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P253: Opinions on the prevention of falls in physically active and physically inactive older persons
S164
Poster presentations, Friday 19 September 2014 / European Geriatric Medicine 5S1 (2014) S159–S234
Results: 148 patients were included; 95 women and 53 men with mean age of 79.9 and 80.5 years respectively. 23 patients complained of poor balance and 125 had one or more falls. Twenty-two percent of patients (29/134) self reported that their vision is good, 63% (84/134) use glasses, 10% (14/134) have poor vision, and 5% (7/134) were registered blind. Data were not available for 14 patients. Thirteen percent of patients (19/146) have cataract or cataract surgery, 9% (13/146) have glaucoma. 8% (12/146) have age related macular degeneration. Some patients have more than one of the above. 20% were diabetic but we do not have exact figure of diabetic retinopathy. Poor vision was considered contributing to the falls in 18% of patients (26/142). Conclusion: Visual disorders are not uncommon in older people with falls. Visual assessment is essential in the evaluation of older people with history of falls. P252 Good interior lighting facilitates the performance of daily activities (ADL) of the visually impaired in their homes F.A. de Boer Royal Dutch Visio, Leiden, The Netherlands Introduction: Elderly live in a care centre because of their need for nursing care. A study in The Netherlands has shown that 20% of them is blind and 22% has low vision. Care centres have poor lighting conditions. The recommended lighting level elderly need for reading (task lighting) is 1500 lux. This is only available near the window. Ambient lighting contributes orientation, mobility, safety and comfort. Illumination levels inside the building average between 100 and 200 lux. This level needs to be at least 500 lux. Objectives: Elderly people with a lower vision have a higher need for lighting in their environment. There is a relation between a safe environment and adequate lighting and contrast. At VISIO work occupational therapists who give advise to care centres. Good interior lighting facilitates the performance of daily activities (ADL) of the visually impaired in their homes. Description/Report/Results: The combination of good interior lighting and regular daylight exposure contributes to regaining and maintaining an active and fulfilling lifestyle – greatly improving quality of life. The combination of poor interior lighting and low vision can lead to unsafe situations and inactivity. A building design in lighting that meets the needs of elderly with low vision increases individual’s ability to perform daily activities and decrease the level of disability associated with these impairments including mobility, safety and decreases the number of fall incidents. Recommendations about good lighting and design in care centres combine several criteria including lighting level, luminance contrast, glare and colour. Conclusion: By improving light conditions and luminance contrasts, residents are more challenged to come to activity and the fall risk is reduced. Contribution to the practice of elderly care. Optimal lighting is one of the prerequisites for performing ADL, improving quality of life. P253 Opinions on the prevention of falls in physically active and physically inactive older persons S. Tuvemo Johnson1 , C. Martin1 , E. Anens1 , A.C. Johansson2 , K. Hellstrom ¨ 1 1 Uppsala university, Uppsala, Sweden; 2 Department of Physiotherapy, School of Health, Care and Welfare, V¨ aster˚ as, Sweden Introduction: The purpose of this study was to explore and describe older persons’ opinions on important actions to prevent fall accidents and to analyse differences in opinions of preventive
actions in physically active versus physically inactive older persons. Methods: Two hundred and sixty-two individuals, 75 years and older (mean 81.3 years), living in ordinary housing answered an open-ended question. The answers were analysed using qualitative content analysis. Differences in emerged categories were compared between physically active and physically inactive older persons. Physical activity was measured by a five level scale based on “hours/week performing moderately strenuous activities”. Results: Eight categories of opinions to prevent falls emerged. Each category contained four to ten subcategories. The categories were Adaptive strategies, Assistive devices, Avoiding hazards, Being physically active, Healthy lifestyle, Modifications indoors, Modifications outdoors, and Seeking assistance. Opinions concerning adaptive strategies and physical activity were mentioned significantly more by physically active older adults and modification indoors were significantly more often mentioned by physically inactive older persons. Conclusions: Responses from older adults living in ordinary housing showed a wide range of opinions on actions to prevent falls. Physically active persons mentioned more active strategies like adaptive strategies and physical activity which are selfenforcing strategies. Less active persons mentioned strategies concerning environmental modification to a larger extent. More support concerning active self-directed personal strategies might be important in fall prevention for inactive older people. P254 Safety profile and efficacy of densumab when used for fracture prevention in geriatric patients A. Vilches Moraga, T. Parajes-Vazquez, ´ A.M. Gomez-Mosquera, A.R. Gomez Quintanilla, D. Perez-Soto Complejo Hospitalario Universitario de Vigo, Vigo, Spain Introduction: Denosumab (DE) is an immune globulin monoclonal antibody that by way of interfering with the protein RANK ligand reduces the formation, maturation and survival rates of osteoclasts. Authorised for the treatment of postmenopausal osteoporosis (OP), clinical experience in very elderly comorbid individuals remains limited. Objectives: We aim to determine the rate of new osteoporotic fractures and adverse drug reactions in patients receiving DE. Methods: Prospective registry between May 31st 2012 and January 31st 2014 of patients undergoing assessment at an outpatient Geriatric clinic for reasons other than osteoporosis, who commenced DE for the prevention of bone fractures. Results: In total 26 females and 2 males with a mean age of 84.8 (76–95) years received 70 dosages of DE over a follow up period of 20 months. Mean body mass index was 28.07 kg/m2 ; patients showed no cognitive or functional impairment, 23 had previous fractures, 12 were naïve to pharmacologic treatment for OP, all except for one took calcium and vitamin D supplements in a state of maintained normocalcemia. We registered 1 isolated incident fracture and one uncomplicated urinary tract infection (treated at home) with no other adverse drug events Six individuals required hospitalization; one received a diagnosis of leukaemia and 3 deaths were recorded (none related to treatment with DE). DE was discontinued in one female due functional deterioration related to underlying Parkinsonism. Conclusions: Denosumab appeared useful, safe and well tolerated in our cohort of very elderly patients at high risk of osteoporotic fractures.
Poster presentations, Friday 19 September 2014 / European Geriatric Medicine 5S1 (2014) S159–S234
Results: 148 patients were included; 95 women and 53 men with mean age of 79.9 and 80.5 years respectively. 23 patients complained of poor balance and 125 had one or more falls. Twenty-two percent of patients (29/134) self reported that their vision is good, 63% (84/134) use glasses, 10% (14/134) have poor vision, and 5% (7/134) were registered blind. Data were not available for 14 patients. Thirteen percent of patients (19/146) have cataract or cataract surgery, 9% (13/146) have glaucoma. 8% (12/146) have age related macular degeneration. Some patients have more than one of the above. 20% were diabetic but we do not have exact figure of diabetic retinopathy. Poor vision was considered contributing to the falls in 18% of patients (26/142). Conclusion: Visual disorders are not uncommon in older people with falls. Visual assessment is essential in the evaluation of older people with history of falls. P252 Good interior lighting facilitates the performance of daily activities (ADL) of the visually impaired in their homes F.A. de Boer Royal Dutch Visio, Leiden, The Netherlands Introduction: Elderly live in a care centre because of their need for nursing care. A study in The Netherlands has shown that 20% of them is blind and 22% has low vision. Care centres have poor lighting conditions. The recommended lighting level elderly need for reading (task lighting) is 1500 lux. This is only available near the window. Ambient lighting contributes orientation, mobility, safety and comfort. Illumination levels inside the building average between 100 and 200 lux. This level needs to be at least 500 lux. Objectives: Elderly people with a lower vision have a higher need for lighting in their environment. There is a relation between a safe environment and adequate lighting and contrast. At VISIO work occupational therapists who give advise to care centres. Good interior lighting facilitates the performance of daily activities (ADL) of the visually impaired in their homes. Description/Report/Results: The combination of good interior lighting and regular daylight exposure contributes to regaining and maintaining an active and fulfilling lifestyle – greatly improving quality of life. The combination of poor interior lighting and low vision can lead to unsafe situations and inactivity. A building design in lighting that meets the needs of elderly with low vision increases individual’s ability to perform daily activities and decrease the level of disability associated with these impairments including mobility, safety and decreases the number of fall incidents. Recommendations about good lighting and design in care centres combine several criteria including lighting level, luminance contrast, glare and colour. Conclusion: By improving light conditions and luminance contrasts, residents are more challenged to come to activity and the fall risk is reduced. Contribution to the practice of elderly care. Optimal lighting is one of the prerequisites for performing ADL, improving quality of life. P253 Opinions on the prevention of falls in physically active and physically inactive older persons S. Tuvemo Johnson1 , C. Martin1 , E. Anens1 , A.C. Johansson2 , K. Hellstrom ¨ 1 1 Uppsala university, Uppsala, Sweden; 2 Department of Physiotherapy, School of Health, Care and Welfare, V¨ aster˚ as, Sweden Introduction: The purpose of this study was to explore and describe older persons’ opinions on important actions to prevent fall accidents and to analyse differences in opinions of preventive
actions in physically active versus physically inactive older persons. Methods: Two hundred and sixty-two individuals, 75 years and older (mean 81.3 years), living in ordinary housing answered an open-ended question. The answers were analysed using qualitative content analysis. Differences in emerged categories were compared between physically active and physically inactive older persons. Physical activity was measured by a five level scale based on “hours/week performing moderately strenuous activities”. Results: Eight categories of opinions to prevent falls emerged. Each category contained four to ten subcategories. The categories were Adaptive strategies, Assistive devices, Avoiding hazards, Being physically active, Healthy lifestyle, Modifications indoors, Modifications outdoors, and Seeking assistance. Opinions concerning adaptive strategies and physical activity were mentioned significantly more by physically active older adults and modification indoors were significantly more often mentioned by physically inactive older persons. Conclusions: Responses from older adults living in ordinary housing showed a wide range of opinions on actions to prevent falls. Physically active persons mentioned more active strategies like adaptive strategies and physical activity which are selfenforcing strategies. Less active persons mentioned strategies concerning environmental modification to a larger extent. More support concerning active self-directed personal strategies might be important in fall prevention for inactive older people. P254 Safety profile and efficacy of densumab when used for fracture prevention in geriatric patients A. Vilches Moraga, T. Parajes-Vazquez, ´ A.M. Gomez-Mosquera, A.R. Gomez Quintanilla, D. Perez-Soto Complejo Hospitalario Universitario de Vigo, Vigo, Spain Introduction: Denosumab (DE) is an immune globulin monoclonal antibody that by way of interfering with the protein RANK ligand reduces the formation, maturation and survival rates of osteoclasts. Authorised for the treatment of postmenopausal osteoporosis (OP), clinical experience in very elderly comorbid individuals remains limited. Objectives: We aim to determine the rate of new osteoporotic fractures and adverse drug reactions in patients receiving DE. Methods: Prospective registry between May 31st 2012 and January 31st 2014 of patients undergoing assessment at an outpatient Geriatric clinic for reasons other than osteoporosis, who commenced DE for the prevention of bone fractures. Results: In total 26 females and 2 males with a mean age of 84.8 (76–95) years received 70 dosages of DE over a follow up period of 20 months. Mean body mass index was 28.07 kg/m2 ; patients showed no cognitive or functional impairment, 23 had previous fractures, 12 were naïve to pharmacologic treatment for OP, all except for one took calcium and vitamin D supplements in a state of maintained normocalcemia. We registered 1 isolated incident fracture and one uncomplicated urinary tract infection (treated at home) with no other adverse drug events Six individuals required hospitalization; one received a diagnosis of leukaemia and 3 deaths were recorded (none related to treatment with DE). DE was discontinued in one female due functional deterioration related to underlying Parkinsonism. Conclusions: Denosumab appeared useful, safe and well tolerated in our cohort of very elderly patients at high risk of osteoporotic fractures.