69 / 290
Results:
The majority of subjects were in group I (53.9%), followed
by group II (23.3%), group III (14.0%), and group IV (8.8%). There were
no correlations between metformin use and dementia status, MMSE,
and IADL scores. After adjusting age, sex, BMI, MMSE scores, and
HbA1C levels, metformin use was not associated with dementia risk
(OR = 0.794; CI: 0.230
–
2.737; p = 0.715). When analyzing subjects
without dementia, therewere no differences in MMSE and IADL scores
among metformin users vs. non-users (p = 0.901 and p = 0.683,
respectively).
Conclusion:
In the analysis of older adults with T2DM, metformin use
was not associated with dementia risk. Further studies are warranted
to clarify inconclusive results.
P-131
Rates of capacity assessment in consent processes are low despite
high rates of cognitive impairment in older patients undergoing
emergency surgery
K. Nichol
1
, E. Dobell
2
, S. Pendlebury
3
.
1
Oxford University Hospitals NHS
Foundation Trust,
2
Oxford School of Public Health,
3
Stroke Prevention
Research Unit, Nuffield Department of Clinical Neurosciences, Oxford,
United Kingdom
Introduction:
Cognitive screening is recommended in the UK for older
people (
≥
75 years) with unplanned hospital admission and should
inform individualised patient care including the need for a capacity
assessment in those undergoing procedures. We therefore undertook
an audit to determine the number of older cognitively impaired
patients in the emergency surgery unit and whether capacity to
consent was documented.
Methods:
Consecutive patients
≥
75 years admitted to the Oxford
University Hospitals general surgical emergency unit between August-
September 2015 had the abbreviated mental test score (AMTS/10),
and documentation of previous dementia diagnosis using a validated
proforma. Procedures and details of the consent process were
recorded. Cognitive impairment was defined as AMTS
≤
8 or known
dementia.
Results:
Among 102 patients (mean age/SD = 83.6/5.1 years), 22/97
with AMTS scored
≤
8 and 15 had dementia (4 had AMTS > 8, and 4 not
tested). Reasons for AMTS non-completion included dysphasia,
deafness and severe dementia. In the 30 cognitively impaired patients,
12 (40%) underwent a surgical procedure inwhom only 2 (17%) had an
appropriately documented consent process: 10 had signed a standard
consent formwith no recorded capacity assessment. In the remaining
2 patients, a best interests from was correctly completed.
Conclusion:
Rates of cognitive impairment in older emergency
surgical patients are high yet there is often failure to take into
account the need for a capacity assessment before completion of
informed consent. Better staff education and the insertion of a prompt
on consent forms may help improve the validity of the consent process
in older patients.
P-132
Gender difference in the association between body weight and
cognitive function in older adults
Hong-Ji Song, Kyung lae Kim, Yong Kyun Roh.
Hallym University Sacred
Heart Hospital/Goseong-gun Hyeonnae Branch Office of the Community
Health Center/Kangnam Sacred Heart Hospital
Introduction:
The prevalence of cognitive dysfunction in the aging
population has been increasing, and so the cost of caring for thosewith
cognitive dysfunction has also increased. Previous studies reported
mixed results regarding the association between cognition and body
weight in late life. The objective of this study was to clarify the
relationship between body weight and cognitive function in Korean
elderly.
Methods:
Study subjects included 8,979 aged 65 years or older from
the Survey of Living Conditions and Welfare Needs of Korean Older
Persons that was conducted by the Korea Institute for Health and
Social Affairs (KIHASA) in 2011. The investigation was composed of
Mini-Mental State Examination Korean version (MMSE-KC), ques-
tionnaires, anthropometric measurements. Body weight status was
measured by bodymass index (BMI) was calculated as the body weight
divided by the height in meters squared (kg/m
2
).
Results:
In multiple logistic regression analysis, gender differences
were observed in the association between body mass index and
cognitive impairment. Compared with normal weight group (18.5
≤
BMI < 23 kg/m
2
), underweight males (BMI < 18.5 kg/m
2
) and over-
weight females (23
≤
BMI < 25 kg/m
2
) have lower risk for cognitive
impairment (OR: 0.67, 95% CI 0.48
–
0.94, OR: 0.75, 95% CI 0.61
–
0.92).
Key conclusions:
Underweight men and overweight women might
have benefit for cognitive function. Further prospective studies are
warranted to establish the optimal body weight for maintaining
cognitive function in the elderly people.
P-133
A nationwide survey of dementia patients admitted to psychiatric
hospitals for behavioral and psychological symptoms of dementia
in Japan
H. Okamura
1
, S. Ishii
2
, T. Ishii
3
, K. Fuchino
4
.
1
Institute of Biomedical &
Health Sciences, Hiroshima University, Hiroshima,
2
Department of
Geriatric Medicine, Graduate School of Medicine, University of Tokyo,
Tokyo,
3
Medical Corporation Tijinkai, Maple Hill Hospital, Otake, Japan,
4
Medical Corporation Fuchinokai, Green-Hill Health Hospital, Oita, Japan
Objectives:
To identify the risk factors preventing discharge of
dementia patients newly admitted to psychiatric hospitals equipped
with dementia units for management of the behavioral and psycho-
logical symptoms of dementia (BPSD), a nationwide prospective
cohort survey in Japan was conducted.
Methods:
The subjects were patients with dementia admitted to
psychiatric hospitals for BPSD and their caregivers. The patient
characteristics, the caregivers
’
sense of burden and depressive states
were assessed at admission. The patients
’
cognitive function (Mini-
Mental State Examination), delirium (Confusion Assessment Method),
depressive states (Cornell Scale for Depression in Dementia), course of
BPSD (Neuropsychiatric Inventory), treatment and care provided
during hospitalization, including those for physical illnesses, etc.,
were also assessed 2, 4 and 6 months after admission using a
questionnaire and interview.
Results:
A total of 229 hospitals (52.8% of the psychiatric hospitals
with dementia units in Japan) provided consent for participation in the
study, and patients were enrolled from 138 hospitals. At the
completion of patient enrollment in March 2016, 456 patients had
been completely assessed and 185 were being assessed (a total of 641
to be assessed). The data obtained are being sorted to create a
database.
Conclusion:
After finishing the data collection, we are planning to
conduct multivariate analysis to compare the data of patients who
were discharged early and those of patients who could not be
discharged, in order to clarify the risk factors preventing discharge,
and identify high-risk groups for long-term hospitalization. The
results will be presented at the meeting.
P-134
Caring for people with hip fracture and cognitive impairments:
qualitative findings from the PERFECTED research programme
M. Patel
1
, S. Lee
1
, S. Hammond
2
, C. Fox
2
, F. Poland
2
, N. Lambert
2
,
A. Varley
2
, T. Backhouse
2
, J. Cross
2
, B. Penhale
2
, T. Smith
2
,
D. Donaldson
2
.
1
Norfolk and Norwich University Hospital Trust (NNUH),
2
University of East Anglia (UEA), Norwich, United Kingdom
Introduction:
An ageing population is a global priority, as are
dementia and hip fracture. Older people with dementia who sustain
a hip fracture are at a high risk of serious complications, linked to
delayed recovery and higher mortality post-operatively. Specific care
treatment pathways which acknowledge differences the presentation
and care needs of this complex patient group are proposed to improve
clinical and process outcomes for this population. This poster will
Poster presentations / European Geriatric Medicine 7S1 (2016) S29
–
S259
S63