FACTORS RELATED TO FALLS AND THE FEAR OF FALLING AMONG ELDERLY PATIENTS ADMITTED TO THE EMERGENCY DEPARTMENT

Savas, Sumru/0000-0003-4836-3786WOS:000505782900010Introduction: This study was conducted to investigate the fear of falling and admissions related to falls, also the associated factors with each of them among elderly patients who are admitted to the emergency department. Materials and Method: The population of this study consisted of patients aged 65 years and over who were admitted to the emergency department in August 2015. The measurement tool included questions regarding outcomes, functional state, sociodemographic data, balance and walking problems, and admissions to the emergency department due to falls within the past year which was filled by a trained interviewer via semi-structured interviews with the patients and/or their relatives. The logistic regression was applied for the analysis. Results: of the 555 patients who were included in the study, 12.6% were admitted because of falls. Admissions due to falls were associated with admissions to the emergency department over the past year due to falls, living in nursing homes, and fear of falling. The fear of falling was shown in 22.2% of the study group, and it was found to be associated with female sex, marital status, falling status, and better functional state. Conclusion: There was a significant relationship between falls and the fear of falling among older patients admitted to the emergency department. There is need for further prospective studies to better understand the effect of fear of falling on falls

Determination of Adiponectin, Tumor Necrosis Factor-Alpha, and Adhesion Molecules in Alzheimer's Disease

WOS: 000485683300010Objective: Though the data regarding the mechanisms behind neurodegeneration in addition to amyloid plaques and neurofibrillary tangles are not clear, there are emerging data for inflammation and microvascular changes to have contribution to the pathology of Alzheimer's disease (AD). The relationships between numerous biomarkers also need to be investigated. This study aimed to assess inflammatory marker tumor necrosis factor-alpha (TNF-alpha), adiponectin (a modulator of anti-inflammation), and potential microvascular markers for AD including both intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) in Turkish patients with AD and healthy elderly subjects, and the relationships among the variables in patients with AD. Materials and Methods: In this study, 46 patients with AD and 30 cognitively healthy controls over 60 years of age from the outpatient clinics of Ege University were included. Adiponectin, ICAM-1, VCAM-1, and TNF-alpha were evaluated by enzyme-linked immunosorbent assays. Results: The median adiponectin level in the AD group was higher than in the controls (p=0.002). Median VCAM-1, ICAM-1, and TNF-alpha values for patients with AD and the controls were similar. There were positive correlations between VCAM-1 and both TNF-alpha and adiponectin in the patients with AD (r=0.540, p<0.001, and r=0.301, p=0.044, respectively). Conclusion: Though a dramatic rise of adiponectin, and associations of VCAM-1 and both TNF-alpha and adiponectin in subjects with AD were shown, the clinical significances of these peripheral measurements need to be further investigated

Platelet function and insulin resistance in aged and middle-aged obese female patients

It is well known that obesity is associated with insulin resistance (IR), and IR may interact with platelet functions. Aging is also associated with (IR) and enhanced platelet aggregation (PA). Though platelet reactivity has been investigated in female individuals, to date there is insufficient data on PA in obese and elderly women for whom the physiological changes associated with aging may overlap the factors associated with obesity. Therefore we investigated PA and IR in obese aged and middle-aged female subjects. Thirty obese elderly women over 60 years of age and 30 middle-aged obese women under the age of 50 years with nonspecific complaints were enrolled in the study from internal medicine outpatient clinic. Anthropometric measurements, fasting blood glucose and insulin levels, and PA tests for collagen, epinephrine, adenosine diphosphate were evaluated. Obesity was defined as body mass index (BMI) &gt;30 kg/m2. Homeostasis model assessment of IR (HOMA-IR) index was calculated to estimate IR. PA tests were performed with a PA profiler. Mean age of the elderly and middle-aged women were = 69.6 ± 9.5 years and 38.6 ± 10.5 years, respectively. Waist circumference and BMI were similar between two groups. Mean HOMA-IR index value and PA with epinephrine was higher in the elderly than the control group (P = 0.04; P = 0.01, respectively). There was a positive correlation between HOMA-IR and PA with epinephrine in the elderly. Insulin resistance and platelet function test for epinephrine increased with advancing age in obese women. Large-scaled studies are needed in this area. [Med-Science 2018; 7(4.000): 813-6

Relationship between 25-hydroxyvitamin D Level and Metabolic Control and Albumin Excretion Rate in Elderly Patients with Type 2 Diabetes Mellitus

The aims of the study were 1. to investigate the frequency of 25-hydroxyvitamin D deficiency and 2. to observe the relationships between D vitamin supplementation for 6 months and albumin excretion in elderly patients with type 2 diabetes mellitus. The study population included 100 patients with type 2 DM treated with insulin therapy (mean age 56.1±8.8 yrs) were enrolled in the study. Of 100 patients, 30 (mean age 65.4±6.4 yrs) had low 25(OH)D level. Patients with low 25(OH)D level received 50,000 unit of vitamin D3 orally per three weeks for 6 months. Albumin excretion rate (AER) was measured in patients with low level 25(OH) D before and after D vitamin supplementation In study group (n= 100), 30 patients had low 25(OH)D level. Concentrations of 25(OH)D were; 10 (33.3%) had insufficient vitamin D levels, 19 (63.4%) had deficient levels, 1 (3.3%) had severe deficiency in patients with deficiency. There were statistically significantly differences for plasma levels of HbA1c (p=0.001), postprandial glucose (p=0.0001), triglyceride (p=0.04), total-Cholesterol (p=0.03), LDL-Cholesterol (p=0.02), and HDL-Cholesterol (p=0.001) between D vitamin supplementation. There were high frequency of 25(OH)D deficiency in patients with type 2 diabetic patients. And also, D vitamin suplementation changed metabolic parameters such as triglyceride, total-Cholesterol, LDL-Cholesterol and HDL-Cholesterol, postprandial glucose and HbA1c levels but not albumin excretion rate. [Med-Science 2013; 2(4.000): 852-62

Predictability of Metabolic Syndrome Diagnosed by Body Mass Index for Cardiovascular Risk in Older Patients Treated with Levothyroxine

Background: We investigated the prevalence and metabolic features of two definitions of metabolic syndrome (MS) between older patients with chronic thyroiditis treated with levothyroxine (LT4) and controls. We also assessed the ability of both criteria to predict cardiovascular (CV) risk. Methods: This cross-sectional, retrospective study included individuals aged >= 60 years who attended a geriatric outpatient clinic between January 2015 and December 2018. The LT4 treatment group was classified as having high or low CV risk based on the Framingham score. Results: This study enrolled 111 patients with chronic thyroiditis treated with LT4 and 131 patients without thyroid disease as the control group. The prevalence of MS according to the World Health Organization (WHO) criteria and American Association of Clinical (AACE) criteria was similar in the LT4 treatment (21.6% and 26.1%, respectively) and the control (30.5% and 34.4%, respectively) groups (p>0.05). While the prevalence of MS and CV risk did not differ significantly between the control and LT4 treatment groups, the prevalence of MS with both definitions was higher among individuals with high CV risk in the LT4 treatment group (p0.05). For the prediction of CV risk, the sensitivity and specificity of the AACE criteria were higher than those of the WHO criteria in the LT4 treatment group. Conclusions: The prevalence of MS in euthyroid patients treated with LT4 was similar to that of patients without thyroid disease. When the LT4 treatment group was classified based on CV risk, MS was more common in those with a high CV risk

The impact of the COVID-19 pandemic on well-being of seniors attending online programs at University of the Third Age: a follow-up study

Background Reports on psychological effects of quarantine during past outbreaks and pandemics showed that quarantined people were more likely to experience psychological problems than those who were not. It was also shown that there was an increase in anxiety, depression, and stress in all age groups during the COVID-19 pandemic. So, we investigated emotional states and quality of life as components of general well-being in older participants of University of the Third Age (U3A) attending online programs during the second year of the pandemic, and compared them with the pre-pandemic COVID-19 period. Methods This study was conducted among 27 participants of a U3A program. Data on sociodemographics, Charlson comorbidity index, the Geriatric Depression Scale Short Form (GDS-SF), The Geriatric Anxiety Scale (GAS), and Turkish version of World Health Organization Quality of Life Instrument Older Adults Module (WHOQOL-OLD) were taken in September 2019 and September 2021. Results The median age of the participants was 68 (60-75) years (81.5% female). In the COVID-19 pandemic period; 'Death and dying' (except for 'Fear of pain before death' score), 'Intimacy' domain, and 'Social participation' domain scores of WHOQOL-OLD decreased compared to the pre-pandemic period (P < 0.001, P = 0.011, and P < 0.001, respectively) whereas the scores for GAS and GDS-SF were higher (P < 0.001 and P = 0.011). The reason for the decrease in 'Social participation' domain scores was the decrease in 'Satisfaction with opportunity to participate in community'. There was no significant difference in 'Autonomy' domain of WHOQOL-OLD (P = 0.598). Conclusion Although there was no change in 'Autonomy' domain among the participants of U3A before and during the pandemic period, anxiety and depression scores were higher in the second year of the COVID pandemic. Only a decrease in satisfaction with opportunity to participate in community might have significant impact on social participation

The Relationship of Balance Disorders with Falling, the Effect of Health Problems, and Social Life on Postural Balance in the Elderly Living in a District in Turkey

WOS: 000474247100005PubMed ID: 31108836The aim of this study was to determine the prevalence of balance disorders; the effects of sociodemographic, medical, and social conditions on postural balance; and the relationship between balance and falls in elderly individuals. The study design was cross-sectional. A total of 607 community-dwelling elderly individuals with a mean age of 73.99 +/- 6.6 years were enrolled after being selected by stratified random sampling. The study was performed as a face-to-face survey in the homes of elderly individuals. Sociodemographic and medical data were obtained from elderly individuals using the Elderly Identification Form. Balance disorders were determined using the Berg Balance Scale (BBS). In this study, the prevalence of balance disorders was found to be 34.3% in the community-dwelling elderly. Older age, physical disability, having four or more chronic illnesses, the presence of incontinence, having a history of falls, not walking regularly, absence of free time activity, and obesity were found to be associated with an increased prevalence of balance disorders. Balance disorders are commonly seen in the elderly and may be triggered by a variety of biological and social factors. It is crucial to develop and implement national health and social policies to eliminate the causes of this problem, as well as to prioritize preventive health services in the ever-increasing elderly population.Ege University Medical Faculty Scientific Research Projects CommissionEge University [2016 TIP-031]This research was funded by Ege University Medical Faculty Scientific Research Projects Commission (protocol number 2016 TIP-031)