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    The Prevalence and Recognition Rate of Delirium in Hospitalized Elderly Patients in Turkey
    (2014) Aki, Ozlem Erden; Derle, Eda; Karagol, Arda; Turkyilmaz, Canan; Taskintuna, Nilgun; https://orcid.org/0000-0003-2122-1016; 24236908; AAI-8830-2021
    Objective. Delirium is frequently observed, but generally under recognized in elderly hospitalized patients. The aims of this study were to determine the prevalence of delirium in elderly patients hospitalized at a university hospital, and to determine the recognition rate by hospital staff during hospitalization. Methods. The study included 108 consecutive patients aged >= 65 years that were hospitalized in the medical and surgical inpatient departments at Baskent University Hospital, Ankara, Turkey. All the patients were evaluated using the Mini Mental State Examination (MMSE) upon admission and Confusion Assessment Method (CAM) on a daily basis during hospitalization. Written documents and consultation requests from psychiatry and/or neurology departments were reviewed for recognition of delirium by hospital staff. Results. Among the 108 patients in the study, delirium was noted in 18 (16.7%) during their hospital stay. Consultation from psychiatry or neurology departments was requested for 5 of the 18 patients, only 1 with a delirium diagnosis, indicating that 17 of the cases (94.4%) were not recognized by their primary physicians. Conclusions. The delirium non-recognition rate in elderly hospitalized patients was very high. We think that hospital staff must be trained to recognize the symptoms of delirium and identify high-risk patients.
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    Treatment of Patients with Multiple Myeloma Over 65 Yr: More Tolerability or Better Response?
    (2015) Tarkun, Pinar; Atalay, Figen; Atesoglu, Elif Birtas; Mehtap, Ozgur; Simsek, Melih; Terzi, Esra; Geduk, Ayfer; Balli, Fatih; Batman, Adnan; Baydemir, Canan; Hacihanefioglu, Abdullah; 0000-0003-4384-2913; 25220635; B-5507-2014
    ObjectiveTwo-thirds of newly diagnosed patients with multiple myeloma (MM) are over 65yr and/or physically unfit. Such patients are not eligible for high-dose chemotherapy or stem cell transplantation. The treatment aims in these patients should be to prolong survival by obtaining the best possible response, while maintaining good tolerability. The aim of our study was to evaluate the response to treatment and treatment-related toxicities in patients treated with conventional and novel protocols. MethodsThe records of 138 elderly (65yr) patients with MM were retrospectively evaluated. ResultsThe median overall survival(OS) of the patients was 46months. The median progression-free survival (PFS) was 18months. The OS and PFS of the patients treated with the conventional protocols did not differ significantly from those treated with the novel protocols. The statistical analysis of the quality of the response to the treatment with the conventional and novel therapies showed that complete remission (CR), combined with a very good partial response (VGPR), was significantly higher in the latter. However, the toxicities were higher in the novel treatment group. ConclusionThe novel drug protocols significantly increased the quality of the responses of elderly patients with MM to therapy, but they did not increase the patients' tolerability.
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    Characterization of Echocardiographic Measures of Cardiac Structure and Function in Healthy Octogenarians
    (2014) Balcioglu, Akif Serhat; Durakoglugil, Murtaza Emre; Okyay, Kaan; Tavil, Yusuf; Abaci, Adnan; https://orcid.org/0000-0001-6134-8826; https://orcid.org/0000-0001-5268-4262; 24506515; Q-3547-2019; AAK-7355-2020
    Background: Currently, there is not enough echocardiographic information regarding aging-associated changes in the octogenarian population. We aimed to characterize echocardiographic measures of structure and function among a group of healthy octogenarians. Methods: Approximately 350 octogenarians, residing in nursing homes, were screened in Ankara, Turkey. According to inclusion criteria, 40 octogenarians were enrolled. These subjects underwent conventional and tissue Doppler echocardiography according to the guidelines of the American Society of Echocardiography (ASE). The population was also separated into various groups according to gender, body mass index (BMI, <25 vs. 25-29.9), and blood pressure (<80/120 mmHg vs. 80-89/120-139 mmHg). All measurements were indexed by dividing to body surface area (BSA) for standardization. Results: Left ventricular mass (LVM), posterior wall thickness, right ventricular diameter, tricuspid E/A ratio, and septal e'-wave velocity were significantly higher in men, which lost significance after adjusting for BSA. There was no significant difference between groups formed by BMI and blood pressure. Moreover, mild global left and right ventricular dysfunction including a prominent diastolic counterpart, however, with normal ejection fraction was revealed using conventional and tissue Doppler techniques. Finally, we checked our results with the current reference values of the ASE and observed the following differences: ventricular septum, relative wall thickness, LVM, and mass index values were above ASE reference range, posterior wall measurements were close to upper range. On the contrary, left ventricular diameters and volumes were below ASE reference range. Conclusions: We described echocardiographic measures of structure and function in a group of healthy octogenarians.
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    Sleep Quality in The Elderly Either Living at Home or In A Nursing Home
    (2014) Daglar, Gulseren; Pinar, Sukran Ertekin; Sabanciogullari, Selma; Kav, Sultan; https://orcid.org/0000-0003-0361-7498; V-9745-2019
    Objective Changes in sleep duration, pattern, and quality occur with ageing. The aim of this study was to analyse the sleep quality and affecting factors in the elderly living either at home or in nursing homes. Design Descriptive and cross-sectional study Setting Sivas, a central Anatolian city in Turkey. Subject This study was carried out with 112 individuals; 52 were living in a nursing home and 60 at home. Main outcome measures A personal information form and Pittsburgh Sleep Quality Index (PSQI). Results There was no statistically significant difference between mean scores and sleep qualities of both groups (p > 0.05). The sleep quality of the individuals in both groups was not significantly influenced by personal variables such as age, gender, education, income, having children, and having a physical illness (p > 0.05). Individuals in both groups who reported their sleep as inadequate had sleep problems, and those who reported their sleep was affected for various reasons and who perceived their health as poor had significantly worse sleep quality (p < 0.05). Conclusion The sleep quality of the elderly living either at home were at similar levels and more than half of individuals in both groups had poor sleep quality.
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    Adding Taxane to Platin-5-Fluorouracil Combination Does Not Improve Survival Rate in Patients >= 65 Years of Age with Advanced Gastric Cancer: A Retrospective-Multicenter Study
    (2018) Gunaldi, Meral; Kose, Fatih; Demirci, Nebi Serkan; Gunduz, Seyda; Ozdemir, Nuriye; Kocoglu, Hakan; Okuturlar, Yildiz; Sedef, Ali Murat; Erdem, Dilek; Goksu, Sema Sezgin; https://orcid.org/0000-0002-0156-5973; 29745086; G-4827-2016
    Purpose: Advanced gastric cancer (AGC) has a dismal prognosis. Platin-5-fluorouracil (CF) combination chemotherapy is the most widely used protocol and addition of a taxane (TCF) seems to increase survival and toxicity rates. We aimed to evaluate efficacy and toxicity of TCF as compared to CF in patients older than 65 years and compare them with the patients younger than 65 years. Methods: A total of 341 patients with AGC have been treated at six different oncology centers in Turkey between 2010 and 2014 and evaluated retrospectively. The characteristics of the patients whose tumors were histologically confirmed and whose survival data were available were registered and analyzed. The study group consisted of 234 patients younger than 65 years (group 1) and 107 patients older than 65 years (group 2). All of the data obtained from the patients were statistically analyzed. Results: The median age of the patients was 58.2 years and the mean follow-up time 14.4 months. For the entire group, progression-free survival (PFS) and overall survival OS) were 9 and 13 months, respectively. Using TCF over CF regimen increased the OS by 4.2 months (i.e., group 1 and 2 together). For group 2, patients with liver metastases and without surgery of the primary tumor were treated with significantly more TCF as compared to CF, respectively. Although TCF yielded significantly higher PFS and OS in group 1 (p=0.0001 and p=0.017), there was no significant difference in group 2 as compared to CF. Also, grade 3-4 toxicity was statistically defined as one of the possible reasons of worsened OS in patients older than 65 years and receiving TCF. Conclusions: The addition of taxanes to CF backbone leads to a significant increase in both PFS and OS in patients younger than 65 years of age but the triplet regimen with taxanes does not provide superior survival in patients older than 65 years of age.
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    Association of Mini Nutritional Assessment with anthropometric measurements and muscle strength in elderly people: a neglected risk group
    (2021) Hoca, Mustafa; Turker, Perim F.
    Aim: Elderly individuals that are one of the neglected risk group are at a higher risk for health problems owing to inadequate and unbalanced nutrition. Nutritional status is also an important determinant of health in people over 65 years of age. Screening and diagnostic instruments are important in the recognition of the elderly people in evaluating the results of malnutrition. Unfortunately, there is no gold standard for the detection of malnutrition in elderly people. In this study, we aimed to assess the association of Mini Nutritional Assessment with anthropometric measurements and muscle strength in elderly people. Materials and Methods: A cross-sectional study included 210 elderly volunteers. Anthropometric measurements were taken, body mass index (BMI) values were calculated and muscle strength was evaluated by a hand dynamometer. Nutritional status was assessed using the Mini Nutritional Assessment (MNA) screening tool. The study was approved by Research Ethics Committee. Results: Elderly individuals with a BMI value of >= 30 kg/m(2) had significantly lower right and left hand grip strengths than BMI values of 18.5-24.9 kg/m(2) and 25-29.9 kg/m(2). However, elderly individuals with a BMI of >= 30 kg/m(2) had significantly higher waist/ hip ratio, waist/height ratio, body fat percentage, waist, hip, calf, neck and mid-upper arm circumferences than BMI values of 18.5-24.9 kg/m(2) and 25-29.9 kg/m(2). Additionally, a positive and statistically significant correlation was determined between the right- and left-hand grip strengths and the MNA score in women. Conclusion: To improve the nutritional status, elderly people should be monitored at regular intervals by obtaining anthropometric and muscle strength measurements and performing nutritional status screening tests.