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Objective: Practical scales with tested validity and reliability are needed to clinically determine frailty.The aim of this study is to find out whether the Fatigue, Resistance, Ambulation, Illnesses, and Loss of weight (FRAIL) Scale is an effective screening scale to show frailty. Patients and Methods: The Frail non-Disabled (FIND) scale validated in the Turkish population was applied for FRAIL Scale validation. Comprehensive geriatric assessment and Fried Index were performed on 85 outpatients who were 65 years and older. The patients were examined in terms of comorbidity, number of falls, living environment, number of drugs used, and hospitalization in the last year. Results: The FRAIL Scale had a high correlation with the FIND scale and Fried Index (correlation coefficients are 0.956 and 0.934, respectively). In addition, it was found to be associated with Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL) scales, the Mini-Mental State Examination (MMSE), Yesavage Geriatric Depression Scale (GDS), Mini Nutritional Assessment short-form (MNA-sf),Clock Drawing Test (CDT), handgrip strength, and timed up and go test (p<0.05). The compliance between independent practitioners and test-retest compliance were found to be 100% (full compliance,Cronbach's alpha coefficient is 1.00). Conclusion: In the Turkish geriatric population, the FRAIL scale was found to be a reliable and valid scale in showing frailty. [ABSTRACT FROM AUTHOR]

Background: This study aims to compare the predictive value of all comprehensive geriatric assessment (CGA) parameters with the predictive value of frailty assessment (with Edmonton Frailty Scale (EFS) and Fried Frailty Index (FFI)) for long-term mortality, in older adults. Methods: A total of 967 patients were included, consecutively. At the first admission, age, gender, comorbidities, number of drugs, and laboratory values of the patients were recorded. Each patient underwent CGA which consisted of anthropometric measurements, functional, cognitive, mood, nutritional, gait, fall, sleep duration, and frailty assessment. Fifty-seven months after the first admission, CGA parameters were analyzed to determine their predictive abilities on long-term mortality due to all causes, comparatively. Results: The median age was 73 years (range 65–94 years). The median follow-up time was 39.9 months (range 0.5–57.3 months). Serum albumin level, FFI, EFS, instrumental activity of daily living (IADL) score, and walking time were the best predictors of mortality. There was no significant difference between these parameters in predicting mortality. Conclusion: FFI and EFS have similar predictive value for mortality. In busy clinical practice, a new index based on IADL, walking time, and serum albumin level may be an alternative of frailty assessment for predicting mortality. [ABSTRACT FROM AUTHOR]

Background and Aim: Mild cognitive impairment (MCI) and dementia prevalence are expected to increase with aging. The DemTect is a very quick and easy tool to administer and recognize the early stages of dementia and MCI. In this study we aimed to evaluate the reliability and validity of a Turkish version of the DemTect and define cut off values for different age and educational levels. One of our aims is also to compare the sensitivity and specifity of the DemTect to other common screening tools. Patients and Methods: Fifty-four patients with MCI, 55 patients with dementia and 91 patients with subjective memory complaints (SMC) were enrolled in the study. The DemTect was translated into Turkish by forward-backward translation and compared with the Mini Mental State Examination (MMSE), the Quick Mild Cognitive Impairment Turkish version (QMCI-TR) and the Montreal Cognitive Assessment (MoCA). In order to test interrater reliability, the DemTect was administered to 11 patients, on the same day, by 2 trained raters. To establish test–retest reliability, the same rater scored the tool a second time on 11 patients within 2 weeks. Results: The median age of the patients was 73 (min-max: 65–90) years, 54.5% were female. We found a strong correlation between DemTect scores and the MMSE, the QMCI, and the MoCA (r = 0.725, r = 0.816, r = 0.821, respectively; p < 0.001). In ROC analysis, the cut-off point of the DemTect to differentiate MCI from SMC was 11.5 with 92.6% sensitivity, 91.2% specificity, AUC 0.973 and the cut-off point of the DemTect to differentiate dementia from SMC was 9.5 with 96.4% sensitivity, 100% specificity, AUC 0.916. Cronbach α was 0.823. Intraclass correlation coefficient was 0.873 (95% CI: 0.598–0.964) for interrater reliability and 0.966 (95% 0.777–0.982) for test-retest reliability (Cronbach α = 0.932, 0.966 respectively). Conclusion: The DemTect is a very reliable tool to assess Turkish patients with MCI and dementia. [ABSTRACT FROM AUTHOR]

Background: The novel molecule endocan, which is released by endothelium and is regulated by proangiogenic and proinflammatory cytokines, may have a role in the pathophysiology of Alzheimer disease (AD). The aim of this study was to evaluate the relationship between serum endocan levels and AD. Methods: A total of 134 patients (47 AD, 42 amnestic mild cognitive impairment [aMCI], and 45 control patients) 65 years of age and older were recruited in this study. Cognitive status of the patients was evaluated by performing the Montreal Cognitive Assessment (MOCA) and the Mini-Mental State Examination (MMSE). Serum endocan levels were measured with an enzyme-linked immunosorbent assay kit. Results: Median serum endocan level was significantly higher in AD patients (380.1 ng/mL) than in both aMCI patients (247.7 ng/mL) and controls (277.6 ng/mL; p < 0.01). Serum endocan level had a weak but significant correlation with MMSE and MOCA scores (r = –0.219 and r = –0.232; p = 0.012 and p = 0.01, respectively). Serum endocan level was detected as a factor independently associated with AD. The cutoff serum level of endocan predicting AD was >288.94 ng/mL in receiver operating characteristic curve analysis (area under the curve 0.71, 95% CI 66.7–90.9, sensitivity 80.9%, specificity 59.8%; p < 0.01). Conclusion: Higher serum endocan levels may be associated with the pathogenesis of AD. [ABSTRACT FROM AUTHOR]

Background: Masked hypertension is described as high ambulatory blood pressure measurements (ABPM) where office blood pressure measurements are normal. Effect of hypertension on cognitive functions is well known. However, the effect of masked hypertension on cognitive functions is unclear. The aim of this study is to examine the relationship between masked hypertension and cognitive functions.Methods: One hundred-two normotensive patients admitted to the Geriatric Medicine outpatient clinic were included. Exclusion criteria were hypertension, dementia, major depression, and usage of antihypertensive medication. All patients underwent ABPM procedures and average daytime blood pressure, mean blood pressure at night and the 24-hour average blood pressure measurements were recorded. Comprehensive geriatric assessment tests and neuropsychological tests were administered. The diagnosis of masked hypertension was based on the definitions in the 2013 guideline of the European Society of Cardiology.Results: Forty-four patients (43%) were diagnosed with masked hypertension. Patients with masked hypertension had significantly lower scores on Mini-Mental State Examination (MMSE) test, Quick Mild Cognitive Impairment Test (QMCI), and Categorical Fluency Test than the normotensive patients (p = .011; p = .046; and p = .004; respectively). Montreal Cognitive Assessment Scale test score was lower in masked hypertension, although this was not statistically significant.Conclusion: This study may indicate that geriatric patients with masked hypertension, compared to normotensive patients have decreased cognitive functions. Masked hypertension should be kept in mind while assessing older adults. When masked hypertension is detected, cognitive assessment is essential to diagnose possible cognitive dysfunction at early stage. [ABSTRACT FROM AUTHOR]

Background: The objective of this study was to validate the Turkish version of the Quick Mild Cognitive Impairment (Qmci-TR) screen. Methods: In total, 100 patients aged ≥65 years referred to a geriatric outpatient clinic with memory loss were included. The Qmci was compared to the Turkish versions of the standardized Mini-Mental State Examination and the Montreal Cognitive Assessment (MoCA). Results: The Qmci-TR had higher accuracy than the MoCA in discriminating subjective memory complaints (SMCs) from cognitive impairment (mild cognitive impairment [MCI] or dementia), of borderline significance after adjusting for age and education (P = .06). The Qmci-TR also had higher accuracy than the MoCA in differentiating MCI from SMC, which became nonsignificant after adjustment (P = .15). A similar pattern was shown for distinguishing MCI from dementia. Test reliability for the Qmci-TR was strong. Conclusion: The Qmci-TR is a reliable and useful screening tool for discriminating MCI from SMC and dementia in a Turkish population. [ABSTRACT FROM AUTHOR]

• Turkish version of Older People's Quality of Life-brief is a highly reliable scale. • Interclass correlation coefficient showed high test-retest reliability. • The scale was strongly correlated with Control, Autonomy, Self-realization, Pleasure-19. There are various 'quality of life' scales developed for older people. Although quality of life is a subjective concept, most of these scales are based on expert opinions rather than perspectives of older people. The aim of this study is to evaluate validity and reliability of Older People's Quality of Life-brief scale (OPQOL-brief), which is based on perspectives of older people, in Turkish population. A cross-sectional study was implemented in a Geriatric medicine outpatient clinic. Total number of 168 older patients who speak in Turkish fluently were recruited. Comprehensive geriatric assessment and OPQOL-brief was applied to all participants together with another quality of life scale validated in Turkish population, CASP-19 (Control, Autonomy, Self-realization, Pleasure). Validity was evaluated with construct validity, convergent validity and discriminant validity. Reliability was assessed with internal consistency and test-retest reliability. Mean age of the study population was 73.3 ± 5.9 years. Female participants were 64.9% (n = 109). Internal consistency was assessed by Cronbach's α coefficient. OPQOL-brief scale demonstrated high internal consistency (Cronbach's α = 0.876). Test-retest reliability was assessed by interclass correlation coefficient (ICC) and showed high reliability (ICC = 0.98, 95%CI = 0.96-0.99, p < 0.001). Strong and significant correlation was detected between OPQOL-brief and CASP-19 scales (r = 0.763, p < 0.001). Turkish version of OPQOL-brief has acceptable validity and reliability in Turkish population. The scale can be used to measure quality of life of older people. [ABSTRACT FROM AUTHOR]

Background: The novel molecule endocan, which is released by endothelium and is regulated by proangiogenic and proinflammatory cytokines, may have a role in the pathophysiology of Alzheimer disease (AD). The aim of this study was to evaluate the relationship between serum endocan levels and AD., Methods: A total of 134 patients (47 AD, 42 amnestic mild cognitive impairment [aMCI], and 45 control patients) 65 years of age and older were recruited in this study. Cognitive status of the patients was evaluated by performing the Montreal Cognitive Assessment (MOCA) and the Mini-Mental State Examination (MMSE). Serum endocan levels were measured with an enzyme-linked immunosorbent assay kit., Results: Median serum endocan level was significantly higher in AD patients (380.1 ng/mL) than in both aMCI patients (247.7 ng/mL) and controls (277.6 ng/mL; p < 0.01). Serum endocan level had a weak but significant correlation with MMSE and MOCA scores (r = -0.219 and r = -0.232; p = 0.012 and p = 0.01, respectively). Serum endocan level was detected as a factor independently associated with AD. The cutoff serum level of endocan predicting AD was >288.94 ng/mL in receiver operating characteristic curve analysis (area under the curve 0.71, 95% CI 66.7-90.9, sensitivity 80.9%, specificity 59.8%; p < 0.01)., Conclusion: Higher serum endocan levels may be associated with the pathogenesis of AD., (© 2018 S. Karger AG, Basel.)