Effect of age-related hyperkyphosis on depression and quality of life.

Background: Hyperkyphosis is a frequent problem in older adults. Depressed mood and decreased quality of life are supposed to be related to age-related hyperkyphosis. This study aimed to explain the relation between depression, quality of life, and hyperkyphosis in old patients. Methods: 142 patients who applied to the outpatient clinic of geriatrics were enrolled in this cross-sectional study. Mean age of participants was 72. Hyperkyphosis was evaluated by the bloc method defined in the Rancho Bernardo Study (1). Depression was evaluated by the Short form of Yesavage Geriatric Depression Scale (GDS). Quality of life was assessed by the 3-level version of EQ-5D. Results: Hyperkyphosis was found to be positively related to depression (P=0.037), negatively related to the QOL (p<0.001). QOL, depression, and hyperkyphosis were in a ship with each other when evaluated with one-way MANOVA (F [3.135] =5.23, P=0.002, Wilk's Λ=0.896, partial η2=0.104). Chronic pain was negatively related to QOL (p<0.001). Depression was positively related to chronic pain (p<0.001). QOL evaluated with VAS was independently related to the presence of hyperkyphosis in logistic regression analysis (r2=0.179, P=0.007). Conclusion: Considering the relationship with depression and quality of life, early recognition, and treatment of hyperkyphosis in elderly individuals is important. More studies evaluating the association between postural disorders, quality of life and mood disorders in older adults will be useful.

An inconvenient status in anti-osteoporotic treatment process: corticosteroid use.

OBJECTIVE: There are limited studies investigating the comparison of the efficacy of anti-osteoporotic drugs in different conditions resulting in osteoporosis in older adults. This study aimed to compare the effectiveness of anti-osteoporotic agents in older adults with or without glucocorticoid-induced osteoporosis. METHODS: This retrospective study included 364 patients with osteoporosis, aged 65 years and older. Bone mineral density measurement was performed, and the percent change from baseline was calculated at month 24. RESULTS: Of the 364 patients, 80 were glucocorticoid users. Similar changes in the bone mineral density of the lumbar spine and femoral neck and fracture risk were found in patients with or without glucocorticoid-induced osteoporosis. There was no significant difference in bone mineral density changes between the groups in terms of anti-osteoporotic agents used. CONCLUSIONS: This study demonstrated that the response to anti-osteoporotic agents was similar in older adults with glucocorticoid-induced osteoporosis and those without glucocorticoid-induced osteoporosis. The results of our study may guide osteoporosis treatment in older individuals with glucocorticoid-induced osteoporosis.

An inconvenient status in anti-osteoporotic treatment process: corticosteroid use

SUMMARY OBJECTIVE: There are limited studies investigating the comparison of the efficacy of anti-osteoporotic drugs in different conditions resulting in osteoporosis in older adults. This study aimed to compare the effectiveness of anti-osteoporotic agents in older adults with or without glucocorticoid-induced osteoporosis. METHODS: This retrospective study included 364 patients with osteoporosis, aged 65 years and older. Bone mineral density measurement was performed, and the percent change from baseline was calculated at month 24. RESULTS: Of the 364 patients, 80 were glucocorticoid users. Similar changes in the bone mineral density of the lumbar spine and femoral neck and fracture risk were found in patients with or without glucocorticoid-induced osteoporosis. There was no significant difference in bone mineral density changes between the groups in terms of anti-osteoporotic agents used. CONCLUSIONS: This study demonstrated that the response to anti-osteoporotic agents was similar in older adults with glucocorticoid-induced osteoporosis and those without glucocorticoid-induced osteoporosis. The results of our study may guide osteoporosis treatment in older individuals with glucocorticoid-induced osteoporosis.

Improvement of cognitive deficit of curcumin on scopolamine-induced Alzheimer's disease models.

BACKGROUND: It has been suggested that curcumin may be useful in diseases with cognitive dysfunction because it slows the progression and leads to the improvement of cognitive functions. In this study, the protective effects of curcumin on scopolamine-induced rat models of cognitive impairment were evaluated. METHODS: 21 male Wistar Albino rats, 1 year old, 200±25 grams, were included in the study. They were divided into three groups (n: 7 in each group); the untreated control group, scopolamine group, and the group treated with curcumin and then exposed to scopolamine. Animals were evaluated for behavioral tasks with the Morris Water Maze test. Interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), total oxidative status (TOS), and total antioxidative status (TAS) were measured in hippocampal tissues. CRP levels were measured in serum specimens. RESULTS: We found that the length to reach the platform was the highest in the scopolamine group, and the lowest in the curcumin group (p<0.001). Time to reach the platform was the longest in the scopolamine group, and the shortest in the curcumin group (P=0.002). The length to reach the platform was the highest in the scopolamine group, and the lowest in the control group in the probe test (p<0.001). IL-6 levels were higher in the scopolamine group than the curcumin group (P=0.017) and the control group (P=0.005). CONCLUSION: We revealed that curcumin provides a protective effect on scopolamine-induced cognitive impairment mimicking Alzheimer's disease. The use of curcumin for the protection of cognition in individuals at risk of developing AD may be considered.

A Prospective Study to Investigate the Effect of Fesoterodine Treatment on Quality of Life, Anxiety, and Depression in Urge-Type Urinary Incontinence.

PURPOSE:   Urinary incontinence (UI) is a fundamental health problem, can occur at any age but is especially common in older women. Depression and anxiety are also considerable problems for the elderly. UI is one of the geriatric syndromes that are thought to be related to depression and quality of life (QOL). MATERIALS AND METHODS: This prospective study was conducted for a period of 2 months from February 2020 to April 2020. Women who applied to the outpatient clinic of geriatrics with UI symptoms were taken into the study. The type of UI was determined by using the 3 Incontinence Questions (3IQ). Only patients with urge incontinence were included in the study. Patients were evaluated for QOL, anxiety, depression, disability, and geriatric syndromes before and after treatment. Data analysis was done by using SPSS version 22. RESULTS: The study population was 42 women; the mean age was 69.7 +/- 4.3 years.  QoL, anxiety, and depression symptoms, and ADL were revealed to be improved after treatment. ICIQ-SF, I-QOL, and HADs scores were associated with UI treatment when evaluated with one-way MANOVA (F [4, 79] =3.25, p=0.00, Wilk's Λ=0.859, partial η2=0.14). CONCLUSION: UI is a common problem in the elderly. Patients usually hesitate to tell this complaint to even doctors. That situation affects their physical and psychological condition negatively. In this study, we reached that anticholinergic treatment (fesoterodine) improved ADL, QoL, and psychological symptoms. Those findings represented us that proper treatment of UI is critical for healthy aging.

Do Long-Term Complications of Type 2 Diabetes Increase Susceptibility to Geriatric Syndromes in Older Adults?

Background and Objectives: Type 2 diabetes is one of the common chronic diseases in the elderly. It is thought that long-term complications of type 2 diabetes will negatively affect the quality of life in elderly individuals. It is possible that geriatric syndromes, especially frailty syndrome, are associated with diabetic complications, too. In this study, we aimed to evaluate the effect of macrovascular and microvascular complications of type 2 diabetes on frailty and other geriatric syndromes. In addition, the effect of these complications on quality of life was also reviewed. Materials and Methods: We conducted a cross-sectional study for four months. Comprehensive geriatric assessment tests were done on all patients. The Fried frailty index (FFI) was used for the evaluation of frailty syndrome. We assessed malnutrition by mini nutritional assessment short-form (MNA-SF), and Global Leadership Initiative on Malnutrition criteria (GLIM). The EWGSOP 2 criteria were used for the diagnosis of sarcopenia. Quality of life (QoL) was evaluated using the short form-36 (SF-36) questionnaire. Data analysis was done by SPSS version 22. Results: 237 females and 142 males with a mean age of 71.7 ± 6.1 years were included in the study. The frequency of macrovascular and microvascular complications was 41.4% and 68.1%, respectively. Frailty was found to be associated with macrovascular complications (p = 0.003). Handgrip strength, skeletal muscle mass index, and gait speed were decreased in the presence of macrovascular complications (p = 0.043, p < 0.001, p < 0.001). QoL was also decreased in patients with macrovascular complications (p = 0.003). Nutritional status and handgrip strength were negatively affected in patients with diabetic neuropathy (p = 0.019, p = 0.014). Polypharmacy was also found to be associated with macrovascular complications (p < 0.001, p < 0.001). Macrovascular complications were 2.5 times more common in malnourished patients according to GLIM and 3.2 times more common in patients with decreased gait speed. Conclusion: In this study, we observed that both macrovascular and microvascular complications of diabetes increase susceptibility to geriatric syndromes in elderly individuals. It could be useful to conduct prospective studies in which we can compare the effectiveness of treatment methods on this subject.

Relationship Between Age-Related Postural Hyperkyphosis and Sarcopenia.

BACKGROUND: Hyperkyphosis is one of the commonly seen disabilities in the elderly. Loss of muscle mass and function is supposed to be related to age-related hyperkyphosis. We aimed to explain the relationship between sarcopenia and hyperkyphosis in old patients in this study. METHODS: 142 patients who were in the polyclinic of geriatrics of Gaziantep University Hospital were enrolled in this cross-sectional study. Hyperkyphotic patients were included in the study group, and non-hyperkyphotic patients were included in the control group by experienced staff. Their mean age was 72±6.9. Thirty-six of them were male, and 106 of them were female. The EWGSOP 2 criteria were used for the diagnosis of sarcopenia. SARC-F (sluggishness, assistance in walking, rising from a chair, climb stairs, falls) test was performed on all patients. The handgrip test was applied to patients who had a score ≥4 from SARC-F. We conducted bioimpedance analysis of the probable sarcopenic patients who were diagnosed with handgrip assessment. Four-meter gait speed test, Timed Up and Go Test (TUG) and Tinetti Test were applied to all patients to evaluate gait speed. Hyperkyphosis was evaluated with the bloc method in the Rancho Bernardo Study. Numbers of the blocks used for keeping patients in a neutral position were recorded. We defined hyperkyphosis as the state in that one or more blocks are needed to maintain the patient's neutral position on the radiology table. RESULTS: Hyperkyphosis was positively related to lower extremity dysfunction which was assessed by 4-m-gait speed test (p=0.018) and TUG (p=0.042). A significant relationship between gait speed and hyperkyphosis was revealed when evaluated with one-way MANOVA (F [5,92] =2.588, p=0.031, Wilk's Λ=0.877, partial η2=0.123). We found a significant relationship between TUG and the number of blocks needed to restore neutral position by linear regression analyses (r2 =0.059, p=0.044). We found a cut-off value of gait speed as 0.65 m/s for the presence of hyperkyphosis (sensitivity:60%, specificity:70%, CI=95%, p<0.001, AUC=0.710). Tinetti balance, gait and total test scores were also negatively related to hyperkyphosis (p=0.006; 0,027; 0.031). CONCLUSION: In previous studies, vertebral compression fractures, degenerative disc disease, weakness of back extensor muscles and genetic predisposition were suggested as predisposing factors for age-related kyperkyphosis. Different from these in our study, lower extremity muscle function was found to be related to age-related hyperkyphosis. More studies on this subject could be helpful. Hyperkifosis prognosis in severe sarcopenic groups might be a new research topic.

Being Both a Parent and a Healthcare Worker in the Pandemic: Who Could Be Exhausted More?

(1) Background: The COVID-19 pandemic has changed the living conditions of many people. Many people felt significantly constrained. However, for individuals who are both parents and healthcare professionals, the situation seems more troubling in other ways. (2) Objectives: Based on this, we planned a study evaluating demographic characteristics, COVID-19-related anxiety levels, and parenting-related stress levels of the health care professionals who were working in the University Hospital. We also evaluated the parameters that affect COVID-19-related anxiety and parenting stress. (3) Methods: The level of COVID-19-related anxiety is assessed by the coronavirus anxiety scale. The parenting stress index-short form is used for evaluation of parenting stress. Statistical analysis was done by SPSS version 22. (4) Results: Female gender, working as a nurse, a history of COVID-19, and having a child attending daycare were parameters that increased the level of COVID-19-related anxiety. Occupation, being a parent of a schoolchild and/or primary school child, being a parent of a child receiving face-to-face education, and having more than two children were found to be risk factors for parenting stress. Clinically significant parenting stress was found to increase threefold in healthcare workers with more than two children (R2 = 0.101, p = 0.039). (5) Conclusions: Healthcare professionals, who are also parents, play a huge role both at home and in the hospital in the pandemic. Therefore, it is inevitable that their stress and anxiety levels increase. It is important to determine the factors that cause stress and anxiety and to take measures in this direction to get through this process well.