S180 Poster presentations, Friday 19 September 2014 / European Geriatric Medicine 5S1 (2014) S159–S234

subgroups, and in the whole study group than in control group. The

BMD of lumbar spine was lower at 12.7% (1.14±0.016 g/cm2 versus

1.161±0.017 g/cm2, p < 0.001), total hip – 15% (0.884±0.015 g/cm2

versus 1.063±0.011 g/cm2, p < 0.001) and total skeleton – 9.4%

(1.049±0.009 g/cm2 versus 1.158±0.009 g/cm2, p < 0.001).

Conclusion: TheBMD in women with Colles fracture was

significantly lower at all surveys sites: lumbar spine, total hip

and the total skeleton. The incidence of systemic osteoporosis in

patients of the study group was significantly higher than in healthy

women of the same age.

P313

Trabecular bone score and bone mineral density in Ukrainian

normal women depending on duration of postmenopausal

period

V.V. Povoroznyuk, N.I. Dzerovych

D.F. Chebotarev Institute of gerontology NAMS Ukraine, Ukraine

The aim of this study is evaluating trabecular bone score (TBS)

and bone mineral density (BMD) in normal women depending on

duration of postmenopausal period (PMP).

Materials and Methods: We’ve examined 122 normal women aged

40–79 years (mean age 56.2±0.8 yrs; mean height 162.6±0.5 cm;

mean weight 71.5±1.3 kg), who were divided into the groups

depending on duration of PMP: without menopause (with normal

menstrual cycle) (n = 25), 1–3 yrs (n = 26), 4–6 yrs (n = 12), 7–9 yrs

(n = 18), 10–12yrs (n = 8), 13–15yrs (n = 4), 16–18yrs (n = 5), ≥19 yrs

(n = 7). BMD of total body, lumbar spine and femoral neck and TBS

(TBS iNsight software package, Med-Imaps) were measured by DXA

using a densitometer Prodigy, GE.

Results: We have determined the significant decrease of

TBS (L1–L4) in women with age (F = 4.52; p = 0.0001).

Duration of PMP has a significant influence on the

variability of BMD of spine (F = 3.20; p = 0.004), BMD of

femoral neck (F = 5.41, p < 0.000) and TBS (with normal

menstrual cycle: 1.36±0.02mm−1; 1–3 yrs: 1.31±0.02mm−1;

4–6 yrs: 1.22±0.04mm−1; 7–9 yrs: 1.23±0.03mm−1; 10–12yrs:

1.21±0.04mm−1; 13–15yrs: 1.16±0.08mm−1; 16–18yrs: 1.15±0.06

mm−1; ≥19 yrs: 1.15±0.03mm−1; F = 5.70, p < 0.000).

The analysis using Scheffe’s test shows that TBS was significantly

lower in women with duration of PMP ≥4yrs [4–6 yrs (p = 0.003),

7–9 yrs (p = 0.002), 10–12yrs (p = 0.002), 13–15yrs (p = 0.0003),

16–18yrs (p = 0.0003), ≥19 yrs (p = 0.00002)] in compare with

women without menopause; BMD of spine significantly decreased

in women with duration of PMP 7–9yrs (p = 0.02), 10–13yrs

(p = 0.003) and ≥19yrs (p = 0.0001).

Conclusion: TBS is independent parameter which has potential

diagnostic value without bone mineral density. TBSwas significantly

decreased with age. Duration of PMP has a significant influence

on the variability of TBS, BMD of spine and femoral neck. TBS

significantly decreased in women in early postmenopausal period.

P314

Expert knowledge for modeling the relation between functional

health and data from ambient assisted living sensor systems

M.B. Robben1, M.C. Pol1, B.J.A. Krose1, B.M. Buurman2

1Amsterdam University of Applied Sciences, The Netherlands;2Academic Medical Center, University of Amsterdam, Amsterdam,

The Netherlands

Introduction: Ambient monitoring systems can be used for

functional health assessments. This information can be used to

assist community-dwelling older patients to live independently.

The problem is identifying which activity patterns, as can

be measured with ambient sensors, are most informative for

predicting functional decline. Expert knowledge is needed in the

analysis of collected data.

Methods: Based on literature and pilot studies, a preliminary

model was constructed that models the relation between functional

health and sensor data (Figure 1). An online survey was created

for obtaining expert feedback on this model. In addition to open

questions for qualitative feedback, the survey included questions for

quantitative feedback on deviations in sensor data. From the model

a set of activities predictive for functional decline were derived.

For each of these, questions were included about the relevance and

magnitude of deviations (in ‘duration’, ‘frequency’ and ‘time’).

Results: The survey was completed by occupational therapists,

physical therapists, geriatricians and (home care) nurses (n = 64).

For the deviations in ‘duration’ and ‘frequency’ typically an increase

of 51–100% or a decrease of 41–60% were considered relevant. For

‘time’ a shift of 2–3 hours was considered relevant. Changes were

considered relevant after 11 days. Some differences were present

between activities and also between specialisms.

Conclusions: The model will be useful as screening instrument

for functional decline. The validity of the model should be further

tested in field trials.

Figure 1. Part of the preliminary model, grounded in the WHO ICF model. The lowest

level includes activity categories, predictive for functional decline.

P315

Older people’s perspectives regarding the use of sensor

monitoring in their home

M.C. Pol1, F. van Nes1, M. van Hartingsveldt1, B.M. Buurman2,

S.E. de Rooij2, B.J.A. Krose3

1Hogeschool van Amsterdam, Amsterdam, The Netherlands; 2Geriatric

Medicine, Academic Medical Center, Amsterdam, The Netherlands;3Researchgroup Digital Life, Amsterdam University of applied Sciences,

Amsterdam, The Netherlands

Introduction: Maintenance of daily functioning and independent

living are important outcomes for older people. Sensors placed

in the home environment could contribute to these outcomes, by

early observation of a decline or changes in daily functioning. It

is unknown how older people value sensor monitoring and what

there expectations of sensor monitoring are. The purpose of this

qualitative study is to investigate perspectives of older people

regarding the use of sensor monitoring in their daily lives.

Method: We conducted in-depth semi-structured interviews with

11 persons between 78 and 93 who had a sensor monitoring system

installed in their home. The data were analyzed using Interpretative

Phenomenological Analysis.

Results: Sensor monitoring was seen as a strategy to remain

independently at home. It was perceived as contributing to the

sense of safety that was found as a premise for independent living.

User-need and user-friendliness were important indicators for the

acceptance of sensor monitoring. Privacy was not an issue for

the participants. Participants found it important that healthcare

professionals had access to their sensor data, to keep an eye on

them; most of the participants didn’t express the desire to control

the sensor data themselves.

Conclusions: The results demonstrate the importance of sensor

monitoring to maintain daily functioning, for the sense of safety

and the importance that healthcare professionals had access to the

sensor data. Based on the present study the development of ways

Poster presentations, Friday 19 September 2014 / European Geriatric Medicine 5S1 (2014) S159–S234 S181

to give older people access to their own sensor data should be

further explored in cooperation with the older people.

P316

Home-monitoring of mobility and activity – two case studies

from the GAL-NATARS study

L. Dasenbrock1, E.E. Steen2, M. Becker3, K. Holtkamp4, P. Bente5,

M. Dolle3, C. Lammel-Polchau3, M. Schulze3, M. Marschollek3,

R. Haux6, A. Hein2, G. Kolb4, M. Meis7, H. Meyer Zu Schwabedissen5,

H. Remmers8, W. Thoben9, J. Wang6, K.H. Wolf6, J.M. Bauer10

1Carl von Ossietzky Universitat Oldenburg, Germany; 2Department

of Health Services, Carl von Ossietzky Universitat Oldenburg,

Oldenburg, Germany; 3Peter L. Reichertz Institute for Medical

Informatics, Hannover, Germany; 4Department for Geriatric Medicine,

Bonifatius Hospital Lingen, Lingen, Germany; 5Department for

Geriatric Medicine, Braunschweig Medical Center, Braunschweig,

Germany; 6Peter L. Reichertz Institute for Medical Informatics,

University of Braunschweig, Braunschweig, Germany; 7Horzentrum

Oldenburg, Oldenburg, Germany; 8Division of Nursing Science, Faculty

of Human Sciences, University Osnabruck, Osnabruck, Germany;9OFFIS – Insitute for Information Technology, Oldenburg, Germany;10Department of Geriatric Medicine, Carl von Ossietzky Universitat

Oldenburg, Oldenburg, Germany

Background: Even in high age older persons prefer to live

independently. Especially in those living alone functional decline

should be detected at an early stage. The aim of the GAL-NATARS

study was to identify a deterioration of mobility and activities by a

home-monitoring system.

Methods: Community-dwelling subjects (age ≥70, rehabilitation

for fracture) were monitored for 3 months. Time of absence (ToA)

from their apartments was categorized by sensor-events (1–30min,

30–90min, 90–240min, 4–8h, <8h/day and week). ToA at week (W)

1, 8, 12 were compared to assessments of physical function and

mobility (PFM). Mobility was evaluated by 4m gait-speed (GS in s),

chair rise (CR in s), Tinetti (points), Timed up&Go (TuG in s), and

falls.

Results: Exemplarily data from 2 subjects are presented.

Case 1: 17% ToA. On 11 days no leaving of the apartment was

observed. Distribution of ToA: W1: 6×1–30min, 2×30–90min;

W8: 1×1–30min, 1×30–90min, 1×90–240min, 1×4–8h, 1× >8h;

W12: 4×1–30min, 2×30–90min, 4×90–240min, 3×4–8h.

PFM at W1/8/12: GS 5.5/3.6/4.5; CR not possible (np)/16/15; Tinetti

27/25/27; TuG 13/12/10; 1 fall (W7).

Increases of ToA were associated with improvement of PFM.

Case 2: 14% ToA. 13% of ToA were a consequence of a hospital stay

(HS). Distribution of ToA: W 1/8/12: HS/0*/0*.

PFM at W1/8/12: GS 9.9/8.8/5.6; CR np/np/25.9; Tinetti 18/19/21;

TuG 34/27/17; 1 fall (W7).

PFM improved but no change of ToA was observed.

Conclusion: The tested home-monitoring system has the capacity

to measure ToA in community-dwelling physically impaired older

persons. Further analyses will show if sensor-based data can reliably

indicate changes of PFM.

P317

Integrated home care technology assistance in frail older

patients with heart failure: Aim and design of the Care@Home

project funded by the Apulian region

D. Sancarlo1, F. Giuliani1, A. Greco1, A. Leone2, M. Manuzzi3,

M. Pistoia3, P. Siciliano2

1IRCSS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy;2CNR-IMM, Lecce, Italy; 3Eresult, Cesena, Italy

Introduction: Heart failure is the leading cause of hospitalization

in the elderly. About 20% of discharged patients tend to be

rehospitalized with a poor prognosis.

Aim of the Care@Home project funded through the call: “ICT

Apulian Living Labs” (European Regional Development Fund. 2013–

2014) is to implement and evaluate an IT system capable of

providing to frail older persons affected by heart failure the

possibility to remain in their own home as long as possible thanks

to an integrated telemonitoring system reducing also the mortality

and the rehospitalisation rate.

Methods: In the pilot cohort study will be included 40 patients aged

>65 years, consecutively discharged from a Geriatric Unit, with a

diagnosis of heart failure and high mortality risk, evaluated through

the use of a multidimensional prognostic index. All patients will

underwent a Comprehensive Geriatric Assessment at the beginning

and at the end of the study. Each patient will be followed for two

weeks at his home using a small telemonitoring system represented

by a small sensor, evaluating the following parameters: EKG,

respiratory rate, motility, risk of falls and temperature, connected to

a computer-server capable to collect, directly and indirectly, other

data such as weight, blood pressure, urine output, pulse oximetry,

sending the data to a central database accessible by all the actors

involved in the care process.

Conclusions: The application of this home care system in this

appropriate selected population could facilitate the developing

of individualized care plans, improve the multidisciplinary

communications and reduce adverse outcomes.

Metabolism/Nutrition/Sarcopenia

P318

The predicitive value of serum B12 and its use in guidelines

and protocols

J.H. Strating, M. Zeeman, J.B. de Kok

Deventer Hospital, The Netherlands

Background: Vitamin B12 deficiency is seen very often. In many

protocols like the Dutch CGA guideline and delirium guideline

serum B12 is advised as a screening tool. Serum cobalamin does

not necessarily reflect a normal B12 status. The determination of

methylmalonic acid is advised to find a true B12 deficiency, but this

is not known by a lot of general practitioners and specialists.

Methods: We performed a retrospective database research to

analyse all vitamin B12 measurements that could be combined with

a serum methylmalonic acid measurement in the period of 2005

until 2012 in the Deventer Hospital clinical chemical laboratory.

A serum methylmalonic acid (MMA) of 340nmol/L or higher was

presumed the gold standard of a true B12 deficiency. Besides that,

we undertook an email enquiry to investigate what treatment

decisions general practitioners and specialists make with a given

serum vitamin B12 result.

Results: We found that in the group with serum B12 between 100–

200 pmol/L only in about 50% of the cases we could diagnose a

true vitamin B12 deficiency (ie MMA >340nmol/L). In our email

enquiry we found that 65% of the physicians never determined

a serum methylmalonic acid. Many physicians started cobalamin

supplementation when serum B12 was below 150pmol/L.

Table 1. B12 values compared to MMA valuesTrue B12 deficiency(MMA >340nmol/L)

No B12 deficiency(MMA 0–340nmol/L)

Serum B12 0–150 pmol/L 41 (A) 51 (C) PPV: 0.45Serum B12 >150 pmol/L 24 (B) 54 (D) NPV: 0.69

Sensitivity: 0.63 Specificity: 0.51

Sensitivity: A/(A +B); Specificity: D/(C +D).PPV, positive predictive value: A/(A +C); NPV, negative predictive value: D/(D+C).

Conclusion: Serum B12 levels do not predict true B12 deficiency,

when compared to methylmalonic acid. Not many physicians