Association of Hypomagnesemia with Geriatric Syndromes and Mortality

Yıl 2020, , 118 - 123, 31.12.2020

Cihan Heybeli , Pinar Soysal

https://doi.org/10.47141/geriatrik.821161

Öz

Aim: Although mild hypomagnesemia is frequently asymptomatic, given it’s widespread physiological roles through the body system hypomagnesemia may be associated with crucial patient outcomes in elderly, whose body systems are more prone to disease states. In this study, we have evaluated association of hypomagnesemia with geriatric syndromes and mortality among subjects with an age of 65 years or more.

Material and Methods: Electronic medical records of subjects who were evaluated in geriatrics clinic were reviewed retrospectively. A serum magnesium level of <1.6 mg/dl was considered as hypomagnesemia. Hypomagnesemia and normomagnesemia groups were compared for demographic and clinical characteristics. Logistic regression analysis was performed for the association of hypomagnesemia with each of the geriatric syndromes and mortality.

Results: Of the 888 patients included, 48 had hypomagnesemia (5.4%). Patients with hypomagnesemia were older, more commonly had diabetes mellitus and chronic kidney disease, exposed to higher number of drugs, and had lower median hemoglobin, serum vitamin B12 and folic acid levels. Hypomagnesemia was independently associated with dynapenia (per 1 mg/dL, OR 2.27, 95% CI 0.97-5.29, p=0.057) and geriatric depression (OR 2.91, 95% CI 1.44-5.89, p=0.003) in multivariate regression models. Between serum magnesium levels of 1.2 through 2.3 mg/dL, an increase of 0.1 mg/dL was associated with a 10% decrease in the risk of dynapenia (95% CI 0.83-0.98, p=0.018) and a 9% decrease in the risk of depression (95% CI 0.85-0.98, p=0.009). A higher serum magnesium level (per 0.1 mg/dL, OR 0.90, 95% CI 0.83-0.98, p=0.018) wes associated with a lower mortality risk.

Conclusions: Hypomagnesemia is independently associated with dynapenia, depression, and mortality in elderly outpatients.

Anahtar Kelimeler

geriatric assessment, magnesium, mortality

Hipomagnezeminin Geriatrik Sendromlar ve Mortalite ile Birlikteliği

Öz

Amaç: Hafif hipomagnezemi sıklıkla asemptomatik olmasına rağmen vücutta önemli olan çok sayıda sistem üzerindeki kofaktör rolü nedeniyle bu sistemleri daha duyarlı yaşlı bireylerde hipomagnezemi ciddi hasta sonlanımlarıyla birlikte olabilir. Ayaktan geriatri polikliniğinde değerlendirilen 65 yaş ve üzeri bireylerde hipomagnezeminin geriatrik sendromlar ve mortalite ile ilişkisini değerlendirmeyi hedefledik.

Gereç ve Yöntemler: Geriatri polikliniğinde değerlendirilen tüm bireylerin (≥65 yaş) elektronik tıbbi kayıtları geriye dönük incelendi. Serum magnezyum düzeyi <1,6 mg/dl olan bireyler hipomagnezemi grubuna dahil edildi. Hipomagnezemi ile normomagnezemi olan bireylerin demografik ve klinik verileri kıyaslandı. Hipomagnezeminin her bir geriatrik sendrom ve mortalite ile ilişkisinin değerlendirilmesi için lojistik regresyon analizi uygulandı.

Bulgular: Araştırmaya dahil edilen 888 hastanın 48’inde (%5,4) hipomagnezemi saptandı. Hipomagnezemi olan bireylerin daha yaşlı olduğu, daha sıklıkla diyabetes mellitus ve kronik böbrek yetmezliği ile birliktelik gösterdiği, daha fazla ilaç kullandığı, ve daha düşük hemoglobin, serum B12 ve folik asit düzeylerine sahip olduğu görüldü. Çok değişkenli analizlerdede hipomagnezeminin dinapeni (her 1 mg/dl için OR 2,27, %95 GA 0,97-5,29, p=0,057) ve geriatrik depresyon (OR 2,91, %95 GA 1,44-5,89, p=0,003) için bağımsız bir risk faktörü olduğu, serum magnezyum düzeyindeki her 1 mg/dl artışın dinapeni riskinde %10 (%95 GA 0,83-0,98, p=0,018), geriatrik depresyon riskinde %9 (%95 GA 0,85-0,98, p=0,009) azalma ile birlikte olduğu görüldü. Magnezyum düzeyinin arttıkça mortalite riskinin azaldığı (her 1 mg/dl için OR 0,90, %95 GA 0,83-0,98, p=0,018) belirlendi.

Sonuç: Hipomagnezeminin ayaktan başvuran geriatrik yaş grubu bireylerde dinapeni, depresyon ve mortalite ile bağımsız birlikteliği gösterilmiştir.

Anahtar Kelimeler

geriatrik değerlendirme, magnezyum, mortalite

Kaynakça

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