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Objective: Idiopathic normal pressure hydrocephalus (iNPH), a classical triad of gait abnormality, cognitive disturbance, and urinary incontinence, increases in prevalence with aging. Sarcopenia is also characterized by low muscle strength and mass, contributing to gait difficulty. Gait abnormality and lower physical activity also lead to the development of sarcopenia. Therefore, this study aims to investigate the relationship between sarcopenia and iNPH. Methods: A total of 327 participants were included in this retrospective cross-sectional study. Demographic and clinical characteristics, including age, sex, comorbidity index, number of medications, recurrent falls in the last year, laboratory findings and comprehensive geriatric assessment (CGA) parameters were recorded. Sarcopenia was defined according to the EGWSOP2 criteria. The relationship between sarcopenia and iNPH was assessed with regression analysis. Results: There were 51 participants with iNPH, 49% female, mean age 78 years (SD 5.7) and 276 control participants, 74% female, mean age 72 years (SD 6.1). The sarcopenia rates in patients with iNPH and controls were 19.6% and 2.5%, respectively (p< 0.01). The odds of probable sarcopenia were 3.89 times, and the slow gait speed was 8.47 times higher in iNPH patients than in controls after adjusting for age, sex, and the other confounders. The Mini-Mental State Examination score (p= 0.042, OR= 0.869 with 95% CI:0.759–0.995) was associated with probable sarcopenia among patients with iNPH. Conclusion: This study demonstrated that sarcopenia was common in older patients with iNPH, which seems to be closely associated with decreased muscle strength and slowed gait speed. Thus, considering the potential untoward effects of both diseases, it is important for physicians to evaluate sarcopenia routinely in the follow-up and treatment of older patients with iNPH.

Aim: This study aimed to determine the possible interrelationships between sarcopenia and Alzheimer’s disease (AD). Background: Sarcopenia and AD are two common geriatric syndromes; however, the relationship between AD and sarcopenia has not been evaluated in detail so far. Objective: The objective is to evaluate the relationship between AD and sarcopenia. Methods: This cross-sectional study was performed retrospectively on 128 patients with probable AD, with a mean age of 76.56±7.54 years. Comprehensive Geriatric Assessment, including the activities of daily living (ADLs), malnutrition, frailty, mini-mental state examination (MMSE), and orthostatic hypotension was performed. Sarcopenia was defined according to the revised EWGSOP-2 criteria. Results: The frequency of probable sarcopenia and definitive sarcopenia was 54.7% and 18.7%, respectively. AD patients with probable sarcopenia had lower MMSE and ADLs scores and were frailer. Clinical dementia rating (CDR) score, MMSE, and basic and instrumental ADLs were independently related to probable sarcopenia in the patients (p=0.003, p<0.001, p=0.001, and p=0.001, respectively). The prevalence of probable sarcopenia in those with CDR 2 was higher than in those with CDR 0.5 and 1 (p=0.002). Conclusion: Our findings suggest that probable sarcopenia seems to be related to worse MMSE and ADLs scores and frailty in patients with AD and seems to be related to the severity of AD. Considering adverse health outcomes and the burden of sarcopenia on the patients and their caregivers, optimal care and treatment of sarcopenia in patients with AD are of great importance.

ABSTRACTObjectiveSarcopenia is a geriatric syndrome characterized by age-related reduction in muscle mass and strength. Assessment of handgrip strength (HGS) is an essential measurement for the diagnosis of sarcopenia; however, disorders affecting upper limb muscles and joints may pose challenges in assessing handgrip strength. Therefore, the present study aimed to show the validity of plantar flexion strength (PFS) in diagnosing probable sarcopenia and investigating the relations between comprehensive geriatric assessment (CGA) and PFS while determining appropriate cutoff values for PFS.MethodsA total of 304 older participans who underwent CGA were included. The revised criteria of the European Working Group on Sarcopenia in Older People (EWGSOP) were used to determine PFS cutoff values for gender groups. Associations between probable sarcopenia and CGA parameters were investigated using PFS cutoffs.ResultsThe mean age was 74.50 ± 7.10, and 170 of the participants (55.9%) were women. The mean HGS was 14.40 ± 5.63 kg in women and 25.08 ± 8.07 kg in men. The mean PFS were 13.17 ± 3.62 and 14.92 ± 3.86 kg respectively. In females, PFS cutoff with sensitivity/specificity; 0.81/0.60 was set at 14.95 kg (AUC 0.69, 95%CI: 0.611–0.772, p < 0.001). In males, PFS cutoff with sensitivity/specificity; 0.80/0.55 was set at 16.80 kg (AUC 0.68, 95%CI: 0.593–0.772, p < 0.001). Probable sarcopenia identified by GMS was associated with basic living activities, mobility, and frailty after adjusting for age and sex (p < 0.001, p = 0.021, and p = 0.011 respectively).ConclusionsProbable sarcopenia identified by PFS could be associated with CGA. PFS may be useful for evaluating probable sarcopenia in older adults whose HGS cannot be estimated accurately.

Background: Despite differences between the studies regarding methods for estimating low muscle mass, the European Working Group on Sarcopenia in Older People (EWGSOP) recommends use of two standard deviations (SDs) below the reference sex-specific means of healthy young adults. Aims: The aim of this study was to determine the cutoff points of skeletal muscle mass index (SMI) and handgrip strength (HS) in Turkish population and to compare the power of different cutoff points to predict comprehensive geriatric assessment (CGA) parameters. Methods: Two hundred and eight young healthy volunteers (104 women, 104 men) were included in the study to define SMI, HS cutoff values. 1150 older adults (784 women, 366 men) underwent CGA, including physical performance, activities of daily living (ADL), HS and frailty. Body composition was obtained from every participant by bioimpedance analysis (BIA). CGA parameters of sarcopenic patients according to EWGSOP and new Turkish cutoff points were compared. Results: SMI cutoff points were defined 5.70 kg/m2for women, 8.33 kg/m2for men. HS thresholds were calculated as 14 kg for women, 28 kg for men using measurements of healthy young adult reference. Considering the new threshold values, the prevalence of sarcopenia was 10% (7% women, 17% men). When new sarcopenia criteria were applied and covariates were adjusted, sarcopenia was found to be more closely related to ADL impairment, balance, frailty in men, and balance, slow walking speed, ADL impairment, frailty in women (p&lt; 0.05). Discussion: Muscle mass and strength may vary between populations because of ethnicity and other related discrepancies. The evaluation of sarcopenia according to the present guidelines may cause overdiagnosis in some populations. Conclusion: Cutoff points specific to populations should be determined.

The prevalence of malnutrition among older adults is increasing, leading to poor health outcomes and increased mortality. This review sheds light on the different etiologies of eating disturbances in the elderly and discusses assessment tools and treatment strategies. Older adults are found to be more prone to nutritional deficiencies and weight loss due to age related physiological and psychosocial changes, in addition to pathological medical and psychiatric disorders. The short form of the Mini Nutritional Assessment is considered the most commonly used screening tool in older persons. Individuals identified as malnourished or at high risk of malnutrition would benefit from comprehensive treatment plans according to the underlying etiology. Those involve environmental changes, oral nutritional supplements and ultimately pharmacotherapy.

Bovine serum albumin is the key protein in blood. Chitin is a widely used biocompatible polymer in bioengineering and it is mainly found as two allomorphs (α, β). In this study the interactions of α-chitin (from the insect Omophlus sp.) and β-chitin (from the cuttlebone of Sepia sp.) with BSA were studied. Chitin isolates were examined by SEM, XRD, BET, TGA and FTIR. β-Chitin exhibited a far higher affinity for BSA than α-chitin, indicating α-chitin can be used in applications where surface–protein interactions should be limited, and β-chitin can be used in chitin-based materials on which protein adsorption is desired. [ABSTRACT FROM AUTHOR]

A 67-year-old man developed macular edema in the left eye as a result of branch retinal vein occlusion. An intravitreal dexamethasone implant (Ozurdex) was injected. Despite macular edema regression 4 weeks later, the corrected distance visual acuity decreased from 0.3 decimal to 0.1 decimal. Anterior segment examination showed the dexamethasone implant was inadvertently injected into the crystalline lens. Although only 1 injection was given, 2 dexamethasone implants were observed, 1 located in the posterior pole of the lens and the other in the anterior vitreous. The intraocular pressure (IOP) was 60 mm Hg. Phacoemulsification surgery was performed. Because of the high IOP, both implants were removed. A 3-piece hydrophobic acrylic intraocular lens was implanted in the ciliary sulcus. At the 3-month follow-up, the visual acuity was 0.6 decimal as a result of the macular complications associated with vein occlusion, the IOP was 18 mm Hg under glaucoma medication, and no complication was observed.

The world population is aging due to increasing life expectancy. The rate of drug use increases, and inappropriate prescribing is frequently encountered with advancing age. In addition, misuse and abuse of prescription drugs is a serious problem in older adults. It is challenging to detect substance and drug abuse in older patients because it may have fewer consequences in social, legal, and occupational fields. However, there is not enough information about the screening, evaluation, diagnosis, and treatment of abuse. Therefore, the awareness of health care professionals and others involved in older patients’ care should be raised about the misuse and abuse of drugs.