Background: Late-life depression is a geriatric syndrome which should be taken seriously. Many clinical scales have been developed for the screening of geriatric depression. Most of these have been validated at different times and in diverse populations. A five-question version of the Geriatric Depression Scale (GDS-5) was developed in 1997. This test has been validated and used in different populations. In the present study, we plan to validate the GDS-5 for the Turkish elderly population. Methods: Patients aged 60 years and older who applied to the Geriatrics Clinic of our hospital between November 2018 and November 2019 were included in the study. We compared the effectiveness of Yesavage Geriatric Depression Scale-30 (YGDS-30) and GDS-5 in screening depression, based on Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) depression criteria. Results: Four hundred participants were included in the study. A significant positive correlation was found between the DSM-5 scale and the GDS-5 scale (rho = 0.726, P <0.001). According to DSM-5, YGDS-30 and GDS-5, 112 participants (28%), 154 patients (%38.5) and 199 patients (%49.8) were diagnosed with depression respectively. When the cut-off value was taken as ≥2, the sensitivity, specificity, positive predictive and negative predictive values for the GDS-5 scale were determined as 96%, 68%, 54%, and 98%, respectively. We obtained these diagnostic measures with 95% confidence intervals. Conclusion:This study demonstrated the validity and reliability of the GDS-5 for Turkish elderly populations. This five-question scale will be significant in daily use to screen for depression in elderly individuals with multiple problems.
Background Although numerous studies have been performed to determine predictors of coronavirus disease 2019 (COVID‐19) mortality, studies that address the geriatric age group are limited. The aim of this study was to investigate the utility of the Nutritional Risk Screening 2002 (NRS‐2002) and the Geriatric 8 (G8) screening tools in predicting clinical outcomes in older adults hospitalized with COVID‐19. Methods Patients aged ≥60 years who were hospitalized with COVID‐19 in the second wave of the pandemic were included in the study. COVID‐19 infection was demonstrated by a positive real‐time reverse transcriptase–polymerase chain reaction on nasopharyngeal swab or positive radiological findings. Disease severity was determined as defined by the National Institutes of Health. Patient demographics, laboratory values on admission, comorbidities, and medications were recorded. The NRS‐2002 and the G8 screening tools were performed for all patients by the same geriatrician. Primary outcome was in‐hospital mortality. Results A total of 121 patients were included. Mean age was 75 ± 9 years, and 51% were female. Mean body mass index was 27 ± 4.5 kg/m2. Sixty‐nine percent of the patients had nutrition risk according to the NRS‐2002. Eighty‐nine percent of the patients had a G8 score ≤14. In‐hospital mortality occurred in 26 (22%) patients. Older age and having nutrition risk as determined by the NRS‐2002 were independently associated with a higher risk of in‐hospital mortality in older patients with COVID‐19. Conclusion The NRS‐2002 tool provides rapid assessment for risk stratification in hospitalized older patients with COVID‐19.
Objective: This study aims to determine the relationship between polypharmacy and Coronavirus disease-2019 (COVID-19) (+) related mortality. Materials and Methods:All older adults >60 years old who had positive COVID-19 polymerase chain reaction tests were included in the study, designed retrospectively. Polypharmacy was defined as drug use of five or more.Results: One hundred and ten people of >60 years old were included in the study. Fifty-nine (53.6%) of the participants were male and the mean age was 70.5+8.81. The prevalence of polypharmacy in patients diagnosed with COVID-19 infection was 31.8% (n=35). Eighty-two (78.8%) of participants had pneumonia. Mortality occurred in 24 (21.8%) of the participants. There was no relationship between polypharmacy and mortality (p=0.241). In multivariate analysis, older age was associated with mortality (odds ratio: 6.82 95% confidence interval: 2.46-18.91, p<0.001). Conclusion:The prevalence of polypharmacy in individuals diagnosed with COVID-19 infection was like the literature. The most significant factors in death in people with COVID-19 infection were older age. There was no relationship between polypharmacy and mortality.
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.
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