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Unit of the Basque Country performed a search using Standardized
MedDRA Query “cardiomyopathy” in Eudravigilance database in
February 2015. Secondly, cases affecting PD patients were selected
and further analysed.
Results: Five cardiomyopathy cases in PD patients were found. Mean
age: 70 ± 11.4 years (range 54 –86). All patients were male. Two cases
were notified in Ireland, 1 in France, 1 in Germany and 1 in USA.
Clozapine dose was only known in three of the cases (12.5, 25 and
100 mg/day respectively). Latency was 6 years in one case, unknown in
all the other reports.
Conclusions: Clozapine associated cardiomyopathy is not circum-
scribed to young schizophrenic patients. This potentially fatal adverse
event ought to be considered when prescribing clozapine to elderly
patients, like patients with PD.
P-852
Emotional and social loneliness, and depressive symptomatology
among adults aged over 50
J.E. McHugh Power1–3, C. Hannigan1, P. Hyland3, R. Kenny1, F. Kee2,
B. Lawlor1. 1Institute of Neuroscience, Trinity College, Dublin 2, Ireland;
2Centre for Public Health, Queen’s University, Belfast BT12 6BJ, United
Kingdom; 3National College of Ireland, Mayor Street, Dublin 1, Ireland
Objectives: Previous research indicates that loneliness precedes
depression, but little attention is paid to a putative reciprocal relation-
ship between the two. We investigated whether a putative reciprocal
causative relationship exists between depressive symptomatology,
and emotional and social loneliness.
Methods: Using the data of 301 participants aged 50–83 (62% female)
who partook in two waves of an observational cohort study, we used
cross-lagged panel analysis within a Structural Equation Model to
investigate potential relationships between loneliness and depressive
symptomatology at two time points, controlling for covariates age and
sex. We then analysed data from 5698 participants in the Irish
Longitudinal Study of Ageing, aged 50 –80 (66% female) to investigate
whether depressive symptomatology is associated with changes in
loneliness over time.
Results: Emotional loneliness was predicted by depressive symptom-
atology (beta = 0.280, p < 0.001), but not vice versa (beta = 0.054,
p > 0.05). Social loneliness was also predicted by depressive symp-
tomatology (beta = 0.128, p < 0.001), but not vice versa (beta = −0.038,
p > 0.05). We then investigated whether depressive symptomatology
at baseline predicts a base-free measure of change in overall loneliness
between two time points, and found that it did (beta = 0.004, p < 0.01,
controlling for covariates) although anxiety symptomatology was a
better predictor (beta = 0.331, p < 0.001).
Conclusions: We report that depressive symptomatology precedes
emotional and social loneliness although the link between depression
and changes in loneliness over time is relatively small. Implications for
clinicians treating patients with depressive symptomatology are
considerable, given the deleterious outcomes associated with loneli-
ness in later life.
P-853
Improving the detection of delirium, depression and suspected
dementia in community hospital settings
C. North1,2, G. Russell, Dr2, N. Hayes 1. 1King’ s College, London, 2Bradford
District Care NHS Trust, Bradford, UK
Introduction: Mental health disorders in older people are significant
contributors to poor outcomes for hospital patients. Literature
suggests hospital mental health liaison services must enable general
hospital staff to better detect andmanage the most common disorders.
Methodology: This pilot study introduced a combined screening tool
in community hospitals for delirium, depression and dementia
(the 3Ds). Three PDSA improvement cycles across three community
hospitals over 18 months implemented a 3Ds Triple Screen supported
by formal teaching, supervised practice and clinical pathway guidance
delivered by an older people ’s mental health liaison team. Mixed
methodology included pre- and post-implementation question-
naires gathering nurses’ perspectives on confidence, competence
and knowledge around detection and management of the 3Ds.
Quantitative analysis related to referral rates to the liaison service,
usage of the Triple Screen, incidence rates for the 3Ds and uptake of
appropriate clinical pathways.
Results: Results indicate 50% reduction in referrals to the mental
health liaison team, and incidence rates of delirium (22%), depression
(59%) and dementia (32%) in keeping with UK national estimates for
this population. 75% of nurses reported improved confidence in
detection and management despite initial versions of the tool proving
complex and burdensome. Informal feedback highlighted practice
change towards more discussion with families to establish accurate
clinical histories.
Conclusions: These results justify wider roll-out of the pilot to other
community hospitals and have precipitated tool re-design and process
enhancements derived directly from nurses’ feedback. Greater focus
is required on data quality and quantity to enable improved analysis of
the project effects.
P-854
Depression as a predisposing factor to the low quality of life in
elderly
C.O. Rocha, L.R. Lima, S.S. Funghetto, C.R.G. Volpe, T.C.M.S.B. Rehem,
M.V.G. Costa, W.S. Santos, A.O. Silva, M.M. Stival. University of Brasilia,
Brazil
Introduction: Based the need to understand the determinants of
quality of life (QOL) during aging and increased rates of depression
in the elderly, this study aimed to evaluate the QOL associated with
depression elderly in Basic Health Unit of the Federal District, Brazil.
Method: Quantitative approach, descriptive and cross-sectional with
277 elderly conducted from February to July 2013 used a semi-
structured questionnaire, Geriatric Depression Scale, WHOQOL-OLD
and WHOQOL-BREF. For analysis was used SPSS 20.0. Research
approved by the Research Ethics Committee of SES/DF 194/10.
Results: In the sample prevailed females (63.5%), aged between 60 and
65 years (45.8%), retired (53.4%), married (54.9%) with complete
primary education (73 3%), with income up to one minimum wage
(59.9%), do not live alone (83.4%), non smoker (88.1%), non-alcoholic
(90.3%) and sedentary (61, 7%). Depression was found in 37.2% (95%
CI 31.0–42.6). The highest score of WHOQOL-BREF were Social
Relations (M = 80.91) and worse in the Environment (M = 67.93). In
the WHOQOL-OLD, better QOL was in past, present and future
activities (M = 15.30) and worse Death and Dying (M = 14.56). The
Cronbach’ s alpha showed homogeneity of the domains and facets.
Elderly people with depression had poorer QOL in four domains of
WHOQOL-BREF and the facets of the WHOQOL-OLD (p < 0.001).
Conclusion: Prevention is the best way to help the mental health of
older people and reduce the damage to their QOL.
P-855
Primary insomnia and acupuncture – is there any evidence?
S. Pessoa1, I. Calvinho1, M. Galo1. 1USF Oriente, Lisbon, Portugal
Introduction: Primary insomnia is a common health issue, affecting
10– 20% of worldwide population and its incidence increases with age.
The aim of this study was to assess the evidence for the efficiency of
the treatment of insomnia with acupuncture.
Methods: We performed a survey of clinical guidelines, systematic
reviews, meta-analysis and randomized-controlled trials in Medline,
Cochrane Library and National Guideline Clearinghouse (NGC),
published between January 2009 and May 2016, in Portuguese and
English, using the MeSH terms insomnia and acupuncture. Exclusion
criteria: secondary insomnia, patients with other psychiatric dis-
orders, cancer, ongoing hemodialysis treatment, menopause, studies
that excluded elderly patients, studies that compared different
auricular point prescriptions or stimulations in parallel groups and
evaluation of acupuncture physiological effects. The SORT (Strength of
Poster presentations / European Geriatric Medicine 7S1 (2016) S29–S259 S254