Validity and reliability of Fried frailty phenotype in Turkish population.

Background/aim: Frailty is an important, multidimensional geriatric syndrome defined as increased vulnerability to stressors. Fried frailty phenotype (FFP) is one of the most widely used models to define physical frailty. The aim of this study is to investigate the cross-cultural validity and reliability of Fried frailty phenotype (FFP) in older Turkish population. Materials and methods: A total of 450 patients, aged 59 years and over, were included. FFP translated into Turkish was used. Hand grip strength cut-off values that best predict low skeletal muscle mass index (SMI) for Turkish men and women were calculated. A modified version of FFP was created by rescoring FFP according to these cut-off values applicable to Turkish population. Correlation analysis between the frailty assessment by comprehensive geriatric evaluation of clinician experienced in geriatric medicine, and FFP and modified version of FFP were performed for validation. Thirty-five patients underwent frailty assessment with FFP twice for reliability assessment. Inter-rater and intra-rater agreements were investigated. Results: Clinician's decision of frailty status demonstrated significant agreement with the results of FFP, as well as modified FFP. Interrater and intra-rater compliance were good. Best hand grip strength cut-off values for predicting low SMI in older Turkish population were determined as ≤13.6 kg (AUC: 0.841, p < 0.001) for women and ≤27.7 kg for men (AUC: 0.779; p < 0.001). Modified FFP had a good agreement with the FFP. Conclusion: FFP is a valid and reliable tool for Turkish population.

Association of physical frailty with cognitive function and mood in older adults without dementia and depression

Background/aim: Physical frailty is thought to be related with a decline in cognitive function, mood, and social activities, especially in patients with depression and dementia. It is not clear whether or not physical frailty is associated with an impairment in cognitive function and mood in patients without dementia and depression. In this study, we evaluated the association of physical frailty with cognitive function and mood in geriatric patients without dementia and depression. Material and methods: In this study, 612 patients aged 65 years and over were evaluated. Physical frailty was assessed by using Fried criteria. Furthermore, comprehensive geriatric assessment was performed to each patient. Results: Median age of the patients was 72 years (min-max: 65­93), 58% were female, and 6.5% were frail. Clock drawing (p < 0.001), MMSE (p < 0.001), and Yesevage geriatric depression scale (p: 0.010) test results were worse in frail patients compared to pre-frail and robust ones. Age (p: 0.009), being university graduate (p: 0.031), three words recall test (p: 0.014), activities of daily living (ADL) (p: 0.006), instrumental activities of daily living (IADL) (p < 0.001), and MNA-SF (p: 0.001) scores were determined to be independent related factors of frailty. Conclusion: We have demonstrated that cognitive function and mood might be associated with physical frailty in patients without dementia and depression.

Masked hypertension is associated with end organ damage in geriatric age: Geriatric MASked Hypertension and End organ damage (G-MASH-End organ Study).

Purpose: It is a question whether masked hypertension (MH) leads to end-organ damage in the geriatric age group. The aim of this study is to evaluate the associations between MH and end-organ damage such as left ventricular hypertrophy (LVH) and proteinuria in geriatric population.Materials and methods: One hundred and two patients who were admitted to the outpatient clinic were included in the study. These patients were also included in the GMASH-Cog study in 2016, which examined the relationship between MH and cognitive function. All patients underwent ambulatory blood pressure measurement procedures. Cardiac functions of all patients were determined by echocardiography. Spot urine albumin/creatinine ratio (ACR) was measured in all patients.Results: Forty four of 102 patients (43%) were diagnosed with MH. ACR was 9.61 mg/gr in the MH group and 7.12 mg/gr in the normal group (p = .021). In addition, left ventricular mass index (LVMI) was found to be higher in the MH group than in the normal group. Mean LVMI scores were 107.76 ± 16.37 in patients with MH and 100.39 ± 19.32 in the normotensive group (p = .046).Conclusion: MH is associated with end-organ damage in geriatric patients. Urinary albumin excretion and LVH which are the parameters of end-organ damage were significantly higher in MH patients. MH may cause end-organ damage and should not be overlooked in geriatric patients.

[The Validity and the Reliability of Turkish Version of the Self-Stigma of Depression Scale]. / Depresyonda Kendini Damgalama Ölçegi: Türkçe Formu, Geçerlilik ve Güvenilirlik Çalismasi.

OBJECTIVE: In this study, we aimed to the Self-Stigma of Depression Scale (SSDS), which evaluates self-stigmatization that can prevent both treatment consultation and compliance by depressed patients run Turkish adaptation, validity and reliability study of. METHOD: The study included a total of 173 subjects consisting of 131 outpatients of the Psychiatry Polyclinic with past or recent major depression disorder (MDD) diagnosis and 42 non-depressed outpatients consulting the Geriatrics Polyclinics for other medical complaints. Each participant was evaluated with the Structured Clinical Interview for DSM IV Axis I Disorders (SCID-I), the Standardized Mini Mental State Examination (MMSE), the Turkish Self-Stigma of Depression Scale (SSDS-TR) and the Beck Depression Inventory (BDI). The MDD patients were further evaluated with the Internalized Stigma of Mental Illness (ISMI) scale. Test-retest reliability of the SSDS-TR was assessed with 27 participants 8-12 weeks after the first test. All analyses were carried out using the IBM-SPSS Statistics version 25 and the IBM SPSS AMOS version 25. RESULTS: In the exploratory factor analysis, the factor structure of SSDS TR differed from the original form. The structural validity of the 4-factor model formed after excluding one problematic item was tested by confirmatory factor analysis and proven to meet the goodness of fit criteria. The Cronbach's α coefficient of the SSDS-TR was 0.847, and a moderate correlation (r=0.436 p=0.023) was obtained by the test-retest analysis. The SSDS-TR scores moderately correlated with the ISMI scores (r=0.485, p<0.001) and weakly correlated with the BDI scores (r=0.246, p<0.001). CONCLUSION: The SSDS-TR formed by excluding one item from the original scale was demonstrated to be a valid and reliable psychometric tool and is expected to fill a gap in the assessment of self stigmatization of MDD patients in Turkey.

Association of Bioelectrical Impedance Analysis-Derived Phase Angle and Sarcopenia in Older Adults.

BACKGROUND: Sarcopenia is an important problem for older adults, leading to morbidity and mortality; therefore, early detection with a precise method is essential. We aimed to investigate the role of bioelectrical impedance analysis-derived phase angle as a determinant of sarcopenia. MATERIALS AND METHODS: A cross section of 263 community-dwelling and hospitalized older adults (>65 years) were assessed in terms of sarcopenia with bioelectrical indices and anthropometric measurements. Sarcopenic and nonsarcopenic groups were compared, and significant determinants of sarcopenia were further analyzed with multivariate logistic regression analysis. RESULTS: Forty patients were diagnosed with sarcopenia. The following were significant correlates of sarcopenia: female sex, low weight/height, low body mass index, decreased muscle strength, low calf circumference, low skeletal muscle mass/index, high impedance at 50 kHz, a history of hypertension, worse nutrition status, and low phase angle. Diagnostic parameters with well-known association were omitted, and sex, height, weight, body mass index, creatinine, nutrition status, phase angle, impedance at 50 kHz, and hypertension category were included in regression analysis. The following were independent associated factors with sarcopenia: phase angle (odds ratio [OR]: 0.59, 95% confidence interval [95% CI]: 0.40-0.87, P = .008), body mass index (OR: 0.84, 95% CI: 0.77-0.93, P = .001) impedance at 50 kHz (OR: 1.010, 95% CI: 1.006-1.015, P < .001), and height (OR: 0.93, 95% CI: 0.88-0.97, P = .001). Receiver operating characteristic analysis revealed that the optimal phase angle cutoff value to detect sarcopenia was ≤4.55º. CONCLUSIONS: Bioelectrical phase angle can be useful for diagnosis of sarcopenia.