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.

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.

Health-related quality of life and fall risk associated with age-related body composition changes; sarcopenia, obesity and sarcopenic obesity.

BACKGROUND: Sarcopenia, obesity, and sarcopenic obesity are various features of the ageing process that can cause important health issues. The present study was undertaken to investigate the interrelationship between those body composition changes, including their clinical components and the quality-of-life variables. METHODS: A total of 423 individuals aged 65 years or older was included in this cross-sectional study. Sarcopenia was diagnosed according to The European Working Group on Sarcopenia in Older People criteria. Body composition parameters were measured with a bioelectrical impedance analyser, and Turkish population-based cut-off points were preferred for diagnosis of sarcopenia. Comprehensive geriatric assessment was performed on all patients. A logistic regression analysis was performed to identify important factors for sarcopenia and sarcopenic obesity. RESULTS: The prevalence of sarcopenic, obese and sarcopenic obese subjects was 14%, 35% and 11% respectively. The lowest mean gait speed and hand grip strength values were seen in the sarcopenic obese group (0.6 ± 0.3 m/s and 19.7 ± 9.8 kg respectively). Sarcopenic obese participants were associated with the highest rate for fall risk. The scores for domains of health-related quality of life were worse in both obesity and sarcopenic obesity when compared to others. Body mass index (BMI), number of drugs used, total body fat ratio and geriatric depression scale-short form scores were negatively correlated with all dimensions of SF-36 quality-of-life scale. CONCLUSIONS: Sarcopenia, obesity and sarcopenic obesity are associated with many negative health outcomes, such as high fall risk and low health-related quality of life in geriatric population.

Mean platelet volume seems to be a valuable marker in patients with systemic sclerosis.

The predictors for the development of cardiovascular diseases and peripheral arterial diseases in patients with systemic sclerosis (SSc) were not clearly established, and there is no specific study conducted to investigate the mean platelet volume (MPV) levels in SSc patients. Therefore, this study evaluates the MPV levels in SSc and possible relationship between SSc, its clinical features and activity/severity scores, and MPV. In total, 76 SSc patients (67 women and 9 men, mean age 50.44 ± 13.21 years) diagnosed according to the classification criteria of the American College of Rheumatology and 45 healthy volunteers were enrolled into study. Data relating to anamnesis, physical examination, MPV, erythrocyte sedimentation rate, C-reactive protein levels, electrocardiography, echocardiography, high-resolution computerized tomography findings, complaints, and treatment processes were recorded into the database. Of the total cases, 17 had (22.3 %) cardiac involvement, 45 had gastrointestinal involvement (59.2 %), 47 had (61.8 %) lung involvement, 31 (32 %) had finger flexion deformity, and 27 (35.5 %) had digital ulcers at the fingertips. The mean MPV levels of SSc patients were significantly higher than those of the control group (p = 0.008). The mean MPV levels of SSc patients with cardiac involvement, digital ulcers, and gangrene presence were significantly high, and lower in Ilomedin-receiving patients than in the Ilomedin naives (p < 0.05). A negative relationship was discovered between the mean MPV levels, Valentini score, and Disease Severity Index of the patients with systemic sclerosis (p = 0.006, r = -0.310; p = 0.047, r = -0.229). MPV levels were significantly elevated in SSc patients and they were negatively correlated with disease activity scores. Increased MPV levels would be a predictive marker in the diagnosis of macrovascular and microvascular disease involvement in SSc patients.