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P-055: Sleep apnea syndrome, hypertension, CSF and dementia
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Poster presentations / European Geriatric Medicine 6S1 (2015) S32–S156
We concluded that in aged males, the high levels of testicular estradiol caused a constant negative feedback of gonadotrophin release and testosterone production. This conclusion was enforced by removing the negative feedback due to estodial by use of an anti-estrogen, clomiphene citrate. P-053 Telomere attrition during old age can’t explain the relation between short telomere and atherosclerosis S. Toupance1 , G. Watfa2 , C. Lakomy1 , A. Kearney-Schwartz3 , C. Labat4 , P. Rossignol5 , P. Lacolley1 , F. Zannad5 , A. Benetos2 1 INSERM U1116, Vandoeuvre-l`es-Nancy, France; 2 France; 3 University Hospital of Nancy, Vandoeuvre-l`es-Nancy, France; 4 Inserm U 1116, Vandoeuvre-l`es-Nancy, France; 5 CIC-P Pierre Drouin, Vandoeuvre-l`es-Nancy, France Objectives: Short leukocyte telomere length (LTL) is associated with atherosclerosis and diminished survival in the elderly. The prevailing view is that LTL serves as a biomarker of cumulative inflammation and oxidative stress during life. However since LTL dynamics are mainly defined during the first 20 years of life, short LTL could precede atherosclerosis and act more as a determinant. We examined whether LTL attrition during old age can affect individuals’ LTL ranking in relation to their peers and which clinical or lifestyle factors can predict it. Methods: We measured LTL by Telomeric Restriction Fragment Southern Blot in samples donated 8 years apart on average by 76 subjects aged 60 to 85 years. Results: Mean LTL attrition was 27 bp/year. No clinical or lifestyle risk factors seem to exert significant effect on LTL attrition. We observed a close relationship (r = 0.88) between baseline and follow-up LTL values. Ranking individuals by LTL deciles revealed that 87.5% showed no rank change or only one decile change over time. We observed relations between values of LTL and BMI as well as between LTL and carotid atheroma. No such relationship was observed between LTL and smoking status or pulse wave velocity. Conclusions: In elderly people LTL ranking changes very little over time. Accordingly, the links of LTL with atherosclerosis and longevity appear to be established earlier in life. It is therefore unlikely that lifestyle and its modification during old age exert a major impact on telomere length that should be considered as an independent risk factor.
Cognition and dementia P-054 The increasing burden of dementia in Chile C. Albala1 , P. Fuentes2 , L. Lera3 , H. Sanchez4 , B. Angel3 , C. Marquez3 1 Universidad de Chile, Santiago, Chile; 2 Fac of. Medicine University of Chile, Santiago, Chile; 3 INTA, Universidad de Chile, Santiago, Chile; 4 INTA. University of Chile, Santiago, Chile Background: Chile is ageing rapidly with a consequent increase in the frequency of chronic diseases, among which probably the most devastating is dementia. Objective: To describe the prevalence of dementia and its contribution to the burden of dependence in Chilean older people. Design: Cross-sectional survey, in a Chilean representative sample of 4867 (63.2% women) community dwelling people ≥60 y selected with a probabilistic, stratified, multi-stage sampling design. Dementia was defined with a validated test consisting in MMSE score <22 and Pffefer Activities Questionnaire score >5. Dependence was defined as need of assistance for ≥1ADL/≥2IADL or dementia. Results: Total crude prevalence of dementia was 7.0% (women 7.7%; men 5.9%; p = 0.15) yielding estimates of 181,761 cases of dementia in Chile 2015 and 221,523 in 2020. Prevalence was higher in rural
than in urban sample (10.3% vs. 6.3%; p = 0.002) and increasing the higher age reaching 32.6% in people ≥85 y old. A strong association with education was observed being the prevalence in illiterates 25.2% vs. 1.2% in people with ≥13 school years. The fraction of dependence attributable to dementia was 32.6%. The age and gender adjusted model for dementia showed association with rurality (OR = 1.42; 95% CI 1.02–2.01) and low education (OR = 2.76; 95% CI 1.54–4.94). Conclusion: The growing number of people with dementia poses a huge challenge to our country. It is imperative to anticipate the demand for a particularly vulnerable group usually forgotten and discriminated. Early detection and design of programmes aimed to fight against reversible risk factors while stimulating protector factors should be a priority for the public health policies in the country Funded by Fondecyt grant 1130947 & SENAMA P-055 Sleep apnea syndrome, hypertension, CSF and dementia J. Attier-Zmudka1 , F. Gleize2 , B. Berteaux2 , Y. Douadi2 , E. Colpart2 , 4 S. Dao2 , A.-S. Macaret3 , I. Gyselinck2 , J.-M. Serot ´ 3 , O. Baledent ´ 1 Centre Hospitalier de Saint Quentin, Saint Quentin, France; 2 Saint Quentin Hospital, Saint Quentin, France; 3 Saint Quentin Hospital, Saint Quentin; 4 University Hospital of Amiens, Amiens, France Objective: To quantify the respiratory, cardiac or hemohydrodynamic alterations in patients with dementia. Many authors show the role of vascular factor. Likewise, that hypertension alters in the CSF, the protein beta42 ´ rate, marker of Alzheimer Disease (AD). Sleep apnea syndrome (SAS) promotes nocturnal elevations of intracranial pressure. According to a recent study, Phase-Contrast magnetic resonance imaging (PC-MRI) makes the differential diagnosis between hydrocephalus, called “normal” pressure with AD. Methods: 21 patients aged 85±8 years, suffering from dementia, with MMS average at 21±5 have been recruited in the geriatric department of Saint Quentin Hospital (France). Each included patient has a biological, neuropsychological and standardized geriatric assessment, a blood pressure holter, polygraphy and PCMRI, in aim to calculate the stroke volume in the internal carotid and vertebral arteries and quantify the oscillatory volumes of CSF during the cardiac cycle. Results: • 2 patients did not stand the polygraphy. 15 of 19 included subjects had sleep apnea, none of them had a pneumological history. • 1 patient did not stand the blood pressure holter. 12 of 20 included subjects had known and treated hypertension and 11 of these 12 also had SAS. • 4 patients did not stand MRI, 4 of 17 included subjects had altered LCS dynamic indicating an active hydrocephalus being investigated and 3 patients showed impairment in cerebral vascular flow. Conclusion: The systematic search of SAS and hemohydrodynamic disorders in elderly patients with neurodegenerative pathology is needed to better identify, understand and heal. P-056 Telematic application for the cognitive valuation, diagnosis and personalized intervention in cognitive impairment and dementia J.J. Calvo Aguirre1 , M. Barandiaran Amilano1 , O. Bueno Yanez ˜ 2, M.I. Bages ¨ Bafaluy3 1 SESOSGI, San Sebastian, Spain; 2 Geriatric Nursing. Residencia Sagrado Coraz´ on, Paseo Gabierrota, Spain; 3 Saludnova, San Sebastian, Spain Objectives: Cognitive stimulation programs are developed for rehabilitation of persons with impairment without considering the
Poster presentations / European Geriatric Medicine 6S1 (2015) S32–S156
We concluded that in aged males, the high levels of testicular estradiol caused a constant negative feedback of gonadotrophin release and testosterone production. This conclusion was enforced by removing the negative feedback due to estodial by use of an anti-estrogen, clomiphene citrate. P-053 Telomere attrition during old age can’t explain the relation between short telomere and atherosclerosis S. Toupance1 , G. Watfa2 , C. Lakomy1 , A. Kearney-Schwartz3 , C. Labat4 , P. Rossignol5 , P. Lacolley1 , F. Zannad5 , A. Benetos2 1 INSERM U1116, Vandoeuvre-l`es-Nancy, France; 2 France; 3 University Hospital of Nancy, Vandoeuvre-l`es-Nancy, France; 4 Inserm U 1116, Vandoeuvre-l`es-Nancy, France; 5 CIC-P Pierre Drouin, Vandoeuvre-l`es-Nancy, France Objectives: Short leukocyte telomere length (LTL) is associated with atherosclerosis and diminished survival in the elderly. The prevailing view is that LTL serves as a biomarker of cumulative inflammation and oxidative stress during life. However since LTL dynamics are mainly defined during the first 20 years of life, short LTL could precede atherosclerosis and act more as a determinant. We examined whether LTL attrition during old age can affect individuals’ LTL ranking in relation to their peers and which clinical or lifestyle factors can predict it. Methods: We measured LTL by Telomeric Restriction Fragment Southern Blot in samples donated 8 years apart on average by 76 subjects aged 60 to 85 years. Results: Mean LTL attrition was 27 bp/year. No clinical or lifestyle risk factors seem to exert significant effect on LTL attrition. We observed a close relationship (r = 0.88) between baseline and follow-up LTL values. Ranking individuals by LTL deciles revealed that 87.5% showed no rank change or only one decile change over time. We observed relations between values of LTL and BMI as well as between LTL and carotid atheroma. No such relationship was observed between LTL and smoking status or pulse wave velocity. Conclusions: In elderly people LTL ranking changes very little over time. Accordingly, the links of LTL with atherosclerosis and longevity appear to be established earlier in life. It is therefore unlikely that lifestyle and its modification during old age exert a major impact on telomere length that should be considered as an independent risk factor.
Cognition and dementia P-054 The increasing burden of dementia in Chile C. Albala1 , P. Fuentes2 , L. Lera3 , H. Sanchez4 , B. Angel3 , C. Marquez3 1 Universidad de Chile, Santiago, Chile; 2 Fac of. Medicine University of Chile, Santiago, Chile; 3 INTA, Universidad de Chile, Santiago, Chile; 4 INTA. University of Chile, Santiago, Chile Background: Chile is ageing rapidly with a consequent increase in the frequency of chronic diseases, among which probably the most devastating is dementia. Objective: To describe the prevalence of dementia and its contribution to the burden of dependence in Chilean older people. Design: Cross-sectional survey, in a Chilean representative sample of 4867 (63.2% women) community dwelling people ≥60 y selected with a probabilistic, stratified, multi-stage sampling design. Dementia was defined with a validated test consisting in MMSE score <22 and Pffefer Activities Questionnaire score >5. Dependence was defined as need of assistance for ≥1ADL/≥2IADL or dementia. Results: Total crude prevalence of dementia was 7.0% (women 7.7%; men 5.9%; p = 0.15) yielding estimates of 181,761 cases of dementia in Chile 2015 and 221,523 in 2020. Prevalence was higher in rural
than in urban sample (10.3% vs. 6.3%; p = 0.002) and increasing the higher age reaching 32.6% in people ≥85 y old. A strong association with education was observed being the prevalence in illiterates 25.2% vs. 1.2% in people with ≥13 school years. The fraction of dependence attributable to dementia was 32.6%. The age and gender adjusted model for dementia showed association with rurality (OR = 1.42; 95% CI 1.02–2.01) and low education (OR = 2.76; 95% CI 1.54–4.94). Conclusion: The growing number of people with dementia poses a huge challenge to our country. It is imperative to anticipate the demand for a particularly vulnerable group usually forgotten and discriminated. Early detection and design of programmes aimed to fight against reversible risk factors while stimulating protector factors should be a priority for the public health policies in the country Funded by Fondecyt grant 1130947 & SENAMA P-055 Sleep apnea syndrome, hypertension, CSF and dementia J. Attier-Zmudka1 , F. Gleize2 , B. Berteaux2 , Y. Douadi2 , E. Colpart2 , 4 S. Dao2 , A.-S. Macaret3 , I. Gyselinck2 , J.-M. Serot ´ 3 , O. Baledent ´ 1 Centre Hospitalier de Saint Quentin, Saint Quentin, France; 2 Saint Quentin Hospital, Saint Quentin, France; 3 Saint Quentin Hospital, Saint Quentin; 4 University Hospital of Amiens, Amiens, France Objective: To quantify the respiratory, cardiac or hemohydrodynamic alterations in patients with dementia. Many authors show the role of vascular factor. Likewise, that hypertension alters in the CSF, the protein beta42 ´ rate, marker of Alzheimer Disease (AD). Sleep apnea syndrome (SAS) promotes nocturnal elevations of intracranial pressure. According to a recent study, Phase-Contrast magnetic resonance imaging (PC-MRI) makes the differential diagnosis between hydrocephalus, called “normal” pressure with AD. Methods: 21 patients aged 85±8 years, suffering from dementia, with MMS average at 21±5 have been recruited in the geriatric department of Saint Quentin Hospital (France). Each included patient has a biological, neuropsychological and standardized geriatric assessment, a blood pressure holter, polygraphy and PCMRI, in aim to calculate the stroke volume in the internal carotid and vertebral arteries and quantify the oscillatory volumes of CSF during the cardiac cycle. Results: • 2 patients did not stand the polygraphy. 15 of 19 included subjects had sleep apnea, none of them had a pneumological history. • 1 patient did not stand the blood pressure holter. 12 of 20 included subjects had known and treated hypertension and 11 of these 12 also had SAS. • 4 patients did not stand MRI, 4 of 17 included subjects had altered LCS dynamic indicating an active hydrocephalus being investigated and 3 patients showed impairment in cerebral vascular flow. Conclusion: The systematic search of SAS and hemohydrodynamic disorders in elderly patients with neurodegenerative pathology is needed to better identify, understand and heal. P-056 Telematic application for the cognitive valuation, diagnosis and personalized intervention in cognitive impairment and dementia J.J. Calvo Aguirre1 , M. Barandiaran Amilano1 , O. Bueno Yanez ˜ 2, M.I. Bages ¨ Bafaluy3 1 SESOSGI, San Sebastian, Spain; 2 Geriatric Nursing. Residencia Sagrado Coraz´ on, Paseo Gabierrota, Spain; 3 Saludnova, San Sebastian, Spain Objectives: Cognitive stimulation programs are developed for rehabilitation of persons with impairment without considering the