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

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Results: 36.4% were males, 25% presented cognitive impairment in the
MMS scale, and of these 72.7% had at least one readmission on the next
90 days after discharge. Of the 75% of the patients without cognitive
impairment, 36.4% were readmitted (p = 0.03). These patients pre-
sented a mean mRankin of 2.24 ± 1,06 while those with cognitive
impairment presented 2,27 ± 1,42 (p = 0.93).
Conclusions: Cognitive impairment is associated with a higher rate of
readmissions in patients older than 75, at 90-days after discharge.
MMS may help to prevent readmissions by alerting medical staff to
anticipate a post-discharge appointment to reavaluate these complex
patients. More studies should carried out to study the impact of
cognitive impairment in prognosis.
P-139
Effect of high dose vitamin D on cognitive performance in healthy
seniors – a randomized controlled trial
S. Schietzel 1,2, P. Brugger3, K. Fischer2, O.W. Meyer1,2, G. Freystaetter1,2,
S. Meyer1,2, M. Gagesch 1,2, H.B. Stäehelin4, R. Theiler1,2, A. Egli2,
H.A. Bischoff-Ferrari1,2. 1Dept. of Geriatrics and Aging Research,
University Hospital Zurich and University of Zurich, Switzerland, 2Centre
on Aging and Mobility, University of Zurich, Switzerland, 3Dept. of
Neurology, University Hospital Zurich, 4Dept. of Geriatrics, University of
Basel
Introduction: Findings on the influence of vitamin D on cognitive
performance have been inconsistent, and clinical trials in healthy
seniors are missing.
Methods: We enrolled 273 seniors age 60+ in an ancillary cognitive
study of the Zurich knee OA trial. All participants were randomized
to either 800 or 2000 IU vitamin D per day in a double-blind manner.
The primary endpoint mini-mental state examination (MMSE) and 3
secondary endpoints (score of 7 executive function tests (EF), Rey
verbal learning, computer-based reaction time) were assessed at
baseline (BL) and at 24 months follow-up.
Results: Participants` mean age was 70.3 years, 56.8% were vitamin D
deficient, and mean baseline MMSE scores were 28.0. While achieved
25(OH)D levels at 24 months differed significantly (800 IU = 28.7 ng/
mL; 2000 IU = 34.7 ng/mL), none of the primary and secondary end-
points differed significantly between treatment groups (all p-values
>0.35). In a pre-defined observational analysis by achieved 25(OH)D
quartile levels at month 24, seniors in the 2nd and 3rd quartile (range:
26.4–35.3 ng/mL) showed better MMSE (ΔBL-24 months: Q1 = −0.09;
Q2 = 0.32; Q3 = 0.33; Q4 = −0.14) and EF (z-scores ΔBL-24 months:
Q1 = − 0.04; Q2 = −0.0006; Q3 = 0.04; Q4 = − 0.11) performance than
those in the lowest ( < 26.4 ng/mL) and highest quartile (>35.3 ng/mL)
of 25(OH)D levels (ptrend quadratic = 0.024 and 0.06).
Key conclusions: Our trial found no difference between daily 800
versus 2000 IU vitamin D on cognitive performance. This may be
explained by our observational findings suggesting that a moderate 25
(OH)D range between 26.4 and 35.3 ng/mL may be most desirable for
cognitive performance.
P-140
The Six-Item Screener-validation of a short cognitive test in its
German translation for geriatric patients
A. Seebens1,2,3, S. Krupp1, M. Willkomm1, F. Balck1,2. 1Research Group
Geriatrics, Hospital Red Cross Lübeck Geriatric Centre, 2University
Hospital Dresden, Technical University Dresden, 3University of Lübeck,
Lübeck, Germany
Introduction: The Six-Item Screener (SIS) is a brief cognitive test for
identifying subjects with cognitive impairment [1]. Its implemen-
tation takes one minute and does not require any material. This
diagnostic study was aimed at measuring the test criteria of the SIS in
its German translation (Krupp) for screening patients in a geriatric
acute clinic.
Methods: 167 patients were enrolled and 136 (age 56–97, M 80.9 SD
7.5 years, 61.8% women) completed five times of testing during 17 days
(4× SIS, 2× Mini Mental State Examination (MMSE) [2], 2× Shulman
Clock Drawing Test (CDT) [3], 2× Regensburg Verbal Fluency Test
(RWT) [4]). Gold standard was a geriatrician’s overall assessment at
discharge.
Results: There was no significant difference between the second and
third SIS on day 3 and 5 of the in-patient stay (p = 0.238) and the
two tests correlated 0.696 (p≤ 0.001). The Alpha was 0.821. The SIS
correlated with the geriatrician’s overall assessment (−0.721), with
MMSE (0.677), CDT (−0.478) and RWT (0.445). The sensitivity and
specificity were 100% and 70.5% (cut-off ≤ 4 points). All 98 patients
that scored 5 or 6 points were also found to have at most a mild
cognitive impairment by the geriatrician’ s overall assessment. The
AUC amounted 0.937.
Key conclusions: The SIS can be conducted on geriatric patients. It can
be administered to patients with visual problems, fine-motor deficits
and reduced resilience. It satisfactorily correlates with a geriatrician’ s
overall assessment, the MMSE, the RWT and the CDT. The SIS is ideal
for implementation during admission.
References
[1] Callahan CM, Unverzagt FW, Hui SL, Perkins AJ, Hendrie HC
(2002). Six-item screener to identify cognitive impairment among
potential subjects for clinical research. Med Care
[2] Folstein MF, Folstein SE, McHugh PR (1975). “Mini-mental state”.
A practical method for grading the cognitive state of patients for
the clinician. J Psychiatr Res
[3] Shulman KI, Shedletsky R, Silver I (1986). The challenge of time:
clock drawing and cognitive function in the elderly. Int J geriatr
Psychiatr
[4] Aschenbrenner S, Tucha O, Lange KW (2000). Regensburger
Wortflüssigkeitstest, Spektrum Akademischer Verlag, Heidelberg
P-141
How to increase the detection of mild neurocognitive disorder?
Comparison of psychometric scales
N. Sokołowska1, R. Sokołowski2, A. Polak-Szabela1, K. Kędziora-
Kornatowska1. 1Department and Clinic of Geriatrics Collegium Medicum
in Bydgoszcz, Nicolaus Copernicus University, 2Department of Hygiene,
Epidemiology, and Ergonomics, Department of Ergonomics and Exercise
Physiology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus
University
Introduction: The Montreal Cognitive Assessment is a screening tool
for mild neurocognitive disorder (mild NCD). Objective. Analyze the
reliability MoCA 7.2 vs. MMSE in detecting mild NCD including the
sensitivity and specificity of the cut off points.
Methods: We recruited 171 older adults, including 79 non NCD and 92
mild NCD patients. The mean ages were 73.44 years for non NCD and
79 years for mild NCD. In the non NCD group the 78.5% of the
participants were female and in themild NCD group the 72%. The study
included detailed inclusion and exclusion criteria. For statistical
analysis we used the STATISTICA 12.5 software.
Results: The mean MoCA 7.2 and MMSE scores showed significant
differences between groups (p < 0,001 for both). In the ROC curve
analysis of the MoCA score in differentiating mild and non NCD,
the area under the curve (AUC) was 0.95. The optimal cut-off score
for mild NCD was 23/24, with a sensitivity and specificity of 90.2%
and 77,2%, respectively. In the ROC curve analysis of the MMSE score
in differentiating mild and non NCD, the area under the curve (AUC)
was 0.86. The optimal cut-off score for mild NCD was 27/28, with a
sensitivity and specificity of 79,6% and 77,2%, respectively. The
difference in AUC fields MoCA 7.2 vs. MMSE was 0.085.
Conclusion: Screening test MoCA 7.2more sensitively detect mild NCD
than MMSE. Further research should aim to increase the study sample
and the creation of an algorithm in greater leveling effect of age and
education on the results of MoCA 7.2.
Poster presentations / European Geriatric Medicine 7S1 (2016) S29–S259 S65