ECE2014 Poster Presentations Pituitary Clinical (<emphasis role="italic">Generously supported by IPSEN</emphasis>) (108 abstracts)
Comprehensive geriatric assessment of elderly cases with acromegaly
Esra Hatipoglu 1 , Mehmet Yuruyen 2 , Ela Keskin 1 , Mutlu Niyazoglu 3 , Hakan Yavuzer 2 , Alper Doventas 2 , Deniz Suna Erdincler 2 , Tanju Beger 2 & Sadi Gundogdu 1
1Division of Endocrinology and Metabolism, Department of Internal Medicine, Cerrahpasa Medical School, University of Istanbul, Istanbul, Turkey; 2Division of Geriatry, Department of Internal Medicine, Cerrahpasa Medical School, University of Istanbul, Istanbul, Turkey; 3Division of Endocrinology and Metabolism, Department of Internal Medicine, Istanbul Training and Research Hospital, Istanbul, Turkey.
Introduction: We aimed to determine changes in geriatric assessment of cases with acromegaly.
Methods: 26 elderly cases with acromegaly (controlled/uncontrolled: 15/11, F/M: 17/9) were included. 20 age, gender and BMI matched cases without acromegaly composed control group (CG) (F/M: 10/10). Presence of concomitant diseases and educational level were not different between the groups. Cognitive functions were evaluated with Mini Mental State Exam (MMSE), affective status with Geriatric Depression Scale, activities of daily living with Katz index, instrumental activities of daily living (IADL) with Lawton scale, and nutrional status with Mini Nutritonal Assessment. For body composition bioimpedance analysis, for functional mobility 6-m walking speed test (6 m-WST) and for overall muscle strength handgrip-strength test were performed. BMI, GH and IGF1 levels, an extensive laboratory evaluation were also obtained.
Results: The mean age of acromegaly cases and CG was 67.3±6.3 and 67.2±4.7 years respectively (P=0.9). Score of MMSE was lower in acromegaly (24.5 (IQR: 21.4–26)) in comparison to CG (29 (IQR: 28–30)) (P=0.001). In the entire cohort cognitive functions decreased as IGF1 levels increased (r=−0.4, P=0.02). In acromegaly group as well as in the whole cohort IGF1 was related with decreased IADL (r=−0.4, P=0.03 and r=−0.4, P=0.02 respectively). More cases with acromegaly had risk for malnutrition (acromegaly/CG: 9/1, P=0.02). In acromegaly GH and IGF1 were positively correlated with the results of 6 m-WST (r=0.4, P=0.04 and r=0.5, P=0.02), showing decreased functional mobility with increased GH and IGF1 levels. Similarly, in the entire group GH and IGF1 levels were positively correlated with 6 m-WST (r=0.3, P=0.004 and r=0.4, P=0.01). In acromegaly increased GH was associated with decreased right-sided handgrip-strength (r=−0.4, P=0.03).
Conclusion: Acromegaly causes an additional burden on cognitive functions, risk of malnutrition, functional mobility and instrumental daily living activities in geriatric population. A multidisciplinary, more comprehensive approach is necessary for acromegaly cases especially when they get elderly.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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