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

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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.
Conclusion: 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.
P-187
Prevalence of geriatric syndromes in older subjects with type 2
diabetes mellitus in comparison to their peers without diabetes
M. Kotsani1,2, T. Chatziadamidou3, D. Economides1, A. Tsapas1,
A. Benos 4, A. Benetos2. 12nd Department of Internal Medicine, Aristotle
University of Thessaloniki, Hippokratio Hospital of Thessaloniki, Greece;
2Université de Lorraine, Service de Gériatrie CHRU Nancy, France; 3Health
Center of Diabata, Genimatas General Hospital, 4Aristotle University of
Thessaloniki, Social Medicine & Primary Health Care Laboratory of
Hygiene and Social Medicine, Thessaloniki, Greece
Objectives: 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.
Methods: 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.
Results: 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: 0.297–0.779,
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 –3.512,
p = 0.024). Depression and falls frequency as well as disability scores
did not differ between the diabetes and control group.
Conclusion: 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
achieved.
P-188
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
Background: 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’ s
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.
Conclusion: 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.
P-189
Impact of underlying conditions in patients over 50 years suffering
from Zoster
L. Torcel-Pagnon1, H. Bricout1, I. Bertrand1, E. Perinetti2, E. Franco 3,
G. Gabutti4, A. Volpi5. 1Sanofi Pasteur MSD, Lyon, France; 2Sanofi Pasteur
MSD, 3Dip. Biomedicina e Prevenzione, Università degli Studi di Roma Tor
Vergata, Roma, 4Dip. di Scienze Mediche, Università degli Studi di Ferrara,
Ferrara, 5Dip. di Scienze Cliniche e Medicina Traslazionale, Università
degli Studi di Roma Tor Vergata, Roma, Italy
Objectives: 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.
Methods: 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.
Results: 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.
Conclusion: 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.
P-190
Complex chronic disease of older in a medical ward
F. Leal-Seabra1, R. Ferreira 1, G. Sarmento 1, R. Verissímo1, A. Oliveira1.
1Internal Medicine Department, Centro Hospitalar Vila Nova de Gaia/
Espinho Hospital Vila Nova de Gaia, Portugal
Background: 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–S259 S78