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

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Forced Expiratory Volume (FEV1) and FEV1/FVC were reported. From
total of 260 elderly, 69.6% were female and the mean age was
83.0 ± 6.46 years with a age range between 65 and 95 years. The FVC
and FEV1 results (expressed as percentage of predicted values) were
the 18% lower using the reference equations provided by GLI2012. On
the other hand, when NHANESIII was used, the FEV1/FVC results were
12% higher. The prevalence of airway obstrution was 73% higher using
the values obtained by ECSC93 while GLI2012 provided more 47% of
restritive defects. The present study showed a meaningful difference
on the reference values and consequently on the results using NHANES
III, ECSC93 and GLI2012 reference equations. The spirometry inter-
pretation was also influenced depending which reference equations
was used.
Keywords: Elderly; spirometry; reference equations.
Granted by FCT – Project GERIA PTDC/SAU-SAP/116563/2010.
P-236
Respiratory symptoms, ventilatory and inflammatory profile in a
sample of institutionalized elderly – GERIA Project
J. Belo 1, T. Palmeiro2, I. Caires2, M. Botelho2, P. Martins2,3,
N. Neuparth 2,3. 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 respiratory system undergoes several changes due to aging which,
associated to environmental and smoking exposure, may lead to the
decline of respiratory function.
The aim of this study is to characterize the spirometric and inflamatory
profile, and respiratory symptoms in a sample of institutionalized
elderly. 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. The spirometry and exhaled breath condensate (EBC) were
collected under the American Thoracic Society/European Respiratory
Society guidelines. Forced Vital Capacity (FVC), Forced Expiratory
Volume (FEV1), FEV1/FVC, pH and nitrites were reported. From total of
277 elderly, 71.1% were females and had a mean age of 83.0 ± 6.79
years. 28.5% had worked one or more years in a dusty environment and
24.2% reported smoking history.19.1% of the elderly referred coughing,
15.2% sputum and 15.9% wheezing in the last 12 months. Spirometry
showed 107 (39.8%) with ventilatory defects, of which 51 correspond-
ing to airway obstruction and 56 suggested a ventilatory restriction.
25.6% of the obstructions were reversible. 47% EBC showed a mean pH
compatible with airway inflamation. This study alowed to detected a
significant proportion of elderly with respiratory symptoms, ventila-
tory defects and a EBC results compatible with airway inflamation.
Keywords: Elderly; ventilatory profile; inflamatory profile, symptoms.
Granted by FCT – Project GERIA PTDC/SAU-SAP/116563/2010.
P-237
A systematic review of the outcomes reported in trials of
medication review in older patients: the need for a core
outcome set
J.B. Beuscart 1, L.G. Pont2, S. Thevelin1, B. Boland3, O. Dalleur1,
J. Westbrook 2, A. Spinewine1,4. 1Louvain Drug Research Institute, UCL,
Brussels, Belgium; 2Centre for Health Systems and Safety Research, AIHI,
Macquarie University, North Ryde, Australia; 3Geriatric Medicine,
CULSLuc, Brussels, 4Pharmacy Department, CHU UCL Namur, UCL, Yvoir,
Belgium
Background: Medication review has been advocated to tackle the
challenge of polypharmacy in older patients, yet there is no consensus
on how best to evaluate its efficacy. This study is part of the OPERAM
project and aimed to assess outcome reporting in clinical trials of
medication review in older patients.
Methods: Relevant randomized controlled trials (RCTs), prospective
studies and RCT protocols were identified through (1) an update of a
recent systematic review; (2) search in RCT registries of ongoing
studies; (3) the Cochrane library. The type, definition, and frequency of
all outcomes reported and measurement instruments used, were
extracted independently by two researchers.
Results: 47 RCTs and prospective studies and 32 RCT protocols were
identified. A total of 327 distinct outcomes were identified in the 47
published studies. Most of the reported outcomes were related to
medication use (n = 114, 35%) and healthcare use (n = 74, 23%); very
few were patient related outcomes (n = 24, 7%). One fifth (21%) of the
studies evaluated the impact of the medication review on adverse
events like adverse drug reactions or drug-related hospital admissions.
A total of 248 distinct outcomes were identified in the 32 RCT pro-
tocols. Compared to published studies, patient-reported outcomes
were planned to be collected more frequently (n = 36, 15%).
Conclusion: Outcome reporting from RCTs concerning medication
review in older patients is inconsistent and poorly defined. This study
highlights the need for a standardised core outcome set for medication
review in older patients, to improve outcome reporting and evidence
synthesis.
P-238
Neither gait speed, nor resident assessment instrument adequately
detect sarcopenia in a GP’ s practice
H. Ekinci1, L. De Dobbeleer2,3, S. Aelbrecht2, I. Bautmans 2,3, I. Beyer1,2,3.
1General Medicine Department, Vrije Universiteit Brussel (VUB),
Laarbeeklaan 103, 2Geriatrics Department, Universitair Ziekenhuis
Brussel (UZ Brussel), Laarbeeklaan 101, 3Gerontology Department and
Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel
(VUB), Laarbeeklaan 103, B-1090 Brussels, Belgium
Introduction: Sarcopenia, the age-related loss of muscle mass
and strength, has been linked to poor quality of life, increased risk of
falls, fractures, disability and death. While Comprehensive Geriatric
Assessment (CGA) is being progressively implemented, screening for
sarcopenia has not yet entered systematic assessement of senior adults
by general practitioners (GP’ s). We used the Belgian version of the
Resident Assessment Instrument (BelRAI) to identify items with a
predictive value for the presence of sarcopenia in a GP’ s practice.
Methods: Prospective cross-sectional study during 7 months in
community dwelling patients 65 years and older in a GP’ s practice in
Belgium using the BelRAI “Home Care”. Thirteen BelRAI items possibly
linked to sarcopeniawere selected for analysis. Diagnosis of sarcopenia
was based on the European Working Group on Sarcopenia in Older
People (EWGSOP) criteria, using bio-electrical impedance analysis
(BIA) for muscle mass.
Results: Sixty women and 40 men (age 74.78 ± 6.25 years and
75.13 ± 6.06 years respectively) were included. Sarcopenia was present
in58%.Patientswithsarcopeniahadsignificantlymore“meals delivered
home” (p = 0.018) and “diagnosis of COPD” (p = 0.049), but better “self-
reported health” (p < 0.001). The combination of these items would
correctly diagnose muscle status in 71%, with moderate sensitivity
(75.9%) and poor specificity (64.3%). This is however better than gait
speed (58% of correct diagnosis, 91% sensitivity, 5% specificity). 40%
of the population had a low gait speed not due to sarcopenia.
Conclusion: We conclude that neither gait speed alone, nor the
BelRAI-HC can adequately screen for sarcopenia. Measurement of grip
strength and muscle mass remain necessary.
P-239
Risk factors for falls following hospital discharge in the elderly
population – follow-up at 6 months
P. Caetano1, J. Pires1, J. Freitas2, I. Campos1, J. Laíns1, M. Veríssimo2.
1Centro de Reabilitação da Região Centro – Rovisco Pais, Tocha,
2Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
Objectives: The incidence of falls after hospital discharge was
reported to be higher, affecting mainly elderly patients. Identifying
Poster presentations / European Geriatric Medicine 7S1 (2016) S29–S259 S91