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Comparison of MMSE and Extended Barthel Index (EBI)
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9th congress of the EUGMS / European Geriatric Medicine 4 (2013) S142–S216
trols (CT) and 12 iNPH age-matched. Before liquor drainage, the blood of iNPH was collected at recruitment (T0), after 6 (T1) and 12 (T2) months. Liquor from AD and iNPH at T0 were analysed by MALDI Profiling for the detection of characteristic protein patterns. Results.– In iNPH, the mRNA levels at T0 were higher than CT and AD (mean ± standard error: 1.09 ± 0.43; 0.67 ± 0.08; 0.71 ± 0.07; P = 0.124) and progressively decreased during the follow-up: 1.09 ± 0.43, 0.86 ± 0.17, 0.46 ± 0.04 (respectively at T0, T1 and T2; P < 0.05). The gene expression in all patients correlated with vascular damage evaluated by Fazekas scale after brain MRI (R2 = 0.11, P = 0.04). The protein patterns of iNPH differed from those of AD for the presence of 18 differentially changed peaks (P < 0.05). http://dx.doi.org/10.1016/j.eurger.2013.07.698 P635
Comparison of MMSE and Extended Barthel Index (EBI) R.J. Schulz a,b , M. Gogol a,b a St Marien Hospital and Univeristy Cologne, Cologne, Germany b Krankenhaus Lindenbrunn Coppenbrügge, Coppenbruegge, Germany Introduction.– Dementia and cognitive decline are common problems in elderly people. In Germany, in-patients were often assessed with the MMSE. While this test is time consuming, shorter tests are sometimes required. Methods.– In a geriatric department of a community hospital, we retrospectively compared patients who were assessed with the MMSE and the Extended Barthel Index (EBI). The EBI is a rating scale with 6 domains (comprehension, communication, social interaction, problem solving, memory and orientation, and viewing and neglect). Three items were rated with 0/5/15 and three with 0/5/10/15 points. The range can be between 0 and 90 points, higher points indicating better function. Results.– We identify via hospital information system 333 patients in 2010, 62% female, with complete data sets out of 392. Mean age was 80.1 ± 7.8 years (y), male 77.5 ± 8.8 y and women 81.6 ± 7.8 y. MMSE in men was 22.1 ± 6.0 and in women 21.0 ± 6.7 (sex difference ns, P 0.106), EBI in men 56.3 ± 25.8 and in woman 54.5 ± 27.5 (sex difference ns, P 0.548). Pearson correlation r in men was 0.909 and in women 0.951. We found no age-dependent effect related to both tests, MMSE –0.068 (men), –0.189 (woman) and EBI –0.015 (men), –0.182 (women). Conclusion.– In this retrospective chart analysis in a single-center design, we found a high correlation between MMSE and EBI for both genders without age dependent effects. Potential bias due to the retrospective character of the study is possible. http://dx.doi.org/10.1016/j.eurger.2013.07.699 P636
Caring for people with dementia in general hospitals S. Gurlit a,b,c,d , R. Thiesemann a,b,c,d , B. Wolff a,b,c,d , J. Brommer a,b,c,d a St. Franziskus Hospital Münster, Münster, Germany b Krankenhaus St. Josef Wuppertal, Wuppertal, Germany c Landesvereinigung für Gesundheit Hannover, Hannover, Germany d Alzheimer Gesellschaft Niedersachsen Hannover, Hannover, Germany Introduction.– Cognitive impairment and dementia are common problems in elderly patients. In Germany, there are no general concepts and recommendations for general hospital how to deal with this growing in-patient population. Methods.– Since 2006, the Alzheimer’s Society of Lower Saxony, Germany, has been working with an interdisciplinary team to
improve care and medical treatment for this patients and discussed preliminary results at various symposia. Results.– In 2011, a two-stage curriculum were completed and sent to all hospitals in Lower Saxony with additional training materials. The manual comprise a two-step approach with a 14-h-training for hospital staff and a 160-h-training for qualification of trainers and dementia appointees. The manual further include a list of 13 essential points for “dealing with demented patients in general hospitals”, the information sheet of the German Alzheimer’s Society on aspects requiring special attention, shor descriptions of a number of best practice models, a list of established speakers in the field, and a 30-min-video. Conclusion.– The curriculum is now in dissemination and the first reactions are positive. The project awarded in 2012 the “Preis für Engagement und Selbsthilfe” of the Hertie Foundation and the “Niedersächsischen Gesundheitspreis” by the Lower Saxony Ministry for Social, Women, Family, and Health Affairs. http://dx.doi.org/10.1016/j.eurger.2013.07.700 P637
Delirium and acute stroke: The incidence, severity and duration of delirium and long-term outcomes for patients post-stroke and delirium S. Ahmed , J.D. Holmes , J.B. Young University of Leeds, Leeds, United Kingdom Introduction.– Delirium is an acute generalised impairment of brain function and a common complication of illness in older people. It affects 5 to 15% of patients in general wards, however, it is commonly overlooked or misdiagnosed in clinical practice. Previous studies have found that delirium is linked to longer hospital stays, an increased need for institutionalisation and future complications e.g. increased risk of dementia and mortality. Delirium onset may be associated with an acute stroke. The aims of this study were to identify the incidence, severity and duration of delirium in acute stroke, compare long-term patient outcomes and identify possible confounding variables. Methods.– A systematic review was conducted to investigate the association between delirium and acute stroke. Stroke patients with and without delirium were recruited into a UK based prospective cohort study and followed over 6 months. Each participant had their stroke diagnosis confirmed by clinical assessment. The presence and severity of delirium was detected and graded during their hospital stay. Other functional assessments were also conducted at regular intervals throughout the study. Results and conclusion.– The systematic review highlighted a wide variation in delirium incidence from the studies published. The implications for the proposed study were assessment of long-term outcomes, more inclusive patient recruitment policies and employing reliable diagnostic tools. A total of 295 patients were recruited and data collection is on-going for the study. This PhD project is funded by CLAHRC for Leeds, York and Bradford and supervised by Dr John D. Holmes and Professor John B. Young. http://dx.doi.org/10.1016/j.eurger.2013.07.701 P638
Factors likely to contribute to postoperative delirium: The cascade study, confusion after surgical cardiac intervention developed S. Allepaerts , Y. Massin , F. Blaffart , J. Pincemail , J.-O. Defraigne , J.-P. Petermans Service de Gériatrie, University Hospital, CHU Sart-Tilman, Liege, Belgium
9th congress of the EUGMS / European Geriatric Medicine 4 (2013) S142–S216
trols (CT) and 12 iNPH age-matched. Before liquor drainage, the blood of iNPH was collected at recruitment (T0), after 6 (T1) and 12 (T2) months. Liquor from AD and iNPH at T0 were analysed by MALDI Profiling for the detection of characteristic protein patterns. Results.– In iNPH, the mRNA levels at T0 were higher than CT and AD (mean ± standard error: 1.09 ± 0.43; 0.67 ± 0.08; 0.71 ± 0.07; P = 0.124) and progressively decreased during the follow-up: 1.09 ± 0.43, 0.86 ± 0.17, 0.46 ± 0.04 (respectively at T0, T1 and T2; P < 0.05). The gene expression in all patients correlated with vascular damage evaluated by Fazekas scale after brain MRI (R2 = 0.11, P = 0.04). The protein patterns of iNPH differed from those of AD for the presence of 18 differentially changed peaks (P < 0.05). http://dx.doi.org/10.1016/j.eurger.2013.07.698 P635
Comparison of MMSE and Extended Barthel Index (EBI) R.J. Schulz a,b , M. Gogol a,b a St Marien Hospital and Univeristy Cologne, Cologne, Germany b Krankenhaus Lindenbrunn Coppenbrügge, Coppenbruegge, Germany Introduction.– Dementia and cognitive decline are common problems in elderly people. In Germany, in-patients were often assessed with the MMSE. While this test is time consuming, shorter tests are sometimes required. Methods.– In a geriatric department of a community hospital, we retrospectively compared patients who were assessed with the MMSE and the Extended Barthel Index (EBI). The EBI is a rating scale with 6 domains (comprehension, communication, social interaction, problem solving, memory and orientation, and viewing and neglect). Three items were rated with 0/5/15 and three with 0/5/10/15 points. The range can be between 0 and 90 points, higher points indicating better function. Results.– We identify via hospital information system 333 patients in 2010, 62% female, with complete data sets out of 392. Mean age was 80.1 ± 7.8 years (y), male 77.5 ± 8.8 y and women 81.6 ± 7.8 y. MMSE in men was 22.1 ± 6.0 and in women 21.0 ± 6.7 (sex difference ns, P 0.106), EBI in men 56.3 ± 25.8 and in woman 54.5 ± 27.5 (sex difference ns, P 0.548). Pearson correlation r in men was 0.909 and in women 0.951. We found no age-dependent effect related to both tests, MMSE –0.068 (men), –0.189 (woman) and EBI –0.015 (men), –0.182 (women). Conclusion.– In this retrospective chart analysis in a single-center design, we found a high correlation between MMSE and EBI for both genders without age dependent effects. Potential bias due to the retrospective character of the study is possible. http://dx.doi.org/10.1016/j.eurger.2013.07.699 P636
Caring for people with dementia in general hospitals S. Gurlit a,b,c,d , R. Thiesemann a,b,c,d , B. Wolff a,b,c,d , J. Brommer a,b,c,d a St. Franziskus Hospital Münster, Münster, Germany b Krankenhaus St. Josef Wuppertal, Wuppertal, Germany c Landesvereinigung für Gesundheit Hannover, Hannover, Germany d Alzheimer Gesellschaft Niedersachsen Hannover, Hannover, Germany Introduction.– Cognitive impairment and dementia are common problems in elderly patients. In Germany, there are no general concepts and recommendations for general hospital how to deal with this growing in-patient population. Methods.– Since 2006, the Alzheimer’s Society of Lower Saxony, Germany, has been working with an interdisciplinary team to
improve care and medical treatment for this patients and discussed preliminary results at various symposia. Results.– In 2011, a two-stage curriculum were completed and sent to all hospitals in Lower Saxony with additional training materials. The manual comprise a two-step approach with a 14-h-training for hospital staff and a 160-h-training for qualification of trainers and dementia appointees. The manual further include a list of 13 essential points for “dealing with demented patients in general hospitals”, the information sheet of the German Alzheimer’s Society on aspects requiring special attention, shor descriptions of a number of best practice models, a list of established speakers in the field, and a 30-min-video. Conclusion.– The curriculum is now in dissemination and the first reactions are positive. The project awarded in 2012 the “Preis für Engagement und Selbsthilfe” of the Hertie Foundation and the “Niedersächsischen Gesundheitspreis” by the Lower Saxony Ministry for Social, Women, Family, and Health Affairs. http://dx.doi.org/10.1016/j.eurger.2013.07.700 P637
Delirium and acute stroke: The incidence, severity and duration of delirium and long-term outcomes for patients post-stroke and delirium S. Ahmed , J.D. Holmes , J.B. Young University of Leeds, Leeds, United Kingdom Introduction.– Delirium is an acute generalised impairment of brain function and a common complication of illness in older people. It affects 5 to 15% of patients in general wards, however, it is commonly overlooked or misdiagnosed in clinical practice. Previous studies have found that delirium is linked to longer hospital stays, an increased need for institutionalisation and future complications e.g. increased risk of dementia and mortality. Delirium onset may be associated with an acute stroke. The aims of this study were to identify the incidence, severity and duration of delirium in acute stroke, compare long-term patient outcomes and identify possible confounding variables. Methods.– A systematic review was conducted to investigate the association between delirium and acute stroke. Stroke patients with and without delirium were recruited into a UK based prospective cohort study and followed over 6 months. Each participant had their stroke diagnosis confirmed by clinical assessment. The presence and severity of delirium was detected and graded during their hospital stay. Other functional assessments were also conducted at regular intervals throughout the study. Results and conclusion.– The systematic review highlighted a wide variation in delirium incidence from the studies published. The implications for the proposed study were assessment of long-term outcomes, more inclusive patient recruitment policies and employing reliable diagnostic tools. A total of 295 patients were recruited and data collection is on-going for the study. This PhD project is funded by CLAHRC for Leeds, York and Bradford and supervised by Dr John D. Holmes and Professor John B. Young. http://dx.doi.org/10.1016/j.eurger.2013.07.701 P638
Factors likely to contribute to postoperative delirium: The cascade study, confusion after surgical cardiac intervention developed S. Allepaerts , Y. Massin , F. Blaffart , J. Pincemail , J.-O. Defraigne , J.-P. Petermans Service de Gériatrie, University Hospital, CHU Sart-Tilman, Liege, Belgium