261 / 290
Recommendation Taxonomy) scale of the American Family Physician
was used to grade the evidence.
Results:
Thirty-seven studies were found. We selected one NGC
guideline, three meta-analysis, four systematic reviews and three
randomized clinical trials. There is consistent evidence of better
quality and efficiency of sleep after treatment with acupuncture when
compared with placebo, hypnotic drugs or sham acupuncture, but
the quality of the studies analyzed was low (level 2). Therefore we
attributed a level B recommendation.
Conclusion:
Although most studies report some improvement of
sleep, the current evidence is not rigorous enough to allow a high
strength recommendation. Therefore we cannot refute or support the
use of acupuncture. Better studies are needed, with larger sample size
and better methodological quality.
P-856
Acute confusional syndrome in hospitalized patients with hip
fracture
M.I. Porras-Guerra
1
, T. Porras-Guerra
2
, M.A. De La Torre-Alonso
3
,
C.E. Benítez-González
1
, M.N. Gómez-Gónzalez
1
.
1
Servicio de Geriatría,
Complejo Asistencial Universitario de León, León,
2
I.E.S. Tomás Bretón,
Villamayor de Armuña, Salamanca,
3
Servicio de Psiquiatria, Complejo
Asistencial Universitario de León, León, España
Delirium is a frequent complication in hospitalized patients.
Objective:
Determining characteristic of admitted patients suffering
from hip fracture and delirium during their hospitalized period.
Material and methods:
Observational, longitudinal and retrospective
study of admitted patients medical records that suffer from hip
fracture and have delirium during hospitalization period. Variables:
sex, age, hospitalized period, domicile, type of delirium, beginning and
duration, associated pathologies and consumed medicines. Tracing: 60
days. Statistical treatment: SPPSv.15.
Results:
n = 66. Males:27,3%. Female:72,7%. Average age 85,1years; no
sex differences. Average stay:14,1days; males 20,5 days; female:12
days. (Double stay for male). Domicile: Family 71,2%, Alone 6,1%,
Residence 22,7%. Delirium: Hyperactive: 66,1%. Hypoactive:16,7%.
Mixed:16,7%. Beginning of delirium:1st day:24,2%, 2nd day:16,7%,
3rd day:13,6%, 4th day:10,6%, 5th day: 1,5%, 6th day:13,6%, 6th
day more than:7,5%. Delirium duration: Average duration: 2,4days.
40,9% 1day. 25,7% 2 days. 10,6% 3 days. 3,6% 4 days, 5 or more days 9%.
Associated pathologies: Average pathologies: 3,1. Hypertension:
66.7%, heart disease: 34,8%, neurological disease: 34,8%, diabetes:
28,8%, dyslipidemia: 25,7%, psychiatric disease: 19,7%. respiratory
disease 10,6%, renal failure:9,1%. Average consumption of drugs:4,8.
Treatment: Surgery: 90,9%. Conservative: 9,1%.
Conclusion:
The most common type is the hyperactive delirium lasts
an average of 2,4 days and is presented in the first 24 hours. The
comorbidity associated with delirium was hypertension, heart and
neurological disease. The patient
“
type
”
with hip fracturewho suffered
delirium during hospitalization is a woman of 85 years with heart
and neurological disease, which has an overactive delirium in the first
24 hours, lives in the family home, taking an average of 4 drugs,
receives surgical treatment and remains hospitalized about 14 days.
P-857
Psychological predictors of the development of impulse control
disorders in Parkinson
’
s disease
A. Powell, Y.Z. Zhuang.
Department of Medicine, The Queen Elizabeth
Hospital (TQEH), Adelaide, Australia
Introduction:
Parkinson
’
s disease is a progressive neurodegenerative
disease affecting the motor systemwith myriad non-motor manifesta-
tions. Impulse control disorders (ICDs) are increasingly recognised as
a complication of Parkinson
’
s disease and, particularly, dopamine
agonist therapy. ICDs involve behaviours that are performed repeti-
tively, excessively and or compulsively to an extent that they interfere
in major areas of life functioning and can have devastating con-
sequences. Examples include hypersexuality, pathological gambling,
punding and dopamine dysregulation syndrome. The aim of this
review is to identify psychological factors that may be predictors of the
development of ICDs in patients with Parkinson
’
s disease. This may
assist clinicians in determining the risk of ICD development when
commencing a dopamine agonist and to advise caregivers and primary
care physicians to be more vigilant.
Methods:
Databases were systematically searched up to 15th April
2016, identifying 23 studies meeting inclusion criteria.
Results:
Significant psychological predictors of the development
of impulse control disorders included impulsivity, novelty seeking
personality traits, alexithymia, mood disorders, anxiety, obsessive
compulsive disorder and higher scores on neuroticism, social
introversion and alienation-self/others on personality inventories.
There was also an association with lower scores on agreeableness and
conscientiousness.
Conclusions:
There is a well-documented association in the litera-
ture between several underlying personality traits and psychiatric
disorders with the development of impulse control disorders in
Parkinson
’
s disease. These factors could be used to predict the
development of ICDs in patients with Parkinson
’
s disease.
P-858
Psychometric properties of Hospital Anxiety and Depression Scale
(HADS) in Iranian older adults
V. Rashedi
1
, M. Foroughan
1
, A. Delbari
1
, H. Nazari
2
.
1
Iranian Research
Center on Aging, University of Social Welfare and Rehabilitation Sciences,
Tehran,
2
Student Research Committee, Hamadan University of Medical
Sciences & Health Services, Hamadan, Iran
Objectives:
Co-morbid symptoms of anxiety and depression in older
adults is associated with more physical and mental health compli-
cations. Late-life anxiety and depression can often be silent, missed
or difficult to diagnose as older adults tend to express their emotions
by body complaints. The present study evaluated the psychometric
properties of Hospital Anxiety and Depression Scale (HADS) in Iranian
older adults.
Methods:
In this methodological study, 230 community-dwelling
older people recruited. Subjects completed Persian version of HADS,
Depression in Old Age Scale (DIA-S), General Practitioner Assessment
of Cognition (GPCOG) along with a socio-demographic questionnaire.
Internal consistency was measured by Cronbach
’
s
α
and reliability
evaluated by test-retest method. Factor structure of HADS was
evaluated by principal component analysis.
Results:
The mean age of the sample was 70.67 ± 9.51 years and 57.4%
were male. Mean score of anxiety and depression were 7.43 (SD:2.51)
and 10.22 (SD:2.81), and the frequency of anxiety and depressive
symptoms were 18.4% and 21.1%, respectively. The Cronbach
’
s
α
for
HADS scorewas 0.844, indicating a high degree of internal consistency.
Factor analysis revealed a two-factor solution that supported the
theoretical construction of the scale. Higher HADS score was associa-
ted with higher DIA-S score and lower GPCOG score that confirmed
concurrent and convergent validity. Significant correlations were
found between age, gender, marital status and schooling and the HADS
scores.
Conclusion:
Persian version of HADS is of appropriate validity and
reliability. It can be used as a screening instrument for anxiety and
depressive symptoms in Iranian older people.
P-859
A quality improvement project to reduce violence and aggression
enhancing patient
’
s sense of safety on an older adult mental health
unit
G. Rodgers, C. Naughton.
NELFT NHS Foundation Trust, Kings College
London, United Kingdom
Background:
A local audit identified that 46% of patients felt unsafe
during their in-patient stay and this was correlated with a high
incidence of violence and aggression on the ward.
Poster presentations / European Geriatric Medicine 7S1 (2016) S29
–
S259
S255