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    Delirium Caused by Hypercalcemia in Older Adults
    (Galenos Publ House, 2023) Yakaryilmaz, Funda Datli; Ozturk, Zeynel Abidin
    Delirium; can be described as a temporary and reversible brain dysfunction syndrome, which manifests itself primarily with physical, physiopathological and psychological disorders. The leading causes of delirium are pneumonia, cancer, urinary infection, electrolyte imbalance (hypo-hypernatremia, hypo-hypercalcemia, hypo-hypermagnesemia), dehydration, congestive heart failure, uremia and stroke. We present a 68-year-old male patient was admitted to the geriatric outpatient clinic with complaints of fatigue, abdominal pain, loss of appetite and weight loss that started about 4 weeks previously. His physical examination was conscious, awake, co-operative but time orientation was not complete. The delirium assessment scale (DAS) was used for delirium evaluation and MDAS 13/30 (delirium >11/30) was detected. At the end of the evaluation the patient was careless and deterioration was detected in the recall test of three items. During the first 48 hours of the treatment, the patient's serum calcium level regressed and the symptoms were controlled. Hyperparathyroidism, malignancy and long-lasting immobilization are the most common causes of hypercalcemia in the elderly. Neuropsychiatric symptoms due to hypercalcemia may occur initially with concentration and increase in sleep time. As the degree of hypercalcemia increases, depression, delirium, confusion and afterwards coma may develop. As described in our patient, acute onset of attention reduction and cognitive or sensory disturbances in the course of delirium are the main features of the fluctuating course. The cause of delirium in elderly patients is multifactorial, so pathologies that may cause delirium should be excluded individually. Delirium is multifactorial, causing serious problems for affected patients, family members, caregivers and healthcare providers. The general purpose of delirium treatment is therefore early diagnosis and treatment with a multidisciplinary approach, which are of great importance in appropriate cases with delirium.
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    Effect of age-related hyperkyphosis on depression and quality of life
    (Babol Univ Medical Sciences, 2023) Soylu, Gulcimen; Cakmak, Guzin; Yalvac, Yusuf; Ozturk, Zeynel Abidin
    Background: Hyperkyphosis is a frequent problem in older adults. Depressed mood and decreased quality of life are supposed to be related to age-related hyperkyphosis. This study aimed to explain the relation between depression, quality of life, and hyperkyphosis in old patients. Methods: 142 patients who applied to the outpatient clinic of geriatrics were enrolled in this cross-sectional study. Mean age of participants was 72. Hyperkyphosis was evaluated by the bloc method defined in the Rancho Bernardo Study (1). Depression was evaluated by the Short form of Yesavage Geriatric Depression Scale (GDS). Quality of life was assessed by the 3-level version of EQ-5D. Results: Hyperkyphosis was found to be positively related to depression (P=0.037), negatively related to the QOL (p<0.001). QOL, depression, and hyperkyphosis were in a ship with each other when evaluated with one-way MANOVA (F [3.135] =5.23, P=0.002, Wilk's ?=0.896, partial eta 2=0.104). Chronic pain was negatively related to QOL (p<0.001). Depression was positively related to chronic pain (p<0.001). QOL evaluated with VAS was independently related to the presence of hyperkyphosis in logistic regression analysis (r2=0.179, P=0.007). Conclusion: Considering the relationship with depression and quality of life, early recognition, and treatment of hyperkyphosis in elderly individuals is important. More studies evaluating the association between postural disorders, quality of life and mood disorders in older adults will be useful.
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    The Relationship of Cognitive Performance with Oxidative Stress in Alzheimer's Disease
    (Taiwan Soc Geriatric Emergency & Critical Care Medicine-Tsgecm, 2022) Yakaryilmaz, Funda Datli; Ozturk, Zeynel Abidin; Ulusal, Hasan; Tarakicoglu, Mehmet
    Aims: Alzheimer's disease (AD) has a complex neurodegenerative etiology and pathogenesis. In addition to oxidative stress, inflammation also plays an important role in the development of AD. In this study, we aimed to determine the total antioxidant status (TAS), total oxidation status (TOS) and oxidative stress index (OSI) levels in AD patients. We also planned to evaluate the relationship of OSI with interleukin-1 beta (IL-1 beta) and tumor necrosis factor-alpha (TNF-alpha). Methods: A total of 33 subjects with AD (mean age 78.9 +/- 7.8) and 33 subjects as control (mean age 72.3 +/- 2.6) were enrolled in this cross-sectional study. TAS and TOS were assessed with commercial kits using an autoanalyzer. TNF-alpha and IL-1 beta were measured with commercial ELISA kits. Results: The AD group demonstrated significantly higher TNF-alpha, IL-1 beta, and TOS levels compared to the control group (p = 0.001, p = 0.029, p = 0.005). The mean TAS level was significantly lower in the AD group than in the control group (p = 0.007). There was a statistically significant negative correlation between TNF-alpha and ADL, IADL, MMSE (p = 0.001, p =0.003, p = 0.003). There was a statistically significant negative correlation between IL-1 beta and AIDL, as well as a positive correlation between IL-1 beta and GDS (p = 0.029, p = 0.016). Conclusion: Our study contributes to the understanding of the situation by showing that the oxidative balance is impaired in favor of oxidants in AD. A negative correlation was found between functional capacity and TNF-alpha and IL-1 beta levels in AD patients. Different therapeutic interventions that reduce the oxidant load can be considered in the treatment of AD. Copyright (C) 2022, Taiwan Society of Geriatric Emergency & Critical Care Medicine.