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P OSTER
A BSTRACTS
dicated greater frailty. Descriptive and non-parametric statistical
analysis was performed using SPSS software and Mann Whitney U.
Results: 202 subjects living independently (62% female, mean
age 92) were included. 61 were octogenarians, 69 nonagenarians, and
10 centenarians. Initial mean BMI ranged from 25.2 in octogenarians
to 22.4 in centenarians with no significant drift between years one and
three. Correlated to BMI at age 50, those with < one SD were less
likely to be frail or were less frail. We confirmed prior observations
that strength training correlated with decreased frailty across all ages.
A U shaped curve correlating frailty/BMI held true for subjects up to
age 89. BMI flattened after age 90, suggesting the impact of BMI on
frailty is less.
Conclusions: Frailty correlates with advancing age; BMI does
not. Much effort is spent to obtain/maintain normal BMIs in the elderly.
Our study identifies a subset of elders with outlying BMIs in
whom BMI is not a significant contributor to frailty. Prolonged activity
at a stable BMI may produce physical conditioning that is beneficial.
Avoidance of frailty in this group should stress continued activity
over caloric manipulation.
D76
Orthostatic Hypotension, its risk factors, and the need for its
measurements in the hospital.
J. Chohan, K. Samtani, E. Baum, S. Snyder, N. Kayani, L. Benedict,
S. Hazelet. Post Acute and Senior Services, Summa Health System,
Akron, OH.
Objectives: To investigate the correlation between falls and orthostatic
hypotension (OH) and to examine the benefits of measuring
orthostatic vital signs on admitted patients at high risk for a fall. Design:
Cross-sectional study. Measurements: Patients at high risk included
those: > 65 years old who have fallen in the last 2 months or
had an admitting diagnosis of a fall, syncope, or pre-syncope. Blood
Pressure (BP) was measured in the supine position and after 2 minutes
of sitting and 2 minutes of standing within 24 hours of admission.
Orthostatic hypotension was defined as 20-mmHg decline in Systolic
BP and/or a 10-mmHg decline in diastolic BP from a supine to sitting,
or sitting to
standing position. Results: While 200 people qualified for the
study, only 99 people had orthostatic vital signs measured and of
those 30 people were orthostatic positive. Only five of the 30 were
non-community dwelling patients. 84% of patients had documented
hypertension, 37% had documented heart failure, 23% had anemia
(HgB90) on admission. Of
those who were orthostatic positive, only 1 had a documented fall
while hospitalized. Conclusion: We saw no correlation between falls
and OH, however, anti-hypertensive medications were held on admission
for OH positive patients and a thorough medication reconciliation
was done on discharge through interdisciplinary communication
and physician notification. These results suggest that orthostatic
vital signs should be measured on patients who are at high risk for a
fall to improve their in-patient admission and discharge medication
assessment.
D77
A comparison of different target criteria for geriatric care.
J. van Kempen, 1 H. Schers, 2 R. Melis, 1 M. Olde Rikkert. 1 1.
Department of Geriatric Medicine, Radboud University Nijmegen
Medical Centre, Nijmegen, Netherlands; 2. Department of Primary
Care, Radboud University Nijmegen Medical Centre, Nijmegen,
Netherlands.
Background: There are several instruments for the identification
of frail elderly. None of these aims to identify frail elderly in primary
care to select them for integrated care. Therefore, we developed a
pragmatic identification method, the Easycare-TOS (Two-step Older
people Screening). It optimally uses information that is readily available
to the family physician and takes health and psychosocial aspects
into account. We studied how frail elderly identified with Easycare-
TOS scored on other criteria for geriatric care: disability, multimorbidity
and Fried Frailty criteria.
Methods: Elderly from 4 health centers were included (n=591,
mean age 77 (SD5), 56% women). They were screened with Easycare-TOS.
Additional data were collected for determining multimorbidity
(CIRS-G score ≥2 on ≥2 items), disability (KATZ15 ≥4) and
Fried frailty criteria. We compared the results on the different criteria
in our study population using a Venn diagram.
Results: Figure 1 shows the Venn diagram. The group frail according
to just Easycare-TOS (n=139) had a mean CIRS-G score of
10 (SD4) compared to 14 (SD4) in the group frail according to Fried
(n=58).There was no difference in psychosocial status.The group with
comorbidity and no frailty (n=222) had a mean CIRS-G of 9 (SD3).
Conclusion: Elderly who were frail according to Fried were
more physical frail than elderly who were frail according to Easycare-
TOS solely. Elderly with merely comorbidity had least physical problems.
Follow-up data should show whether Easycare-TOS is able to
identify elderly who will benefit from integrated care.
D78
Fall Stop...MOVE STRONG program to reduce fall risk among
community dwelling older adults.
J. Prager, J. Kardachi, C. Carlucci, S. M. Bradley. Geriatrics, Mount
Sinai Hospital, New York, NY.
Background: Falls is a leading cause of injury and death in older
adults. Approximately, one third of community-dwelling people over
65 years of age fall each year resulting in a significant source of morbidity
and mortality, an important threat to patient safety. Exercise
programs have been shown to reduce rate of falls. The Fall
Stop…MOVE STRONG program is an exercise and education based
fall prevention program. The core content of the program includes a
graduated individualized exercise program, which targets strengthening,
coordination, flexibility, and balance with concurrent education
about personal and environmental fall risk factors and safety strategies
lasting 75 minutes each session. The purpose of this study is to
evaluate if Fall Stop…MOVE STRONG decrease fall risk in community
dwelling older patients.
Methods: Fall Stop...MOVE STRONG if offered over a 12 week
period three times a year in an urban geriatric academic practice. Patients
were approached for participation and consent was obtained.
The measures of functional assessment, falls risk, and fear of falling
were obtained before and after falls prevention program including
The Functional Reach Test, The Four Square Step Test, The Timed Up
AGS 2012 ANNUAL MEETING
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