Changes in sexual behaviour of male physicians during the COVID-19 pandemic.

Healthcare workers have been affected both physically and mentally during the COVID-19 pandemic. This study aimed to investigate the impacts of COVID-19 on the mental health and sexual behaviour of male physicians working during the pandemic. A survey was carried out on male physicians working in Turkey during the pandemic. Participants' sexual behaviours, anxiety symptoms, and depressive symptoms were assessed. The frequency of anxiety and depressive symptoms was 55.9% and 44.1%, respectively. Among the 102 participants, 35.3% reported decreased sexual desire, and 41.2% reported decreased sexual intercourse. Working more, caring for COVID-19 patients, having higher scores for anxiety and depressive symptoms were related to changes in sexual behaviour. High prevalences of anxiety and depressive symptoms and sexual behaviour changes were found among male physicians during the COVID-19 pandemic. This study points out the importance of psychosocial support in health professionals during the pandemic period.

Recurrent lower urinary tract infections: more than an infection for older women.

Background/aim: Older adults tend to have more urinary tract infections (UTIs). The frequency of recurrent lower urinary tract infections (rLUTIs) increases with age. rLUTIs are associated with long-term chronic effects on geriatric syndromes in older adults. We aimed to investigate possible risk factors that influence rLUTIs in older adults based on comprehensive geriatric assessment (CGA). Materials and methods: This cross-sectional study included 235 older adults admitted to Gaziantep University's Geriatric Outpatient Clinic between June 1 and November 30, 2022. All patients underwent CGA. The Geriatric Depression Scale (GDS), the European Quality of Life-Five Dimension (EQ-5D) questionnaire, the Pittsburgh Sleep Quality Index (PSQI), the Katz Index of Activities of Daily Living (ADL), the Lawton and Brody Index of Instrumental Activities of Daily Living (IADL), and the Mini Nutritional Assessment (MNA) tool were,administered. Handgrip strength (HGS) and gait speed were also measured, and the number of falls in the last year was recorded. Results: The mean age of the participants was 72.8 ± 6.8 years and 61.3% were female. Sixty-four patients had rLUTIs. The rLUTI group had higher frequencies of sarcopenia, hypertension, and diabetes; higher numbers of comorbidities and medications; higher GDS and PSQI scores; and more reported falls. They had lower ADL, MNA, EQ-5D, and gait speed scores. HGS was found to be lower in women with rLUTIs. Higher numbers of comorbidities and GDS scores and lower HGS were independent predictors of rLUTIs in women (p = 0.011, OR: 1.75; p = 0.018, OR: 1.14; and p = 0.042, OR: 0.91, respectively). Conclusion: We revealed that decreased HGS, higher GDS, and the number of comorbidities in older women were independent risk factors for rLUTIs. Our findings offer a new perspective on the importance of CGA in diagnosing and preventing rLUTIs.

The Influence of Nutritional Status and Sleep Quality on Gustatory Function in Older Adults.

Background and Objectives: Age-related declines in taste function are common. Taste acuity can be affected by nutritional status and sleep quality. This research aims to examine the effect of nutritional status and sleep quality on gustatory function in community-dwelling older adults. Materials and Methods: This cross-sectional study included 119 community-dwelling older adults (50.4% of whom were female). The gustatory function was evaluated using four liquid taste solutions (sweet, bitter, sour, and salty) each at four different concentrations and the Mini Nutritional Assessment (MNA) and Pittsburgh Sleep Quality Index (PSQI) was applied. Additionally, anthropometric measurements were taken. Results: The mean scores on the gustatory test for the sweet, bitter, sour, and salty tastes were 2.11 ± 1.27, 2.12 ± 1.03, 2.28 ± 1.03, and 1.98 ± 1.41, respectively. There were significant differences according to gender, polypharmacy, nutritional status, and sleep quality in identifying sweet tastes (all p < 0.05). It was also found that females and participants without polypharmacy had better scores for bitter tastes. When the gustatory functions were evaluated according to BMI classification, it was determined that underweight participants had a higher sour taste score than the obese ones. Multiple regression analysis revealed that age, MNA score, PSQI score, and gender accounted for a total of 20.4% of the variance in the sweet taste score. Conclusions: Determining the relationship between taste function, nutritional status, and sleep quality in older adults is important in terms of developing new strategies for older adults who have these problems.

Do Long-Term Complications of Type 2 Diabetes Increase Susceptibility to Geriatric Syndromes in Older Adults?

Background and Objectives: Type 2 diabetes is one of the common chronic diseases in the elderly. It is thought that long-term complications of type 2 diabetes will negatively affect the quality of life in elderly individuals. It is possible that geriatric syndromes, especially frailty syndrome, are associated with diabetic complications, too. In this study, we aimed to evaluate the effect of macrovascular and microvascular complications of type 2 diabetes on frailty and other geriatric syndromes. In addition, the effect of these complications on quality of life was also reviewed. Materials and Methods: We conducted a cross-sectional study for four months. Comprehensive geriatric assessment tests were done on all patients. The Fried frailty index (FFI) was used for the evaluation of frailty syndrome. We assessed malnutrition by mini nutritional assessment short-form (MNA-SF), and Global Leadership Initiative on Malnutrition criteria (GLIM). The EWGSOP 2 criteria were used for the diagnosis of sarcopenia. Quality of life (QoL) was evaluated using the short form-36 (SF-36) questionnaire. Data analysis was done by SPSS version 22. Results: 237 females and 142 males with a mean age of 71.7 ± 6.1 years were included in the study. The frequency of macrovascular and microvascular complications was 41.4% and 68.1%, respectively. Frailty was found to be associated with macrovascular complications (p = 0.003). Handgrip strength, skeletal muscle mass index, and gait speed were decreased in the presence of macrovascular complications (p = 0.043, p < 0.001, p < 0.001). QoL was also decreased in patients with macrovascular complications (p = 0.003). Nutritional status and handgrip strength were negatively affected in patients with diabetic neuropathy (p = 0.019, p = 0.014). Polypharmacy was also found to be associated with macrovascular complications (p < 0.001, p < 0.001). Macrovascular complications were 2.5 times more common in malnourished patients according to GLIM and 3.2 times more common in patients with decreased gait speed. Conclusion: In this study, we observed that both macrovascular and microvascular complications of diabetes increase susceptibility to geriatric syndromes in elderly individuals. It could be useful to conduct prospective studies in which we can compare the effectiveness of treatment methods on this subject.

How have older adults reacted to coronavirus disease 2019?

AIM: Outbreaks have a wide spectrum of psychosocial impact on individuals. This study aimed to investigate the psychosocial effects of measures to prevent the spread of the novel coronavirus disease on older adults in Turkey. METHODS: A survey was conducted of 104 adults who had to stay at home during the pandemic. Participants' depressive symptoms, anxiety symptoms, nutritional status, health-related quality of life, and sleep quality were assessed. RESULTS: The frequency of depressive and anxiety symptoms was 37.5% and 29.8%, respectively. The frequency of depressive symptoms was higher in women, individuals age ≥85 years, and those with less education and low monthly income. Anxiety symptom frequency was also higher in women and those with less education and low monthly income. Quality of life and sleep were worse in those with depressive symptoms and anxiety symptoms. CONCLUSION: To our knowledge, this is the first published study to investigate the effect of a pandemic on the mood, anxiety symptoms, nutrition status, quality of life, and sleep of older adults during the pandemic period. Our findings indicate the importance of psychosocial support in older individuals during and after the pandemic period.

Health-related quality of life and fall risk associated with age-related body composition changes; sarcopenia, obesity and sarcopenic obesity.

BACKGROUND: Sarcopenia, obesity, and sarcopenic obesity are various features of the ageing process that can cause important health issues. The present study was undertaken to investigate the interrelationship between those body composition changes, including their clinical components and the quality-of-life variables. METHODS: A total of 423 individuals aged 65 years or older was included in this cross-sectional study. Sarcopenia was diagnosed according to The European Working Group on Sarcopenia in Older People criteria. Body composition parameters were measured with a bioelectrical impedance analyser, and Turkish population-based cut-off points were preferred for diagnosis of sarcopenia. Comprehensive geriatric assessment was performed on all patients. A logistic regression analysis was performed to identify important factors for sarcopenia and sarcopenic obesity. RESULTS: The prevalence of sarcopenic, obese and sarcopenic obese subjects was 14%, 35% and 11% respectively. The lowest mean gait speed and hand grip strength values were seen in the sarcopenic obese group (0.6 ± 0.3 m/s and 19.7 ± 9.8 kg respectively). Sarcopenic obese participants were associated with the highest rate for fall risk. The scores for domains of health-related quality of life were worse in both obesity and sarcopenic obesity when compared to others. Body mass index (BMI), number of drugs used, total body fat ratio and geriatric depression scale-short form scores were negatively correlated with all dimensions of SF-36 quality-of-life scale. CONCLUSIONS: Sarcopenia, obesity and sarcopenic obesity are associated with many negative health outcomes, such as high fall risk and low health-related quality of life in geriatric population.

Quality of life and fall risk in frail hospitalized elderly patients

Background/aim: Frailty is a complex, multifactorial, and important geriatric syndrome characterized by decline in physiological reserves and functional deficiency in multiple systems. The aim of the current study is to investigate the prevalence of frailty and to determine the correlation between quality of life (QoL) and falling risk in geriatric hospitalized patients. Materials and methods: A total of 420 patients, aged 65 years and above, were enrolled in the study. All participants were hospitalized at a university hospital in the internal medicine clinics. The Cardiovascular Health Study (CHS) frailty scale, Health-Related Quality of Life Short Form (SF-36) scale, and Hendrich II Fall Risk Model were administered to the patients. Demographic data of patients, number of chronic diseases, and information on used medication were also collected.Results: The median age of patients was 71.9 ± 6.3 years and 49.5% of the patients were female. By applying the CHS frailty scale, the proportion of frail patients was determined to be 65.5%. There were statistically significant differences among quality of life mean scores of robust, prefrail, and frail patients (P < 0.001). Frail patients had the lowest scores in all SF-36 subgroups. Eighty-three (19.8%) patients were in the low-risk group while 337 (80.2%) were high-risk according to the Hendrich II Fall Risk Model. The rate of patients with high falling risk and poor QoL reached a maximum in the frail group (96%).Conclusion: Frailty is an important geriatric syndrome in elderly hospitalized patients. Poor QoL and high falling risk are issues commonly experienced with frailty.

Association of depression and sleep quality with complications of type 2 diabetes in geriatric patients.

BACKGROUND: Diabetes mellitus (DM) is highly prevalent and increasing in geriatric population. Depression and sleep disorders occur at a higher rate in patients with diabetes compared with controls. AIM: The purpose of this study was to demonstrate whether diabetic complications influence the sleep quality and depression in elderly patients. METHODS: 154 geriatric diabetic patients (male/female: 69/85) were enrolled in this study. Patients were investigated for microvascular and macrovascular complications. The Pittsburgh Sleep Quality Index (PSQI) and Geriatric Depression Scale (GDS) were performed for assessment of sleep quality and depression, respectively. Linear regression analysis was performed to identify significant independent related factors for GDS and PSQI scores. RESULTS: Microvascular and macrovascular complications were found in 47.4 % and 29.2 of study population. PSQI and GDS scores of patients with microvascular complications were significantly higher than those of patients without microvascular complications (8.23 ± 3.83 vs 5.76 ± 3.04, p 0.001; 11.07 ± 6.07 vs 6.94 ± 5.35, p 0.001), respectively. There was no difference in GDS scores between the patients with and without macrovascular complications. There was a positive correlation between DM duration and PSQI, GDS scores. Neuropathy was an independent variable for poor sleep quality (OR 1.362, 95 % CI 0.032-2.692, p 0.045) and depression (OR 2.909, 95 % CI 0.610-5.209, p 0.014). CONCLUSION: Depression status and sleep quality are strongly influenced by diabetic complications and DM duration in elderly patients.

Does Ramadan fasting alter body weight and blood lipids and fasting blood glucose in a healthy population? A meta-analysis.

In this study, we conducted a meta-analysis of self-controlled cohort studies comparing body weights, blood levels of lipids and fasting blood glucose levels before and after Ramadan taking into account gender differences. Several databases were searched up to June 2012 for studies showing an effect of Ramadan fasting in healthy subjects, yielding 30 articles. The primary finding of this meta-analysis was that after Ramadan fasting, low-density lipoprotein (SMD = -1.67, 95 % CI = -2.48 to -0.86) and fasting blood glucose levels (SMD = -1.10, 95 % CI = -1.62 to -0.58) were decreased in both sex groups and also in the entire group compared to levels prior to Ramadan. In addition, in the female subgroup, body weight (SMD = -0.04, 95 % CI = -0.20, 0.12), total cholesterol (SMD = 0.05, 95 % CI = -0.51 to 0.60), and triglyceride levels (SMD = 0.03, 95 % CI = -0.31, 0.36) remained unchanged, while HDL levels (SMD = 0.86, 95 % CI = 0.11 to 1.61, p = 0.03) were increased. In males, Ramadan fasting resulted in weight loss (SMD = -0.24, 95 % CI = -0.36, -0.12, p = 0.001). Also, a substantial reduction in total cholesterol (SMD = -0.44, 95 % CI = -0.77 to -0.11) and LDL levels (SMD = -2.22, 95 % CI = -3.47 to -0.96) and a small decrease in triglyceride levels (SMD = -0.35, 95 % CI = -0.67 to -0.02) were observed in males. In conclusion, by looking at this data, it is evident that Ramadan fasting can effectively change body weight and some biochemical parameters in healthy subjects especially in males compared to pre-Ramadan period.

Do Ramadan fasting restrictions alter eating behaviours in obese women?

Ramadan fasting can be considered as a kind of dietary restriction. Eating restriction is a risk factor for later development of eating disorders. The purpose of this study is to evaluate whether Ramadan fasting changes the eating behaviours of obese women. Our sample consisted of 34 obese women who fasted during the Ramadan month. The data were collected by using Questionnaire Form, Eating Attitude Test (EAT) and Bulimic Investigatory Test, Edinburgh (BITE). No statistically significant differences were found between the scores of EAT, BITE, BMI, which were administered within the weeks before and after Ramadan. According to our results, Ramadan fasting restrictions do not seem to change the eating behaviours of obese women.

Poor sleep quality is an overlooked risk for geriatric syndromes in older adults with type 2 diabetes mellitus.

BACKGROUND: Aging and type 2 diabetes mellitus (DM) are two different conditions that impair sleep quality. The primary objective of this study was to investigate the impact of sleep quality on geriatric syndromes in older diabetic adults. METHODS: Comprehensive geriatric assessment was performed on 236 patients. The assessment included the Geriatric Depression Scale (GDS), Beck Anxiety Inventory (BAI), European Quality of Life Questionnaire (EQ-5D), Mini Mental Statement Examination (MMSE), Pittsburgh Sleep Quality Index (PSQI), Mini Nutritional Assessment, and measurement of handgrip strength (HGS). RESULTS: Of the participants, 55% had DM, and 61.4% had poor sleep quality. Poor sleep prevalence was higher in diabetic patients (68.5%) than in non-diabetics (52.8%). Diabetic patients with poor sleep quality had higher frequencies of chronic pain, recurrent urinary tract infections, confirmed sarcopenia, and frailty (p = 0.015, p < 0.001, p = 0.027, and p < 0.001, respectively), a higher number of comorbidities and higher GDS and BAI scores (p = 0.046, p < 0.001 and p < 0.001, respectively), and lower scores of activities of daily living, HGS, and EQ-5D index (p = 0.023, p = 0.004, and p < 0.001, respectively) compared to diabetic patients with good sleep quality. According to the correlation analysis results, PSQI score had a positive correlation with GDS score (r = 0.461, p < 0.001) and a negative correlation with Mini Nutritional Assessment score (r = -0.317, p < 0.001), skeletal muscle mass index (r = -0.283, p = 0.002) and HGS (r = -0.307, p < 0.001) scores in diabetic older adults. CONCLUSION: Poor sleep quality in older diabetic patients has a negative impact on several geriatric syndromes. Our findings suggest that poor sleep quality is an independent risk factor for depression, malnutrition, and lower muscle mass in older diabetic adults. Improving sleep quality may play a crucial role in preventing and managing geriatric syndromes in this population.

The role of comprehensive geriatric assessment in predicting fall risk.

BACKGROUND: The prevention of falls among older adults is one of the most important public health issues in today's aging society. There are many factors significantly affecting the risk of falls. AIMS: This study aimed to investigate the factors on fall risk in older adults. METHODS: A total of 335 elderly outpatients aged 65 and over were included in this cross-sectional study. Comprehensive geriatric assessment was performed on the participants. Tinetti Balance and Gait Assessment Tool (TBGA) and Mini-Mental State Examination (MMSE) were used to assess fall risk and cognitive functions, respectively. RESULTS: The mean age of 335 participants was 72.1 ± 6.0 years and 55.2% was female. Of the participants, 40.6% had a moderate-high fall risk according to TBGA and 31.6% had a history of falls within the last year. Although there was no significant difference in MMSE results between the medium-high fall risk group and the low fall risk group, higher MMSE attention and calculation domain score was found to be an independent variable for decreased fall risk and sarcopenia for increased fall risk (p = 0.039, OR = 0.70 and p = 0.037, OR = 3.43, respectively). CONCLUSION: The role of sarcopenia in fall risk is well established. In this study, we also showed that attention and calculation play important roles in fall risk. Elderly individuals with low scores in attention and calculation domains need a more detailed assessment in terms of fall risk, even if cognitive functions are considered normal according to the MMSE.

Effect of age-related hyperkyphosis on depression and quality of life.

Background: Hyperkyphosis is a frequent problem in older adults. Depressed mood and decreased quality of life are supposed to be related to age-related hyperkyphosis. This study aimed to explain the relation between depression, quality of life, and hyperkyphosis in old patients. Methods: 142 patients who applied to the outpatient clinic of geriatrics were enrolled in this cross-sectional study. Mean age of participants was 72. Hyperkyphosis was evaluated by the bloc method defined in the Rancho Bernardo Study (1). Depression was evaluated by the Short form of Yesavage Geriatric Depression Scale (GDS). Quality of life was assessed by the 3-level version of EQ-5D. Results: Hyperkyphosis was found to be positively related to depression (P=0.037), negatively related to the QOL (p<0.001). QOL, depression, and hyperkyphosis were in a ship with each other when evaluated with one-way MANOVA (F [3.135] =5.23, P=0.002, Wilk's Λ=0.896, partial η2=0.104). Chronic pain was negatively related to QOL (p<0.001). Depression was positively related to chronic pain (p<0.001). QOL evaluated with VAS was independently related to the presence of hyperkyphosis in logistic regression analysis (r2=0.179, P=0.007). Conclusion: Considering the relationship with depression and quality of life, early recognition, and treatment of hyperkyphosis in elderly individuals is important. More studies evaluating the association between postural disorders, quality of life and mood disorders in older adults will be useful.

Risk factors of poor sleep quality in older adults: an analysis based on comprehensive geriatric assessment.

OBJECTIVES: Sleep quality is associated with many diseases and conditions that affect individuals' health in various ways. We aimed to investigate the association between sleep quality and common geriatric conditions in older adults. METHODS: The study included 237 older adults admitted to the geriatric outpatient clinic of a university hospital. All patients underwent comprehensive geriatric assessment (CGA). The Geriatric Depression Scale (GDS), Beck Anxiety Inventory (BAI), European Quality of Life (EQ-5D), Pittsburgh Sleep Quality Index (PSQI), Katz Index of Independence in Activities of Daily Living (ADL) and Lawton and Brody Instrumental Activities of Daily Living (IADL) questionnaires, Tinetti Balance and Gait Assessment (TBGA), and Mini Nutritional Assessment (MNA) were performed on the participants. RESULTS: Participants had a mean age of 72.2 ± 6.3 years, and 146 (61.6%) of them had poor sleep quality. Of the participants, 61.2% were female. In the poor sleep quality group, GDS and BAI scores were higher while ADL, IADL, MNA, and EQ-5D index scores were lower. PSQI score had a negative correlation with ADL (r = -.207, p = .01), EQ-5D index (r = -.372, p = .00), MNA (r = -.277, p = .00), and TBGA (r = -.263, p = .41) scores and a positive correlation with GDS (r = .426, p = .00) and BAI (r = .450, p = .00) scores according to the results of correlation analysis. Multivariate logistic regression analysis showed that the presence of diabetes mellitus (DM) and higher GDS and BAI scores were independent variables for poor sleep quality [(p = .48, OR = 1.92; p = .20, OR = 1.11; and p <.01, OR = 1.11, respectively)]. CONCLUSIONS: We found that DM and depressive and anxiety symptoms were the risks of poor sleep quality. In addition, participants with poor sleep quality had a worse quality-of-life and nutritional status. Improving sleep quality may be helpful in the management of geriatric syndromes and that sleep quality assessment should be part of CGA.

Colistin treatment in older adults: why should we know more?

OBJECTIVES: We aimed to investigate the risk factors of colistin-associated nephrotoxicity in patients older than 65 years treated in the palliative care unit. METHODS: 119 palliative care patients who received intravenous colistimethate for at least 7 days were included in the study. The estimated glomerular filtration rate (GFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) 2021 equation. Data were obtained from the hospital information system. RESULTS: The mean age of the participants was 76.7 ± 9.9 years and 49.4% were female. Of the 119 patients, 57 had colistin-induced nephropathy (CIN) according to Kidney Disease: Improving Global Outcomes (KDIGO) criteria. The rate of CIN was higher in women than in men. The baseline phosphate level was higher in the CIN (+) group than in the CIN (-) group. The lower GFR values in patients with pneumonia persisted at days 14 and 30, whereas the lower GFR in patients without pneumonia did not. According to multivariate logistic regression, female gender and baseline phosphate level ≥ 4.5 mg/dl were found as independent variables for the development of nephropathy. CONCLUSIONS: The creatinine levels of the patients with pneumonia and CIN did not improve after nephrotoxicity, whereas the creatinine levels of the other patients without pneumonia and CIN did. Female gender and baseline phosphate were independent risk factors for CIN. Prolonged kidney failure may lead to a more difficult clinical follow-up process for clinicians. Therefore, clinicians should be aware of persistent renal insufficiency in older patients with pneumonia receiving colistimethate.

A different outlook to consequences of anemia in older adults.

OBJECTIVES: Anemia is a common health issue in older adults with crucial consequences. We aimed to investigate the relationship of anemia with various components of geriatric syndromes. METHODS: A total of 486 older individuals aged 65 and over admitted to a university hospital were included in this cross-sectional study. According to WHO criteria, we defined anemia as hemoglobin concentration lower than 13 g/dL in men and 12 g/dL in women. The Working Group on Sarcopenia in Older People (EWGSOP2) criteria were used to diagnose sarcopenia. Handgrip strength (HGS) was measured by a hand dynamometer. Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) questionnaires were used to evaluate functionality. Geriatric Depression Scale (GDS), Mini Nutritional Assessment (MNA), Mini-Mental State Examination (MMSE), and European Quality of Life-5 Dimensions (EQ-5D) questionnaires were also used. RESULTS: Participants' mean age was 72.2 ± 6.4 years and 58.8% of them were female. Ninety-two of 486 patients were anemic and 64.1% of anemic patients were female. Anemic group had lower IADL, EQ-5D, HGS scores, and higher GDS scores. According to multivariate logistic regression analysis, age, and anemia were found to be independent risk factors for dependency in IADL in both genders. Anemia, age, and depression were found to be independent risk factors for low HGS in women. CONCLUSION: Anemia and depression are independent factors for low HGS in women, and anemia and age are independent factors for dependency on instrumental daily activities in older persons. Treating depression and raising Hb to optimal levels may be critical interventions to improve the health and life quality of people aged 65 and over, particularly in the female gender.

Bone mineral density response to antiosteoporotic drugs in older depressed adults.

Until now, studies did not evaluate the efficacy of antiosteoporotic agents in depressed patients. We demonstrate that the presence of depression and/or serotonergic antidepressant use was associated with non-response to osteoporosis treatment in older adults. PURPOSE: This study aimed to evaluate the effects of depression and antidepressants on bone mineral density (BMD) and response to antiosteoporotic agents in older adults. METHODS: A total of 198 participants with osteoporosis, aged 65 and over, were included in this retrospective study. BMD was measured by dual-energy x-ray absorptiometry scanning at baseline and month 24. RESULTS: Eighty-three of the 198 patients had a diagnosis of depression, and all were serotonergic antidepressant users. Baseline BMD was similar in depressed and non-depressed patients. Lumbar spine BMD change was significantly lower in depressed patients than non-depressed patients (2.89% and 4.85%, respectively, p < 0.001). In addition, of those receiving denosumab treatment, depressed ones had lower lumbar spine BMD changes. Depression and/or antidepressant use was an independent variable for non-response to osteoporosis treatment in both the femoral neck (p = 0.008, OR = 2.61) and lumbar spine (p = 0.015, OR = 6.87), while alendronate and zoledronic acid were independent variables for non-response in the femoral neck and total femur compared to denosumab. CONCLUSIONS: Our study has shown that the presence of depression and/or serotonergic antidepressant use was associated with non-response to osteoporosis treatment in older adults. The results of our study may guide physicians to make treatment decisions in older individuals with depression.

Alzheimer's disease is associated with a low prevalence of hypertension.

BACKGROUND/AIM: Dementia is one of the most common health problems in the world. Alzheimer's disease (AD) is the most common form of dementia. The relation between blood pressure (BP) and dementia has been the subject of numerous epidemiological studies, and midlife hypertension (HT) is a risk factor for AD. The association between BP and risk of dementia is lower in the older population. The aim of this study was to examine the association between the prevalence of HT and AD in elderly individuals. METHODS: In this cross-sectional study, 193 patients with AD and 1,860 patients with normal cognitive function were evaluated. RESULTS: The prevalence of HT was lower in the AD group (60.6 vs. 70.5%; p = 0.005). In multivariate analysis, AD was found to be negatively correlated with HT (OR = 0.649; 95% CI 0.461-0.916). CONCLUSION: The prevalence of HT was lower in patients with AD compared to subjects without AD. Physicians who deal with AD patients must keep in mind that the need for antihypertensive medication may decline during the dementia process.

The evaluation of neutrophil-lymphocyte ratio in Alzheimer's disease.

BACKGROUND/AIM: There is growing consensus in the literature that inflammation plays a significant role in the pathophysiology of Alzheimer's disease (AD). The blood neutrophil-lymphocyte ratio (NLR) is a new, inexpensive and easily applicable marker of inflammation. The aim of this study was to investigate the association between NLR, as an inflammatory biomarker, and AD. METHODS: 241 AD patients and 175 patients with normal cognitive function were evaluated in this study. RESULTS: The mean ± SD NLR of AD patients was significantly higher than that of patients with normal cognitive function (3.21 ± 1.35 vs. 2.07 ± 0.74, p < 0.001, respectively). Receiver operating characteristic curve analysis suggested that the optimum NLR cutoff point for AD was 2.48 with 69.29% sensitivity, 79.43% specificity, 82.30% positive predictive values and 65.30% negative predictive values. Logistic regression analysis showed that elevated NLR (OR: 4.774, 95% CI: 2.821-8.076, p < 0.001) was an independent variable for predicting AD. CONCLUSION: Elderly people with AD have higher NLR than healthy controls. Elevated NLR levels are usually considered as an inflammatory marker. The results of this study suggested that inflammation plays a role in the pathogenesis of AD.

An inconvenient status in anti-osteoporotic treatment process: corticosteroid use.

OBJECTIVE: There are limited studies investigating the comparison of the efficacy of anti-osteoporotic drugs in different conditions resulting in osteoporosis in older adults. This study aimed to compare the effectiveness of anti-osteoporotic agents in older adults with or without glucocorticoid-induced osteoporosis. METHODS: This retrospective study included 364 patients with osteoporosis, aged 65 years and older. Bone mineral density measurement was performed, and the percent change from baseline was calculated at month 24. RESULTS: Of the 364 patients, 80 were glucocorticoid users. Similar changes in the bone mineral density of the lumbar spine and femoral neck and fracture risk were found in patients with or without glucocorticoid-induced osteoporosis. There was no significant difference in bone mineral density changes between the groups in terms of anti-osteoporotic agents used. CONCLUSIONS: This study demonstrated that the response to anti-osteoporotic agents was similar in older adults with glucocorticoid-induced osteoporosis and those without glucocorticoid-induced osteoporosis. The results of our study may guide osteoporosis treatment in older individuals with glucocorticoid-induced osteoporosis.