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Background/aim: Türkiye is a country with an increasing life expectancy and an older adult population in parallel with the rest of the world. Several national small-scale studies were performed regarding the prevalence and characteristics of dementia in Türkiye, and the results of these studies differ from each other. We aimed to determine the prevalence of dementia in Türkiye to present the demographic characteristics, the frequency of use of health services, and the management of dementia. Materials and methods: Patients aged 65 years and over with a diagnosis of any type of dementia between January 1, 2019, and December 31, 2020, were retrospectively screened from the electronic health records of the Ministry of Health using ICD-10 codes. Results: In 2019, the total number of dementia cases identified in individuals aged 65 years and older was 247,727, of whom 150,529 (60.8%) were women. In 2020, the total number of dementia cases identified in this age group was 233,949, with 142,878 (61.1%) of these cases being women. The rate of patients admitted to the emergency department was 72.3% and 66.2% of all dementia patients in 2019 and 2020, respectively. In terms of the use of outpatient clinics, most patients with dementia were admitted to neurology (71.0% in 2019 and 62.4% in 2020). The geriatric medicine outpatient clinic was the least used by patients with dementia both in 2019 and 2020. Conclusion: The prevalence of patients living with dementia in Türkiye is lower than the global average. This suggests that most dementia cases are overlooked, highlighting the need to raise dementia awareness both in the community and among primary health care providers who frequently encounter older individuals. The study is significant in that it is the first to show the nationwide frequency of dementia in Türkiye. [ABSTRACT FROM AUTHOR]

Objective: Polypharmacy (PP) is associated with various adverse outcomes in older adults. Although few studies have shown an association between PP and orthostatic blood pressure changes (OBPCs), its relationship with orthostatic intolerance syndrome (OIS), which describes a group of signs and symptoms triggered by standing up straight with or without OBPCs, is not known. Therefore, we assessed the association between PP and OIS in the geriatric population. Materials and Methods: Ninety-nine geriatric outpatients were enrolled in the study. In addition to comprehensive geriatric assessment, frailty evaluation (modified fried frailty index), OBPC evaluations [active standing test (AST)], and OIS questioning both experienced in the last three months (self-reported OIS) and symptoms emerged during the AST were performed. PP was defined as using >4 drugs. Results: The participants' median age was 74 and ranged from 69.5 to 79.0 years, and 66.7% (n=66) of them were female. Patients were split into Non-OIS and OIS groups based on self-reported OIS, with 51 (51.5%) and 48 (48.5%) patients in each group, respectively. The frequency of PP was higher in the OIS group (p<0.05). In the regression analysis, OIS was significantly related to PP independent of age, sex, malnutrition, and frailty (odds ratio: 0.353, 95% confidence interval: 0.13-0.92, p=0.033). In addition, the number of drugs used was correlated with the total number of OIS symptoms (r=0.204, p=0.042). Conclusion: This is the first study to show the link between PP and OIS. Further research is required to verify our results. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the effect of the clinical frailty scale (CFS) and body mass index (BMI) on the 2-year mortality prediction in hospitalized internal medicine patients. Materials and Methods: A prospective observational study was conducted between January 2019 and February 2020. Subjects (18 years and older) admitted to the internal medicine wards and expected to stay for at least 72 h were included. Participants were evaluated within 48 h of admission. The Charlson comorbidity index (CCI) was calculated. Anthropometric measurements and handgrip strength were obtained within 48 h. CFS was used for frailty assessment. Cox regression analysis was performed for mortality analysis. Results: One hundred eighteen patients were included. Fifty-eight of the (49.2%) patients were 65 years and over. In multivariate analysis, BMI and CFS were independently associated with 2-year mortality, regardless of age, sex, and CCI. Hazard ratios for BMI and CFS were 0.898 [95% confidence interval (CI), 0.840-0.961; p=0.002] and 1.313 (95% CI, 1.002-1.719; p=0.048), respectively. Conclusion: Higher CFS scores and lower BMI scores are independently associated with 2-year mortality in hospitalized internal medicine patients. [ABSTRACT FROM AUTHOR]

Background: Changed body composition with increased fat content and decreased muscle mass is seen in renal transplantation recipients (RTRs). Increased fat mass might mask underlying muscle mass loss; measuring low body mass index and weight reduction alone may not be sensitive enough to diagnose malnutrition in RTRs. We aimed to determine the prevalence of malnutrition in stable RTRs using the Global Leadership Initiative on Malnutrition (GLIM) criteria and to assess the use of muscle ultrasonography (US) to compare the performance of various muscle US measurements in the diagnosis of reduced muscle mass. Methods: Ninety‐one patients who had renal transplantation >6 months ago were enrolled in the study. GLIM criteria were performed for all patients, but not those at risk of malnutrition. Bioelectrical impedance analysis and muscle US were performed to identify reduced muscle mass. Results: The prevalence of malnutrition according to GLIM criteria was 25.3% (n = 23). All muscle US measurements were lower in the malnourished group than the well‐nourished group; however, the malnourished group had substantially lower muscle thicknesses in abdominal muscles, specifically the external oblique (EO) and internal oblique (IO) muscles, than the well‐nourished group (P = 0.001 and P = 0.007, respectively). There was a significant association between malnutrition and EO (odds ratio [OR] = 0.338, 95% CI = 0.163–0.699; P = 0.003) and IO (OR = 0.620, 95% CI = 0.427–0.900; P = 0.012) regardless of age and sex. Conclusion: One in four RTRs experience malnutrition. Muscle US could be used effectively for the diagnosis of reduced muscle mass and malnutrition in RTRs according to GLIM criteria. [ABSTRACT FROM AUTHOR]

Objective: Mini Nutritional Assessment-Short Form is a malnutrition screening scale that evaluates the patient from different perspectives and is thought to be used in frailty screening. The present study aimed to evaluate the reliability of Mini Nutritional Assessment-Short Form for frailty screening by using 2 frailty scales. Methods: It was a cross-sectional study that included patients admitted to the geriatric medicine outpatient clinic of a university hospital. Mini Nutritional Assessment-Short Form was performed on all patients. The FRAIL Scale and Clinical Frailty Scale were used as reference frailty scales. Results: While 62.2% (n = 61) of the 98 participants were female, the median age was 72 (interquartile range: 10.0). The FRAIL Scale (Spearman rho: -0.64, P < .001) and Clinical Frailty Scale (Spearman rho: -0.55, P < .001) were both correlated inversely and moderately with Mini Nutritional Assessment-Short Form. For both frailty scales, Mini Nutritional Assessment-Short Form cut-off for frailty identification was 11 (for FRAIL Scale, sensitivity: 68.00%, specificity: 87.67%, area under the curve: 0.83, P < .001; for Clinical Frailty Scale, sensitivity: 76.47%, specificity: 83.95%, area under the curve: 0.84, P < .001), and the cut-off was 13 for robust and pre-frail/frail identification (for FRAIL Scale, sensitivity: 71.70%, specificity: 73.33%, area under the curve: 0.80, P < .001; for Clinical Frailty Scale, sensitivity: 71.74%, specificity: 67.31%, area under the curve: 0.74, P < .001). Conclusion: For quick evaluation of frailty and nutritional status concurrently, Mini Nutritional Assessment-Short Form may be an appropriate option. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to explore the effect of sarcopenia, malnutrition, and frailty screening tools on one-year mortality in hospitalized adult patients with coronavirus disease 2019 (COVID-19). Materials and Methods: Patients, 18 years of age, who were admitted to the COVID-19 clinic were enrolled in this prospective study. The clinical frailty scale (CFS) and SARC-F questionnaire were used for frailty and sarcopenia screening. Nutrition Risk Screening (NRS-2002) and Mini Nutritional Assessment-Short Form (MNA-SF) were performed to screen for malnutrition. The survival of all participants was investigated by using the Turkish national death registry. Multivariable logistic regression analyses were performed. Results: A total of 72 subjects were enrolled in this study. The rate of patients with sarcopenia risk, malnutrition risk (via MNA-SF), malnutrition risk (via NRS-2002), and living with frailty were 75%, 93.8%, 81.3%, and 50.0% in the deceased group, respectively. Conversely, the rates of patients with sarcopenia risk, malnutrition risk (via MNA-SF), malnutrition risk (via NRS-2002), and living with frailty were 23.2%, 71.4%, 60.7%, and 16.1% in the alive group, respectively. SARC-F score (OR 1.331, p=0.006), MNA-SF score (OR 1.695, p=0.002), NRS-2002 score (OR 1.580, p=0.024), and CFS (OR 1.639, p=0.009) score were independently associated with one-year mortality after adjusting for sex and age. Conclusion: MNA-SF, SARC-F, and CFS may be used for mortality risk estimation after discharge from the hospital who were admitted for acute disease. [ABSTRACT FROM AUTHOR]

Objective: Numerous easy-to-apply and reliable tools have been developed for frailty detection with realizing the obvious importance of it. We aimed to evaluate the reliability and validity of the PRISMA-7 questionnaire in the Turkish community-dwelling older population, incorporating the geriatrician perspective. Materials and Methods: Upon application of the exclusion criteria, a total of 97 older patients were enrolled. All participants underwent a comprehensive geriatric assessment. After the necessary permissions were obtained, the Turkish version of PRISMA-7 was properly translated into Turkish with a forward-backward translation approach. The adaptation was made complied with the guideline recommendations. A reference tool, the Turkish version of the clinical frailty scale (CFS), was used for validation. Results: Median (interquartile range) age of participants was 72 (10) years, and 61 (62.9%) were female. According to CFS, 17.5% (n=17) patients were in the frail group, and 82.4% (n=80) were in the Robust/Vulnerable group. When we evaluated the concordance of PRISMA-7 and CFS, there was a moderate concordance (Cohen's kappa: 0.589, p<0.001). At its optimal cut-off for differentiating frail from non-frail patients (≥3), the PRISMA-7 questionnaire had a sensitivity of 94.1% and a specificity of 82.5% (area under the curve: 0.956, p<0.001). For PRISMA-7 inter-rater and retest reliabilities, Cohen's kappas were 0.615, p=0.03 & 1.0, p<0.001, respectively. Conclusion: The Turkish version of PRISMA-7 is a valid and reliable frailty evaluation instrument for the Turkish geriatric population. [ABSTRACT FROM AUTHOR]

Background and Aims: This study aimed to investigate the potential role of shear‐wave elastography (SWE) in evaluating muscle quality and assess its association with muscle strength and mass. Methods: A total of 129 patients aged 18–87 years were included. Patients aged >65 years underwent comprehensive geriatric assessment. Anthropometric measurements, assessment of physical performance, muscle strength (handgrip strength [HGS]), muscle mass (B‐mode muscle ultrasonography), and muscle quality (identified via SWE) were performed for all patients. Results: The median (interquartile range) age of participants was 69 (59–76) years and 62% (n = 80) were female. According to HGS, patients were divided into normal and low HGS groups, and there were 85 (65.9%) and 44 (34.1%) patients in each group, respectively. The median average value of SWE measurement (Vmean) of the rectus femoris (RF) in passive stretching was significantly lower in the low HGS group. In regression analyses, Vmean was significantly associated with HGS independently of age, sex, and body mass index. Optimal cutoff values of the Vmean value (m/s) of RF in passive stretching for predicting low HGS were ≤2.62 for male (area under the curve [AUC], 0.882; 95% CI, 0.705–0.938; P = <0.0001), and ≤2.52 for female (AUC, 0.719; 95% CI, 0.605–0.833; P = 0.002). Conclusion: To the best of our knowledge, this is the first study revealing SWE is a good predictor of muscle strength, and it could be a useful tool for evaluating muscle quality in clinical practice. Further randomized controlled studies are needed to confirm the presented cutoff values. [ABSTRACT FROM AUTHOR]

Background: The aim of this study is to identify cutoff values for muscle ultrasound (US) to be used in Global Leadership Initiative on Malnutrition (GLIM) criteria, and to define the effect of reduced muscle mass assessment on malnutrition prevalence at hospital admission. Methods: A total of 118 inpatients were enrolled in this cross‐sectional study. Six different muscles were evaluated by US. Following defining thresholds for muscle US to predict low muscle mass measured by bioelectrical impedance analysis, malnutrition was diagnosed by GLIM criteria with seven approaches, including calf circumference, mid‐upper arm circumference (MAC), handgrip strength (HGS), skeletal muscle index (SMI), rectus femoris (RF) muscle thickness, and cross‐sectional area (CSA) in addition to without using the reduced muscle mass criterion. Results: The median age of patients was 64 (18–93) years, 55.9% were female. RF muscle thickness had moderate positive correlations with both HGS (r = 0.572) and SMI (r = 0.405). RF CSA had moderate correlation with HGS (r = 0.567) and low correlation with SMI (r = 0.389). The cutoff thresholds were 11.3 mm (area under the curve [AUC] = 0.835) and 17 mm (AUC = 0.737) for RF muscle thickness and 4 cm² (AUC = 0.937) and 7.2 cm² (AUC = 0.755) for RF CSA in females and males, respectively. Without using the reduced muscle mass criterion, malnutrition prevalence was 46.6%; otherwise, it ranged from 47.5% (using MAC) to 65.2% (using HGS). Conclusions: Muscle US may be used in GLIM criteria. However, muscle US needs a standard measurement technique and specific cutoff values in future studies. [ABSTRACT FROM AUTHOR]

Objective: Individuals who are clinically vulnerable and older are more susceptible to severe consequences, either directly from the coronavirus disease 2019 (COVID-19) infection or indirectly from the rigorous social isolation policies. Increased frailty, reduced quality of life, high level of stress, and increased depressive symptoms were observed during the social isolation period. Patients with dementia are more vulnerable to the direct and indirect effects of COVID-19. In this study, we have explored the impact of the COVID-19 pandemic on nutrition in patients with dementia who were followed up in our outpatient clinic. Methods: Patients with a diagnosis of dementia who were followed up in the geriatric outpatient clinic at our university hospital were included in the study. The risk of malnutrition was evaluated using the Mini-Nutritional Assessment-Short Form (MNASF). An MNA-SF score between 8 and 11 was defined as risk of malnutrition, and scores < 8 were accepted as malnutrition. A retrospective study was performed using the identified electronic records of 121 patients who were admitted to the hospital between March 11, 2020, and March 31, 2021. Results: The mean age of the study population was 80.12 ± 7.12 years, and 60.3% of the patients were female. The MNA-SF scores decreased and malnutrition prevalence increased as the dementia worsened, and the difference before and during the pandemic was statistically significant (P < .05). Conclusion: For patients living with dementia, COVID-19 restrictions, particularly those related to social isolation like social distancing and lockdowns, might not only have mental and cognitive implications but also disturb their already vulnerable nutritional status. [ABSTRACT FROM AUTHOR]

Background: A novel coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) occurred in China in December 2019 and has spread globally. In this study, we aimed to describe the clinical characteristics and outcomes of hospitalized older adults with coronavirus disease 2019 (COVID-19) in Turkey.Methods: We retrospectively analyzed the clinical data of hospitalized patients aged ≥ 60 years with confirmed COVID-19 from March 11, 2020 to May 27, 2020 using nationwide health database.Results: In this nationwide cohort, a total of 16,942 hospitalized older adults with COVID-19 were enrolled, of whom 8,635 (51%) were women. Mean age was 71.2 ± 8.5 years, ranging from 60 to 113 years. Mortality rate before and after curfew was statistically different (32.2% vs. 17.9%; p < .001, respectively). Through multivariate analysis of the causes of death in older patients, we found that male gender, diabetes mellitus, heart failure, dementia, were all significantly associated with mortality in entire cohort. In addition to abovementioned risk factors, in patients aged between 60 and 79 years, hypertension, chronic kidney disease and cancer and in patients 80 years of age and older malnutrition were also associated with increased risk of mortality.Conclusions: In addition to the results of previous studies with smaller sample size, our results confirmed the age-related relationship between specific comorbidities and COVID-19-related mortality. [ABSTRACT FROM AUTHOR]

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