2020-01-01T00:00:00Z, SOYSAL, PINAR, Arik, Ferhat, Smith, Lee, Jackson, Sarah E., IŞIK, AHMET TURAN, SOYSAL, PINAR

Chronic inflammation, which is called -inflamm-aging-, is characterized by an increased level of inflammatory cytokines in response to physiological and environmental stressors, and causes the immune system to function consistently at a low level, even though it is not effective. Possible causes of inflammaging include genetic susceptibility, visceral obesity, changes in gut microbiota and permeability, chronic infections and cellular senescence. Inflammation has a role in the development of many age-related diseases, such as frailty. Low grade chronic inflammation can also increase the risk of atherosclerosis and insulin resistance which are the leading mechanisms in the development of cardiovascular diseases (CVD). As it is well known that the risk of CVD is higher in older people with frailty and the risk of frailty is higher in patients with CVD, there may be relationship between inflammation and the development of CVD and frailty. Therefore, this important issue will be discussed in this chapter.

2019-05-01, VERONESE, N, SALLER, A, INCALZI, RA, PUNZI, L, STUBBS, B, Soysal, PINAR, MAGGI, S, SOYSAL, PINAR

2021-04-05T00:00:00Z, Ontan, Mehmet Selman, Dokuzlar, Ozge, Ates Bulut, Esra, Soysal, PINAR, Isik, Ahmet Turan, SOYSAL, PINAR

2020-03-01T00:00:00Z, Büyükaydın, Banu, Yabacı, Ayşegül, Kiremitçi, Sercan, Soysal, Pınar, Biberci Keskin, Elmas, Şentürk, Hakan, BİBERCİ KESKİN, ELMAS, BÜYÜKAYDIN, BANU, SOYSAL, PINAR, YABACI TAK, AYŞEGÜL, ŞENTÜRK, HAKAN

AimThe aim of this study was to investigate the impact of obesity on acute pancreatitis outcomes in older patients.FindingsObesity in older patients with acute pancreatitis was not associated with worse outcomes, including in-hospital mortality, long-term mortality, and recurrence.MessageThe impact of obesity in older people with acute pancreatitis may not be as deleterious as seen in younger patients.AbstractPurposeAlthough obesity is an established risk factor for a number of diseases, several epidemiological studies have demonstrated that older obese patients have better survival rates than non-obese old patients in various disease states. In this context, the relationship between obesity and acute pancreatitis outcome in older patients is controversial. Therefore, the authors aimed to investigate the impact of obesity on acute pancreatitis outcomes in older patients.MethodsPatients aged > 65years who had been hospitalized for acute pancreatitis were retrospectively analyzed. Among them, 190 patients were included. The median age was 73 (68–79) years, and 118 (62.1%) were women. Obesity was assessed according to body mass index, and patients were classified as either obese or non-obese. The primary endpoint of the study was in-hospital major adverse events (major in-hospital complications and death). The secondary endpoints were acute pancreatitis recurrence, 30-day all-cause mortality, and long-term all-cause mortality.ResultsA total of 77 (40.5%) patients were obese. In-hospital major adverse events were observed in 40 (21.1%) patients. There was no statistical difference in major in-hospital adverse events between the two groups (27 [23.9%] in non-obese patients vs. 13 [16.9%] in obese patients,p = 0.24). Further, the 30-day mortality, long-term survival, and acute pancreatitis recurrence rates were similar (allp > 0.05). The median follow-up time was 18 (0–80) months.ConclusionObesity does not result in higher mortality or complications in older patients with acute pancreatitis. Although the underlying mechanism needs to be elucidated, the deleterious effect of obesity seems to be diminished in older patients.

2019-11-07, Veronese, Nicola, Smith, Lee, Torbahn, Gabriel, Jackson, Sarah E., Yang, Lin, SOYSAL, PINAR, Rivasi, Giulia, Rafanelli, Martina, Petrovic, Mirko, Maggi, Stefania, Isik, Ahmet Turan, Demurtas, Jacopo, SOYSAL, PINAR

Purpose Orthostatic hypotension (OH) is associated with older age and many negative clinical outcomes in geriatric practice. We aimed to capture the breadth of outcomes that have been associated with the presence of OH and systematically assess the quality, strength and credibility of these associations using an umbrella review with integrated meta-analyses. Methods We systematically searched several major databases from their commencements through to 16th May 2019 for meta-analyses of observational studies of OH and any health-related outcome. We used these metrics to categorize the strength of evidence of significant outcomes (p < 0.05) from class I (convincing) to class IV (weak), according to the pre-established criteria. Results From 975 abstracts, seven meta-analyses of 12 outcomes were included. For each outcome, the median number of studies was four, and the median number of participants was 46,493, with a median of 3630 incident cases. There was suggestive (class III) evidence that OH was associated with significantly higher risk of coronary heart disease (HR = 1.32, 95% CI 1.12-1.56), stroke (HR = 1.22, 95% CI 1.08-1.38), congestive heart failure (HR = 1.30, 95% CI 1.09-1.55), all-cause mortality (RR = 1.50, 95% CI 1.24-1.81), falls (OR = 1.84, 95% CI 1.39-2.44), and dementia (HR = 1.22, 95% CI 1.11-1.35). Conclusion The current evidence base indicates that OH is significantly associated with a range of adverse cardiovascular, cognitive, and mortality outcomes in older people, although the strength of this evidence remains only suggestive. Further research in larger samples and with lower risk of bias is required to build a fuller picture of the impact of OH on health.

2016-12-01T00:00:00Z, Soysal, PINAR, Isik, Ahmet Turan, Stubbs, Brendon, Solmi, Marco, Volpe, Marco, Luchini, Claudio, D'Onofrio, Grazia, Pilotto, Alberto, Manzato, Enzo, Sergi, Giuseppe, Schofield, Patricia, Veronese, Nicola, SOYSAL, PINAR

We conducted a systematic review and meta-analysis investigating the influence of acetylcholinesterase inhibitors (AChEIs) therapy on nutritional status and weight across observational and interventional studies. Two authors searched major electronic databases from inception until 10/14/2015 for longitudinal, open-label and randomised double-blind placebo controlled (randomised controlled trials (RCTs)) studies of AChEIs in patients with dementia reporting nutritional status outcome data. Out of 3551 initial hits, 25 studies (12 open-label trials, 9 RCTs and 4 longitudinal studies) including 10 792 patients with dementia were metaanalysed. In longitudinal studies (median follow-up 6 months), a significant cumulative incidence of weight loss between baseline and follow-up evaluation was observed (studies= 2; 5%; 95% CI 1% to 34%, p< 0.0001; I2= 95%). These findings were confirmed in open-label trials (6%; 95% CI 4% to 7%, p< 0.0001; I-2= 78%). In 9 RCTs (median followup 5 months), those taking AChEIs more frequently experienced weight loss than participants taking placebo (OR= 2.18; 95% CI 1.50 to 3.17, p< 0.0001; I-2= 29%). AChEIs therapy contributes to weight loss in patients with dementia, with a 2-fold increased risk observed in the meta-analysis of RCTs. Clinicians should carefully consider the benefit and risk of prescribing AChEIs. Nutritional status should be routinely evaluated in patients with dementia treated with AChEIs.

2020-01-02T04:00:00Z, Bulut, Esra Ates, SOYSAL, PINAR, Dokuzlar, Ozge, Kocyigit, Suleyman Emre, Aydin, Ali Ekrem, Yavuz, Idil, IŞIK, AHMET TURAN, SOYSAL, PINAR

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/m(2) for women, 8.33 kg/m(2) for 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 < 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.

2021-09-27T00:00:00Z, Tan, Semen Gokce, Soysal, PINAR, SOYSAL, PINAR

2016-04-01T00:00:00Z, Kaya, Derya, Isik, Ahmet Turan, Usarel, Cansu, Soysal, PINAR, Ellidokuz, Hulya, Grossberg, George T., SOYSAL, PINAR

Introduction: Presence of detailed screening instruments to detect cognitive impairment in the older adults- culture and language is very essential. The Saint Louis University Mental Status Examination (SLUMS) is one of cognitive screening scales used. The aim of the study was to establish the validity and reliability of the Turkish version of SLUMS (SLUMS-T).

2020-10-01T00:00:00Z, Demurtas, Jacopo, Schoene, Daniel, Torbahn, Gabriel, Marengoni, Alessandra, Grande, Giulia, Zou, Liye, Petrovic, Mirko, Maggi, Stefania, Cesari, Matteo, Lamb, Sarah, Soysal, Pınar, Kemmler, Wolfgang, Sieber, Cornel, Mueller, Christoph, Shenkin, Susan D., Schwingshackl, Lukas, Smith, Lee, Veronese, Nicola, SOYSAL, PINAR

Objectives: The aim of this umbrella review was to determine the effect of physical activity/exercise on improving cognitive and noncognitive outcomes in people with MCI (mild cognitive impairment) and dementia.