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

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Methods: Research in PubMed, National Guideline Clearinghouse and
Cochrane for meta-analyses (MA), systematic reviews (SR), rando-
mized controlled clinical trials, observational studies (OS) and clinical
guidelines, published in the last five years, using the MeSH terms
“depression” and “dementia”. Strength of Recommendation Taxonomy
(SORT) scale was used to assign levels of evidence and strength of
recommendations.
Results: Of the 138 articles obtained, three MA, one SR and one OS met
the inclusion criteria. All included studies evaluated the risk of
dementia in individuals with depression and found a statistically
significant increase of dementia incidence. MA compared the risk of
dementia of any cause, Alzheimer’ s disease (AD) and vascular
dementia (VD), and two MA showed a significantly higher risk for
VD. One MA and one OS also had mild cognitive impairment (MCI) as
an outcome in depressed individuals – the MA showed a higher
incidence of MCI, while in the OS depression wasn ’t associated with
incident MCI, but participants with MCI and depression had twice the
risk of progression to dementia.
Conclusions: Available evidence shows an increased incidence of
dementia in depressed individuals (SORT A). We need studies with
more homogeneous methodology, regarding diagnosis criteria and
confounding factors such as vascular risk factors and characteristics of
depression.
P-098
The DONDA STUDY (DONepezil and vitamin D in Alzheimer ’ s
disease)
A. Castagna1, C. Ruberto1, G. Ruotolo2, P. Gareri1. 1Ambulatory for
Cognitive Disorders, Catanzaro Lido and Chiaravalle-Soverato, ASP
Catanzaro; 2Geriatric Unit, Azienda Ospedaliera “Pugliese-Ciaccio”,
Catanzaro, Italy
Introduction: Aging is associated with a large increase in the
prevalence of hypovitaminosis D. Its possible role in the pathogenesis
of Alzheimer ’s disease (AD), the leading cause of dementia in the
elderly, is particularly important. We hypothesized that the com-
bination of donepezil with vitamin D could be neuroprotective in AD.
The aim of this trial is to compare the effectiveness of one year oral
intake of vitamin D3 plus donepezil vs patients receiving donepezil
alone in patients suffering from mild-to-moderate AD.
Methods: This was a retrospective study, performed on 196 patients,
mean age 81,37 ± 4,61 years (M 29%) attending our Geriatric
Outpatient Clinics with diagnosis of AD. Patients aged 65 years and
older presenting with mild-to-moderate AD, hypovitaminosis D
(serum 25(OH)D < 30 ng/mL), normocalcemia and being treated with
donepezil were recruited. The vitamin D group (case) was composed of
103 patients, mean age 82,01 ± 3,97 years. The control group consisted
of 93 patients, mean age 80,67 ± 5,17 years. All case received vitamin
D3 (25.000 IU orally every week). MMSE, ADL, IADL, GDS, NIP were
assessed at baseline, 6 (T1) and 12 months (T2), together with the
serum concentrations of 25(OH)D, calcium and parathyroid hormone.
Results: A significant difference in MMSE was found between the
study and control groups, at T1 and T2 (T115,39 ± 2,99 vs 13,77 ± 3,05;
T2 15,51 ± 3,12 vs 13,79 ± 3,03).
Key conclusions: The DONDA Study showed that taking vitamin D
supplementation offers significant advantage in cognitive perform-
ance in AD patients treated with donepezil. The combination of
donepezil plus vitamin D may represent a new multi-target thera-
peutic class for the treatment of AD.
P-099
Could that fall have been a syncope? Data from a multicenter study
on older subjects with dementia
A. Ceccofiglio 1, E. Mossello1, M. Rafanelli1, A. Riccardi1, C. Mussi2,
G. Bellelli3, A. Marengoni4, M. Bo5, D. Riccio6, A.M. Martone7,
A. Langellotto 8, E. Tonon9, G. Noro 10, P. Abete11, A. Ungar1. 1Geriatric
Cardiology and Medicine, University of Florence and AOU Careggi,
Florence, 2Chair of Geriatrics, University of Modena, 3Acute Geriatric Unit,
San Gerardo Hospital, Monza, 4Medicine and Geriatric Unit, Spedali Civili
of Brescia, 5Geriatric Department, Molinette Hospital, Turin, 6Geriatric
Department, SS. Trinità Hospital, Cagliari, 7Department of Geriatrics,
Catholic University of the Sacred Heart, Rome, 8S. Maria di Ca” Foncello
Hospital, Treviso, 9Geriatric Department, S. Jacopo Hospital, Pistoia,
10Geriatric Unit, Santa Chiara Hospital, Trento, 11Department of
Translational Medical Sciences, University of Naples, Federico II, Italy
Objectives: The “Syncope & Dementia (SYD) registry” is a multicenter
observational study of syncope in dementia. The present analysis
is aimed at identifying predictors of differential diagnosis between
fall and syncope, focusing on the characteristics of patients with
unexplained falls.
Methods: We have included 372 patients, evaluated according to the
European Society of Cardiology guidelines on syncope. We have
compared patients with “Confirmed Syncope” (CS, n = 199), in whom
the initial suspect of syncope was confirmed, patients with “Syncopal
Fall”, (SF, n = 84) in whom subjects presented with an unexplained fall
and a diagnosis of syncope was performed, and “Non-Syncopal Fall”
(NSF, n = 89), in whom a diagnosis of syncope was excluded at the end
of the diagnostic work-up.
Results: The three groups did not differ according to age (mean 84)
and gender (61% females). The Mini Mental State Examination score
was significantly higher among patients with SF (18.5 ± 4.9) compared
to CS (16.5 ± 5.5, p = 0.016) and NSF-patients (15.6 ± 5.8, p = 0.02). In a
multinomial logistic regression model taking NSF as reference group,
CS patients experienced less injuries and reported more prodromes,
and SF had a better cognitive status and more precipitating factors
(including postural changes, neck movements, pain, fear). The intake
of benzodiazepines and insulin was highest in NSF-patients compared
to the other two groups.
Conclusion: An unexplained fall in a dementia patient can suggest
the diagnosis of syncope in the presence of precipitating factors.
Conversely, treatment with benzodiazepines or insulin and a worse
cognitive status predict a not-syncopal episode.
P-100
Association between neuropsychiatric symptoms and
neurocognitive disorders
C.M. Chimbi1, D.A. Chavarro-Carvajal1,2, M.G. Borda1,3, R.A. Samper1,
J.M. Santacruz1,2. 1School of Medicine, Aging Institute, Pontificia
Universidad Javeriana (PUJ) Bogotá, 2Hospital Universitario San Ignacio,
Bogotá, 3Semillero de Neurociencias y Envejecimiento, Facultad de
Medicina, Pontificia Universidad Javeriana (PUJ) Bogotá, Colombia
Introduction: The purpose of this study was to evaluate the
association between the major neurocognitive disorder (any etiology
(MND) and due to Alzheimer’s disease (MNDA)) and minor neuro-
cognitive disorder (minor ND) with neuropsychiatric symptoms in
patients evaluated in the center of cognition and memory-Intellectus
Hospital Universitario San Ignacio (HUSI) in Bogota – Colombia.
Methods: It is an analytical cross-sectional study with patients
evaluated in the center of memory and cognition “HUSI–Intellectus”.
The diagnosis of neurocognitive disorder was made between January
1st of 2015 and December 31st of 2015; through an interdisciplinary
evaluation (geriatrics, psychiatry, neurology and neuropsychology).
Results: 507 patients were collected with a diagnosis of neurocogni-
tive disorder; 79 were diagnosed with MND and 428 with minor ND
with an average age of 71.64 and 75.32 years respectively (p < 0.001).
Female sex was more prevalent (56.96% in minor ND and 63.73%
in MND). Neuropsychiatric symptoms were present at 71.73% in MND
vs. 13.92% in minor NCD. MND was associated with the presence
of affective lability, irritability, apathy, paranoia and aggressiveness
(p < 0.005), MNDA with affective lability, irritability, sadness and
depression (p < 0.005), and minor ND was associated with the
presence of apathy (p < 0.005). An adjusted logistic regression model
by age, sex and functionality with neuropsychiatric symptoms and the
presence of MND and MNDA showed OR of 13,89 (IC7,8– 24,75,
p < 0.001), and OR 2,4 (CI 1.59 to 3.6, p < 0.001) respectively.
Poster presentations / European Geriatric Medicine 7S1 (2016) S29–S259 S54