9th Congress of the EUGMS / European Geriatric Medicine 4 (2013) S20–S80
P016
Claim for a new paradigm of hospital
physicians: Evolution along 13 years
in an acute internal medicine ward in
Portugal
F.T. Lopes , A.R. Dias , A.N. Miranda , M. Alves ,
M.R. Narciso , T.P. Fonseca , J. Gorjão Clara
UUG-CHLN, Lisbon, Portugal
Introduction.– Equally to the rest of the world, the Portuguese soci-
ety is ageing. Thus, the patients admitted at the internal medicine
wards are older than a few years ago. However, the doctors’
approach didn’t change accordingly. The authors intend to evalu-
ate the magnitude of polypathology and polypharmacy in patients
admitted in the same acute internal medicine ward in an academic
tertiary hospital, with a time interval of 13 years.
Methods.– One-hundred consecutive old-patients admitted in an
internal medicine department were analyzed about their proven-
ance (nursing home/home), length of stay, number of diagnoses,
specifically dementia, number of medications at admission and
post-discharge. Some of this data was then compared with a similar
study done more than a decade before (1999 vs. 2012).
Results.– Nowadays the median age was 80,6 years (35%
patients ≥ 85 years), 42% males; 21% were from nursing home; the
mean length of stay was 8,8 days, the median of diagnoses per
patient was 7,9. Thirty-one percent of the patients had dementia.
The mean number of medications was 7,6 at admission and 8,3
post-discharge. Between the two periods, the median age increased
from 78,5 years to 80,6 years, the mean length of stay decreased
16% (2 days less), the number of diagnoses per patient increased
28% (from 5.7 to7.9) and dementia increased by 55%.
Conclusions.– Comparing with the study made 13 years ago,
the admitted patients are older now, the number of diagnoses
increased substantially and dementia has duplicated but interest-
ingly, the length of stay became 2 days shorter. This recalls for the
urgent need of a new paradigm concerning the approach of the
older patient in the internal medicine wards.
http://dx.doi.org/10.1016/j.eurger.2013.07.080
P017
Risk factors for complications of
osteoporosis in older people
G.I. Prada , I.G. Fita , R. Nacu , I. Ignat , R. Petrescu ,
O. Jugravu , A. Catar , A.M. Herghelegiu , S.P. Prada
“Ana Aslan” National Institute of Gerontology and Geriatrics,
Romania
Objective.– Aim of this study was to analyze risk factors for compli-
cations of osteoporosis in older patients.
Patients and methods.– We evaluated 295 older patients with osteo-
porosis, consecutively admitted to our Institute, 79% women, 21%
men, age range 65 to 89, mean age 75 years. Three age groups were
considered: young-old (65-74 years), old-old (75–84 years), very
old (85 years and older). Osteoporosis was diagnosed by analysis of
bone density using DXA in all patients.
Results.– Vertebral fractures were most prevalent in men (55%),
while hip fractures were more frequent in women (38%). In
younger age groups Pouteau-Colles fractures were most preva-
lent (32%), older age groups were affected mainly by hip fractures
(42%). Regarding risk factors for complications in older age group,
dementia was most significant (RR = 5.3), together with decreased
physical activity (RR = 1.65), medication use (RR = 1.77), high frailty
index (RR = 1.69), poor visual acuity (RR = 1.47), lower body weight
(RR = 1.38). In younger age groups, most significant risk factors were
arterial hypotension (RR = 1.9), smoking (RR = 1.65), estrogen deficit
at younger age (RR = 1.46). In patients with high frailty index, hip
fracture was most prevalent (59.38%), followed by vertebral frac-
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S25
tures (28.13%). Dementia is very little involved in vertebral and
Pouteau-Colles fractures, but is important risk factor for hip frac-
tures in older age groups. A fracture increases by 83% the risk of a
second fracture in older age groups, irrespective of gender.
Conclusions.– Risk factors for complications of osteoporosis in older
people have severe impact on quality of life and survival and need
constant assessment and management.
http://dx.doi.org/10.1016/j.eurger.2013.07.081
P018
Inflammation and oxidative stress in
elderly patients with atrial fibrillation
G. Arık , Ö. Kara , M.E. Kuyumcu , Y. Yeşil ,
M. Cemal Kızılarslanoğlu , M.K. Kılıç ,
B. Balam Yavuz , M. Halil , M. Cankurtaran ,
S. Arıoğul
Department of internal medicine, division of geriatric medicine of
Hacettepe üni, Ankara, Turkey
Aim.– Atrial fibrillation (AF) is the most common form of arythmia
in the population. It is associated with increased cardiovascu-
lar mortality. It is important to understand the pathogenesis and
risk factors of this rhythm disorder for appropriate management.
Hypertention, type 2 diabetes, cardiovascular disease, obesity,
chronic kidney disease are known major risk factors. Recently
inflammation and oxidative stress pathways gain importance in
the pathogenesis of AF. In the present study, we aimed to inves-
tigate the relationship between inflammation and oxidative stress
markers and the prevalence of AF in elderly.
Methods.– Two thousand three hundred and thirty-six elderly
patients (≥ 65 years old) admitted to our hospital were included
in the study. Data including age, sex, body mass index (BMI),
comorbidities, serum uric acid (UA), albumin, homocysteine, total
bilirubin, eryhtrocyte sedimentation rate (ESR) and C-reactive pro-
tein (CRP) were evaluated. AF was diagnosed from medical history
and using 12-lead electrocardiogram. Statistical analysis were per-
formed using SPSS version 15.0 programme. Statistical significance
was accepted as P < 0.05.
Results.– The mean age was 72.1 ± 6.26. The prevalence of AF was
%5. On the univariate analysis, the means of albumin and BMI were
significantly lower, the prevalence of coronary heart disease (CHD)
and congestive heart failure (CHF) and the mean of UA were signif-
icantly higher in patients with AF. Multivariate regression analysis
revealed that UA (OR: 0.875, 95% CI: 0.793–0.966, P: 0.008) and
albumin (OR: 2.801, 95% CI: 1.695–4.626, P < 0.001) levels are inde-
pendent variables predicting the occurrence of AF.
Conclusions.– Higher UA levels and lower albumin levels in elderly
patients with AF may suggest the role of oxidative stress and inflam-
mation in the pathogenesis of AF.
http://dx.doi.org/10.1016/j.eurger.2013.07.082
P019
The determinants of muscle strength
in Parkinson’s disease
H.C. Roberts a , H.E. Syddall b , J.W. Butchart c ,
E.L. Stack a , C. Cooper b , A. Aihie Sayer a,b
a Academic Geriatric Medicine, University of Southampton,
Southampton, UK
b MRC Lifecourse Epidemiology Unit, University of Southampton,
Southampton, UK
c Medicine for Older People; Southampton General Hospital,
Southampton, UK
Introduction.– Muscle weakness is a common complaint in Parkin-
son’s disease (PD). Research studies have produced conflicting
results on whether there is true muscle weakness in PD but have not
accounted for known influences of age, gender, body size, physical