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Background Dysphagia is a geriatric syndrome. Changes in the whole body that occur with aging also affect swallowing functions and cause presbyphagia. This condition may progress to oropharyngeal and/or esophageal dysphagia in the presence of secondary causes that increase in incidence with aging. However, no study has been published that provides recommendations for use in clinical practice that addresses in detail all aspects of the management of dysphagia in geriatric individuals. This study aimed to answer almost all potential questions and problems in the management of geriatric dysphagia in clinical practice. Methods A multidisciplinary team created this recommendation guide using the seven-step and three-round modified Delphi method via e-mail. The study included 39 experts from 29 centers in 14 cities. Results Based on the 5W and 1H method, we developed 216 detailed recommendations for older adults from the perspective of different disciplines dealing with older people. Conclusion This consensus-based recommendation is a useful guide to address practical clinical questions in the diagnosis, rehabilitation, and follow-up for the management of geriatric dysphagia and also contains detailed commentary on these issues.

Background and Objectives: Age-related declines in taste function are common. Taste acuity can be affected by nutritional status and sleep quality. This research aims to examine the effect of nutritional status and sleep quality on gustatory function in community-dwelling older adults. Materials and Methods: This cross-sectional study included 119 community-dwelling older adults (50.4% of whom were female). The gustatory function was evaluated using four liquid taste solutions (sweet, bitter, sour, and salty) each at four different concentrations and the Mini Nutritional Assessment (MNA) and Pittsburgh Sleep Quality Index (PSQI) was applied. Additionally, anthropometric measurements were taken. Results: The mean scores on the gustatory test for the sweet, bitter, sour, and salty tastes were 2.11 ± 1.27, 2.12 ± 1.03, 2.28 ± 1.03, and 1.98 ± 1.41, respectively. There were significant differences according to gender, polypharmacy, nutritional status, and sleep quality in identifying sweet tastes (all p < 0.05). It was also found that females and participants without polypharmacy had better scores for bitter tastes. When the gustatory functions were evaluated according to BMI classification, it was determined that underweight participants had a higher sour taste score than the obese ones. Multiple regression analysis revealed that age, MNA score, PSQI score, and gender accounted for a total of 20.4% of the variance in the sweet taste score. Conclusions: Determining the relationship between taste function, nutritional status, and sleep quality in older adults is important in terms of developing new strategies for older adults who have these problems.

Background: Hyperkyphosis is a frequent problem in older adults. Depressed mood and decreased quality of life are supposed to be related to age-related hyperkyphosis. This study aimed to explain the relation between depression, quality of life, and hyperkyphosis in old patients. Methods: 142 patients who applied to the outpatient clinic of geriatrics were enrolled in this cross-sectional study. Mean age of participants was 72. Hyperkyphosis was evaluated by the bloc method defined in the Rancho Bernardo Study (1). Depression was evaluated by the Short form of Yesavage Geriatric Depression Scale (GDS). Quality of life was assessed by the 3-level version of EQ-5D. Results: Hyperkyphosis was found to be positively related to depression (P=0.037), negatively related to the QOL (p

Aim:Malnutrition is a geriatric syndrome that should not be ignored considering its negative consequences in older adults. There are many factors that affect nutritional status. We aimed to determine the factors related to malnutrition in the elderly in this study.Materials and Methods:This cross-sectional study included 356 elderly outpatients admitted to a geriatric outpatient clinic. Comprehensive geriatric assessments were performed and factors related to nutritional status were assessed. The Mini Nutritional Assessment Tool (MNA) and the Global Leadership Initiative on Malnutrition (GLIM) criteria were used to screen and diagnose malnutrition.Results:The participants had a mean age of 72.2±6.5 years. Of the participants, 93 (26.1%) were considered malnourished according to the GLIM criteria. Malnourished participants had poorer quality of life, physical functioning, sleep quality, and higher depressive and anxiety symptoms. MNA scores were positively correlated with quality of life scores (r=0.355, p=0.000) and negatively correlated with depressive and anxiety symptoms scores (r=-0.346, p=0.000, and r=-0.301, p=0.000, respectively). Age and higher depressive symptom scores were found to be independent variables for malnutrition [p=0.026, Odds ratio (OR): 1.07 and p=0.045, OR: 1.07, respectively].Conclusion:This study has shown that malnourished older adults are more likely to have impaired functional status, depressive and anxiety symptoms, poorer quality of life and sleep quality. Depressive symptoms and age have been found to increase the risk of malnutrition. Comprehensive geriatric assessment should be performed in all older adults to avoid undesirable consequences.

Purpose: There are few studies comparing the effectiveness of anti-osteoporotic drugs among elderly population. In this study, we aimed to compare the effectiveness of alendronate, zoledronic acid, and denosumab in older adults. Materials and Methods: A total of 350 older adults with osteoporosis, aged 65 and over were included in this retrospective study. The number of patients receiving alendronate, zoledronic acid, and denosumab was 111, 121, and 118, respectively. Bone mineral density (BMD) was measured at baseline and 24th month by performing dual-energy x-ray absorptiometry (DXA) scans. Results: The age, comorbidities, and laboratory analysis results of the patients were similar. While there was no statistically significant difference in BMD response at the femoral neck between the treatment groups (Baseline BMDs for alendronate, zoledronic acid, and denosumab were 0.61, 0.59, and 0.58, respectively, while 24th month BMDs were 0.62, 0.60, and 0.59, respectively), alendronate and zoledronic acid improved lumbar spine BMD more than denosumab (Baseline BMDs for alendronate, zoledronic acid, and denosumab were 0.74, 0.74, and 0.71, respectively, while 24th month BMDs were 0.77, 0.78, and 0.73). Conclusion: This study has shown that, like parenteral antiresorptive agents, alendronate can elicit a desirable BMD response in older osteoporotic adults. The results of our study may guide osteoporosis treatment in older individuals.

ABSTRACT. Alzheimer's disease (AD) is the most common cause of dementia in the elderly. Although AD treatment is still insufficient despite all the recent developments, detection and treatment in the early stage of disease have provided more clinical benefits. Objective: In this study, we aimed to use the critical flicker fusion (CFF) threshold test to diagnose AD in the early stage. Methods: In this study, 120 patients (above 65 years of age) and 50 control groups who were admitted to geriatrics outpatient clinic and diagnosed in early- and middle-stage AD were included. The remaining 58 patients and 25 healthy volunteers underwent comprehensive geriatric assessment and CFF testing. Results: The mean CFF value of AD group was significantly lower than the control group (36.44±7.00 vs. 44.24±3.82, p0.05). The cutoff value for the CFF variable was determined as 39 Hz [p

Background: It has been suggested that curcumin may be useful in diseases with cognitive dysfunction because it slows the progression and leads to the improvement of cognitive functions. In this study, the protective effects of curcumin on scopolamine-induced rat models of cognitive impairment were evaluated. Methods: 21 male Wistar Albino rats, 1 year old, 200±25 grams, were included in the study. They were divided into three groups (n: 7 in each group); the untreated control group, scopolamine group, and the group treated with curcumin and then exposed to scopolamine. Animals were evaluated for behavioral tasks with the Morris Water Maze test. Interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), total oxidative status (TOS), and total antioxidative status (TAS) were measured in hippocampal tissues. CRP levels were measured in serum specimens. Results: We found that the length to reach the platform was the highest in the scopolamine group, and the lowest in the curcumin group (p

Background and Objectives: Type 2 diabetes is one of the common chronic diseases in the elderly. It is thought that long-term complications of type 2 diabetes will negatively affect the quality of life in elderly individuals. It is possible that geriatric syndromes, especially frailty syndrome, are associated with diabetic complications, too. In this study, we aimed to evaluate the effect of macrovascular and microvascular complications of type 2 diabetes on frailty and other geriatric syndromes. In addition, the effect of these complications on quality of life was also reviewed. Materials and Methods: We conducted a cross-sectional study for four months. Comprehensive geriatric assessment tests were done on all patients. The Fried frailty index (FFI) was used for the evaluation of frailty syndrome. We assessed malnutrition by mini nutritional assessment short-form (MNA-SF), and Global Leadership Initiative on Malnutrition criteria (GLIM). The EWGSOP 2 criteria were used for the diagnosis of sarcopenia. Quality of life (QoL) was evaluated using the short form-36 (SF-36) questionnaire. Data analysis was done by SPSS version 22. Results: 237 females and 142 males with a mean age of 71.7 ± 6.1 years were included in the study. The frequency of macrovascular and microvascular complications was 41.4% and 68.1%, respectively. Frailty was found to be associated with macrovascular complications (p = 0.003). Handgrip strength, skeletal muscle mass index, and gait speed were decreased in the presence of macrovascular complications (p = 0.043, p < 0.001, p < 0.001). QoL was also decreased in patients with macrovascular complications (p = 0.003). Nutritional status and handgrip strength were negatively affected in patients with diabetic neuropathy (p = 0.019, p = 0.014). Polypharmacy was also found to be associated with macrovascular complications (p < 0.001, p < 0.001). Macrovascular complications were 2.5 times more common in malnourished patients according to GLIM and 3.2 times more common in patients with decreased gait speed. Conclusion: In this study, we observed that both macrovascular and microvascular complications of diabetes increase susceptibility to geriatric syndromes in elderly individuals. It could be useful to conduct prospective studies in which we can compare the effectiveness of treatment methods on this subject.

(1) Background: The COVID-19 pandemic has changed the living conditions of many people. Many people felt significantly constrained. However, for individuals who are both parents and healthcare professionals, the situation seems more troubling in other ways. (2) Objectives: Based on this, we planned a study evaluating demographic characteristics, COVID-19-related anxiety levels, and parenting-related stress levels of the health care professionals who were working in the University Hospital. We also evaluated the parameters that affect COVID-19-related anxiety and parenting stress. (3) Methods: The level of COVID-19-related anxiety is assessed by the coronavirus anxiety scale. The parenting stress index-short form is used for evaluation of parenting stress. Statistical analysis was done by SPSS version 22. (4) Results: Female gender, working as a nurse, a history of COVID-19, and having a child attending daycare were parameters that increased the level of COVID-19-related anxiety. Occupation, being a parent of a schoolchild and/or primary school child, being a parent of a child receiving face-to-face education, and having more than two children were found to be risk factors for parenting stress. Clinically significant parenting stress was found to increase threefold in healthcare workers with more than two children (R2 = 0.101, p = 0.039). (5) Conclusions: Healthcare professionals, who are also parents, play a huge role both at home and in the hospital in the pandemic. Therefore, it is inevitable that their stress and anxiety levels increase. It is important to determine the factors that cause stress and anxiety and to take measures in this direction to get through this process well.

Non-alcoholic fatty liver disease (NAFLD) is the leading cause of liver disease in the Western world and is closely associated with metabolic syndrome, which includes hypertension, central obesity, dyslipidemia and insulin resistance. NAFLD includes a wide spectrum of liver alterations, ranging from simple hepatic steatosis to variable degrees of fibrosis, cirrhosis and even hepatocellular carcinoma. Although the etiology and progression of the disorder remain poorly understood, insulin resistance is considered to play a pivotal role in the pathogenesis. Insulin sensitizers such as biguanides, thiazolidinediones (TZDs), glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase 4 inhibitors have been studied as therapeutic approaches for NAFLD in recent years. Metformin improves insulin sensitivity and serum alanine transaminase and aspartate transaminase (ALT/AST) levels in the majority of subjects; however, it has no significant effect on liver histology. TZDs improve insulin sensitivity, serum ALT/AST levels and histology in some cases, but there are some concerns about the safety of long-term therapy. Selection of appropriate patients for avoiding side effects and the treatment of underlying disease are the main points. These drugs are the best choice for the treatment of NAFLD in patients with type 2 DM who are also candidates for treatment with an insulin sensitizer. The present review provides an overview of insulin sensitizers in the treatment of NAFLD.