To identify potential risk factors and the yield of routine screens for early detection of malignancy associated with dermatomyositis (DM) and polymyositis (PM). Design: Retrospective study of malignancies in all patients with DM or PM followed up between the years 1981 and 2000 and a review of the relationship of DM and PM to malignancy, the usefulness of various tests or examinations for malignancy search, and the patients' course. Setting: Departments of internal medicine and dermatology in a teaching hospital. Patients: Forty consecutive adult patients with DM (33 cases) or PM (7 cases). Main Outcome Measures: (1) Rate of false-negative results of routine workup and yield (percentage of positive results) of blind malignancy search and (2) comparison of 16 characteristics in patients with malignancy vs those without. Results: Malignancy occurred in 16 patients: 13 with DM and 3 with PM. In all cases, the diagnosis of malignancy was made concurrently with or shortly after the diagnosis of DM or PM. Factors associated with malignancy were recruitment in the internal medicine department (P=.02), constitutional symptoms (PϽ.01), a rapid onset of DM or PM (P=.02), the lack of Raynaud phenomenon (PϽ .01), and a higher mean erythrocyte sedimentation rate (PϽ.01) and creatine kinase level (PϽ.01). Initial routine search failed to discover 4 malignancies, 3 of which were discovered at an advanced stage by more extensive investigations. The positive result yield of blind malignancy search was only 13% (11 of 87), but reached 28% (5 of 18) for blind abdominal-pelvic and thoracic computed tomographic scans. Conclusion: Extensive search for malignancy, particularly computed tomographic scans, may be warranted in at least a subset of patients with DM or PM and risk factors of malignancy.

S188th Congress of the EUGMS / European Geriatric Medicine 3S (2012) S1-S32Methods.-In a retrospective cohort study, we merged chart and administrative data of unique seniors aged 65 years and older admitted for pneumonia at three acute care hospitals over one year. We constructed a Frailty Index (range: 0 to 1) from the number of deficits out of 16 items that spanned comorbidity, functional and social domains. Logistic regression modelling was performed to quantify the association of this index with 30-day mortality, after adjustment for demographic characteristics, severity of acute illness, and recent hospitalization. Results.-Among 2,379 seniors hospitalized for pneumonia, 30-day mortality was 24.8%. Their median (inter-quartile range) Frailty Index was 0.38 (0.31 to 0.44). The Frailty Index was significantly associated with 30-day mortality (odds ratio 1.28, 95% confidence interval 1.17 to 1.41, for every increase of 0.1 in the index) after adjustment for the pre-specified potential confounders. Conclusion.-The Frailty Index was an independent predictor of 30-day mortality among seniors hospitalized for pneumonia. If this finding can be replicated for other medical diagnoses, then the utility of such an index may extend beyond identifying long-term mortality risk, to include prediction of seniors' short-term mortality risk with episodes of acute illness requiring hospitalization. The presentation makes the argument for a lifecourse approach to studying cognitive ageing. Much research in this domain is on dementia, the 2009 World Alzheimer Report estimates 36 million cases of dementia in 2010 and projects that this number will double every 20 years, with most of the increase coming from low-income countries. The dementia epidemic requires strategic choices in setting research priorities to allow rapid translation into prevention, delaying the age of onset and improving clinical care. There is now quite a lot of evidence to suggest that dementia develops over many years, perhaps as long as 20-30 years. Thus, the longitudinal process of age-related changes in cognitive function is an important outcome of interest. Furthermore, proposed changes to the DSM-5 highlight the importance of both "major" and "minor" neurocognitive disorder. In order to meet these challenges, we recommend adoption of an extended time window to study cognitive ageing and identify the risk factors associated with adverse cognitive outcomes. A shift away from binary outcomes such as dementia assessed at one point in time in elderly populations to research on cognitive ageing using repeated measures of cognitive function and starting earlier in the lifecourse would allow the sources of variability in cognitive ageing to be better understood. This approach also ensures that the risk factors are assessed prior to the beginning of the dementia process. There might be critical periods (childhood, adolescence, early adulthood, midlife, etc.) of exposure that late life measures of risk factors cannot assess.http://dx

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