258 results on '"Gulistan Bahat"'
Search Results
52. Malnutrition in the elderly and its relationship with other geriatric syndromes
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Saka, Bulent, Kaya, Omer, Ozturk, Gulistan Bahat, Erten, Nilgun, and Karan, M. Akif
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- 2010
- Full Text
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53. Orthogeriatrics: a vital requirement for improving fragility fracture patient care internationally with particular reference to Turkey
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Gulistan Bahat, Jean-Yves Reginster, Nezahat Muge Catikkas, and Mehmet Akif Karan
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0301 basic medicine ,medicine.medical_specialty ,Turkey ,Health Services for the Aged ,Frail Elderly ,030209 endocrinology & metabolism ,Laboratory testing ,Patient care ,03 medical and health sciences ,0302 clinical medicine ,Intervention (counseling) ,Osteoporosis treatment ,medicine ,Humans ,Orthopedics and Sports Medicine ,Intensive care medicine ,Aged ,Fragility fracture ,Hip Fractures ,business.industry ,Geriatric assessment ,Nutritional status ,Hospitalization ,030101 anatomy & morphology ,business ,Developed country ,Osteoporotic Fractures - Abstract
Orthogeriatrics is a team approach that aims to provide adequate and timely intervention for individuals suffering from fragility fractures, particularly hip fractures. These patients are mostly the frailest older adults. The aim of orthogeriatrics is to re-gain functionality as early as possible and to decrease disability and mortality. Some developed countries have established orthogeriatric services, while many others, including Turkey, have so far not. Here, to identify areas for improvement, we outline the status of the orthogeriatrics in older adults in Turkey. We present clear calls for action, emphasizing possible and noteworthy areas for improvement. Our proposals include the need for an easily applied, short version of comprehensive geriatric assessment; appropriate laboratory testing on admission; paracetamol with a special emphasis in its dosings and clues for state-of-the-art analgesic management; the essential need to introduce oral nutritional supplementation, irrespective of nutritional status; the need for vitamin D commencement, in almost all patients; and starting osteoporosis treatment in fracture hospitalization, whenever appropriate. Last but not least, the ever-increasing prerequisite to establish “fracture liaison services” is stipulated. We suggest that our recommendations offer great potential in Turkey, for the improvement of frail fracture patients’ care. We call the other countries that do not have established orthogeriatric lines to model our approach to improve the management of fracture patients globally.
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- 2021
54. Barriers and facilitators in using a Clinical Decision Support System for fall risk management for older people: a European survey
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Kim J, Ploegmakers, Stephanie, Medlock, Annemiek J, Linn, Yumin, Lin, Lotta J, Seppälä, Mirko, Petrovic, Eva, Topinkova, Jesper, Ryg, Maria Angeles Caballero, Mora, Francesco, Landi, Heinrich, Thaler, Katarzyna, Szczerbińska, Sirpa, Hartikainen, Gulistan, Bahat, Birkan, Ilhan, Yvonne, Morrissey, Tahir, Masud, Nathalie, van der Velde, and Julia C M, van Weert
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Male ,Risk Management ,Physicians ,Surveys and Questionnaires ,Humans ,Accidental Falls ,Female ,Disease Susceptibility ,Decision Support Systems, Clinical ,Aged - Abstract
Fall-Risk Increasing Drugs (FRIDs) are an important and modifiable fall-risk factor. A Clinical Decision Support System (CDSS) could support doctors in optimal FRIDs deprescribing. Understanding barriers and facilitators is important for a successful implementation of any CDSS. We conducted a European survey to assess barriers and facilitators to CDSS use and explored differences in their perceptions.We examined and compared the relative importance and the occurrence of regional differences of a literature-based list of barriers and facilitators for CDSS usage among physicians treating older fallers from 11 European countries.We surveyed 581 physicians (mean age 44.9 years, 64.5% female, 71.3% geriatricians). The main barriers were technical issues (66%) and indicating a reason before overriding an alert (58%). The main facilitators were a CDSS that is beneficial for patient care (68%) and easy-to-use (64%). We identified regional differences, e.g., expense and legal issues were barriers for significantly more Eastern-European physicians compared to other regions, while training was selected less often as a facilitator by West-European physicians. Some physicians believed that due to the medical complexity of their patients, their own clinical judgement is better than advice from the CDSS.When designing a CDSS for Geriatric Medicine, the patient's medical complexity must be addressed whilst maintaining the doctor's decision-making autonomy. For a successful CDSS implementation in Europe, regional differences in barrier perception should be overcome. Equipping a CDSS with prediction models has the potential to provide individualized recommendations for deprescribing FRIDs in older falls patients.
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- 2021
55. SARC-F can detect sarcopenia with a high sensitivity
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Duygu Erbas Sacar and Gulistan Bahat
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Oncology ,Aging ,medicine.medical_specialty ,Geriatrics gerontology ,business.industry ,Internal medicine ,Sarcopenia ,medicine ,MEDLINE ,Sensitivity (control systems) ,Geriatrics and Gerontology ,medicine.disease ,business - Published
- 2021
56. International Validation of the Turkish Inappropriate Medication Use in the Elderly (TIME) Criteria Set
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Mehmet Akif Karan, Birkan Ilhan, Yvonne Morrissey, Doron Garfinkel, Graziano Onder, Mirko Petrovic, Alfonso J. Cruz-Jentoft, Heinrich Burkhardt, Nathalie van der Velde, Tugba Erdogan, Eline Tommelein, Meryem Merve Oren, Farhad Pazan, Michael Denkinger, Eva Topinkova, Gulistan Bahat, Pharmaceutical and Pharmacological Sciences, Experimental Pharmacology, Geriatrics, AMS - Ageing & Vitality, and APH - Aging & Later Life
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medicine.medical_specialty ,Consensus ,Delphi Technique ,Turkish ,education ,Delphi method ,MEDLINE ,Inappropriate Prescribing ,Likert scale ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Pharmacology (medical) ,Original Research Article ,030212 general & internal medicine ,Set (psychology) ,Aged ,computer.programming_language ,Medication use ,business.industry ,language.human_language ,Eastern european ,Family medicine ,language ,Geriatrics and Gerontology ,business ,computer ,030217 neurology & neurosurgery ,Delphi - Abstract
Objective Explicit screening tools and implicit evaluation methods have been developed to assist healthcare professionals in the management of pharmacotherapy in older adults. As prescribing habits and locally available medications vary considerably between countries, guides tailored to the needs of specific regions may be required. We aimed to report the results of the international Delphi validation study for the Turkish Inappropriate Medication use in the Elderly (TIME) criteria set, which aims to detect inappropriate prescribing in older adults in Eastern Europe. Methods The study was conducted between June 2019 and March 2020. Delphi rounds were conducted by the TIME international working group, which included 11 internationally recognized experts in geriatric pharmacotherapy as Delphi panelists. They were asked to indicate to what extent they agreed or disagreed with each TIME criterion, taking into account both the available evidence and their own experience. We used a five-point Likert scale from 1 (strongly agree) to 5 (strongly disagree) and an online software program (SurveyMonkey®) to grade the level of agreement. Criteria with a median value of 1 or 2 and a 75th centile value of 1 or 2 were accepted, and criteria with a median value > 2 were rejected. Those with a median value of 1 or 2 but a 75th centile value > 2 were retained, to be assessed in the following round. The initial list of Delphi criteria comprised 153 TIME items. Results After three Delphi rounds, 134 criteria were accepted and seven criteria were rejected, while 12 criteria did not achieve consensus, and so were not included in the final validated set of TIME criteria. Conclusion We developed the internationally validated TIME criteria set based on a Delphi process involving international experts. The validation study suggests that the TIME criteria set can be applied in both central and Eastern European settings. Further studies are needed to assess the utility and benefit of the TIME criteria in reducing inappropriate drug use and improving clinical outcomes. Supplementary Information The online version contains supplementary material available at 10.1007/s40266-021-00855-5.
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- 2021
57. Putting Sarcopenia at the Forefront of Clinical Practice
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Gulistan Bahat and Alfonso J. Cruz-Jentoft
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Gerontology ,Clinical Practice ,business.industry ,Sarcopenia ,medicine ,medicine.disease ,business - Published
- 2019
58. A Challenging Hypoactive Delirium Case with Multiple Etiological Considerations
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Tugba Erdogan, Birkan Ilhan, Mehmet Akif Karan, and Gulistan Bahat
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medicine.medical_specialty ,business.industry ,medicine ,Etiology ,Delirium ,medicine.symptom ,Intensive care medicine ,business - Published
- 2019
59. The relationship between sarcopenia and urinary incontinence
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Meryem Merve Oren, Pinar Kucukdagli, Gulistan Bahat, Cihan Kilic, Mehmet Akif Karan, Onur Erdogan, and Tugba Erdogan
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medicine.medical_specialty ,Constipation ,030214 geriatrics ,business.industry ,Urinary incontinence ,medicine.disease ,Preferred walking speed ,03 medical and health sciences ,Grip strength ,0302 clinical medicine ,Sarcopenia ,Physical therapy ,Medicine ,Outpatient clinic ,Fecal incontinence ,030212 general & internal medicine ,medicine.symptom ,business ,human activities ,Body mass index - Abstract
The purpose of this research was to investigate the relationship between urinary incontinence (stress and/or urgency) and sarcopenia in a large group of female older adults. UI is independently associated with sarcopenia when muscle mass was adjusted by weight and also with presence of low muscle mass when muscle mass was adjusted by weight or BMI. Evaluation of sarcopenia may have a role in the management of stress and urgency urinary incontinence. Urinary incontinence (UI) is a common cause of morbidity in the female older adult. Identification of factors associated with UI is necessary to identify risky individuals, to take preventive measures, and to recognize commonly associated co-morbidities. We suggest that sarcopenia may be associated with UI through decrease in muscle mass/strength. In this study, we aimed to investigate the relationship between UI (stress and/or urgency) and sarcopenia. Female older adults ≥ 60 years that applied to geriatric outpatient clinic were analyzed cross-sectionally. The presence of UI, UI types, fecal incontinence, and constipation was obtained. Functional status was assessed by basic and instrumental activities of daily living (ADL and IADL), nutrition by mini-nutritional assessment-short form (MNA-SF). Total muscle mass was measured by bioimpedance analysis. Hand grip strength and walking speed were assessed. A total of 802 female adults were included. The prevalence of UI was 48.9%. Associated factors with presence of UI were higher age and BMI, presence of fecal incontinence, constipation, lower activities of ADL and IADL scores, lower grip strength, lower skeletal muscle mass adjusted by weight and BMI, and presence of sarcopenia adjusted by weight and BMI. Independent factors related with UI were presence of fecal incontinence, constipation, IADL dependency, low muscle mass adjusted by weight and body mass index, and sarcopenia adjusted by weight. The results of our study suggest that UI is independently associated with sarcopenia when muscle mass was adjusted by weight and also with presence of low muscle mass when muscle mass was adjusted by weight or BMI.
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- 2019
60. Association between Dysphagia and Frailty in Community Dwelling Older Adults
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Gulistan Bahat, Mehmet Akif Karan, Cemil Tascioglu, Ozlem Yilmaz, Cihan Kilic, and S. Durmazoglu
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Male ,Gerontology ,030309 nutrition & dietetics ,Frail Elderly ,Medicine (miscellaneous) ,Poison control ,Suicide prevention ,Occupational safety and health ,03 medical and health sciences ,0302 clinical medicine ,Injury prevention ,medicine ,Humans ,Outpatient clinic ,Prospective Studies ,030212 general & internal medicine ,Association (psychology) ,Geriatric Assessment ,Aged ,Aged, 80 and over ,0303 health sciences ,Nutrition and Dietetics ,Frailty ,business.industry ,Human factors and ergonomics ,Middle Aged ,Dysphagia ,Cross-Sectional Studies ,Female ,Independent Living ,Geriatrics and Gerontology ,medicine.symptom ,Deglutition Disorders ,business - Abstract
Dysphagia is described as a geriatric syndrome that occurs more frequently with aging. It is associated with the deterioration in functionality however, it is usually ignored. Frailty is a geriatric syndrome that is recognized more with its well-known adverse consequences. Very recently, dysphagia has been suggested to accompany frailty in older adults. We aimed to investigate the association between dysphagia and frailty in the community dwelling older adults.Prospective, cross-sectional study.Geriatric outpatient clinic.Older adults aged ≥60 years.Dysphagia was evaluated by EAT-10 questionnaire and frailty by FRAIL scale. Handgrip strength (HGS) was evaluated by hand-dynamometer. Gait speed was evaluated by 4-meter usual gait speed (UGS). Nutritional status was assessed by mini-nutritional assessment-short form (MNA-SF).1138 patients were enrolled. Mean age was 74.1±7.3 years. EAT-10 questionnaire was answered by all and FRAIL-scale by 851 subjects. EAT-10 score15 points was regarded as significant dysphagia risk. The participants with EAT-1015 points were older when compared to the participants with EAT-10=15 points (p=0.002). Among participants with EAT-1015 points, women gender and neurodegenerative diseases were more prevalent (p=0.04, p=0.002; respectively); number of chronic diseases, number of drugs and FRAIL score were higher (p=0.001 for each), and HGS, UGS, MNA-SF scores were lower (p=0.002, p=0.01, p0.001; respectively). In multivariate analyses, the factors independently associated with presence of EAT-10 score15 were FRAIL score and the number of drugs.Dysphagia is associated with frailty irrespective to age, presence of neurodegenerative diseases, number of chronic diseases and drugs. To our knowledge, this is the largest serie in the literature providing data on independent association of dysphagia with frailty.
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- 2019
61. The impact of frailty and its associations among a sample of community-dwelling older adults
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Meris E. Bozkurt, Nezahat M. Catikkas, Meryem M. Oren, Cihan Kilic, Mehmet A. Karan, and Gulistan Bahat
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Endocrinology, Diabetes and Metabolism ,Radiology, Nuclear Medicine and imaging ,Orthopedics and Sports Medicine - Published
- 2022
62. The current situation in the approach to osteoporosis in older adults in Turkey: areas in need of improvement with a model for other populations
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Gulistan Bahat, Nezahat M. Catikkas, Dilek Gogas Yavuz, Pinar Borman, Rengin Guzel, Meris E. Bozkurt, and Jean-Yves Reginster
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Endocrinology, Diabetes and Metabolism ,Radiology, Nuclear Medicine and imaging ,Orthopedics and Sports Medicine - Published
- 2022
63. Anorexia is Independently Associated with Decreased Muscle Mass and Strength in Community Dwelling Older Adults
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Mehmet Akif Karan, Gulistan Bahat, Birkan Ilhan, Cihan Kilic, and Tugba Erdogan
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Male ,Sarcopenia ,medicine.medical_specialty ,Turkey ,030309 nutrition & dietetics ,media_common.quotation_subject ,Appetite ,Medicine (miscellaneous) ,Anorexia ,03 medical and health sciences ,Grip strength ,0302 clinical medicine ,Surveys and Questionnaires ,Prevalence ,medicine ,Humans ,Prospective Studies ,030212 general & internal medicine ,Muscle, Skeletal ,Prospective cohort study ,Aged ,media_common ,Aged, 80 and over ,0303 health sciences ,Univariate analysis ,Nutrition and Dietetics ,Hand Strength ,business.industry ,medicine.disease ,Walking Speed ,Cross-Sectional Studies ,Poor Appetite ,Quality of Life ,Physical therapy ,Female ,Geriatric Depression Scale ,Independent Living ,Geriatrics and Gerontology ,medicine.symptom ,business ,human activities - Abstract
We aimed to investigate the association between anorexia and sarcopenia in community dwelling older adults. Anorexia was assessed by Simplified Nutritional Appetite Questionnaire (SNAQ) and sarcopenia defined by EWSGOP criteria. Study participants consisted of 442 patients from Turkish validation study of the SNAQ. Study is designed as cross-sectional in community dwelling outpatients. Muscle mass was determined by using bioimpedance analysis. Skeletal muscle mass index (SMMI) was calculated as SMM (kg)/height (m)2. Muscle strength was evaluated by hand grip strength (HGS) with Jamar hydraulic hand dynamometer. Gait speed (GS) was assessed by usual 4 meters speed. Depression and quality of life were assessed by using Geriatric Depression Scale (GDS) and Euro-Quality of Life-5D(EQ-5D). Univariate analysis and multivariate regression analysis were run to evaluate the association between poor appetite and components of sarcopenia. Prevalences of low HGS, low gait speed and sarcopenia were higher in group with poor appetite (p=0.001, p
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- 2018
64. Prevalence of sarcopenia and its components in community-dwelling outpatient older adults and their relation with functionality
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Gulistan Bahat, Alfonso J. Cruz-Jentoft, Mehmet Akif Karan, Cihan Kilic, and Asli Tufan
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Male ,Sarcopenia ,medicine.medical_specialty ,Activities of daily living ,Osteoporosis ,030232 urology & nephrology ,Poison control ,030209 endocrinology & metabolism ,03 medical and health sciences ,Grip strength ,0302 clinical medicine ,Activities of Daily Living ,Outpatients ,Prevalence ,medicine ,Humans ,Outpatient clinic ,Muscle, Skeletal ,Aged ,Aged, 80 and over ,Bone mineral ,Geriatrics ,Hand Strength ,business.industry ,medicine.disease ,Physical therapy ,Female ,Independent Living ,Geriatrics and Gerontology ,business ,human activities - Abstract
AIM Sarcopenia is recognized with its adverse functional outcomes. We aimed to report the prevalence of European Working Group on Sarcopenia in Older People (EWGSOP) defined sarcopenia and its individual components in community dwelling outpatient older adults and study the correlations of EWGSOP defined sarcopenia, muscle mass, muscle strength, and physical performance with functional status. MATERIAL AND METHODS The subjects were prospectively recruited from the geriatrics outpatient clinics of our university hospital. Body composition was assessed with bioimpedance analysis. Muscle strength was assessed by measurement of hand grip strength with hydraulic hand dynamometer, physical performance was assessed by 4 meter usual gait speed (UGS). Impaired muscle function was defined as presence of low muscle strength and or slow gait speed. As a measure of functionality, modified version of Katz activities of daily living (ADL) and Lawton instrumental activities of daily living (IADL) were assessed. RESULTS A total of 242 community dwelling outpatients with mean age of 79.4 ± 5.7 years were enrolled. 31.8% were male. Prevalence of low muscle mass was 2.1% and impaired muscle function was 71.1%. Prevalence of EWGSOP defined sarcopenia was 0.8% (1.3% in men and 0.6% in women). Most correlated parameter with ADL and IADL was the usual gait speed (r = 0.49, r = 0.63; p
- Published
- 2018
65. SARC-F Questionnaire Detects Frailty in Older Adults
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Serdar Ozkok, Mehmet Akif Karan, Cihan Kilic, and Gulistan Bahat
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Gerontology ,Male ,030309 nutrition & dietetics ,Medicine (miscellaneous) ,03 medical and health sciences ,0302 clinical medicine ,Surveys and Questionnaires ,Area under curve ,medicine ,Humans ,030212 general & internal medicine ,Geriatric Assessment ,Quality of Life Research ,Aged ,Retrospective Studies ,Aged, 80 and over ,0303 health sciences ,Nutrition and Dietetics ,Receiver operating characteristic ,Frailty ,business.industry ,Area under the curve ,Mean age ,NUTRITION&DIETETICS ,medicine.disease ,Confidence interval ,Cross-Sectional Studies ,Sarcopenia ,Female ,Geriatrics and Gerontology ,business - Abstract
The physical phenotype of frailty, described by Fried et al., shows significant overlap with sarcopenia. EWGSOP2 recommends the SARC-F questionnaire to screen for sarcopenia. Considering common features between both conditions, we aimed to investigate whether the SARC-F questionnaire could also be a valid and reliable tool to screen or evaluate frailty. Retrospective, cross-sectional. Istanbul University Istanbul Faculty of Medicine. A total of 447 older adults (70.7% female, mean age: 74.5±6.6 years). Frailty was assessed by the modified Fried scale. SARC-F questionnaire was performed by all participants. We used a receiver operating characteristics curve to obtain SARC-F cut-off values to detect frailty, and calculated the area under the curve and 95% confidence interval. There were 93 (20.8%) older adults with frailty according to the modified Fried scale. SARC-F cut-off ≥1 had 91.4% sensitivity and 44.9% specificity. SARC-F cut-off ≥2 presented the best balance between sensitivity and specificity (sensitivity: 74.1% vs. specificity: 73.7%) to identify frailty (area under curve: 0.807; 95% confidence interval: 0.76–0.84, p
- Published
- 2021
66. Prevalence and Associates of Fear of Falling among Community-Dwelling Older Adults
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Gulistan Bahat Ozturk, Cihan Kilic, M. E. Bozkurt, and Mehmet Akif Karan
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Gerontology ,Male ,Activities of daily living ,030309 nutrition & dietetics ,Medicine (miscellaneous) ,Timed Up and Go test ,Fear of falling ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Prevalence ,Medicine ,Outpatient clinic ,Humans ,030212 general & internal medicine ,Depression (differential diagnoses) ,Aged ,Retrospective Studies ,Aged, 80 and over ,0303 health sciences ,Nutrition and Dietetics ,business.industry ,Fear ,Middle Aged ,medicine.disease ,Cross-Sectional Studies ,Sarcopenia ,Anxiety ,Accidental Falls ,Female ,Independent Living ,Geriatrics and Gerontology ,medicine.symptom ,business ,human activities - Abstract
We aimed to study the prevalence of fear of falling (FOF), and its association with physical performance, functionality, frailty, sarcopenia, and a variety of geriatric syndromes including cognitive impairment, depression, quality of life and hearing. Retrospective, cross-sectional study. Community-dwelling older adults applied to the geriatric outpatient clinic of a university hospital. A total of 1021community-dwelling older adults >= 60 years of age applying to the geriatric outpatient clinic of a university hospital. We screened for falls and FOF by single close-ended questions. We performed screening and assessment of probable sarcopenia by SARC-F test and handgrip strength evaluation according to EWGSOP2. We used timed up and go test (TUG), usual gait speed (UGS) for physical performance, and Katz- activities of daily living (ADL) and Lawton-Brody instrumental activities of daily living (IADL) for functional evaluation. We screened anxiety with the Generalized Anxiety Disorder-7 scale. The prevalence of FOF was 44.6% and falls, 37.7%. Prevalence of FOF in sarcopenia screening positive participants was 30.1%; in probable sarcopenic (35/20 kg) participants, 43.9%; in those with undernutrition, 45.7%; in fallers, 51.1%; in females, 80.4%; and in prefrail/frail was 74.7% Multivariate regression analyses revealed that female sex (OR=4.1, 95%CI= 2.0–8.4, p
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- 2021
67. Skeletal muscle mass assessment to detect low muscle mass: Regional or total?
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Nezahat Muge Catikkas, Mehmet Akif Karan, and Gulistan Bahat
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Pathology ,medicine.medical_specialty ,Sarcopenia ,Nutrition and Dietetics ,business.industry ,Geriatrics gerontology ,Critical Care and Intensive Care Medicine ,Skeletal muscle mass ,Low muscle mass ,Medicine ,Humans ,Body Weights and Measures ,business ,Muscle, Skeletal - Published
- 2021
68. The current situation in the approach to osteoporosis in older adults in Turkey: areas in need of improvement with a model for other populations
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Gulistan Bahat, Pınar Borman, Dilek Gogas Yavuz, Rengin Güzel, Jean-Yves Reginster, and Nezahat Muge Catikkas
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Fracture risk ,Gerontology ,Male ,FRAX ,Turkey ,business.industry ,Geriatrics gerontology ,Osteoporosis ,High fracture ,Fall risk ,medicine.disease ,Risk Assessment ,Absorptiometry, Photon ,Bone Density ,medicine ,Humans ,Orthopedics and Sports Medicine ,Osteoporotic fracture ,business ,Reimbursement ,Osteoporotic Fractures ,Aged - Abstract
PURPOSE The total number of older adults in Turkey is striking, amounting to around 8 million, and this translates into considerably higher numbers of cases of osteoporosis (OP) and fractures in older adults. In this article, we outlined the current situation of OP in older adults in Turkey and investigated the differences between Turkey and a representative developed European country (Belgium), in terms of the screening, diagnosis, and treatment of OP. Our intention in this regard was to identify areas in need of improvement and subsequently to make a clear call for action to address these issues. METHODS Herein, considering the steps related to the OP approach, we made a complete review of the studies conducted in Turkey and compared with the literature recommendations. RESULTS There is a need for a national osteoporotic fracture registry; measures should be taken to improve the screening and treatment of OP in older males, such as educational activities; technicians involved in dual-energy X-ray absorptiometry (DXA) scanning should undergo routine periodic training; all DXA centers should identify center-specific least significant change values; all older adults should be considered for routine lateral dorsolumbar X-ray imaging for the screening of vertebral fractures while ordering DXA scans; the inclusion of vertebral fracture assessment (VFA) software in DXA assessments should be considered; screening using a fracture risk assessment tool (FRAX) algorithm that is specific to Turkey should be integrated; the fortification of foods with vitamin D is required; the high fracture risk by country-specific FRAX algorithm and the presence of falls/high fall risk should be integrated in reimbursement terms; and finally, more "fracture liaison services" should be established. CONCLUSION We suggest that the practical consideration of our suggestions will provide considerable support to the efforts for combating with the adverse consequences of OP in society. This approach can be subsequently modeled for other populations to improve the management of OP globally.
- Published
- 2021
69. TİP 2 DİYABETLİ YAŞLI BİREYLERDE KIRILGANLIĞI ETKİLEYEN FAKTÖRLER NELERDİR?
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Mehmet Akif Karan, Ramazan Çakmak, Ozlem Yilmaz, Gulistan Bahat, Sakin Tekin, Sena Gürkaş, Ilhan Satman, Meryem Merve Oren, Nurdan Gul, and Cemile Idiz
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Gynecology ,medicine.medical_specialty ,Health Care Sciences and Services ,business.industry ,medicine ,Elderly people ,Kırılganlık,yaşlılık,diyabet,malnütrisyon,depresyon,yaşam kalitesi ,Type 2 diabetes ,Sağlık Bilimleri ve Hizmetleri ,medicine.disease ,business ,Frailty,elderly,diabetes,malnutrition,depression,quality of life - Abstract
Amaç: Çalışmamızın amacı tip 2 diyabet tanısı almış yaşlı erişkinlerde kırılganlıkla ilgili faktörleri belirlemektir. Gereç ve Yöntem: Çalışmaya 65 yaş ve üstü, tip 2 diyabet tanısı almış 108 kişi dahil edildi. Katılımcıların kırılganlığı FRAIL anketi ile değerlendirilmiş, beslenme durumu Mini Beslenme Değerlendirme Kısa Formu (MNA-SF) ile, depresyon durumu Hasta Sağlığı Anketi-2 (PHQ2) ve Geriatrik Depresyon Ölçeği Kısa Formu (GDS-SF) ile değerlendirilirken, yaşam kalitesi EuroQol-5 Boyut (EQ5D) ve EQ VAS puanlaması ile, kişisel bakım durumları ise Günlük Yaşamın Temel Aktiviteleri (BADL) ve Günlük Yaşamın Enstrümantal Aktiviteleri (IADL) formları ile değerlendirilmiştir. Bulgular: Kırılgan grupta, kırılgan olmayanlara göre uyku sorunları, düşme korkusu, idrar kaçırma, PHQ2, GDS-SF ve EQ5D skorları anlamlı olarak yüksek; MNASF skoru ise anlamlı olarak düşüktü (p, Objective: Our study aimed to determine the factors related to frailty in elderly adults having been diagnosed with type 2 diabetes mellitus. Material and Method: A total of 108 people aged 65 and over, diagnosed with type 2 diabetes, were included in the study. The frailty of the participants was evaluated with the FRAIL questionnaire, their nutritional status was evaluated with the Mini Nutrition Assessment Short Form (MNA-SF), the depression status with the Patient Health Questionnaire-2 (PHQ2) and the Geriatric Depression Scale Short Form (GDS-SF), while the quality of life was evaluated with the EuroQol-5 Dimension (EQ5D) and Scoring the EQ-VAS, and personal care status were evaluated with Basic Activities of Daily Living (BADL) and Instrumental Activities of Daily Living (IADL) forms. Results: Sleep problems, fear of falling, presence of urinary incontinence, PHQ2, GDS-SF, and EQ5D scores were significantly higher; the MNASF score was significantly lower in the frail group than the values in the non-frail group (p
- Published
- 2021
70. Comparison of standard
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Gulistan, Bahat, Cihan, Kilic, Mustafa, Altinkaynak, and Mehmet, Akif Karan
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Aged, 80 and over ,Male ,Sarcopenia ,Cross-Sectional Studies ,Hand Strength ,Time and Motion Studies ,Prevalence ,Humans ,Female ,Postural Balance ,Aged ,Retrospective Studies - Abstract
We aimed to compare European Working Group on Sarcopenia in Older People (EWGSOP2)-suggested and population-specific handgrip strength (HGS) thresholds to detect probable sarcopenia and their associations with physical-performance measures and frailty.A retrospective cross-sectional observational-study included geriatrics outpatients applied to a university-hospital. HGS, timed up and go test (TUG), and usual gait speed (UGS) were assessed. Frailty was screened by FRAIL-scale.A total of 1825 older adults were included (mean age, 74.5 + 7.0 years; 68.8% female). Prevalence of low-HGS were 12.2% by the EWGSOP2-recommended (27/16 kg) cut-offs and 37.5% by population-specific cut-offs (35/20 kg) (Application of EWGSOP2-recommended standard HGS-cut-offs showed successful application in-practice. However, use of standard HGS cut-offs may result in underdiagnosis of probable sarcopenia. Therefore, we suggest that, whenever available, use of population-specific cut-offs for HGS may be better for correctly identifying older adults at risk.
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- 2021
71. Atrial fibrillation: a geriatric perspective on the 2020 ESC guidelines
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Serdar Ozkok, Anne Sophie Boureau, Roman Pfister, Gulistan Bahat, Mariana Alves, Mario Bo, M. Cristina Polidori, Nicola Veronese, Alberto Pilotto, Polidori, M.C., Alves, M., Bahat, G., Boureau, A.S., Ozkok, S., Pfister, R., Pilotto, A., Veronese, N., Bo, M., and on behalf of the Special Interest Group Cardiovascular Diseases of the EuGMS
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medicine.medical_specialty ,Atrial fbrillation · Advanced age · Older patients · Anticoagulation · Cognitive impairment ,Clinical Decision-Making ,Cardiology ,Management of atrial fibrillation ,Review ,Palpation ,Anticoagulation ,Older patients ,Humans ,Medicine ,Intensive care medicine ,Geriatric Assessment ,Contraindication ,Aged ,Frailty ,medicine.diagnostic_test ,business.industry ,Perspective (graphical) ,Atrial fibrillation ,Advanced age ,medicine.disease ,Clinical trial ,Cognitive impairment ,Cardiothoracic surgery ,business - Abstract
Key Summary Points Aim To provide a geriatric perspective on the 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio–Thoracic Surgery (EACTS). Findings While the large majority of AF patients in real life are older, frail and cognitively impaired, these are mostly excluded from clinical trials, and physicians’ attitudes often prevail over standardized algorithms. On the basis of existing evidence, we suggest that (1) opportunistic AF screening by pulse palpation or ECG rhythm strip is cost-effective, and (2) whereas advanced chronological age by itself is not a contraindication to AF treatment, a Comprehesive Geriatric Assessment (CGA) including frailty, cognitive impairment, falls and bleeding risk may assist in clinical decision making to provide the best individualized treatment. Message The integration of CGA might positively influence clinical decision making in older patients with atrial fibrillation., Background The Task Force for the diagnosis and management of atrial fibrillation (AF) of the European Society of Cardiology (ESC) published in 2020 the updated Guidelines for the Diagnosis and Management of Atrial Fibrillation with the contribution of the European Heart Rhythm Association (EHRA) of the ESC and the European Association for Cardiothoracic Surgery (EACTS). Methods and results In this narrative viewpoint, we approach AF from the perspective of aging medicine and try to provide the readers with information usually neglected in clinical routine, mainly due to the fact that while the large majority of AF patients in real life are older, frail and cognitively impaired, these are mostly excluded from clinical trials, and physicians’ attitudes often prevail over standardized algorithms. Conclusions On the basis of existing evidence, (1) opportunistic AF screening by pulse palpation or ECG rhythm strip is cost-effective, and (2) whereas advanced chronological age by itself is not a contraindication to AF treatment, a Comprehensive Geriatric Assessment (CGA) including frailty, cognitive impairment, falls and bleeding risk may assist in clinical decision making to provide the best individualized treatment.
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- 2021
72. Protecting older patients with cardiovascular diseases from COVID-19 complications using current medications
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Tomasz Grodzicki, Nikos Werner, A. Benetos, Chakravarthi Rajkumar, Francesco U.S. Mattace-Raso, Timo E. Strandberg, Hugo Clemente, Gulistan Bahat, Athanase Benetos, Marilia Andreia Fernandes, Manuel Martínez-Sellés, Andrea Ungar, Mariana Alves, HUS Internal Medicine and Rehabilitation, Timo Strandberg / Principal Investigator, Department of Medicine, Clinicum, University of Helsinki, and Internal Medicine
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Enfermedad cardiovascular ,Angiotensin-Converting Enzyme Inhibitors ,030204 cardiovascular system & hematology ,Cardiovascular Diseases / drug therapy ,Renin-Angiotensin System ,0302 clinical medicine ,RAAS ,Renin-Angiotensin System / drug effects ,INFECTION ,030212 general & internal medicine ,Vitamin D ,VITAMIN-D ,media_common ,RISK ,Aspirin ,OUTCOMES ,Medicamento ,Diabetes ,ASSOCIATION ,NSAID ,3. Good health ,PREVALENCE ,Antiarrhytmic ,Cardiovascular Diseases ,Anticoaculant ,RECEPTOR BLOCKERS ,medicine.drug ,Drug ,medicine.medical_specialty ,Statin ,medicine.drug_class ,media_common.quotation_subject ,Infecciones por coronavirus ,Anciano ,Angiotensin Receptor Antagonists ,Special Article ,03 medical and health sciences ,SDG 3 - Good Health and Well-being ,Diabetes mellitus ,medicine ,Coagulopathy ,Humans ,DRUGS ,Intensive care medicine ,Pandemics ,Aged ,Polypharmacy ,SARS-CoV-2 ,business.industry ,SARS-CoV-2 / pathogenicity ,COVID-19 ,Angiotensin Receptor Antagonists / therapeutic use ,HCC MED ,medicine.disease ,STATIN USE ,COVID-19 Drug Treatment ,CONVERTING ENZYME-INHIBITORS ,3121 General medicine, internal medicine and other clinical medicine ,Propensity score matching ,SARS-CoV-2 / isolation & purification ,Observational study ,business ,Colchicine ,Angiotensin-Converting Enzyme Inhibitors / therapeutic use ,COVID-19 / diagnosis - Abstract
Key summary points Aim To review current cardiovascular medications for benefits and potential harms during COVID-19. Findings Several cardiovascular drugs have a potential to protect patients with COVID-19, although evidence is largely based on observational studies and age-specific data are scarce. Message Most current cardiovascular drugs can be safely continued during COVID-19, but general conditions common in older patients must be considered. Supplementary Information The online version contains supplementary material available at 10.1007/s41999-021-00504-5., Purpose In the pathogenesis of severe COVID-19 complications, derangements of renin–angiotensin–aldosterone system (RAAS), vascular endothelial dysfunction leading to inflammation and coagulopathy, and arrhythmias play an important role. Therefore, it is worth considering the use of currently available drugs to protect COVID-19 patients with cardiovascular diseases. Methods We review the current experience of conventional cardiovascular drugs [angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers, anticoagulants, acetosalicylic acid, antiarrhythmic drugs, statins] as well as some other drug classes (antidiabetic drugs, vitamin D and NSAIDs) frequently used by older patients with cardiovascular diseases. Data were sought from clinical databases for COVID-19 and appropriate key words. Conclusions and recommendations are based on a consensus among all authors. Results Several cardiovascular drugs have a potential to protect patients with COVID-19, although evidence is largely based on retrospective, observational studies. Despite propensity score adjustments used in many analyses observational studies are not equivalent to randomised controlled trials (RCTs). Ongoing RCTs include treatment with antithrombotics, pulmonary vasodilators, RAAS-related drugs, and colchicine. RCTs in the acute phase of COVID-19 may not, however, recognise the benefits of long term anti-atherogenic therapies, such as statins. Conclusions Most current cardiovascular drugs can be safely continued during COVID-19. Some drug classes may even be protective. Age-specific data are scarce, though, and conditions which are common in older patients (frailty, comorbidities, polypharmacy) must be individually considered for each drug group. Supplementary Information The online version contains supplementary material available at 10.1007/s41999-021-00504-5.
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- 2021
73. STOPPFall (Screening Tool of Older Persons Prescriptions in older adults with high fall risk): a Delphi study by the EuGMS Task and Finish Group on Fall-Risk-Increasing Drugs
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Andrea Correa-Pérez, Tischa J. M. van der Cammen, Peter Crome, Alpana Mair, Adalsteinn Gudmundsson, Eva Topinkova, Wilma Knol, George Soulis, Denis O'Mahony, Antonio Cherubini, Martin Wehling, Nathalie van der Velde, Lotta Seppälä, Francesco Landi, Mirko Petrovic, Gijsbertus Ziere, Michael Denkinger, Sirpa Hartikainen, Katarzyna Szczerbińska, Gulistan Bahat, Marielle H. Emmelot-Vonk, María Ángeles Caballero Mora, Jesper Ryg, Birkan Ilhan, Stephen H D Jackson, Yvonne Morrissey, Marta Gutiérrez-Valencia, Graduate School, APH - Aging & Later Life, AMS - Amsterdam Movement Sciences, Geriatrics, AMS - Ageing & Vitality, Internal Medicine, and Epidemiology
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Aging ,medicine.medical_specialty ,Delphi Technique ,Delphi method ,SCREENING TOOL ,Likert scale ,Task (project management) ,older people ,deprescribing ,Deprescribing ,ALERT DOCTORS ,medicine ,Medicine and Health Sciences ,80 and over ,CRITERIA ,Humans ,Medical prescription ,computer.programming_language ,Aged ,Aged, 80 and over ,business.industry ,Adverse effects ,General Medicine ,Fall-risk-increasing drugs ,fall-risk-increasing drugs ,Europe ,aged ,Systematic review ,Prescriptions ,Pharmaceutical Preparations ,Family medicine ,adverse effects ,Accidental Falls ,accidental falls ,Geriatrics and Gerontology ,Older people ,business ,computer ,Delphi ,Fall prevention - Abstract
Background Healthcare professionals are often reluctant to deprescribe fall-risk-increasing drugs (FRIDs). Lack of knowledge and skills form a significant barrier and furthermore, there is no consensus on which medications are considered as FRIDs despite several systematic reviews. To support clinicians in the management of FRIDs and to facilitate the deprescribing process, STOPPFall (Screening Tool of Older Persons Prescriptions in older adults with high fall risk) and a deprescribing tool were developed by a European expert group. Methods STOPPFall was created by two facilitators based on evidence from recent meta-analyses and national fall prevention guidelines in Europe. Twenty-four panellists chose their level of agreement on a Likert scale with the items in the STOPPFall in three Delphi panel rounds. A threshold of 70% was selected for consensus a priori. The panellists were asked whether some agents are more fall-risk-increasing than others within the same pharmacological class. In an additional questionnaire, panellists were asked in which cases deprescribing of FRIDs should be considered and how it should be performed. Results The panellists agreed on 14 medication classes to be included in the STOPPFall. They were mostly psychotropic medications. The panellists indicated 18 differences between pharmacological subclasses with regard to fall-risk-increasing properties. Practical deprescribing guidance was developed for STOPPFall medication classes. Conclusion STOPPFall was created using an expert Delphi consensus process and combined with a practical deprescribing tool designed to optimise medication review. The effectiveness of these tools in falls prevention should be further evaluated in intervention studies.
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- 2021
74. Yaşlı Malnutrisyonunda Diyet ve Fiziksel Egzersizin Beslenme Durumu, Fiziksel Performans, Yaşam Kalitesi Üzerine Etkisi
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Huzeyfe Arici, Akpinar, Timur Selcuk, Gulistan Bahat Ozturk, Bayramlar, Osman Faruk, and Bulent Saka
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- 2021
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75. Acute sarcopenia changes following hospitalization : influence of pre-admission care dependency level
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Evelien Wynendaele, Gulistan Bahat, Ester Marco, Hana Vankova, Karolina Piotrowicz, Genia Decker, Nele Van Den Noortgate, Anton De Spiegeleer, Dhurgham Hussein, Suzy Hope, Celine Detremerie, Florence Benoit, Dhayana Dallmeier, Dolores Sánchez-Rodríguez, Hasan Kahya, Dirk Elewaut, Jerzy Gasowski, Miguel Toscano-Rico, Delky Meza-Valderrama, Joanna Czesak, Murielle Surquin, Francesco Landi, Amélie Descamps, and Dana Hrnciarikova
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Gerontology ,Aging ,Sarcopenia ,Acute sarcopenia ,Care home ,Psychological intervention ,Affect (psychology) ,Linear regression ,Medicine ,Humans ,Prospective Studies ,Risk factor ,Geriatric Assessment ,Aged ,Hand Strength ,business.industry ,Care dependency ,Confounding ,General Medicine ,medicine.disease ,Preferred walking speed ,Hospitalization ,Older people ,Geriatrics and Gerontology ,business - Abstract
Introduction Hospitalization is associated with acute changes in sarcopenia status in older people, but the influencing factors are not fully understood. Pre-admission care dependency level as a risk factor has not yet been investigated. Objective Evaluate if pre-admission care dependency level is an independent predictor of sarcopenia changes following hospitalization. Setting and subjects Data came from the Sarcopenia 9+ EAMA Project, a European prospective multi-centre study. For this study, 227 hospitalised older people were included from four different hospitals in Belgium, Spain and Poland, between 18 February 2019 and 5 September 2020. Methods Sarcopenia status at admission and discharge were calculated using a combined score (desirability value) based on muscle mass (calf circumference), strength (grip) and function (walking speed). Ratio of admission to discharge status was the outcome (desirability ratio; 1.00 meaning no difference). Predictor variable was the pre-admission care dependency level, classified into three groups: independent older people living at home, dependent older people living at home and older people living in a care home. Linear regression models were applied, considering potential confounders. Results Mean desirability ratio for dependent older people living at home (‘middle dependent group’) was lower (0.89) compared to independent older people (0.98; regression coefficient −0.09 [95% CI −0.16, −0.02]) and care home patients (1.05; −0.16 [95% CI −0.01, −0.31]). Adjusting for potential confounders or using another statistical approach did not affect the main results. Conclusion Dependent older people living at home were at higher risk of deterioration in sarcopenia status following hospitalization. In-depth studies investigating causes and potential interventions of these findings are needed.
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- 2021
76. Corticosteroid treatment normalizes QTc prolongation and improves heart block in an elderly patient with anti-Ro-positive systemic lupus erythematosus
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Saribayev, Maksat, Tufan, Fatih, Oz, Fahrettin, Erer, Burak, Ozpolat, Tahsin, Ozturk, Gulistan Bahat, Akin, Sibel, Saka, Bulent, Erten, Nilgun, Tascioglu, Cemil, and Karan, Akif
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- 2014
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77. Older Adults Hospitalized with Covid-19: Clinical Characteristics and Early Outcomes from a Single Center in Istanbul, Turkey
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Alpay Medetalibeyoğlu, Naci Senkal, Murat Kose, Yunus Catma, Emine Bilge Caparali, Mustafa Erelel, Mustafa Oral Oncul, Gulistan Bahat, and Tufan Tukek
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Male ,Turkey ,characteristics ,Medicine (miscellaneous) ,Comorbidity ,elderly ,Article ,clinical ,Fibrin Fibrinogen Degradation Products ,Risk Factors ,Humans ,Hospital Mortality ,Pandemics ,Aged ,Retrospective Studies ,Nutrition and Dietetics ,SARS-CoV-2 ,Age Factors ,COVID-19 ,Pneumonia ,Middle Aged ,mortality ,Hospitalization ,Female ,Geriatrics and Gerontology ,Triage - Abstract
Objective: Older adults have been continuously reported to be at higher risk for adverse outcomes of Covid-19. We aimed to describe clinical characteristics and early outcomes of the older Covid-19 patients hospitalized in our center comparatively with the younger patients, and also to analyze the triage factors that were related to the in-hospital mortality of older adults.Design: Retrospective; observational studySetting: Istanbul Faculty of Medicine hospital, TurkeyParticipants: 362 hospitalized patients with laboratory-confirmed Covid-19 from March 11 to May 11, 2020.Measurements: The demographic information; associated comorbidities; presenting clinical, laboratory, radiological characteristics on admission and outcomes from the electronic medical records were analyzed comparatively between the younger (Results: The median age was 56 years (interquartile range [IQR], 46-67), and 224 (61.9%) were male. There were 104 (28.7%) patients ≥65 years of age. More than half of the patients (58%) had one or more chronic comorbidity. The three most common presenting symptoms in the older patients were fatigue/myalgia (89.4%), dry cough (72.1%), and fever (63.5%). Cough and fever were significantly less prevalent in older adults compared to younger patients (p=0.001 and 0.008, respectively). Clinically severe pneumonia was present in 31.5% of the study population being more common in older adults (49% vs. 24.4%) (pConclusion: Older patients presented with more prevalent chronic comorbidities, less prevalent symptomatology but more severe respiratory signs and laboratory abnormalities than the younger patients. Among the triage assessment factors, the clinical evaluation of pulmonary involvement came in front to help clinicians to stratify the patients for mortality risk.
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- 2020
78. Associations between polypharmacy and physical performance measures in older adults
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Serdar Ozkok, Duygu Erbas Sacar, Cihan Kilic, Tugba Erdogan, Caglar Ozer Aydin, Nezahat Muge Catikkas, Gulistan Bahat, and Mehmet Akif Karan
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Gerontology ,Aging ,Health (social science) ,Timed Up and Go test ,Logistic regression ,Humans ,Medicine ,Outpatient clinic ,Geriatric Assessment ,Postural Balance ,Aged ,Retrospective Studies ,Aged, 80 and over ,Polypharmacy ,business.industry ,Physical Functional Performance ,Test (assessment) ,Preferred walking speed ,Cross-Sectional Studies ,Physical performance ,Time and Motion Studies ,Female ,Geriatrics and Gerontology ,business ,Body mass index - Abstract
A preserved ambulation is one of the keypoints for functionality and polypharmacy, a common problem in older adults, is associated with worse functional status. Our aim was to examine the associations of polypharmacy with certain physical performance measures used to evaluate ambulation.This retrospective, cross-sectional study was conducted in a geriatric outpatient clinic. Using ≥5 medications was accepted as polypharmacy. Usual gait speed (UGS), chair sit-to-stand test (CSST), timed up and go test (TUG) and short physical performance battery (SPPB) were performed to assess physical performance status. We created two models for logistic regression analyses: Model 1 was adjusted for age, sex and body mass index (BMI). We added comorbidities to Model 1 and further created Model 2.There were 392 participants (69.1% were female, mean age: 73.9±6.2 years). Polypharmacy was seen in 62.5%. Participants with polypharmacy presented with a poor physical performance compared to the no-polypharmacy group (p0.001, for each). In multivariate analyses, polypharmacy was independently associated with poor SPPB (Odds Ratio (OR)=2.5; 95% Confidence Interval (CI)=1.3-4.7 and OR=2.4; 95% CI=1.2-4.8 for Model 1 and 2, respectively) and long CSST (OR= 2.6; 95% CI=1.3-5.2 and OR=3.7; 95% CI=1.7-8.2 for Model 1 and 2, respectively). There was a significant association between polypharmacy and slow UGS in Model 1 (OR=1.9; 95% CI=1.0-3.5); but relationship did not persist after adding comorbidities into the first model (OR=1.6; 95% CI= 0.8-3.1). There was no significant association between long TUG and polypharmacy in any of the models.Polypharmacy is well-known with its association with falls and fractures in older adults and this might be explained by its association with poor physical performance. Whether polypharmacy causes a deterioration in physical performance is an issue needs to be enlightened by further longitudinal studies.
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- 2022
79. Effect of bladder training on post catheterization urinary retention remains to be resolved
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Muge Catikkas, Nezahat, Merve Oren, Meryem, and Ozturk, Gulistan Bahat
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- 2020
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80. Measuring calf circumference: a practical tool to predict skeletal muscle mass via adjustment with BMI
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Gulistan Bahat
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Aging ,Sarcopenia ,medicine.medical_specialty ,Nutrition and Dietetics ,business.industry ,Malnutrition ,Medicine (miscellaneous) ,NUTRITION&DIETETICS ,Skeletal muscle mass ,Body Composition ,Calf circumference ,Physical therapy ,Humans ,Medicine ,Muscle, Skeletal ,business - Published
- 2021
81. Mannose binding lectin gene 2 (rs1800450) missense variant may contribute to development and severity of COVID-19 infection
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Alpay Medetalibeyoglu, Sacide Pehlivan, Gulistan Bahat, Ümmühan Isoglu-Alkaç, Gozde Yesil Sayin, Murat Kose, Naci Senkal, Kader Avci, and Tufan Tükek
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0301 basic medicine ,Microbiology (medical) ,Adult ,Male ,030106 microbiology ,Mutation, Missense ,Disease ,Comorbidity ,Biology ,Hyperinflammation ,Microbiology ,Mannose-Binding Lectin ,Severity of Illness Index ,03 medical and health sciences ,Exon ,Young Adult ,Genotype ,Genetics ,Missense mutation ,Humans ,Genetic Predisposition to Disease ,Protein Interaction Maps ,Gene mutation ,Gene ,Molecular Biology ,Cytokine ,Ecology, Evolution, Behavior and Systematics ,Mannan-binding lectin ,Aged ,Aged, 80 and over ,Univariate analysis ,SARS-CoV-2 ,COVID-19 ,Odds ratio ,Middle Aged ,030104 developmental biology ,Infectious Diseases ,MBL2 ,Case-Control Studies ,Immunology ,Female ,Research Paper - Abstract
Background/objectives COVID-19 followed a mortal course in some young patients without any underlying factors, however, it followed a very benign course in some very older individuals with multiple comorbidities. These observations question if some genetic factors may be related to the vulnerability and poor prognosis of the disease. In this study, we aimed to investigate whether MBL2 gene B variant at codon 54 (rs1800450) were related to the variabilities in clinical course of this infection. Methods 284 PCR-confirmed COVID-19 patients and 100 healthy controls were included in the study. COVID-19 patients were subdivided according to the clinical features and clinical characteristics were analyzed. DNAs of all patients and controls were examined for the codon 54 A/B (gly54asp: rs1800450) variation in exon 1 of the MBL2 gene. Results In univariate analysis, BB genotype of MBL2 gene was more common among COVID-19 cases compared with controls (10.9% vs 1.0%, respectively; OR = 12.1, 95%CI = 1.6–90.1, p = 0.001). Multivariate analyses, adjusted for age, sex and MBL genetic variants, revealed that when compared with the COVID-19 patients that had AA genotype (reference), the patients that had BB or AB genotypes suffered from a higher risk for severe disease (for BB genotype, odds ratio (OR) = 5.3, p, Highlights • MBL2 gene encodes soluble mannose-binding lectin (MBL) or mannose-binding protein (MBP). • The deficiency of MBL2 gene previously has been reported as associated with susceptibility to infectious and autoimmune diseases. • MBL2 BB variant results in the overall absence of MBL2 protein and is related to the more severe clinical course of COVID-19 infection.
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- 2020
82. Cut-off values of skeletal muscle index and psoas muscle index at L3 vertebra level by computerized tomography to assess low muscle mass
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Gulistan Bahat, Baris Bakir, Banu Ozulu Turkmen, Samil Aliyev, Nezahat Muge Catikkas, and Mehmet Akif Karan
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0301 basic medicine ,Adult ,Male ,medicine.medical_specialty ,Turkish population ,Percentile ,Sarcopenia ,Adolescent ,030209 endocrinology & metabolism ,Critical Care and Intensive Care Medicine ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Reference Values ,Internal medicine ,medicine ,Humans ,Muscle, Skeletal ,Psoas Muscles ,030109 nutrition & dietetics ,Nutrition and Dietetics ,Lumbar Vertebrae ,business.industry ,Skeletal muscle ,Gold standard (test) ,Middle Aged ,medicine.disease ,Vertebra ,Transplantation ,medicine.anatomical_structure ,Population study ,Female ,business ,Tomography, X-Ray Computed - Abstract
Summary Background & Aims Computerized tomography (CT) is considered the gold standard for the evaluation of total skeletal muscle quantity. Skeletal muscle assessments at the L3 vertebra level revealed significantly correlated with total body muscle measurements. Clinicians need cut-offs to evaluate low muscle mass in various patients who already had CT imaging without any additional cost. This assessment is important to help the physicians to stratify the patients for mortality and other complications. It may also enable the diagnosis of malnutrition by the GLIM criteria. Few studies reported cut-offs in different populations. We aimed to provide cut-off values for total skeletal muscle index (SMI) and psoas muscle mass index (PMI) at the L3 vertebra level in the Turkish population. Methods We assessed the preoperative plain CT images of living adult liver donors who were admitted to a single transplantation center between June 2010 and April 2018. We derived cut-off values with two alternative methods, the 5th percentile value or mean minus two standard deviations and from two groups of study participants, i.e. the total study population and the younger subgroup aged between 18 and 40. Results The study population involved 601 subjects with a mean age of 32.5 ± 9 (range: 18–59 years) and 326 (54.2%) was male. The younger subgroup was composed of 482 individuals with a mean age of 28.8 ± 5.9 and 55.6% male. In patients aged between 18 and 40, PMI and SMI cut-offs by using the 5th percentile were 5.40 cm2/m2, 41.42 cm2/m2 for males; and 3.56 cm2/m2, 30.70 cm2/m2 for females; respectively. The cut-offs of PMI and SMI by using mean minus two standard deviations were 4.62 cm2/m2, 38.67 cm2/m2 for males; and 2.66 cm2/m2, 27.8 cm2/m2 for females; respectively. These cut-offs were comparable to the other populations. Conclusions Our study provided cut-offs to be used in CT images for PMI and SMI. There is a need for further longitudinal studies to verify whether these cut-offs are successful in predicting mortality or other adverse outcomes associated with low muscle mass.
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- 2020
83. Non-vitamin K antagonist oral anticoagulant use at doses inappropriately lower than recommended in outpatient older adults: a real-life data
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Onur Erdogan, Mehmet Akif Karan, Tugba Erdogan, Gulistan Bahat, Meryem Merve Oren, and Savas Ozturk
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Pediatrics ,medicine.medical_specialty ,Vitamin K ,medicine.drug_class ,Logistic regression ,03 medical and health sciences ,0302 clinical medicine ,Atrial Fibrillation ,Outpatients ,medicine ,Outpatient clinic ,Humans ,030212 general & internal medicine ,Dosing ,Stroke ,Aged ,Aged, 80 and over ,030214 geriatrics ,business.industry ,Low dose ,Anticoagulants ,Atrial fibrillation ,Vitamin K antagonist ,medicine.disease ,Real life data ,business - Abstract
The purpose of this research is to determine if inappropriate NOAC prescribing is a significant problem and whether it is related to existing diseases, demographic-data, CHA2DS2-VASc and HASBLED-scores, frailty and falls. Inappropriate NOAC prescribing is a common problem, and we suggest that dose reduction was performed only in the consideration of the age factor. No association was identified between inadequate dosing and falling or frailty. Inappropriate NOAC use is a significant problem, especially in older adults, and patients in this group are at greater risk of stroke. There has been a rapid increase in the use of non-vitamin K-antagonist oral anticoagulants (NOAC). Current guidelines recommend dose adjustments be made in accordance with certain criteria for each NOAC. This study is aimed at determining whether or not NOAC were prescribed for non-valvular atrial fibrillation (AF) in guideline-recommended doses in community-dwelling older adults. Older adults taking NOAC for non-valvular AF presenting to a cardiology outpatient clinic for the first time were included in the study. The NOAC dose for each patient was assessed based on the recommendations of the European Society of Cardiology and were categorized as appropriate or inappropriate (low or high dose). The patients were also evaluated for demographic data, diseases, CHA2DS2-VASc score, HASBLED score, frailty and falls in the previous year. A total of 302 older adults were included in the study, with a mean age of 75.5 ± 7.5 years. One hundred eighty-four patients (60.9%) were found to be on appropriate doses of NOAC, while 109 (36.1%) were on inappropriately low doses and nine (2.98%) were on inappropriately high doses. Accordingly, 39.1% of the AF patients were found to be on inappropriate doses of NOAC, 92.4% of which were inappropriately low. A multivariate logistic regression analysis revealed that the only factor associated with inappropriate low-dose NOAC use was patient age (OR = 1.061, 95% CI = 1.009–1.116, p = 0.022). Our study suggests that the inappropriate use of lower dose NOAC may emerge as a significant problem in outpatient older adults. This inappropriate practice seems to be associated with older age rather than the diseases, CHA2DS2-VASc/HASBLED scores, frailty and presence of falls.
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- 2020
84. Muscle strength cutoff values calculated from the young reference population to evaluate sarcopenia in Turkish population
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Caglar Ozer Aydin, Alfonso J. Cruz-Jentoft, Asli Tufan, Gulistan Bahat, and Mehmet Akif Karan
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Aging ,medicine.medical_specialty ,Turkish population ,Sarcopenia ,Population ,Standard deviation ,03 medical and health sciences ,0302 clinical medicine ,Physical medicine and rehabilitation ,Reference Values ,medicine ,Cutoff ,Humans ,Reference population ,030212 general & internal medicine ,Muscle Strength ,education ,Muscle, Skeletal ,education.field_of_study ,Hand Strength ,business.industry ,Skeletal muscle ,medicine.disease ,medicine.anatomical_structure ,Muscle strength ,Geriatrics and Gerontology ,business ,human activities ,030217 neurology & neurosurgery - Abstract
Sarcopenia is defined as a progressive and generalized skeletal muscle disorder that is associated with an increased likelihood of adverse outcomes, including mobility problems and mortality. To reach a global consensus for its standard definition and diagnosis, more recently, a revised EWGSOP consensus (EWGSOP2) has been published. In EWGSOP2 definition, sarcopenia has been regarded as skeletal muscle failure and low muscle strength has been put forward as its key defining characteristics. EWGSOP2 suggested the use of handgrip strength cutoff values calculated by mean minus 2.5 standard deviations of the young healthy population. In this report, following EWGSOP2's suggestion, we aimed to outline the handgrip strength cutoffs derived from a young Turkish reference population, and compare them with the other population-specific reports.
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- 2020
85. Best Practice Recommendations for Stroke Patients with Dysphagia: A Delphi-Based Consensus Study of Experts in Turkey-Part II: Rehabilitation
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Gulistan Bahat, Banu Aydeniz, Ilknur Albayrak Gezer, Ebru Umay, Canan Tikiz, Mazlum Serdar Akaltun, Arif Yüksel, Baha Sezgin, Mehmet Fevzi Oztekin, Güleser Saylam, Sevnaz Şahin, Aylin Sari, Sibel Alicura, Nefati Kiylioglu, Dilek Keskin, Meltem Vural, Aylin Demirhan, Betul Yavuz Keles, Ayşe Yaliman, Yalkın Calik, Esra Giray, Yaprak Seçil, Ekin Ilke Sen, Murat Inanir, Ali Yavuz Karahan, Cumhur Ertekin, Özgür Zeliha Karaahmet, Meral Bilgilisoy, Eda Gurcay, Ebru Alemdaroğlu, Sibel Eyigör, Zeliha Unlu, Zeynep Alev Ozcete, Fatih Karaahmet, and Barin Selcuk
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medicine.medical_specialty ,Consensus ,Turkey ,Best practice ,medicine.medical_treatment ,Delphi method ,Speech and Hearing ,medicine ,Humans ,Stroke ,computer.programming_language ,Rehabilitation ,business.industry ,Gastroenterology ,Stroke Rehabilitation ,Guideline ,medicine.disease ,Dysphagia ,Otorhinolaryngology ,Medical emergency ,medicine.symptom ,business ,Deglutition Disorders ,computer ,Delphi - Abstract
Dysphagia is one of the most common and important complications of stroke. It is an independent marker of poor outcome following acute stroke and it continues to be effective for many years. This consensus-based guideline is not only a good address to clinical questions in practice for the clinical management of dysphagia including management, diagnosis, follow-up, and rehabilitation methods, but also includes detailed algorithms for these topics. The recommendation paper has been written by a multidisciplinary team and offers 117 recommendations for stroke patients with dysphagia. While focusing on management principles, diagnosis, and follow-up in the 1st part (45 items), rehabilitation details were evaluated in the 2nd part (72 items).
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- 2020
86. Start low, go slow, but look far: the case of geriatric medicine in Balkan countries
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Gregor Veninšek, Emmanouil Smyrnakis, Mirko Petrovic, Genc Burazeri, Biljana Petreska-Zovic, Predrag Erceg, Gulistan Bahat, Athanase Benetos, Finbarr C. Martin, Chrysanthos Zamboulis, Nenad Bogdanovic, John Ellul, Gabriel Ioan Prada, and Marina Kotsani
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medicine.medical_specialty ,Turkey ,Croatia ,media_common.quotation_subject ,Slovenia ,Specialty ,Context (language use) ,Special needs ,Subspecialty ,Scarcity ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,030212 general & internal medicine ,media_common ,Aged ,Geriatrics ,Harmony (color) ,Medical education ,030214 geriatrics ,Greece ,business.industry ,Romania ,Balkan Peninsula ,Republic of North Macedonia ,Albania ,Risk assessment ,business ,Serbia - Abstract
To briefly present the current situation regarding Geriatric Medicine in Balkan countries and discuss possible perspectives of development by exchange and interaction with countries with more developed Geriatric Medicine. Balkan countries seem to encounter similar difficulties and share common challenges regarding under- and post-graduate education in geriatric medicine, accessibility to comprehensive geriatric assessment and response to special needs of older people in various clinical settings. Proposed solutions need to be pragmatic, effective, applicable in harmony with available services and adjusted to each country’s special context. InterEuropean networking, cooperation among countries under the auspices of EuGMS, and suitable application of experience from countries with developed Geriatrics, could contribute to the development of Geriatric Medicine in Balkan countries as well. To present an insight of the situation of geriatric medicine in Balkan countries, as it was presented in the context of the 2nd pre-congress seminar of the 16th European Geriatric Medicine Society (EuGMS) Congress Athens 2021. Representatives from 8 Balkan countries (Albania, Croatia, Greece, Republic of North Macedonia, Romania, Serbia, Slovenia, Turkey) answered 3 questions to reflect the state of geriatric medicine in their country: education on geriatrics; systems/methods for assessment of functional status and frailty; pre-operative risk assessment. An open discussion followed. Undergraduate education in geriatric medicine seems underestimated in medical faculties of Balkan countries, whereas a high heterogeneity is observed at a post-graduate level. Only a few Balkan countries have geriatric medicine as a recognized medical specialty or subspecialty. Functional status and frailty are only sporadically assessed, and pre-operative risk assessment is very rarely performed with a geriatric focus. Scarcity of expertise and structures relevant to geriatric medicine seems to be common. Developing a training curriculum and geriatrics-related structures are two interconnected aspects. Cooperation among physicians and multidisciplinary teams are essential for the practice of geriatric medicine. A functional geriatric network is eventually necessary and ambulatory geriatric expertise is probably a feasible and clinically relevant starting point. Providing pragmatic solutions to the pressing challenges in variable clinical settings, supplementing and working in harmony with existing components of each health system, is probably the most convincing strategy to gain political support in developing geriatric medicine. Balkan countries share common experiences and challenges in developing geriatrics. Whilst the principles of geriatric medicine are perhaps universal, proposed solutions should be adapted to each country’s specific circumstances. Cooperation of the Balkan countries could promote in each the development of geriatric medicine. EuGMS is willing to foster relevant actions.
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- 2020
87. Cut-off points for height, weight and body mass index adjusted bioimpedance analysis measurements of muscle mass with use of different threshold definitions
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Timur Selcuk Akpinar, Nilgun Erten, Asli Tufan, Tugba Aydin, Cihan Kilic, Alfonso J. Cruz-Jentoft, Gulistan Bahat, Mehmet Akif Karan, and Murat Kose
- Subjects
Male ,Sarcopenia ,030232 urology & nephrology ,030209 endocrinology & metabolism ,Muscle mass ,Body Mass Index ,03 medical and health sciences ,Low muscle mass ,0302 clinical medicine ,Animal science ,Humans ,Medicine ,Muscle Strength ,Muscle, Skeletal ,Aged ,Hand Strength ,Receiver operating characteristic ,business.industry ,medicine.disease ,Bioimpedance Analysis ,Muscle strength ,Female ,Cut-off ,Geriatrics and Gerontology ,business ,Body mass index - Abstract
Aim Low muscle mass (LMM) is a prerequisite to define sarcopenia. We aimed to report muscle-mass reference cut-off points adjusted for height and weight as muscle-mass threshold best discriminating muscle-weakness and adjusted for body mass index (BMI) significantly lower than that of healthy young population. Material and method We included young adults between 18 and 39 years and community dwelling older adults 60-99 years of age. Bioimpedance analysis (BIA) was used to assess skeletal muscle mass. Skeletal muscle mass index (SMMI) adjusted for height, weight, BMI were calculated [SMMI (height), SMMI (weight), SMMI (BMI)]. Handgrip strength was evaluated with Jamar hydraulic dynamometer for muscle-strength. SMMI (height) and SMMI (weight) cut-offs that predict low muscle-strength were calculated with receiver operator characteristic (ROC) analysis. Low muscle-strength was evaluated by three different thresholds, i.e. 32 kg/22 kg, 30 kg/20 kg, 26 kg/16 kg in males/females. SMMI (BMI) cut-offs were calculated as "mean young SMMI (BMI)-two standard deviation." Results The young and older reference groups included 301 and 992 individuals, respectively. LMM cut-points for SMMI (height) were (i) 10.8 vs. 8.9 kg/m2 for 32/22 kg; 10.8 vs. 9.4 kg/m2 for 30/20 kg and 11.1 vs. 8.9 kg/m2 for the 26/16 kg thresholds, in males and females, respectively. LMM cut-points for the SMMI (weight) were 40.6% and 33.2% for the all three studied muscle-strength thresholds for males and females, respectively. For all the analyses sensitivity, specificity and likelihood ratios were not sufficiently high in both genders. The SMMI (BMI) cut-points were 1.049 vs. 0.823 kg/BMI for males and females, respectively. Conclusions We presented the very first cut-off thresholds for muscle-mass adjusted by height and weight that best discriminate muscle-weakness in the older adults and by BMI that is significantly lower than that of healthy young population. This study suggests that correlation between total skeletal muscle mass measured by BIA (either adjusted for height or weight) and muscle strength is low.
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- 2018
88. International Group for Reducing Inappropriate Medication Use & Polypharmacy (IGRIMUP): Position Statement and 10 Recommendations for Action
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Graziano Onder, Mirko Petrovic, Beatrice A. Golomb, Laurie Mallery, Paige Moorhouse, Dee Mangin, Gulistan Bahat, and Doron Garfinkel
- Subjects
medicine.medical_specialty ,Drug-Related Side Effects and Adverse Reactions ,Psychological intervention ,Beers Criteria ,Context (language use) ,Inappropriate Prescribing ,Comorbidity ,THERAPEUTIC HARMONIZATION ,030204 cardiovascular system & hematology ,Drug Prescriptions ,HOSPITALIZED-PATIENTS ,03 medical and health sciences ,0302 clinical medicine ,Quality of life (healthcare) ,BEERS CRITERIA ,Health care ,Medicine and Health Sciences ,medicine ,Humans ,Pharmacology (medical) ,030212 general & internal medicine ,Medical prescription ,Intensive care medicine ,ELDERLY-PATIENTS ,Aged ,Polypharmacy ,CONSENSUS PANEL ,business.industry ,NURSING-HOME RESIDENTS ,ADVERSE DRUG EVENTS ,FRAIL OLDER-ADULTS ,Health equity ,Current Opinion ,HEALTH-CARE ,Quality of Life ,CLINICAL-PRACTICE GUIDELINES ,Geriatrics and Gerontology ,business - Abstract
Globally, the number of drug prescriptions is increasing causing more adverse drug events, which is now a significant cause of mortality, morbidity, and disability that has reached epidemic proportions. The risk of adverse drug events is correlated to very old age, multiple co-morbidities, dementia, frailty, and limited life expectancy, with the major contributor being polypharmacy. Each characteristic alters the risk-benefit balance of medications, typically reducing anticipated benefits and amplifying risk. Current clinical guidelines are based on evidence proven in younger/healthier adult populations using a single disease model and their application to older adults with multimorbidity, in whom testing has not been conducted, yields a different risk-benefit prospect and makes inappropriate medication use and polypharmacy inevitable. Applying inappropriate clinical practice guidelines to older adults is antithetical to good healthcare, is likely to increase health inequity, and is associated with substantial negative clinical, economic, and social implications for health systems. The casualties are on the scale of a war or epidemic, yet are usually invisible in measures of healthcare quality and formal recommendations. Radical and rapid action is required to achieve a better quality of life for older populations and to remain true to the principles of medical professionalism and evidence-based medicine that place patients' interests and autonomy at the fore. This first International Group for Reducing Inappropriate Medication Use & Polypharmacy position statement briefly details the causes, consequences, and extent of inappropriate medication use and polypharmacy. This article outlines current strategies to reduce inappropriate medication use, provides evidence for their effect, and then proposes recommendations for moving forward with 10 recommendations for action and 12 recommendations for research. We conclude that an urgent integrated effort to reduce inappropriate medication use and polypharmacy should be a leading global target of the highest priority. The cornerstone of this position statement from the International Group for Reducing Inappropriate Medication Use & Polypharmacy is the understanding that without evidence of definite relevant benefit, when it comes to prescribing, for many older patients 'less is more'. This approach differs from most other current recommendations and guidance in medical care, as the focus is on what, when, and how to stop, rather than on when to start medications/interventions. Disrupting the framework that indiscriminately applies standard guidelines to older adults requires a new approach that better serves patients with multimorbidity. This transition requires a shift in medical education, research, and diagnostic frameworks, and re-examination of the measures used as quality indicators. In achieving this objective, we promote a return to some of the original concepts of evidence-based medicine: which considers scientific data (where it exists), clinical judgment, patient/family preference, and context. A shift is needed: from the current model that focuses on single conditions to one that simultaneously considers multiple conditions and patient priorities. This approach reframes the clinician's role as a professional providing care, rather than a disease technician.
- Published
- 2018
89. Autologous stem cells collected after debulking by high dose chemotherapy in late phase chronic myeloid leukemia may improve Imatinib efficacy
- Author
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Kalayoglu-Besisik, Sevgi, Ozturk, Gulistan Bahat, Caliskan, Yasar, Nalcaci, Meliha, Gurses, Nuray, Cin, Naci, Ozbek, Ugur, and Sargin, Deniz
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- 2007
- Full Text
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90. Hypotension in Nursing Home Residents on Antihypertensive Treatment: Is it Associated with Mortality?
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H. Dogan, Mehmet Akif Karan, Hilal Özkaya, Birkan Ilhan, E. Karisik, Cihan Kilic, Meryem Merve Oren, Gulistan Bahat, Athanase Benetos, S. Muratli, and Asli Tufan
- Subjects
Male ,medicine.medical_specialty ,Blood Pressure ,03 medical and health sciences ,0302 clinical medicine ,Mobility status ,Internal medicine ,Humans ,Medicine ,030212 general & internal medicine ,Antihypertensive Agents ,General Nursing ,Aged ,Aged, 80 and over ,business.industry ,Proportional hazards model ,Health Policy ,Mortality rate ,Hazard ratio ,Nutritional status ,General Medicine ,Middle Aged ,Confidence interval ,Nursing Homes ,Blood pressure ,Hypertension ,Hypotension ,Geriatrics and Gerontology ,Nursing homes ,business ,030217 neurology & neurosurgery - Abstract
Objective To assess whether low systolic blood pressure (SBP) or diastolic blood pressure (DBP) due to antihypertensive medications might be related to mortality among nursing home (NH) residents. Design Observational, longitudinal. Setting Nursing home. Participants Age ≥60 years, receiving antihypertensive medications. Measurements Demographic characteristics, mobility status, number of chronic diseases and drugs, nutritional status, and antihypertensive medications were noted. At the first visit, we recorded blood pressure (BP) measurements of last 1 year, which were measured regularly at 2-week intervals and considered their mean values. SBP and DBP thresholds were analyzed for mortality by ROC analysis. Multivariate Cox regression analyses were performed to determine factors related to mortality. Results The sample included 253 residents with a mean age of 75.7 ± 8.7 years, and 66% were male. Residents were evaluated at a mean follow-up time of 14.3 ± 5.2 months (median: 15) for short-term mortality and 31.6 ± 14.3 months (median: 40) for long-term mortality. The prevalence of low SBP (≤110 mm Hg) and low DBP (≤65 mm Hg) was 34.8% and 15.8%, respectively. In follow-up, the short-term mortality rate was 21.7% (n = 55) and the long-term mortality rate was 42.2% (n = 107). Low SBP (≤110 mm Hg) was related to mortality in short- and long-term follow-ups [short-term follow-up: hazard ratio (HR) 3.7, 95% confidence interval (CI) 1.5-8.6, P = .01; long-term follow-up: HR 1.8, 95% CI 1.1-3.0, P = .02], adjusted for age, mobility status, nutritional state, and total number of diseases and drugs. Low DBP (≤65 mm Hg) was related to mortality in short- and long-term follow-ups [short-term follow-up: HR 3.0, 95% CI 1.2-7.8, P = .02, long-term follow-up: HR 2.8, 95% CI 1.5-5.2, P = .001], adjusted for age, mobility status, nutritional state, and total number of diseases and drugs. Conclusions and Implications Systolic hypotension was found in more than one-third of the NH residents receiving antihypertensive treatment. Low SBP and DBP were significant factors associated with mortality. Particular attention should be paid to prevent low SBP and DBP in NH residents on antihypertensive treatment.
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- 2021
91. The thresholds for components of sarcopenia: need for an objective approach
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Mehmet Akif Karan and Gulistan Bahat
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Gerontology ,Sarcopenia ,Hand Strength ,business.industry ,Geriatrics gerontology ,Objective approach ,medicine ,Humans ,Muscle Strength ,medicine.disease ,business - Published
- 2020
92. Handgrip strength cut-offs to define sarcopenia in Turkish population
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Gulistan Bahat, Mehmet Akif Karan, and Mustafa Altinkaynak
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Geriatrics ,Aging ,education.field_of_study ,medicine.medical_specialty ,Download ,Turkish ,Population ,Conflict of interest ,MEDLINE ,Library science ,language.human_language ,03 medical and health sciences ,0302 clinical medicine ,Honorarium ,medicine ,language ,030212 general & internal medicine ,Geriatrics and Gerontology ,education ,Citation ,030217 neurology & neurosurgery - Abstract
Cruz-Jentoft AJ, Bahat G, Bauer J et al (2019) Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 48:16–31. https://doi.org/10.1093/ageing/afy169 Article PubMed Google Scholar Bahat G, Tufan A, Tufan F et al (2016) Cut-off points to identify sarcopenia according to EuropeanWorking Group on Sarcopenia in older people (EWGSOP) definition. Clin Nutr 35:1557–1563. https://doi.org/10.1016/j.clnu.2016.02.002 Article PubMed Google Scholar Lauretani F, Russo CR, Bandinelli S et al (1985) Age-associated changes in skeletal muscles and their effect on mobility: an operational diagnosis of sarcopenia. J Appl Physiol 2003:1851–1860 Google Scholar Sallinen J, Stenholm S, Rantanen T et al (2010) Hand-grip strength cut points to screen older persons at risk for mobility limitation. J Am Geriatr Soc 58:1721–1726. https://doi.org/10.1111/j.1532-5415.2010.03035.x Article PubMed PubMed Central Google Scholar Ates Bulut E, Soysal P, Dokuzlar O et al (2020) Validation of population-based cutoffs for low muscle mass and strength in a population of Turkish elderly adults. Aging Clin Exp Res. https://doi.org/10.1007/s40520-019-01448-4 Article PubMed Google Scholar Dodds RM, Syddall HE, Cooper R et al (2014) Grip strength across the life course: normative data from twelve British studies. PLoS ONE 9:e113637. https://doi.org/10.1371/journal.pone.0113637 Article PubMed PubMed Central Google Scholar Download references As authors of this article: “Gulistan Bahat, Mehmet Akif Karan, Mustafa Altinkaynak” and the institution we work for, we received no grant, consuting fee or honorarium, support for any travel or other purposes, fees for participation in any review activities, payment for writing or reviewing, provision of writing assistance, medicines, equipment or administrative support, or any other. We have no relevant activities outside the submitted work as board membership, consultancy, employment, expert testimony, grants/grant pending, payment for any lectures, payment for manuscript preparation, patents, royalties, payment for educational activities, stock/stock options, travel/accommodation/meeting expenses unrelated to activities listed, or any other. There are no other relationships/conditions/circumstances that present a potential conflict of interest. Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics, Istanbul University, Capa, 34390, Istanbul, Turkey Gulistan Bahat & Mehmet Akif Karan Istanbul Medical School, Department of Internal Medicine, Istanbul University, Capa, 34390, Istanbul, Turkey Mustafa Altinkaynak You can also search for this author in PubMed Google Scholar You can also search for this author in PubMed Google Scholar You can also search for this author in PubMed Google Scholar Correspondence to Gulistan Bahat. On behalf of all the authors, the corresponding author states that there is no conflict of interest. This article does not contain any studies with human participants or animals performed by any of the authors. For this type of study formal consent is not required. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Reprints and Permissions Bahat, G., Altinkaynak, M. & Karan, M.A. Handgrip strength cut-offs to define sarcopenia in Turkish population. Aging Clin Exp Res (2020). https://doi.org/10.1007/s40520-020-01704-y Download citation Received: 28 July 2020 Accepted: 31 August 2020 Published: 28 September 2020 DOI: https://doi.org/10.1007/s40520-020-01704-y
- Published
- 2020
93. Important Points to Consider During Practical Application and in the Validation Studies of SARC-F Tool to Screen Sarcopenia [Letter]
- Author
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Gulistan Bahat and Ozlem Yilmaz
- Subjects
Gerontology ,business.industry ,Sarcopenia ,MEDLINE ,medicine ,Geriatric assessment ,General Medicine ,Geriatrics and Gerontology ,medicine.disease ,business - Published
- 2020
94. Grading the Reduced Muscle Mass in the Context of GLIM Criteria
- Author
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Tommy Cederholm and Gulistan Bahat
- Subjects
medicine.medical_specialty ,Physical medicine and rehabilitation ,business.industry ,Reduced muscle mass ,Medicine ,GLIM ,business ,Grading (tumors) - Published
- 2020
95. Comment on: 'Pharmacological Management of Osteoporosis in Rheumatoid Arthritis Patients: A Review of the Literature and Practical Guide'
- Author
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Gulistan Bahat, Birkan Ilhan, and Mehmet Akif Karan
- Subjects
medicine.medical_specialty ,Geriatrics gerontology ,business.industry ,Pharmacological management ,Pharmacology toxicology ,Osteoporosis ,MEDLINE ,Arthritis ,medicine.disease ,Arthritis, Rheumatoid ,Pharmacotherapy ,Rheumatoid arthritis ,medicine ,Humans ,Pharmacology (medical) ,Geriatrics and Gerontology ,Intensive care medicine ,business - Published
- 2020
96. Some Comments for Better Understanding of the Study Entitled 'Reduced Vitamin D Levels are Associated with Stroke-Associated Pneumonia in Patients with Acute Ischemic Stroke' [Letter]
- Author
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Savas Ozturk, Mehmet Akif Karan, Serdar Ozkok, and Gulistan Bahat
- Subjects
Male ,acute ischemic stroke ,medicine.medical_specialty ,Letter ,genetic structures ,stroke-associated pneumonia ,MEDLINE ,Brain Ischemia ,Risk Factors ,Internal medicine ,medicine ,Vitamin D and neurology ,Humans ,In patient ,Vitamin D ,Acute ischemic stroke ,Stroke ,Original Research ,Aged ,business.industry ,Pneumonia ,General Medicine ,Middle Aged ,Vitamin D Deficiency ,medicine.disease ,Female ,Geriatrics and Gerontology ,business - Abstract
Background and aim Stroke-associated pneumonia (SAP) is a common complication in patients with acute ischemic stroke (AIS). This study explored the potential relationship between serum vitamin D levels and SAP. Methods This study recruited 863 consecutive AIS patients. In-hospital SAP was defined as a complication that occurred after stroke, during hospitalization, that was confirmed radiographically. Serum vitamin D levels were measured within 24 hrs of admission and the patients were divided into vitamin D sufficient (>50 nmol/L), insufficient (25–50 nmol/L), and deficient (
- Published
- 2020
97. Effect of bladder training on post catheterization urinary retention remains to be resolved
- Author
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Nezahat Muge Catikkas, Gulistan Bahat Ozturk, and Meryem Merve Oren
- Subjects
medicine.medical_specialty ,Urinary retention ,business.industry ,medicine.medical_treatment ,Arthroplasty, Replacement, Hip ,Treatment outcome ,Urinary Bladder ,MEDLINE ,Urology ,Urinary Retention ,Arthroplasty ,Bladder training ,Treatment Outcome ,medicine ,Humans ,medicine.symptom ,business ,Arthroplasty, Replacement, Knee ,Urinary Catheterization ,General Nursing - Published
- 2019
98. Comment on Comparing Vitamin D Supplementation Versus Placebo for Urgency Urinary Incontinence: A Pilot Study
- Author
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Cemil Tascioglu, Mustafa Altinkaynak, and Gulistan Bahat
- Subjects
medicine.medical_specialty ,Vitamin d supplementation ,Geriatrics gerontology ,business.industry ,MEDLINE ,Pilot Projects ,Urinary Incontinence, Urge ,Urinary incontinence ,Placebo ,Urinary Incontinence ,Internal medicine ,Dietary Supplements ,medicine ,Vitamin D and neurology ,Humans ,Vitamin D ,Geriatrics and Gerontology ,medicine.symptom ,business - Published
- 2019
99. Frailty is associated with multimorbidities due to decreased physical reserve independent of age
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Pinar Kucukdagli, Basar Aykent, Ozlem Yilmaz, Gulistan Bahat, and Cemil Tascioglu
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Gerontology ,Frailty ,Hand Strength ,business.industry ,Frail Elderly ,Internal Medicine ,Medicine ,Humans ,Multimorbidity ,Middle Aged ,business ,Developing Countries ,Aged - Published
- 2019
100. Muscle mass adjustment method affects association of sarcopenia and sarcopenic obesity with metabolic syndrome
- Author
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Ozlem, Yilmaz and Gulistan, Bahat
- Subjects
Metabolic Syndrome ,Sarcopenia ,Humans ,Obesity ,Body Mass Index - Published
- 2018
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