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P129: Mortality and functional decline one year after a hip fracture in elderly over 75 years
Poster presentations, Thursday 18 September 2014 / European Geriatric Medicine 5S1 (2014) S83–S158
Results: 94 older adults, mean age 78.9±6.7ys (range 65–90ys), 60 females, MMSE 27.2±2.0 were evaluated. Only 6 subjects met Fried criteria for frailty. Although many of the assessed features were significantly associated with frailty (Table), total time to perform TUGt was the variable who best discriminated between frail and non-frail participants (AUC = 0.93). Conclusions: uTUG may be used to identify frailty the communitydwelling older population.
Age Gender (female) Mini Mental State Examination CES-D Score Assumed drugs (N) Trail Making Test – Part A SPPB Falls last 12 months (Ys) TUG total time (s) Sit to stand and start walking time (s) Time to turn 180° (s) Log-time to turn before take a seat (s) Time to take a seat (s) Range Accelerometer Stand to Walk (m/s2 )
Frail (n=7)
78.58±6.70 55 (63.22%) 27.18±2.07 17.24±8.36 3.12±1.90 68.47±31.53 9.97±1.84 17 (19.54%) 11.71±2.53 1.36±0.53 2.09±0.60 0.54±0.50 3.10±0.82
83.71±5.19 5 (71.43%) 27.86±1.07 20.00±3.46 4.86±2.67 69.43±39.75 6.57±2.94 2 (28.57%) 17.38±3.45 2.14±0.76 2.52±0.49 0.85±0.49 3.75±1.11
AP 8.42±2.17 ML 2.86±1.14 V 6.07±1.59
Root Mean Square Accelerometer Stand to Walk (m/2 ) AP ML V Log-Jerk Accelerometer Stand to Walk (m) AP ML V AP Range Gyroscope Stand to Walk (°/s) ML V 2 Root Mean Square Gyroscope Stand to Walk (m/s ) AP
Log-Normalize Jerk Score Gyroscope Stand to Walk
Not frail (n=87)
ML V AP ML V
2.95±0.80 0.77±0.49 1.58±0.57 2.29±0.69 1.52±0.71 2.22±0.76 37.73±18.75 157.62±37.56 67.07±24.63
3.06±0.69 0.97±0.38 1.36±0.79 3.10±0.76 2.62±0.76 3.06±0.82 36.19±8.60 128.24±50.34 53.14±7.72
0.70 0.20 0.44 0.01 0.01 0.02 0.69 0.18 0.00
9.47±4.41 43.72±10.59 17.50±6.28 5.74±1.39 4.84±0.67 6.41±1.40
8.70±1.80 36.58±14.86 13.60±1.99 6.84±2.27 5.28±0.69 7.33±0.95 10.20±1.83 4.20±1.98 8.83±4.49
Root Mean Square Accelerometer Turn to Sit (m/s2 )
AP ML V AP ML V AP ML V AP ML V AP ML V
3.77±0.49 1.20±0.76 2.21±1.07 2.08±0.38 1.74±0.49 2.49±0.53 52.46±34.11 157.23±121.58 63.93±28.28 14.11±9.01 40.21±23.19 16.90±6.06 5.60±1.11 4.45±0.53 5.28±0.69 57.45±10.83 57.21±17.07 101.28±22.16 107.79±29.36 6.72±0.79 6.37±0.98
Root Mean Square Gyroscope Turn to Sit (°/s)
Log-Normalize Jerk Score Gyroscope Turn to Sit
Average speed 180 (°s) Average speed Turn to Sit (°/s) Max speed 180 (°/s) Max speed Turn to Sit (°/s) Log-Normalize Jerk Score turn 180 Log-Normalize Jerk Score turn Turn to Sit
0.04 1.00 0.17 0.11 0.14 0.95 0.02 0.63 0.01 0.02 0.06 0.11 0.11 0.47 0.44 0.10
AP 8.89±2.14 ML 3.81±1.90 V 7.11±2.63
Range AP Gyroscope Turn to Sit (°/s)
0.93 0.88 0.74
p
8.92±1.73 3.23±1.35 4.63±2.14
Range Accelerometer Turn to Sit (m/s2 )
Log-Jerk Accelerometer Turn to Sit (m)
AUC
3.13±0.77 0.99±0.50 1.66±0.61 1.89±0.84 1.41±0.88 2.16±0.81 49.42±24.64 107.75±34.90 57.82±25.47 12.29±5.95 30.88±9.43 15.84±7.29 5.81±1.33 4.16±0.88 5.17±1.24 76.89±18.22 88.66±29.01 139.68±33.12 156.28±46.19 6.27±0.69 5.66±0.76
0.83 0.88 0.83
0.71
0.71
0.34 0.26 0.00 0.25 0.14 0.06 0.11 0.63 0.35
0.77
0.66
0.84 0.83 0.83 0.83
0.03 0.35 0.22 0.23 0.10 0.02 0.82 0.32 0.60 0.62 0.33 0.67 0.65 0.22 0.74 0.00 0.00 0.00 0.00 0.12 0.11
P128 Effects of serum iron markers on functional outcomes in sarcopenic elderly. A cross-sectional study S. Perna1 , E. Sauta2 , E. Riggi2 , G. Peroni2 , F. Guerriero1 , C. Sgarlata2 , M. Rollone3 , C. Donelli2 , D. Guido2 , I. Degli Agosti3 , M. Rondanelli1 , M.A. Faliva2 , M. Naso2 1 University of Pavia, Azienda di Servizi alla Persona of Pavia, Pavia, Italy; 2 University of Pavia, Pavia, Italy; 3 Azienda di Servizi alla Persona of Pavia, Pavia, Italy Introduction: This study investigates the effects of iron markers on functional outcomes, i.e. Relative Skeletal Muscle Mass (RSMM) and Barthel index (BI), in sarcopenic elderly. Materials and Methods: The study was conducted on 197 elderly (i.e. 65+y) patients: 139 females, 58 males, age = 81.1±6.5y, BMI = 24±4 kg/m2 . Body composition markers are measured by dual energy X-ray absorptiometry (DEXA), while the hemato-chemical parameters by blood tests. The study has been focused on the effects (b) of serum iron markers such as iron (Fe+) (64±30 mcg/dl), transferrin (221±57 mg/dl), and
S123
hemoglobin (12.4±1.6 g/dl) levels on the two functional outcomes: RSMM (6.33±1.24 kg/m2 ) and BI (60±28 u). Statistical analysis was performed by a multivariate multiple regression model adjusted for gender, age, albumin (%) (55±5), BMI, and lean mass (39±7 kg). b-estimates with p-values <0.05 were considered significant. Results: The regression model showed only one significant evidence for the effect of iron levels on BI (b = +0.185, P = 0.014, and 95% CI= [0.041; 0.335]): according to other relevant variables included, for an increase of 10 mcg/dl of iron, functionality increases of 1.85 BI units. R2 goodness of fit indexes resulted equal to 0.291 (for BI) and 0.576 (for RSMM). Conclusion: Iron plays a protective role in the progression of functional decline. Since iron biochemical parameters are important for monitoring functional skills in sarcopenic elderly. P129 Mortality and functional decline one year after a hip fracture in elderly over 75 years S. Drevet, B.J. Chedal Bornu, C. Bioteau, S. Maziere, J. Tonetti, P. Merloz, P. Couturier, G. Gavazzi CHU Grenoble, Grenoble, France Introduction: 1% of falls in over-75 year-olds cause proximal femoral fracture (PFF). PFF appears one of the worst complications of elderly’s fall and is associated with high morbidity and functional decline (FD). Methods: A prospective observational epidemiological study about patients aged over 75 years, one year after a PFF. The principal objective was to determine the mortality rate one year after the PFF. Secondary objectives were to identify factors associated with mortality, prevalence of FD one year after PFF and factors associated with FD. Factors associated were collected: ADL, IADL, CIRS-G, MNA, MMSE and severity. Scores were compared on quantitative tests (Student t) with the significance threshold set at p < 0.05. Results: Mean age of 113 patients included was 86.96 years. Mortality rate was 37.2%. Mortality was associated with low IADL D-15 (p = 0.000), elevated CIRS-G (p = 0.001), low MMSE (p = 0.031) and severity (p = 0.042). Malnutrition appears as a risk of death with OR = 3.095 (1.014–9.446). Among survival cohort whole data were available for 51 patients. Prevalence of FD was 41.2% with an average of 0.81 point. The unique factor associated with FD was ADL at the time of discharge from orthopedic unit (p = 0.027). Conclusions: Given the present economic stakes and the high morbi-mortality rate in geriatric trauma patients, it is essential to study this challenging group. Interventional studies are needed to determine whether management of modifiable factors may improve early and long term outcomes. P130 Erythrocyte sedimentation rate (ESR) and C-reactive protein (PCR) as inflammation markers in sarcopenic elderly. Repercussions on functional status. A cross-sectional study in nursing home residents S. Perna1 , D. Guido2 , E. Riggi2 , F. Guerriero1 , C. Sgarlata2 , E. Sauta2 , M. Rollone3 , L. Oberto3 , D. Maddalena1 , M. Rondanelli1 1 University of Pavia, Azienda di Servizi alla Persona of Pavia, Pavia, Italy; 2 University of Pavia, Pavia, Italy; 3 Azienda di Servizi alla Persona of Pavia, Pavia, Italy Introduction: The aim of our research was to investigate the effects of inflammatory markers, specifically ESR, on functionality of sarcopenic elderly. Material and Methods: We enrolled 257 elderly (65+y) patients (181 females, 76 males, mean age = 81.7, BMI 24.8) hospitalized. ESR (48.5) and PCR (1.38) were considered as inflammation markers. Relative Skeletal Muscle Mass (RSMM) (6.41) was considered as sarcopenia marker. Barthel index (58.3), such as functional outcome. The analysis was conducted with a structural
Results: 94 older adults, mean age 78.9±6.7ys (range 65–90ys), 60 females, MMSE 27.2±2.0 were evaluated. Only 6 subjects met Fried criteria for frailty. Although many of the assessed features were significantly associated with frailty (Table), total time to perform TUGt was the variable who best discriminated between frail and non-frail participants (AUC = 0.93). Conclusions: uTUG may be used to identify frailty the communitydwelling older population.
Age Gender (female) Mini Mental State Examination CES-D Score Assumed drugs (N) Trail Making Test – Part A SPPB Falls last 12 months (Ys) TUG total time (s) Sit to stand and start walking time (s) Time to turn 180° (s) Log-time to turn before take a seat (s) Time to take a seat (s) Range Accelerometer Stand to Walk (m/s2 )
Frail (n=7)
78.58±6.70 55 (63.22%) 27.18±2.07 17.24±8.36 3.12±1.90 68.47±31.53 9.97±1.84 17 (19.54%) 11.71±2.53 1.36±0.53 2.09±0.60 0.54±0.50 3.10±0.82
83.71±5.19 5 (71.43%) 27.86±1.07 20.00±3.46 4.86±2.67 69.43±39.75 6.57±2.94 2 (28.57%) 17.38±3.45 2.14±0.76 2.52±0.49 0.85±0.49 3.75±1.11
AP 8.42±2.17 ML 2.86±1.14 V 6.07±1.59
Root Mean Square Accelerometer Stand to Walk (m/2 ) AP ML V Log-Jerk Accelerometer Stand to Walk (m) AP ML V AP Range Gyroscope Stand to Walk (°/s) ML V 2 Root Mean Square Gyroscope Stand to Walk (m/s ) AP
Log-Normalize Jerk Score Gyroscope Stand to Walk
Not frail (n=87)
ML V AP ML V
2.95±0.80 0.77±0.49 1.58±0.57 2.29±0.69 1.52±0.71 2.22±0.76 37.73±18.75 157.62±37.56 67.07±24.63
3.06±0.69 0.97±0.38 1.36±0.79 3.10±0.76 2.62±0.76 3.06±0.82 36.19±8.60 128.24±50.34 53.14±7.72
0.70 0.20 0.44 0.01 0.01 0.02 0.69 0.18 0.00
9.47±4.41 43.72±10.59 17.50±6.28 5.74±1.39 4.84±0.67 6.41±1.40
8.70±1.80 36.58±14.86 13.60±1.99 6.84±2.27 5.28±0.69 7.33±0.95 10.20±1.83 4.20±1.98 8.83±4.49
Root Mean Square Accelerometer Turn to Sit (m/s2 )
AP ML V AP ML V AP ML V AP ML V AP ML V
3.77±0.49 1.20±0.76 2.21±1.07 2.08±0.38 1.74±0.49 2.49±0.53 52.46±34.11 157.23±121.58 63.93±28.28 14.11±9.01 40.21±23.19 16.90±6.06 5.60±1.11 4.45±0.53 5.28±0.69 57.45±10.83 57.21±17.07 101.28±22.16 107.79±29.36 6.72±0.79 6.37±0.98
Root Mean Square Gyroscope Turn to Sit (°/s)
Log-Normalize Jerk Score Gyroscope Turn to Sit
Average speed 180 (°s) Average speed Turn to Sit (°/s) Max speed 180 (°/s) Max speed Turn to Sit (°/s) Log-Normalize Jerk Score turn 180 Log-Normalize Jerk Score turn Turn to Sit
0.04 1.00 0.17 0.11 0.14 0.95 0.02 0.63 0.01 0.02 0.06 0.11 0.11 0.47 0.44 0.10
AP 8.89±2.14 ML 3.81±1.90 V 7.11±2.63
Range AP Gyroscope Turn to Sit (°/s)
0.93 0.88 0.74
p
8.92±1.73 3.23±1.35 4.63±2.14
Range Accelerometer Turn to Sit (m/s2 )
Log-Jerk Accelerometer Turn to Sit (m)
AUC
3.13±0.77 0.99±0.50 1.66±0.61 1.89±0.84 1.41±0.88 2.16±0.81 49.42±24.64 107.75±34.90 57.82±25.47 12.29±5.95 30.88±9.43 15.84±7.29 5.81±1.33 4.16±0.88 5.17±1.24 76.89±18.22 88.66±29.01 139.68±33.12 156.28±46.19 6.27±0.69 5.66±0.76
0.83 0.88 0.83
0.71
0.71
0.34 0.26 0.00 0.25 0.14 0.06 0.11 0.63 0.35
0.77
0.66
0.84 0.83 0.83 0.83
0.03 0.35 0.22 0.23 0.10 0.02 0.82 0.32 0.60 0.62 0.33 0.67 0.65 0.22 0.74 0.00 0.00 0.00 0.00 0.12 0.11
P128 Effects of serum iron markers on functional outcomes in sarcopenic elderly. A cross-sectional study S. Perna1 , E. Sauta2 , E. Riggi2 , G. Peroni2 , F. Guerriero1 , C. Sgarlata2 , M. Rollone3 , C. Donelli2 , D. Guido2 , I. Degli Agosti3 , M. Rondanelli1 , M.A. Faliva2 , M. Naso2 1 University of Pavia, Azienda di Servizi alla Persona of Pavia, Pavia, Italy; 2 University of Pavia, Pavia, Italy; 3 Azienda di Servizi alla Persona of Pavia, Pavia, Italy Introduction: This study investigates the effects of iron markers on functional outcomes, i.e. Relative Skeletal Muscle Mass (RSMM) and Barthel index (BI), in sarcopenic elderly. Materials and Methods: The study was conducted on 197 elderly (i.e. 65+y) patients: 139 females, 58 males, age = 81.1±6.5y, BMI = 24±4 kg/m2 . Body composition markers are measured by dual energy X-ray absorptiometry (DEXA), while the hemato-chemical parameters by blood tests. The study has been focused on the effects (b) of serum iron markers such as iron (Fe+) (64±30 mcg/dl), transferrin (221±57 mg/dl), and
S123
hemoglobin (12.4±1.6 g/dl) levels on the two functional outcomes: RSMM (6.33±1.24 kg/m2 ) and BI (60±28 u). Statistical analysis was performed by a multivariate multiple regression model adjusted for gender, age, albumin (%) (55±5), BMI, and lean mass (39±7 kg). b-estimates with p-values <0.05 were considered significant. Results: The regression model showed only one significant evidence for the effect of iron levels on BI (b = +0.185, P = 0.014, and 95% CI= [0.041; 0.335]): according to other relevant variables included, for an increase of 10 mcg/dl of iron, functionality increases of 1.85 BI units. R2 goodness of fit indexes resulted equal to 0.291 (for BI) and 0.576 (for RSMM). Conclusion: Iron plays a protective role in the progression of functional decline. Since iron biochemical parameters are important for monitoring functional skills in sarcopenic elderly. P129 Mortality and functional decline one year after a hip fracture in elderly over 75 years S. Drevet, B.J. Chedal Bornu, C. Bioteau, S. Maziere, J. Tonetti, P. Merloz, P. Couturier, G. Gavazzi CHU Grenoble, Grenoble, France Introduction: 1% of falls in over-75 year-olds cause proximal femoral fracture (PFF). PFF appears one of the worst complications of elderly’s fall and is associated with high morbidity and functional decline (FD). Methods: A prospective observational epidemiological study about patients aged over 75 years, one year after a PFF. The principal objective was to determine the mortality rate one year after the PFF. Secondary objectives were to identify factors associated with mortality, prevalence of FD one year after PFF and factors associated with FD. Factors associated were collected: ADL, IADL, CIRS-G, MNA, MMSE and severity. Scores were compared on quantitative tests (Student t) with the significance threshold set at p < 0.05. Results: Mean age of 113 patients included was 86.96 years. Mortality rate was 37.2%. Mortality was associated with low IADL D-15 (p = 0.000), elevated CIRS-G (p = 0.001), low MMSE (p = 0.031) and severity (p = 0.042). Malnutrition appears as a risk of death with OR = 3.095 (1.014–9.446). Among survival cohort whole data were available for 51 patients. Prevalence of FD was 41.2% with an average of 0.81 point. The unique factor associated with FD was ADL at the time of discharge from orthopedic unit (p = 0.027). Conclusions: Given the present economic stakes and the high morbi-mortality rate in geriatric trauma patients, it is essential to study this challenging group. Interventional studies are needed to determine whether management of modifiable factors may improve early and long term outcomes. P130 Erythrocyte sedimentation rate (ESR) and C-reactive protein (PCR) as inflammation markers in sarcopenic elderly. Repercussions on functional status. A cross-sectional study in nursing home residents S. Perna1 , D. Guido2 , E. Riggi2 , F. Guerriero1 , C. Sgarlata2 , E. Sauta2 , M. Rollone3 , L. Oberto3 , D. Maddalena1 , M. Rondanelli1 1 University of Pavia, Azienda di Servizi alla Persona of Pavia, Pavia, Italy; 2 University of Pavia, Pavia, Italy; 3 Azienda di Servizi alla Persona of Pavia, Pavia, Italy Introduction: The aim of our research was to investigate the effects of inflammatory markers, specifically ESR, on functionality of sarcopenic elderly. Material and Methods: We enrolled 257 elderly (65+y) patients (181 females, 76 males, mean age = 81.7, BMI 24.8) hospitalized. ESR (48.5) and PCR (1.38) were considered as inflammation markers. Relative Skeletal Muscle Mass (RSMM) (6.41) was considered as sarcopenia marker. Barthel index (58.3), such as functional outcome. The analysis was conducted with a structural