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.

The prevalence of type 2 diabetes is expected to increase gradually with the prolongation of population aging and life expectancy. In addition to macrovascular and microvascular complications of elderly patients of diabetes mellitus, geriatric syndromes such as cognitive impairment, depression, urinary incontinence, falling and polypharmacy are also accompanied by aging. Individual functional status in the elderly shows heterogeneity so that in these patients, there are many unanswered questions about the management of diabetes treatment. The goals of diabetes treatment in elderly patients include hyperglycemia and risk factors, as in younger patients. comorbid diseases and functional limitations of individuals should be taken into consideration when setting treatment targets. Thus, treatment should be individualized. In the treatment of diabetes in vulnerable elderly patients, hypoglycemia, hypotension, and drug interactions due to multiple drug use should be avoided. Since it also affects the ability to self-care in these patients, management of other concurrent medical conditions is also important.

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Background: Hyperkyphosis is one of the commonly seen disabling problems 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 applied to 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[1]. SARC-F (sluggishness, assistance in walking, rise from a chair, climb stairs, falls) test were done to all patients. The handgrip test was applied to patients that had a score ≥4 from SARC-F. We did bioimpedance analysis to the probable sarcopenic patients who diagnosed with handgrip assessment. Four-meter gait speed test, Timed Up and Go Test (TUG) and Tinetti Test was applied to all patients to evaluate gait speed. Hyperkyphosis was evaluated with the bloc method in the Rancho Bernardo Study[2]. Numbers of the blocks used for keeping patients in neutral position were recorded. We defined hyperkyphosis as the state that one or more blocks 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 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). Conclusions: 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[3]. 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.