Association between depression scores and comprehensive geriatric assessment and frailty in geriatric outpatients with somatic complaints: an observational cross-sectional study.

BACKGROUND: Depression is the most common psychiatric problem in older individuals. In some countries, the common approach is to ignore psychiatric disorders. This study aimed to reveal the importance of newly diagnosed high depression scores in the geriatric population admitted to outpatient clinics with somatic complaints. METHODS: Patients who did not have a previous diagnosis of a psychiatric disorder and were not receiving treatment were included in the study. A comprehensive geriatric evaluation of 235 elderly patients was performed using established assessment tests. The time and quality of sleep and the Clinical Frailty Scores (CFSs) were documented. RESULTS: The mean age of the 235 patients was 73.6 ± 6.39 years, 65.5% (n = 154) were women, and 34.9% (n = 81) had a geriatric depression score ≥ 5. In the higher depression rating scores group, the Lawton-Brody, Mini-Mental State Examination (MMSE), and Mini Nutritional Assessment (MNA-SF) scores were low (p = 0.010, p < 0.001, p = 0.003). Sleep duration was short, and sleep quality was poor (p = 0.042, p = 0.006). The CFSs were high. (p = 0.035) According to the regression analysis results, the MMSE, MNA-SF and CFS predicted higher depression scores significantly (p = 0.048, ß = .892; p = 0.045, ß = .661; p = 0.045, ß = 1.245). DISCUSSION: Depression scores in older people may be associated with not only mood but also the functionality. As with other geriatric syndromes, symptoms in depression may be atypical rather than typical.

Association between sarcopenia and erectile dysfunction in older males.

INTRODUCTION: In advanced age, both sarcopenia and erectile dysfunction (ED) occur with similar underlying causes through different mechanisms. In our study we investigated the association between sarcopenia and ED in older men. METHODS: A total of 193 male patients aged 60 years and older were included in the study. The presence of sarcopenia was investigated in accordance with EWGSOP2 diagnostic criteria. For evaluation of ED, we used the 5-question International Index of Erectile Dysfunction questionnaire with categories of no ED, mild-moderate ED, and moderate-severe ED. Total testosterone levels were measured. RESULTS: The median age of the patients was 71.9 (range 60-93 years). The prevalence of sarcopenia was 24.9%, and moderate-severe ED was 49.2%. Moderate-severe ED was more common in patients with sarcopenia than those without (70.8% vs 42.1%, p < 0.001). After adjustment for age and Charlson Comorbidity Index, the presence of sarcopenia was significantly associated with moderate-severe ED with odds ratio (OR) of 2.71 (95% Confidence Interval [CI] 1.29-5.73, p = 0.009). The components of sarcopenia were assessed separately in multivariate analysis. Muscle strength and muscle mass were significantly associated with moderate-severe ED with OR of 0.93 (95%CI 0.89-0.98) and 0.68 (95%CI 0.54-0.86), respectively, whereas gait speed was not associated with moderate-severe ED. CONCLUSION: The presence of sarcopenia in older men is associated with an increased risk of moderate-severe ED. In addition, decreased muscle strength and decreased muscle mass are associated with an increased risk of moderate-severe ED. Prospective studies are needed to reveal the causality between sarcopenia and ED.

The relationship between sarcopenia and central hemodynamics in older adults with falls: a cross-sectional study.

PURPOSE: Falls are an important cause of morbidity and mortality in geriatric patients. Sarcopenia and central blood pressure may be associated with falls. This study aimed to investigate the association between sarcopenia and blood pressure parameters in older patients with falls. METHODS: A comprehensive geriatric evaluation of 72 elderly patients was performed using established assessment tests. Peripheral and central hemodynamic measurements, including office DBP and SBP, daytime-night peripheral and central DBP and SBP, cardiac output, augmentation index, pulse wave velocity (PWV), pulse rate, and peripheral resistance and reflection, were measured with a 24-hour ambulatory blood pressure measuring device. RESULTS: Of 72 patients with a mean age of 77.51 ± 6.5 years, 12 (16.7%) were non-sarcopenic, 32 (44.4%) were probable, nine (12.5%) were confirmed, and 19 (26.4%) were severe sarcopenic. PWV, which is an indicator of arterial stiffness, was found to be significantly higher in the sarcopenic group. The other cardiac risk markers [daytime peripheral SBP, mean arterial pressure (night), pulse pressure (daytime), and peripheral resistance (daytime and night)] were significantly lower in the sarcopenic patients. PWV correlated with gait speed, Katz score, and hand grip strength (Spearman's rho: -0.337, -0.310, and -0.334; P < 0.001, 0.008, and 0.001, respectively). Age and hypertension were the most important factors increasing the risk of falls. CONCLUSION: Sarcopenia is associated with central and peripheral blood pressure changes in patients with falls. When sarcopenia is diagnosed in older people with falls, 24-hour ambulatory peripheral and central pressures should be evaluated for cardiac risk screening.