicine), degradation of Instrumental Activity of Daily Living
(IADL), hypoalbuminemia and long-duration of hospitalization as the
risk factor for ADR. By multiple-variable analysis, long-duration of
hospitalization affected the occurrence of ADR. Our study showed
that the risk factor for the occurrence of ADR in elderly inpatients by
single variable analysis that we stated abovewas also the phenotype of
frailty which is one of the important problems in the elderly these
days. Sowe suggest that we need intervention for frailty to avoid of the
incidence of ADR.
P-706
Is plasma klotho associated to hemoglobin blood concentration in
elderly? Results from the InCHIANTI Study
E. Talluri, V. Del Panta, G. Sini, D. Cerasuolo, S. Bandinelli. Laboratory of
Clinical Epidemiology, InCHIANTI Study Group, LHTC Local Health
Tuscany Center, Firenze, Italy
Introduction: Klotho is a recently discovered hormone that plays a
role in human aging and aging-related conditions. In animal models
klotho deficiency negatively affect hematopoietic stem cell develop-
ment. In humans, disruption of normal hematopoiesis, an aging-
associated process, results in an increased prevalence of anemia,
which in turn has been associated with with sarcopenia and low
muscle strength in older persons. The objective of this study is to
explore the association between plasma klotho and Hemoglobin (Hb)
concentration in person 65 years old and older in cross sectional
analysis.
Methods: Data from 922 participants at InCHIANTI FU-1 aged ≥65
years old (76.9 ± 7.1 ys old, 56.1%F, 43.9%M). Klotho and Hb variables
were evaluated as continuous measures. Relationships of Klotho and
Hbwere tested in linear regressionmodels adjusted for age and gender
(Model I), chronic diseases (Model II) and multiple potential biological
confounders (Model III).
Results: Even after adjusting for multiple confounders, plasma klotho
was strongly associated with Hb concentration (0.0007, P < 0.001).
Among the other biological confounders, parameters significantly
associated with Hb were folic acid (−0.029, P = 0.025), C-reactive
protein (−0.012, P = 0.008), erythropoietin (−0.041, P < 0.001), RDW
(−0.206, P < 0.001) and vitamin E (0.012, P = 0.029).
Conclusion: Plasma klotho is significantly associated with Hb blood
concentration in older persons. Further studies are needed to elucidate
the potential biological mechanisms by which circulating klotho could
affect Hb blood levels in humans.
Keywords: InCHIANTI; Klotho; Hemoglobin; Aging.
P-707
Can mild to moderate chronic kidney disease lead to anemia?
C. Tchénio. Hopital Paul Brousse
Background: Anemia of kidney disease represents 8 –45% of the
anemia in the elderly. However there are few studies about the
relationship between renal function and anemia in elderly patients.
The main objective of this study was to find the cut-off of creatinine
clearance that leads to anemia. We also analyzed the association of
erythropoietin (EPO) with renal function and hemoglobin (Hb).
Method: Patients were selected from acute and reeducation wards of
the Paul Brousse Hospital, in Villejuif. All participants were eligible for
measurement of blood cell count, reticulocytes, folates, vitamin B12,
ferritin, transferrin saturation, TSH and EPO. We included patients that
Poster presentations / European Geriatric Medicine 7S1 (2016) S29–S259 S214