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Oral presentations

Area: Frailty and geriatric syndromes


Quantitative calcaneal ultrasonometry: normative data and age-

related changes for stiffness index in the Italian population

A. Giusti


, P. Serpi


, A. Cardetta


, A. Barone


, S. Maggi


, A. Pilotto




Department of Geriatric Care, Ortho-Geriatrics and Rehabilitation,

Galliera Hospital, Genova,


Caresmed SRL, Milan,


National Council for

Research (CNR), Neuroscience, Aging Section, Padua, Italy


Quantitative ultrasound (QUS) is a reliable technique to

evaluate skeletal status and estimate fracture risk. The aims of this

study were to generate QUS normative data for the Italian population

(Lunar Achilles Express-II), and to evaluate QUS usefulness in defining

osteoporosis prevalence.


This is an ongoing, cross-sectional study undertaken in nine

Regions from the North, Centre and South of Italy, in subjects aged


years. The recruitment was made by general practitioners and

pharmacists. The QUS parameter Stiffness Index (SI) was measured.

T-scores and Z-scores were calculated using manufacturers


We studied age-dependent changes in SI, and proportions of subjects

presenting with T-score <



We enrolled 26,619 subjects (1,084 males). Mean age ± SDwas

60 ± 11 years (age range 20

89). Mean value of SI was greater in males

compared to females (P < .001). In the overall population, the mean SI

decreased progressively with age by 30,5% (31,6% in females). An

inverse correlation between SI and age was found (r =

0.373, P < .001)

in the overall population, as well as in subgroups defined by gender.

The 16% of females and 12% of males presented with a T-score <


The respective figures in subjects aged >50 years were 19% and 14%.

The prevalence of T-score <

2.5 peaked in the sixth decade in females

and in the seventh decade in males.


The results of this ongoing study may serve as reference

normative data for the Italian population. These results confirm the

usefulness of QUS measurements as a screening tool for detecting

individuals at risk of fractures.


Risk of cardiovascular disease morbidity and mortality in frail and

pre-frail elderly people: results from a meta-analysis

N. Veronese


, E. Cereda


, B. Stubbs


, M. Solmi


, C. Luchini


, E. Manzato



G. Sergi


, C.U. Correll


, S. Maggi




University of Padova, Padova,


Nutrition and Dietetics Service, Fondazione IRCCS Policlinico San Matteo,

Viale Golgi, Pavia, Italy;


Physiotherapy Department, South London and

Maudsley NHS Foundation Trust, London, UK;


University of Verona,

Verona, Italy;


The Zucker Hillside Hospital, Psychiatry Research, North

Shore - Long Island Jewish Health System, Glen Oaks, Hofstra Northwell

School of Medicine, Hempstead, NY, USA;


National Research Council,

Padova, Italy


Frailty is common in the elderly, but its risk factor status

for cardiovascular disease (CVD) morbidity remains debated. We

aimed to perform a systematic reviewand meta-analysis summarizing

the evidence of frailty and pre-frailty as possible risk factors for CVD in

the elderly.


A major databases search was conducted for studies

comparing data about CVD prevalence or incidence between frail or

pre-frail vs. robust, or frail vs. pre-frail/robust. Datawere extracted by 2

independent reviewers for a random-effects meta-analyses, calculat-

ing odds ratios (ORs) ±95% confidence intervals (CIs) for CVD

prevalence from cross-sectional studies, or pooling the most adjusted

hazard ratios (HRs) for time until CVD in longitudinal studies

(obtained from study authors according to a pre-defined list of

covariates). The primary outcomes were the prevalence and incidence

of CVD by frailty status. As secondary outcomes, specific CVDs and CV

mortality were considered.


Out of 8,953 hits, 19 studies (n = 31,734, age = 75.4 ± 6.5 years:

frail = 4,536, pre-frail = 7,529, robust = 6,964) were meta-analyzed.

Compared to robust participants, frail (studies = 11; OR = 3.30; 95%

CI = 2.35

4.63, I2 = 78%) and pre-frail participants (studies = 11;

OR = 1.56; 95%CI = 1.27

1.92, I2 = 72%) had a significant higher preva-

lence of CVD in cross-sectional studies. Similarly, frail had higher CVD

risk than pre-frail/robust participants (studies = 17; OR = 2.04; 95%

CI = 1.52

2.75, I2 = 89%). After a median follow-up of 4.4 (range =


11.4) years, five studies reported a shorter time to CVD onset for

frailty (HR = 1.64; 95%CI:1.18

2.26; I2 = 55%) and pre-frailty (HR = 1.29;

95%CI = 1.06

1.56; I2 = 58%) as well as time to CVDmortality compared

to robustness.


Frailty and pre-frailty constitute addressable risk factor

for CVD in older people.


Frailty associates with accumulation of geriatric syndromes and

progresses with walking unsteadiness

K. Kozaki, M. Tanaka, H. Koshiba, K. Nagai.

Department of Geriatric

Medicine, Kyorin University School of Medicine, Tokyo, Japan


Edmonton Frail Scale (EFS, Age Ageing 2006) is a well-

balanced frail measure, which is composed of 9 domains, 17 points in

total. In this study, we evaluated EFS in the outpatients to the memory

clinic to identify the characteristics of the frailty and find out the

progression factor of frailty.


Subjects were outpatients to the memory clinic of Kyorin

University Hospital (n = 332, average age 80.5 y/o). We evaluated EFS,

presence of geriatric syndromes (14 items), physical&functional

measures such as handgrip strength, gait speed and balance ability,

MMSE, and others.


The average EFS point was 4.0 ± 2.3 (Mean ± SD). EFS

paralleled positively with age (r = 0.20), timed up&go (r = 0.49), and

negatively with MMSE (r =

0.26), handgrip strength (r =

0.21), gait

speed (r =

0.38). When we graded the EFS 5 levels (I to V), the

prevalence was I 56%, II 29%, III 12%, IV and V 3%. In the grade analysis,

we found that the number of geriatric syndromes increased stepwise

with the EFS grade. In the longitudinal study, 32 patients (54%), whose

initial EFS grade was I or II, were found to have made a progress in the

EFS grade. Between the EFS progressed (PR) and not progressed (NP)

group, tandem gait was poorer in the PR group (3.2 ± 3.0 vs 5.5 ± 3.4

steps), which was statistically significant by the logistic regression

analysis after adjusting for other gait parameters (odds ratio = 0.66).

European Geriatric Medicine 7S1 (2016) S1 S27

Available online at

1878-7649/© 2016 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.