Relationship of serum vitamin D level on geriatric syndromes and physical performance impairment in elderly hypertensive patients

Objective To investigate the relationship among serum vitamin D levels, physical performance impairment, and geriatric syndromes in elders with hypertension. Methods According to the concentration of vitamin D levels, a total of 143 elderly patients with hypertension were classified into vitamin D deficient group （vitamin D 〈 20 ng/mL, n = 94） and vitamin D appropriate group （vitamin D 〉 20 ng/rnL, n = 49）. Geriatric syndromes and physical performance were assessed by using comprehensive geriatric assessment （CGA）. Correlation among vitamin D levels, geriatric syndromes and physical performance was analyzed. Results No statistical differences were found in various aspects of geriatric syndromes between the two groups （P 〉 0.05）. While correlation analysis indicated that vitamin D levels had a positive association with ADL score （r = 0.235, P 〈 0.01） and a negative association with Morse fall scale score （r = 0.238, P 〈 0.01）. Patients with deficient vitamin D level had longer time both in the Five Time Sit to Stand Test （5tSTS）, （15.765 ± 5.593） and the four-meter walk test [7.440 （5.620, 9.200）], a weaker hand-grip in the grip strength test （28.049 ± 9.522）, and a lower Tinetti performance-oriented mobility assessment （Tinetti POMA） [26 （22, 27）] and Balance subscale of the Tinetti performance-oriented mobility assessment （B-POMA） score [ 14 （12, 16）], compared with appropriate vitamin D level [（13.275 ± 3.692）; 5.810 （4.728, 7.325）]; （31.989 ± 10.217）; [26.5 （25, 28）]; [15 （14, 16）, respectively, all P 〈 0.05]. Furthermore, results of logistic regression indicated that vitamin D was significantly associated with 5tSTS （OR = 1.2, 95% CI = 1.050-1.331, P 〈 0.01）, Tinetti POMA （OR = 3.7, 95% CI：1.284-10.830, P 〈 0.05） and B-POMA （OR = 0.8, 95% CI：0.643-0.973, P 〈 0.05）. Conclusions In elderly hypertensive patients, serum vitamin D deficient level is associated with physical performance impairment. However, no statistical significance was found between vitamin D and geriatric syndromes. Further study is required to investigate possible mechanisms for the association between vitamin D and physical performance.

The Evaluation of Differenceson Geriatric Syndromesbetween Active and Sedentary Elderly

Purpose:The purpose of the present study was to investigate the differences between diseases,geriatric syndrome and medication use among sedentary and active community-dwelling elderly in Tehran.Method:In this cross-sectional study,465 community-dwelling elderly men aged 60-95 living independently in Tehran city,Iran participated voluntarily.After the evaluation of PA(physical activity)levels,subjects were divided into two(active elderly and sedentary elderly)groups.Then age-related geriatric syndromes and diseases were measured by questionnaires and functional tests.Data analysis was performed using SPSS(Statistical Package for the Social Sciences)statistical software version 21 and p-value of<0.05 was considered to be statistically significant.Achievements of the study:The result of T-test showed that compared with sedentary participants,highly active individuals had better life expectancyand lower risk of fall and sarcopenia(p<0.01).In relation to comorbidities,the number of diseases in physically active individuals was the same as men in sedentary group(p>0.05).It can be stated that higher PA level plays an effective role in the improvement of many age-related disorders and successful aging.

Presbyphagia:Dysphagia in the elderly

Dysphagia has been classified as a“geriatric syndrome”and can lead to serious complications that result in a tremendous burden on population health and healthcare resources worldwide.A characteristic age-related change in swa-llowing is defined as“presbyphagia.”Medical imaging has shown some changes that seriously affect the safety and efficacy of swallowing.However,there is a general lack of awareness of the effects of aging on swallowing function and a belief that these changes are part of normal aging.Our review provides an overview of presbyphagia,which has been a neglected health problem for a long time.Attention and awareness of dysphagia in the elderly population should be strengthened,and targeted intervention measures should be actively imple-mented.

Complex multimorbidity and health outcomes in older adult cancer survivors

Objective:To characterize complex multimorbidity among cancer survivors and evaluate the association between cancer survivorship,time since cancer diagnosis,and self-reported fair/poor health,self-rated worse health in 2 years,and 2-year mortality.Methods:We used the 2010-2012 Health and Retirement Study.Cancer survivors were indi-viduals who reported a(nonskin)cancer diagnosis 2 years or more before the interview.We defined complex multimorbidity as the co-occurrence of chronic conditions,functional limitations,and/or geriatric syndromes.In addition to descriptive analyses,we used logistic regression to evaluate the independent association between cancer survivor status and health outcomes.We also examined whether cancer survivorship differed by the number of years since diagnosis.Results:Among 15,808 older adults(age≥50 years),11.8%were cancer survivors.Compared with cancer-free individuals,a greater percentage of cancer survivors had complex multimorbidity:co-occurring chronic conditions,functional limitations,and geriatric syndromes.Cancer survivor-ship was significantly associated with self-reported fair/poor health,self-rated worse health in 2 years,and 2-year mortality.These effects declined with the number of years since diagnosis for fair/poor health and mortality but not for self-rated worse health.Conclusion:Cancer survivor status is independently associated with more complex multi-morbidity,and with worse health outcomes.These effects attenuate with time,except for patient perception of being in worse health.