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Comparison of different cognition short tests to the MMSE
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8th Congress of the EUGMS / European Geriatric Medicine 3S (2012) S33–S143
“Rothman”. Areas under the receiver operating characteristic curve (AUC) were compared for each scale. Results.– Two hundred and thirty-seven patients were included with a median age of 80.6 years. Within 90 days, 46.0% of patients were readmitted, 6.8% had died and 0.8% were institutionalised. Of the patients who completed 90-day follow-up, 19.7% had functional decline. The AUC was low for all instruments (0.53–0.67) indicating poor discriminatory ability apart for the FI in predicating functional decline (0.74 CI: 0.54–0.96). Conclusion.– Frail older patients admitted to the acute setting are at an increased risk of adverse outcomes. None of the frailty-rating scales were able to adequately identify patients at risk of these outcomes. These results raise questions over the usefulness of current frailty-scales in the acute setting. Disclosure.– No significant relationships. http://dx.doi.org/10.1016/j.eurger.2012.07.104 P104
Comprehensive geriatric intervention in elderly patients with hip fracture. The experience in a non-teaching hospital E. Martin-Perez a,∗ , Y.R. Davila Barboza b , E.H. Azana Fernandez b , A. Rodriguez-Rosa b , L. Rodriguez-Milia c a Geriatric Department, Hospital San Juan de Dios, Leon, Spain b Geriatric Department, Leon, Spain c Research Department, Leon, Spain Text.– Background.– Hip fractures are frequent cause for long time hospital staying, especially in old-old patients. Approximately one third of all patients die within the first year. As a consequence, several collaboration models between geriatricians and orthopaedic surgeons have been implemented. In January 2011 a multidisciplinary collaboration with the Orthopaedic Unit in our hospital was started. Methods.– Prospective study and follow up of 155 elderly patients with fracture that were admitted in the Orthopaedic Unit. All patients were evaluated at entry with daily clinic follow up until patient discharge. Data was based on medical records. Results.– One hundred and fifty five elderly with hip fracture patients admitted to the Orthopaedic Unit were recorded. The average age was 87.9 years (SD = 6.2, range = 74 a 101), 85.8% women, chronic conditions and comorbidities: 56.2%; mayors complications in-hospital: 52.4%, median length of stay in 12.01 days, preoperative stay in 1.96 days (SD = 1.28); types of fracture: intracapsular (41.9%) y extracapsular (51%); In-hospital mortality: 2.3%. Functional: 22.6% were independent for BADL. 29.7% live in nursing homes and 6.5% alone, discharge to NH: 30.9%. Conclusions.– The collaboration between geriatricians and orthopaedic surgeons is an improvement of quality care in terms of reduction of intra-hospital complications and mortality. Given the special conditions of the Spanish longest living population in our province, we established as primary target the control of the pre-surgery period, focusing on medical factors and avoiding the delay of the surgery. This resulted in most patients being surged within 48 hours after hospitalization. Disclosure.–No significant relationships. http://dx.doi.org/10.1016/j.eurger.2012.07.105
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Comparison of different cognition short tests to the MMSE M. Gogol a,∗ , A. Dettmer-Flügge a , D. Schmidt a , R. Schulz b Krankenhaus Lindenbrunn, Geriatric Department, Coppenbruegge, Germany b St. Marien-hospital, Geriatric Department, Köln, Germany
a
Text.– Comparison of different cognition short tests to the MMSE Background: Cognitive decline is common in elderly inpatients. The often-used Mini Mental Status Examination (MMSE) is in different settings (e.g. emergency room) often not applicable. Research question: In a German geriatric hospital setting the short tests BAS (Brief Alzheimer Screen), SBT (Short Blessed Test), O3DY (Ottawa 3DY) and TICS-m (Telephone Interview for Cognitive Status-modified) were compared with the MMSE. Setting: Prospective comparison in a Geriatric department with acute, subacute and rehab care. Results.– In total, 267 (107 male (M), 160 female (F)) patients were included. Mean age of M was76.29 ± 9.53 y and of F 82.03 ± 7.60 y. Mean MMSE was 23.26 ± 4.51 (M) and 22.42 ± 5.21 (F) points. The results for BAS were 21.45 ± 8.94 (M) and 19.93 ± 9.36 (F), SBT 9.82 ± 6.62 (M) and 9.97 ± 7.57 (F), O3DY 6.05 ± 2.45 (M) and 5.77 ± 2.46 (F) and TICS-m 10.43 ± 3.23 (M) and 9.16 ± 3.80 (F) points. Pearson’s correlation r for BAS/SBT/O3DY/TICS-m for M was 0.797/–0.795/0.785/0.637 and F 0.761/–0.788/0.764/0.665. Discussion.– In our setting, the short tests BAS, SBT and O3DY showed a very good correlation with the MMSE while TICS-m was less good. It seems useful to proof the short tests in further setting in the German health care system. Disclosure.– No significant relationships. http://dx.doi.org/10.1016/j.eurger.2012.07.106 P106
The study of val279phe polymorphism and lipoprotein-associated phospholipase A2 enzyme in Turkish patients with Alzheimer’s disease S. Savas a , C. Kabaroglu b , A. Alpman c , F. Sarac a,∗ , Z. Parildar b , M.A. Yalcin a , E. Kumral d , F. Ozkınay e , F. Akcicek a a Internal Medicine Department, Geriatrics Section, Ege University Medical Faculty, Izmir, Turkey b Clinical Biochemistry, Ege University Medical Faculty, Izmir, Turkey c Medical Genetics, Ege University Medical Faculty, Izmir, Turkey d Neurology Department, Ege University Medical Faculty, Izmir, Turkey e Medical Genetics Department, Ege University Medical Faculty, Izmir, Turkey Introduction.– Alzheimer’s disease (AD) is a genetically complex disorder associated with multiple genetic defects. High plasma lipoprotein phospholipase A2 activity (Lp-PLA2) is reported to be a risk factor for dementia. Lp-PLA2 influences the process and secretion of the amyloid precursor protein, the major component of the amyloid plaque in AD. Val279Phe (G > T) change takes place in active side of the Lp-PLA2 enzyme and inactive protein production has been observed in functional studies. So we aimed to evaluate Val279Phe polymorphism and Lp-PLA2 enzyme levels in Turkish Alzheimer patients. Methods.– Val279Phe polymorphism of gene encoding Lp-PLA2 enzyme was analysed in a case-control sample using 57 patients (age; mean ± SD 71.45 ± 6.05 years) with AD and 33 (age; mean ± SD 71.45 ± 6.05 years) matched healthy controls. Serum taken for Lp-PLA2 enzyme levels were stored at –80 ◦ C and ELISA method was applied. The study was approved by the local ethics council. Results.– There was no difference in age between the groups. For Val279Phe polymorphism, GG genotype was significantly higher in AD patients according to control group (P < 0.001). There was
8th Congress of the EUGMS / European Geriatric Medicine 3S (2012) S33–S143
“Rothman”. Areas under the receiver operating characteristic curve (AUC) were compared for each scale. Results.– Two hundred and thirty-seven patients were included with a median age of 80.6 years. Within 90 days, 46.0% of patients were readmitted, 6.8% had died and 0.8% were institutionalised. Of the patients who completed 90-day follow-up, 19.7% had functional decline. The AUC was low for all instruments (0.53–0.67) indicating poor discriminatory ability apart for the FI in predicating functional decline (0.74 CI: 0.54–0.96). Conclusion.– Frail older patients admitted to the acute setting are at an increased risk of adverse outcomes. None of the frailty-rating scales were able to adequately identify patients at risk of these outcomes. These results raise questions over the usefulness of current frailty-scales in the acute setting. Disclosure.– No significant relationships. http://dx.doi.org/10.1016/j.eurger.2012.07.104 P104
Comprehensive geriatric intervention in elderly patients with hip fracture. The experience in a non-teaching hospital E. Martin-Perez a,∗ , Y.R. Davila Barboza b , E.H. Azana Fernandez b , A. Rodriguez-Rosa b , L. Rodriguez-Milia c a Geriatric Department, Hospital San Juan de Dios, Leon, Spain b Geriatric Department, Leon, Spain c Research Department, Leon, Spain Text.– Background.– Hip fractures are frequent cause for long time hospital staying, especially in old-old patients. Approximately one third of all patients die within the first year. As a consequence, several collaboration models between geriatricians and orthopaedic surgeons have been implemented. In January 2011 a multidisciplinary collaboration with the Orthopaedic Unit in our hospital was started. Methods.– Prospective study and follow up of 155 elderly patients with fracture that were admitted in the Orthopaedic Unit. All patients were evaluated at entry with daily clinic follow up until patient discharge. Data was based on medical records. Results.– One hundred and fifty five elderly with hip fracture patients admitted to the Orthopaedic Unit were recorded. The average age was 87.9 years (SD = 6.2, range = 74 a 101), 85.8% women, chronic conditions and comorbidities: 56.2%; mayors complications in-hospital: 52.4%, median length of stay in 12.01 days, preoperative stay in 1.96 days (SD = 1.28); types of fracture: intracapsular (41.9%) y extracapsular (51%); In-hospital mortality: 2.3%. Functional: 22.6% were independent for BADL. 29.7% live in nursing homes and 6.5% alone, discharge to NH: 30.9%. Conclusions.– The collaboration between geriatricians and orthopaedic surgeons is an improvement of quality care in terms of reduction of intra-hospital complications and mortality. Given the special conditions of the Spanish longest living population in our province, we established as primary target the control of the pre-surgery period, focusing on medical factors and avoiding the delay of the surgery. This resulted in most patients being surged within 48 hours after hospitalization. Disclosure.–No significant relationships. http://dx.doi.org/10.1016/j.eurger.2012.07.105
P105
Comparison of different cognition short tests to the MMSE M. Gogol a,∗ , A. Dettmer-Flügge a , D. Schmidt a , R. Schulz b Krankenhaus Lindenbrunn, Geriatric Department, Coppenbruegge, Germany b St. Marien-hospital, Geriatric Department, Köln, Germany
a
Text.– Comparison of different cognition short tests to the MMSE Background: Cognitive decline is common in elderly inpatients. The often-used Mini Mental Status Examination (MMSE) is in different settings (e.g. emergency room) often not applicable. Research question: In a German geriatric hospital setting the short tests BAS (Brief Alzheimer Screen), SBT (Short Blessed Test), O3DY (Ottawa 3DY) and TICS-m (Telephone Interview for Cognitive Status-modified) were compared with the MMSE. Setting: Prospective comparison in a Geriatric department with acute, subacute and rehab care. Results.– In total, 267 (107 male (M), 160 female (F)) patients were included. Mean age of M was76.29 ± 9.53 y and of F 82.03 ± 7.60 y. Mean MMSE was 23.26 ± 4.51 (M) and 22.42 ± 5.21 (F) points. The results for BAS were 21.45 ± 8.94 (M) and 19.93 ± 9.36 (F), SBT 9.82 ± 6.62 (M) and 9.97 ± 7.57 (F), O3DY 6.05 ± 2.45 (M) and 5.77 ± 2.46 (F) and TICS-m 10.43 ± 3.23 (M) and 9.16 ± 3.80 (F) points. Pearson’s correlation r for BAS/SBT/O3DY/TICS-m for M was 0.797/–0.795/0.785/0.637 and F 0.761/–0.788/0.764/0.665. Discussion.– In our setting, the short tests BAS, SBT and O3DY showed a very good correlation with the MMSE while TICS-m was less good. It seems useful to proof the short tests in further setting in the German health care system. Disclosure.– No significant relationships. http://dx.doi.org/10.1016/j.eurger.2012.07.106 P106
The study of val279phe polymorphism and lipoprotein-associated phospholipase A2 enzyme in Turkish patients with Alzheimer’s disease S. Savas a , C. Kabaroglu b , A. Alpman c , F. Sarac a,∗ , Z. Parildar b , M.A. Yalcin a , E. Kumral d , F. Ozkınay e , F. Akcicek a a Internal Medicine Department, Geriatrics Section, Ege University Medical Faculty, Izmir, Turkey b Clinical Biochemistry, Ege University Medical Faculty, Izmir, Turkey c Medical Genetics, Ege University Medical Faculty, Izmir, Turkey d Neurology Department, Ege University Medical Faculty, Izmir, Turkey e Medical Genetics Department, Ege University Medical Faculty, Izmir, Turkey Introduction.– Alzheimer’s disease (AD) is a genetically complex disorder associated with multiple genetic defects. High plasma lipoprotein phospholipase A2 activity (Lp-PLA2) is reported to be a risk factor for dementia. Lp-PLA2 influences the process and secretion of the amyloid precursor protein, the major component of the amyloid plaque in AD. Val279Phe (G > T) change takes place in active side of the Lp-PLA2 enzyme and inactive protein production has been observed in functional studies. So we aimed to evaluate Val279Phe polymorphism and Lp-PLA2 enzyme levels in Turkish Alzheimer patients. Methods.– Val279Phe polymorphism of gene encoding Lp-PLA2 enzyme was analysed in a case-control sample using 57 patients (age; mean ± SD 71.45 ± 6.05 years) with AD and 33 (age; mean ± SD 71.45 ± 6.05 years) matched healthy controls. Serum taken for Lp-PLA2 enzyme levels were stored at –80 ◦ C and ELISA method was applied. The study was approved by the local ethics council. Results.– There was no difference in age between the groups. For Val279Phe polymorphism, GG genotype was significantly higher in AD patients according to control group (P < 0.001). There was