Long-Term Risk of Reduced Cognitive Performance and Associated Factors in Discharged Older Adults with COVID-19: A Longitudinal Prospective Study.

BACKGROUND: Increasing numbers of reports have suggested a deterioration in cognitive performance after recovery from coronavirus disease 2019 (COVID-19), however insufficient information is available regarding long-term brain health and risk factors related to reduced cognitive performance in advanced age. We investigated the prevalence of reduced cognitive performance and its associated factors among older adults after COVID-19. METHODS: This prospective observational study enrolled older individuals (aged ≥65 years) hospitalized for COVID-19. Discharged patients were contacted after an average of 15 months and a brief battery was administered during telephone interviews to assess their mental status. RESULTS: Among the 174 patients, 77 (44.3%) showed reduced cognitive performance at follow-up. Multivariate analysis revealed that female sex, education level, and increased Deyo/Charlson Comorbidity Index score, which is an objective indicator of chronic disease burden, were independent risk factors for long-term cognitive performance. Depression and anxiety symptoms, assessed using the Patient Health Questionnaire-2 and Generalized Anxiety Disorder 2-item questionnaire at the end of the study, were not associated with reduced cognitive performance. CONCLUSION: Our findings provide key insights into discharged older adults with COVID-19 at risk of long-term cognitive impairment, and help to ascertain the factors associated with this problem.

Geriatric syndromes in the population older than 90 years: The prevalence and association with chronic diseases.

OBJECTIVE: The aim of this study was to explore the prevalence of geriatric syndromes and comorbid conditions, as well as their interrelationships, in individuals aged 90 years and over. METHODS: This study included participants aged 90 years and older who underwent a comprehensive geriatric assessment in a tertiary geriatric outpatient clinic. Demographic and clinical characteristics were obtained using the electronic medical records. The geriatric syndrome burden was calculated by adding each syndrome, which was then stratified into one of two groups based on the median value: no or low burden (<4) and high burden (≥4). The modified Charlson comorbidity index was used to determine chronic disease burden. RESULTS: A total of 235 participants (93.2 ± 2.7 years) were recruited in this study. The mean index score was 7.3, and 46% (n = 107) of participants had a high geriatric syndrome burden. The most common geriatric syndrome was incontinence (69%), followed by polypharmacy (60%) and depression (43%). When compared to patients without such a diagnosis, the prevalence of polypharmacy was significantly higher in patients diagnosed with hypertension, chronic kidney disease, cardiovascular disease, diabetes mellitus and chronic obstructive pulmonary disease (p = 0.02, p = 0.02, p < 0.001, p = 0.008, p = 0.007, respectively). However, no chronic disease was associated with geriatric syndrome burden. CONCLUSIONS: We found that the burden of medical conditions in the older population over 90 years of age could influence general health status significantly, with a high prevalence of chronic diseases and geriatric syndromes.

Reliability and validity of the Turkish version of the elder abuse suspicion index in community-dwelling older adults.

BACKGROUND: Elder abuse is among the most important ethical issue during the management of older population. The elder abuse suspicion index (EASI) was developed for evaluating abuse in older adults. We aimed to assess the reliability and validity of the Turkish version EASI-Türkiye (TR) among older adults. METHODS: This study included 89 community-dwelling older adults. The EASI-TR and other scales, including HwalekSengstock Elder Abuse Screening Test-Türkiye (HS/EAST-TR), YGDS, Yesavage Geriatric Depression Scale (YGDS), Instrumental Activities of Daily Living (IADL), and Activities of Daily Living (ADL) were administered to all participants. Internal consistency and external validity were assessed. RESULTS: EASI-TR revealed an excellent test-retest reliability and acceptable level of internal consistency (Cronbach's α = 0.711). The item-total correlations ranged between 0.296 and 0.701, except for the second item. This test showed significant correlations with the HS/EAST-TR and IADL (p < 0.05), demonstrating good external validity. DISCUSSION: The EASI-TR appears to have acceptable reliability and validity in screening for abuse in older adults. This tool may recognize cases that require additional evaluation in managing of ethical issues.

Psychological Burden among Community-dwelling Older Adults with and without a History of a Recent Covid-19 Infection.

OBJECTIVES: The outbreak of Covid-19's psychological burden to recovered vs. non-infected older individuals has not been compared yet. We aimed to perform a comparative analysis of psychological symptoms in community-dwelling older adults with and without a history of a Covid-19 infection. METHODS: In this study, we utilized a geriatric care unit's outpatient registry to prospectively enroll older adults with and without a history of Covid-19. An interviewer administered generalized anxiety disorder-2 (GAD-2), patient health questionnaire-2 (PHQ-2), six-item cognitive impairment (6-CIT), and post-traumatic stress disorder-5 (PTSD-5) tests over the phone. Correlation and multivariate logistic regression analyses were used to examine associations. RESULTS: The study included 120 older subjects, 46 (38.3%) reported past Covid-19 infection. Anxiety and depression were both significantly more prevalent among subjects without a history of Covid-19. Having no history of Covid-19, female gender, and psychoactive medication use showed independent associations with the risk of depression symptoms among all subjects, and female gender was additionally associated with anxiety symptoms. CONCLUSIONS: This study showed that the risk of depression symptoms was higher in a sample of older adults who were not infected with Covid-19 compared to those recovering from the disease. CLINICAL IMPLICATIONS: The impact of "fear of transmission" on the mental health of the elderly may be a significant issue to deal with. Older women are more prone to mental health risks by Covid-19.