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Soysal P, Smith L. The prevalence and co-existence of geriatric syndromes in older patients with dementia compared to those without dementia. Aging Clin Exp Res 2024; 36:66. [PMID: 38472505 DOI: 10.1007/s40520-024-02724-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 02/09/2024] [Indexed: 03/14/2024]
Abstract
BACKGROUND This study aims to compare frequency and coexistence of geriatric syndromes in older patients with dementia to those without dementia. METHODS 1392 patients admitted to geriatric outpatient clinics were evaluated. Evaluations for eleven geriatric syndromes including polypharmacy, malnutrition, fraility, sarcopenia, dysphagia, urinary incontinence, fear of falling, falls, insomnia, excessive daytime sleepiness, and orthostatic hypotension (OH) were carried out in consultation with the patient and the caregiver. Two groups with and without dementia were matched according to age and gender using the propensity score matching method. RESULTS A total of 738 patients, 369 with dementia and 369 without dementia were included, of whom 70.1% were female and the mean age was 80.5 ± 6.8. Polypharmacy, malnutrition, frailty, sarcopenia, dysphagia, fear of falling, and excessive daytime sleepiness were significantly higher in patients with dementia (p < 0.05). There was no difference between OH, urinary incontinence and insomnia between groups (p > 0.05). The co-existence of 0, 1, 2, 3, 4 and ≥ 5 geriatric syndromes in the same patient was 4.3%, 10.2%, 11.8%, 16.8%, 13.4% and 43.7% in non-dementia patients, respectively; 2.4%, 7.2%, 9.6%, 8.3%, 10.4% and 62.1% in those with dementia, respectively (p < 0.05). CONCLUSION The presence and co-existence of geriatric syndromes is common in patients with dementia. These geriatric syndromes should be examined by clinicians and healthcare professionals who work with the demented population, so that more successful management of dementia patients may be achieved.
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Affiliation(s)
- Pinar Soysal
- Faculty of Medicine, Department of Geriatric Medicine, Bezmialem Vakif University, 34093, Fatih, Istanbul, Turkey
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Adnan Menderes Bulvarı Vatan Street, 34093, Fatih, Istanbul, Turkey
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK.
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Catikkas NM, Tunc M, Soysal P. The prevalence of excessive daytime sleepiness and associated factors in older diabetic patients. Aging Clin Exp Res 2023; 35:3205-3214. [PMID: 38064108 DOI: 10.1007/s40520-023-02602-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 10/20/2023] [Indexed: 12/18/2023]
Abstract
OBJECTIVES Sleep disorders are a frequent health problem in older patients with diabetes mellitus (DM). There has been no study investigating the factors associated with excessive daytime sleepiness (EDS) in older diabetic patients. We aimed to investigate the prevalence and associated factors of EDS. METHODS We performed a retrospective cross-sectional study in older diabetic patients. The Epworth Sleepiness Scale score of ≥ 11 points indicated EDS. All patients underwent comprehensive geriatric assessment including demographic characteristics, blood pressures, comorbid diseases, cognitive and nutritional states, basic and instrumental daily living activity indexes, lower urinary tract symptoms, and laboratory values. RESULTS Of 227 patients, 73.1% were females, with a mean age of 78.8 ± 6.5. The prevalence of EDS was 19.8%. Patients with EDS were mostly males with dementia and used significantly more medication with more anticholinergic drug burden, falls, urge incontinence, and nocturia (p < 0.05). They had higher SARC-F and lower Barthel index, Lawton-Brodie, Tinetti, MMSE scores, and high-density lipoprotein than the patients without EDS (p < 0.05). After adjusting for age, sex, and dementia, all parameters that were significant in univariate analysis remained associated with EDS, except for falls, and MMSE scores. CONCLUSION The EDS was found in one in five older diabetic patients. There was a significant relationship between EDS and drug use, anticholinergic drug burden, impaired excretory functions, sarcopenia, decreased functional capacity, falls, gait-balance disorder, and cognitive dysfunction. The recognization of EDS and the implementation of interventions may be helpful in the management of geriatric syndromes.
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Affiliation(s)
- Nezahat Muge Catikkas
- Hamidiye Faculty of Medicine, Sancaktepe Prof. Dr. Ilhan Varank Training and, Research Hospital, Department of Internal Medicine, Division of Geriatrics, University of Health Sciences Istanbul, 34785, Sancaktepe, Istanbul, Turkey
| | - Muhammed Tunc
- Faculty of Medicine, Department of Internal Medicine, Bezmialem Vakif University, 34093, Fatih, Istanbul, Turkey
| | - Pinar Soysal
- Faculty of Medicine, Department of Geriatric Medicine, Bezmialem Vakif University, 34093, Fatih, Istanbul, Turkey.
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Piovezan RD, Jadczak AD, Tucker G, Visvanathan R. Daytime Sleepiness Predicts Mortality in Nursing Home Residents: Findings from the Frailty in Residential Aged Care Sector Over Time (FIRST) Study. J Am Med Dir Assoc 2023; 24:1458-1464.e4. [PMID: 37062370 DOI: 10.1016/j.jamda.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 03/08/2023] [Accepted: 03/10/2023] [Indexed: 04/18/2023]
Abstract
OBJECTIVES Excessive daytime sleepiness is an increasingly frequent condition among older adults with comorbidities and living in nursing homes (NHs). This study investigated associations between participants' characteristics and excessive daytime sleepiness (EDS); the ability of the Epworth Sleepiness Scale (ESS) scores, EDS, and EDS severity levels to predict mortality at 12 months of follow-up; and the optimal cut-off for ESS to predict mortality among NH residents. DESIGN Prospective and cross-sectional analysis in a prospective study. SETTING AND PARTICIPANTS Older adults permanently residing in 12 NHs from South Australia. METHODS Baseline characteristics including the ESS were collected and mortality at 12 months was assessed. Logistic regression analyzed associations between participants' characteristics and EDS (ESS >10). Kaplan-Meier cumulative survival estimates followed by log-rank and adjusted Cox proportional hazards models explored associations of ESS scores, EDS, and EDS severity levels with time-to-incident death. Receiver operator curve analysis assessed the best cut-off for ESS to predict mortality risk. RESULTS A total of 550 participants [mean (SD) age, 87.7 (7.2) years; 968 (50.9%) female]. Malnutrition [adjusted odds ratio (aOR) 2.02, 95% confidence interval (CI) 1.13‒3.61], myocardial infarction (aOR 1.91, 95% CI 1.20‒3.03), heart failure (aOR 2.85, 95% CI 1.68‒4.83), Parkinson's disease (aOR 2.16, 95% CI 1.04‒4.47) and severe dementia (aOR 8.57, 95% CI 5.25‒14.0) were associated with EDS. Kaplan-Meier analyses showed reduced survival among participants with EDS (log-rank test: χ2 = 25.25, P < .001). EDS predicted increased mortality risk (HR 1.63, 95% CI 1.07-2.51, P = .023). ESS score of 10.5 (>10) was the best cut point predicting mortality risk (area under the curve = 0.62). CONCLUSIONS AND IMPLICATIONS EDS predicts mortality risk and is associated with age-related comorbidities in NH residents. Screening for EDS is a simple strategy to identify NH residents at higher risk of adverse outcomes, triggering an assessment for reversibility or conversations about end-of-life care.
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Affiliation(s)
- Ronaldo D Piovezan
- Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, Adelaide Medical School, the Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia; Aged and Extended Care Services, The Queen Elizabeth Hospital, Central Adelaide Local Health Network, Adelaide, Australia.
| | - Agathe D Jadczak
- Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, Adelaide Medical School, the Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Graeme Tucker
- Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, Adelaide Medical School, the Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Renuka Visvanathan
- Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, Adelaide Medical School, the Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia; Aged and Extended Care Services, The Queen Elizabeth Hospital, Central Adelaide Local Health Network, Adelaide, Australia
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Fotbolcu H, Soysal P. Effect of insomnia and excessive daytime sleepiness on cardiac functions in older adults. Psychogeriatrics 2023; 23:800-807. [PMID: 37414531 DOI: 10.1111/psyg.12999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/08/2023] [Accepted: 06/12/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND We investigated the potential harmful effect in older adults of insomnia and excessive daytime sleepiness (EDS) on myocardial functions and electrophysiologic changes of the heart in terms of heart rate and QT intervals corrected for heart rate (QTc). METHODS The study included 32 insomnia patients and 30 control subjects. An Insomnia Severity Index score of ≥15 indicated insomnia, while a score of <8 was accepted as the control group. The Epworth Sleepiness Scale was used to assess EDS, with a score of ≥11/24 points indicating EDS. Diastolic and systolic functions were evaluated in each patient by transthoracic two-dimensional, conventional and tissue Doppler echocardiography. Heart rate and QTc were calculated for electrophysiologic changes. RESULTS The mean age was 73.2 ± 7.9 years, with 59.7% being female. Biventricular systolic and diastolic functions were impaired in the insomnia patients. The E' value for diastolic function was lower in the patients with insomnia than the controls (5.99 ± 1.59 vs. 6.88 ± 0.97, P = 0.053). Furthermore, values for the systolic function parameters Lateral-S (7.41 ± 1.92 vs. 9.37 ± 1.83, P < 0.001), Septal-S (6.69 ± 1.40 vs. 8.10 ± 1.30, P = 0.001), and Tricuspid-S (12.25 ± 2.00 vs. 14.37 ± 3.13, P = 0.004) were lower for insomnia patients than for controls. In the case of EDS coexistence, the heart rate and QTc values were higher than the controls (76.47 ± 7.18 vs. 71.03 ± 10.95, P = 0.001, and 413.72 ± 28.24 vs. 394.67 ± 24.47, P = 0.015, respectively). CONCLUSION Insomnia is associated with impaired systolic-diastolic functions, independent of EDS. The co-existence of insomnia and EDS may lead to electrophysiological changes in older adults, including increased heart rate and longer QTc.
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Affiliation(s)
- Hakan Fotbolcu
- Department of Cardiology, Bezmialem Vakif University, Istanbul, Turkey
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
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Yildiz S, Heybeli C, Smith L, Soysal P, Kazancioglu R. The prevalence and clinical significance of loss of appetite in older patients with chronic kidney disease. Int Urol Nephrol 2023; 55:2295-2302. [PMID: 36867375 DOI: 10.1007/s11255-023-03540-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 02/24/2023] [Indexed: 03/04/2023]
Abstract
PURPOSE To determine predictors of loss of appetite among older adults with chronic kidney disease (CKD). METHODS Demographic and clinical data, and scores of comprehensive geriatric assessment parameters of patients who were ≥ 60 years old and have CKD according to an estimated glomerular filtration rate (eGFR) of < 60 mL/min/1.73 m2 were reviewed. Loss of appetite was defined as a score of ≤ 28 in The Council on Nutrition Appetite Questionnaire. Logistic regression analysis was performed to determine the predictors of loss of appetite. RESULTS Of the 398 patients included, 288 (72%) were female, and the mean age was 80 ± 7. Loss of appetite was present in 233 (59%) of patients. The frequency appeared to significantly increase with a decline in eGFR to < 45 mL/min/1.73 m2 (p < 0.05). Older age, female sex, the presence of frailty, and higher scores of Insomnia Severity Index and geriatric depression scale-15 were associated with a higher risk of loss of appetite, while longer time on education, higher levels of hemoglobin, eGFR, and serum potassium, and higher scores of handgrip strength, Tinetti gait and balance test, basic and instrumental activities of daily living, and Mini-Nutritional risk Assessment (MNA) were associated with a lower risk (p < 0.05). Associations between insomnia severity and geriatric depression remained significant after adjustment for all parameters including the MNA score. CONCLUSION Loss of appetite is quite common in older adults with CKD and may be a sign of poor health status in older people with CKD. There is a close relationship between loss of appetite and insomnia or depressive mood.
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Affiliation(s)
- Serkan Yildiz
- Division of Nephrology, Medicana Hospital, Izmir, Turkey
| | - Cihan Heybeli
- Division of Nephrology, Mus State Hospital, Mus, Turkey
| | - Lee Smith
- Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Pinar Soysal
- Division of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Adnan Menderes Bulvarı (Vatan Street), Fatih, 34093, Istanbul, Turkey.
| | - Rumeyza Kazancioglu
- Division of Nephrology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
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Soysal P, Heybeli C, Koc Okudur S, Caliskan Bozyel E, Smith L, Kazancioglu R. Prevalence and co-incidence of geriatric syndromes according to glomerular filtration rate in older patients. Int Urol Nephrol 2023; 55:469-476. [PMID: 36030356 DOI: 10.1007/s11255-022-03356-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/21/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Geriatric syndromes are complex clinical manifestations and significant causes of mortality and morbidity. This study was aimed to determine the frequency and co-incidence of geriatric syndromes in older patients with chronic kidney disease (CKD). METHODS Older patients were included in this cross-sectional retrospective study. All patients were questioned in terms of geriatric syndromes including dementia, polypharmacy, malnutrition, frailty, probable sarcopenia, urinary incontinence, falls, fear of falling, depression, insomnia, and excessive daytime sleepiness. Geriatric syndromes were evaluated according to Glomerular Filtration Rate (GFR) ≥ 60 ml/min/1.73 m2, 30-59 ml/min/1.73 m2 and < 30 ml/min/1.73 m2. RESULTS Of the 1320 patients included, the mean age was 79.6 ± 7.8 and 929 (70%) were female. GFR groups ≥ 60 ml/min/1.73 m2, 30-59 ml/min/1.73 m2, and < 30 ml/min/1.73 m2 comprised of 55%, 38%, and 7% patients, respectively. The rate of ≥ 3 syndromes in the same person was 66.4% in the group with GFR ≥ 60 ml/min/1.73 m2. After age and sex adjusted; it was observed that frailty was 2.5 times, probable sarcopenia 2.4 times, and malnutrition 2.7 times more in those with GFR 30-59 ml/min/1.73 m2 compared to those with GFR ≥ 60 ml/min/1.73 m2 (p < 0.05). Dementia 1.4, frailty 1.55, polypharmacy 2.0, and urinary incontinence were 1.6 times more common in those with a GFR < 30 ml/min/1.73 m2 (p < 0.05). CONCLUSIONS Each of the geriatric syndromes and their co-incidence are high in older CKD patients. Geriatricians and nephrologists should be aware of geriatric syndromes in older CKD patients, and they should cooperate for the management of these patients.
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Affiliation(s)
- Pinar Soysal
- Division of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
| | - Cihan Heybeli
- Division of Nephrology, Muş State Hospital, Muş, Turkey
| | - Saadet Koc Okudur
- Division of Geriatric Medicine, Manisa State Hospital, Manisa, Turkey
| | - Emel Caliskan Bozyel
- Division of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Lee Smith
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Rumeyza Kazancioglu
- Division of Nephrology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
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Xi WZ, Wu C, Liang YL, Wang LL, Cao YH. Analysis of malnutrition factors for inpatients with chronic kidney disease. Front Nutr 2023; 9:1002498. [PMID: 36687720 PMCID: PMC9852827 DOI: 10.3389/fnut.2022.1002498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 11/21/2022] [Indexed: 01/09/2023] Open
Abstract
Objective Malnutrition is a common complication of Chronic Kidney Disease (CKD), and it is the risk factor of CKD prognosis. This study aim to evaluate the nutritional status of inpatients with CKD by using the Subjective Global Assessment (SGA), and to analyze the related factors of malnutrition; and to provide effective reference for early detection of malnutrition status in patients with CKD and timely nutrition intervention. Methods A total of 426 patients (238 male patients, 188 female patients) aged 62.62 ± 14.61 and 61.14 ± 14.82, respectively admitted to the Nephrology Department of Wannan Medical College from February 2020 to December 2020 were selected and included in to this study by convenience sampling. 426 patients with CKD were evaluated by SGA. Human body weight, hemoglobin (Hb), total protein (TP), albumin (ALB), pre-albumin (PA), qualitative analysis of urinary protein and other laboratory indexes were collected and measured. The correlation between malnutrition and age, education, gender, diet, CKD stage and other factors was analyzed by spearman correlation analysis. Results The incidence of malnutrition was 85.7% among 426 patients with CKD. Gender, age, education level, CKD stage, diabetes mellitus, weight loss and reduced food intake were related to SGA nutritional assessment (P < 0.05). The expression levels of ALB, PA and Hb in the malnutrition group were significantly lower than those in the normal group (P < 0.05). The degree of malnutrition in CKD patients was significant negatively correlated with the expression levels of ALB (r = -0.188), PA (r = -0.262) and Hb (r = -0.176) (P < 0.05). The multivariate Logistic regression analysis model showed that female (OR = 2.155), ≥60 years old (OR = 7.671), weight loss (OR = 10.691), reduced food intake (OR = 28.953), moderate and severe serum ALB expression (OR = 3.391 and 8.326) were risk factors for malnutrition in patients with CKD (P < 0.05). Malnutrition was correlated with the results of qualitative examination of urinary protein (r = 0.268, P < 0.05). Conclusion Gender, age, weight loss, reduced food intake, serum ALB expression were independently associated with malnutrition in patients with chronic kidney disease, Hence, the medical staff should take timely and effective nutrition intervention for the patients with malnutrition, delay the renal function damage of patients with CKD and improve the quality of life of patients. Inpatients with CKD, especially women, should increase their dietary intake, maintain normal weight and improve their nutritional status.
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Kara O, Soysal P, Kiskac M, Smith L, Karışmaz A, Kazancioglu R. Investigation of optimum hemoglobin levels in older patients with chronic kidney disease. Aging Clin Exp Res 2022; 34:3055-3062. [PMID: 36136237 DOI: 10.1007/s40520-022-02246-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 08/29/2022] [Indexed: 02/06/2023]
Abstract
AIM The aim of the present study is to determine target hemoglobin (Hgb) values in older females and males with chronic kidney disease (CKD) according to best performance in mood, gait and balance, muscle strength and activities of daily living, which are important parameters of geriatric assessment. METHOD Patients' age, gender, education level, and comorbidities were recorded. All the participants underwent comprehensive geriatric assessment (CGA) including Basic and Instrumental Activities of Daily Living for functional evaluation, Tinetti Performance-Oriented Assessment of Mobility and Timed Up and Go Test for fall risk, and hand grip strength for muscle strength. Hgb levels and kidney functions were analyzed on the same day as CGA measurements. Receiver Operating Characteristic (ROC) analysis was used to detect the optimum level of Hgb according to the best performance of CGA parameters. RESULTS 622 elderly CKD patients (69.3% female, 55.7% with anemia) were included. After adjustment for confounders, those with anemia had dynapenia (OR 1.60), high risk of falls (OR 1.60), and decreased functional capacity (OR 1.83) among females and those with anemia had dynapenia (OR 4.31), a high risk of falling (OR 2.42) and decreased functional capacity (OR 2.94) among males. The optimum value of Hgb level is 11.8-12.1 in females and 12.6-12.8 in males according to ROC analysis. CONCLUSION Anemia is associated with dynapenia, high risk of falls, and decreased functional capacity in older CKD patients regardless of genericity. To prevent these negative outcomes, Hgb should be kept in the range of 11.8-12.1 in older females with CKD and 12.6-12.8 in older males with CKD.
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Affiliation(s)
- Osman Kara
- Department of Hematology, Atasehir Medicana International Health Group, Istanbul, Turkey
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
| | - Muharrem Kiskac
- Department of Internal Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Abdülkadir Karışmaz
- Istanbul Training and Research Hospital, Clinic of Hematology, Istanbul, Turkey
| | - Rumeyza Kazancioglu
- Department of Nephrology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
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Kara O, Elibol T, Koc Okudur S, Smith L, Soysal P. Associations between anemia and insomnia or excessive daytime sleepiness in older adults. Acta Clin Belg 2022; 78:223-228. [PMID: 36036443 DOI: 10.1080/17843286.2022.2116895] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
OBJECTIVE Sleep disorders including excessive daytime sleepiness (EDS), insomnia and anemia are both common. The aim of this study is to investigate associations between anemia and insomnia/EDS in the elderly. METHODS A total of 744 older outpatients were included in this cross-sectional study. Anemia was defined as a hemoglobin concentration below 12 g/dL in females and <13 g/dl in males. Patients were divided into two groups as anemic and non-anemic. The Epworth Sleepiness Scale score of ≥11 points indicates EDS. Insomnia Severity Index with scores of ≥8 indicates insomnia. RESULTS The mean age was 79.8±7.7 years. The prevalence of insomnia, EDS and anemia was 62.1%, 23.8%, and 47.2%, respectively. Insomnia (66.3% vs 58.5%) and EDS (29.6% vs 18.6%) were more common in patients with anemia compared to those without anemia (p<0.05). In univariate analysis, there were significant associations between anemia and insomnia [odds ratio (OR):1.4, 95% confidence interval (CI):1.0-1.9], and EDS (OR:1.8,95% CI:1.3-2.6). In multivariate analysis, the relationship between insomnia and nocturia, chronic obstructive pulmonary disease (COPD), and number of drugs used persisted, whereas being male, of an older age, coronary arterial disease, COPD, Parkinson's disease, dementia, and urinary incontinence were associated with EDS (p<0.05), but there was no significant relationships between anemia and insomnia/EDS (p>0.05). CONCLUSION The present data suggests that an elderly who has anemia is 1.4 times more likely to experience insomnia and 1.8 times more likely to experience EDS than those without anemia.
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Affiliation(s)
- Osman Kara
- Department of Hematology, Bahcesehir University Medical Park Goztepe Hospital, Istanbul, Turkey
| | - Tayfun Elibol
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Saadet Koc Okudur
- Department of Geriatric Medicine, Manisa State Hospital, Manisa, Turkey
| | - Lee Smith
- Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
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Wearable gait analysis systems: ready to be used by medical practitioners in geriatric wards? Eur Geriatr Med 2022; 13:817-824. [PMID: 35243600 PMCID: PMC9378320 DOI: 10.1007/s41999-022-00629-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 02/16/2022] [Indexed: 11/06/2022]
Abstract
Aim To investigate the feasibility of wearable gait analysis in geriatric wards by testing the effectiveness and acceptance of the system. Findings Wearable gait analysis can be implemented into geriatric wards, showing its readiness for a transformation from a pure research tool to a practically usable gait analysis system. Message Despite good transferability into clinical practice, future research should aim to increase functionality and applicability of wearable gait analysis systems in clinical contexts. Purpose We assess feasibility of wearable gait analysis in geriatric wards by testing the effectiveness and acceptance of the system. Methods Gait parameters of 83 patients (83.34 ± 5.88 years, 58/25 female/male) were recorded at admission and/or discharge to/from two geriatric inpatient wards. Gait parameters were tested for statistically significant differences between admission and discharge. Walking distance measured by a wearable gait analysis system was correlated with distance assessed by physiotherapists. Examiners rated usability using the system usability scale. Patients reported acceptability on a five-point Likert-scale. Results The total distance measures highly correlate (r = 0.89). System Usability Scale is above the median threshold of 68, indicating good usability. Majority of patients does not have objections regarding the use of the system. Among other gait parameters, mean heel strike angle changes significantly between admission and discharge. Conclusion Wearable gait analysis system is objectively and subjectively usable in a clinical setting and accepted by patients. It offers a reasonably valid assessment of gait parameters and is a feasible way for instrumented gait analysis.
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