A simple method for clinical implications of pain; comprehensive geriatric assessment.

OBJECTIVE: The effect of chronic pain on the elderly population is enormous in terms of both human suffering and cost. This study aimed to investigate the factors associated with chronic low back pain in older adults by performing a comprehensive geriatric assessment. METHODS: This cross-sectional study included 225 elderly patients admitted to a geriatric outpatient clinic. All participants underwent a comprehensive geriatric assessment, and factors related to chronic low back pain were assessed. Participants were grouped as those with and without chronic pain. RESULTS: The mean age of the participants was 72.9±6.9 years, and 149 (66.2%) of them had chronic pain complaints. The number of chronic diseases and medications, depressive symptom scores, and sleep quality scores were higher, and quality of life (European Quality of Life-5 Dimensions index and European Quality of Life-5 Dimensions visual analog scale) and nutritional status scores were lower in the chronic pain group. The pain visual analog scale score had a statistically significant moderate negative correlation with the European Quality of Life-5 Dimensions index (r=-0.440, p=0.000) and European Quality of Life-5 Dimensions visual analog scale (r=-0.398, p=0.000) scores. The male gender was associated with a reduced risk of chronic pain, while poor sleep quality and number of comorbidities were associated with an increased risk of chronic pain (p=0.000, OR 0.20, p=0.021, OR 2.54, and p=0.010, OR 1.40, respectively). CONCLUSION: Chronic pain is common and independently associated with poor sleep quality, an increased number of diseases, and female gender. The results of our study may guide pain management in older individuals.

A simple method for clinical implications of pain; comprehensive geriatric assessment

SUMMARY OBJECTIVE: The effect of chronic pain on the elderly population is enormous in terms of both human suffering and cost. This study aimed to investigate the factors associated with chronic low back pain in older adults by performing a comprehensive geriatric assessment. METHODS: This cross-sectional study included 225 elderly patients admitted to a geriatric outpatient clinic. All participants underwent a comprehensive geriatric assessment, and factors related to chronic low back pain were assessed. Participants were grouped as those with and without chronic pain. RESULTS: The mean age of the participants was 72.9±6.9 years, and 149 (66.2%) of them had chronic pain complaints. The number of chronic diseases and medications, depressive symptom scores, and sleep quality scores were higher, and quality of life (European Quality of Life-5 Dimensions index and European Quality of Life-5 Dimensions visual analog scale) and nutritional status scores were lower in the chronic pain group. The pain visual analog scale score had a statistically significant moderate negative correlation with the European Quality of Life-5 Dimensions index (r=-0.440, p=0.000) and European Quality of Life-5 Dimensions visual analog scale (r=-0.398, p=0.000) scores. The male gender was associated with a reduced risk of chronic pain, while poor sleep quality and number of comorbidities were associated with an increased risk of chronic pain (p=0.000, OR 0.20, p=0.021, OR 2.54, and p=0.010, OR 1.40, respectively). CONCLUSION: Chronic pain is common and independently associated with poor sleep quality, an increased number of diseases, and female gender. The results of our study may guide pain management in older individuals.

A new diagnostic approach in Alzheimer's disease: The critical flicker fusion threshold.

Alzheimer's disease (AD) is the most common cause of dementia in the elderly. Although AD treatment is still insufficient despite all the recent developments, detection and treatment in the early stage of disease have provided more clinical benefits. Objective: In this study, we aimed to use the critical flicker fusion (CFF) threshold test to diagnose AD in the early stage. Methods: In this study, 120 patients (above 65 years of age) and 50 control groups who were admitted to geriatrics outpatient clinic and diagnosed in early- and middle-stage AD were included. The remaining 58 patients and 25 healthy volunteers underwent comprehensive geriatric assessment and CFF testing. Results: The mean CFF value of AD group was significantly lower than the control group (36.44±7.00 vs. 44.24±3.82, p<0.001, respectively). There was a significant difference in standardized mini-mental state examination (MMSE) score in both groups (18.05±5.25 vs. 25.96±2.85, p<0.001, respectively). There was also a positive correlation between CFF value and MMSE score (p<0.001, r=0.459). Thirty-four patients were in the early-stage AD group and 24 patients were in the middle-stage AD group. There was a significant difference in CFF values between the three groups when we compared the patients in early- and middle-stage AD and control groups (p<0.001). The mean CFF values in patients with early- and middle-stage AD were 37.93±7.33 and 34.97±7.43, respectively. The mean age, gender, education level, and the number of drugs used did not show a statistically significant difference in both groups (p>0.05). The cutoff value for the CFF variable was determined as 39 Hz [p<0.001; area under the curve (AUC)=0.852; sensitivity=70.69% (95% confidence interval [95%CI] 57.3-81.9); specificity=92.00% (95%CI 74.00-99.00)]. Conclusions: There is a significant difference in mean CFF values between AD and healthy groups. CFF testing may play an important role in diagnosing AD in the early stage.

A doença de Alzheimer (DA) é a causa mais comum de demência em idosos. Embora o tratamento da DA ainda seja insuficiente mesmo com todos os desenvolvimentos recentes, a detecção precoce e o tratamento no estágio inicial da doença têm demonstrado maior benefício clínico. Objetivo: Neste estudo, nosso objetivo foi usar o teste Critical Flicker Fusion Threshold (CFF) para diagnosticar a DA em estágio inicial. Métodos: Foram incluídos 120 pacientes e 50 controles em ambulatório de geriatria, com diagnóstico de DA inicial e moderada e acima de 65 anos. Os 58 pacientes restantes e 25 voluntários saudáveis foram submetidos a avaliação geriátrica abrangente e ao CFF. Resultados: A média de CFF do grupo AD foi significativamente menor do que a do grupo controle (36,44±7,00 vs. 44,24±3,82, p<0,001, respectivamente). Houve diferença significativa na pontuação do Miniexame do Estado Mental (MMSE) em ambos os grupos (18,05±5,25 vs. 25,96±2,85, p<0,001, respectivamente). Também houve correlação positiva entre o valor CFF e o escore MMSE (p<0,001, r=0,459). Trinta e quatro estavam no estágio inicial e 24 estavam no estágio moderado do grupo DA. Houve diferença significativa nos valores de CFF entre os três grupos quando comparamos os pacientes com DA inicial e moderada e os grupos controle (p<0,001). O valor médio de CFF em pacientes com DA em estágio inicial foi de 37,93±7,33 e de 34,97±7,43 nos pacientes em estágio moderado. As médias de idade, sexo, escolaridade e número de medicamentos usados não apresentaram diferença estatisticamente significativa entre os dois grupos (p>0,05). O valor de corte para a variável CFF foi determinada como 39 Hz (p<0,001; área sob a curva ­ AUC=0,852; sensibilidade=70,69% [intervalo de confiança de 95%­ IC95% 57,3­81,9]; especificidade=92,00% [IC95% 74,00­99,00]). Conclusões: Há diferença significativa entre os valores médios de CFF do grupo de DA e do grupo saudável. O CFF pode desempenhar um papel importante no diagnóstico de DA no estágio inicial.

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.