Prevalence of cognitive impairment and related risk factors in community-dwelling elderly in Kayseri, Turkey.

BACKGROUND/AIM: The increased rate of elderly individuals in the general population leads to functional decline because of cognitive impairment (CImp). We aimed to detect the prevalence of CImp and related risk factors in community-dwelling elders living in an urban area (Kayseri, Turkey). MATERIALS AND METHODS: This is a cross-sectional, population-based study conducted in a sample of 900 community-dwelling elders aged 60 years and older. Cognitive status and depressive symptoms were assessed by standardized Mini Mental State Examination (MMSE) and the Geriatric Depression Scale (GDS), respectively. RESULTS: The mean age of the participants was 71.6 ± 0.18 years, of whom 47.9% were female. Prevalences of CImp and depressive symptoms were 26.1% and 24.9%, respectively. Female sex, illiteracy, low income, increased age, being a housewife, being a nonsmoker, being depressive, being single, and having more than four children were significantly related with CImp based on univariate logistic regression analysis. However, in multivariate logistic regression analysis, it was found that being illiterate, being depressive, and having an increased number of children were determinants of CImp in the elderly. Self-reported chronic diseases were not detected as risk factors for CImp. CONCLUSION: Increasing socioeconomic status and education levels and preventing depression should be accepted as primary protective measures for CImp.

Arm anthropometry indices in Turkish children and adolescents: changes over a three-year period.

OBJECTIVE: Time-related changes and comparisons for mid-upper arm circumference (MUAC), triceps skinfold thickness (TSF), arm fat area (AFA) are lacking for Turkish children and adolescents. To determine the arm anthropometry indices (MUAC, TSF, AFA) in children and adolescents and to also assess the changes in these indices over a 3-year time period. METHODS: The data of the Anthropometry of Turkish Children Aged 0-6 Years (ATCA-06) study and the Second Study of Determination of the Anthropometric Measurements of Turkish Children and Adolescents (DAMTCA-II) were used to calculate the arm anthropometry percentiles in a total group of 6982 children and adolescents aged 28 days to 17 years. The 3rd-97th percentiles were computed by the LMS method. RESULTS: In girls, 50th percentile MUAC values linearly increased with age. In boys, 50th percentile TSF values linearly increased until 10 years of age and decreased after age 11 years, while in girls, TSF values increased linearly with age. 50th percentile values for AFA showed a linear increase in both genders with age. Significant differences were found between the 5th, 50th and 95th percentile values for MUAC and AFA obtained in the two studies (DAMTCA-II and DAMTCA-I) in both boys and girls. CONCLUSIONS: The prominent finding was the significant and alarming increase in arm anthropometry indices in both genders within as short period of time as three years.

Growth patterns of children of same geographic background reared in different environments.

OBJECTIVE: Growth charts are essential tools used to assess children's health status. The aim of the present study was to determine the effect of environmental factors on the growth of children of a common geographic background. We constructed growth charts for children living in the East of Turkey and compared them with those for Turkish children living in other regions or countries. METHODS: Growth data were obtained from 6 917 school children living in Eastern Turkey. The median values on smoothed percentile curves for the study subjects were compared with those for Turkish children living in the West of Turkey, in Western Europe and in Germany. RESULTS: Children living in Turkey were lighter than their European peers at early ages. Weight curves of children living in the West of Turkey reached those of their European peers, after 11 years of age in boys and after 12 years of age in girls. At all ages, girls and boys in our region had the lowest weight values. Between 7 and 11 years of age, the median height in boys and girls were similar in the West of Turkey and in Europe. At older ages, median height was higher in Turkey. Girls and boys living in Eastern Turkey were the shortest children until 16 years of age; after that age, their height was similar to their peers. CONCLUSIONS: Weight may interact with environmental factors, but genetic potential appears to be the most important factor determining height at 17 years of age. Growth patterns of children should be evaluated using specific reference values for specific regions.

Four-site skinfolds and body fat percentage references in 6-to-17-year old Turkish children and adolescents.

OBJECTIVE: As skinfolds from four-sites (triceps, biceps, subscapular, suprailiac) and body fat percentage in 6-17 years is lacking in Turkey. This study was undertaken to produce references for four-site skinfolds and body fat percentage in children and adolescents. METHODS: The cross-sectional study was conducted between September 2007-May 2008 in Kayseri, Turkey, after approval by ethics committee of Erciyes University and local educational authority. Data were obtained from the Determination of Anthropometric Measures of Turkish Children and Adolescents Study-II. Using multistage sampling method, 4285 children were selected from the schools representing city centre, rural and urban areas of the province. Skinfolds were measured from four sites and body fat percentage was calculated according to Westrate and Deurenberg equation. LMS Chart Maker Pro version 2.3 software was used to obtain skinfold references. RESULTS: There were 1914 (44.6%) boys, 2371 (55.3%) girls in the study; the age range being 6-17 years. The peripheral skinfolds increased with age for girls (7.2 mm at age 10 versus 8.7 mm at age 17), while this was true for boys until 10 years (6.2 mm at age 10 versus 4.2 mm at age 17) after which the values gradually decreased. In terms of central skinfolds, girls had higher numbers in each age (11.7 mm for boys versus 12.8 mm for girls at age 6; 24.9 mm versus 26.3 mm at age 17). CONCLUSION: Skinfolds and body fat percentage provide information that helps monitor secular trends in obesity in Turkey and may be used to make national and international comparisons in the future.

Change in waist circumference over 3 years in Turkish children and adolescents.

AIM: To observe change in waist circumference (WC) over 3 years in children and adolescents and to compare these data with local and international references. SUBJECTS AND METHODS: The data of the second study determining the anthropometric measurements of Turkish children and adolescents (DAMTCA-II) were used to calculate WC percentiles. A total of 4234 children and adolescents aged 6-17 years (1890 boys and 2344 girls) were enrolled. The 3rd, 5th, 10th, 25th, 50th, 75th, 85th, 90th, 95th and 97th percentiles and z-scores were computed by the LMS Method. RESULTS: The mean WC was significantly higher in boys than in girls in 12.5, 13 and 15-17 year old children (p < 0.001). The prevalence of central obesity (WC ≥ 90th percentile) was 13.5% (14.3% in boys and 12.9% in girls, respectively). There was no significant difference in prevalence of abdominal obesity, between each gender (p = 0.179) and age group from 6-17 years (p = 0.590). In a comparison with the available contemporary international references, the 50th percentiles of these references were similar to those in Bulgaria, but markedly higher than those of Malaysian children and of Chinese children living in Hong Kong. CONCLUSIONS: The prominent finding of this study was the significant increase in WC percentiles in a short time in both genders. In addition, the WC references are similar to other regional references, but significantly higher than those of East Asia.

Body weight, length and head circumference at birth in a cohort of Turkish newborns.

OBJECTIVE: Intrauterine growth references are primarily useful indicators in the assessment of the general health status of newborn infants. Although Lubchenco's references are still used in many neonatal care units, we believe that there is a need for up-to-date intrauterine growth references specific for different populations. To develop gestational age-and gender-specific national references for birth weight, birth length and head circumference. METHODS: Data were collected from neonatal records of perinatology services of eleven hospitals from January to December 2009. The anthropometry of a total of 4750 singleton live births born between 28 and 41 weeks of gestation were recorded. Means and standard deviations were calculated, and percentiles for each gender and gestational week were produced using the LMS program. The results were compared with US infants and also with local data. RESULTS: Gestational age- and gender-specific 3rd, 5th, 10th, 15th, 25th, 50th, 75th, 85th, 90th, 95th and 97th percentile values were produced. Comparison of the 10th, 50th and 90th percentile values showed that the boys were heavier and longer than the girls. Head circumference values were also higher in the boys. Proportions of small for gestational age (SGA), appropriate for gestational age (AGA) and large for gestational age (LGA) infants in the sample were 10.1%, 79.1% and 10.8%, respectively. CONCLUSION: These gender- and gestational age-specific references will be of use in clinical practice and also for research purposes until more comprehensive, reliable and accessible national data pertaining to the intrauterine growth of Turkish infants are produced.

Anthropometric risk factors for elevated blood pressure in adolescents in Turkey aged 11-17.

To investigate the relationship between anthropometric parameters and elevated blood pressure in adolescents, we measured blood pressure (BP), height, weight, triceps skinfold (TSF) thickness, waist circumference (WC), and mid-upper-arm circumference (MUAC) in 2,860 student volunteers aged 11-17 years in Kayseri, Turkey. Waist-to-height ratio (WHtR), waist-to-arm-span ratio (WASR), body mass index (BMI), arm-fat area (AFA), and fat percentage (FP) were also calculated. Participants were divided into two groups: hypertensive [systolic blood pressure (SBP) or diastolic blood pressure (DBP) ≥ 95th percentiles, n = 246] and normotensives (SBP or DBP < 95th percentiles, n = 2614). Multiple logistic regression models were produced within these groups for the examined risk factors, and cutoff points were investigated for SBP or DBP ≥ 95th percentiles using receiver operating characteristics (ROC) analysis. BMI, WC, WHtR, WASR, MUAC, and BMI had statistically significant cutoffs among boys. Whereas BMI, WHtR, WASR, WC, MUAC, AFA, and TSF were statistically significant for girls younger than 15, only BMI and WC were statistically significant for participants older than 15. The independent risk factors for elevated BP were determined according to BMI and WC. Although several anthropometric measurements were significant in our participants, BMI and WC were significant among all participants irrespective of age and sex.

Risk factors for low back pain and its relation with pain related disability and depression in a Turkish sample.

AIM: To investigate the relation of depression and pain-related disability associated with Low Back Pain (LBP). MATERIAL AND METHODS: The Quebec Back Pain Disability Scale, Visual Analogue Scale (VAS) and Zung Depression Scale were sent to 3800 randomly select adults in Kayseri, Turkey. The demographic characteristics of the participants (Socioeconomic status, age etc) and low back pain (frequency, intensity, duration) features together with pain-related factors were investigated in responding participants. The participants who had self-reported LBP during the study period were accepted as the study group. RESULTS: 807 (37.1%) of the participants reported that they had low back pain at the time of interview. The study group had a score of 52.91+/-24.20 mm for VAS, 52.30+/-10.67 for the Zung Depression Scale and 24.53+/-17.22 for the Quebec Back Pain Disability Scale. Age, female gender, smoking ( > 20 cigarettes per day), low socioeconomical status and living in a rural habitat were found to be associated with low back pain. Depression (P= 0.017) and disability (P= 0.002) were found to be independent risk factors for VAS. CONCLUSION: Determination of the frequency and intensity of low back pain and related factors is needed for the prevention and management of pain. Mood disorders and self reported restriction in daily activities should be screened in patients with low back pain.