Serum alpha klotho levels in Parkinson's Disease.

PURPOSE: Parkinson's Disease (PD), a neurodegenerative disorder, is associated with substantial morbidity. α-Klotho, an anti-aging protein known for its neuroprotective properties, has gained attention. This study aims to assess serum levels of α-Klotho in PD patients. METHODS: This study is a cross-sectional case-control study. PD was diagnosed according to UK Parkinson Disease Society Brain Bank criteria. Serum α-Klotho level was measured using a commercially available enzyme-linked immunosorbent assay. RESULTS: Of the 314 participants in the study, 157 were patients with PD and 157 were controls. Lower levels of α-Klotho were observed in PD (0.85 nmol/L) in comparison to the controls (1.47 nmol/L, p < 0.001). α-Klotho levels were also significantly lower among PD patients with dementia compared to PD patients without dementia. In logistic regression analysis, α-Klotho (OR: 0.04, p < 0.001) demonstrated a significant relationship between PD. A significant correlation was identified between α-Klotho levels and Mini-Mental State Examination scores in PD patients. The sensitivity and the specifity of α-Klotho were 90% and 65% for predicting PD. CONCLUSIONS: Our findings suggest that α-klotho could potentially serve as a biomarker. However additional studies are needed to confirm our findings.

A new possible marker: can pennation angle defined by ultrasound predict the frailty?

BACKGROUND: Frailty indicates older people who are vulnerable to stressors. The relation between ultrasonographic parameters of muscle and frailty among older people has yet to be investigated. AIMS: The aim of the study is to investigate the relationship between frailty and the ultrasonographic measurements of the rectus femoris muscle (RFM). METHODS: This cross-sectional study included 301 participants who were ≥65 years. The FRAIL questionnaire assessed frailty. The thickness, cross-sectional area (CSA), fascicle length, pennation angle (PA), stiffness, and echogenicity of RFM were assessed by ultrasound. The accuracy of parameters in predicting the frailty was evaluated by ROC analysis. RESULTS: Of all 301 participants, 24.6% were frail. Pre-frail and frail participants had significantly lower thickness (p = 0.002), CSA (p = 0.009), and fascicle length (p = 0.043) of RFM compared to robust. PA was significantly lowest in frails (p < 0.001). The multivariate logistic regression analysis showed that PA values lower than 10.65 degrees were an independent predictor of frailty (OR = 0.83, 95% Cl: 0.70-0.97, p = 0.019). Results of ROC analysis demonstrated a satisfactory result between the PA and frailty (AUC = 0.692, p < 0.001). DISCUSSION: Thickness, CSA, and PA of RFM were found to be lower in frail subjects, which may indicate the changes in muscle structure in frailty. Among all parameters, lower PA values were independent predictors of frailty. These findings may indicate a novel ultrasound-based method in frailty, that is more objective and unrelated to the cross-sectional evaluation. CONCLUSIONS: Ultrasonographic measurements of RFM, especially the lower PA may predict frailty in older people. As an objective and quantitative method, PA may be used to define frailty with acceptable sensitivity.

Association between depression scores and comprehensive geriatric assessment and frailty in geriatric outpatients with somatic complaints: an observational cross-sectional study.

BACKGROUND: Depression is the most common psychiatric problem in older individuals. In some countries, the common approach is to ignore psychiatric disorders. This study aimed to reveal the importance of newly diagnosed high depression scores in the geriatric population admitted to outpatient clinics with somatic complaints. METHODS: Patients who did not have a previous diagnosis of a psychiatric disorder and were not receiving treatment were included in the study. A comprehensive geriatric evaluation of 235 elderly patients was performed using established assessment tests. The time and quality of sleep and the Clinical Frailty Scores (CFSs) were documented. RESULTS: The mean age of the 235 patients was 73.6 ± 6.39 years, 65.5% (n = 154) were women, and 34.9% (n = 81) had a geriatric depression score ≥ 5. In the higher depression rating scores group, the Lawton-Brody, Mini-Mental State Examination (MMSE), and Mini Nutritional Assessment (MNA-SF) scores were low (p = 0.010, p < 0.001, p = 0.003). Sleep duration was short, and sleep quality was poor (p = 0.042, p = 0.006). The CFSs were high. (p = 0.035) According to the regression analysis results, the MMSE, MNA-SF and CFS predicted higher depression scores significantly (p = 0.048, ß = .892; p = 0.045, ß = .661; p = 0.045, ß = 1.245). DISCUSSION: Depression scores in older people may be associated with not only mood but also the functionality. As with other geriatric syndromes, symptoms in depression may be atypical rather than typical.

Attitudes of a geriatric population towards risks about COVID-19 pandemic: in the context of anxiety and depression.

BACKGROUND: A curfew for elderly people was announced in Turkey to protect the geriatric population during the COVID-19 pandemic. Although this may have the beneficial effect of preventing infection, psychological distress may also increase with prolongation of the pandemic. METHODS: Geriatric patients were interviewed by telephone due to the ongoing curfew. Demographical characteristics, comorbidities, personal risk perception of COVID-19, common concerns related to COVID-19, and experiences of delayed hospital admission due to the pandemic were recorded. The Hospital Anxiety and Depression Scale (HADS) was used to assess psychological distress, anxiety, and depression. RESULTS: Participants (n = 136; 82 females, 60.3%) had a mean age of 73.4 ± 5.9 years. The most common comorbidity was hypertension (75%). Approximately 80% of the participants reported a decrease in physical activity during the curfew period. The HADS scores indicated rates of anxiety as 25.7% and depression as 16.9%. Anxiety was significantly more common in females than males (P = 0.002). Sleep problems (P = 0.000), fatigue (P = 0.000), and hopelessness (P = 0.000) were more common in participants with depression and anxiety. Logistic regression analyses showed an association between a delay in hospital admission and the presence of depression (P = 0.0029, R2  = 0.146). Personal risk perception of COVID-19 was statistically significantly higher among patients with anxiety (P = 0.0027, R2  = 0.157). CONCLUSION: Decreased adaptation to external and internal factors among older individuals may facilitate unfavourable outcomes of the pandemic. These results indicate that the geriatric population was mentally and physically affected by the restrictions and isolation.

Vitamin D deficiency and risk of Helicobacter pylori infection in older adults: a cross-sectional study.

BACKGROUND: Vitamin D deficiency is known to cause increased predisposition to various infectious diseases and the addition of vitamin D to antimicrobial treatment may improve treatment responses. However, the relationship between vitamin D and Helicobacter pylori (H. pylori) remains to be determined. AIMS: To assess the association between vitamin D deficiency and H. pylori infection. METHODS: This cross-sectional study included patients aged 65 and over, who underwent gastroscopy and had gastric biopsy performed between 2010 and 2017. Of the 441 patients, 254 had available 25-hydroxyvitamin D level results and were included in the analyses. Patients were categorized into H. pylori (+) and H. pylori (-) groups, according to histopathological examination results of gastric biopsies. Serum 25(OH) vitamin D levels less than 20 ng/mL were defined as vitamin D deficiency. RESULTS: Of all patients, 43 were H. pylori (+) and 211 were H. pylori (-). More patients had vitamin D deficiency (< 20 ng/mL) in the H. pylori (+) group than the H. pylori (-) group (86% vs 67.3%, p = 0.014). The proportion of H. pylori (+) patients decreased across increasing quartiles of 25(OH) vitamin D levels (p for trend = 0.010). In multivariable logistic regression analysis, vitamin D deficiency was associated with increased odds of H. pylori infection after adjustment for age, gender, and Charlson Comorbidity Index (OR = 3.02, 95% CI 1.19-7.69, p = 0.020). CONCLUSION: Vitamin D deficiency can be associated with increased risk of H. pylori infection. The potential protective effect of vitamin D against H. pylori infection and its possible role in the treatment of H. pylori should be evaluated in prospective trials.

The relationship between all-cause mortality sarcopenia and sarcopenic obesity among hospitalized older people.

BACKGROUND AND AIM: Sarcopenia and sarcopenic obesity (SO) are associated with adverse health outcomes in older people. Data on sarcopenia- and SO-related mortality are insufficient for hospitalized older people. The aim of this study was to evaluate the relationship between sarcopenia, SO and mortality among hospitalized older people. METHODS: Two-centered prospective observational study was conducted among 350 hospitalized older people in geriatric units of two university hospitals. Sarcopenia was defined according to the European Working Group on Sarcopenia in Older People. Obesity was defined according to fat mass percentage. Medical history, cognitive status, nutritional status and functionality and laboratory tests were assessed. All-cause mortality rate was recorded at 2 years. RESULTS: The prevalence of SO was 21.1%. The prevalence of sarcopenia was 11.4%. Both sarcopenia (log rank p < 0.001) and SO (log rank p < 0.001) were associated with all-cause mortality at 2 years. There was no difference between sarcopenia and SO for mortality. SO (HR 5.23, p < 0.001), sarcopenia (HR 9.26, p < 0.001), male gender (HR 2.25, p = 0.035), Lawton IADL (HR 0.77, p = 0.02), heart failure (HR 3.25, p = 0.02) and chronic obstructive lung disease (HR 5.16, p = 0.01) were independently related to all-cause mortality. DISCUSSION AND CONCLUSIONS: Both sarcopenia and SO showed an independent relationship for 2-year all-cause mortality after hospital discharge. These results suggest that preventive and treatment options should be taken to decrease mortality associated with these conditions among hospitalized older people.

Comparison of diagnostic accuracy of the SARC-F, SARC-CalF, and Ishii tests for diagnosis of sarcopenia in hospitalized older patients: A cross-sectional study.

BACKGROUND: Several screening tools have been developed to identify sarcopenia. However, data on the use of these screening tools in hospital settings are limited. This study assessed the diagnostic accuracy of three screening methods-strength, assistance walking, rising from a chair, climbing stairs, and falls (SARC-F); SARC-F combined with calf circumference (SARC-CalF); and the Ishii tests-for detecting sarcopenia in older individuals who are hospitalized. METHODS: This study included 204 older people who were hospitalized. Sarcopenia was assessed relative to the diagnostic criteria established by the European Working Group on Sarcopenia in Older People 2 (EWGSOP2). Muscle mass, muscle strength, and physical performance were evaluated using bioimpedance analysis, handgrip strength, and usual gait speed, respectively. Sensitivity and specificity analyses were conducted for the SARC-F, SARC-CalF, and Ishii tests to determine their effectiveness. Receiver operating characteristics curves were generated, and the area under curve was calculated to compare the overall diagnostic accuracy of the SARC-F, SARC-CalF, and Ishii tests. RESULTS: The SARC-F, SARC-CalF, and Ishii tests demonstrated sensitivities of 72%, 88.6%, and 93.5%, respectively, and specificities of 41%, 78.5%, and 30.3%, respectively. CONCLUSIONS: SARC-CalF demonstrates the highest performance in terms of sensitivity and specificity compared with the other two tests, making it a valuable tool for detecting sarcopenia in hospital settings. In contrast, the Ishii test exhibits high sensitivity but low specificity within this population. Based on our results, we found that SARC-CalF can be used as a simple, effective test for identifying sarcopenia in older patients in the hospital setting.

Impact of sarcopenia and vitamin D levels on the severity of lower urinary tract symptoms in older males.

OBJECTIVES: To assess the impact of sarcopenia and vitamin D levels on the severity of lower urinary tract symptoms (LUTS). METHODS: A total of 193 male patients, aged 60 years and above, who visited the geriatric outpatient clinic at Ibn-i Sina Hospital in Ankara, Turkey, between December 2019 and March 2021, were enrolled. Sarcopenia was diagnosed according to the criteria set by the European Working Group on Sarcopenia in Older People. The presence and severity of lower urinary tract symptoms were assessed using the International Prostate Symptom Score questionnaire, categorizing symptom severity as mild or moderate-to-severe. RESULTS: The median patient age was 71 years (range: 66-77). Sarcopenia affected 24.9% of the population studied. Mild LUTS was observed in 43.5% and moderate-to-severe LUTS was observed in 56.5% of patients. Sarcopenia prevalence was significantly higher in the individuals with moderate-to-severe LUTS compared to those with mild-LUTS (p=0.021). After adjusting for Charlson comorbidity index and age, only vitamin D levels were significantly associated with increased odds of moderate-to-severe LUTS (odds ratio [OR]=0.95, 95% confidence interval [CI]: [0.92-0.98], p=0.002). Sarcopenia was not significantly associated with the severity of LUTS (OR=2.04, 95% CI: [0.94-4.45], p=0.070). An inverse linear trend was observed between quartiles of 25 (OH) vitamin D and LUTS severity. As 25 (OH)vitamin D levels increased, the proportion of patients with moderate-to-severe LUTS decreased (p=0.023). CONCLUSION: Sarcopenia did not significantly impact LUTS severity, but low vitamin D levels were associated with moderate-to-severe LUTS.

The relationship between sarcopenia, sarcopenia related quality of life and ultrasound findings of the rectus femoris muscle in older outpatients.

PURPOSE: Skeletal muscle ultrasonography stands out as a promising method for detecting sarcopenia. We aimed to evaluate the relationship between sarcopenia, sarcopenia related quality of life and US findings of the Rectus Femoris muscle. METHODS: A total of 300 older individuals were included in this cross-sectional study. Sarcopenia was diagnosed according to the European Working Group on Sarcopenia in Older People 2 criteria. Rectus F muscle thickness, cross-sectional area, fascicle length, pennation angle, stiffness and echogenicity were measured by an experienced radiologist using a B-mode US device. Quality of life was determined with the Sarcopenia- Quality of life questionnaire. Correlation analysis, receiver operating analysis, sensitivity and specificity analysis were performed. RESULTS: The median age of participants was 72. 191 (63.9%) and 109 (36.1%) of the participants were male and female, respectively. The prevalence of sarcopenia was 15.6%. Fascicle length, cross-sectional area and thickness showed the highest sensitivity (81%) and specificity (87%) for men. Fascicle length and pennation angle showed the highest sensitivity (87%) and specificity (66%) for women. Rectus Femoris ultrasound parameters differed across SarQoL quartiles, and higher Sarcopenia- Quality of life scores were associated with better ultrasound parameters. All ultrasound parameters had positive correlations with Sarcopenia- Quality of life. CONCLUSION: Different Rectus Femoris ultrasound parameters are useful for detecting sarcopenia according to gender. A combination of these parameters can increase diagnosis accuracy. Ultrasound parameters are associated with sarcopenia related quality of life.

Psychosocial health and activities during the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic has become a major cause of stress at work. OBJECTIVE: To examine the effect of self-management and self-control skills on perceived stress of employees in the COVID-19 period. METHODS: The study's self-administered survey included demographics and the Perceived Stress Scale (PSS) and Self-Control and Self-Management Scale (SCMS). Associations with PSS were determined using a multiple variable linear regression analysis. RESULTS: Scores for stress (28.45±7.82) and self-management (55.73±12.15) were moderate for employees. Of the 181 employees, 41.43% had a mild, 52.48% had moderate, and 6.07% had severe stress levels. Stress was significantly associated with lower self-management level. A negative relation was found between SCMS and PSS (p = 0.000, r = -0.320). Employees with high self-management skills had low stress levels. Employees also reported negative changes to physical activity, income and sleep. Gender, occupation, income category, compliance with COVID-related rules and self-management were associated with levels of stress (p < 0.05). The regression model explained 24.8% of the variance in stress perception (R2 = 0.248, F = 11.452, p = 0.000). Multiple linear regression analysis showed gender (ß = 5.089, 95% CI: 2.820 to 7.358, p = 0.000) compliance with COVID-related rules (ß = 2.274, CI: 0.066 to 4.483, p = 0.044), a decrease in income (ß = 2.051, CI: -0.64 to 4.166, p = 0.057) and self-management (ß = -0.173, CI: -0.258 to -0.087, p = 0.000) were significantly associated with lower scores in the stress perception. CONCLUSION: Self-control and self-management were associated with a decline in mental health. Health-promotion strategies directed at adopting or maintaining positive self-control and self-management-related behaviors should be utilized to address increases in psychological distress during the COVID-19 pandemic.

Comparison of different glomerular filtration methods in the elderly: which formula provides better estimates?

OBJECTIVES: Technetium-99m diethylenetriaminepentaacetic acid ((99m)Tc-DTPA) is an ideal radioisotopic method having a high correlation with inulin clearance for the determination of glomerular filtration rate (GFR). Different formulas like creatinine clearance (CrCl) in 24 h urine samples, Cockroft-Gault formula (CGF), and modification of diet in renal disease (MDRD) are being used to come up with an estimate. In this study, we compared (99m)Tc-DTPA with the formulas mentioned above in an attempt to best identify the method that would yield the nearly ideal GFR estimates in the elderly. MATERIALS AND METHODS: In 76 patients who were admitted to our clinic, we measured 24 h urine volume (V), urine creatinine (Ucr), and serum creatinine (Scr) levels together with CrCl, Scr, serum urea (Su), and albumin (Alb) levels. By using coefficients identified for age, gender, and race, we calculated modification of diet in renal disease 1 (MDRD1). Different from MDRD1, we calculated modification of diet in renal disease 2 (MDRD2) that does not include Su and Alb parameters and formulas like CGF that include Scr, age, gender, and weight parameters to come up with GFR levels. All patients underwent (99m)Tc-DTPA procedure. RESULTS: The mean of the GFR values measured by (99m)Tc-DTPA was 54.3 ± 19.9. The means of GFR values calculated by CrCl, MDRD1, MDRD2, and CGF were 58.0 ± 30.5, 60.9 ± 22.1, 54.4 ± 20.1, and 57.9 ± 22.4, respectively. GFR as measured by (99m)Tc-DTPA showed statistically significant correlations with the results of other methods (p < 0.001 for all methods). The most significant correlation was with MDRD1. CONCLUSION: MDRD1 can be used for next to ideal and accurate predictions of GFR in the elderly in the daily practice.

Comparison of the C14 urea breath test and histopathology in the diagnosis of Helicobacter pylori in the elderly.

OBJECTIVES: To compare the sensitivity and specificity of C[14] urea breath test with histopathological findings in biopsies obtained through endoscopy. METHODS: In this cross-sectional study, conducted at the Medical Faculty Ankara University, Ankara, Turkey between January and October 2009, 100 patients aged 65 and above who fulfilled the criteria for inclusion were enrolled. Oesophago-gastroduodenoscopy was carried out on the patients after eight hours of fasting, using a Fujinon endoscope, by the same expert. C14 urea breath tests were carried out on all patients with a capsule containing 37 kBq(1micro Ci) C14 urea/citric acid. Evaluation of all data was carried out using SPSS 11.5. Categorical variables were compared through Pearson Chi squared or Fisher's exact test. P < 0.005 was taken as statistically significant. RESULTS: The average age of the patients was 71 +/- 5 years; 43 (43%) were male; and 57 (57%) were female. Helicobacter pylori positivity was found to be 35 (35%) in histopathological evaluation, and 36 (36%) in the C14 urea breath test. Of the 35 patients, 32 (91.4%) were found to be positive by the C14 urea breath test also. Of the 65 patients who were found to be negative on histopathology, 61 (93.8%) were also found to be Hp negative by the C14 urea breath test, and 4 (6.2%) were evaluated as false positive. A statistically significant correlation (p < 0.001) was found between histopathological and C14 urea breath test results. Compared with histopathology, the sensitivity of the urea breath test was 91.4%, and its specificity was 93.8%. A statistically significant (p < 0.001) relationship was found between histopathological results and the results of the C14 urea breath test. CONCLUSION: The sensitivity and specificity of the C[14] urea breath test in the group of elderly patients selected was high. The C14 urea breath test can be considered in the elderly group for diagnosis of Helicobacter pylori infection.

Association between sarcopenia and erectile dysfunction in older males.

INTRODUCTION: In advanced age, both sarcopenia and erectile dysfunction (ED) occur with similar underlying causes through different mechanisms. In our study we investigated the association between sarcopenia and ED in older men. METHODS: A total of 193 male patients aged 60 years and older were included in the study. The presence of sarcopenia was investigated in accordance with EWGSOP2 diagnostic criteria. For evaluation of ED, we used the 5-question International Index of Erectile Dysfunction questionnaire with categories of no ED, mild-moderate ED, and moderate-severe ED. Total testosterone levels were measured. RESULTS: The median age of the patients was 71.9 (range 60-93 years). The prevalence of sarcopenia was 24.9%, and moderate-severe ED was 49.2%. Moderate-severe ED was more common in patients with sarcopenia than those without (70.8% vs 42.1%, p < 0.001). After adjustment for age and Charlson Comorbidity Index, the presence of sarcopenia was significantly associated with moderate-severe ED with odds ratio (OR) of 2.71 (95% Confidence Interval [CI] 1.29-5.73, p = 0.009). The components of sarcopenia were assessed separately in multivariate analysis. Muscle strength and muscle mass were significantly associated with moderate-severe ED with OR of 0.93 (95%CI 0.89-0.98) and 0.68 (95%CI 0.54-0.86), respectively, whereas gait speed was not associated with moderate-severe ED. CONCLUSION: The presence of sarcopenia in older men is associated with an increased risk of moderate-severe ED. In addition, decreased muscle strength and decreased muscle mass are associated with an increased risk of moderate-severe ED. Prospective studies are needed to reveal the causality between sarcopenia and ED.

The relationship between sarcopenia and central hemodynamics in older adults with falls: a cross-sectional study.

PURPOSE: Falls are an important cause of morbidity and mortality in geriatric patients. Sarcopenia and central blood pressure may be associated with falls. This study aimed to investigate the association between sarcopenia and blood pressure parameters in older patients with falls. METHODS: A comprehensive geriatric evaluation of 72 elderly patients was performed using established assessment tests. Peripheral and central hemodynamic measurements, including office DBP and SBP, daytime-night peripheral and central DBP and SBP, cardiac output, augmentation index, pulse wave velocity (PWV), pulse rate, and peripheral resistance and reflection, were measured with a 24-hour ambulatory blood pressure measuring device. RESULTS: Of 72 patients with a mean age of 77.51 ± 6.5 years, 12 (16.7%) were non-sarcopenic, 32 (44.4%) were probable, nine (12.5%) were confirmed, and 19 (26.4%) were severe sarcopenic. PWV, which is an indicator of arterial stiffness, was found to be significantly higher in the sarcopenic group. The other cardiac risk markers [daytime peripheral SBP, mean arterial pressure (night), pulse pressure (daytime), and peripheral resistance (daytime and night)] were significantly lower in the sarcopenic patients. PWV correlated with gait speed, Katz score, and hand grip strength (Spearman's rho: -0.337, -0.310, and -0.334; P < 0.001, 0.008, and 0.001, respectively). Age and hypertension were the most important factors increasing the risk of falls. CONCLUSION: Sarcopenia is associated with central and peripheral blood pressure changes in patients with falls. When sarcopenia is diagnosed in older people with falls, 24-hour ambulatory peripheral and central pressures should be evaluated for cardiac risk screening.

A new easily accessible and practical method for dynapenia screening: blink rate.

BACKGROUND: The methods used in the diagnosis and screening of sarcopenia are not available everywhere. There is a need for more practical tests that can be used especially in the first step. AIMS: We aimed to investigate the usability of blink rate as an alternative test for dynapenia screening. METHODS: A total of 355 patients ≥ 65 years of age (254 (71.50%) female and 101 (28.50%) male) who were admitted to geriatric outpatient clinic were included in this prospective cross-sectional study. RESULTS: Blink rate was positively correlated with grip strength and negatively correlated with SARC-F. Also, it was found that the blink rate was associated with dynapenia independent of other factors. The optimal cut-off value of 15 s blink rate to predict dynapenia was measured as ≤ 40.5, with 70.3% sensitivity and 43.3% specificity. CONCLUSION: Our study indicated the relationship between blink rate with dynapenia and grip strength. Especially in patients with limited mobilization and where it is not possible to reach the hand dynamometer to measure grip strength, the blink rate can be used as an alternative test to detect dynapenia.

Risk of sarcopenia in hospitalized patients and related clinical factors: a multicenter study from Turkey.

PURPOSE: To investigate the risk of sarcopenia in hospitalized older patients and to assess the associations between sarcopenia risk and health care outcomes including dependency, malnutrition, and dysphagia. METHODS: This multicenter cross-sectional study was a part of the annual National Prevalence Measurement of Quality of Care (LPZ) in Turkey. Hospitalized patients age 65 and older were included in the study. The SARC-F was used to assess risk of sarcopenia. Dependency was appraised according to the Care Dependency Scale (CDS). Nutritional status was established with respect to the Malnutrition Universal Screening Tool (MUST). Dysphagia was screened by two structured questions. RESULTS: A total of 492 patients were included in the analysis. Two hundred and forty patients (48.8%) were at risk of sarcopenia. Sarcopenia risk was more prevalent among women (p = 0.007) and patients with risk of sarcopenia were older (p < 0.001). Hospital stay was longer and malnutrition and dysphagia were more prevalent in patients with sarcopenia risk than without (all p < 0.001). All nutritional interventions were applied mostly to patients with sarcopenia risk than without. In multivariate analysis, advanced age (OR: 1.068, CI 1.032-1.104, p < 0.001), female gender (OR: 2.414, CI 1.510-3.857, p < 0.001), and dependency (OR: 5.022, CI 2.922-8.632, p < 0.001) were independently associated with sarcopenia risk. CONCLUSIONS: Sarcopenia risk is related with unfavorable outcomes in hospitalized patients. Primarily older female patients are at risk for sarcopenia. It is important to recognize sarcopenia at an early stage and to prevent its progression, before dependency develops. The SARC-F may be a useful tool for screening sarcopenia risk in hospitalized patients.

May zoledronic acid have negative effects on cognition and muscle performance?

BACKGROUND: We aimed to investigate the effects of zoledronic acid treatment on daily living activities, cognitive functions, depression, muscle strength, and performance. METHODS: The study was conducted retrospectively. Bone mineral densitometry (BMD) values, Katz activities of daily living (ADL), Lawton-Brody instrumental activities of daily living (IADL), mini mental state examination (MMSE), geriatric depression scale (GDS), mini nutritional assessment (MNA), grip strength, and gait speed scores before and 6 months after zoledronic acid administration were compared. RESULTS: A total of 115 patients were included in the study. There was a significant increase in lumbar total (p < .001), femoral neck (p = .002), and femur total (p = .001) BMD values after zoledronic acid treatment. Significant decrease was found in MMSE (p = .016) and gait speed scores (p = .008) after zoledronic acid treatment, but no significant difference was found in terms of Katz ADL, Lawton-Brody IADL, MNA, GDS, and grip strength (p > .05). CONCLUSION: Our study indicated that zoledronic acid did not affect daily living activities, depression, and muscle strength. Although we have concluded that cognitive and muscle performance may be adversely affected by zoledronic acid treatment.

The relationship between frailty and serum alpha klotho levels in geriatric patients.

BACKGROUND: Frailty is a medical syndrome resulting in loss of endurance, strength and physiological function. There is insufficient data to understand the process of frailty formation at the gene level, however one of the product of Klotho gene known as an anti-aging gene with many functions that prolong lifespan is alpha klotho protein. We aimed to investigate the relationship between frailty and the serum alpha klotho protein levels. METHODS: In this cross-sectional analysis, there were 89 patients aged 65 years old and older, 45 of whom were frail and 44 of whom were not frail, were included in the study. Within the scope of the study, a sociodemographic and clinical information form, the Turkish version of the FRAIL scale and a comprehensive geriatric assessment were evaluated. In addition to routine laboratory tests, plasma alpha klotho protein levels were measured. RESULTS: The mean alpha klotho protein levels of the patients were 0.76 ± 1.01 ng/ml in the control group and 0.54 ± 0.61 ng/ml in the frail group, however, there was no statistically significant difference between the two groups (p = 0.286). C-reactive protein (CRP) levels were significantly higher and hemoglobin (Hb) levels were significantly lower in the frail patients compared to the control group (p < 0.05). It was observed that alpha klotho protein level was inversly correlated with increased CRP levels but association was weak (p = 0.022, R: -0.245). Hb levels (p = 0.018, R: 0.250) was weakly correlated with alpha klotho protein level. CONCLUSION: No significant relationship was found between frailty and alpha klotho protein levels in the geriatric patients. Further comprehensive studies are needed to explore this subject.

Effects of garlic consumption on plasma and erythrocyte antioxidant parameters in elderly subjects.

BACKGROUND: The oxidative stress theory of aging is one of the most widely acknowledged theories of aging. The intake of fruits and vegetables with antioxidant power is associated with a reduced incidence of many chronic diseases of aging. OBJECTIVE: The effects of ingesting garlic on plasma and erythrocyte antioxidant parameters of elderly subjects were investigated in this study. METHODS: 13 subjects (mean age 70.69 +/- 4.23) participated in the study. They ingested garlic at the daily dose of 0.1 g/kg b.w. for 1 month. Before and after this period, fasting blood samples were obtained, and oxidant [malondialdehyde (MDA) and xanthine oxidase (XO)] and antioxidant [superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and catalase (CAT)] parameters were studied in erythrocytes, and MDA levels were studied in plasma samples obtained from the subjects. Routine blood biochemical parameters were also measured in blood samples. RESULTS: In the plasma fraction and erythrocyte hemolysate, MDA levels were found to be significantly lower, but erythrocyte GSH-Px and SOD activities were significantly higher in the second samples relative to the first ones. XO activity was found to be lower in the second samples, but this decrease was not statistically meaningful. LDL cholesterol was found to be significantly lower in the second samples relative to the first ones. CONCLUSION: Our results show that ingestion of garlic leads to significantly lowered plasma and erythrocyte MDA levels and to increased activities of some antioxidant enzymes, which indicates that consumption of garlic decreases oxidation reactions. It is quite possible that reduced peroxidation processes due to garlic consumption may play a part in some of the beneficial effects of garlic in elderly subjects.