Person: SOYSAL, PINAR
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Publication Metadata only Inflammation, Frailty and Cardiovascular Disease(2020-01-01T00:00:00Z) SOYSAL, PINAR; Arik, Ferhat; Smith, Lee; Jackson, Sarah E.; IŞIK, AHMET TURAN; SOYSAL, PINARChronic 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.Publication Open Access Association between physical multimorbidity and sleep problems in 46 low-and middle-income countries(2022-06-01T00:00:00Z) Smith, Lee; Il Shin, Jae; Jacob, Louis; Schuch, Felipe; Oh, Hans; Tully, Mark A.; Lopez Sanchez, Guillermo F.; Veronese, Nicola; SOYSAL, PINAR; Yang, Lin; Butler, Laurie; Barnett, Yvonne; Koyanagi, Ai; SOYSAL, PINARBackground: Little is known about the association between multimorbidity (i.e., two or more chronic conditions) and sleep problems in the general adult populations of low- and middle-income countries (LMICs). Thus, we aimed to assess this association among adults from 46 LMICs, and to quantify the extent to which anxiety, depression, stress, and pain explain this association. Methods: Cross-sectional, predominantly nationally representative, community-based data from the World Health Survey were analyzed. Nine chronic physical conditions (angina, arthritis, asthma, chronic back pain, diabetes, edentulism, hearing problems, tuberculosis, visual impairment) were assessed. To be included in the analysis, sleep problems had to have been experienced in the past 30 days and to have been severe or extreme; they included difficulties falling asleep, waking up frequently during the night or waking up too early in the morning. Multivariable logistic regression and mediation analyses were conducted to explore the associations. Results: Data on 237,023 individuals aged ≥18 years [mean (SD) age 38.4 (16.0) years; 49.2% men] were analyzed. Compared with no chronic conditions, having 1, 2, 3, and ≥4 conditions was associated with 2.39 (95%CI=2.14, 2.66), 4.13 (95%CI=3.62, 4.71), 5.70 (95%CI=4.86, 6.69), and 9.99 (95%CI=8.18, 12.19) times higher odds for sleep problems. Pain (24.0%) explained the largest proportion of the association between multimorbidity and sleep problems, followed by anxiety (21.0%), depression (11.2%), and stress (10.4%). Conclusions: Multimorbidity was associated with a substantially increased odds for sleep problems in adults from 46 LMICs. Future studies should assess whether addressing factors such as pain, anxiety, depression,Publication Metadata only Physical multimorbidity and incident urinary incontinence among community-dwelling adults aged ≥50 years: findings from a prospective analysis of the Irish Longitudinal Study on Ageing.(2021-07-17T00:00:00Z) Smith, Lee; Shin, Jae Il; Ghayda, Ramy Abou; Hijaz, Adonis; Sheyn, David; Pope, Rachel; Hong, Sun Hwi; Kim, Sung Eun; Ilie, Petre Cristian; Carrie, Anne Marie; Ippoliti, Simona; Soysal, PINAR; Barnett, Yvonne; Pizzol, Damiano; Koyanagi, Ai; SOYSAL, PINARPublication Open Access An umbrella review of systematic reviews with meta-analyses evaluating positive and negative outcomes of hydroxychloroquine and chloroquine therapy.(2020-12-11T00:00:00Z) Celotto, Stefano; Veronese, Nicola; Barbagallo, Mario; Ometto, Francesca; Smith, Lee; Pardhan, Shahina; Barnett, Yvonne; Ilie, Petre Cristian; Soysal, PINAR; Lagolio, Erik; Kurotschka, Peter Konstantin; Tonelli, Roberto; Demurtas, Jacopo; SOYSAL, PINARBackground & aims: Hydroxychloroquine (HCQ) and chloroquine (CQ) are anti-malarial drugs frequently used in the rheumatologic field. They were recently identified as potential therapeutic options for Coronavirus Disease (COVID-19). The present study aims to map and grade the diverse health outcomes associated with HCQ/CQ using an umbrella review approach. Methods: Umbrella review of systematic reviews of observational and intervention studies. For observational studies, random-effects summary effect size, 95% confidence interval, and 95% prediction interval were estimated. We also assessed heterogeneity, evidence for small-study effect, and evidence for excess significance bias. The quality of evidence was then graded using validated criteria from highly convincing to weak. The evidence from randomized controlled trials (RCTs) was graded using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) tool. Results: From 313 articles returned in the literature search, six meta-analyses were included (n = 25 outcomes). Among meta-analyses (MAs) of observational studies, HCQ/CQ are weakly associated with a reduced risk for cardiovascular events and diabetes when used for autoimmune diseases and with spontaneous abortion; they are also associated with a higher risk of death in COVID-19 patients. Among MAs of RCTs, HCQ/CQ are associated with an improvement of articular manifestations of rheumatic diseases. Conclusions: There is high evidence of the efficacy of HCQ/CQ in the rheumatologic field. The lack of evidence for efficacy and the risk of death associated with the use of HCQ/CQ for COVID-19 indicate the inappropriateness of their inclusion in recent COVID-19 therapy guidelines and the urgent need for RCTs to determine eventual appropriateness as a COVID-19 therapy. Keywords: COVID-19; Chloroquine; Hydroxychloroquine; umbrella review.Publication Metadata only Body mass index categories and anxiety symptoms among adults aged ≥ 50 years from low and middle income countries.(2021-10-18T00:00:00Z) Smith, Lee; Pizzol, Damiano; López-Sánchez, Guillermo F; Oh, Hans; Jacob, Louis; Yang, Lin; Veronese, Nicola; Soysal, PINAR; McDermott, Daragh; Barnett, Yvonne; Butler, Laurie; Koyanagi, Ai; SOYSAL, PINARPublication Open Access STEM CELLS FOR TREATMENT OF CARDIOVASCULAR DISEASES: AN UMBRELLA REVIEW OF RANDOMIZED CONTROLLED TRIALS.(2021-01-09T00:00:00Z) Demurtas, Jacopo; Fanelli, Giuseppe Nicolò; Romano, Simone Lorenzo; Solari, Marco; Yang, Lin; Soysal, Pınar; Sánchez, Guillermo F López; Grabovac, Igor; Smith, Lee; Zorzi, Alessandro; Luchini, Claudio; Veronese, Nicola; SOYSAL, PINARAIMS Stem cells are a promising therapy for various medical conditions. The literature regarding their adoption for the clinical care of cardiovascular diseases (CVD) is still conflicting. Therefore, our aim is to assess the strength and credibility of the evidence on clinical outcomes and application of stem cells derived from systematic reviews and meta-analyses of intervention studies in CVD. METHODS and RESULTS Umbrella review of systematic reviews with meta-analyses of randomized controlled trials (RCTs) using placebo/no intervention as control group. For meta-analyses of RCTs, outcomes with a random-effect p-value< 0.05, the GRADE (Grading of Recommendations Assessment, Development and Evaluation) assessment was used, classifying the evidence from very low to high. From 184 abstracts initially identified, 11 meta-analyses (for a total of 34 outcomes) were included. Half of the outcomes were statistically significant (p < 0.05), indicating that stem cells are more useful than placebo. High certainty of evidence supports the associations of the use of stem cells with a better left ventricular end systolic volume and left ventricular ejection fraction (LVEF) in acute myocardial infarction; improved exercise time in refractory angina; a significant lower risk of amputation rate in critical limb ischemia; a higher successful rate in complete healing in case of lower extremities ulcer; and better values of LVEF in systolic heart failure, as compared to placebo. CONCLUSION and RELEVANCE The adoption of stem cells in clinical practice is supported by a high certainty of strength in different CVD, with the highest strength in acute myocardial infarction and refractory angina.Publication Metadata only Excessive daytime sleepiness is associated with an increased frequency of falls and sarcopenia.(2021-04-20T00:00:00Z) Soysal, PINAR; Smith, Lee; Tan, Semen Gokce; Capar, Emre; Veronese, Nicola; Yang, Lin; SOYSAL, PINARPublication Metadata only Anxiety symptoms among informal caregivers in 47 low- and middle-income countries: a cross-sectional analysis of community-based surveys.(2021-11-14T00:00:00Z) Smith, Lee; Shin, Jae Il; Oh, Hans; López Sánchez, Guillermo F; Underwood, Benjamin; Jacob, Louis; Veronese, Nicola; Soysal, PINAR; Butler, Laurie; Barnett, Yvonne; Tully, Mark A; Koyanagi, Ai; SOYSAL, PINARPublication Metadata only The development of a short depression screening tool in older adults.(2022-05-07T00:00:00Z) Soysal, PINAR; Smith, Lee; SOYSAL, PINARPublication Metadata only Body Mass Index and Mild Cognitive Impairment Among Middle-Aged and Older Adults from Low- and Middle-Income Countries.(2021-12-10T00:00:00Z) Smith, Lee; Shin, Jae Il; Oh, Hans; Carmichael, Christina; Jacob, Louis; Stefanac, Sinisa; Lindsay, Rosie K; Soysal, PINAR; Veronese, Nicola; Tully, Mark A; Butler, Laurie; Barnett, Yvonne; Koyanagi, Ai; SOYSAL, PINARBackground: The effect of weight modification on future dementia risk is currently a subject of debate and may be modified by age. Objective: The aim of the present study was to investigate the association between body mass index (BMI) status with mild cognitive impairment (MCI) (a preclinical stage of dementia) in middle-aged and older adults residing in six low- and middle-income countries using nationally representative data. Methods: Cross-sectional data from the Study on Global Ageing and Adult Health (SAGE) were analyzed. MCI was defined using the National Institute on Aging-Alzheimer's Association criteria. BMI (kg/m2) was based on measured weight and height and categorized as: underweight (<18.5), normal (18.5-24.9), overweight (25.0-29.9), and obese (≥30.0). Multivariable logistic regression analysis and meta-analysis were conducted to assess associations. Results: Data on 32,715 individuals aged ≥50 years with preservation in functional abilities were analyzed [mean (SD) age 62.1 (15.6) years; 51.7% females]. Among those aged 50-64 years, compared to normal weight, underweight (OR = 1.44; 95% CI = 1.14-1.81), overweight (OR = 1.17; 95% CI = 1.002-1.37), and obesity (OR = 1.46; 95% CI = 1.09-1.94) were all significantly associated with higher odds for MCI. In those aged ≥65 years, underweight (OR = 0.71; 95% CI = 0.54-0.95) and overweight (OR = 0.72; 95% CI = 0.55-0.94) were associated with significantly lower odds for MCI, while obesity was not significantly associated with MCI. Conclusion: The results of the study suggest that the association between BMI and MCI is likely moderated by age. Future longitudinal studies are required to confirm or refute the present findings before recommendations for policy and practice can be made.