OBJECTIVE: This study aimed to evaluate the relationship between hospital admission potentially inappropriate medications use (PIM) and in-hospital mortality of COVID-19, considering other possible factors related to mortality.METHODS: The Turkish inappropriate medication use in the elderly (TIME) criteria were used to define PIM. The primary outcome of this study was in-hospital mortality.RESULTS: We included 201 older adults (mean age 73.1 +/- 9.4, 48.9% females). The in-hospital mortality rate and prevalence of PIM were 18.9% (n=38) and 96% (n=193), respectively. The most common PIM according to TIME to START was insufficient vitamin D and/or calcium intake per day. Proton -pump inhibitor use for multiple drug indications was the most prevalent PIM based on TIME to STOP findings. Mortality was related to PIM in univariate analysis (p=0.005) but not in multivariate analysis (p=0.599). Older age (hazards ratio (HR): 1.08; 95% confidence interval (CI): 1.02-1.13; p=0.005) and higher Nutritional Risk Screening 2002 (NRS-2002) scores were correlated with in-hospital mortality (HR: 1.29; 95%CI 1.00-1.65; p=0.042).CONCLUSION: Mortality was not associated with PIM. Older age and malnutrition were related to in-hospital mortality in COVID-19.

OBJECTIVE. Depression is highly prevalent in frail older adults and both clinical situations share similar clinical and prognostic factors. The aim of this study was to investigate the relationship between frailty and depression by considering each component of frailty, in both genders. METHODS: Six hundred and forty-one patients aged 60 years and older, admitted to a Geriatrics outpatient clinic in a tertiary hospital, were included in this cross-sectional study. FRIED criteria were used for defining frailty. Depression was assessed by the Geriatric depression scale (GDS). Evaluations related to disability, nutrition, and cognition were performed by the Katz/Lawton scales, mini nutritional assessment (MNA), and the mini mental state examination (MMSE), respectively. RESULTS: Prevalence of frailty and depression was 48.7% and 36.7%, respectively. Co-occurrence of frailty and depression was observed as 24.0%. Both in men (OR: 3.977, CI: 1.423-11.114, p=0.008) and in women (OR: 2.704, CI: 1.695-4.315, p<0.001), depression was independently associated with frailty, after adjusting with confounders regarding frailty. All FRIED criteria were significantly correlated with the higher GDS scores in women. Two FRIED criteria regarding physical activity and strength measures were not related to depressive symptoms in men. Lawon (p<0.001), MMSE (p=0.004), and MNA scores (p<0.001) were lower in patients with co-occurring frailty and depression, than both as separate conditions. CONCLUSION: Depression may play a key role in the development of frailty in both genders. Albeit, depressed men seem to be at a higher risk than women for development of frailty are, physical activity and strength measures in the FRIED criteria had a high impact in women for depressive symptoms. Patients with co-occurring frailty and depression are more prone to develop geriatric syndrome related disabilities.

Unintentional weight loss is defined as a more than 5% decrease in body weight within 1 year. Various physical and psychiatric etiologies cause unintentional weight loss, including major depressive disorder (MDD). We present the case of a 69-year-old woman who lost 10 kg in 2 months. She had anhedonia, mobility limitations, and incontinence. Her Mini Nutritional Assessment score indicated malnutrition, whereas her Geriatric Depression Scale score indicated a diagnosis of MDD. Whole-body fluorodeoxyglucose (FDG)–positron emission tomography/computed tomography showed intensely increased FDG uptake in the muscles adjacent to the right and left mandibular rami and the temporal muscle, compatible with jaw clenching associated with the patient's MDD. Subsequent temporal muscle biopsy did not suggest the causes of malignant disorders, dermatomyositis, or polymyositis. Having ruled out all possible organic pathologies, the patient was thus diagnosed with MDD. Escitalopram was prescribed for her MDD, and oral nutritional supplement treatments were initiated for her malnutrition. Patients who present with unintentional weight loss should be assessed first for physical etiologies, and then psychiatric etiologies, particularly as weight loss may be a major symptom of MDD in older adults.

Sarcopenia is a multifactorial skeletal muscle disease commonly observed in the geriatric population. It is influenced by hormonal changes that occur during the postmenopausal period. This study aims to evaluate the sarcopenia status of postmenopausal women. The study included 300 postmenopausal women. Sarcopenia was defined according to the updated European Working Group on Sarcopenia in Older People (EWGSOP-2) definition. Of the evaluated patients, 44.7% (n = 134) and 15.4% (n = 46) were sarcopenic and sarcopenic obese, respectively. Older age, the number of chronic diseases, medications used and the status of polypharmacy were significantly higher in the sarcopenic group (all p < 0.050). Non-obese patients with sarcopenia showed greater dependence in activities of daily living (ADLs) (p = 0.002) and instrumental ADLs (IADLs) (p = 0.001). In ADLs (p = 0.001) and IADLs (p = 0.001), non-sarcopenic obese patients showed greater independence. Postmenopausal sarcopenia was related to older age (hazard ratio [HR]: 1.07, 95% confidence interval (CI): [1.04-1.10]; p < 0.001), the presence of osteoporosis (HR: 1.86, 95% CI: [1.05-3.30]; p = 0.034) and the existence of vasomotor symptoms (HR: 2.30, 95% CI: [1.31-4.04]; p = 0.004). This study highlights the importance of sarcopenia awareness among specialists providing healthcare services to postmenopausal patients. The study underscores the significance of initiating preventive and treatment strategies for at-risk patients before they reach old age.