Prevalence of Potentially Inappropriate Medication and Frailty: A Comparison of Three Criteria in Older Turkish Adults

Objective: The aim of this study is to determine the prevalence of potentially inappropriate medication (PIM) use in older Turkish adults on the basis of three criteria as well as to investigate its relationship with frailty. Materials and Methods: This cross-sectional study was conducted in an outpatient clinic. The Turkish Inappropriate Med- ication Use in the Elderly (TIME), Beers 2019, and Screening Tool of Older Person’s Prescriptions Version 2 (STOPPv2) criteria were used to detect PIM. Frailty was determined using the Fried Frailty Index categorized as 0 points, non-frail; 1, pre-frail; and ≥2, frail. Results: Of the 382 patients, 179 (46.9%) were identified with at least one PIM according to the three sets of criteria. The prevalence rates of PIM based on the TIME, Beers 2019, and STOPPv2 criteria were 46.1%, 30.6%, and 26.2%, respec- tively. No association was found between PIM and frailty (p=0.593 for the TIME criteria, 0.562 for the Beers 2019 criteria, and 0.524 for the STOPPv2 criteria). The risk of PIM presence was higher when the TIME criteria were applied than when the other criteria were used (odds ratio [OR]: Beers 2019 vs. TIME, 0.5231 and STOPPv2 vs. TIME, 0.4072; p<0.001 for all). The number of prescribed medications and older age were associated with the use of any PIM (ORs, 1.3143 and 1.0301, respectively). Conclusion: The TIME criteria showed the highest PIM frequency in older Turkish adults and had moderate-to-significant concordance with non-country-specific criteria. Further studies are needed to evaluate the relationship between frailty and PI

Depression in Frail Older Adults: Associations and Gender Difference

OBJECTIVE. Depression is highly prevalent in frail older adults and both clinical situations share similar clinical and prognostic factors. The aim of this study was to investigate the relationship between frailty and depression by considering each component of frailty, in both genders

Falls in Older Women and Men: Associated Factors and Sarcopenia

Objective: Falls are the fifth leading cause of death among the older adults, and most of the risk factors of falls are modifiable. We aimed to investigate the clinical factors associated with falls comprehensively, by evaluating the sarcopenia components separately, in each gender. Materials and Methods: This is a cross-sectional study. Six hundred thirty-three female and 269 male outpatients, underwent a comprehensive geriatric assessment, were included. Falls, in the previous 12 months, were recorded. Geriatric evaluation regarding frailty, depression, nutrition, cognitive functions, and disabilities were done with related scales. SARC-F determined sarcopenia risk, and probable sarcopenia was defined according to handgrip strength. Skeletal muscle mass index and muscle performance were measured by bioimpedance analysis and physical performance tests, including 4-meter gait speed (4-m GS) and timed up and go (TUG) tests, respectively. Results: In the study population 35.2% of female and 30.9% of male patients experienced falls. In multivariate analysis, probable sarcopenia in women [odds ratio (OR): 1.56, p=0.034] and longer TUG test performance in men (OR: 1.06, p=0.020) were independently related to falls. In addition, both in women and men urinary incontinence (OR: 1.62, p=0.016 and OR: 1.95, p=0.045, respectively), sarcopenia risk defined by SARC-F (OR: 2.74, p≤0.001 and OR:4.79, p≤0.001, respectively) and depression (OR: 1.56, p=0.025 and OR: 1.93, p=0.046, respectively) were independently related with falls. Conclusion: Depression, incontinence, and sarcopenia risk were independent associated factors for falls in both genders. SARC-F appears to be effective in both genders in predicting the risk of falls. However, muscle strength in women and muscle performance in men get high impact for the falls

Revisiting the former approach: Low-dose dopamine in kidney transplant recipients

Objective: We aim to evaluate the effects of low-dose dopamine (LDD) infusion (0.5 - 2.5 g/kg/m) on hemodynamic status and short-term graft function in kidney transplant recipients. Materials and Methods: Patients who underwent kidney transplantation surgery between January 2007 and December 2016 were included in the study. Demographic and laboratory data, presence of delayed graft function, and the rates of rejection, graft loss, and mortality were recorded. The data were compared between patients with and without LDD treatment. Results: A total of 126 patients were included in the study (M/F:50.8%/49.2%; mean age, 38.94 +/- 11.8 years). Ninety-four patients (74.6%) received living-donor transplants. Fifty-seven patients underwent LDD infusion in the postoperative period (LDD group), while 69 patients did not receive LDD infusion. Demographic and laboratory data of the patients did not significantly differ between groups. Nineteen patients in the LDD group experienced delayed graft function (p=0.039). However, these patients tended to be older, have a longer dialysis period prior to transplantation, deceased and hypertensive donors. There was no significant difference in renal function at 6 months after transplantation between groups. Conclusion: Although, LDD infusion increases kidney blood flow, we observed no significant effects on short-term graft function or patient survival between the LDD and non-LDD groups