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“Get up early” test: A short screening tool for psychomotor disadaptation syndrome
S62
8th Congress of the EUGMS / European Geriatric Medicine 3S (2012) S33–S143
Results.– Within two years, most people (56.3%) had unchanged SRH, but declined SRH (22.3%) was associated with worse baseline functioning and declined functioning. Clear declines in SRH were found after six and nine years and were associated with increased diseases (OR = 1.23) and declined functioning (OR = 1.28). The impact of diseases and functioning was smaller among institutionalized people (diseases OR = 0.90; functioning OR = 1.18) than among people living independently (diseases OR = 1.30; functioning OR = 1.44). Conclusion.– Earlier studies demonstrated the validity of SRH in very old age by showing its predictive value for mortality. The current study adds to this evidence by showing that SRH is sensitive for changes in disease and functioning, although more pronounced on the longer than on the shorter term. Disclosure.– No significant relationships. http://dx.doi.org/10.1016/j.eurger.2012.07.097 P097
Determinants of functional status impairment among Finnish war veterans: Results from the veteran project 1992 and 2004 surveys R. Leskinen a,∗ , T. Laatikainen b , M. Peltonen b , R. Antikainen c Geriatrics, Oulu City Hospital, Oulu, Finland b National Institute For Health And Welfare, Helsinki, Finland c Institute Of Health Sciences/geriatrics, Oulu University, Oulu, Finland
a
Introduction.– The aim of this study was to determine the predictors for impaired basic (BADL) and instrumental activities of daily living (IADL) during the twelve years follow-up among 2615 Finnish war veterans without the wartime disability. Methods.– In the Veteran Projects, the postal questionnaire was sent in 1992 to all veterans (n = 242,720) living in Finland, and in 2004 to 5750 veterans who had participated in the study in 1992. The relations were determined between the presence different baseline variables in 1992 and the impaired BADL and IADL in 2004 using multiple regression analysis. The impaired BADL and IADL were defined if any of the activities was impaired in 2004. Results.– In 2004, the mean age of veterans was 82.2 years. Of them, 55.8% reported to cope with all BADLs and 42.7% with all IADLs without difficulties. The highest estimates for impaired BADL and IADL in 2004 were severe walking difficulties [odds ratio (OR) 2.07 and 95% Confidence Interval (95% CI) 1.58–2.70 for impaired BADL and OR 2.82 (95% CI 2.04-3.89) for impaired IADL] and neurological diseases [OR 5.78 (95% CI 2.49–13.43) and OR 2.34 (95% CI 1.02–5.38)]. Vision and hearing impairment, the presence of fatigue, depression, cardiovascular and musculoskeletal diseases had significant bur lower OR estimates. Conclusions.– Predictors of functional status impairment found in our study have proved to be associated with impaired BADL and IADL also in previous studies. By active treatment of chronic conditions and providing relevant aid to elderly, functional capacity decline could be partly prevented. Disclosure.– No significant relationships. http://dx.doi.org/10.1016/j.eurger.2012.07.098
P098
The determinants of functionality in community dwelling Turkish elderly G. Bahat a,∗ , Y. Aydin a , F. Tufan b , S. Akin b , B. Saka b , N. Erten b , M.A. Karan b a Internal Medicine Division Of Geriatrics, Istanbul University Istanbul Medical School, Istanbul, Turkey b Internal Medicine, Istanbul, Turkey Introduction.– The main goal of care of elderly is preservation of functionality. Our aim was to assess the functional status and its determinants in community-dwelling Turkish elderly. Methods.– Geriatrics outpatient clinics patients were assessed retrospectively. Age, gender, height, weight, BMI, nutritional-status, ADL, IADL, MMSE, GDS, diseases, drugs, total number of chronicdiseases/drugs, smoking and alcohol-use were noted. Results.– Among 789 patients, 274 were male, 515 were female. Mean age was 73.7 ± 7 years. Mean ADL-score and IADL-score were 9.3 ± 1.6, 10.8 ± 4.1, respectively. By univariate-analysis ADL was related with age, MMSE, GDS, MNA, number-of-chronic-diseases, nutritional-status, and Parkinson’s disease. Multivariate analysis yielded only nutritional-status, MMSE-point and Parkinson’s disease related to ADL. By univariate-analysis, IADL was related with age, MMSE, GDS, MNA, number-of-chronic-diseases, dementia, and diabetes. Multivariate analysis yielded only nutritional-status, MMSE-point, Parkinson’s disease, diabetes and age related to IADL. Conclusion.– In our study, we examined effect of many factors and diseases on functionality. Only poor nutrition, low MMSE, Parkinson’s disease, diabetes, advanced age were significant negative factors. To improve functionality of elderly, targets should include nutrition, diabetes, dementia and Parkinson’s disease. Disclosure.– No significant relationships. http://dx.doi.org/10.1016/j.eurger.2012.07.099 P099
“Get up early” test: A short screening tool for psychomotor disadaptation syndrome G. Cremer ∗ , E. Toussaint , M. Iacovelli , J. Jamart , C. Swine , D. Schoevaerdts Geriatric Medicine, CHU Mont-Godinne, UCL, Yvoir, Belgium
Text.– Older persons admitted at the hospital often have a post-fall syndrome or its precursor, the Psychomotor Disadaptation Syndrome (PDS). Mini Motor Test (TMM) is the gold standard used by skilled physiotherapists in order to assess the syndrome. Targeting its screening by healthcare providers without specific skills in geriatric medicine, our aim was to elaborate a short PDS screening tool, called the “Get Up Early” test. The test was firstly elaborated through consensus of nine experts in the geriatric field, and the final 4-item version with substantial inter-rater concordance included the following items: – inability to sit independently on the edge of the bed; – manipulation difficulty: he/she refuses, becomes heavy, holds on; – the trunk is thrown backwards, slipping from the edge of the bed; – apprehension: cries, frightened look, stiff body. Compared to the TMM as gold standard, with a cut-off value ≥ 1/4, diagnostic performance was good (sensibility: 0.73 and specificity 0.88; area under the curve: 0.823). The last step was to implement the screening tool in three Mobile Geriatric Units who reported good face validity and clinical value. Using an informational bookmark with four pictures, we report the educational usefulness of the support. We conclude that the “Get Up Early” test may be suggested as a short screening tool in order to detect PDS before more in-depth comprehensive geriatric assessment and to recommend early functional physiotherapy within the care plan. Disclosure.– No significant relationships. http://dx.doi.org/10.1016/j.eurger.2012.07.100
8th Congress of the EUGMS / European Geriatric Medicine 3S (2012) S33–S143
Results.– Within two years, most people (56.3%) had unchanged SRH, but declined SRH (22.3%) was associated with worse baseline functioning and declined functioning. Clear declines in SRH were found after six and nine years and were associated with increased diseases (OR = 1.23) and declined functioning (OR = 1.28). The impact of diseases and functioning was smaller among institutionalized people (diseases OR = 0.90; functioning OR = 1.18) than among people living independently (diseases OR = 1.30; functioning OR = 1.44). Conclusion.– Earlier studies demonstrated the validity of SRH in very old age by showing its predictive value for mortality. The current study adds to this evidence by showing that SRH is sensitive for changes in disease and functioning, although more pronounced on the longer than on the shorter term. Disclosure.– No significant relationships. http://dx.doi.org/10.1016/j.eurger.2012.07.097 P097
Determinants of functional status impairment among Finnish war veterans: Results from the veteran project 1992 and 2004 surveys R. Leskinen a,∗ , T. Laatikainen b , M. Peltonen b , R. Antikainen c Geriatrics, Oulu City Hospital, Oulu, Finland b National Institute For Health And Welfare, Helsinki, Finland c Institute Of Health Sciences/geriatrics, Oulu University, Oulu, Finland
a
Introduction.– The aim of this study was to determine the predictors for impaired basic (BADL) and instrumental activities of daily living (IADL) during the twelve years follow-up among 2615 Finnish war veterans without the wartime disability. Methods.– In the Veteran Projects, the postal questionnaire was sent in 1992 to all veterans (n = 242,720) living in Finland, and in 2004 to 5750 veterans who had participated in the study in 1992. The relations were determined between the presence different baseline variables in 1992 and the impaired BADL and IADL in 2004 using multiple regression analysis. The impaired BADL and IADL were defined if any of the activities was impaired in 2004. Results.– In 2004, the mean age of veterans was 82.2 years. Of them, 55.8% reported to cope with all BADLs and 42.7% with all IADLs without difficulties. The highest estimates for impaired BADL and IADL in 2004 were severe walking difficulties [odds ratio (OR) 2.07 and 95% Confidence Interval (95% CI) 1.58–2.70 for impaired BADL and OR 2.82 (95% CI 2.04-3.89) for impaired IADL] and neurological diseases [OR 5.78 (95% CI 2.49–13.43) and OR 2.34 (95% CI 1.02–5.38)]. Vision and hearing impairment, the presence of fatigue, depression, cardiovascular and musculoskeletal diseases had significant bur lower OR estimates. Conclusions.– Predictors of functional status impairment found in our study have proved to be associated with impaired BADL and IADL also in previous studies. By active treatment of chronic conditions and providing relevant aid to elderly, functional capacity decline could be partly prevented. Disclosure.– No significant relationships. http://dx.doi.org/10.1016/j.eurger.2012.07.098
P098
The determinants of functionality in community dwelling Turkish elderly G. Bahat a,∗ , Y. Aydin a , F. Tufan b , S. Akin b , B. Saka b , N. Erten b , M.A. Karan b a Internal Medicine Division Of Geriatrics, Istanbul University Istanbul Medical School, Istanbul, Turkey b Internal Medicine, Istanbul, Turkey Introduction.– The main goal of care of elderly is preservation of functionality. Our aim was to assess the functional status and its determinants in community-dwelling Turkish elderly. Methods.– Geriatrics outpatient clinics patients were assessed retrospectively. Age, gender, height, weight, BMI, nutritional-status, ADL, IADL, MMSE, GDS, diseases, drugs, total number of chronicdiseases/drugs, smoking and alcohol-use were noted. Results.– Among 789 patients, 274 were male, 515 were female. Mean age was 73.7 ± 7 years. Mean ADL-score and IADL-score were 9.3 ± 1.6, 10.8 ± 4.1, respectively. By univariate-analysis ADL was related with age, MMSE, GDS, MNA, number-of-chronic-diseases, nutritional-status, and Parkinson’s disease. Multivariate analysis yielded only nutritional-status, MMSE-point and Parkinson’s disease related to ADL. By univariate-analysis, IADL was related with age, MMSE, GDS, MNA, number-of-chronic-diseases, dementia, and diabetes. Multivariate analysis yielded only nutritional-status, MMSE-point, Parkinson’s disease, diabetes and age related to IADL. Conclusion.– In our study, we examined effect of many factors and diseases on functionality. Only poor nutrition, low MMSE, Parkinson’s disease, diabetes, advanced age were significant negative factors. To improve functionality of elderly, targets should include nutrition, diabetes, dementia and Parkinson’s disease. Disclosure.– No significant relationships. http://dx.doi.org/10.1016/j.eurger.2012.07.099 P099
“Get up early” test: A short screening tool for psychomotor disadaptation syndrome G. Cremer ∗ , E. Toussaint , M. Iacovelli , J. Jamart , C. Swine , D. Schoevaerdts Geriatric Medicine, CHU Mont-Godinne, UCL, Yvoir, Belgium
Text.– Older persons admitted at the hospital often have a post-fall syndrome or its precursor, the Psychomotor Disadaptation Syndrome (PDS). Mini Motor Test (TMM) is the gold standard used by skilled physiotherapists in order to assess the syndrome. Targeting its screening by healthcare providers without specific skills in geriatric medicine, our aim was to elaborate a short PDS screening tool, called the “Get Up Early” test. The test was firstly elaborated through consensus of nine experts in the geriatric field, and the final 4-item version with substantial inter-rater concordance included the following items: – inability to sit independently on the edge of the bed; – manipulation difficulty: he/she refuses, becomes heavy, holds on; – the trunk is thrown backwards, slipping from the edge of the bed; – apprehension: cries, frightened look, stiff body. Compared to the TMM as gold standard, with a cut-off value ≥ 1/4, diagnostic performance was good (sensibility: 0.73 and specificity 0.88; area under the curve: 0.823). The last step was to implement the screening tool in three Mobile Geriatric Units who reported good face validity and clinical value. Using an informational bookmark with four pictures, we report the educational usefulness of the support. We conclude that the “Get Up Early” test may be suggested as a short screening tool in order to detect PDS before more in-depth comprehensive geriatric assessment and to recommend early functional physiotherapy within the care plan. Disclosure.– No significant relationships. http://dx.doi.org/10.1016/j.eurger.2012.07.100