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Inflammation, Frailty and Cardiovascular Disease
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.
Validation of population-based cutoffs for low muscle mass and strength in a population of Turkish elderly adults
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.
Challenges experienced by elderly people in nursing homes due to the coronavirus disease 2019 pandemic
Objectively measured far vision impairment and sarcopenia among adults aged ≥ 65 years from six low- and middle-income countries.
Comment on -Association between habitual coffee consumption and skeletal muscle mass in middle-aged and older Japanese people-.
Physical Activity and Exercise in Mild Cognitive Impairment and Dementia: An Umbrella Review of Intervention and Observational Studies
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.
Anticholinergic Burden and Increased Excessıve Daytime Sleepiness in Older Women.
The relationship between osteoporosis and sarcopenia, according to EWGSOP-2 criteria, in outpatient elderly.
The impact of obesity on acute pancreatitis outcomes in older patients
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.
Willingness to work with elderly people scale for medical and nursing students: cross cultural adaptation and psychometric validation
The number of older people is increasing globally, particularly in middle-income countries like Turkey. The psychometric properties of the Turkish version of the Willingness to Work with Elderly People Scale (WEPS-T) was evaluated in this study. A descriptive, methodological and cross-sectional design was used. The data were collected using a sociodemographic form and WEPS-T during April to June 2021. The language and content validity, explanatory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to assess the validity of the scale. The scale’s reliability was obtained using Cronbach’s alpha coefficient, item-total correlations, and test-retest reliability. Content validity index of WEPS-T was excellent (CVI was 1.00). All the factor loadings were found to be > .30 in factors analysis. In CFA, it was inferred that the model had a good fit (×2/df = 5.344; GFI = .864; CFI = .868; RMSEA = .079; RMR <.01). A Cronbach’s alpha value was obtained 0.881 for the entire scale. The test-retest reliability scores of the first sub-dimension were r = .84 and p < .001, the second r = .97 and p < .001, the third r = .98 and p < .001, the fourth r. = .95 and p < .001 and the total score was r = .96 and p < .001. WEPS-T is a valid and reliable measurement tool that determines the willingness of Turkish nursing and medical students to work with the older people.