MANAGEMENT OF SYNCOPE IN THE ELDERLY

WOS: 000282657400012Syncope in elderly patients is a clinical syndrome frequently observed both in emergency rooms and outpatient clinics and it may cause mortality depending on the etiology. The main pathology at the background is global cerebral hypoperfusion. Although syncope may be seen at all age groups, it is more common in older ages. Age-associated changes in various physiological parameters contribute to development of syncope in the elderly and the underlying etiology determines its prognosis. Among the many types of syncope in the elderly, cardiac syncope is the primary syndrome resulting in increased mortality. Therefore, identification of the etiology is very important in the management of syncope. When detailed anamnesis, physical examination and EKG are inadequate for the diagnosis of an elderly syncope patient, further invasive or noninvasive examination should be performed. In the case of syncope related to neural pathways, nonpharmacological approaches are preferred. Physicians should evaluate all the medications the patient is using and the withdrawal or reduction of culprit medication should be considered. Patients must be informed about the reasons and triggers of syncope. Patients with cardiac syncope require specific treatment and an implantable cardiac defibrillator (ICD) may be life saving for appropriate indications. Syncope in the elderly is an important geriatric syndrome that requires comprehensive assessment, rapid diagnosis and treatment

Translation, Cross-cultural Adaptation, and Psychometric Properties of the Turkish Version of the Self-care Ability Scale for the Elderly

Purpose: The Self-care Ability Scale for the Elderly (SASE) is a frequently used scale that was created in Sweden according to Orem's self-care deficit theory and later modified according to Porn's theory of environment and purpose. This study translated and cross-culturally adapted the Turkish version of the SASE (T-SASE) and demonstrated its psychometric properties, including its reliability and construct validity. Methods: This study recruited a total of 122 participants and applied international guidelines for the translation and adaptation of the scale. The test-retest reliability of the SASE was calculated at 1-week intervals. Internal consistency was analyzed using Cronbach's alpha. For construct validity, we compared the T-SASE to the Nottingham Extended Activities of Daily Living Scale (NEADLS) and the Exercise of Self-Care Agency Scale (ESCAS). Results: The mean age of the participants was 68.6 +/- 5.7 years. The test-retest reliability of the T-SASE was excellent (intraclass correlation coefficient=0.914; 95% confidence interval, 0.81-0.95). The internal consistency of the total T-SASE score was also excellent (Cronbach's alpha=0.912), as were the Cronbach's alpha scores for the individual items, ranging from 0.901 to 0.915. The items were also highly consistent with each other (Cronbach's alpha>0.80). The construct validity of the T-SASE was acceptable (0.35<r<0.50) in a convergent manner. The T-SASE was also strongly correlated with the NEADLS and ESCAS (r(1)=0.405, r(2)=0.437, p<0.01). Conclusions: The T-SASE was a reliable and valid tool for assessing the self-care ability of community-dwelling older adults. Owing to its multidimensional structure, the T-SASE is an essential tool for evaluating self-care in older adults

The test-retest reliability and concurrent validity of the 3-m backward walk test and 50-ft walk test in community-dwelling older adults

Ozden, Fatih/0000-0001-6593-3758WOS:000628466300001PubMed: 33715071Background Three-meter backward walk test (3MBWT) and 50-ft walk test (50FWT) are frequent physical performance tests in clinical practice. Aims The aim of the study was to determine the test-retest reliability and concurrent validity of the 3MBWT and 50FWT in community-dwelling older adults. Methods A cross-sectional study was carried out with 65 participants. 3MBWT, 50FWT, Timed Up and Go Test (TUG), and Five Times Sit to Stand Test (FTST) were evaluated in the first assessment. The test-retest reliability was evaluated by performing two repetitions of the 3MBWT and 50FWT with 1-h interval. The test-retest reliability and validity were assessed by the intraclass correlation coefficient (ICC) and the Spearman correlation coefficient, respectively. Results The mean age of the participants was 68.9 +/- 3.7 years. The ICC score of 3MBWT and 50FWT were 0.940 and 0.820, respectively. The test-retest reliability of both tests was excellent (> 0.80). Both the test and retest assessment of the 3MBWT were strongly correlated with TUG (r(test) = 0.649, r(retest) = 0.645, p 0.05). 50FWT (retest) were weakly correlated with FTST (r = 0.260, p < 0.05). Both the test and retest assessments of the 50FWT was strongly correlated with TUG (r(test) = 0.550, r(retest) = 0.596, p < 0.01). Conclusions The 3MBWT and 50FWT are valid and reliable performance tests in community-dwelling older adults. MDC value of both tests provides an essential contribution to clinical practice

THE PREDICTORS OF THE PULMONARY FUNCTION IN COMMUNITY-DWELLING OLDER ADULTS

Purpose: The aim of the study was to observe the relationship between age, body mass index (BMI), physical activity, and kyphosis angle parameters with respiratory function capacity in community-dwelling older adults and to determine the main predictor. Methods: A prospective cross-sectional study was carried out with 70 older adults. Physical activity level was questioned with the Physical Activity Scale for Elderly (PASE). Thoracic kyphosis degrees were measured with a digital inclinometer. Pulmonary Function Test (PFT) was used to measure pulmonary function capacity. The correlation between age, BMI, PASE, thoracic kyphosis angle with parameters of PFT measurement was analyzed. In addition, a linear multivariate regression model was built to determine the main predictor. Results: The mean age of the participants was 69.88 +/- 4.52 years. There was a low degree but a statistically significant positive correlation between BMI and FEV1 (r=0.258, p<0.05). BMI was also associated with FEV1/FVC (r=0.338, p<0.001). PASE was related with FVC, FEV1 and PEF (r1=0.241, p<0.05; r2=0.281, p<0.05;r3=0.317,p<0.001). In the multivariate linear regression model, higher levels of PASE score were associated with higher levels of FVC (standardized 11=0.25, p<0.05). The high PASE score was associated with a high FEV1 score (standardized 11=0.30, p<0.05). BMI was the main predictor of FEV1/FVC (standardized 11=0.34, p<0.001). Besides, PASE was the main predictor of PEF (standardized 11=0.32, p<0.001). Conclusion: According to the results of the study, greater levels of physical activity and body mass index were associated with greater levels of pulmonary function capacity. Physical activity level was the main predictor for all pulmonary function parameters except FEV1/FVC.Ege University Scientific Research Projects Coordination Unit [TGA-2019-20857]The authors would like to thank Ege University Scientific Research Projects Coordination Unit for their financial support to this project (TGA-2019-20857)

The Impact of the Otago Exercise Program on Frailty and Empowerment in Older Nursing Home Residents: A Randomized Controlled Trial

Background: This study assessed the impact of Otago exercises on frailty and empowerment in older nursing home residents. Methods: This randomized controlled trial included 72 individuals aged over 65 years residing in a single nursing home in Izmir, Turkey. The participants were randomly assigned to the Otago exercise group (OEG) or control group (CG). The OEG performed Otago exercises for 45 minutes, 3 days per week for 12 weeks plus a walking program the 3 other days of the week. In addition to Otago exercise training, the OEG received training based on empowerment consisting of 10 sessions lasting 30 minutes each. The CG received no intervention except routine care in the nursing home. The data collected were sociodemographic characteristics, Edmonton Frail Scale (EFS) scores, and Elderly Empowerment Scale (EES) scores before and 3 months after the intervention. Results: We observed significant differences between the mean EFS (p=0.0001) and mean EES (p=0.0001) before and 3 months after the intervention in the OEG compared to the CG. We also observed a significant difference between the OEG and CG in mean EFS (p=0.018) and EES (p=0.0001) 3 months after the intervention. Conclusion: The results of the present study demonstrated the positive impact of the Otago exercise program on preventing/delaying frailty and enhancing empowerment in older people

Adaptation of Diabetic Empowerment Scale-Short Form to Older Individuals and to Turkish Language: Validity and Reliability Study

WOS: 000542299000005PubMed: 32612417Objective: the empowerment of old people is important in order for them to gain control over their own lives and to raise their quality of life. the purpose of this study was to adapt the Diabetes Empowerment Scale-Short Form (DES-SF) to old people and to the Turkish language, and to determine its validity and reliability. Materials and Methods: This methodological type study was conducted between 1 January and 30 March 2017 with 106 old people fitting the criteria of acceptance in the study who attended the geriatrics clinic of a university hospital. in determining validity, language equivalence, content, and predictive validity were used, while reliability was tested with temporal invariance, Cronbach's alpha coefficient, and item total correlation. We examined its reliability and validity via item analyses, content validity (expert panel), confirmatory factor analyses, and construct validity (exploratory factor analyses). Results: the Cronbach's alpha of the scale was 0.883. the scale items were grouped under a single factor in accordance with the original. Confirmatory and exploratory factor analysis showed good fit signs. Conclusion: After conducting validity and reliability testing on the adaptation of the Diabetic Empowerment Scale-Short Form to old people and the Turkish language, it is was concluded that it is a reliable scale to determine the empowerment levels of old people. Based on the statistical analyses applied to evaluate the validity and reliability of the scale obtained by adapting the DES-SF to old people, it was inferred that it is an instrument with high validity and reliability. the scale is a short and practical instrument to evaluate the empowerment levels of old people. the new name of the scale is the elderly empowerment scale

Factors Determining Mortality in Geriatric Palliative Care Patients

WOS: 000533539600005Background: As life expectancy at birth increases, the elderly population is growing, both in Turkey and globally. the aim of this study was to investigate the factors associated with 12-month mortality in patients receiving geriatric palliative care. Methods: Geriatric inpatients who were treated for 48 hours or more in the palliative care unit of our hospital between January 2016 and January 2017 were included in the study. Results: A total of 233 geriatric palliative care patients (50.6% women) with a mean age of 77.6 +/- 11.0 were included in the study. Eighty of the patients in our study died while in palliative care. Chronic kidney disease (CKD) and chronic obstructive pulmonary disease (COPD) were significantly more common among the deceased patients. of the 153 surviving patients, 94 (61.4%) died within 12 months of discharge and 59 (38.6%) survived beyond 12 months. Presence of CKD was associated with a 2.17-fold reduction in survival time and albumin level 20.5, 1.60-fold shorter with Charlson Comorbidity Index (CCI) > 6.5, and 1.98-fold shorter with albumin levels < 3.2 mg/L. Conclusion: CKD and low albumin were identified as independent risk factors for reduced hospital survival time. Independent risk factors for shorter post-discharge survival time included the presence of solid organ malignancy, high APACHE-II score, high CCI, and low albumin level. Copyright (C) 2020, Taiwan Society of Geriatric Emergency & Critical Care Medicine