Here - American Geriatrics Society

P OSTER
A BSTRACTS
The diagnosis of Alzheimer’s disease (AD) and normal pressure
hydrocephalus (NPH), as several neurodegenerative diseases, mainly
based on clinical examination, neuropsychological assessment and
conventional imaging, remains difficult.
The aim of this study is to demonstrate the role of Phase-contrast
magnetic resonance imaging (PC-MRI) in the assessment of
cerebral flows, and in consequence in the differential diagnosis between
AD and NPH.
Materials and methods:
Our population consisted of 20 AD patients (mean age: 80 ± 5
years) and 13 NPH (mean age: 70 ± 6 years). Patients were categorized
during a special consultation by a neuropsychologist and a geriatrician.
All the patients underwent cerebral MRI using a 3T-scanner including
PC-MRI imaging for CSF and blood flows quantification.
They were compared with a population (n = 12) of age-matched
healthy elderly (HE) (mean age: 71 ± 9 years) with normal neurological
and neuropsychological screening results (MMSE).
PC-MRI acquisition was then performed in addition of classical
morphological sequences. The PC-MRI sections were positioned at
the cervical level to investigate cerebral vascular input flows from internal
carotids and vertebral vessels. PC-MRI was also performed at
the aqueductal and cervical levels to measure the CSF flows. Afterwards,
PC-MRI images were analyzed to calculate global arterial flow
curves during cardiac cycle (cc). NPH, MA, HE populations were
compared.
Results:
There was no statistical difference of the mean arterial CBF between
the 3 groups (in ml/min): MA (495 ± 84), NPH (450 ± 129) and
HE (509 ± 108).
Cervical CSF flow analysis showed also similar values for all
3 groups (in μl/cc): MA (530 ± 210), NPH (455 ± 133) and HE
(457 ± 154).
In contrast, NPH presented significantly the highest aqueductal
CSF stroke volume (167 μl/cc ± 89) compared to AD (50 ± 30) and
HE (34 ± 17) (P < 0, 05).
Conclusion:
CSF flows quantification can be helpful for aetiological and differential
diagnosis between AD and NPH, especially in case of enlargement
of lateral ventricles.
D26
The First Intervention Study in Elder Self-Neglect: A Randomized
Clinical Trial to Improve Vitamin D Levels.
J. Burnett, 1,4 A. E. Hochschild, 1,4 S. M. Smith, 2,4 A. L. Stotts, 1,4
P. M. Diamond, 3,4 C. B. Dyer. 1,4 1. Internal Medicine, UT Health,
Houston, TX; 2. National Aeronautics and Space Administration
(NASA), Houston, TX; 3. Health Promotoin and Behavioral Sciences,
UT, School of Public Health, Houston, TX; 4. Texas Elder Abuse and
Mistreatment Institute (TEAM), Houston, TX.
Supported By: The National Institute on Aging. Grant # 1R21
AG033261-01A1
Background: Despite high mortality rates, elder self-neglect is
characterized by refusal of medical and social interventions. To date
there have been no tested clinical interventions in elders who selfneglect.
Previous TEAM Institute research has shown significantly
low vitamin D levels in this population. This study aimed to determine
the feasibility of a clinical intervention. Replacement of vitamin
D was chosen because of its ease of administration and favorable
safety profile. Methods: A randomized clinical trial using directly observed
therapy of vitamin D was conducted using 50 elders, >65 years
of age, with Adult Protective Services (APS) validated self-neglect. A
staggered intervention with waiting controls was used to maximize
statistical power. One-third (n=17) of the group was administered
50,000 IU vitamin D2 (ergocalciferol) monthly and the remainder
(n=33) were administered 400 IU monthly. Serum 25-OH vitamin D
was assessed at baseline and 5-months. Results: 69% agreed to participate
in the study and of those n=40 (80%) remained at 5-months. At
baseline, 12% (n=7) were deficient in vitamin D (