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Geriatric syndrome accumulates with the progression of

frailty. Body unsteadiness appears a significant determinant for

predicting the progression of frailty.


Impact of dysphagia and undernutrition on mortality and

hospitalization in community-dwelling disabled older people

H. Enoki


, M. Sugiyama


, M. Kuzuya




Aichi Syukutoku University,



Kanagawa University of Human Services, Yokosuka,



University Graduate School of Medicine, Nagoya, Japan


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.


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.


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.


The results highlight the need to prevent the under-

nutrition among community-dwelling dependent older people.


Cognitive impairment and physical frailty in older adults: impact

on survival

G. Grande


, D. Rizzuto


, B. Caracciolo


, C. Mariani


, D.L. Vetrano



A.K. Welmer


, L. Fratiglioni




Aging Research Center (ARC), Department

of Neurobiology, Care Sciences and Society, Karolinska Institutet and

Stockholm University, Stockholm, Sweden


Center for Research and

Treatment on Cognitive Dysfunctions, Biomedical and Clinical Sciences


Luigi Sacco

Hospital, University of Milan, Italy


Department of Geriatrics, Neurosciences and Orthopedics, Catholic

University of Rome, Italy


Stockholm Gerontology Research Center,

Stockholm, Sweden


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.


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).


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



Subjects with both physical frailty and cognitive

impairment represent a special frail and complex population that

deserves ad hoc assessments and care.


Circumstances and consequences of falls in pre-frail community-

dwelling older adults

S. Tuvemo Johnson


, E. Anens


, A.C. Johansson


, K. Hellström




Department of Neuroscience, Uppsala University, Uppsala,


School of

Health Care and Welfare, Mälardalen University, Västerås, Sweden


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.


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.


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



(rising up from sitting). There was no difference in type of activity in

the fall situations resulting in an injury or not.


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


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


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.


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.


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).




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



(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