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Düşük Serum Albümin Düzeyi Geriatrik Sendromlar İçin Risk Faktörü Olabilir mi?

Yıl 2022, Cilt: 44 Sayı: 1, 98 - 105, 14.01.2022
https://doi.org/10.20515/otd.982409

Öz

Düşük serum albümin düzeyinin yaşlı hastalarda morbidite ve mortalite risk artışı ile ilişkisi çalışmalarla gösterilmiştir. Bu çalışmada, yaşlılarda serum albümin düzeyleri ile geriatrik sendromlar arasında bir ilişki olup olmadığının incelenmesini amaçladık. Ocak 2014-Nisan 2018 tarihleri arasında geriatri kliniğine ayaktan başvuran ve ayrıntılı geriatrik değerlendirme ile eş zamanlı serum albümin düzeyi bakılan 65 yaş üstü hastaların dosyaları retrospektif olarak incelendi. Dahil edilme kriterlerini karşılayan ve dışlama kriteri bulunmayan 802 hasta çalışmaya dahil edildi. Bütün hastaların demografik verileri, komorbiditeleri, kan serum albümin düzeyleri, geriatrik sendromlar kaydedildi. Katılımcıların yaş ortalaması 72,96±8,14 yıl ve %66,7’si kadın idi. Hastaların %30,5’inde düşme, %49,4’ünde ağrı, %48,1’inde üriner inkontinans, %47,7’sinde polifarmasi, %19,3’ünde demans, %29,7’sinde depresyon, %20,6’sinde malnütrisyon riski ve %5,9’unda malnütrisyon saptandı. %49,3’ü kırılgan adayı ve %21,2’si kırılgandı. Ek olarak, %30,9 hastada muhtemel sarkopeni, %5,2 hastada sarkopeni ve %4,2 hastada şiddetli sarkopeni saptandı. Tüm hastaların ortalama serum albümin düzeyi 4,12±0,36 g/dl idi. Serum albümin düzeyi ile geriatrik sendromlar arasındaki ilişki incelendiğinde serum albümin düzeyindeki düşüşün düşme, ağrı, üriner inkontinans, polifarmasi, demans, malnütrisyon, kırılganlık ve sarkopeni riskini artırdığı görüldü (p<0,05). Bu ilişki yaş, cinsiyet ve nütrisyon durumunun etkisi ortadan kaldırıldığında devam etti (p<0,05). Serum albümin düzeyi ve depresyon arasında ilişki saptanmadı (p>0,05). Düşük serum albümin düzeyleri düşme, ağrı, üriner inkontinans, polifarmasi, demans, malnütrisyon, kırılganlık ve sarkopeni gibi geriatrik sendromlar için bir öngördürücü olabilir. Serum albümin düzeyinde düşüş olan hastalarda eşlik edebilecek geriatrik sendromlar akılda tutulmalıdır.

Destekleyen Kurum

yok

Proje Numarası

yok

Teşekkür

yok

Kaynakça

  • 1. Işık AT, Soysal P. Sendrom, Geriatri ve Geriatrik Sendrom. Soysal P, Işık AT, edt, In: Geriatri Pratiğinde Geriatrik Sendromlar 1. baskı, İzmir, US Akademi, 2018. p. 7–50.
  • 2. Franceschi C, Bonafè M, Valensin S, et al. Inflamm‐aging: an evolutionary perspective on immunosenescence. Ann N Y Acad Sci. 2000;908(1):244–54.
  • 3. Roxburgh CS, McMillan DC. Role of systemic inflammatory response in predicting survival in patients with primary operable cancer. Future Oncol. 2010;6(1):149–63.
  • 4. Singh T, Newman AB. Inflammatory markers in population studies of aging. Ageing Res Rev. 2011;10(3):319–29.
  • 5. Hubbard RE, O’Mahony MS, Savva GM, et al. Inflammation and frailty measures in older people. J Cell Mol Med. 2009;13(9b):3103–9.
  • 6. van Atteveld VA, Van Ancum JM, Reijnierse EM, et al. Erythrocyte sedimentation rate and albumin as markers of inflammation are associated with measures of sarcopenia: a cross-sectional study. BMC Geriatr. 2019;19(1):233.
  • 7. Cabrerizo S, Cuadras D, Gomez-Busto F, et al. Serum albumin and health in older people: Review and meta analysis. Maturitas. 2015;81(1):17–27.
  • 8. Seltzer MH, Bastidas JA, Cooper DM, et al. Instant nutritional assessment. JPEN J Parenter Enteral Nutr. 1979;3(3):157–9.
  • 9. Kane RL, Shamliyan T, Talley K, et al. The Association Between Geriatric Syndromes and Survival. J Am Geriatr Soc. 2012;60(5):896–904.
  • 10. Friedman AN, Fadem SZ. Reassessment of albumin as a nutritional marker in kidney disease. J Am Soc Nephrol. 2010;21(2):223–30.
  • 11. de Mutsert R, Grootendorst DC, Indemans F, et al. Association between serum albumin and mortality in dialysis patients is partly explained by inflammation, and not by malnutrition. J Ren Nutr. 2009;19(2):127–35.
  • 12. Troyanov S, Wall CA, Scholey JW, et al. Idiopathic membranous nephropathy: definition and relevance of a partial remission. Kidney Int. 2004;66(3):1199–205.
  • 13. Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189–98.
  • 14. Durmaz B, Soysal P, Ellidokuz H, et al. Validity and Reliability of Geriatric Depression Scale - 15 (Short Form) in Turkish older adults. North Clin Istanb. 2018;5(3):216–20.
  • 15. Dokuzlar O, Soysal P, Usarel C, et al. The evaluation and design of a short depression screening tool in Turkish older adults. Int Psychogeriatr. 2018;30(10):1541–8.
  • 16. Guigoz Y, Vellas BJ. Malnutrition in the elderly: the Mini Nutritional Assessment (MNA). Ther Umsch. 1997;54(6):345–50. 17. Tinetti ME. Performance‐Oriented Assessment of Mobility Problems in Elderly Patients. J Am Geriatr Soc. 1986;34(2):119–26.
  • 18. Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142–8.
  • 19. Lawton MP, Brody EM. Assessment of older people: Self-maintaining and instrumental activities of daily living. Gerontologist. 1969;9(3):179–86.
  • 20. Mahoney FI, Barthel DW. Functional evaluation: The barthel index. Md State Med J. 1965;14:61–5.
  • 21. Ates Bulut E, Soysal P, Dokuzlar O, et al. Validation of population-based cutoffs for low muscle mass and strength in a population of Turkish elderly adults. Aging Clin Exp Res. 2020;32(9):1749–55.
  • 22. Dokuzlar O, Koc Okudur S, Smith L, et al. Assessment of factors that increase risk of falling in older women by four different clinical methods. Aging Clin Exp Res. 2020;32(3):483–90.
  • 23. Dutoglu E, Soysal P, Smith L, et al. Nocturia and its clinical implications in older women. Arch Gerontol Geriatr. 2019 Jul;85:103917.
  • 24. Koc Okudur S, Dokuzlar O, Aydin AE, et al. The Evaluation of Relationship Between Polypharmacy and Anticholinergic Burden Scales. North Clin Istanb. 2021;8(2):139–44.
  • 25. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th edn. Arlington, DC: American Psychiatric Association, 2013.
  • 26. Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: Revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16–31.
  • 27. Kim S, McClave SA, Martindale RG, et al. Hypoalbuminemia and clinical outcomes: What is the mechanism behind the relationship? Am Surg. 2017;83(11):1220–7.
  • 28. Cabrerizo S, Cuadras D, Gomez-Busto F, et al. Serum albumin and health in older people: Review and meta analysis. Maturitas. 2015;81(1):17–27.
  • 29. Zhang Z, Pereira SL, Luo M, et al. Evaluation of blood biomarkers associated with risk of malnutrition in older adults: A systematic review and meta-analysis. Nutrients. 2017;9(8):829.
  • 30. Baumgartner RN, Koehler KM, Romero L, et al. Serum albumin is associated with skeletal muscle in elderly men and women. Am J Clin Nutr. 1996;64(4):552–8.
  • 31. Lin CH, Liao KC, Pu SJ, et al. Associated factors for falls among the community-dwelling older people assessed by annual geriatric health examinations. PLoS ONE. 2011;6(4):2–6.
  • 32. Llewellyn DJ, Langa KM, Friedland RP, et al. Serum Albumin Concentration and Cognitive Impairment. Curr Alzheimer Res. 2010;7(1):91–6.
  • 33. Wang L, Wang F, Liu J, Zhang Q, et al. Inverse relationship between baseline serum albumin levels and risk of mild cognitive impairment in elderly: A seven-year retrospective cohort study. Tohoku J Exp Med. 2018;246(1):51–7.
  • 34. Kim JW, Byun MS, Lee JH, et al. Serum albumin and beta-amyloid deposition in the human brain. Neurology. 2020;95(7):e815–26.
  • 35. Chong E, Chan M, Lim WS, et al. Frailty Predicts Incident Urinary Incontinence Among Hospitalized Older Adults-A 1-Year Prospective Cohort Study. J Am Med Dir Assoc. 2018;19(5):422–7.
  • 36. Parker-Autry C, Houston DK, Rushing J, et al. Characterizing the Functional Decline of Older Women With Incident Urinary Incontinence. Obstet Gynecol. 2017;130(5):1025–1032.
  • 37. Domenichiello AF, Ramsden CE. The silent epidemic of chronic pain in older adults. Prog Neuropsychopharmacol Biol Psychiatry. 2019;93:284–90.
  • 38. Gutiérrez-Valencia M, Izquierdo M, Cesari M, Casas-Herrero, Inzitari M, Martínez-Velilla N. The relationship between frailty and polypharmacy in older people: A systematic review. Br J Clin Pharmacol. 2018;84(7):1432–44.

Could Low Serum Albumin Level Be a Risk Factor for Geriatric Syndromes?

Yıl 2022, Cilt: 44 Sayı: 1, 98 - 105, 14.01.2022
https://doi.org/10.20515/otd.982409

Öz

There are many studies showing that low serum albumin levels increase the risk of morbidity and mortality in older adults. In this study, we aimed to examine whether there is a relationship between serum albumin levels and geriatric syndromes in older adults. The records of patients over the age of 65 who were admitted to the geriatric clinic between January 2014 and April 2018 and whose serum albumin levels were measured simultaneously with a comprehensive geriatric assessment were reviewed retrospectively. 802 patients who met the inclusion criteria and had no exclusion criteria were included in the study. Demographic data, comorbidities, serum albumin levels, geriatric syndromes were recorded for all patients. The mean age of the participants was 72.96±8.14 years and 66.7% were women. We determined falling in 30.5% of the patients, pain in 49.4%, urinary incontinence in 48.1%, polypharmacy in 47.7%, dementia in 19.3%, depression in 29.7%, malnutrition risk in 20.6% and malnutrition in 5.9%. Of the patients, 49.3% were prefrail and 21.2% were frail. In addition, probable sarcopenia was found in 30.9%, sarcopenia in 5.2%, and severe sarcopenia in 4.2% of the participants. The mean serum albumin level of all participants was 4.12±0.36 g/dl. When the relationship between serum albumin level and geriatric syndromes was examined, it was observed that the decrease in serum albumin level increased the risk of falls, pain, urinary incontinence, polypharmacy, dementia, malnutrition, frailty, and sarcopenia (p<0.05). This relationship continued when the effects of age, gender and nutritional status were removed (p<0.05). No relationship was found between serum albumin level and depression (p>0.05). Low serum albumin levels may be a predictor of geriatric syndromes such as falls, pain, urinary incontinence, polypharmacy, dementia, malnutrition, frailty, and sarcopenia. Geriatric syndromes that may accompany patients with decreased serum albumin levels should be kept in mind.

Proje Numarası

yok

Kaynakça

  • 1. Işık AT, Soysal P. Sendrom, Geriatri ve Geriatrik Sendrom. Soysal P, Işık AT, edt, In: Geriatri Pratiğinde Geriatrik Sendromlar 1. baskı, İzmir, US Akademi, 2018. p. 7–50.
  • 2. Franceschi C, Bonafè M, Valensin S, et al. Inflamm‐aging: an evolutionary perspective on immunosenescence. Ann N Y Acad Sci. 2000;908(1):244–54.
  • 3. Roxburgh CS, McMillan DC. Role of systemic inflammatory response in predicting survival in patients with primary operable cancer. Future Oncol. 2010;6(1):149–63.
  • 4. Singh T, Newman AB. Inflammatory markers in population studies of aging. Ageing Res Rev. 2011;10(3):319–29.
  • 5. Hubbard RE, O’Mahony MS, Savva GM, et al. Inflammation and frailty measures in older people. J Cell Mol Med. 2009;13(9b):3103–9.
  • 6. van Atteveld VA, Van Ancum JM, Reijnierse EM, et al. Erythrocyte sedimentation rate and albumin as markers of inflammation are associated with measures of sarcopenia: a cross-sectional study. BMC Geriatr. 2019;19(1):233.
  • 7. Cabrerizo S, Cuadras D, Gomez-Busto F, et al. Serum albumin and health in older people: Review and meta analysis. Maturitas. 2015;81(1):17–27.
  • 8. Seltzer MH, Bastidas JA, Cooper DM, et al. Instant nutritional assessment. JPEN J Parenter Enteral Nutr. 1979;3(3):157–9.
  • 9. Kane RL, Shamliyan T, Talley K, et al. The Association Between Geriatric Syndromes and Survival. J Am Geriatr Soc. 2012;60(5):896–904.
  • 10. Friedman AN, Fadem SZ. Reassessment of albumin as a nutritional marker in kidney disease. J Am Soc Nephrol. 2010;21(2):223–30.
  • 11. de Mutsert R, Grootendorst DC, Indemans F, et al. Association between serum albumin and mortality in dialysis patients is partly explained by inflammation, and not by malnutrition. J Ren Nutr. 2009;19(2):127–35.
  • 12. Troyanov S, Wall CA, Scholey JW, et al. Idiopathic membranous nephropathy: definition and relevance of a partial remission. Kidney Int. 2004;66(3):1199–205.
  • 13. Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189–98.
  • 14. Durmaz B, Soysal P, Ellidokuz H, et al. Validity and Reliability of Geriatric Depression Scale - 15 (Short Form) in Turkish older adults. North Clin Istanb. 2018;5(3):216–20.
  • 15. Dokuzlar O, Soysal P, Usarel C, et al. The evaluation and design of a short depression screening tool in Turkish older adults. Int Psychogeriatr. 2018;30(10):1541–8.
  • 16. Guigoz Y, Vellas BJ. Malnutrition in the elderly: the Mini Nutritional Assessment (MNA). Ther Umsch. 1997;54(6):345–50. 17. Tinetti ME. Performance‐Oriented Assessment of Mobility Problems in Elderly Patients. J Am Geriatr Soc. 1986;34(2):119–26.
  • 18. Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142–8.
  • 19. Lawton MP, Brody EM. Assessment of older people: Self-maintaining and instrumental activities of daily living. Gerontologist. 1969;9(3):179–86.
  • 20. Mahoney FI, Barthel DW. Functional evaluation: The barthel index. Md State Med J. 1965;14:61–5.
  • 21. Ates Bulut E, Soysal P, Dokuzlar O, et al. Validation of population-based cutoffs for low muscle mass and strength in a population of Turkish elderly adults. Aging Clin Exp Res. 2020;32(9):1749–55.
  • 22. Dokuzlar O, Koc Okudur S, Smith L, et al. Assessment of factors that increase risk of falling in older women by four different clinical methods. Aging Clin Exp Res. 2020;32(3):483–90.
  • 23. Dutoglu E, Soysal P, Smith L, et al. Nocturia and its clinical implications in older women. Arch Gerontol Geriatr. 2019 Jul;85:103917.
  • 24. Koc Okudur S, Dokuzlar O, Aydin AE, et al. The Evaluation of Relationship Between Polypharmacy and Anticholinergic Burden Scales. North Clin Istanb. 2021;8(2):139–44.
  • 25. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th edn. Arlington, DC: American Psychiatric Association, 2013.
  • 26. Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: Revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16–31.
  • 27. Kim S, McClave SA, Martindale RG, et al. Hypoalbuminemia and clinical outcomes: What is the mechanism behind the relationship? Am Surg. 2017;83(11):1220–7.
  • 28. Cabrerizo S, Cuadras D, Gomez-Busto F, et al. Serum albumin and health in older people: Review and meta analysis. Maturitas. 2015;81(1):17–27.
  • 29. Zhang Z, Pereira SL, Luo M, et al. Evaluation of blood biomarkers associated with risk of malnutrition in older adults: A systematic review and meta-analysis. Nutrients. 2017;9(8):829.
  • 30. Baumgartner RN, Koehler KM, Romero L, et al. Serum albumin is associated with skeletal muscle in elderly men and women. Am J Clin Nutr. 1996;64(4):552–8.
  • 31. Lin CH, Liao KC, Pu SJ, et al. Associated factors for falls among the community-dwelling older people assessed by annual geriatric health examinations. PLoS ONE. 2011;6(4):2–6.
  • 32. Llewellyn DJ, Langa KM, Friedland RP, et al. Serum Albumin Concentration and Cognitive Impairment. Curr Alzheimer Res. 2010;7(1):91–6.
  • 33. Wang L, Wang F, Liu J, Zhang Q, et al. Inverse relationship between baseline serum albumin levels and risk of mild cognitive impairment in elderly: A seven-year retrospective cohort study. Tohoku J Exp Med. 2018;246(1):51–7.
  • 34. Kim JW, Byun MS, Lee JH, et al. Serum albumin and beta-amyloid deposition in the human brain. Neurology. 2020;95(7):e815–26.
  • 35. Chong E, Chan M, Lim WS, et al. Frailty Predicts Incident Urinary Incontinence Among Hospitalized Older Adults-A 1-Year Prospective Cohort Study. J Am Med Dir Assoc. 2018;19(5):422–7.
  • 36. Parker-Autry C, Houston DK, Rushing J, et al. Characterizing the Functional Decline of Older Women With Incident Urinary Incontinence. Obstet Gynecol. 2017;130(5):1025–1032.
  • 37. Domenichiello AF, Ramsden CE. The silent epidemic of chronic pain in older adults. Prog Neuropsychopharmacol Biol Psychiatry. 2019;93:284–90.
  • 38. Gutiérrez-Valencia M, Izquierdo M, Cesari M, Casas-Herrero, Inzitari M, Martínez-Velilla N. The relationship between frailty and polypharmacy in older people: A systematic review. Br J Clin Pharmacol. 2018;84(7):1432–44.
Toplam 37 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm ORİJİNAL MAKALELER / ORIGINAL ARTICLES
Yazarlar

Özge Dokuzlar 0000-0001-7079-9696

Fatma Sena Dost 0000-0002-3748-8156

Ahmet Turan Işık 0000-0001-5867-6503

Proje Numarası yok
Yayımlanma Tarihi 14 Ocak 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 44 Sayı: 1

Kaynak Göster

Vancouver Dokuzlar Ö, Dost FS, Işık AT. Düşük Serum Albümin Düzeyi Geriatrik Sendromlar İçin Risk Faktörü Olabilir mi?. Osmangazi Tıp Dergisi. 2022;44(1):98-105.


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