MALNUTRITION AND MALNUTRITION RISK CAN BE ASSOCIATED WITH SYSTOLIC ORTHOSTATIC HYPOTENSION IN OLDER ADULTS

Background: Malnutrition and orthostatic hypotension(OH) are the two important geriatric syndromes, which have similar negative outcomes such as falls. The aim of the study is to detect whether there is any relation between malnutrition and OH. Methods: 862 geriatric patients, who had undergone comprehensive geriatric assessment (CGA), were included in the retrospective study. OH was identified as 20 and/or 10 mmHg dropped for systolic and/or diastolic blood pressures with the active standing test when patients got up from supine to standing position. Nutritional status was checked according to Mini Nutritional Assesment-Short Form(MNA-SF). Results: The mean age of the patients was 74 +/- 8.05, and %66.3 of them were female. The prevalence of malnutrition, malnutrition-risk and OH were detected as 7.7%, 26.9% and 21.2%, respectively. When OH, systolic OH, diastolic OH and control group were compared with CGA parameters and the effects of age and gender were removed, the frequency of falls and Timed-Up and Go Test were higher, activity daily living indexes and TINETTI-Balance scores were lower in systolic OH than without it (p0.05). OH was only higher in malnutrition-risk group than robust (p<0.05). Conclusion: Our findings suggest that not only malnutrition but also malnutrition-risk may be associated with systolic OH, which leads to many negative outcomes in older adults. Because malnutrition/malnutrition risk is preventable and reversible, nutritional status should be checked during the evaluation of OH patients

Cognitive and Metabolic Outcomes of Vildagliptin Addition to the Therapy in Patients with Type 2 Diabetes Mellitus: 26 Week Follow-up Study

Aims: Type 2 Diabetes Mellitus(DM) is a well-known risk factor for cognitive impairment. Recent evidences suggest that Dipeptidyl peptidase-4(DPP-4) inhibitors might have neuroprotective effects. Therefore, this study aimed to investigate vildagliptin, a DPP-4 inhibitor, effects on cognitive function in older patients with DM. Materials and Methods: A retrospective longitudinal clinical trial was carried out on total 130 subjects with type 2 DM. Patients underwent comprehensive geriatric assessment twice within six months interval. The patients were divided into three groups according to antidiabetic treatment: untreated control group (patients achieve individual goal HbA1c without antidiabetic medication), vildagliptin(+) group(patients using vildagliptin alone or combination) and the vildagliptin(–) group. Results: The mean age was 75.72 ± 7.46 years. The control group was older, of a lighter weight and also had a higher female gender ratio(p ≤ 0.01). When sex, age, educational level and metabolic profile were adjusted, there was only change in copying subdomain of Mini Mental State Examination between vildagliptin(+) and other groups at the end of 6 months. Vildagliptin also resulted in reduction of HbA1c and weight(p<0.05). Conclusion: The addition of vildagliptin to treatment improved the copying subdomain of cognitive function and metabolic control of the older patients with type 2 DM within 6 months

Malnutrition and Malnutrition Risk Can Be Associated with Systolic Orthostatic Hypotension in Older Adults

Background: Malnutrition and orthostatic hypotension(OH) are the two important geriatric syndromes, which have similar negative outcomes such as falls. The aim of the study is to detect whether there is any relation between malnutrition and OH. Methods: 862 geriatric patients, who had undergone comprehensive geriatric assessment (CGA), were included in the retrospective study. OH was identified as 20 and/or 10 mmHg dropped for systolic and/or diastolic blood pressures with the active standing test when patients got up from supine to standing position. Nutritional status was checked according to Mini Nutritional Assesment-Short Form(MNA-SF). Results: The mean age of the patients was 74 +/- 8.05, and %66.3 of them were female. The prevalence of malnutrition, malnutrition-risk and OH were detected as 7.7%, 26.9% and 21.2%, respectively. When OH, systolic OH, diastolic OH and control group were compared with CGA parameters and the effects of age and gender were removed, the frequency of falls and Timed-Up and Go Test were higher, activity daily living indexes and TINETTI-Balance scores were lower in systolic OH than without it (p0.05). OH was only higher in malnutrition-risk group than robust (p<0.05). Conclusion: Our findings suggest that not only malnutrition but also malnutrition-risk may be associated with systolic OH, which leads to many negative outcomes in older adults. Because malnutrition/malnutrition risk is preventable and reversible, nutritional status should be checked during the evaluation of OH patients