8 / 290
Conclusion:
Geriatric syndrome accumulates with the progression of
frailty. Body unsteadiness appears a significant determinant for
predicting the progression of frailty.
O-04
Impact of dysphagia and undernutrition on mortality and
hospitalization in community-dwelling disabled older people
H. Enoki
1
, M. Sugiyama
2
, M. Kuzuya
3
.
1
Aichi Syukutoku University,
Nagakute,
2
Kanagawa University of Human Services, Yokosuka,
3
Nagoya
University Graduate School of Medicine, Nagoya, Japan
Objectives:
This study aimed to examine whether the presence of
malnutrition or dysphagia is an independent predictor of mortality or
hospitalization among community-dwelling disabled older people.
Methods:
A 2 years prospective study of 1,142 community-dwelling
disabled older people (81.2 ± 8.7 years) from KANAGAWA-AICHI
Disabled Elderly Cohort (KAIDEC) study was conducted. Data included
the participants
’
demographic characteristics, nutritional status (Mini
Nutritional Assessment short-form: MNA-SF) and dysphagia severity
(Dysphagia Severity scale: DSS). Kaplan-Meier method and multivari-
ate Cox proportional hazards models were used to assess the
association between malnutrition or dysphagia and poor outcomes
including mortality or hospitalization.
Results:
Among the 1,142 participants, 171 dies or 464 were
hospitalized during the 2-year follow-up period. Although the
malnutrition was associated with mortality and hospitalization, no
apparent association was observed between the swallowing difficulty
and these events after adjusting for confounding factors.
Conclusion:
The results highlight the need to prevent the under-
nutrition among community-dwelling dependent older people.
O-05
Cognitive impairment and physical frailty in older adults: impact
on survival
G. Grande
1,2
, D. Rizzuto
1
, B. Caracciolo
1
, C. Mariani
2
, D.L. Vetrano
1,3
,
A.K. Welmer
1
, L. Fratiglioni
1,4
.
1
Aging Research Center (ARC), Department
of Neurobiology, Care Sciences and Society, Karolinska Institutet and
Stockholm University, Stockholm, Sweden
2
Center for Research and
Treatment on Cognitive Dysfunctions, Biomedical and Clinical Sciences
Department,
“
Luigi Sacco
”
Hospital, University of Milan, Italy
3
Department of Geriatrics, Neurosciences and Orthopedics, Catholic
University of Rome, Italy
4
Stockholm Gerontology Research Center,
Stockholm, Sweden
Introduction:
The presence of both physical frailty and cognitive
impairment has been recently proposed as a distinctive entity. We
investigated the effect of physical frailty and cognitive impairment on
survival among elderly.
Methods:
Study participants included 2,251 dementia-free people
aged 60+ years enrolled in the Swedish National study on Aging and
Care in Kungsholmen, Stockholm. Physical frailty was defined
according to Fried
’
s phenotype (weight loss, weakness, exhaustion,
slowness, low physical activity). Cognitive Impairment Non Dementia
(CIND) was defined on the basis of an extensive neuropsychological
battery. We investigated the impact of CIND and physical frailty
alone and the combination of these two conditions on survival.
Survival was assessed in terms of mortality rate at 5 and 10 years of
follow-up (Cox models) and differences in median age at death
(Laplace regression).
Results:
The strongest association with short and long survival was
found among people with both CIND and physical frailty. Those
people, after 5 years, had three times higher mortality rate (HR: 3.1;
95% CI: 1.8
–
5.4) and 4.2 years shorter life compared to robust subjects
(neither CIND nor physical frail). People with only physical fraility but
cognitively intact had an HR of 1.8 (95% CI: 1.1
–
2.8) as compared with
robust ones. Isolated CIND was not associated with mortality. After 10
years, similar results were observed, although attenuated (for CIND+
physical frailty: HR: 2.1; 95% CI: 1.3
–
3.2).
Conclusion:
Subjects with both physical frailty and cognitive
impairment represent a special frail and complex population that
deserves ad hoc assessments and care.
O-06
Circumstances and consequences of falls in pre-frail community-
dwelling older adults
S. Tuvemo Johnson
1
, E. Anens
1
, A.C. Johansson
2
, K. Hellström
1
.
1
Department of Neuroscience, Uppsala University, Uppsala,
2
School of
Health Care and Welfare, Mälardalen University, Västerås, Sweden
Introduction:
Pre-frail older adults appear to be at risk for falls and
injuries. The aim of this study was to describe the circumstances and
consequences of occurred falls the first year of a fall prevention study
and to describe activities according to the International classification
of functioning, disability and health (ICF) at the time of the falls.
Methods:
Fall frequencies were self-reported via a calendar and were
followed up by a standardized telephone interview. Activities in the
fall situation were classified according to ICF. Of the pre-frail
community-dwelling older adults
≥
75 yrs (n = 175, M = 83 yrs) 74
individuals (42%), 50 females and 24 males, fell during their first year
in the study, M = 1.1 falls/y/person.
Results:
Falls were most common indoors at home (bedroom and
living room). Perceived causes of the falls were e.g. stumbling, balance
deficits, and inattention. Injuries were reported in 82 (44.3%) of the
185 fall incidents where seven (3.8%) resulted in fractures. Six-teen
falls (8.7%) required outpatient care and seven falls (3.8%) required
hospital stay. The falls mostly occurred in connection with the ICF-
classified activities
“
Moving around within the home
”
and
“
Standing
”
(rising up from sitting). There was no difference in type of activity in
the fall situations resulting in an injury or not.
Conclusion:
Injuries were most commonwhile moving around within
the home or rising to an upright position. This indicates that in fall
prevention special attention on those activities might be of import-
ance in pre-frail older adults
O-07
Relationship between the nutritional status of institutionalized
elderly people with the risk of falling
M. Cebola, A. Mahendra, B. Marques, E. Carolino, L. Mendes.
Licenciatura em Dietética e Nutrição
–
Escola Superior de Tecnologia da
Saude de Lisboa
–
Instituto Politecnico de Lisboa
Introduction:
The elderly represent group that is vulnerable numer-
ous changes that can compromise nutritional status, which is likely to
worsen when admitted at the hospital. The risk of falls is one of the
consequences that frequently occur when elder people, with deteri-
oration of nutritional status, are hospitalized. The aimof this study is to
evaluate the relationship between nutritional status and the risk of
falls in elderly admitted in general medicine service of a hospital
located in Lisbon.
Methods:
Nutritional Status was assessed by the application of the
Mini Nutritional Assessment (MNA
®
), body mass index (BMI), arm
circumference (AC), calf circumference (CC), triceps skinfold (TSF), arm
muscle area (AMA); albumin, hemoglobin, hematocrit, lymphocytes
and C-reactive protein (CRP). The risk of falling by Morse Scale.
Results:
A total of 57 elderly people admitted in general medicine
service were evaluated. The risk of falls only showed a negative
correlation with MNA
®
(rs =
−
0.285, p = 0.042).
Conclusions:
TheMNA
®
identified 63.1% of patients withmalnutrition
installed and/or risk of malnutrition, emphasizing the importance of
evaluation of nutritional risk in this age group in hospital. This
instrument allowed to relate malnutrition with the risk of falls,
concluding that patients classified with normal nutritional status by
MNA
®
(n = 21) had a lower risk of falling representing 76.16%. Protocols
for nutritional risk identification and nutritional status evaluation
must be created, so that the dietitian can step in appropriately and in a
timely manner, reducing the risk of complications associated with
hospitalized elderly, such as falls.
Oral presentations / European Geriatric Medicine 7S1 (2016) S1
–
S27
S2