Yalnız Yaşayan Yaşlı Yetişkinlerde Kataraktın Geriatrik Sendrom Yükü Üzerindeki Cinsiyete Özgü Etkisi

Öz

Yalnız yaşayan yaşlılar, geriatrik sendromlara yakalanma riski daha yüksektir ve katarakt kaynaklı görme bozukluğu bu riski daha da artırabilir. Ancak, bu popülasyonda katarakt ve geriatrik sendrom yükü arasındaki ilişkiye dair veriler sınırlıdır. Yalnız yaşayan yaşlılarda katarakt ve geriatrik sendrom yükü arasındaki ilişkiyi araştırmayı planladık. Bu retrospektif, kesitsel çalışma, Ocak 2022 ile Aralık 2024 tarihleri arasında Balıkesir Atatürk Şehir Hastanesi Geriatri Polikliniği'nde kapsamlı geriatrik değerlendirmeye tabi tutulan, yalnız yaşayan ve 65 yaş ve üzeri toplumda yaşayan yetişkinleri içermektedir. Katarakt durumu oftalmoloji kayıtları ile doğrulandı. Değerlendirilen geriatrik sendromlar arasında bilişsel bozukluk, depresif belirtiler, malnütrisyon, kırılganlık ve düşme öyküsü yer aldı. Geriatrik sendrom yükü, kapsamlı geriatrik değerlendirmenin ana alanlarından en az iki alanda bozulma olarak tanımlanmıştır. Çok değişkenli lojistik regresyon, yaş, cinsiyet, eğitim, polifarmasi, BMI ve komorbidite sayısı için düzeltildi. Toplam 299 katılımcı (ortalama yaş 77.0 ± 7.3 yıl, %63 kadın) çalışmaya dahil edildi; 139'unda (%46.5) katarakt vardı. Kataraktı olmayanlarla karşılaştırıldığında, etkilenen bireyler daha yaşlı (78.68 ± 6.90 vs. 75.57 ± 7.46 yıl, p = 0.02), daha düşük eğitimli (5.17 ± 3.43 vs. 5.98 ± 3.65 yıl, p = 0.02) ve daha yüksek polifarmasi oranlarına sahipti (%67 vs. %53, p = 0.01). Bilişsel bozukluk prevalansı katarakt grubunda daha yüksekti (%67'ye karşı %56, p = 0.03). Kadınlarda katarakt daha yüksek geriatrik sendrom yükü ile ilişkiliyken (OR 2.30, %95 CI 1.04-5.12, p = 0.04); erkeklerde anlamlı bir ilişki gözlenmemiştir (OR 0.91, %95 CI 0.54-1.55, p = 0.74). Katarakt, yalnız yaşayan yaşlı yetişkinler arasında daha fazla bilişsel bozulma ve kadınlarda daha yüksek geriatrik sendrom yükü ile bağlantılıdır. Görme değerlendirmesinin geriatrik değerlendirmelere dahil edilmesi, hassas bireylerin belirlenmesine ve hedeflenen müdahalelerin bilgilendirilmesine yardımcı olabilir.

Anahtar Kelimeler

• Katarakt
• geriatrik sendromlar
• malnütrisyon
• bilişsel bozukluk
• polifarmasi
• yalnız yaşamak
• yaşlı yetişkinler

Gender-Specific Impact of Cataracts on Geriatric Syndrome Burden in Solitary-Living Older Adults

Öz

Older adults living alone are at increased risk for geriatric syndromes, and visual impairment from cataract may further exacerbate this vulnerability. However, data on the relationship between cataracts and geriatric syndrome burden in this population remain limited. We planned to investigate the relationship between cataracts and geriatric syndromes burden among older adults who live alone. This retrospective, cross-sectional study included community-dwelling older adults who lived alone and underwent comprehensive geriatric assessment at the Geriatrics Outpatient Clinic of Balıkesir Atatürk City Hospital between January 2022 and December 2024. Cataract status was confirmed by ophthalmology records. Geriatric syndromes assessed included cognitive impairment, depressive symptoms, malnutrition, frailty, and history of falls. The geriatric syndrome burden was defined as the presence of at least two impairments in the main domains of comprehensive geriatric assessment. Multivariate logistic regression adjusted for age, sex, education, polypharmacy, BMI, and comorbidity count. A total of 299 participants (mean age 77.0 ± 7.3 years, 63% female) were included; 139 (46.5%) had cataracts. Compared with those without cataracts, affected individuals were older (78.68 ± 6.90 vs. 75.57 ± 7.46 years, p = 0.02), had lower education (5.17 ± 3.43 vs. 5.98 ± 3.65 years, p = 0.02), and higher polypharmacy rates (67% vs. 53%, p = 0.01). Cognitive impairment prevalence was greater in the cataract group (67% vs. 56%, p = 0.03). In women, cataracts were associated with higher geriatric syndrome burden (OR 2.30, 95% CI 1.04–5.12, p = 0.04); no significant association was observed in men (OR 0.91, 95% CI 0.54–1.55, p = 0.74). Cataracts are linked to greater cognitive impairment and, in women, a higher geriatric syndrome burden among older adults living alone. Incorporating vision assessment into geriatric evaluations may help identify vulnerable individuals and inform targeted interventions.

Anahtar Kelimeler

• Cataract
• geriatric syndromes
• malnutrition
• cognitive impairment
• polypharmacy
• living alone
• older adults

Kaynakça

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