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Background: Suicide is one of the most important causes of deaths in the United Kingdom, and the numbers are currently increasing. Aim: There are numerous identified determinants of suicidality, and physical multimorbidity is potentially important but is currently understudied. Thus, this study aims to investigate the association of physical multimorbidity with suicidality. Methods: Cross-sectional data from the Adult Psychiatric Morbidity Survey 2007, which was conducted in England between October 2006 and December 2007 by the National Center for Social Research and Leicester University were analyzed. Respondents were asked about 20 physical health conditions, and suicidal ideation and suicide attempts were assessed. Results: Out of 7,403 individuals aged 16 years or over, the prevalence of physical multimorbidity, suicidal ideation, and suicide attempts were 35.1%, 4.3%, and 0.7%, respectively. After adjustment for potential confounders, compared to no physical conditions, 1, 2, 3, and ⩾4 conditions were associated with significant 1.79 (95% CI [1.25, 2.57]), 2.39 (95% CI [1.63, 3.51]), 2.88 (95% CI [1.83, 4.55]), and 6.29 (95% CI [4.12, 9.61]) times higher odds for suicidal ideation. Mediation analysis showed that cognitive problems (mediated percentage 39.2%) and disability (37.5%) explained the largest proportion between multimorbidity and suicidal ideation. Pain (38.0%) and cognitive problems (30.7%) explained the largest proportion between multimorbidity and suicide attempts. Conclusion: In this large sample of UK adults, physical multimorbidity was associated with significantly higher odds for suicidal ideation and suicide attempts. Moreover, several potential mediators were identified, and these may serve as future targets for interventions that aim to prevent suicidality among people with physical multimorbidity.

People with depression and subjective cognitive complaints (SCC) may be at particularly high risk for developing dementia. However, to date, studies on depression and SCC are limited mainly to single high-income countries. Thus, the aim of the present study was to investigate the association between depression and SCC in adults from low- and middle-income countries (LMICs). Cross-sectional, community-based data were analyzed from the World Health Survey. Two questions on subjective memory and learning complaints in the past 30 days were used to create a SCC scale ranging from 0 (No SCC) to 100 (worse SCC). ICD-10 Diagnostic Criteria for Research was used for the diagnosis of subsyndromal depression, brief depressive episode, and depressive episode. Multivariable linear regression was conducted to explore the associations. Data on 237,952 individuals aged >= 18 years [mean (SD) age 38.4 (16.0) years; females 50.8%] were analyzed. After adjustment for potential confounders (age, sex, education, anxiety), compared to no depressive disorder, subsyndromal depression (b-coefficient 7.91; 95%CI = 5.63-10.18), brief depressive episode (b-coefficient 10.37; 95%CI = 8.95 11.78), and depressive episode (b-coefficient 13.57; 95%CI = 12.33 14.81) were significantly associated with higher mean SCC scores. The association was similar in all age groups (i.e., 18 44, 45 64, and >= 65 years), and both males and females. All depression types assessed were associated with worse SCC among adults in 47 LMICs. Future longitudinal studies are needed to investigate whether older people with depression and SCC are at higher risk for dementia onset in LMICs.

Background Sarcopenia has been associated with a lower quality of life (QoL). However, studies on this association from low- and middle-income countries (LMICs) are scarce. Aims To examine the association between sarcopenia and QoL, in a large nationally representative sample of older adults from six LMICs. Methods Cross-sectional, community-based data from the WHO study on global ageing and adult health (SAGE) were analysed. Non-severe sarcopenia was defined as having low skeletal muscle mass (SMM) and weak handgrip strength but no slow gait speed, while severe sarcopenia was defined as having low SMM, weak handgrip strength, and slow gait speed. QoL was assessed with the 8-item WHO QoL instrument (range 0-100) with higher scores representing better QoL. Multivariable linear regression analysis was conducted. Results Data on 14,585 people aged >= 65 years were analyzed [mean (SD) age 72.6 (11.5) years; 55.0% female]. After adjustment for potential confounders, compared to no sarcopenia, severe sarcopenia was associated with a significant - 3.37 points [95% CI - 5.56, - 1.18] lower QoL score. Non-severe sarcopenia was not significantly associated with lower QoL. Discussion The association between sarcopenia and QoL observed in our study may be explained by factors such as functional impairment and disability related with sarcopenia. Conclusions In this large representative sample of older adults from multiple LMICs, compared to no sarcopenia, only severe sarcopenia was associated with a significantly lower QoL score. Interventions to prevent or manage sarcopenia among older adults in LMICs may contribute to better QoL in this population.

Introduction: We aim to provide guidance on outcomes and measures for use in patients with Alzheimer's clinical syndrome. Methods: A consensus group of 20 voting members nominated by 10 professional societies, and a non-voting chair, used a Delphi approach and modified GRADE criteria. Results: Consensus was reached on priority outcomes (n = 66), measures (n = 49) and statements (n = 37) across nine domains. A number of outcomes and measurement instruments were ranked for: Cognitive abilities; Functional abilities/dependency; Behavioural and neuropsychiatric symptoms; Patient quality of life (QoL); Caregiver QoL; Healthcare and treatment-related outcomes; Medical investigations; Disease-related life events; and Global outcomes. Discussion: This work provides indications on the domains and ideal pertinent measurement instruments that clinicians may wish to use to follow patients with cognitive impairment. More work is needed to develop instruments that are more feasible in the context of the constraints of clinical routine.

Background Previous studies on the association between pain and cognitive decline or impairment have yielded mixed results, while studies from low- and middle-income countries (LMICs) or specifically on mild cognitive impairment (MCI) are scarce. Thus, we investigated the association between pain and MCI in LMICs and quantified the extent to which perceived stress, sleep/energy problems, and mobility limitations explain the pain/MCI relationship. Methods Data analysis of cross-sectional data from six LMICs from the Study on Global Ageing and Adult Health (SAGE) were performed. MCI was based on the National Institute on Aging-Alzheimer's Association criteria. "Overall in the last 30 days, how much of bodily aches or pain did you have?” was the question utilized to assess pain. Associations were examined by multivariable logistic regression analysis and meta-analysis. Results Data on 32,715 individuals aged 50 years and over were analysed [mean (SD) age 62.1 (15.6) years; 51.7% females]. In the overall sample, compared to no pain, mild, moderate, and severe/extreme pain were dose-dependently associated with 1.36 (95% CI = 1.18–1.55), 2.15 (95% CI = 1.77–2.62), and 3.01 (95% CI = 2.36–3.85) times higher odds for MCI, respectively. Mediation analysis showed that perceived stress, sleep/energy problems, and mobility limitations explained 10.4%, 30.6%, and 51.5% of the association between severe/extreme pain and MCI. Conclusions Among middle-aged to older adults from six LMICs, pain was associated with MCI dose-dependently, and sleep problems and mobility limitations were identified as potential mediators. These findings raise the possibility of pain as a modifiable risk factor for developing MCI.

Background Outdoor air pollution has been reported to be associated with frailty (including slow gait speed) in older adults. However, to date, no literature exists on the association between indoor air pollution (eg, unclean cooking fuel use) and gait speed. Therefore, we aimed to examine the cross-sectional association between unclean cooking fuel use and gait speed in a sample of older adults from 6 low- and middle-income countries (China, Ghana, India, Mexico, Russia, and South Africa). Methods Cross-sectional, nationally representative data from the World Health Organization Study on global AGEing and adult health were analyzed. Unclean cooking fuel use referred to the use of kerosene/paraffin, coal/charcoal, wood, agriculture/crop, animal dung, and shrubs/grass based on self-report. Slow gait speed referred to the slowest quintile based on height, age, and sex-stratified values. Multivariable logistic regression and meta-analysis were done to assess associations. Results Data on 14 585 individuals aged ≥65 years were analyzed (mean [standard deviation] age 72.6 [11.4] years; 45.0% males). Unclean cooking fuel use (vs clean cooking fuel use) was significantly associated with higher odds for slow gait speed (odds ratio = 1.45; 95% confidence interval: 1.14–1.85) based on a meta-analysis using country-wise estimates. The level of between-country heterogeneity was very low (I2 = 0%). Conclusions Unclean cooking fuel use was associated with slower gait speed among older adults. Future studies of longitudinal design are warranted to provide insight into the underlying mechanisms and possible causality.

Background There is a scarcity of studies examining the longitudinal relationship between dynapenic abdominal obesity (DAO; ie, impairment in muscle strength and high waist circumference) and future fall risk. Therefore, we aimed to investigate the prospective association between DAO at baseline and falls occurring during 2 years of follow-up in a nationally representative sample of middle-aged and older individuals from Ireland. Methods Data from 2 consecutive waves of the Irish Longitudinal Study on Ageing survey were analyzed. Dynapenia was defined as handgrip strength of 88 cm for women and >102 cm for men. DAO was assessed at Wave 1 (2009–2011) and was defined as having both dynapenia and abdominal obesity. Falls occurring between Wave 1 and Wave 2 (2012–2013) were self-reported. Multivariable logistic regression analysis was conducted. Results Data on 5 275 individuals aged ≥50 years were analyzed (mean [standard deviation {SD}] age 63.2 [8.9] years; 48.8% males). After adjustment for potential confounders, compared to no dynapenia and no abdominal obesity at baseline, DAO was significantly associated with 1.47 (95% confidence interval [CI]: 1.14–1.89) times higher odds for falls at 2-year follow-up. Dynapenia alone (odds ratio [OR] = 1.08; 95% CI: 0.84–1.40) and abdominal obesity alone (OR = 1.09; 95% CI: 0.91–1.29) were not significantly associated with falls at follow-up. Conclusions DAO increased the risk for falls among middle-aged and older adults in Ireland. Interventions to prevent or reverse DAO may be beneficial for fall reduction.

Purpose Multimorbidity (i.e., ≥ 2 chronic conditions) poses a challenge for health systems and governments, globally. Several studies have found inverse associations between multimorbidity and quality of life (QoL). However, there is a paucity of studies from low- and middle-income countries (LMICs), especially among the older population, as well as studies examining mediating factors in this association. Thus, the present study aimed to explore the associations, and mediating factors, between multimorbidity and QoL among older adults in LMICs. Methods Cross-sectional nationally representative data from the Study on Global Ageing and Adult Health were analyzed. A total of 11 chronic conditions were assessed. QoL was assessed with the 8-item WHO QoL instrument (range 0–100) with higher scores representing better QoL. Multivariable linear regression and mediation analyses were conducted to assess associations. Results The final sample consisted of 34,129 adults aged ≥ 50 years [mean (SD) age 62.4 (16.0) years; age range 50–114 years; 52.0% females]. Compared to no chronic conditions, 2 (b-coefficient − 5.89; 95% CI − 6.83, − 4.95), 3 (− 8.35; − 9.63, − 7.06), 4 (− 10.87; − 12.37, − 9.36), and ≥ 5 (− 13.48; − 15.91, − 11.06) chronic conditions were significantly associated with lower QoL, dose-dependently. The mediation analysis showed that mobility (47.9%) explained the largest proportion of the association between multimorbidity and QoL, followed by pain/discomfort (43.5%), sleep/energy (35.0%), negative affect (31.9%), cognition (20.2%), self-care (17.0%), and interpersonal activities (12.0%). Conclusion A greater number of chronic conditions was associated with lower QoL dose-dependently among older adults in LMICs. Public health and medical practitioners should aim to address the identified mediators to improve QoL in patients with multimorbidity.

Aims the literature regarding the association between multimorbidity and dementia is still unclear. Therefore, we aimed to explore the potential association between multimorbidity at the baseline and the risk of future dementia in the SHARE (Survey of Health, Ageing and Retirement in Europe) study, a large European research survey, with a follow-up of 15 years. Methods in this longitudinal study, multimorbidity was defined as the presence of two or more chronic medical conditions, among 14 self-reported at the baseline evaluation. Incident dementia was ascertained using self-reported information. Cox regression analysis, adjusted for potential confounders, was run and hazard ratios (HRs), with their 95% confidence intervals (CIs), that were estimated in the whole sample and by 5 year groups. Results among 30,419 participants initially considered in wave 1, the 23,196 included participants had a mean age of 64.3 years. The prevalence of multimorbidity at baseline was 36.1%. Multimorbidity at baseline significantly increased the risk of dementia in the overall sample (HR = 1.14; 95% CI: 1.03–1.27) and in participants younger than 55 years (HR = 2.06; 95% CI: 1.12–3.79), in those between 60 and 65 years (HR = 1.66; 95% CI: 1.16–2.37) and in those between 65 and 70 years (HR = 1.54; 95% CI: 1.19–2.00). In the overall sample, high cholesterol levels, stroke, diabetes and osteoporosis increased the risk of dementia, particularly if present among participants between 60 and 70 years of age. Conclusions multimorbidity significantly increases the risk of dementia, particularly in younger people, indicating the need for early detection of multimorbidity for preventing cognitive worsening.

Background-\ud \ud Both obesity and malnutrition are common health problems in older adults.\ud \ud Aim-\ud \ud The aim of our study is to investigate the prevalence of undernutrition and related factors in older obese patients.\ud \ud Methods-\ud \ud 1911 older outpatients who underwent comprehensive geriatric assessment were included in this cross-sectional study. Body mass index (BMI) was categorized as follows: ‘Underweight’ = BMI 23.5, 17–23.5, or

Background: Sleep duration may influence risk for sarcopenia but studies on this topic are scarce, especially from low and- middle-income countries (LMICs). Thus, the aim of the present study was to investigate the association between sleep duration and sarcopenia among adults aged ≥ 65years from five LMICs (China, Ghana, India, Russia, South Africa). Methods: Cross-sectional, community-based data from the WHO study on global ageing and adult health (SAGE) were analysed. Sarcopenia was defined as having low skeletal muscle mass (SMM) and weak handgrip strength, while severe sarcopenia was defined as having low SMM, weak handgrip strength, and slow gait speed. Self-reported sleep duration in the past two nights were averaged and classified as ≤ 6, > 6 to ≤ 9, and ≥ 9h/day. Multivariable logistic regression analysis was conducted. Results: Data on 13,210 adults aged ≥ 65years [mean (SD) age 72.6 (11.3) years; 55.0% females] were analyzed. In the overall sample, compared to > 6 to ≤ 9h/day of sleep duration, > 9h/day was associated with 1.70 (95% CI 1.15–2.51) and 1.75 (95% CI 1.08–2.84) times higher odds for sarcopenia and severe sarcopenia, respectively. No significant associations were observed among males, but associations were particularly pronounced among females [i.e., OR = 2.19 (95% CI 1.26–3.81) for sarcopenia, and OR = 2.26 (95% CI 1.20–4.23) for severe sarcopenia]. Conclusions: Long sleep duration was associated with an increased odds of sarcopenia and severe sarcopenia in LMICs, particularly in females. Future studies should investigate whether addressing long sleep duration among females can lead to lower risk for sarcopenia onset in LMICs. © 2022, The Author(s), under exclusive licence to Springer Nature Switzerland AG.

BackgroundPain and sarcopenia are common in older people. Cross-sectional studies have reported a significant association between these two conditions, but cohort studies exploring pain as a potential risk factor for sarcopenia are scarce. Given this background, the aim of the present work was to investigate the association between pain (and its severity) at baseline, and the incidence of sarcopenia over 10 years of follow-up in a large representative sample of the English older adult population.MethodsPain was diagnosed using self-reported information and categorized as mild to severe pain at four sites (low back, hip, knee, and feet). Incident sarcopenia was defined as having low handgrip strength and low skeletal muscle mass during the follow-up period. The association between pain at baseline and incident sarcopenia was assessed using an adjusted logistic regression analysis, and reported as odds ratios (ORs) with their 95% confidence intervals (CIs).ResultsThe 4 102 participants without sarcopenia at baseline had a mean ± standard deviation age of 69.7 ± 7.2 years, and they were mainly male (55.6%). Pain was present in 35.3% of the sample. Over 10 years of follow-up, 13.9% of the participants developed sarcopenia. After adjusting for 12 potential confounders, people with pain reported a significantly higher risk of sarcopenia (OR = 1.46: 95% CI: 1.18–1.82). However, only severe pain was significantly associated with incident sarcopenia, without significant differences across the four sites assessed.ConclusionsThe presence of pain, particularly severe pain, was associated with a significantly higher risk of incident sarcopenia.

Physical activity is beneficial for overall health; however, informal carers may have lower levels of physical activity than non-carers. The primary aim of this systematic review was to identify barriers and facilitators to physical activity from the perspective of carers internationally, excluding the UK. The study found that barriers to physical activity include lack of time, fatigue, lack of motivation and lack of support. Facilitators of physical activity include health and well-being as a motivator, using physical activity as a coping mechanism, and social support. Participating with the care recipient and care duties were both barriers and facilitators depending on the study or participant.

BackgroundPain may increase the risk for sarcopenia, but existing literature is only from high-income countries, while the mediators of this association are largely unknown. Thus, we aimed to investigate the association between pain and sarcopenia using nationally representative samples of older adults from 6 low- and middle-income countries (LMICs), and to identify potential mediators.MethodsCross-sectional data from the WHO Study on global AGEing and adult health (SAGE) were analyzed. Sarcopenia was defined as having low skeletal muscle mass and weak handgrip strength, while the presence and severity of pain in the last 30 days were self-reported. Multivariable logistic regression and mediation analyses were performed. The control variables included age, sex, education, wealth, and chronic conditions, while affect, sleep/energy, disability, social participation, sedentary behavior, and mobility were considered potential mediators.ResultsData on 14,585 adults aged ≥65 years were analyzed (mean [SD] age 72.6 [11.5] years; 55.0% females). Compared to no pain, mild, moderate, severe, and extreme pain were associated with 1.42 (95% confidence interval [CI] = 1.05–1.94), 1.43 (95%CI = 1.02–2.00), 1.92 (95%CI = 1.09–3.37), and 2.88 (95%CI = 1.10–7.54) times higher odds for sarcopenia, respectively. Disability (mediated percentage 18.0%), sedentary behavior (12.9%), and low mobility (56.1%) were significant mediators in the association between increasing levels of pain and sarcopenia.ConclusionsHigher levels of pain were associated with higher odds for sarcopenia among adults aged ≥65 years in 6 LMICs. Disability, sedentary behavior, and mobility problems were identified as potential mediators. Targeting these factors in people with pain may decrease the future risk of sarcopenia onset, pending future longitudinal research.

Purpose Food insecurity and multimoribidity (i.e., ≥ 2 chronic conditions) may be linked bidirectionally, but there are no studies on this topic from LMICs. Therefore, the aim of the present study was to examine the association between food insecurity and physical multimorbidity in a large representative sample of older adults from six LMICs. Methods Cross-sectional, community-based data on adults aged ≥ 50 years from the World Health Organization’s Study on Global AGEing and Adult Health (SAGE) conducted in China, Ghana, India, Mexico, Russia, and South Africa were analyzed. A total of 11 chronic physical conditions were assessed. Past 12 month food insecurity was assessed with two questions on frequency of eating less and hunger due to lack of food. Multivariable logistic regression analysis was conducted to assess the associations. Results Data on 34,129 adults aged ≥ 50 years [mean (SD) age 62.4 (16.0) years; age range 50–114 years; 47.9% males] were analyzed. After adjustment for potential confounders, in the overall sample, compared to being food secure, moderate and severe food insecurity were associated with 1.29 (95% CI 1.06–1.56) and 1.56 (95% CI 1.13–2.16) times higher odds for multimorbidity, respectively Conclusion Food insecurity was associated with greater odds for multimorbidity in older adults from LMICs. Addressing food insecurity in the general population may reduce risk for multimorbidity, while screening for food insecurity and addressing it among those with multimorbidity may lead to better clinical outcomes, pending future longitudinal research

Aim: To compare anticholinergic burden (ACB) in older patients with and without cancer and evaluate the effects of ACB on geriatric syndromes. Methods: A total of 291 patients from the geriatric clinic and 301 patients from the oncology clinic were evaluated. ACB

Background: Insomnia and excessive daytime sleepiness (EDS) are common sleep disorders in older adults. Both are associated with numerous adverse health conditions.Objectives: The aim of our study is to evaluate the effects of insomnia and/or EDS on functionality, gait-balance functions, cognition, mood, falls and fear of falling (FoF) in older adults, to determine its importance in terms of nursing practice and to raise awareness on the subject.Methods: A cross-sectional study design was used. A total of 661 outpatients were included, aged ≥ 65 years. All patients underwent comprehensive geriatric assessment. Comorbidities, falls in the last year and drugs used were recorded. The Falls Efficacy Scale–International (FES-I) was used to determine and classify FoF. MMSE was applied to all patients for neurocognitive evaluation. Activities of daily living were assessed by Basic Activities of Daily Living Scale (BADL) and Instrumental Activities of Daily Living (IADL) scales. Insomnia Severity Index (ISI) with scores of 8 and over indicated insomnia. The Epworth Sleepiness Scale score of ≥ 11 points indicated EDS. Results: The mean age was 77.78 ± 7.73 years. The prevalences of EDS, insomnia, and EDS+insomnia were 5.45%, 50.38%, and 12.56%, respectively. As a result of bivariate and multivariate logistic regression analysis, there was a significant relationship between EDS+insomnia with moderate and high FoF (OR=2.24, 95% CI: 1.74 to 2.89), polypharmacy (OR=1.20, 95% CI: 1.09 to 1.30), BADL (OR=0.94, 95% CI: 0.93 to 0.96) ), IADL (OR=0.87, 95% CI: 0.84 to 0.91) and MMSE (OR=0.91, 95% CI: 0.86 to 0.98) (p, Giriş: Uykusuzluk ve gündüz aşırı uykululuk (GAU), yaşlı hastalarda sık görülen uyku bozukluklarındandır. Her ikisi de çok sayıda olumsuz sağlık durumlarıyla ilişkilidir. Amaç: Uykusuzluk ve/veya GAU’nun yaşlılarda fonksiyonellik, yürüme-denge fonksiyonları, kognisyon, duygu durum, düşme ve düşme korkusu (DK) üzerine etkilerini değerlendirmek, hemşirelik pratiği açısından önemini belirlemek ve konuyla ilgili farkındalık yaratmaktır. Yöntem: Kesitsel araştırma tasarımı kullanıldı. Çalışmaya ≥ 65 yaş, 661 ayaktan hasta dahil edildi. Tüm hastalara ayrıntılı geriatrik değerlendirme yapıldı. Komorbiditeler, son bir yıldaki düşmeler ve kullanılan ilaçlar kaydedildi. DK' nu belirlemek ve sınıflandırmak için Uluslararası Düşme Etkinliği Ölçeği (UDEÖ), nörokognitif değerlendirme için Standardize Mini Mental Test (SMMT) ölçeği, günlük yaşam aktivitelerini değerlendirmek için Temel Günlük Yaşam Aktiviteleri (TGYA) ve Enstrümental Günlük Yaşam Aktiviteleri (EGYA) kullanılmıştır. Uykusuzluk Şiddet İndeksinin ≥ 8 puan olması uykusuzluk, Epworth Uykululuk Skalasının ≥ 11 puan olması GAU olarak değerlendirildi. Bulgular: Yaş ortalaması 77.78 ±7.73 yıldı. GAU, uykusuzluk ve GAU ve uykusuzluk halinin prevalansları sırasıyla %5.45, %50.38 ve %12.56 idi. İki değişkenli ve çok değişkenli lojistik regresyon analizi sonucunda; GAU ve uykusuzluk ile orta ve yüksek DK (OR=2.24, %95 CI: 1.74-2.89), polifarmasi (OR=1.20, %95 CI: 1.09-1.30), TGYA (OR=0.94, %95 CI: 0.93-0.96), EGYA (OR=0.87, %95 CI: 0.84-0.91) ve SMMT (OR=0.91, %95 CI: 0.86-0.98) arasında anlamlı ilişki saptanmıştır (p

Both excessive daytime sleepiness (EDS) and nutritional deficiencies are common and can cause similar negative consequences, such as falls, and cognitive impairment in older adults, but there is no study investigating the relationship between the two. The aim of this study is to investigate the relationship between malnutrition/micronutrient deficiency and EDS in patients with and without dementia.Cross-sectional study.A total of 800 outpatients (243 of whom had dementia), aged ≥65 years, were included.All patients underwent comprehensive geriatric assessment. Mini Nutritional Assessment (MNA) scores23.5, 17-23.5, or17 were categorized as well-nourished, malnutrition risk, and malnutrition, respectively. Eating Assessment Tool score of ≥3 was accepted as dysphagia. Serum vitamin BThe mean age was 79.1±7.5 years. The prevalence of EDS was 22.75%. In patients with dementia, those with EDS had significantly lower MNA scores and more frequent dysphagia (P.05). In patients without dementia, those with EDS have lower MNA scores than those without EDS; malnutrition, dysphagia, and vitamin D deficiency were higher (P.05). In multivariable analysis adjusted for age, gender, living status, ischemic heart disease, cerebrovascular events, polypharmacy, dementia, and insomnia, the association between EDS and malnutrition [odds ratio (OR) 1.73, 95% confidence interval (CI) 1.37-2.20], dysphagia (OR 2.01, 95% CI 1.33-2.88), and vitamin D deficiency (OR 2.0, 95% CI 1.12-3.55) persisted.There is a significant relationship between EDS and malnutrition risk, dysphagia, and vitamin D deficiency in older adults. Therefore, when examining an older patient with EDS, dysphagia, malnutrition, and vitamin D levels should be evaluated, or EDS should be investigated in an older patient with malnutrition, dysphagia, and vitamin D deficiency. Thus, it will be possible to manage all these conditions more effectively.

Aims: Methodological rigour enhances reproducibility in preclinical studies and translation from preclinical to clinical studies. We aimed to investigate the prevalence and the trends of essential study design elements in preclinical urological studies, as well as key factors which may improve methodological rigour. Methods and Results: PubMed database was searched, and all the resulting articles in preclinical urological articles published over the past 14-years were reviewed. Total 3768 articles met inclusion criteria. Data on study design elements and animal model used were collected. Citation density and journal impact factor was also examined as a surrogate marker of study influence. We performed analysis on prevalence of seven critical study design elements, and temporal patterns over 14 years. Randomization was reported in 50.0%, blinding in 15.0%, sample size estimation in 1.0%, inclusion of both sexes in 5.7%, statistical analysis in 97.1%, housing and husbandry in 47.7%, and inclusion/exclusion criteria in 5.0%. Temporal analysis showed that the implementation of these study design elements has increased, except for inclusion of both sexes and inclusion/exclusion criteria. Reporting study design elements were not associated with increased citation density. Conclusions: The risk of bias is prevalent in 14-year publications describing preclinical urological research, and the quality of methodological rigour is poorly related to the journal impact factor or the citation of the article. Yet guidelines seem helpful in improving the research quality, because five study design elements (randomization, blinding, sample size estimation, statistical analysis, housing and husbandry) proposed by both NIH and ARRIVE guidelines have been either well reported or improved. Systematic review registration: PROSPERO CRD42022233125 One-sentence summary: Research bias still exists in the fields in preclinical urology, but it is gradually improving.

The main aim of this study was to compare older patients with Alzheimer's disease (AD) to those with dementia with Lewy bodies (DLB) according to their dependency in daily living activities and comprehensive geriatric assessment parameters.A total of 227 AD and 123 DLB patients underwent a geriatric assessment that included comorbidities, number of drugs used, falls, urinary incontinence, hand grip strength, Mini-Nutritional Assessment (MNA), Tinetti Performance Oriented Mobility Assessment Scale, Insomnia Severity Index (ISI), and Epworth Sleepiness Scale. Basic and instrumental activities of daily living were assessed by the Barthel Index and the Lawton scale, respectively.The mean age of the participants was 83.4 years, and 73% were female. There were no statistically significant differences between AD and DLB patients in age, gender, cognitive function, or comorbidities except for coronary artery disease (P 0.05). The number of falls, drugs used, and ISI and Epworth scores were higher in patients with DLB than patients with AD (P 0.05). DLB patients had lower MNA, Tinetti scale, and hand grip strength scores than AD patients. The ratio of patients highly dependent in basic daily activities as a whole was significantly greater in DLB than in AD (P 0.05), but there was no significant difference in the overall levels of dependency in instrumental activities.DLB patients are more dependent on their caregivers than AD patients. Nutritional deterioration, sleep disorders, falls, balance and gait problems, decreased muscle strength, and multiple drug use are more common in those with DLB compared to those with AD. The management of older patients with DLB may be more difficult than older patients with AD.