BackgroundGeriatric syndromes are complex clinical manifestations that are not an isolated disease in older adults and have common risk factors within themselves. The syndromes are significant causes of mortality, morbidity, and increased health care costs.ObjectiveTo determine the frequency of geriatric syndromes such as malnutrition, dementia, depression, falls, polypharmacy, urinary incontinence, pressure ulcer, sarcopenia, and frailty in community-dwelling older adults.MethodsA total of 2,816 patients, who applied to geriatric outpatient clinic and were evaluated by comprehensive geriatric assessment, were included in this cross-sectional retrospective study. Falls in the last year and urinary incontinence were recorded. Polypharmacy was accepted as concurrent use of more than four drugs. Diagnosis of dementia and depression was defined according to Diagnostic and Statistical Manual of Mental Disorders Fifth Edition diagnostic criteria. In addition, frailty and sarcopenia were evaluated according to Fried’s physical frailty scale and European Working Group on Sarcopenia criteria, respectively.ResultsThe frequency of polypharmacy was 54.5%, urinary incontinence 47.6%, malnutrition 9.6%, depression 35.1%, dementia 21.6%, falls 33.6%, sarcopenia 31.7%, and frailty 28.3%. When all the participants were divided into three groups (60–69, 70–79, ≥80 years), all syndromes were significantly increased with age, except for depression. While 20% of cases in 60–69 years age group did not have any syndromes, 48% of cases in ≥80 years had more than four syndromes simultaneously.ConclusionThe frequency and coincidence of geriatric syndromes, except for depression, increases with age. Therefore, clinicians other than geriatricians taking care of older people should be aware of these syndromes as well as their treatment mechanisms.

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Abstract Background The relationship between sarcopenia and orthostatic hypotension (OH) is unclear. Objectives The aim of the present study was to investigate associations between sarcopenia/sarcopenia severity and OH. Design A total of 511 patients attending a geriatric outpatient clinic were included. OH was defined as a decrease in systolic and/or diastolic blood pressure of ≥ 20 mmHg and/or ≥ 10 mmHg, respectively, when one transitions from the supine to an upright position. OH was measured by the Head-up Tilt Table test at 1, 3 and 5 min (OH1, OH3 and OH5, respectively). Sarcopenia and its severity were defined according to the revised European consensus on definition and diagnosis. Results The mean age of the sample was 75.40 ± 7.35 years, and 69.9% were female. The prevalence of probable sarcopenia, sarcopenia and severe sarcopenia was 42.2%, 6.06% and 11.1%, respectively. After adjustment for all covariates, systolic OH1, OH1 and systolic OH5 were statistically significantly different between severe sarcopenia and the robust group (odds ratio [OR]: 3.26, confidence interval [CI] 0.98–10.84; P = 0.05 for systolic OH1; OR 4.31, CI 1.31–14.15; P = 0.016 for OH1; OR 4.09, CI 1.01–16.55; P = 0.048 for systolic OH5). Only systolic OH1 was statistically different between the sarcopenia and severe sarcopenia groups (OR 2.64, CI 1.87–8.73; P = 0.012). OH1 and OH5 were statistically significant different between severe sarcopenia and probable sarcopenia groups (P < 0.05); there was no relationship between the robust group and probable sarcopenia (P > 0.05). Conclusions There is a close relationship between sarcopenia and severe sarcopenia and OH in older adults. Therefore, when a healthcare practitioner is evaluating an older patient with sarcopenia, OH should also be evaluated, and vice versa.

Background/Aims: Inflammatory bowel disease (IBD) has a major impact on patients' quality of life (QoL), mood, and sexual life. The purpose of the present study was to show the effect of disease type and activity on sexual life and QoL in patients with IBD. Materials and Methods: A total of 122 patients with IBD and 42 sex-and age-matched control cases were included in the study. Demographic characteristics were recorded. The disease activity of patients with IBD was assessed by the Harvey-Bradshaw Index in Crohn's disease (CD) and the Mayo Clinical Ulcerative Colitis Activity Index in ulcerative colitis (UC). All participants were subjected to complete three questionnaires: Short Form 36 (SF-36), Hospital Anxiety and Depression Scales (HAD-A and HAD-D), and Arizona Sexual Experience Scale (ASEX). Results: There was no difference in terms of demographic characteristics between the three groups, except cigarette exposure in CD. The disease activity of patients with UC and CD was not different (p>0.05). The mean HAD-A score was significantly higher in the CD group, whereas the mean HAD-D score was higher in the IBD group than in the control group (p<0.05). Anxiety was seen more frequently in women. SF-36 scale scores were found to be lower in the UC and CD groups than in the control group (p<0.05). The mean ASEX scores of women with UC (19.59±7.59) and CD (19.38±6.27) were both significantly higher than those of the control group (15±4.76). Although the mean ASEX scores of men were not different, some ASEX subscores of the IBD groups were worse than those of the control. Conclusion: Inflammatory bowel disease is a chronic disease that has multiple complications affecting patients' psychosocial life. Patients have more anxiety, depression, and sexual dysfunction when their disease is active. Patients should be screened for psychological diseases and sexual dysfunction, and necessary treatments should be given.

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Background The aging population and increasing chronic diseases make a tremendous burden on the health care system. The study evaluated the relationship between comorbidity indices and common geriatric syndromes. Methods A total of 366 patients who were hospitalized in a university geriatric inpatient service were included in the study. Sociodemographic characteristics, laboratory findings, and comprehensive geriatric assessment(CGA) parameters were recorded. Malnutrition, urinary incontinence, frailty, polypharmacy, falls, orthostatic hypotension, depression, and cognitive performance were evaluated. Comorbidities were ranked using the Charlson Comorbidity Index(CCI), Elixhauser Comorbidity Index(ECM), Geriatric Index of Comorbidity(GIC), and Medicine Comorbidity Index(MCI). Because, the CCI is a valid and reliable tool used in different clinical settings and diseases, patients with CCI score higher than four was accepted as multimorbid. Additionally, the relationship between geriatric syndromes and comorbidity indices was assessed with regression analysis. Results Patients’ mean age was 76.2 ± 7.25 years(67.8% female). The age and sex of multimorbid patients according to the CCI were not different compared to others. The multimorbid group had a higher rate of dementia and polypharmacy among geriatric syndromes. All four indices were associated with frailty and polypharmacy(p < 0.05). CCI and ECM scores were related to dementia, polypharmacy, and frailty. Moreover, CCI was also associated with separately slow walking speed and low muscle strength. On the other hand, unlike CCI, ECM was associated with malnutrition. Conclusions In the study comparing the four comorbidity indices, it is revealed that none of the indices is sufficient to use alone in geriatric practice. New indices should be developed considering the complexity of the geriatric cases and the limitations of the existing indices.

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