Here - American Geriatrics Society

P OSTER
A BSTRACTS
tia in geriatric patients, but they may be associated with cardiovascular
side effects that increase morbidity. Currently, there are few specific
criteria to assess the risks and benefits of cholinesterase inhibitors
and there is insufficient data regarding monitoring for
potential cardiovascular side effects.
Methods: We sought to evaluate cardiovascular side effects such
as bradycardia, syncope, near-syncope, dizziness or falls that might be
associated with taking cholinesterase inhibitors. The electronic medical
records (EMR) of all patients from the Reynolds Institute on
Aging (RIOA) who completed a clinic visit during the period of August
1, 2009 to October 31st 2009 and who were taking cholinesterase
inhibitors were reviewed. The medical history of these patients before
and after initiation of cholinesterase inhibitors was examined.
Results: The EMR of 82 patients who were taking
cholinesterase inhibitor were retrospectively reviewed. The mean age
of patients was 81 years. The patients were predominantly female
(73%) and were white (79%). Memory loss/disorder (59%) was the
most common reason for initiation of cholinesterase inhibitor, followed
by Alzheimer’s disease (21%) and some form of dementia
(17%). Four patients were deceased since the index clinic visit (5%).
The common new cardiovascular symptoms reported after the initiation
of cholinesterase inhibitor were: bradycardia – 9% (N=7); atrial
fibrillation or arrhythmia – 5% (N=4); syncope or near syncope– 4%
(N=3); sick sinus syndrome – 2.4% (N=2). Dizziness was reported in
13 % of the patients (N=11). Falls were reported by 11% of the patients
(N=9). Sinus bradycardia (15%) (N=12) was the most common
new EKG finding, followed by bundle branch block (7%) (N=6) and
atrial fibrillation (4%) (N=3).
Conclusions: Cardiovascular side effects of cholinesterase inhibitors
are common, morbid and under-appreciated. More studies
are needed to better understand this problem. Monitoring for potential
cardiovascular side effects of cholinesterase inhibitors will enhance
compliance and maximize benefits in vulnerable older patients
with cognitive impairment while preventing potentially devastating
cardiovascular complications.
D148
Screening, Diagnosis, and Treatment of Osteoporosis in Patients
with Dementia.
L. J. Gleason, K. R. McCormick, J. Frankel, S. M. Friedman.
Department of Medicine, University of Rochester, Highland Hospital,
Rochester, NY.
Background: Older adults with dementia are at higher risk for
fractures than cognitively intact individuals and some studies have
shown that these patients are less frequently screened and receive
fewer treatments for osteoporosis.
Objective: To examine rates of screening, diagnosis, and treatment
of osteoporosis in older adults with and without dementia at an
academic outpatient geriatric clinic.
Methods: We performed a retrospective chart review of 440 patients
ages ≥ 65 who entered into the Geriatric and Medicine Associate
Practice (GAMA) between January 2000 and December 2007.
Baseline characteristics were recorded including age, gender, body
mass index (BMI), self-reported health status, and activities of daily
living (ADLs). Patients with dementia were compared to those without
cognitive impairment, with respect to the screening, diagnosis,
and treatment of osteoporosis.
Results: Of the 440 patients included in the study, the average
age was 78.9 years old, 304 (69%) were women, 89% of patients were
able to complete 5/5 ADLs, and 53 (12%) were diagnosed with dementia.
We found that only 53 patients (12%) had a recorded DEXA
scan within six months of enrollment in the clinic, and those with dementia
were less likely to have had a DEXA scan (11.3% vs. 25.3%,
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