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

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Area: Diabetes and nutrition
O-08
The importance of HDL cholesterol levels in diabetic individuals
K. Ina, T. Hayashi, M. Kuzuya. Department of Geriatrics, Nagoya
University Graduate School of Medicine
Introduction: The risk factors for ischemic heart disease (IHD) or
cerebrovascular accident (CVA) in elderly diabetic individuals with
type IIb dyslipidemia are not fully known. Therefore, we investigated
the relationship between lipid levels and IHD and CVA in diabetic
individuals with type IIb dyslipidemia.
Methods: The Japan Cholesterol and Diabetes Mellitus Study is a
prospective cohort study of 4,014 type 2 diabetic patients (1,936
women; age 67.4 ± 9.5 years) with 9.2 years of follow-up. The primary
end points were the onset of IHD or CVA. Lipid and glucose levels and
other factors were investigated in relation to the occurrence of IHD or
CVA. 483 subjects were included in the group of patients with type IIb
dyslipidemia.
Results: 218 cases of IHD and 138 cases of CVA occurred over 9.2 years.
In this study, we focused on type IIb dyslipidemia. 483 diabetic
participants with type IIb dyslipidemia were divided into those who
were aged <65 years, 65–74 years, and ≧75 years (n = 175, 202, and
106, respectively). HDL-cholesterol (HDL-C) was significantly asso-
ciated with risk of CVA in diabetic individuals with type IIb
dyslipidemia who were aged <65 years. Risk factors for cardiovascular
events appear to change with advancing age.
Conclusions: HDL-C was an important risk factor for CVA in diabetic
individuals with type IIb dyslipidemia who were aged <65 years. The
importance of HDL-C is different for each age-group. This result is
important for developing individualized strategies to prevent athero-
sclerotic disease.
O-09
Nutritional follow-up in malnourished geriatric patients after
discharge: does the follow-up method influence the number of
readmissions to hospital?
J. Lindegaard-Pedersen, P.U. Pedersen, E.M. Damsgaard. Department of
Geriatrics, Aarhus University Hospital, Denmark; Aalborg University,
Denmark
Introduction: Disease-related malnutrition affects older individuals
negatively after discharge from hospital. Objective Comparison of the
effect of two nutritional follow-up intervention methods (home visit
or telephone consultation) with no follow-up, on readmissions to
hospital 30 days after discharge.
Material and methods: The study is a randomized clinical trial.
Inclusion: Malnourishment or risk of malnutrition, age 75+ years,
home-dwelling, and living alone. Exclusion: Terminal illness, cognitive
impairment, and nursing home residency. At discharge the partici-
pants were randomized to “home visit” (HV), “telephone consultation ”
(TG), or “control group” (CG). The intervention was individualized
nutritional counseling one, two, and four weeks after discharge. The
risk of readmissionwas analysed as intention-to-treat (ITT) and as per-
protocol (PP) using the Cox proportional hazard regression model.
Results: 208 patients were randomized and included in the ITT-
analysis (HV = 73, TG = 68, CG = 67). HV had a lower risk of readmission
to hospital compared to CG (HR = 0.4; 95% CI:0.2–0.9, p = 0.03). No
difference was detected between TG and CG (HR = 0.6, 95% CI:0.3 –1.3,
p = 0.18). 166 patients completed the full intervention and were
included in the PP-analysis (HV = 52, TG = 51, CG = 54). HV had a lower
risk of readmission to hospital compared to CG (HR = 0.1; 95% CI:0.03–
0.6, p < 0.01). TG also had a lower risk of readmission compared to CG
(HR = 0.2, 95% CI:0.07–0.8, p = 0.02).
Conclusion: Individualized nutritional follow-up performed as home
visits reduces readmission to hospital 30 days after discharge in
malnourished geriatric patients who live alone. Nutritional
counselling given over the telephone may reduce readmission to
hospital, but only when patients receive the full intervention
programme.
O-010
Specialized oral nutritional supplement (ONS) improves handgrip
strength in hospitalized, malnourished older patients with
cardiovascular and pulmonary disease
E. Matheson1, J. Nelson2, G. Baggs2, M. Luo2, C. Steele2, R. Hegazi2,
N. Deutz3. 1Department of Family Medicine, Medical University of South
Carolina, Charleston, South Carolina, 2Abbott Nutrition, Columbus, Ohio,
3Center for Translational Research in Aging & Longevity, Department of
Health & Kinesiology, Texas A&M University, College Station, Texas, USA
Objectives: ONS has been used to treat malnutrition and improve
clinical outcomes in malnourished patients. Poor handgrip strength
(HGS) is associated with increased risk of mortality, disability and
other health complications. This study examined the effect of an ONS
containing high protein and beta-hydroxy-beta-methylbutyrate (HP-
HMB) on HGS and its relationship to nutritional status in hospitalized,
older patients with malnutrition.
Methods: We enrolled older (≥65 years), malnourished (Subjective
Global Assessment [SGA] class B/C) patients hospitalized for congest-
ive heart failure, acute myocardial infarction, pneumonia, or chronic
obstructive pulmonary disease in a randomized, placebo-controlled,
double-blind trial (NOURISH study [1]). During hospitalization and
until 90 days after discharge, patients received standard-of-care plus
HP-HMB (n = 328) or a placebo supplement (n = 324) 2/day. HGS was
evaluated by dynamometer at baseline, hospital discharge, day (d) 30,
d60, and d90 post-discharge.
Results: Post hoc, repeatedmeasures analysis of data at discharge, d30,
d60, and d90 showed significantly higher HGS in the HP-HMB vs. the
placebo group (p = 0.043). At d90, there was a significant positive
association between HGS and nutritional status (SGA). 49% of patients
with increased HGS from discharge (change >0) had improved
nutritional status over 31% with unchanged or decreased HGS
(p = 0.003).
Conclusions: A specialized high protein/HMB containing ONS pro-
vided during hospitalization and up to 90 days post-discharge
improves HGS in malnourished older patients following cardiovascu-
lar and pulmonary events.
References
[1] Deutz et al. Clin Nutr. 2016;35(1):18– 26.
O-011
Near visual activity loss and major eye diseases in relation to
diabetes in older people. The 3 City study
M. Danet-Lamasou1, K. Pérès2,3 , F. Matharan2,3, C. Delcourt2,3,
C. Berr4,5, I. Carrière5,6, J-F. Dartigues3,4, I. Bourdel-Marchasson1,6. 1CHU
of Bordeaux, Clinical Gerontology, F-33604 Pessac Cedex, 2ISPED, INSERM
U897-Epidemiologie-Biostatistique, 3University of Bordeaux, ISPED,
INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, 4Inserm,
U1061, 5University of Montpellier, Montpellier, 6CNRS, RMSB, UMR 5536,
F-33000 Bordeaux, France
Introduction: Prevalence of diabetes (DM) and visual impairment
increase with ageing but few is known in the oldest. We aimed to
describe near visual impairment in relation with DM in people older
than 65 y.
Methods: The study included 8,412 subjects of the 3C-study. Glucose
metabolism status (DM, undiagnosed DM, Impaired Fasting Glucose
(IFG), others) was determined according to self-reported diabetes,
antidiabetic treatment and fasting blood glucose determination. Near
visual acuity was measured with the Parinaud scale (Jaeger-like
reading test) at baseline, 2, 4 and 7 years after baseline. Cross-sectional
and longitudinal analyses investigated diabetes and near vision loss
association.
Oral presentations / European Geriatric Medicine 7S1 (2016) S1–S27 S3