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It is a well-known fact that dyslipidemia plays a role in the progression and initiation of renal diseases. Additionally, chronic kidney disease causes alternations in lipid metabolism that result in increased cardiovascular morbidity and mortality. As the incidence of kidney dysfunction increases with aging, understanding and treating abnormalities in lipid metabolism become central in the geriatric patients with chronic kidney disease. Unfortunately, there is no large randomized clinical study about outcomes of dyslipidemia treatment specifically in this particular age group. The data on this issue are generally derived from the subgroup analysis of several landmark secondary-prevention trials. According to these data, lipid-lowering agents among elderly patients with kidney dysfunction seem to have a benefit, but the data remain limited. Moreover, it should always be considered that elderly patients with chronic kidney disease are at greater risk of adverse drug reactions; therefore, the lowest possible dose of medications should be used.

Elderly nursing home residents are under high risk of malnutrition. Early interventions to prevent malnutrition may play a critical role in malnutrition-mortality correlation. This study aimed to obtain insight into the prevalence of malnutrition in nursing homes in the capital city of Turkey and the role of malnutrition in predicting the risk for short-term mortality.This study was conducted in seven different residential care facilities in Ankara.Nutritional status was evaluated by Mini Nutritional Assessment-Short Form.The mean age of the 534 participants was 79.46±7.22 years. Nutritional assessment revealed that 15.9% of all older adults suffered from malnutrition and another 53.6% were at risk of malnutrition. The mortality rate for all subjects was 118 (22.1%) over 18 months, which was significantly higher in participants with malnutrition.We noted a high prevalence of malnutrition and a strong correlation of increased mortality with malnutrition in nursing home residents. Given the negative impact of malnutrition on mortality and morbidity, an emphasis should be placed on an effective nutritional policy in nursing homes.

Akciger grafisi ulasilabilirligi ve kolay degerlendirilebilmesi nedeniyle bircok klinisyenin ilk tercihleri arasindadir. Aslen akciger ve kalp hastaliklari tanisinda yardimci olmakla beraber, komsu organlarin hastaliklarinin tanimlanmasinda da yardimci olabilmektedir. Bu makalede bahsi gecen hasta karin agrisi, sirt agrisi ve kilo kaybi sikâyetleriyle hastanemize basvurmustur. Akciger grafisinde mide fundusunda supheli bir radyoopasite tespit edilmesi uzerine yapilan ust endoskopiyle mide kanseri tanisi konulmustur. Evrelemeye yonelik goruntulemede tani aninda uzak metastazlari tespit edilmis, kemoterapi baslanmis, hasta beslenme destegi de verilerek izleme alinmistir. Akciger grafisi dogru ve dikkatli yorumlanmasi halinde, benzer olgularda erken tani konulmasina hizmet edebilecektir.

Increasing evidence supports the theory that oxidative stress plays an important role in the pathogenesis of Alzheimer's disease (AD). Homocysteine (Hcy), uric acid (UA), bilirubin, and albumin are simple laboratory parameters that are related to oxidative stress. In this study we compared serum Hcy and antioxidant levels in patients with AD and normal cognitive function. In this cross-sectional study, 143 AD patients and 1,553 patients with normal cognitive function aged 65 years and over were enrolled. Mean values of UA and albumin levels of AD patients were significantly lower than normal cognitive function subjects (p: 0.003 versus p < 0.001, respectively). Mean value of Hcy levels of AD patients was significantly higher than normal cognitive function subjects (p = 0.031). Multivariate regression analysis revealed that Mini-nutritional assessment short form (OR: 0.905, 95% CI: 0.850-0.965, p = 0.002), hypertension (OR: 1.573, 95% CI: 1.148-2.155, p = 0.005), UA (OR: 0.879, 95% CI: 0.788-0.981, p = 0.021), Hcy (OR: 1.040, 95% CI: 1.022-1.059, p < 0.001), and albumin (OR: 0.505, 95% CI: 0.339-0.753, p < 0.001) were independent variables predicting the occurrence of AD. Our study supports the hypothesis that a decrease in antioxidants and an increase in oxidative damage are linked to AD.

Previous studies showed oxidative stress had an important impact on osteoclastic and osteoblastic functions. Oxidative stress or low levels of antioxidants are supposed to reduce BMD and cause osteoporosis. hcy, gamma glutamyltransferase (GGT), uric acid, albumin and total bilirubin are simple laboratory parameters that are related with oxidative stress. In this study we compare the serum hcy and antioxidant levels in patients with osteoporosis, osteopenia and control subjects. A total of 2190 elderly persons (1348 patients with osteoporosis, 643 patients with osteopenia and 199 control subjects) who were referred to the outpatient clinic of the Department of Internal Medicine, Division of Geriatric Medicine at Hacettepe University Hospital for comprehensive geriatric assessment were included in this cross-sectional study. Mean age of subjects were 72.30 ± 6.34 in osteoporosis group, 71.92 ± 6.90 in osteopenia and 71.86 ± 5.88 in control group (p: 0.260). Multivariate regression analysis revealed that hypertension (HT) (OR: 0.675, 95% CI: 0.534-0.854, p: 0.001), diabetes mellitus (DM) (OR: 1.669, 95% CI: 1.301-2.142, p

Deficiency of iron, which plays an important role in oxygen transport and storage, may lead to cerebral hypoxia and cognitive decline. This relationship which was studied in children and adults was not evaluated in the elderly. The objective of this study is to examine the effect of iron deficiency on cognitive function in the elderly. This is a cross-sectional study conducted in a geriatric medicine outpatient clinic of a university hospital. Consecutive 2009 patients admitted to Geriatric Medicine outpatient clinic were examined and 622 patients who fulfilled the inclusion criteria were enrolled in the study. Comprehensive geriatric assessment, cognitive assessment and laboratory analysis including blood count, iron, total iron binding capacity, ferritin, and transferrin saturation were performed. Mean age of the study group was 72.5±6.5 and 439 (70.6%) were women. MMSE scores were moderately and significantly correlated with iron levels (r=0.33, p

Vascular risk factors play a significant role in the pathogenesis and progression of AD. MPV is an index of platelet activation and may be a potential marker of inflammation to demonstrate the vascular damage in AD. The aim of the present study is to assess whether platelet volume would be useful in predicting vascular damage in AD. A total of 126 patients with AD (male/female: 44/82, mean age 76.2 ± 6.8 years) and 286 patients as controls with normal cognitive function (male/female: 123/163, mean age 75.2 ± 6.3 years) were enrolled in this cross-sectional study. MPV values were determined for all study participants. Mini-Mental State Examination (MMSE) and clock drawing tests (CDT) were performed for cognitive assessment, DSM-IV and NINCDS-ADRDA criteria were used for diagnosis of AD. The mean MPV values were significantly higher in AD group (8.46 ± 1.15 vs. 8.17 ± 0.90; p=0.011). In this study, significantly higher MPV values in patients with AD have been detected. Since increased MPV levels are usually considered as a vascular risk factor, the results of this study suggested the role of platelet activation in the vascular pathogenetic basis of AD.

Strontium ranelate is claimed to be related with increased risk of thromboembolic events. No explanation of this increased incidence of thromboembolism has been identified. However, growing evidence has clearly demonstrated the involvement of blood rheology in any thrombotic process. The aim of this study was to assess hemorheological changes with strontium ranelate treatment in elderly women with osteoporosis. This study was designed in a prospective manner. Twenty-two elderly women diagnosed with osteoporosis were included. During a 2-month treatment period, participants received strontium ranelate 2g/day. Hemorheological parameters including erythrocyte deformability, erythrocyte aggregation and plasma viscosity were measured before and after 2 months therapy with strontium ranelate. The median age of the patients was 70.0 (range=65-80) years. After 60 days of treatment, there was no statistically significant change in hemorheological parameters. None of the subjects developed clinical venous thromboembolic event (VTE) during the 2-month period of strontium ranelate treatment. Our study demonstrated that in elderly women, treatment of osteoporosis with strontium ranelate did not change hemorheological parameters over 2 months of time. However, its long-term effects on hemorheologic parameters should be evaluated further with a larger sample.

Evidence regarding the vascular basis of Alzheimer’s disease (AD) is growing. In vascular damage thrombomodulin tears of the cell wall and its level increases in the plasma. von Willebrand factor (vWF) is also thought to be a biomarker for vascular damage. The aim of this study was to examine the levels of vWF and thrombomodulin in AD as possible markers for vascular damage and to test their utility as an early biomarker in AD. Case-control study. Geriatric medicine outpatient clinic of a university hospital. Twenty Alzheimer’s disease patients free from vascular risk factors and 20 controls were enrolled in the study. Thrombomodulin and VWF levels of 20 AD patients and 20 controls were analyzed by commercial kits. Thrombomodulin levels were not different between Alzheimer’s disease and control groups [median (range) = 4.25 (2.27–37.00) ng/ml in Alzheimer’s disease and 3.55 (2.27–14.00) in control group, p=0.15]. Von Willebrand Factor antigen (%) levels were 188.5 (96–306) in Alzheimer’s disease, and 181 (112–284) in control group (p=0.74). Although vascular damage is thought to play role in the pathogenesis of AD, vWF and thrombomodulin failed to demonstrate the vascular damage in AD. Their utility to be used as early biomarkers of AD could not be shown.

Thrombopoiesis is regulated by a variety of cytokines. Intracellular adhesion molecules are inducible cell-surface glycoproteins that belong to the immunoglobulin superfamily. Cytokines, endothelium and adhesive molecules represent the point of crosstalk in normal and pathological hematopoiesis. With the hypothesis that circulating intracellular adhesion molecule-1 (ICAM-1) and lymhocyte adhesion molecule-1 (L-selectin) concentrations could be changed based on pathological thrombopoiesis resulting in quantitative platelet disorders, we evaluated ICAM-1 and L-selectin levels in patients with thrombocytosis, thrombocytopenia and healthy controls. The L-selectin levels were found to be significantly higher in the thrombocytopenia group compared to the control group. ICAM-1 levels were found to be significantly higher in both thrombocytopenia and thrombocytosis groups compared to control group. Our study corroborates our original hypothesis implying the roles of adhesion molecules in the challenging status of pathological thrombopoiesis.

The aim of this study was to investigate the frequency and correlated factors of white coat effect (WCE) in the elderly. Geriatric patients who were known as normotensive and office BP exceeding 140/90 mmHg underwent 24-hour ambulatory blood pressure monitoring (ABPM). Correlation of WCE with clinical parameters, geriatric assessment scales, co-existing diseases, and laboratory results were analyzed. Within 61 patients 72.1% were diagnosed as white coat hypertension (WCH). Independent correlates of systolic WCE were activities of daily living, instrumental activities of daily living scores, creatinine; independent correlate of diastolic WCE was Geriatric Depression Scale score. White coat hypertension constitutes a major part of office-detected hypertension in geriatric patients. Ambulatory blood pressure monitoring should be performed on geriatric patients with office-measured hypertension in order to avoid overtreatment.

The ESR is commonly used to assess the acute phase response. It is most useful among patients in whom the probability of disease is moderate following initial history-taking and examination. In this study, we examined retrospectively the patients admitted to our hospital to lighten the cause of a high ESR and accompanying anemia and compared the results between the geriatric population and younger adults. There were 139 patients between ages of 16 and 89 years. Of them, 51.7% were elderly. In 80 patients (57.6%) a specific underlying pathology as a possible cause of elevated ESR was found. Malignancy was the leading cause (21.6%), followed by infectious disorders (10.1%), collagen vascular diseases (9.4%), and non-neoplastic hematologic disorders (5.0%). In 59 patients (42.4%) no specific pathology could be found. There were no statistically significant differences between elderly and non-elderly patients according to the diagnostic groups. Elevated ESRs, while more prevalent in the elderly than in younger individuals, have a similar pathological significance. But as clinical conditions in the elderly are usually obscure, we should be more careful to investigate the issue of high ESR in geriatric population, even when they are asymptomatic.

Rheumatic mitral stenosis (RMS), an autoimmune sequel of streptococcal infection, causes significant morbidity and mortality. As Hashimoto's thyroiditis (HT) is recognized as the major form of chronic autoimmune thyroiditis, it was hypothesized that the coexistence of HT and RMS might have an autoimmune origin. The study aim was to examine this possible relationship.A total of 55 consecutive patients with RMS was examined and compared to 54 healthy controls with normal echocardiographic findings. All subjects underwent transthoracic echocardiography and thyroid ultrasonography after a complete medical history and laboratory examination.The demographic data of the RMS group (38 females, 17 males; mean age 39.9 +/- 9.3 years) and control group (39 females, 15 males; mean age 39.6 +/- 10.5 years) were similar. HT was found to occur significantly more frequently in RMS patients (n = 16; 29%) than in controls (n = 6; 11%) (p = 0.019)The higher frequency of HT in patients with RMS than controls may have genetic associations. Hence, further genetic-based studies should be conducted to provide a better understanding of this suggested relationship.

Background and aims: Aging is accompanied by a progressive decline in serum testosterone. Evidence concerning the clinical manifestations of low serum testosterone levels is contradictory. We aimed to examine the age-related decline in testosterone and the possible clinical outcomes, including erectile dysfunction, prostatism, cognitive function, daily life activities, depression, and osteoporosis. Methods: One hundred and twenty men underwent comprehensive geriatric assessment. Testosterone and free testosterone levels were measured, geriatric assessment scales, International Index of Erectile Function (IIEF) and International Prostate Symptom Scale (IPSS) were performed, and bone mineral densities were determined. Results: The mean age of the 120 men was 73.8±5.90. A significant decrease in testosterone and free testosterone levels with increasing age was determined (p=0.021). It was also found that erectile dysfunction, as determined by IIEF (r=0.66, p

Objectives The aim of this study was to investigate the link between the risk of developing coronary heart disease as determined by Framingham risk score (FRS) and the novel cardiac risk factors including serum levels of ferritin, C reactive protein (CRP), homocysteine, creatinine, and uric acid. Methods A total of 1698 patients aged 65 years or more were examined. Plasma concentrations of lipids, CRP, ferritin, homocysteine, uric acid, and creatinine were measured in all the patients. The FRS was calculated for each patient who were divided into three groups according to their FRSs: score 0–9, score 10–19, and score 20 or more group. Results Levels of creatinine, uric acid, CRP, triglyceride, high-density lipoprotein, folate, ferritin, and homocysteine were significantly different between the three groups. Homocysteine, ferritin, triglyceride, uric acid, and creatinine significantly increased the risk of passing from score 0–9 group to 10–19 group. Triglyceride and creatinine also increased the risk of passing from score 10–19 group to 20 or more group. Conclusion An increase in homocysteine, uric acid, ferritin, creatinine, and triglyceride levels is associated with an increase in FRS in elderly people. The current findings support the use of these novel risk factors for diagnosis of coronary heart disease in elderly patients.

The aim of this study was to assess the plasma levels of von Willebrand factor antigen and ristocetin cofactor activity, which are well-known markers of endothelial function, in atrial fibrillation (AF) with or without mitral stenosis (MS). Forty-two patients (16 patients with MS and AF [MS(+)AF(+)], 13 patients with nonvalvular AF [MS(−)AF(+)], and 13 patients with MS and sinus rhythm [MS(+)AF(−)]) were included. Von Willebrand factor antigen levels and ristocetin cofactor activities in all participants were assessed. Overall, von Willebrand factor antigen levels and ristocetin cofactor activities in the AF(+) patients were higher than in the AF(−) patients ( P = .003 and P = .002, respectively). Von Willebrand factor antigen levels and ristocetin cofactor activities in the 3 groups were found to be different ( P = .012 and P = .01, respectively). Von Willebrand factor antigen levels were similar between the MS(+)AF(+) and MS(−)AF(+) groups and were higher than that of the MS(+)AF(−) group. Ristocetin cofactor activity in the MS(−)AF(+) group was significantly higher than in the other 2 groups. The ristocetin cofactor activity and von Willebrand factor antigen levels were significantly higher in diabetic or hypertensive patients than in nondiabetic or normotensive patients. According to the results of this study, circulating von Willebrand factor antigen levels and plasma ristocetin cofactor activities are affected by the presence of AF, MS, and associated comorbidities including type 2 diabetes mellitus and systemic hypertension. Further studies are needed to assess the role of von Willebrand factor antigen and ristocetin cofactor activity in predicting vascular thrombotic events in AF, MS, systemic hypertension, and diabetes mellitus.

To compare endothelial function of people with Alzheimer's disease (AD) with that of people without.Case-control study.Geriatric medicine outpatient clinic of a university hospital.Twenty-five patients with AD who were free of vascular risk factors and 24 healthy elderly controls were enrolled. Exclusion criteria were diabetes mellitus, hypertension, dyslipidemia, evident stroke, smoking, documented coronary artery disease, history of myocardial infarction, heart failure, acute or chronic infection, malignancy, peripheral artery disease, renal disease, rheumatologic diseases, alcohol abuse, and certain drugs that may affect endothelial function. Both groups underwent comprehensive geriatric assessment and neuropsychiatric assessment.Endothelial function was evaluated according to flow-mediated dilation (FMD) from the brachial artery.Mean age +/- standard deviation was 78 +/- 5.9 in the group with AD (11 female and 14 male) and 72.1 +/- 5.8 in the control group (9 female and 11 male). Multiple linear regression analysis revealed that FMD was significantly lower in patients with AD (median 3.45, range 0-7) than controls (median 8.41, range 1-14) (P.001), independent of age. It was also found that FMD values were inversely correlated with the stage of the disease as determined according to the Clinical Dementia Rating scale (r=-0.603, P.001).Endothelial function is impaired in patients with AD. Endothelial function was worse in patients with severe AD. These findings provide evidence that vascular factors have a role in the pathogenesis of AD.

The aim of this study was to investigate the prevalence of monoclonal gammopathy of undetermined significance (MGUS) in a geriatric population in Turkey and compare bone mineral densities and related laboratory parameters of MGUS patients with those who do not have MGUS. Among 1,012 patients enrolled, monoclonal band was detected in serum samples of 22 patients (2.17%), most of which were IgG type. Further tests revealed multiple myeloma and lung carcinoma in two patients. The remaining 20 patients were diagnosed with MGUS (1.97%). The clinical and laboratory parameters of patients with and without MGUS were mostly comparable; however, bone mineral density measurements of patients with MGUS were significantly lower than those without MGUS (p = 0.007). We suggest evaluation of geriatric patients with MGUS for the presence of osteopenia/osteoporosis considering the high frequency observed in this study.

Aim The study aimed to investigate the effects of frailty on clinical outcomes of patients in an intensive care unit (ICU).

Because medically useful information could also be gathered through hospital-based studies, the aim of this study was to assess the prevalence, awareness, treatment, and control of HT among the elderly at a university hospital in Turkey. A total of 3,038 elderly were enrolled. Overall, 75.1% of the patients had HT. Among the hypertensive elderly, 88.9% were aware that they had HT, and only 20.9% had BPs that were under control. The low prevalence of control, even among individuals aware of their HT, suggests that the education of health care providers at all stages of professional training is especially important.

As life expectancy increases, the elderly population grows accordingly. Today, physicians interface with elderly patients more frequently and, therefore, geriatric education should be a part of medical training. Examining medical students' knowledge and attitudes about elderly will provide valuable information in planning the geriatric education in medical school. The aim of this study is to determine and compare the attitudes and knowledge of class-1, -4 and -6 Turkish medical students about the elderly. A questionnaire that included statements about physical and social situations of the elderly, developed by Reuben et al., was used. Five-hundred-thirty-five students educating in Hacettepe University Medical Faculty took part in the study. Age, gender and the number of people aged >65 living with the students were also asked. Gender and number of old people living with the students had no significant effect on the answers. Social statements were answered positively, and there were no significant changes among the classes. Statements about physical situations and illnesses were significantly associated with the students' years of education. Geriatric education in developing countries needs more attention because the students' attitudes towards elderly and caregiver preference are mostly affected by the students' own experiences and knowledge.

Celiac disease is a genetic disorder, presenting with malabsorption-related problems because of mucosal damage after ingestion of gluten. The only known effective treatment is a gluten-free diet. Early diagnosis and treatment are essential in preventing complications due to malabsorption. Here we report the case of an elderly patient with a fifteen-year history of diarrhea, diagnosed with celiac disease, who had developed several complications due to malabsorption such as anemia, electrolyte imbalance and osteoporosis. We believe that late diagnosis of celiac disease had played a great role in the development of complications. Moreover, celiac disease poses an increased risk for all types of malignancies. Our patient also had concurrent plasma cell dyscrasia, but did not fulfil the criteria for diagnosis of multiple myeloma.

Throughout the 1980s, a progressive increase in the incidence of Streptococcus pyogenes-related invasive infections has occurred. It has been suggested that a host-related immunogenetic background, as well as bacterial virulence factors may play an important role in the outcome of streptococcal infections. Here, we present the first case of pancarditis in the literature caused by direct bacterial invasion due to a new emm-type 12 allele of S. pyogenes in an immunocompetent patient. The pathogenesis of this invasive infection, as well as predictors of poor prognosis are discussed.

The phenomenon of falls is not well studied in developing world. However, being aware of possible correlates for falls specific to different populations and trying to eliminate these factors is very important to prevent falls. This study investigated occurrence and correlates of falls among elderly in a developing country, Turkey. A total of 2322 patients aged 65 years and over presented to outpatient clinics of a reference hospital were included in this cross-sectional study. All patients had a complete comprehensive geriatric assessment and questioned for fall history. Correlates for falls were analyzed by using logistic regression. The mean age of participants was 71.8 years; 63.5% were female and 28.5% were found to have fallen within one year. Female sex, visual problems, auditory problems, use of mobility aids, mobility problems and depression were the only independent correlates for falls. Although the cross-sectional design of this study may not prove the causal role of the risk indicators, the size of the study group as well as the large number of possible correlates examined enriches the study. The results from this cross-sectional study form a basis for further prospective study on falls in the Turkish elderly population.

EGb 761 is widely used in the management of mild cognitive impairment in the elderly population. Elucidation of the effects of EGb 761 on primary haemostasis via PFA-100 could represent an important step for better understanding of the haemostatic safety of EGb 761. The purpose of this prospective study is to assess the effects of Ginkgo biloba special extract, EGb 761, on PFA-100 in vitro bleeding time in elderly patients with mild cognitive impairment. A total of 40 elderly patients aged 65-79 years who were referred for geriatric assessment and who were diagnosed as having mild cognitive impairment were included. Patients were started on 80 mg EGb-761 three times daily. The complete set of PFA-100 in vitro bleeding time and coagulation parameters including prothrombin time, activated partial thromboplastin time and International Normalized Ratio were assessed before and on the seventh day of treatment with EGb 761. There was no statistically significant prolongation in PFA-100 in vitro bleeding time or coagulation parameters in patients receiving EGb 761 after 7 days. The data about the safety of EGb 761 from the point of primary haemostasis in our elderly patient population with mild cognitive impairment casts hope for the future management of this 'difficult-to-treat' population with the promising Ginkgo extracts.

P604 Effect of cholinesterase inhibitors on the long-term course of cognition in patients with Alzheimer’s disease treated in a ‘real-life’ clinical setting: Results from The Frisian Alzheimer’s Disease Cohort Study E. Droogsma , M. Diekhuis , N. Veeger , P. van Walderveen , E. Huinink , C. van der Hooft , D. van Asselt Department of Geriatric Medicine, Medical Centre Leeuwarden, Leeuwarden, The Netherlands

all included patients and subgroups. Determination of predictors was done by multivariable binary logistic regression. Results.– Four hundred and forty-two people aged 75 years or older were included in the study, 73.5% (n=325) were admitted to the hospital, of which 35.1% (n=114) were admitted to an acute geriatric ward. Of the patients being discharged from the ED, 26.5% (31/117) had an unplanned ED revisit within 3 months. Nursing care at home (OR 4.63, 95% CI 1.45–14.77) and depression (OR 3.91, 95% CI 1.16–13.19) were found to be independent predictors for unplanned ED readmission in the multivariable analysis. A significant trend was found for falls in the last year (OR 2.99, 95% CI 0.95–9.37). Conclusion.–This study confirms thehigh readmission rates of older persons being discharged from the ED and suggests the potential value ofmultidisciplinary, psychosocial and functional assessment, interventions and follow-up to avoid early-unplanned ED readmissions.

ntroduction.– Though highly prevalent, the pathophysiology of rthostatic hypotension (OH), postprandial hypotension (PPH), and arotid sinus hypersensitivity (CSH) are rarely studied together. herefore we conducted such a comprehensive study focusing n the common role of the cardiovascular autonomic system. e hypothesized that in geriatric patients, OH, PPH and CSH re manifestations of cardiovascular autonomic dysfunction, and nvestigated state of the art cardiovascular autonomic function ndices in a group of geriatric falls or syncope patients. ethods.– In a retrospective cohort study of 242 consecutive eligile falls clinic patients, we compared heart rate variability (HRV), lood pressure variability (BPV) and baroreflex sensitivity (BRS) as otential autonomic function determinants of the three different ypotensive syndromes. esults.– OH, PPH and CSH were diagnosed in 129 of 239 (54%), 39 of 236 (59%) and 104 of 208 (50%) of patients, respectively. n a population relevant for geriatric practice, we found no differnces in HRV, BPV and BRS between patients with andwithout OH, ith and without PPH and with and without CSH, respectively, nor etween patients with no versus one, two or three hypotensive yndromes. onclusions.– In geriatric patients with hypotensive syndromes, ardiovascular autonomic function as measured by HRV, BPV, and RS is comparable to patientswithout such syndromes. These findngs argueagainst a single ordominant etiological factor, i.e. cardiac utonomic dysfunction and show that there is a need for a broader, ultifactorial pathophysiological approach in understanding geritric hypotensive syndromes. isclosure.– No significant relationships.

17564 Background: In this study, we aimed to investigate the prevalence of monoclonal gammopathy of unknown significance (MGUS) in the geriatric population in Turkey, with their clinical and laboratory parameters. Methods: The study group consisted of all individuals who applied to the outpatient clinic of Geriatrics Department between January-December 2005 in Hacettepe University Hospital in Ankara, Turkey. This clinic serves patients older than 65 years of age either with various acute/chronic diseases or healthy individuals for check-up purposes. All the participants had serum protein electrophoresis (SPE) -and immunofixation as needed- along with their routine laboratory tests and bone mineral density (BMD) measurements. Patients with a monoclonal protein in their SPEs were further evaluated for the presence of multiple myeloma. Clinical and laboratory parameters of patients with MGUS were compared with a control group of randomly selected 100 individuals who did not have MGUS. Results: A total of 1012 patients were enrolled in the study. Monoclonal band was detected in 22 patients (2.17%). The majority of the M proteins (63%) were of Ig G type. Of the remainder, 32% were Ig A, and 5% Ig M. Further investigations in these patients depicted one patient to have multiple myeloma and one patient to have lung carcinoma. The remaining 20 patients were diagnosed as MGUS (1.97%). BMD measurements of the patients with MGUS were significantly lower than the control group. Median lumbar BMD t score was -2.66 (Interquartile range (IQR): −.72 −3.77) in MGUS patients and -1.76 (IQR: −0.50 −2.47) in controls (p = 0.007). The two groups were found to be comparable in terms of comorbid diseases and other laboratory parameters. Conclusions: The prevalence of MGUS above the age of 25 is 1%, above 50 it is 1.7%, and above 70 it is approximately 3%. In our study, the frequency of MGUS above 65 years of age was found to be 1.97%, which is a little lower than the above quoted figures. It must be noted that our study group was not population-based and chronic diseases may be more common than the general population, resulting in a higher prevalence of MGUS. Another finding was the lower BMD measurements in patients with MGUS. BMD data is limited in patients with MGUS in the literature and further studies are needed to elucidate whether there is an association or not. No significant financial relationships to disclose.