Community Living In Advanced Age: Implications Of LiLACS NZ
LiLACS NZ is a cohort study of 421 Māori aged 80-90 years and 517 non-Māori aged 85 years (56% and 59% participation rate respectively) recruited in 2010 in the Bay of Plenty region of New Zealand. Health social economic cultural and environmental factors were ascertained by interview at baseline and then yearly for 5 years.
This presentation will focus on dementia prevalence and prediction of serious fractures in the LiLACS NZ cohorts. Dementia prevalence in New Zealand is not known and has not been assessed amongst older Māori and predictors of fractures in octogenarians may differ by ethnic group.
The 3MS screening tool for dementia was validated in 76 participants comparing scores with a clinical assessment of dementia. Ethnic specific criteria were established to estimate the most accurate score on the 3MS to indicate presence of dementia. For Māori this was a score of 80 and for non- Māori it was 85 points out of 100.
Fracture risk factors were ascertained at baseline and covered osteoporosis and fall risk factors. Fractures were ascertained from the hospital discharge dataset from 48 month follow up data available on 498 non-Māori and 379 Māori. By 3 years FU, a total of 438 (47% of baseline): 161 Maori (39% of baseline); and 276 non-Maori (54% of baseline) people were interviewed.
Using the above 3MS cut points 19% of Māori and 14% of non-Māori were estimated to have dementia at baseline. By 3 years of follow up (participants now aged 83-93 for Māori and 88 for non- Māori) 26% of participant had had dementia. Comorbidity of dementia with chronic conditions was common and hospitalisations were more frequent and quality of life lower for those with dementia and a chronic condition.
Considering hospitalization for fracture the 5 year fracture incidence 28 Māori and 74 non-Māori had fracture related hospitalizations over 3,700 person-years follow-up. Accumulated fracture risk -5 years was 20 per 1000 person years for Māori and 34 per 1000 person years for non-Māori. More non-Māori and more women were hospitalized for fractures. Risk factors for serious fracture differed between the two ethnic groups and comprised risks for falls in both ethnic groups and osteoporosis risk factors for non- Māori.
Primary Care Initiatives for Older People New Zealand and beyond
With the demographic ageing of community care of older people has become increasingly important. Proactive preventive care, increased support services and optimisation of complex illness management may show some benefits to community dwelling older people.
This presentation outlines initiatives around New Zealand to improve community care of older people. Brief overview of several initiatives aiming to reduce falls, improve efficiency of care, reduce hospitalisation show a range of initiatives. Evaluations are commented on where present.
Presentation of a new systematic review of community proactive preventive interventions concludes the presentation; 22 clinical trials were assessed and summarised for impact on patient level outcomes and health service utilisation. It appears difficult to improve outcomes.
Call for Abstracts open: 25th October 2016
Registration Opens: 18th November 2016
Call for Abstracts Closes: 24th February 2017
Notification of Abstracts: 20th March 2017
Close of Early Registration: 31st March 2017
Conference: 10th May 2017
Australian and New Zealand Society for Geriatric Medicine (ANZSGM)
145 Macquarie Street
Sydney NSW 2000, Australia
Tel: +61 2 9256 5460
Fax: +61 2 9241 3458