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

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Results: The sample of 30 enrolled subjects (mean age 73, 50%
females, mean HbA1c 48 mmol/mol) showed an inverse correlation
between Glp-1 and neuropsychological performance: peak levels
were inversely related to verbal fluency test (Rho = −0.045, p = 0.014)
and IAUC to prose memory test (Rho = − 0.432, p = 0.017). Higher
Glp-1 values were associated with lower serum levels of 25-OH
vitamin D (Rho = −0.397, p = 0.045) and worse physical performance
(Rho = −0.435, p = 0.016). Among 19 subjects who completed follow-
up, baseline Glp-1 correlated with decline Trail Making Test A (fasting:
Rho = 0.623, p = 0.004; peak: Rho = 0.507, p = 0.027).
Conclusions: In this study of older adults with T2DM, higher Glp-1
unexpectedly correlated with a worse cognitive performance, both in
cross-sectional and in longitudinal analysis, and a greater physical
frailty. We hypothesize a possible compensatory increase of Glp-1 in
these subjects.
P-112
Access to timely formal care in dementia: baseline results of the
Actifcare cohort study with a focus on the Portuguese sample
M. Gonçalves-Pereira 1, M. de Vugt2, B. Woods3, H. Jelley3, R. Handels2,
M.J. Marques1, C. Balsinha1, A.S. Machado1, T. Reis1, L. Alves1,
J. Guimarães 1, A. Fernandes1, M. Caldas de Almeida1, B. Barahona-
Corrêa 1, H. Bárrios1, A. Verdelho4, C. Wolfs2, G. Meyer5, A. Stephan5,
A. Bieber 5, A. Wimo6, A. Sköldunger6, G. Selbaeck7, J. Røsvik7, K. Irving8,
L. Hopper 8, O. Zanetti9, E. Portolani9, M. Orrell10, F. Verhey 2, on behalf
of the Actifcare EU-JPND Consortium. 1CEDOC, NOVA Medical School/
Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Portugal;
2Department of Psychiatry and Neuropsychology, Maastricht University,
Maastricht, The Netherlands; 3Bangor University, Wales, United Kingdom;
4Department of Neurosciences (Neurology), Hospital de Santa Maria/
CHLN, University of Lisboa, Portugal; 5Institute for Health and Nursing
Sciences, Martin Luther University Halle-Wittenberg Medical Faculty,
Halle, Germany; 6KI Alzheimer ’s Disease Research Center, Dep.
Neurobiology, Care Sciences & Society, Karolinska Institutet, Stockholm,
Sweden; 7Norwegian Advisory Unit on Ageing and Health, Tonsberg,
Faculty of Medicine, University of Oslo, Oslo, Norway; 8School of Nursing
and Human Sciences, Dublin City University, Ireland; 9Alzheimer’ s RU-
Memory Clinic, ‘Centro S. Giovanni di Dio’, Fatebenefratelli, Brescia, Italy;
10Institute of Mental Health, Nottingham University, Nottingham,
England, United Kingdom
Introduction: Persons with dementia (PwD) and their informal carers
have unmet needs, partly related to untimely access to services (e.g.
day care, home support). We lack international comparisons on
how these issues impact on quality of life, namely in the interme-
diate stages of dementia. The Actifcare (ACcess to Timely Formal Care)
EU-JPND project aims to evaluate access to and (non)utilization of
dementia formal care in eight countries (The Netherlands, UK,
Germany, Sweden, Norway, Ireland, Italy, Portugal), as related to
unmet needs and quality of life.
Methods: Besides conducting reviews on access/utilization of services
and qualitative explorations of PwD, carers and professionals ’ views,
Actifcare includes a prospective study (one year follow-up) of PwD
and their informal carers. Assessments include the Camberwell
Assessment of Need for the Elderly and QoL-AD. We describe the
baseline characteristics of our cohort, focusing on Portuguese data
(FCT-JPND-HC/0001/2012).
Results: We recruited 453 dyads (n = 66 in Portugal), generally
interviewed at home. PwD were mostly women (54%), aged 47 –98
years; Alzheimer ’s disease was the most frequent diagnosis (48%).
Carers were spouses (60%), women (66%), mean age 66 (SD = 14) years.
In Portugal, recruitment took place in primary care, neurology and
psychiatry outpatient services, NGOs and Alzheimer Portugal.
Conclusions: The cohort study is being successfully conducted. By
mid-2016, we will start to analyse international differences regarding
the (un)timely access to services and its impact on quality of life and
needs for care. Some differences amongst countries are already
becoming apparent. We hope to contribute significantly to best
practice recommendations in dementia.
P-113
The 10/66 DRG prevalence study of dementia and old age
depression in Portugal
M. Gonçalves-Pereira1, A.M. Cardoso1, A. Verdelho2, J.A. da Silva 1,3,
C. Raminhos1, A. Fernandes5, M.C. Almeida4, M. Prina6, C.P. Ferri6,7,
M. Prince6, M. Xavier1. 1CEDOC, NOVA Medical School/FCM, Univ. Nova
Lisboa, 2Dep. Neurosciences, H. Santa Maria/CHLN, Univ. Lisboa,
3Champalimaud Centre for the Unknown, Lisboa, 4S.C. Misericórdia de
Mora, UMP, 5ACES Almada-Seixal, USF Fernão Ferro mais, Portugal; 6IoP,
King’s College London, UK; 7Federal Univ. S. Paulo, Brasil
Introduction: Dementia and old age depression represent a high
burden of disease for individuals, their families and society as awhole.
In Portugal, epidemiological studies are scarce in this area, and health
policies lack adequate evidence-base. The 10/66-Dementia Research
Group (DRG) population-based research programmes
yielded high-quality studies on the prevalence and/or
incidence of dementia (and elderly depression) in developing
countries. Given the feasibility of the 10/66-DRG assessments, which
are education and culture fair, in low literacy populations, we aimed to
conduct the first 10/66-DRG prevalence study in Portuguese settings.
Methods: A cross-sectional comprehensive one-phase survey was
implemented of all residents aged 65 and over of defined catchment
areas in southern Portugal (Fernão Ferro and Mora). Assessments
included a cognitive module and the Geriatric Mental State-AGECAT
(GMS), including the EURO-D scale. Reliability training was conducted
with 10/66-DRG’s supervision, and pilot studies ensured the feasibility
and preliminary validity of the protocol.
Results: We interviewed 1481 elderly participants. The prevalence
rate of dementia, according to the 10/66-DRG algorithmwas 9.6 (95%CI
8.2–11.3). The prevalence rate of EURO-D depression was 18.4 (95%
16.5–20.6).
Conclusions: 10/66-DRG dementia prevalence in this sample was
higher than DSM-IV dementia prevalence in a previous Portuguese
study, and GMS depression was more prevalent than expected.
Although our results must be interpreted with caution, this survey
provides real community prevalence data for dementia and depression
in Portuguese elderly populations.
Acknowledgement: Research grant FCT (PTDC/SAU-EPI/113652/2009).
P-114
Sporadic form of Creutzfeldt Jacob disease
K. Goossens, R.L. van Bruchem-Visser. Erasmus MC
We present a 65 year old man who was admitted to the internal
department because of rapidly progressive cognitive disorders, ataxia
and visual loss. He used to drink 6 consumptions of alcohol a day and
he used to drink much more in the past. With physical examination
there was a n. abducens paresis on the right side and cerebellar ataxia.
We made the diagnosis of an acute Wernicke’s encephalopathy
and treated him with high dose of thiamine. The visual loss and
ataxia diminished and he went home with thiamine supplementation
to recover. Unfortunately, 6 weeks later the cognitive impairment
became worse and the patient was not able to eat or speak. There was
again ataxia, abducens paresis and hypertonia of the muscles. The
vitamin B1 levels (taken before thiamine supplementation) appear to
be normal. This ruled out the diagnosis of Wernicke’ s encephalopathy.
The differential diagnoses were a space-occupying lesion in the brain,
(limbic) encephalitis or Creuztfeldt Jacob’s disease (CJD). Examination
of the liquor puncture showed no abnormalities, besides an increased
14-3-3 protein. Meanwhile, the clinical situation of the patient
progressively decreased and he developed mutism and myoclonus of
the muscles. At that time we diagnosed CJD and the patient died the
day after. Autopsy of the body showed prion-protein depositions in
serveral regions of the brain, which made the diagnosis “ sporadic
form of Creutzfeldt Jacob disease”.
Poster presentations / European Geriatric Medicine 7S1 (2016) S29–S259 S58