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

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report qualitative findings from the National Institute for Health
Research funded Peri-operative Enhanced Recovery hip FacturE Care of
paTiEnts with Dementia (PERFECTED) research programme which
aims to address this need.
Methods: Using qualitative methods to explore current and best
practice, we will report two interconnected studies reporting findings
from: (1) Ethnographic research, undertaken by both lay and research
observers, in several orthopaedic hospital wards and Emergency
Departments to observe current care practices and (2) A qualitative
multi-methods exploration of stakeholder views of care experiences.
Results and key conclusions: Insights from ethnographic observa-
tions and perspectives from a diverse range of healthcare professionals
will highlight and encourage critical reflections on the systematic and
unsustainable difficulties faced by strained frontline staff.
P-135
Eye tracking exploration in social cognition tasks in patients with
neurodegenerative diseases: preliminary results
K. Polet 1, S. Hesse1, B. Kullmann1, A. Morisot1, S. Louchart de la
Chapelle 1, A. Pesce1. 1Centre Hospitalier Princesse Grace, Monaco
Objectives: It is commonly admitted that facial emotion recognition
and Theory of Mind (ToM) impairments are associated with social
behavior disorders. This kind of disorders are observed in Fronto-
Temporal Dementia (DFT), Dementia of the Alzheimer ’ s Type (DTA)
and Parkinson’ s Disease (PD). Our hypothesis is that patients apply
inappropriate visual exploration strategies to decode the emotions and
intentions of others, explaining misinterpretation of others ’ inten-
tions, and then inappropriate social behaviors.
Methods: This preliminary study, conducted in the Gerontologic
Center Rainier III (Monaco), compares eyes movements in social
cognition tasks in normal elderly people (n = 10), patients with DFT
(n = 3), DTA (n = 3) or PD (n = 3). ToM (understanding of facial
emotions) was explored using the “Reading mind in the eyes” test
and recognition of facial emotions using pictures from the Ekman faces
library. Behavior was assessed with the Neuropsychiatric Inventory.
Finaly, eyes movements were recorded with a Mobile EyeBrain
Tracker ®.
Results: We highlighted a link between social cognition impairments
and atypical eyes behaviors when decoding facial emotions, with a
specific profile for each pathology.
Conclusion: These preliminary results open new perspectives of care,
as explicits technics engaging patients to attend to the eye region of
faces, to assess the effects on social cognition and behavioral disorders
associated with these diseases.
P-136
Caregiving, a source of self-fulfillment
F. Potier1,2, G. Aubouy1, J. Degryse2, M. de Saint-Hubert1,2. 1Department
of Geriatrics, CHU Université Catholique de Louvain, Namur, 2Institute of
Health and Society, Université Catholique de Louvain, Brussels, Belgium
Introduction: Evidence suggests that providing care may have
implications for the caregiver’s own health. In spite of the numerous
existing instruments to assess the burden for the caregivers, only the
Caregiver Reaction Assessment (CRA) measures the positive reactions
of the caregivers, including self-esteem.
Methods: Community-dwelling spousal caregivers of frail older
patients were recruited mainly by the geriatric outpatient clinic and
assessed using the CRA (self-esteem, lack of family support, disrupted
schedule, financial and health problems). Burden was assessed using
the Zarit Burden Interview (ZBI) and depression screened with the
Geriatric Depression Scale (GDS-15).
Results: Are presented with mean and SD.
Results: 80 caregivers (44 women ’ s, age 79.6 ± 5.4). Among care-
receivers (age 81.4 ± 5.2), 81% had cognitive impairment. 31% of
caregivers were at risk of depression. The burden (ZBI 32.4 ± 14.4)
correlated with neuropsychiatric symptoms of the care-receiver
(R = 0.4). Disruption of their schedule was a more important negative
aspect (4 ± 3.4) than lack of family support (2.6 ± 0.9), financial
problems (2.3 ± 0.8) or health problems (2.9 ± 0.9). Despite this,
caregivers’ self-esteem was high (>3/5) among 69% caregivers (mean
3.8 ± 0.8). This dimension takes into account the desire and pleasure to
give care.
Conclusions: Caregivers carry a heavy burden and are at risk for
depression. Nevertheless, 69% of them consider caregiving as a source
of self-fulfillment. Health professionals should not only screen the
caregivers for depression but also recognize their important role in
order to enhance their positive reactions.
P-137
Extreme agitation in nursing home residents with dementia;
prevalence, characteristics and correlates
A.E. Veldwijk-Rouwenhorst1, D.L. Gerritsen1, M. Smalbrugge 2,
R.B. Wetzels1, H. Bor1, S.U. Zuidema3, R.T.C.M. Koopmans1,4.
1Department of Primary and Community Care, Radboud Alzheimer
Centre, Radboud University Medical Center, Nijmegen, 2Department of
General Practice and Elderly Care Medicine/EMGO+ Institute, VU
University Medical Center, Amsterdam, 3Department of General Practice,
University of Groningen, University Medical Center, Groningen, 4Joachim
en Anna, Center for Specialized Geriatric Care, Nijmegen, Netherlands
Objective: Although many nursing home (NH)-residents with demen-
tia show agitation to some extent, hardly any literature is published
about extreme agitation. The Waalbed-III study focuses on the
prevalence and correlates of extreme agitation in these residents and
their characteristics.
Methods: Data of 4 studies in NH-residents with dementia was
combined into one dataset (n = 2074). Residents with extreme
agitation were defined as those having a score of 6 (several times a
day) or 7 (several times an hour) on at least 5 CMAI-items and a CMAI
total score above the 90th percentile. We compared this group with
residents with less severe agitation on different characteristics.
Residents without agitation (CMAI total score = 29) were excluded. A
multivariate multilevel logistic regression analysis was performed to
assess the association of several variables with extreme agitation.
Results: 154 NH-residents met the definition (7.4%). Compared to the
residents with less severe agitation (n = 1704), characteristics of NH-
residents with extreme agitation differed. These residents were
younger, had a more severe stage of dementia and used psychotropic
drugs more often. Several correlates were found for extreme agitation:
age (OR 0.967, p = 0.011), dementia severity (OR 3.646, p = 0.000 for
GDS 6, OR 2.958, p = 0.008 for GDS 7 (ref GDS 4 and 5)), delusions (OR
2.481, p = 0.0000), anxiety (OR 1.903, p = 0.002), euphoria (OR 3.709,
p = 0.000) and irritability (OR 4.419 p = 0.000).
Conclusion: Characteristics of these NH-residents are different from
residents with less severe agitation. Furthermore, we obtained more
insight in several correlated factors. In clinical practice, these factors
may signal the possible occurrence of extreme agitation, and may
therefore be a starting point for treatment.
P-138
Cognitive impairment and readmissions in very old and very very
old patiens in a Heart Failure Unit
G. Sarmento1, A. Félix-Oliveira1, P. Mendonça1, I. Araujo1, F. Marques1,
C. Fonseca1. 1Acute Heart Failure Unit, Internal Medicine Department,
Centro Hospitalar Lisboa Ocidental
Introduction: With the aging of population, more and more people
are now being admitted in specialized hospital units. Very old (75–85
years) and very very old adults (older than 85), who demand special
attention due to their physical and cognitive condition, are increas-
ingly being managed in these units.
Methods: A Mini Mental State (MMS) questioner was randomly
applied to 44 patients admitted in a Heart Failure Unit, with ages 75
years or older (very old and very very old) during a 9-month period.
Readmissons at 90 days after discharge were analyzed. The mRankin
comorbidities scale was applied to attest patients’ physical conditions.
Poster presentations / European Geriatric Medicine 7S1 (2016) S29–S259 S64