Background
The Global Leadership Initiative on Malnutrition (GLIM) has developed new criteria for diagnosing patients with malnutrition. The aims of this study were to investigate the prevalence of malnutrition according to the GLIM criteria, Subjective Global Assessment (SGA), and Nutrition Risk Screening 2002 (NRS‐2002) and their association with long‐term mortality in patients hospitalized for acute illnesses.
Methods
A retrospective analysis was performed in a sample of 231 patients with different comorbidities hospitalized for acute illnesses in medical or surgical wards. Nutrition status was retrospectively assessed with GLIM criteria using patients’ records at admission in addition to SGA and NRS‐2002. The agreement between the tools was calculated using κ statistics, and the association of malnutrition according to each tool and mortality were analyzed using Cox regression analysis.
Results
The mean age of the patients was 62.2 ± 18.2 years, and 56.7% were women. The prevalence of malnutrition was 35.9% with GLIM criteria, 37.2% with SGA, and 38% with NRS‐2002. The agreement between tools was good (GLIM‐SGA, κ = 0.804; GLIM–NRS‐2002, κ = 0.784). During a median follow‐up period of 63.2 months, 79 deaths occurred. The sensitivity in predicting 5‐year mortality was 59.49%, 58.23%, and 58.23%, and specificity was 76.32%, 73.68%, and 72.37% for GLIM criteria, SGA, and NRS‐2002, respectively. After adjusting for confounders, GLIM criteria best predicted 5‐year mortality (hazard ratio, 3.09; 95% CI, 1.96–4.86; P < .001).
Conclusions
Our findings support the effectiveness of GLIM in diagnosing malnutrition and predicting all‐cause mortality among patients hospitalized for acute illnesses.
The caregiver burden in Turkish family caregivers was found mild to moderate and correlated with the degree of frailty. Policymakers should focus on culture-specific formal caregiver services.
Background
A novel coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) occurred in China in December 2019 and has spread globally. In this study we aimed to describe the clinical characteristics and outcomes of hospitalized older adults with coronavirus disease 2019 (COVID-19) in Turkey.
Methods
We retrospectively analyzed the clinical data of hospitalized patients aged ≥ 60 years with confirmed COVID-19 from March 11, 2020, to May 27, 2020 using nationwide health database.
Results
In this nationwide cohort, a total of 16942 hospitalized older adults with COVID-19 were enrolled, of whom 8635 (51%) were women. Mean age was 71.2 ± 8.5 years, ranging from 60 to 113 years. Mortality rate before and after curfew was statistically different (32.2% vs 17.9%; p & 0.001, respectively). Through multivariate analysis of the causes of death in older patients, we found that male gender, diabetes mellitus, heart failure, chronic kidney disease, dementia, cancer, admission to intensive care unit, computed tomography finding compatible with COVID-19 were all significantly associated with mortality in entire cohort. In addition to abovementioned risk factors, in patients aged between 60-79 years, coronary artery disease, oxygen support need, total number of drugs, and cerebrovascular disease during hospitalization, and in patients 80 years of age and older acute coronary syndrome during hospitalization were also associated with increased risk of mortality.
Conclusions
In addition to the results of previous studies with smaller sample size, our results confirmed the age-related relationship between specific comorbidities and COVID-19 related mortality.
Background
Dysphagia is an important and frequent symptom in Alzheimer's dementia (AD). We hypothesized that dysphagia could be seen in the early stages of AD and sarcopenia presence rather than the severity of the AD affecting dysphagia. The main aim of this study was to investigate swallowing functions in AD patients according to stages. The second aim was to investigate the correlation between sarcopenia and dysphagia in AD.
Methods
This study involved 76 probable AD patients. For all participants, diagnosis of sarcopenia was based on definitions from the revised version of European Working Group on Sarcopenia in Older People at 2018. Dysphagia symptom severity was evaluated by the Turkish version of the Eating Assessment Tool, a videofluoroscopic swallowing study (VFSS) was performed for instrumental evaluation of swallowing. The patients were divided into 3 groups according to the clinical dementia rating (CDR) scale as CDR 1 (mild dementia), CDR 2 (moderate dementia), and CDR 3 (severe dementia). Swallowing evaluation parameters were analyzed between these groups.
Results
Mean age was 78.9 ± 6.4 years, and 56.4% were female. Twenty‐six patients had mild dementia, 31 patients had moderate dementia, 19 patients had severe dementia (CDR 3). We found that sarcopenia rates were similar between AD stages according to CDR in our study population and dysphagia could be seen in every stage of AD. In a multivariate analysis, polypharmacy and sarcopenia were found to be independently associated factors for dysphagia, irrespective of stage of AD (OR: 6.1, CI: 1.57‐23.9, P = 0.009; OR: 4.9, CI: 1.24‐19.6, P = 0.023, respectively).
Conclusion
Aspirations may be subtle so that AD patients and caregivers may not be aware of swallowing difficulties. Therefore, all AD patients, especially those who have polypharmacy and/or sarcopenia (probable‐sarcopenia‐severe sarcopenia), should be screened for dysphagia in every stage.
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