Symposia / European Geriatric Medicine 5S1 (2014) S17–S43 S39

And: Schouten HJ, Koek HL, Kruisman-Ebbers M, Geersing GJ, Oudega R,

Kars MC, Moons KG, Van Delden JJ. Decisions to withhold diagnostic

investigations in nursing home patients with a clinical suspicion of

VTE. PlosOne. 2014. Accepted for publication.

SS8.02

Implementing ageing research in primary and secondary care:

The UK Ageing Research Network Model

C. Rajkumar1, J.T. Timeyin2, K.M. Ali1, S.T. Parker3

1Brighton and Sussex Medical School, Brighton, United Kingdom;2Brighton and Sussex University Hospital Trust, Brighton, United

Kingdom; 3Sheffield Institute for studies on ageing, Sheffield, United

Kingdom

Why do we need a Research Network?

(C. Rajkumar):

The talk will inform the audience of the benefits of a Comprehensive

Local Research Network (CLRN) in Surrey and Sussex in relation to

recruiting to large multi-centre studies with objective performance

outcomes (recruiting to time and target). Professor Rajkumar

will highlight the beneficial role of CLRN in working with the

UK research governance mechanisms resulting in non-academic

partners embracing the research agenda.

Running a multicentre trial: The Probiotics experience

(J.T. Timeyin):

The Probiotic study (Probiotics for preventing antibiotic associated

diarrhoea including closridium difficile infection) recruited 1127

patients from 28 hospitals across the UK. Ms Timeyin will present

how interaction with the national CLRN has enhanced recruitment

and ensured that the study sample size is achieved.

Patient and Public Involvement (PPI) in supporting ageing

research in the UK

(K.M. Ali):

The concept of engaging older people (patients and their carers)

in all stages of clinical research is a unique UK priority. In the

UK model, patient and public are equal partners in the research

enterprise with a valuable contribution to research conduct,

delivery, dissemination and implementation. Specific examples of

successful PPI will be presented such as the Stroke Oxygen Study

experience whereby meaningful PPI resulted in recruiting 8000

patients to the study.

Overview of the UK Ageing Research Network

(S.T. Parker):

This talk will present the UK Ageing Research Network and how it

facilitated successful recruitment to large multi-centre studies. By

presenting the UK model and its links with the European strategic

ageing research agenda a platform for future collaborations will be

established.

SS8.03

Hip fractures in Norway and the Netherlands: Can we learn

something about the underlying risk factors?

K. Holvik1, N.M. van Schoor2, M.S. Bakken1, O.M. Steihaug1

1University of Bergen, Bergen, Norway; 2VU University Medical Center,

Amsterdam, The Netherlands

Hip fractures in Norway and The Netherlands

(K. Holvik):

Between-population comparisons can produce knowledge about

factors affecting fracture risk that vary geographically, and provide

indications as to whether differences in lifestyle, environment

or ethnic and genetic constitution may explain the geographic

variations. Such information is important for planning preventive

measures on a public health level.

We have identified incident hip fractures in older people

participating in two community-based studies in Norway and

the Netherlands: the Oslo Health Study (HUBRO), 59°N and the

Longitudinal Aging Study Amsterdam (LASA), 52°N, respectively.

These were large multipurpose studies collecting anthropometric

measurements and lifestyle and background data from older

individuals living at home. 25-hydroxyvitamin D and other blood

sample markers were also collected in these studies.

We will present descriptive data on hip fracture incidence in

European countries, with focus on Norway and the Netherlands,

and between-country differences and similarities in risk factors for

hip fracture. We also plan to explore whether immigrants to Norway

from the Netherlands and its neighboring countries maintain their

lower fracture risk after migration, or whether these populations

approach the fracture incidence of the high-risk host population.

Longitudinal changes in vitamin D levels during aging in The

Netherlands

(N.M. van Schoor):

Purpose: Longitudinal changes in serum 25-OHD levels during aging

have not been studied extensively. When studying the longitudinal

change, it is highly important to adequately adjust for seasonal

variation. The objectives are: (1) To examine longitudinal changes

in serum 25-OHD levels during aging; and (2) To describe the

seasonal variation using a cosine function.

Methods: Data of the Longitudinal Aging Study Amsterdam (LASA)

were used, an ongoing cohort study. Two different cohorts were

included: (1) younger cohort: aged 55–65 years at baseline, n = 738,

follow-up of six years; (2) older cohort: aged 65–88 years at

baseline, n = 1320, follow-up of thirteen years.

Results: In the younger cohort, a longitudinal increase in mean

serum 25-OHD levels of 4 nmol/L in six years was observed; in

the older cohort, a longitudinal decrease of 4 nmol/L in thirteen

years was observed. The seasonal variation was ±12nmol/L in the

younger cohort, and ±7nmol/L in the older cohort.

Conclusions: Long term serum 25-hydroxyvitamin D levels remained

fairly stable during ageing with slightly increasing levels in persons

aged 55–65 years, and slightly decreasing levels in persons aged

65–88 years. On average, the seasonal variation was larger than the

longitudinal change.

Associations between hip fractures and psychotropic drugs

(M.S. Bakken):

Psychotropic drugs are widely used and may cause injurious falls.

Aim: To examine associations between the use of antidepressants,

anxiolytics and hypnotics among older people and the risk of hip

fracture.

Methods: A nationwide prospective cohort study of people in

Norway born before 1945 (n =906,422) was conducted. We obtained

information on all prescriptions of antidepressants, anxiolytics and

hypnotics dispensed in 2004–2010 (the Norwegian Prescription

Database) and all primary hip fractures in 2005–2010 (the

Norwegian Hip Fracture Registry). We compared the incidence

rates of hip fracture during drug exposure and non-exposure by

calculating the standardized incidence ratio (SIR).

Results: Altogether, 39,938 people (4.4%) experienced a hip fracture.

The risk of hip fracture was increased for people exposed to any

antidepressant, SIR 1.7 (95% confidence interval 1.7–1.8); tricyclic

antidepressants, SIR 1.4 (1.3–1.5) and selective serotonin reuptake

inhibitors (SSRIs), SIR 1.8 (1.7–1.8). Preliminary analysis revealed an

increased risk of hip fracture among people exposed to anxiolytics,

SIR 1.4 (1.4–1.5) and hypnotics, SIR 1.2 (1.1–1.2); the excess risk was

highest regarding short-acting benzodiazepine (SAB) anxiolytics,

SIR 1.5 (1.4–1.6). Benzodiazepine-like hypnotics (z-hypnotics) were

associated with higher excess risk of hip fracture at night, SIR 1.3

(1.2–1.4) than during the day, SIR 1.1 (1.1–1.2).

Conclusions: Our nationwide study shows an excess risk of hip

fracture among older people using antidepressants, anxiolytics

or hypnotics, including the widely prescribed SSRIs, SABs and

z-hypnotics (particularly at night). Thus, cautious prescribing is

needed.