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

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(p < 0.001) tests showed significant decline with decreasing Mini-
Cog scores. There was a sharp drop in these markers of functional
impairment between Mini-Cog scores of 0 and ≥1.
Conclusion: The Mini-Cog score, when used as a continuous variable,
could be useful in determining the presence and degree of functional
disability in older cancer patients.
P-232
Development of a targeted geriatric assessment for predicting poor
outcomes in older outpatients after acute care: prospective cohort
study
M.J.R. Aliberti 1, J.A. Melo1, S.Q. Fortes-Filho1, C.B. Trindade1,
D. Apolinario1, W. Jacob-Filho1. 1Division of Geriatrics, Department of
Internal Medicine, University of Sao Paulo Medical School, Sao Paulo,
Brazil
Objectives: Comprehensive geriatric assessment is time-consuming.
We aimed to develop a 10-minute Targeted Geriatric Assessment
(10-TaGA) for predicting poor outcomes in older patients treated in
overloaded healthcare settings.
Methods: Prospective cohort involving 537 participants aged 60
and older admitted to a day hospital for acute care in Sao Paulo, Brazil.
The 10-TaGA constructed by Delphi Technique was performed on
admission. It includes information on co-habitation status, previous
hospitalizations, falls, medications, functionality (Katz index), cog-
nition (10-point cognitive screener), self-rated health, depression
(4-item Geriatric Depression Scale), nutrition and gait speed. An index
(from 0 to 1) identified low-risk (0–0.25), medium-risk (0.26–0.50)
and high-risk (0.51 –1) by balancing the scores of the ten domains.
Based on six-month follow-up, we used hierarchical Cox proportional
hazards regressions to associate the 10-TaGA index with unfavorable
outcomes (fall, emergency department visit [ED-visit], hospitaliza-
tion, incident disability and mortality).
Results: The 10-TaGA showed remarkable improvement in all out-
comes predictions when included in models containing demographics
(block-1) and comorbidities (block-2). The 10-TaGA high-risk was
strongly associated with fall (hazard ratio [HR] 2.68, 95% confidence
interval [CI] 1.55–4.61, p < 0.0001), ED-visit (HR 1.76, 95% CI 1.17 –2.67,
p < 0.010), hospitalization (HR 3.68, 95% CI 1.97–6.86, p < 0.0001),
disability (HR 5.93, 95% CI 2.83–12.40, p < 0.0001) and mortality (HR
2.76, 95% CI 1.06 –7.16, p = 0.036). The 10-TaGA properties on the
accuracy of the outcomes was fair with Harrell ’s C ranging from 0.594
(ED-visit) until 0.700 (disability).
Conclusion: The 10-TaGA satisfactorily predicted older adults in high
risk for poor outcomes in an overloaded healthcare setting.
P-233
Back to square one
K. Asante1, S. Lee1, H. Chamberlain1. 1Good Hope Hospital, Heart of
England NHS Trust, UK
Introduction: Falls and falls-related injuries are a significant cause of
hospital admissions for older people worldwide. The financial burden
of falls on the UK’ s National Health Service (NHS) is estimated to be
more than £2.3 billion a year. Careful assessment of the older patient is
therefore vital, not only for identifying the responsible causes in those
who have fallen, but also for the prevention of falls in individuals
at risk.
Case report: We discuss the case of an 84 year old gentleman, who
presented to our hospital multiple times over the course of a month,
each episode preceded by a fall. During his final admission, thorough
history taking and non-verbal communication revealed previously
unreported symptoms of vertigo, and an MRI scan revealed a
vestibular schwannoma (acoustic neuroma). Interestingly, 1st degree
heart block with right bundle branch block, postural hypotension and
vascular dementia were all diagnosed during the course of his earlier
admissions, and were indeed the diagnoses to which his previous falls
had been attributed to.
Discussion: Our case therefore highlights the importance of conduct-
ing a comprehensive geriatric assessment upon each presentation
with a fall, regardless of any previously established diagnoses. We also
give particular regard to the value of detailed history taking, careful
exploration of the patient’s circumstances and non-verbal signs
used in eliciting the primary reason of this gentleman’s falls. The
diversity of our patient’s diagnoses also serves to reinforce the value of
a multidisciplinary approach when managing patients with multiple
co-morbidities and complex care needs.
P-234
Spirometry quality control and related features in extremely aged
people – GERIA Project
J. Belo1, T. Palmeiro2, I. Caires2, M. Botelho2, P. Martins2,3,
N. Neuparth2,3. 1Lisbon School of Health Technology, Polytechnic Institute
of Lisbon, 2Chronic Diseases Research Center, CEDOC, NOVA Medical
School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa,
3Immunoallergoly Service, Dona Estefânia Hospital, Central Lisbon
Hospital Center, EPE, Lisbon, Portugal
Spirometry is the selected method to identify ventilatory defects,
nevertheless it is not frequently used in elderly due to the fact that it is
common to consider that they are not able to collaborate. The aim of
this study is to evaluate spirometry collaboration and related features
in extremely aged people. 307 subjects from GERIA project (geriatric
study on health effects of air quality in elderly care centers) were
included in this study and performed spirometry. All spirometries
were evaluated by an expert panel of researchers in accordance with
American Thoracic Society/European Respiratory Society 2005. From a
total of 307 elderly, 70.4% were females, the mean age was 83.4 ± 6.92
years with an age range between 65 and 101 years. 90.2% of the
spirometry fulfilled the quality criteria for achieving collaboration. The
reasons for not fulfilling the quality criteria were: exhalation time less
than 6 seconds or an inexistent plateau in the volume–time curve
(76.7%), ascendant ramp although more than 6 second (10%), artifact
(6.7%) and slow start (6.7%). The mean percentage of the predictive
value for peak expiratory flow (PEF) was 103.3 ± 39.2% and for back
extrapolation the mean volume was 0.03 ± 0.02 mL. Associations
between valid spirometry and age, education, dementia and respira-
tory disease were not found. The spirometry test with quality criteria
wasn’t possible in only 9.8% of elderly care center residents. This data
shows that this exam is achievable in elderly even in advanced ages
without associations with specific features.
Keywords: Elderly; spirometry; collaboration.
Granted by Fundação para a Ciência e Tecnologia – Projeto GERIA
PTDC/SAU-SAP/116563/2010.
P-235
Differences between spirometry values obstained by GLI2012,
NHANES III and ECSC93 reference equations in an extremely aged
people: across-sectional study – GERIA Project
J. Belo1, T. Palmeiro2, I. Caires2, M. Botelho2, P. Martins2,3,
N. Neuparth2,3. 1Lisbon School of Health Technology, Polytechnic Institute
of Lisbon, 2Chronic Diseases Research Center, CEDOC, NOVA Medical
School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa,
3Immunoallergoly Service, Dona Estefânia Hospital, Central Lisbon
Hospital Center, EPE, Lisbon, Portugal
The reference equations for spirometry have been discussed in the past
years. The aim of this study is to compare the reference values based
on National Health and Nutrition Assessment Survey (NHANESIII),
European Community of Steel and Coal (ECSC93) and Global Lung
Initiative (GLI2012) equations, in a sample of extremely aged people.
Subjects from GERIA project (geriatric study on health effects of air
quality in elderly care centers) with more than 65 years and being
resident in nursing homes for more than 6 months were included.
Spirometry was performed according American Thoracic Society/
Euroepan Respiratoty Socienty guidelines. Forced Vital Capacity (FVC),
Poster presentations / European Geriatric Medicine 7S1 (2016) S29–S259 S90