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Poster presentations / European Geriatric Medicine 6S1 (2015) S32–S156 S73

indexes for women in postmenopausal period with higher risk of Oral anticoagulation was started in 60% of AF patients, in 20% of
osteoporotic fracture, assessed by FRAX, independent of age. the strokes, in 16.7% of the syncope and falls.
Conclusion: Thus, low cortical indexes, measured with the Conclusion: ILR is useful in detecting arrhythmias both in high risk
“Osteolog” workstation are reliable predictors of high fracture risk. patients and in the TLoC diagnostic pathway.
There is a significant correlation between low cortical indexes and
high fracture risk, assessed by FRAX. P-156
Safety and tolerability of Tilt Testing and Carotid Sinus Massage
P-154 in the oldest old
Trabecular bone score and bone mineral density in Ukrainian G. Rivasi1 , M. Rafanelli1 , G. Toffanello1 , A. Ceccofiglio1 , F. Tesi1 ,
men with vertebral fractures N. Marchionni2 , A. Ungar3
V. Povoroznyuk1 , A. Musiienko1 , N. Dzerovych1 1
Geriatric Cardiology and Medicine, University of Florence and
1
D.F. Chebotarev Institute of Gerontology NAMS Ukraine, Kyiv, Ukraine AOU Careggi, Florence, Italy; 2 Geriatric Cardiology and Medicine,
The aim of this study is to evaluate the trabecular bone score (TBS) Careggi Univesrity Hospital, Florence, Florence, Italy; 3 Azienda
and bone mineral density (BMD) in men with osteoporotic vertebral Ospedaliero Universitaria Careggi, Florence, Italy
fractures. Objectives: To evaluate the safety and tolerability of Tilt Testing (TT)
Materials and Methods: We examined 243 men aged 30–89 years, and Carotid Sinus Massage (CSM) in the oldest old (patients aged
divided according to the gerontologic classification: 30–44 yrs 80 and older) and in younger patients with unexplained syncope
(n = 46), 45–59 yrs (n = 83), 60–74 yrs (n = 86), 75–89 yrs (n = 28). The and/or falls.
basic group consists of 52 men with osteoporotic vertebral fractures Methods: 1170 patients referred to our Syncope Unit for
in the anamnesis and control group – of 191 men without fractures. unexplained syncope or falls were enrolled. 549 patients were 80 or
The BMD of PA lumbar spine and proximal femur were measured older and 621 were younger. TT and CSM were performed according
by the DXA method (Prodigy, GEHC Lunar, Madison, WI, USA) and to the European Society of Cardiology Guidelines. Complications
PA spine TBS were assessed by the TBS iNsight® software package were evaluated in each group. An early interruption of TT was
installed on our DXA machine (Med-Imaps, Pessac, France). defined intolerance and considered as a negative response.
Results: We have observed a significantly lower TBS (L1-L4) in Results: Complications after TT were observed in 5.3% of the
the basic group (30–44 yrs: 1.083±0.187; 45–59 yrs: 1.025±0.248; older patients and in 2.4% of the younger ones (p = 0.01). Most of
60–74 yrs: 1.084±0.170; 75–89 yrs: 0.951±0.170) as compared to the complications (88.6%) were minor, as persistent hypotension;
the control group (30–44 yrs: 1.276±0.121; 45–59 yrs: 1.226±0.156; serious ones occurred in 2.3% of the cases. Minor complications
60–74 yrs: 1.150±0.175; 75–89 yrs: 1.183±0.174); F = 1.56; p < 0.001. were the most frequent in both groups (93.1% in the older patients
We also found the lower BMD of lumbar spine in the basic and 80% in the younger ones). Orthostatic hypotension was a
group of patients – 30–44 yrs: 0.981±0.125 g/cm2 ; 45–59 yrs: predictor of complications. No complications occurred after CSM.
1.028±0.184 g/cm2 ; 60–74 yrs: 1.014±0.158 g/cm2 ; 75–89 yrs: Intolerance was reported in 2.7% of the older patients and 1.1% of
0.970±0.183 g/cm2 (F = 1.52; p < 0.001) and of the proximal femur – the younger ones (p = 0.04); in most cases (68.2%), the test was
30–44 yrs: 0.854±0.149 g/cm2 ; 45–59 yrs: 0.873±0.139 g/cm2 ; stopped because of orthostatic intolerance.
60–74 yrs: 0.823±0.136 g/cm2 ; 75–89 yrs: 0.716±0.107 g/cm2 Conclusions: Complications after TT were more common in older
(F = 1.10; p < 0.001) compared to the control group. patients, probably due to a higher prevalence of orthostatic
Conclusion: Subjects with vertebral fractures have TBS and BMD hypotension. No complications occurred during CSM. Intolerance
parameters significantly lower than the healthy men. was very low in each group, mainly due to orthostatic intolerance.
TT and CSM are safe and well tolerated in the oldest old.
P-155
Implantable loop recorder: A syncope unit experience P-157
M. Rafanelli1 , A. Ceccofiglio1 , F. Tesi1 , G. Toffanello1 , V.M. Chisciotti1 , Physical performance measures compare favorably with
G. Rivasi1 , N. Marchionni2 , A. Ungar3 geriatric assessment in elderly oncological patients
1
Geriatric Cardiology and Medicine, University of Florence and A.T. Roberts1 , L. Biganzoli2 , D. Becheri3 , G. Mottino3 , E. Mossello4 ,
AOU Careggi, Florence, Italy; 2 Geriatric Cardiology and Medicine, M. Di Bari4
1
Careggi Univesrity Hospital, Florence, Florence, Italy; 3 Azienda AOU Careggi, Firenze, Italy; 2 Oncologia geriatica, Dipartimento
Ospedaliero Universitaria Careggi, Florence, Italy Oncologico, Prato, Prato, Italy; 3 U.O. Geriatria, Prato, Italy; 4 Unit of
Gerontology and Geriatric Medicine, Firenze, Italy
Aim: To test the Implantable Loop Recorder (ILR) in syncopal
and non-syncopal transient loss of consciousness (TLoC) and in Objective: In oncology there is a growing interest in geriatric
detecting atrial fibrillation (AF) in cryptogenic stroke. assessment (GA). In a sample of older oncological patients, we
Methods: 182 patients were implanted between January 2003 and evaluated the associations between the outcome of GA tools on
May 2014. 81 (45%) syncope; 3 (1.6%) pseudo-syncope; 32 (18%) one side and, on the other, the Vulnerable Elders’ Survey-13
epileptics; 35 (19.2%) unexplained falls; 6 (3.3%) patients with (VES-13), Fried’s frailty phenotype and a simple index of physical
syncope/fall; 5 (2.7%) suspected AF; 20 (11%) cryptogenic stroke. performance, combining the handgrip (HG) and walking speed
Results: The mean age was 70±14.2 years. After a follow-up of (WS), categorized as normal or abnormal.
19±16 months, 109 patients (59.9%) relapsed. Asystole was detected Methods: 273 patients aged ≥70 years with solid tumors attending
in 51.9% of the syncope, in 100% of the epileptics, in 53.9% of the the Oncology outpatient clinic in Prato, Italy, underwent a GA.
fallers, in 20% of the syncope/falls and in 33.3% of the strokes. Mean values of ADLs, IADLs, GDS, MMSE, MNA and CIRS were then
AF was confirmed in 80% of the suspected cases, in 66.7% of the compared across the three categories of the VES-13 (fit, score of
strokes, in 40% of those with syncope and falls. Diagnosis was 0–2; vulnerable, score of 3–6; frail, score of 7–13), Fried’s phenotype
made in 70.4% of the syncope, in 59.4% of the epileptics, in 74.3% of (fit: no impairment, prefrail: 1 impairment, frail: 2+ impairments)
the fallers, in 100% of the syncope/falls, in 66.7% of the pseudo- and according to physical performance (both HG and WS abnormal,
syncope, in 50% of the strokes and in the 100% of the suspected HG or WS abnormal, both HG and WS normal).
AF. No arrhythmia was recorded in 64 patients, in 49 of these the Results: No significant differences in ADLs, MMSE and CIRS
monitoring is ongoing. Pacemaker was implanted in 22.2% of the emerged between fit and vulnerable (according to VES-13) or fit and
syncope, in 18.8% of the epileptics, in the 20% of the suspected AF. pre-frail (according to Fried) patients, whereas GDS score differed

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