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significant point to be undelrined is the statistically higher percentage

(p < 0.001) of elderly women suffering from unexplained anaemia

in comparison to elderly men. This kind of anaemia is typically mild

(Hb 9

12 mg/dL), normocytic, hypoproliferative and erythropoietin

(EPO) levels are inappropriately low for the decline of hemoglobal (Hb)

level, despite the fact they fall down within normal range.


The prevelance of the causes of anaemia in the Greek

elderly corresponds to the respective data as regards general world

population. Nevertheless, further discussion for the prompt inter-

vention to avoid the severity of heterozygous thalassaemia and the

appearance of unexplained anaemia in the Greek elderly, is in order.


Prevalence of geriatric syndromes in older subjects with type 2

diabetes mellitus in comparison to their peers without diabetes

M. Kotsani


, T. Chatziadamidou


, D. Economides


, A. Tsapas



A. Benos


, A. Benetos




2nd Department of Internal Medicine, Aristotle

University of Thessaloniki, Hippokratio Hospital of Thessaloniki, Greece;


Université de Lorraine, Service de Gériatrie CHRU Nancy, France;



Center of Diabata, Genimatas General Hospital,


Aristotle University of

Thessaloniki, Social Medicine & Primary Health Care Laboratory of

Hygiene and Social Medicine, Thessaloniki, Greece


Apart from the traditional well-characterized diabetic

complications, type 2 diabetes mellitus (T2DM) may have an even

wider impact on older patients. The aim of the present study was to

compare the prevalence of geriatric syndromes in older subjects with

T2DM and in controls of the same age.


We conducted a cross-sectional study in primary health

care settings in 3 semi-urban regions in Greece. We studied 403

community dwelling older subjects (age > 65 years, median: 73), 198

with T2DM and 205 without. The following common geriatric

syndromes were studied: cognitive impairment, depression, mobility

and functional decline and falls using structured individual interviews

and widely used screening scales.


Among patients with T2DM, 84.3% (n = 167) were under

antidiabetic treatment and the diabetic group presented globally a

strict euglycemic control (median HbA1c: 6,6%). After dichotomizing

the outcome variables and adjusting for significant possible con-

founders, subjects with T2DM presented worse cognitive and physical

performances, as controlled by MMSE (OR: 0.481, 95%CI: 0.297


p = 0.003), Clock Test (OR: 0.653, 95%CI: 0.430

0.991, p = 0.045) and

Timed Up And Go Test (TUG) (OR: 1.959, 95%CI: 1.093


p = 0.024). Depression and falls frequency as well as disability scores

did not differ between the diabetes and control group.


In this community dwelling population, we suggest that

the differences in MMSE, Clock Test and TUG performances between

the subjects with T2DM in comparison to those without reflect a

certain cognitive and physical fragilization in the diabetic group. The

lack of significant differences between these two groups regarding

several other geriatric syndromes could be due to the relatively young

age of the participants and the fact that they were a relatively robust

population, as reflected also in the euglycemic goals aimed and



Treating rectal haemorrhage in a patient with saddle pulmonary

embolism: a complex geriatric case

E.E. Ladikou, S. Attar.

University Hospitals of Leicester NHS trust, Health

Education East Midlands, United Kingdom


Treating older patients with complex presentations

poses an ever-increasing challenge to healthcare professionals. Case:

JW is a 94-year-old inpatient in a geriatric ward. Past medical history

includes stroke, hip replacement, left leg ulcer and a saddle pulmonary

embolism (PE), diagnosed one month ago. Prior to admission, she lived

in a residential home, needing assistance with personal care. The

patient presented with lower gastrointestinal haemorrhage whilst

on warfarin, initiated to treat the saddle PE. INR was therapeutic,

gastroenterologists advising that surgery or endoscopy were not

appropriate. CT angiogram showed no bleeding point but a thickened

endometrium. The patient was treated with blood transfusion and,

following haematology advice, INR was reversed with low-dose

vitamin K administered cautiously. Vascular interventional radio-

logists warned that an IVC filter to prevent further PEs was

inappropriate. After haemorrhage ceased, haematology advised a

trial of prophylactic lowmolecular weight heparin (LMWH) and, if the

patient remains stable, trial split dose therapeutic LMWH. As JW


condition deteriorated, the complexity of her case increased.

Therefore, an in-depth multidisciplinary team assessment was

sought to determine the best management plan. The patient

s saddle

PE as well as a possible endometrial malignancy increase her

thromboembolic risk. Concurrently, she is at high risk of lower

gastrointestinal haemorrhage if anticoagulated.


This case illustrates the complexity in decision-making

confronting geriatricians whose patients typically present with

multimorbidity. Their treatment represents an escalating problem

within the growing ageing population, among whom a holistic

approach is vital with every aspect of wellness meticulously being

considered and integrated.


Impact of underlying conditions in patients over 50 years suffering

from Zoster

L. Torcel-Pagnon


, H. Bricout


, I. Bertrand


, E. Perinetti


, E. Franco



G. Gabutti


, A. Volpi




Sanofi Pasteur MSD, Lyon, France;


Sanofi Pasteur



Dip. Biomedicina e Prevenzione, Università degli Studi di Roma Tor

Vergata, Roma,


Dip. di Scienze Mediche, Università degli Studi di Ferrara,



Dip. di Scienze Cliniche e Medicina Traslazionale, Università

degli Studi di Roma Tor Vergata, Roma, Italy


Chronic conditions have been investigated as risk factors

for developing zoster, but in patients suffering from zoster, the impact

of these conditions on zoster-related pain and quality of daily life

(QOL) remains unclear.


We performed a post-hoc analysis of a prospective cohort of

immunocompetent zoster patients aged over 50 years, followed by

their general practitioners in Italy between 2009 and 2010. Zoster

symptoms, pain intensity and characteristics, and physical and mental

health scores were assessed at baseline (zoster diagnosis), 1, 3 and 6

months follow-up.


Among 413 patients in the cohort, 73% (303/413) suffered

from underlying conditions of which 69% were aged over 65 years and

86% had at least one chronic condition. Cardiovascular diseases (75%),

diabetes (24%) and respiratory diseases (17%) were most frequent

chronic conditions. One to three months after zoster onset, patients

with underlying conditions experienced more intense zoster-related

pain than those without. QOL scores were significantly lower in

patients with underlying conditions, and age-adjusted difference in

QOL scores between the groups increased over time, demonstrating a

slower recovery for patients with underlying conditions.


In addition to age, the main risk factor of zoster

occurrence and severity, the presence of underlying conditions

results in more painful and impactful zoster episodes, creating a

significant burden for these patients. With 80% of people aged over 65

years having at least one chronic condition, prevention of zoster and

PHN in elderly may contribute to preserve their functional status and

QOL, and thus to healthy ageing.


Complex chronic disease of older in a medical ward

F. Leal-Seabra


, R. Ferreira


, G. Sarmento


, R. Verissímo


, A. Oliveira




Internal Medicine Department, Centro Hospitalar Vila Nova de Gaia/

Espinho Hospital Vila Nova de Gaia, Portugal


A Complex Chronic Disease (CCD) is a condition involv-

ing multiple morbidities that require the attention of multiple health

care providers or facilities and possibly home-based care.

Poster presentations / European Geriatric Medicine 7S1 (2016) S29