RESUMO
BACKGROUND: Late-life depression is a geriatric syndrome which should be taken seriously. Many clinical scales have been developed for the screening of geriatric depression. Most of these have been validated at different times and in diverse populations. A five-question version of the Geriatric Depression Scale (GDS-5) was developed in 1997. This test has been validated and used in different populations. In the present study, we plan to validate the GDS-5 for the Turkish elderly population. METHODS: Patients aged 60 years and older who applied to the Geriatrics Clinic of our hospital between November 2018 and November 2019 were included in the study. We compared the effectiveness of Yesavage Geriatric Depression Scale-30 (YGDS-30) and GDS-5 in screening depression, based on Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) depression criteria. RESULTS: Four hundred participants were included in the study. A significant positive correlation was found between the DSM-5 scale and the GDS-5 scale (rho = 0.726, P <0.001). According to DSM-5, YGDS-30 and GDS-5, 112 participants (28%), 154 patients (%38.5) and 199 patients (%49.8) were diagnosed with depression respectively. When the cut-off value was taken as ≥2, the sensitivity, specificity, positive predictive and negative predictive values for the GDS-5 scale were determined as 96%, 68%, 54%, and 98%, respectively. We obtained these diagnostic measures with 95% confidence intervals. CONCLUSION: This study demonstrated the validity and reliability of the GDS-5 for Turkish elderly populations. This five-question scale will be significant in daily use to screen for depression in elderly individuals with multiple problems.
Assuntos
Depressão , Avaliação Geriátrica , Idoso , Depressão/diagnóstico , Manual Diagnóstico e Estatístico de Transtornos Mentais , Humanos , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
Oropharyngeal dysphagia has features of geriatric syndromes and is strongly associated with sarcopenia. In this cross-sectional study, we aimed to evaluate the association between dysphagia and sarcopenia, in a practical way, accompanied by comprehensive geriatric assessment. Dysphagia and sarcopenia were defined by the EAT-10 and SARC-F questionnaires, respectively. Cognition and mood, was evaluated by the Mini-mental State Examination (MMSE) and Geriatric Depression Scale (GDS), respectively. Physical performance was assessed by the Timed up and Go Test (TUG) and muscle strength was determined by Hand Grip Strength (HGS). Functionality was stated by Katz and Lawton Indexes. Serum levels of hemoglobin, triglyceride, albumin, and total cholesterol were recorded. A total of 512 (151 male/361 female) patients age 60 and older were included in the study. Prevalences of dysphagia and sarcopenia were 23% and 40.6%, respectively. In multivariate analysis sarcopenia (OR:2.596, p = 0.008), depressive symptoms (OR:1.115, p < 0.001), and lower KATZ scores (OR:0.810, p = 0.036) were independently related with dysphagia. Dysphagic patients with sarcopenia had lower scores on the Katz and Lawton scales (p < 0.001, rpb = 0.380 and p < 0.001, rpb = 0.447 respectively) and TUG performances were worse (p = 0.009, rpb = - 0.254). Serum hemoglobin and albumin levels were significantly low in dysphagic patients with sarcopenia (p < 0.001, rpb = 0.345, p = 0.008, rpb = 0.243). Dysphagia is independently associated with sarcopenia, depressive symptoms, and functionality. Dysphagia coexist with sarcopenia is associated with worse clinical consequences than without sarcopenia.
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Transtornos de Deglutição , Sarcopenia , Idoso , Estudos Transversais , Transtornos de Deglutição/complicações , Transtornos de Deglutição/epidemiologia , Feminino , Avaliação Geriátrica , Força da Mão , Humanos , Masculino , Pessoa de Meia-Idade , Equilíbrio Postural , Sarcopenia/complicações , Sarcopenia/epidemiologia , Estudos de Tempo e MovimentoRESUMO
BACKGROUND/AIM: To assess sarcopenia and dynapenia and their relationship with disease severity and disabilities in PD and to state body composition in PD. METHODS: We conducted a case-control, cross-sectional study that included 70 patients with idiopathic PD and 85 controls. Sarcopenia was defined according to the European Working Group on Sarcopenia in Older People (EWGSOP) criteria. Dynapenia was detected by a handheld dynamometer. Bioimpedance analysis (BIA) was performed, and the SARC-F questionnaire was applied. Disabilities were appointed according to the Katz and Lawton indexes. RESULTS: Sarcopenia and dynapenia were more prevalent in PD than in controls (50 vs 30.6% and 31.4 vs 17.6%, respectively). Dynapenia was significantly associated with the severity of the disease and disabilities (p = 0.047, p = 0.001); however, sarcopenia was not. The skeletal muscle mass index (SMMI), fat mass index (FMI), and fat-free mass index (FFMI) did not differ between the PD and controls. FMI was lower in the advanced stages of the disease. Higher scores in the SARC-F questionnaire were significantly associated with disabilities and the severity of the disease (p < 0.001, p < 0.001). CONCLUSION: Muscle strength was closely associated with the severity of the disease and disabilities in PD, but muscle mass was not. Sarcopenia, defined by the SARC-F questionnaire, was a good predictor of disabilities in PD, while the EWGSOP criteria were not. PD patients have a favorable body composition even in advanced stages of the disease with lower FMI and protected lean mass.
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Composição Corporal/fisiologia , Força da Mão/fisiologia , Doença de Parkinson/epidemiologia , Sarcopenia/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Pessoas com Deficiência/reabilitação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Força Muscular/fisiologia , Músculo Esquelético , Doença de Parkinson/complicações , PrevalênciaAssuntos
Lacerações , Idoso , Estudos Transversais , Hospitalização , Humanos , Lacerações/epidemiologia , Prevalência , Fatores de Risco , Pele/lesõesRESUMO
INTRODUCTION: To determine the prevalence of low muscle mass (LMM) and the relationship between LMM with functional and nutritional status as defined using the LMM evaluation method of European Working Group on Sarcopenia in Older People (EWGSOP) criteria among male residents in a nursing home. METHODS: Male residents aged >60 years of a nursing home located in Turkey were included in our study. Their body mass index (BMI) kg/m2, skeletal muscle mass (SMM-kg) and skeletal muscle mass index (SMMI-kg/m2) were calculated. The participants were regarded as having low SMMI if they had SMMI <9.2 kg/m2 according to our population specific cut-off point. Functional status was evaluated with Katz activities of daily living (ADL) and Lawton Instrumental Activities of Daily Living (IADL). Nutritional assessment was performed using the Mini Nutritional Assessment (MNA). The number of drugs taken and chronic diseases were recorded. RESULTS: One hundred fifty-seven male residents were enrolled into the study. Their mean age was 73.1 ± 6.7 years with mean ADL score of 8.9 ± 2.0 and IADL score of 8.7 ± 4.6. One hundred twelve (71%) residents were aged >70 years. Thirty-five men (23%) had low SMMI in group aged >60 years, and twenty-eight subjects (25%) in the group aged >70 years. MNA scores were significantly lower in residents with low SMMI compared with having normal SMMI (17.1 ± 3.4 versus 19.6 ± 2.5, p = 0.005). BMI was significantly lower in the residents with low SMMI compared with normal SMMI (19.6 ± 2.7 versus 27.1 ± 4.1, p< 0.001). ADL scores were significantly different between residents with low SMMI and normal SMMI in those aged >70 years (8.1 ± 2.6 versus 9.1 ± 1.6, p = 0.014). In regression analyses, the only factor associated with better functional status was the lower age (p = 0.04) while the only factor associated with better nutrition was higher SMMI (p = 0.01). CONCLUSIONS: Low SMMI detected by LMM evaluation method of EWGSOP criteria is prevalent among male nursing home residents. There is association of low SMMI with nutritional status and probably with functional status within the nursing home setting using the EWGSOP criteria with Turkish normative reference cut-off value.
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Atividades Cotidianas , Casas de Saúde/estatística & dados numéricos , Estado Nutricional , Sarcopenia/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Humanos , Masculino , Desnutrição/complicações , Pessoa de Meia-Idade , Avaliação Nutricional , Sarcopenia/etiologia , Turquia/epidemiologiaRESUMO
AIM: The purpose of this study is to determine the prevalence of frailty with the Fried Frailty Index (FFI) and FRAIL scales (Fatigue, Resistance, Ambulation, Illness, Low weight) and also its associated factors in the community-dwelling Turkish elderly. METHODS: This is a cross-sectional population-based study in an urban area with a population of over 1,200,000. We sampled 1/100 of the elderly population. Frailty prevalence was assessed with a modified version of the FFI and FRAIL scale. Nutritional status was assessed by Mini Nutritional Assessment. Cognitive function was assessed by Mini-Mental State Examination. Depressive mood was assessed by GDS. Functional capacity was assessed by the instrumental activities of daily living scale. Falls and fear of falling were noted. Uni- and multivariate analyses were done to determine associated factors for frailty. RESULTS: A total of 906 community-dwelling elderly were included, in whom the mean age and standard deviation (SD) of age were 71.5 (5.6) years (50.6 % female). We detected frailty (female 30.4 %, male 25.2 %), pre-frailty and non-frailty prevalence with FFI as 27.8, 34.8, and 37.4 %, respectively. The prevalence of frailty (female 14.5 %, male 5.4 %), pre-frailty and non-frailty with the FRAIL scale was detected as 10, 45.6, and 44.4 %. Coexisting associated factors related with frailty in both models were found as depressive mood, cognitive impairment, and malnutrition in multivariate analysis. CONCLUSIONS: According to both scales, frailty was strongly associated with cognitive impairment, depressive mood, and malnutrition in the community-dwelling Turkish elderly population.
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Acidentes por Quedas/estatística & dados numéricos , Envelhecimento , Transtornos Cognitivos , Idoso Fragilizado , Vida Independente/estatística & dados numéricos , Estado Nutricional , Atividades Cotidianas , Idoso , Envelhecimento/fisiologia , Envelhecimento/psicologia , Cognição , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/epidemiologia , Estudos Transversais , Feminino , Idoso Fragilizado/psicologia , Idoso Fragilizado/estatística & dados numéricos , Avaliação Geriátrica/métodos , Avaliação Geriátrica/estatística & dados numéricos , Humanos , Testes de Inteligência , Masculino , Prevalência , Turquia/epidemiologiaRESUMO
Adverse-outcomes related to sarcopenia are mostly mentioned as physical disability. As the other skeletal muscles, respiratory muscles may also be affected by sarcopenia. Respiratory muscle strength is known to affect pulmonary functions. Therefore, we aimed to investigate the relations between extremity muscle strength, respiratory muscle strengths and spirometric measures in a group of male nursing home residents. Among a total of 104 male residents, residents with obstructive measures were excluded and final study population was composed of 62 residents. Mean age was 70.5 ± 6.7 years, body mass index: 27.7 ± 5.3 kg/m2 and dominant hand grip strength: 29.7 ± 6.5 kg. Hand grip strength was positively correlated with maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) (r = 0.35, p < 0.01 and r = 0.26, p < 0.05, respectively). In regression analysis, the only factor related to MIP was hand grip strength; among spirometric measures only parameter significantly related to grip strength was peak cough flow (PCF). The association of PCF with grip strength disappeared when MIP alone or "MIP and MEP" were included in the regression analysis. In the latter case, PCF was significantly associated only with MIP. We found peripheric muscle strength be associated with MIP and PCF but not with MEP or any other spirometric parameters. The relation between peripheral muscle strength and PCF was mediated by MIP. Our findings suggest that sarcopenia may affect inspiratory muscle strength earlier or more than the expiratory muscle strength. Sarcopenia may cause decrease in PCF in the elderly, which may stand for some common adverse respiratory complications.
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Força da Mão/fisiologia , Força Muscular/fisiologia , Músculos Respiratórios/fisiologia , Idoso , Idoso de 80 Anos ou mais , Humanos , Masculino , Pessoa de Meia-Idade , Casas de Saúde/estatística & dados numéricos , EspirometriaRESUMO
BACKGROUND AND AIMS: Adipokine levels may have a role in the diagnostic and prognostic evaluation of malnutrition. The aim of the present study was to evaluate the correlation between malnutrition score and leptin, other biological markers, and body mass index (BMI) in the diagnosis of malnutrition in the elderly. METHODS: In this cross-sectional observational study, we enrolled subjects over 70 years. Exclusion criteria were diabetes mellitus, obvious thyroid disorders, significant edema, renal dysfunction, chronic liver disease, symptomatic cardiovascular diseases, and malignity. Patients' demographic and medical data were recorded and anthropometric measurements were performed. Laboratory parameters including leptin, IGF-1, IGFBP-3, IL-6, TNF-α were measured. We defined malnutrition according to mini nutritional assessment (MNA) scale. Patients were divided into four groups according to BMI quartiles. RESULTS: Average age of the patients was 81.9 ± 4.8 years, 68.2 % female and 31.8 % male. According to their MNA scores, 103 (66.9 %) were well nourished, 33 (21.4 %) were under malnutrition risk and 18 (11.7 %) were malnourished. MNA total and screening scores were positively correlated with albumin, BMI, high-density lipoprotein cholesterol and estimated glomerular filtration rate. Serum leptin levels (ng/ml) were 18.9 ± 22.6, 22.3 ± 21.9, 51.9 ± 85.5, and 61.7 ± 56.1 in BMI groups 1-4, respectively. BMI was positively correlated with leptin and triglyceride levels. Leptin levels were similar among nutritional state groups. Neither BMI nor MNA scores had any significant correlation with adiponectin, ghrelin, IGF-1, or IGFBP-3. CONCLUSIONS: Adipokine levels do not seem to give relevant information in nutritional state assessment.
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Adipocinas/sangue , Envelhecimento/sangue , Desnutrição/sangue , Desnutrição/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Estudos Transversais , Citocinas/sangue , Feminino , Humanos , Leptina/sangue , Lipídeos/sangue , Masculino , Desnutrição/patologia , Avaliação Nutricional , Fatores de RiscoRESUMO
The incidence of deep vein thrombosis (DVT) and pulmonary embolism has been increasing in the elderly because of hypercoagulability associated with aging. Age has also been identified as an independent risk factor for bleeding complications related to anticoagulation therapy. Inferior vena cava filters could be used as alternatives to anticoagulant therapy for the prevention of pulmonary embolism when anticoagulation is either contraindicated or ineffective. Here, we report two geriatric patients who had documented acute DVT and in whom inferior vena caval filter was used because of the patients have a contraindication to use an anticoagulation.
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Anticoagulantes/uso terapêutico , Filtros de Veia Cava , Trombose Venosa/prevenção & controle , Idoso , Feminino , Humanos , Masculino , Embolia Pulmonar/prevenção & controleRESUMO
Systemic lupus erythematosus (SLE) is a multisystemic disease which potentially involves various organs including the skin, joints, kidneys, liver, hematopoetic system, and serous membranes. It is rarely seen in elderly males. The most common cardiovascular involvement type is pericarditis. Anti-Ro antibodies may be associated with neonatal lupus which causes heart blocks. Recent literature indicates that anti-Ro antibodies may be associated with various rhythm and conduction disturbances in the adulthood. The most common finding associated with anti-Ro antibodies is prolonged corrected QT (QTc) interval. Herein, we present an elderly male patient with anti-Ro-positive SLE associated with prolonged QTc interval and AV blocks that significantly improved after corticosteroid treatment.
Assuntos
Corticosteroides/uso terapêutico , Anticorpos Antinucleares/sangue , Bloqueio Cardíaco/tratamento farmacológico , Bloqueio Cardíaco/etiologia , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/imunologia , Corticosteroides/efeitos adversos , Idoso , Infecção Hospitalar/etiologia , Eletrocardiografia , Evolução Fatal , Bloqueio Cardíaco/fisiopatologia , Humanos , Imunossupressores/efeitos adversos , Imunossupressores/uso terapêutico , Lúpus Eritematoso Sistêmico/diagnóstico , MasculinoRESUMO
BACKGROUND: It has been reported that the inflammatory process plays a role in the pathophysiology of frailty in elderly individuals and that diet is effective in regulating chronic inflammation. OBJECTIVE: This study aims to evaluate the effects of nutritional status and dietary inflammatory index on frailty and activities of daily living in the elderly. METHOD: A cross-sectional study in a hospital in Turkey has been carried out with 187 over the age of 65 who presented to the geriatric outpatient clinic participants. Anthropometric measurements of the patients were recorded, and the dietary inflammatory index (DII) was calculated using the 24-h dietary recall method. Mini Nutritional Assessment (MNA) was used to determine the malnutrition risk, the FRAIL scale was used for frailty assessment, and Katz and Lawton & Brody scales were used for daily living activities. RESULTS: The mean age of the elderly is 70.83 ± 4.98 years. The frailty rate was determined to be 28.3%. The DII score was determined as 4.41 ± 5.16 in frail patients and 1.62 ± 4.39 in non-frail patients (p < 0.05). While DII showed a negative correlation with the Lawton & Brody scale score (r = - 0.353), MNA was positively correlated to the Katz score (r = 0.386, p = 0.000) and the Lawton & Brody score (r = 0.475). In addition, one-unit increase in the MNA score was associated with a 29% decrease in the risk of frailty. CONCLUSIONS: The dietary inflammatory index was found to be high in frail and malnourished individuals. It was determined that the quality of life of individuals with malnutrition decreased.
Assuntos
Atividades Cotidianas , Fragilidade , Avaliação Geriátrica , Inflamação , Estado Nutricional , Humanos , Idoso , Masculino , Feminino , Estudos Transversais , Fragilidade/fisiopatologia , Avaliação Geriátrica/métodos , Dieta , Pacientes Ambulatoriais/estatística & dados numéricos , Avaliação Nutricional , Idoso Fragilizado , Idoso de 80 Anos ou mais , Turquia , DesnutriçãoRESUMO
BACKGROUND: There is no universally accepted definition of sarcopenic obesity (SO), and its prevalence is ambiguous. This study aimed to investigate the prevalence of SO in older adults based on different definitions and determine which predicts all-cause mortality. METHODS: This prospective longitudinal follow-up study included outpatients aged ≥60 years. SO was defined by sarcopenia definition based on the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria plus obesity. Three different methods were used to define obesity. Body mass index (BMI) ≥ 30 kg/m2, waist circumference (WC) ≥ 102 cm for men and ≥88.0 cm for women, and body fat percentage (BF%) ≥ 37.3% for men and ≥51.1% for women. Different definitions of SO and their mortality predictions were compared. RESULTS: The median age of the 584 patients in the study was 70.0 (interquartile range, 66.0-76.0) years. The prevalence of sarcopenia was 38.5% (47.5% in men and 35.7% in women). The prevalence of SO based on BMI, WC, and BF% was 15.3%, 16.4%, and 10.5%, respectively. The mortality rate was 6.7%. SO based on BMI (odds ratio [OR], 2.73; 95% CI, 1.12-17.9; P = 0.024) and BF% (OR, 1.43; 95% CI, 1.19-3.02; P = 0.007) were significantly associated with 3-year mortality after adjusting for the confounding variables of age, sex, and number of comorbidities. SO based on WC was not associated with mortality (OR, 0.78; 95% CI, 0.07-1.27; P = 0.104). CONCLUSION: The use of BF% and BMI for defining SO is appropriate in outpatient older adults.
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Composição Corporal , Índice de Massa Corporal , Obesidade , Sarcopenia , Circunferência da Cintura , Humanos , Sarcopenia/mortalidade , Sarcopenia/epidemiologia , Masculino , Feminino , Idoso , Estudos Prospectivos , Obesidade/epidemiologia , Obesidade/mortalidade , Obesidade/complicações , Prevalência , Estudos Longitudinais , Seguimentos , Pessoa de Meia-Idade , Avaliação Geriátrica/métodosRESUMO
Edema can be observed as side-effect of many medications, of which calcium channel blockers are the best known. Elderly people use many more medications than their younger counterparts and are usually more prone to developing medication-induced side-effects. Atypical antipsychotics have occasionally been shown to induce peripheric edema. Age is put forward as a risk factor for olanzapine-induced edema. We present here the case of an elderly man who developed upper- and lower-limb edema during use of olanzapine to emphasize its relatively frequent association with edema in the elderly.
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Antipsicóticos/efeitos adversos , Benzodiazepinas/efeitos adversos , Edema/induzido quimicamente , Idoso de 80 Anos ou mais , Arterite de Células Gigantes/tratamento farmacológico , Glucocorticoides/efeitos adversos , Humanos , Masculino , Olanzapina , Prednisolona/efeitos adversos , Psicoses Induzidas por Substâncias/tratamento farmacológico , Psicoses Induzidas por Substâncias/etiologiaRESUMO
Cytomegalovirus (CMV) infection is generally associated with significant immunosuppression. Cellular immunity is particularly important and corticosteroid treatment increases the risk of CMV infection substantially. Immunocompetence generally decreases with age, older patients are at higher risk for developing CMV disease than are younger patients. CMV infection in the immunocompetent adults is quite rare. Esophagitis is the second most common gastrointestinal manifestation of CMV infection after colitis. Herein, we present three cases of giant cell arteritis who developed CMV esophagitis after various periods of corticosteroid treatment. CMV infection should be included in the differential diagnosis of GI disease in immunocompromised patients, and the clinician should pursue appropriate diagnostic and therapeutic interventions aggressively.
Assuntos
Infecções por Citomegalovirus/induzido quimicamente , Esofagite/virologia , Arterite de Células Gigantes/tratamento farmacológico , Glucocorticoides/efeitos adversos , Prednisona/efeitos adversos , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Terapia de Imunossupressão/efeitos adversos , MasculinoRESUMO
OBJECTIVES: This study aimed to determine the prevalence and factors associated with frailty in older hospitalized patients. METHODS: The point-prevalence study was completed on 263 patients aged 65 and over hospitalized in internal medicine and surgical clinics at a tertiary hospital in Türkiye. Data were collected between July 19th and July 22nd, 2021. A comprehensive geriatric assessment was performed on the participants. The Edmonton Frailty Scale (EFS) and FRAIL scale were used for frailty assessment. RESULTS: The mean age of the individuals was 72.40 ± 6.42, 51.7% were female, and 63.9% were hospitalized in internal medicine and surgical units. The prevalence of frailty was 57.4% according to the FRAIL scale and 46.8% according to EFS. Factors affecting frailty were gender (OR 3.36, 95% CI 1.48-7.64), comorbidity (OR 1.29, 95% CI 1.01-1.64), polypharmacy (OR 0.33, 95% CI 0.13-0.80), history of falling in the last year (OR 3.54, 95% CI 1.34-9.35), incontinence (OR 5.93, 95% CI 2.47-14.27), and functional dependency (ADL, OR 0.65, 95% CI 0.46-0.92; IADL, OR 0.59, 95% CI 0.46-0.76). This model correctly predicted the participants' frailty at 70.5%. CONCLUSIONS: The importance of frailty, which affects one out of every two hospitalized older persons, to the health care system should not be overlooked. Considering the increasing trend of the aging person population, national and global plans should be made to prevent and manage frailty.
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Fragilidade , Incontinência Urinária , Idoso , Humanos , Feminino , Idoso de 80 Anos ou mais , Masculino , Fragilidade/epidemiologia , Idoso Fragilizado , Prevalência , Avaliação GeriátricaRESUMO
Differentiation of "dementia with Lewy body pathology" (DLB) and delirium may be problematic in some cases, due to some of their common clinical characteristics such as fluctuations and hallucinations. Longer duration of cognitive changes usually aids in DLB diagnosis. However, presentation of DLB with an abrupt onset as a prolonged confusional state and hallucinations is also, even if rarely, described. We report the case of an elderly patient with probable dementia with Lewy body pathology, presenting with a prolonged acute confusional state, in order to draw attention to its diagnostic difficulty and the importance of careful target-oriented anamnesis in such cases. This type of dementia should be included in the differential diagnosis of elderly patients presenting with otherwise unexplained prolonged acute confusional states.
Assuntos
Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/patologia , Demência/diagnóstico , Demência/patologia , Doença por Corpos de Lewy/diagnóstico , Doença por Corpos de Lewy/patologia , Idoso , Atenção/fisiologia , Diagnóstico Diferencial , Humanos , Doença por Corpos de Lewy/psicologia , MasculinoRESUMO
BACKGROUND: The Global Leadership Initiative on Malnutrition (GLIM) published malnutrition identification criteria. The Mini Nutritional Assessment (MNA) is malnutrition assessment tool commonly used in older adults. This study aimed to determine prevalence of malnutrition and the relationship between the GLIM and the MNA long form (MNA-LF) and short form (MNA-SF) and energy-protein intake. METHODS: A total of 252 older adult outpatients (aged 68.0 years, 61% females) were included. Malnutrition was defined according to the GLIM, MNA-LF, and MNA-SF. Food intake was assessed using the 24-h dietary recall. We analyzed the cutoff value on the MNA-LF score, MNA-SF score, and energy-protein intake for GLIM criteria-defined malnutrition severity with receiver operating characteristic analysis. RESULTS: Malnutrition was present in 32.2%, 12.7%, and 13.1% of patients according to the GLIM criteria, MNA-LF, and MNA-SF, respectively. It was determined that 92.7% and 89.0% of patients, based on GLIM criteria, had malnutrition with the MNA-LF and MNA-SF, respectively. The daily energy-protein intake was less in patients with malnutrition according to GLIM, as in the MNA-LF and MNA-SF classifications (p < .05). For the MNA-LF and MNA-SF score, the cutoff value of 11 and 9 points for severe malnutrition (area under curve [AUC] 0.92; p < .001 and 0.90; p < .001), 22 and 11 points for moderate malnutrition (AUC 0.79; p < .001 and 0.76; p < .001) were determined. CONCLUSION: According to GLIM criteria, one-third of outpatient older adults were malnourished, whereas the prevalence was much lower applying both the MNA-LF and the MNA-SF.
Assuntos
Desnutrição , Pacientes Ambulatoriais , Idoso , Estudos Transversais , Feminino , Humanos , Liderança , Masculino , Desnutrição/diagnóstico , Desnutrição/epidemiologia , Avaliação Nutricional , Estado Nutricional , PrevalênciaRESUMO
Objective: Depression is highly prevalent in frail older adults and both clinical situations share similar clinical and prognostic factors. The aim of this study was to investigate the relationship between frailty and depression by considering each component of frailty, in both genders. Methods: Six hundred and forty-one patients aged 60 years and older, admitted to a Geriatrics outpatient clinic in a tertiary hospital, were included in this cross-sectional study. FRIED criteria were used for defining frailty. Depression was assessed by the Geriatric depression scale (GDS). Evaluations related to disability, nutrition, and cognition were performed by the Katz/Lawton scales, mini nutritional assessment (MNA), and the mini mental state examination (MMSE), respectively. Results: Prevalence of frailty and depression was 48.7% and 36.7%, respectively. Co-occurrence of frailty and depression was observed as 24.0%. Both in men (OR: 3.977, CI: 1.423-11.114, p=0.008) and in women (OR: 2.704, CI: 1.695-4.315, p<0.001), depression was independently associated with frailty, after adjusting with confounders regarding frailty. All FRIED criteria were significantly correlated with the higher GDS scores in women. Two FRIED criteria regarding physical activity and strength measures were not related to depressive symptoms in men. Lawon (p<0.001), MMSE (p=0.004), and MNA scores (p<0.001) were lower in patients with co-occurring frailty and depression, than both as separate conditions. Conclusion: Depression may play a key role in the development of frailty in both genders. Albeit, depressed men seem to be at a higher risk than women for development of frailty are, physical activity and strength measures in the FRIED criteria had a high impact in women for depressive symptoms. Patients with co-occurring frailty and depression are more prone to develop geriatric syndrome related disabilities.
RESUMO
BACKGROUND: Dysphagia is a geriatric syndrome. Changes in the whole body that occur with aging also affect swallowing functions and cause presbyphagia. This condition may progress to oropharyngeal and/or esophageal dysphagia in the presence of secondary causes that increase in incidence with aging. However, no study has been published that provides recommendations for use in clinical practice that addresses in detail all aspects of the management of dysphagia in geriatric individuals. This study aimed to answer almost all potential questions and problems in the management of geriatric dysphagia in clinical practice. METHODS: A multidisciplinary team created this recommendation guide using the seven-step and three-round modified Delphi method via e-mail. The study included 39 experts from 29 centers in 14 cities. RESULTS: Based on the 5W and 1H method, we developed 216 detailed recommendations for older adults from the perspective of different disciplines dealing with older people. CONCLUSION: This consensus-based recommendation is a useful guide to address practical clinical questions in the diagnosis, rehabilitation, and follow-up for the management of geriatric dysphagia and also contains detailed commentary on these issues.
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PURPOSE: To determine whether the use of implant-supported overdentures (IODs) with different attachments influences the Mini Nutritional Assessment (MNA) and Geriatric Oral Health Assessment Index (GOHAI) scores in edentulous patients > 65 years of age. MATERIALS AND METHODS: The MNA and GOHAI were administered to 54 edentulous patients > 65 years of age (mean age = 68.35 ± 4.1 years) before treatment (A) and 6 months after treatment (B): 10 with maxillary + mandibular conventional complete dentures (CDs); 10 with a maxillary conventional CD + mandibular magnetic-retained IOD; 12 with a maxillary conventional CD + mandibular ball-retained IOD; 12 with a maxillary conventional CD + mandibular Locator-retained IOD; and 10 with a maxillary conventional CD + mandibular bar-retained IOD. Statistical differences between treatment types were evaluated using one-way analysis of variance and paired-sample t tests. The correlation between MNA and GOHAI scores was determined using Pearson correlation analysis (α = .05). RESULTS: The difference between mean GOHAI-A and GOHAI-B scores was statistically significant for each type of denture (P < .005). The difference between the mean MNA-A and MNA-B scores was statistically significant for all types of denture except for conventional CDs (P < .05). There was a statistically significant positive correlation between MNA and GOHAI scores (P < .01). CONCLUSION: Regardless of the type of denture used, treatment of edentulous geriatric patients is important for improving nutritional status and self-rated oral health.