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

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Oral presentations
Area: Frailty and geriatric syndromes
O-01
Quantitative calcaneal ultrasonometry: normative data and age-
related changes for stiffness index in the Italian population
A. Giusti1, P. Serpi2, A. Cardetta2, A. Barone1, S. Maggi3, A. Pilotto1.
1Department of Geriatric Care, Ortho-Geriatrics and Rehabilitation,
Galliera Hospital, Genova, 2Caresmed SRL, Milan, 3National Council for
Research (CNR), Neuroscience, Aging Section, Padua, Italy
Objectives: 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.
Methods: This is an ongoing, cross-sectional study undertaken in nine
Regions from the North, Centre and South of Italy, in subjects aged ≥20
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 ’ software.
We studied age-dependent changes in SI, and proportions of subjects
presenting with T-score < −2.5.
Results: 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 < −2.5.
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.
Conclusions: 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.
O-02
Risk of cardiovascular disease morbidity and mortality in frail and
pre-frail elderly people: results from a meta-analysis
N. Veronese1, E. Cereda2, B. Stubbs3, M. Solmi1, C. Luchini4, E. Manzato1,
G. Sergi 1, C.U. Correll5, S. Maggi6. 1University of Padova, Padova,
2Nutrition and Dietetics Service, Fondazione IRCCS Policlinico San Matteo,
Viale Golgi, Pavia, Italy; 3Physiotherapy Department, South London and
Maudsley NHS Foundation Trust, London, UK; 4University of Verona,
Verona, Italy; 5The Zucker Hillside Hospital, Psychiatry Research, North
Shore - Long Island Jewish Health System, Glen Oaks, Hofstra Northwell
School of Medicine, Hempstead, NY, USA; 6National Research Council,
Padova, Italy
Objectives: 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.
Methods: 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.
Results: 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 =
1–11.4) 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.
Conclusions: Frailty and pre-frailty constitute addressable risk factor
for CVD in older people.
O-03
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
Objectives: 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.
Methods: 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.
Results: 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).
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