Role of muscle ultrasound in frailty assessment in older adults with type 2 diabetes mellitus.

BACKGROUND: Frailty is a geriatric syndrome that is characterized by increased vulnerability to intrinsic and extrinsic stressors due to decreased biologic reserves. Muscle ultrasound (US) is a valid and reliable method for assessing muscle quantity in older adults. The study aims to examine the relationship between frailty definitions and US-derived muscle parameters. METHODS: We conducted a cross-sectional study with type 2 diabetes mellitus outpatients in a tertiary hospital, and all participants underwent a comprehensive geriatric assessment. For frailty assessment, the Fried Frailty Phenotype (FFP), the Clinical Frailty Scale (CFS), and the Edmonton Frailty Scale (EFS) were performed. Muscle US measurements included Gastrocnemius Medialis (GM) muscle thickness, GM fascicle length, GM pennation angle, Rectus Femoris (RF) muscle thickness, Rectus Femoris cross-sectional area (RFCSA), Rectus Abdominis (RA) muscle thickness, External Oblique (EO) muscle thickness, Internal Oblique (IO) muscle thickness, and Transverse Abdominis (TA) muscle thickness. RESULTS: In all, 373 participants were included in the study. The median age of participants was 72.7 ± 5.9 years, and 64.6% of them were female. According to the FFP, 18.2% of the participants were living with frailty, 56% of them were pre-frail; 57.4% of them were living with frailty according to the CFS; 25.2% of them were living with frailty, and 20.6% of them were pre-frail according to the EFS. The FFP, CFS, and EFS scores were related to muscle thickness of GM, RF, and RA, fascicle length of GM, and pennation angle of GM and RFCSA. Particularly, GM pennation angle, RF muscle thickness, and RFCSA were associated with an increased risk of frailty. Besides muscle thickness of GM, RF, and RA, fascicle length of GM, pennation angle of GM, and RFCSA were significant for predicting the presence of frailty. CONCLUSIONS: US-derived regional muscle measurements are associated with frailty definitions (in both physical, cumulative deficit, and multidimensional models) in a diabetic geriatric population.

A pilot study for a practical screening tool for dementia: validation of 5-minute cognitive test in a geriatric population.

BACKGROUND: The aim of this study is to validate the Turkish version of the 5-minute cognitive test (FCT) in a geriatric population. MATERIALS AND METHOD: In total, 61 participants aged ≥65 years with normal cognitive functions, mild cognitive impairment (MCI), and early stage dementia were included. The FCT was compared to the standardised Mini Mental State Examination (MMSE) and the Qmci-TR (quick mild cognitive impairment) test. RESULTS: Test reliability for the FCT was strong (Cronbach's α = 0.747). We demonstrated a strong correlation of FCT scores with MMSE and Qmci-TR scores (respectively, r = 0.730, P < 0.001, r = 0.723, P < 0.001). The fact that the scores obtained in the dementia group were significantly lower also showed that the test can be used reliably in the differentiation of MCI and early dementia (P < 0.001). CONCLUSIONS: The FCT is a brief, reliable, and valid cognitive screening test for screening dementia at early stages in a Turkish geriatric population.

Clinical pharmacist-led assessment and management of anticholinergic burden and fall risk in geriatric patients.

BACKGROUND: The aim of this study was to examine the risk of fall with the surrogate outcome of the Aachen Falls Prevention Scale and to assess the clinical pharmacist interventions in order to minimize anticholinergic drug burden and associated risk of fall according to a fall risk assessment scale in the older adults. METHODS: Patients who admitted to the geriatric outpatient clinic of a university hospital and taking at least one anticholinergic drug were evaluated both retrospectively and prospectively as groups of different patients by the clinical pharmacist. Patients' anticholinergic burden was assessed using the Anticholinergic Cognitive Burden Scale. For fall risk assessment, the Aachen Falls Prevention Scale was also administered to each patient whose anticholinergic burden was determined in the prospective phase of the study. RESULTS: A total of 601 patients were included. Risk of falls increased 2.50 times in patients with high anticholinergic burden (OR (95% CI) = 2.503 (1.071-5.852); p = 0.034), and the existing history of falls increased the risk of high anticholinergic burden 2.02 times (OR (95%CI) = 2.026 (1.059-3.876); p = 0.033). In addition, each unit increase in the fall scale score in the prospective phase increased the risk of high anticholinergic burden by 22% (p = 0.028). Anticholinergic burden was significantly reduced as a result of interventions by the clinical pharmacist in the prospective phase (p = 0.010). CONCLUSION: Our study revealed that incorporating a clinical pharmacist in the handling of geriatric patients aids in the detection, reduction, and prevention of anticholinergic adverse effects.

Turkish translation, cross-cultural adaptation and reliability of the Groningen Frailty Indicator.

BACKGROUND: Frailty is an important geriatric syndrome that can be seen as a way of recognizing and distinguishing the complex health conditions of older people. Due to the time limitation, short and simple instruments are most feasible in clinical practice, and several quick screening tools have been developed and validated, Groningen frailty indicator (GFI) is one of these scales. We aimed to validate and evaluate the reliability of the GFI in outpatient older adults in the Turkish population. METHODS: A total of 101 older patients were enrolled to the study. GFI was scored by a geriatrician for every patient at first admission to the geriatric outpatient clinic. Fried Physical Frailty Phenotype (FPFP) was performed as a reference test. RESULTS: The median age (IQR) was 72.0 (10.0) and 62.4% of the study population (n = 63) was female. Based on the GFI, 34 patients (33.7%) were defined as robust, and 67 patients (66.3%) were defined as living with frailty. There was a statistically significant concordance between GFI and FPFP (Cohen's kappa: 0.415 p < 0.001). GFI had excellent consistency in inter-rater reliability (Cronbach's alpha: 0.99, 95% CI 0.97-1.00) and in intra-rater reliability (Cronbach's alpha: 0.99, 95% CI 0.96-1.0). CONCLUSION: Our study showed that GFI is a valid and reliable scale in the Turkish older population.

Dysphagia is closely related to frailty in mild-to-moderate Alzheimer's disease.

INTRODUCTION: Physical phenotype and the cumulative deficit model are two well-known concepts of frailty. One of the main components of frailty is loss of muscle mass and function, which may also include swallowing muscles, therefore is a risk factor for dysphagia. Since dysphagia is seen starting from the early stages of Alzheimer's Disease (AD), in this study we aimed to reveal the relationship between frailty and dysphagia and dysphagia-related quality of life through Swallow Quality of Life (SwalQoL) tool in patients with AD and compare them with cognitively intact older adults. METHODS: Comprehensive geriatric assessment, dysphagia evaluation by Eating-Assessment Tool (EAT-10) and SwalQoL questionnaire, and frailty assessment via FRAIL and Clinical Frailty Scale (CFS) were performed on all 101 participants of the study. Thirty-five patients were cognitively intact, 36 patients were diagnosed with mild AD, and 30 patients were diagnosed with moderate AD. RESULTS: Sex distribution was similar between the groups, however, there was a statistically significant age difference. The prevalence of frailty increased according to both frailty indexes as the cognitive status deteriorated. All parameters of SwalQoL except fear and sleep parameters deteriorated as cognitive status impaired. In quantile regression of the total score of the SwalQoL questionnaire and multivariable logistic regression of EAT-10, frailty, as defined by CFS and FRAIL, was associated with dysphagia and poor quality of life regardless of age, presence of dementia, as well as nutritional status. CONCLUSION: Swallowing difficulties in AD negatively affects the quality of life, and it is closely related to frailty in mild-to-moderate AD.

Pan-immune inflammation value; a novel biomarker reflecting inflammation associated with frailty.

BACKGROUND: Frailty is suggested to be associated with age-related changes in the immune system, namely immunosenescence. Few studies have investigated the association of frailty with circulating immune biomarkers reflecting immunosenescence. Pan-immune inflammation value (PIV) is a new composite circulating immune biomarker to predict inflammation status. AIM: This study aimed to assess the relationship between PIV and frailty. METHODS: A total of 405 geriatric patients were enrolled in the study. All participants underwent a comprehensive geriatric assessment. The comorbidity burden was evaluated with Charlson Comorbidity Index. Frailty status was evaluated via the Clinical Frailty Scale (CFS), and patients with CFS scores ≥ 5 were defined as living with frailty. PIV was calculated using the formula: (Neutrophil × monocyte × platelet)/lymphocyte. Patients were defined as PIV-low (≤ 372) and PIV-high (> 372). RESULTS: The median age of participants was 72 (IQR = 67-78) years and; 63.0% (n = 225) were female. Patients were divided into two categories (i.e., robust and living with frailty groups), and 320 (79.0%) and 85 (21.0%) patients were in each group, respectively. Median PIV was higher in the living with frailty group (p = 0.008). In the linear and logistic regression analyses, both PIV and PIV-high (> 372) were significantly associated with frailty independently of confounders. DISCUSSION AND CONCLUSION: This is the first study revealing the relationship between PIV and frailty. PIV may be seen as a novel biomarker reflecting inflammation associated with frailty.

Lower gastrocnemius muscle stiffness, derived from elastography, is an independent factor for falls in older adults.

BACKGROUND AND AIMS: It is well known that components of sarcopenia (i.e., decreased muscle strength and mass) are related to falls in older adults. However, the possible effects of changes in muscle quality on falls have not been identified. This study aimed to evaluate the changes in muscle quality reflected by muscle stiffness derived from shear-wave elastography (SWE) and its association with falls in older adults. METHODS: A total of 101 geriatric outpatients were included in the study. Assessments of physical performance, muscle strength (handgrip strength), muscle mass (muscle ultrasonography and bioelectrical impedance analysis), and muscle stiffness of the medial head of gastrocnemius (GCM) in relaxation and passive stretching were performed. The history of falls in the previous year was questioned and recorded. RESULTS: The median (25-75 percentiles) age of participants was 73 (69-77) years, and 66.3% (n = 67) were female. According to fall history, participants were divided into non-fallers and fallers groups, and 72 (71.3%) and 29 (28.7%) participants were in each group, respectively. The median muscle stiffness of (Emean) the GCM in passive stretching was significantly lower in the fallers group (p < 0.001), and it was significantly correlated with the number of falls in the previous year (r: - 0.274, p: 0.010). In regression analyses, the Emean value of GCM in passive stretching was significantly associated with falls independent of confounders (OR: 0.944, 95% CI 0.90-0.98, p = 0.010). DISCUSSION AND CONCLUSION: This is the first study to reveal the relationship between falls and SWE-defined lower GCM stiffness independently of muscle mass and strength.

Balance performance measured by posturography in mild-moderate Alzheimer's Disease: An undervalued assessment.

PURPOSE: The aim of the study was to compare balance performance in mild-moderate stage Alzheimer's disease (AD) patients and healthy peers using clinical balance tests and computerized posturography. METHODS: We recruited 95 patients and divided them into two groups; 51 patients (62 % (n=32) female) in AD group and 44 patients in healthy controls group (50 % (n=22) female). Berg Balance Scale (BBS) and Timed Up & Go (TUG) test were performed. Computerized posturography was performed. RESULTS: The mean age was 77.2±5.5 years in the AD group and 73.8±4.4 years in the control group (p<0.001). Sensory organization test composite equilibrium score (60[30-81], p<0.001), step quick turn-sway velocity (69.2 [38.2-95.8], p<0.001) and step quick turn-time (3.8 [1.6-8.4], p<0.001) were significantly impaired in mild-moderate stage AD patients. Berg Balance Scale (50 [32-56], p<0.001) and TUG test (13.0 [7.0-25.7], p<0.001) results were worse in AD. CONCLUSIONS: Computerized posturography measures were impaired in mild-moderate AD patients. The results highlight importance of early screening for balance and fall risk in AD patients. The study provides multi-dimensional and holistic assessment of balance performance in early-stage AD patients. Alzheimer's disease patients at earlier stages are prone to fall risk and should be evaluated accordingly.

Changes in Place of Death of Older Adults during the COVID-19 Pandemic: A Retrospective Study from an Aging Country.

In the COVID-19 pandemic, due to the difficulties in patients' applications to health centres, changes have occurred in the places of death of older adults. It is aimed to investigate the change in the places of death of older adults in Turkey, which is one of the countries most affected by the pandemic. Patients admitted to the geriatric outpatient clinic of a university hospital from 01.01.2013 to 29.02.2020 were included. Place and date of death were recorded as hospital or out-of-hospital death. According to results, while the median age of those who died during the pandemic was higher than before (p < 0.001) and during the pandemic, the hospital mortality ratio was higher than before. During the pandemic period, the hospital mortality ratio of older adults has increased in Turkey. This situation, which has occurred despite the increasing healthcare burden, can show the importance of the measures taken and robust health infrastructure.

Frailty and sarcopenia among Turkish people aged 40 and above living with HIV.

BACKGROUND: People living with HIV face a variety of challenges, including accelerated ageing and geriatric syndromes. In this study, we aimed to examine the prevalence of frailty and sarcopenia among Turkish people living with HIV. METHODS: In total, 100 people living with HIV were recruited in this study. Frailty was determined using Fried's frailty phenotype, and we calculated the Charlson Comorbidity Index, Veterans Aging Cohort Study (VACS) index, fracture risk assessment tool scores, and Mini-Mental State Exam scores. We determined muscle mass using bioelectric impedance analysis, gastrocnemius muscle thickness using ultrasonography, and muscle strength using handgrip strength. RESULTS: The mean ± standard deviation age was 50.0 ± 8.3 years. In total, 11% of the patients were frail. The risk of comorbidity and mortality, VACS index, and 5-year mortality risk was significantly higher in the frail group, as was sarcopenia. Fat-free muscle mass and handgrip strength were correlated with gastrocnemius muscle thickness. Gastrocnemius muscle thickness suggestive of sarcopenia was defined as 13.05 mm. The cognitive impairment rate was 5% and was associated with physical frailty. CONCLUSION: Frailty is common and associated with higher morbidity and mortality rates among Turkish people living with HIV.

Association of frailty with chemotherapy toxicity in chemotherapy-naive older patients with cancer.

OBJECTIVE: The purpose of this study is to assess the relationship between chemotherapy toxicity and frailty as determined using the Edmonton Frail Scale (EFS). METHODS: Older adults (≥ 65 years old) newly diagnosed with cancer were evaluated for frailty with EFS prior to chemotherapy. Participants evaluated on 17 points were grouped as "No Frailty" (0-4), "Apparently Vulnerable" (5-6), "Mild Frailty" (7-8), "Moderate Frailty" (9-10), and "Severe Frailty" (11 or more). Before the second and third chemotherapy cycles, patients were reassessed for toxicity. RESULTS: Of the 44 participants, 12 (27.4%) were rated as "frail" (EFS score ≥ 7). The median Charlson Age-Comorbidity Index score was 3 (IQR: 1), and the median EFS score was 5 (IQR: 3). There was no significant difference between the "frail" and "robust" groups in terms of the toxicity. There was no correlation between age, gender, chemotherapy intent, chemotherapy dosing, ECOG performance score, or other parameters with grade 3 or higher toxicity development. CONCLUSION: The Edmonton Frail Scale is not successful in predicting the toxicity risk of chemotherapy. However, it may be used as a tool to determine the need for comprehensive geriatric assessment and it may lead to increased alertness to adverse events during treatment of frail patients.

Antibody response with SARS-CoV-2 inactivated vaccine (CoronaVac) in Turkish geriatric population.

BACKGROUND: Sars-CoV-2 infection influences older individuals at the forefront, and there is still limited data on the COVID-19 vaccine response in the geriatric population. This study aimed to assess antibody response after vaccination with SARS-CoV-2 inactivated vaccine and examine possible factors affecting this response in a geriatric population. METHODS: individuals who have been on at least the 28th day after the second dose of the COVID-19 vaccine were included. Comprehensive geriatric assessment tools and the Clinical Frailty Scale were performed. SARS-CoV-2 spike-specific IgG antibodies were detected and, levels ≥1 U/ml were defined as seropositive, <1 U/ml were defined as seronegative. RESULTS: a total of 497 patients were included and divided into three groups according to the days past after the second dose of the vaccine (Group 1: 28-59 days, Group 2: 60-89 days and Group 3: 90 days and more). Groups included 188, 148 and 171 patients, respectively. Seropositivity rate in each group was 80.9,73.2 and 57.3%, respectively. In Groups 1 and 2, Charlson Comorbidity Index score was higher in the seronegative group (P = 0.023 and P = 0.011, respectively). In Group 3, the prevalence of frailty was significantly higher in the seronegative group (P = 0.002). CONCLUSION: to the best of our knowledge, this is the first study assessing the antibody response after vaccination with Sars-CoV 2 inactivated vaccine in the Turkish geriatric population. Moreover, this is the first study revealing the relationship between antibody response and frailty. Larger studies are needed to confirm the antibody response duration and the association between frailty and COVID-19 vaccine response.

Cognitive Status is Better in Older Adults under Colchicine Treatment: A Case-Control Study.

PURPOSE: We aimed to investigate the effects of colchicine, an important anti-inflammatory agent, on cognitive functions in a geriatric population diagnosed with gout or osteoarthritis by comparing it to non-colchicine users. METHODS: 138 geriatric patients (67 colchicine users and 71 non-users) were enrolled. Within comprehensive geriatric assessment (CGA), cognitive status assessment via Mini-Mental State Examination test (MMSE), Quick Mild Cognitive Impairment Screening test (Qmci), clock drowning test (CDT), and digit span tests were performed. RESULTS: Median age was 68 (65-72), and there were 82 female (59.4%) patients. The scores of CDT, Backward Digit Span Test, MMSE-Total, MMSE-Attention, MMSE-Motor Function, Qmci-Total Score, Qmci-Clock drawing, and Qmci-Logical Memory were significantly higher in the colchicine user group (p < .005), showing better cognitive function. Adjusted model analysis showed that colchicine usage is independently correlated with higher Qmci-Total Score and Qmci-Logical Memory Score (For Qmci total score ß = 7.87 95%CI = 5.48-10.27, p = <0.0001, and for Qmci Logical memory score ß = 3.52, 95%CI = 2.12-4.91, p = <0.0001). CONCLUSION: To the best of our knowledge, this is the first study revealing that colchicine usage is associated with better cognitive performance in older adults. Further investigations with a prospective, larger-sampled and randomized design are needed to show the causal relationship between colchicine and cognition.

Cognitive assessment in the time of pandemics: mandatory surgical face mask usage affects cognitive test performance of older adults.

BACKGROUND: The most important disadvantage of surgical mask usage is that it can aversely affect communication. This study aimed to evaluate the possible effects of face masks on the cognitive test performance of older adults. METHODS: A total of 198 geriatric patients were enrolled after applying the exclusion criteria. Within the comprehensive geriatric assessment (CGA), cognitive status assessment was performed with the Mini-Mental State Examination test (MMSE) and Quick Mild Cognitive Impairment Screening test (Q-MCI) tests. RESULTS: The median age was 70 (66-77) years, and there were 119 female (60.7%) patients. Patients were divided into normal cognitive status (NC), mild cognitive impairment (MCI), and probable Alzheimer's disease (AD) groups. There were 129 (65.2%), 30 (15.2%), and 37 (18.7%) patients in each group, respectively. For differentiating MCI from NC, calculated optimal cut-offs for the Q-MCI and MMSE total scores were ≤50 (sensitivity 83.3%, specificity 90.7%) and ≤26 (sensitivity 63.3%, specificity 87.5%), respectively. For differentiating AD from MCI, calculated optimal cut-offs for the Q-MCI and MMSE total scores were ≤28 (sensitivity 76.8%, specificity 86.7%), and ≤24 (sensitivity 94.4%, specificity 64.5%), respectively. CONCLUSION: Our results revealed that screening tests are still sensitive in discriminating cognitive disorders although cut-offs are lower with mask usage than for previously validated cut-offs. This is the first study revealing the impact of surgical mask usage on cognitive test performance, indicating that cut-offs validated before the pandemic may cause overdiagnosing of cognitive disorders since the previous cut-offs are not validated for mask usage. Large sample studies are needed to determine new cut-offs validated with mask usage.

Frailty in community-dwelling older adults: reliability and validity of the Turkish version of the Gérontopôle frailty screening tool.

BACKGROUND: Recognizing frailty had a great importance in countries with an increasing geriatric population. The study aims to evaluate the reliability and validation of the Gérontopôle frailty screening tool (GFST), which was developed to screen frailty in the community-dwelling older adults, for the Turkish population. METHODS: In this crosssectional study, participants who applied to the geriatrics outpatient clinic of a university hospital were included. Comprehensive geriatric assessments of all patients were performed. The validity of the GFST was tested by its concordance with the FRAIL scale. Test-retest and interrater reliability analyses were made. RESULTS: Ninety-six patients were included in the study. Sixty-one and five-tenths percent (n = 59) of them are females. The median age was 72.0 (IQR: 10.0). There was a moderate concordance between the GFST and the FRAIL scale (Cohen's kappa: 0.566, p < 0.001). The Gérontopôle frailty screening tool interrater and retest reliabilities were excellent (Cohen's kappa: 0.814, p < 0.001 and 1.0, p < 0.001; respectively). The sensitivity of the GFST determined according to the FRAIL scale is 69.39%, the specificity is 86.36%, the positive predictive value is 85.00%, and the negative predictive value is 71.70%. DISCUSSION: The Gérontopôle frailty screening tool, which can be used by all healthcare professionals, is a valid and reliable tool for the Turkish geriatric population.

Insomnia and falls in older adults: are they linked to executive dysfunction?

BACKGROUND: Insomnia increases the incidence of falls and impairs executive function. Moreover, falls are associated with executive function impairment. The relationship between falls and executive function in patients with insomnia is not clear. The aim of this study was to evaluate relationship between falls and executive function in individuals with insomnia and a control group. METHODS: This study involved 122 patients (47 insomnia, 75 controls). The Mini-Mental State Examination, Quick Mild Cognitive Impairment Screen, Trail Making Test A, clock-drawing test, and digit span test were used to measure executive function. Semantic and working memory dual task was also performed. Fall history was recorded and the Falls Efficacy Scale - International administered. RESULTS: The median age of the patients was 71 years (range: 65-89 years), and 60.7% were women. The insomnia group scored lower on the three-word recall than the control group (P = 0.005), but there was no difference between the groups on cognitive tests. Fall history and fear of falling were more frequent in the insomnia group (P = 0.003, P < 0.001). Semantic and working memory dual tasks were correlated with clock-drawing test only in the insomnia group (r = -0.316, P = 0.031; r = -0.319, P = 0.029). Depression (odds ratio (OR) = 9.65, P = 0.001) and Trail Making Test A (OR = 1.025, P = 0.07) were independently associated with insomnia. Four-metre walking speed (OR = 2.342, P = 0.025), insomnia (OR = 3.453; P = 0.028), and the semantic memory dual task (OR = 1.589; P = 0.025) were also independently associated with falls. CONCLUSION: Our study showed that dual tasking and executive function are related to falls in patients with insomnia. Managing insomnia and assessment of executive dysfunction may have beneficial effects on preventing falls.

Treatment of hypothyroidism improves glomerular filtration rate (GFR) in geriatric patients

Background/aim: Renal function of patients with hypothyroidism increases after reaching euthyroid state. There is no data regarding geriatric age group. The aim of the study was determined to investigate whether renal function of geriatric patients with hypothyroidism increases after they become euthyroid. Materials and methods: Patients who were sixty-five years or older were retrospectively screened in two centers. TSH, T3, T4, creatinine, and eGFR calculated by CKD-EPI formula were recorded under the presence of accompanying hypothyroidism. The same variables were recorded after the patients became euthyroid. Results: 285 patients were included in the study, the median age was 73(65­84), and 234 patients were female. Patients were examined in four groups according to TSH values. There were 160 (56.1%) patients with TSH 5­9.9 uIU/mL, 60(21.1%) patients with TSH between 10­19.9 uIU/mL, 41(14.4 %) patients with TSH between 20­49.9 uIU/mL and 24(8.4%) patients with TSH> 50uIU/mL. There was a significant and negative correlation between the initial TSH values and the first calculated eGFR values (p: 0.001; r: ­0.191). The median eGFR of the patients in hypothyroid cases was 66.59 (14.62­116.07), while the median eGFR value of patients was 69.6 (12.91­109.31) in the euthyroid state. This value obtained after thyroid replacement was significantly improved when compared to the first eGFR (p: 0.001). In logistic regression analysis, pretreatment TSH value was found to independently affect eGFR (p: 0.009; Exb: 1.017). Conclusion: It has been observed that hypothyroidism treatment increases eGFR in geriatric patients. Similar results were obtained after studies with younger patients in the literature. This study is a study in which only geriatric age group patients were examined. It should be kept in mind that hypothyroidism which is not corrected in geriatric patients may also contribute to a decrease in eGFR.

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.