Gulistan Bahat

Gulistan Bahat
Istanbul University · Department of Internal Medicine (Istanbul Medical Faculty) Division of Geriatrics

MD

About

292
Publications
84,189
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6,567
Citations
Introduction
I am especially interested in sarcopenia, inappropriate medication use, functionality, frailty, and malnutrition. I am also interested in the ideal management of chronic diseases, i.e. hypertension, diabetes, hyperlipidemia, atrial fibrillation, and osteoporosis in older adults.
Additional affiliations
December 1998 - present
Istanbul Medical University
Position
  • Professor (Associate)
January 1998 - January 2020
Istanbul University
Position
  • Professor (Full)

Publications

Publications (292)
Article
Objectives Frailty is a state of homeostenosis associated with adverse outcomes. Chronic kidney disease (CKD) increases considerably by aging and shares the common risk factors with frailty. We aimed to examine the prevalence and independent associates of frailty status in CKD patients.DesignIn this single-centre, cross-sectional study, we used the...
Article
Background and aims Ageing brings alterations in body composition, as skeletal muscle gradually declines and accumulation of adipose tissue accompanies it. Although sarcopenia (S) and obesity (O) were seperately reported to be associated with frailty and poor physical performance, whether they bring more detrimental or favorable effect when they co...
Article
PurposeEWGSOP2 defines “probable sarcopenia” as the presence of low muscle strength without non-muscle causes. The associations of probable sarcopenia have been studied in few reports to date, and our intention in this study is to identify associations of probable sarcopenia with common geriatric syndromes in a sample of older adults who attended t...
Article
Full-text available
Background Previous studies have evaluated the prognostic effects of sarcopenia in cancer patients receiving various treatments, including chemotherapy and surgery, but few studies have focused on radiotherapy (RT). Aims We aimed to investigate the prevalence of sarcopenia and the relationship between sarcopenia and outcomes in older cancer patien...
Article
Background While there are substantial reports on the acute phase of Covid-19, the data on post-Covid phase are limited. Aim To report the data on older post-Covid patients comparatively with the young adults. Study design Retrospective, single-center study in post-Covid outpatient clinic. Clinical characteristics, laboratory examination, chest i...
Article
Frailty is a common geriatric syndrome that indicates homeostenosis and increased risk of disability and mortality. It is amenable to intervention when detected. Hence, screening frailty is of utmost importance to preserve quality-of-life and function in older age. Simpler Modified Fried Frailty Scale is a very practical frailty screening tool that...
Article
Background and Objective: Hypertension is the most prevalent chronic disease in older adults. Antihypertensive drug use increases with aging. In some studies, hypotension developing under antihypertensive medication use has been indicated as a potential risk factor for morbidity and mortality in older adults. Our objective was to assess the relatio...
Article
Objective: Calf circumference (CC) is used as a simple and practical anthropometric measure for evaluating skeletal muscle mass (SMM). CC cut-offs to indicate the presence of low SMM were determined through calculation of CC values that predicted low SMM with receiver operating characteristic analyses. Also, to date CC cut-off points were obtained...
Article
Objectives There are studies on associations between obesity and mortality in nursing home (NH) residents, but the presence of concomitant muscle weakness has not been examined. We considered that self-reported weakness might be a low muscle strength proxy marker. We aimed to examine associations of obesity alone, self-reported muscle weakness alo...
Article
Full-text available
Background: Dysphagia is a geriatric syndrome. Changes in the whole body that occur with aging also affect swallowing functions and cause presbyphagia. This condition may progress to oropharyngeal and/or esophageal dysphagia in the presence of secondary causes that increase in incidence with aging. However, no study has been published that provide...
Conference Paper
Amaç: Delirium, kalça kırığı olan yaşlı hastalarda perioperatif dönemde sık görülen bir komplikasyondur. Kalça kırığı olan yaşlı hastalarda önemli bir morbidite ve mortalite sebebi olan delirium ile ilişkili olabilecek risk faktörlerinin erken tespiti ve yönetimi olumsuz sonuçların önlenebilmesi bakımından oldukça önemlidir. Bu çalışmada, hastanede...
Conference Paper
Background: Frailty, sarcopenia and fragility fractures are closely related to epidemiologically, biologically and clinical impactions. Fragility fracture is observed more frequently in sarcopenic older adults. Older persons who have had a fragility fracture should be assessed for sarcopenia to better develop prevention and recovery after fractures...
Poster
Background: Frailty, sarcopenia and fragility fractures are powerful correlated and all of them are predictors of clinical adverse outcomes. Elderly individuals with have a fragility fracture should be assessed for frailty and sarcopenia to better develop a care plan. For these reason interventions are necessary to determinate and treat frailty. Th...
Article
Full-text available
Dysphagia is one of the most common and important complications of stroke. It is an independent marker of poor outcome after acute stroke and may become chronic after the acute period and continues to affect all aspects of the patient's life. Patients with stroke may encounter any of the medical branches in the emergency room or outpatient clinic,...
Article
Full-text available
Background Sarcopenia is associated with an increased likelihood of major adverse health outcomes. Therefore, screening and early and timely identification of sarcopenia are essential. EWGSOP2 (European Working Group on Sarcopenia in Older People2) suggests Ishii screening test for formal-case findings. We aimed to define the diagnostic value of th...
Article
Full-text available
Background and aims The alpha-actinin (ACTN) genes are important structural components of the sarcomere. Sarcopenia is a common geriatric syndrome characterized by morbidity and mortality. Our study aimed to examine the relationship between the ACTN3 R577X gene and sarcopenia in community-dwelling Turkish adults. Methods We designed a cross-sect...
Article
Introduction Hip fractures are important causes of disability and mortality in older adults. The orthogeriatric assessment proved beneficial while it is limited in many developing countries. Objectives Herein, we aimed to report the results derived from the first two orthogeriatric assessment centers in Turkey. Methods 103 older adults underwent...
Article
Introduction The total number of older adults in Turkey is striking, amounting to around 8 million, and this translates into considerably higher numbers of cases of osteoporosis (OP) and fractures in older adults. Objectives We aimed to outline the current situation of OP in older adults in Turkey and investigate the differences between Turkey and...
Article
Introduction Frailty, sarcopenia and fragility fractures are powerful correlated and all of them are predictors of clinical adverse outcomes. Elderly individuals with have a fragility fracture should be assessed for frailty and sarcopenia to better develop a care plan. For these reason interventions are necessary to determinate and treat frailty....
Conference Paper
Objectives: Hip fractures are important causes of disability and mortality in older adults. The orthogeriatric assessment proved beneficial while it is limited in many developing countries. Herein, we aimed to report the results derived from the first two orthogeriatric assessment centers in Turkey. Material and Methods: 103 older adults underwent...
Conference Paper
Objectives: The total number of older adults in Turkey is striking, amounting to around 8 million, and this translates into considerably higher numbers of cases of osteoporosis (OP) and fractures in older adults.We aimed to outline the current situation of OP in older adults in Turkey and investigate the differences between Turkey and a representat...
Book
Sevgili okuyucular, Nütrisyon hasta tedavisinin ayrılmaz bir parçası, hasta sonuçlarını yüksek dü- zeyde etkileyen bir bileşenidir. Dünyada ve ülkemizde hasta bakımında beslen- menin yeri ve yönetimi geçmişte yaygın olarak göz ardı edilmiştir. Bu da özellik- le onkoloji hastalarında tedavi sonuçlarını kötü yönde etkilemiştir. Son yıllarda, hasta s...
Article
PurposeFall-Risk Increasing Drugs (FRIDs) are an important and modifiable fall-risk factor. A Clinical Decision Support System (CDSS) could support doctors in optimal FRIDs deprescribing. Understanding barriers and facilitators is important for a successful implementation of any CDSS. We conducted a European survey to assess barriers and facilitato...
Chapter
Full-text available
Aging is a nonhomogeneous, complex and biological process characterized by the grad- ual decline of organ functions, leading to an increased risk of age-related disease and death. Organs and tissues in the same person are aged at different rates, influenced by many factors, such as genetic form, lifestyle choices, and environmental exposures. Delay...
Article
PurposeAmong approaches to adjust skeletal muscle mass (SMM) for body size, adjustment for body mass index (BMI) correlated better with functional measures. To enhance applicability of GLIM criteria, we report grade 1 and grade 2 reduced muscle mass cut-offs for SMM adjusted by BMI.Methods301 young, healthy adults involving students, patient relati...
Conference Paper
Background & Aim: There are studies on associations of obesity and mortality in nursing home (NH) residents, but the presence of concomitant sarcopenia has been examined in none of them. We aimed to examine asso- ciations of obesity alone, probable sarcopenia alone, and their combination (sarcopenic obesity, SO) with mortality in NH residents....
Article
Vitamin-D receptors are found in a variety of cells with the potential to regulate many cellular functions. Higher COVID-19 severity has been reported in individuals, which are known to have lower vitamin-D levels. The relation between vitamin-D and COVID-19 has been analysed with a number of studies but only few met high standards. Studies reveale...
Poster
Rationale: There are studies on associations of obesity and mortality in nursing home (NH) residents, but the presence of concomitant sarcopenia has been examined in none of them. In this study, we aimed to examine associations of obesity alone, probable sarcopenia alone, and their combination (sarcopenic obesity, SO) with mortality in NH residents...
Article
Purpose of review: Sarcopenia screening tools can enable clinicians to select individuals for more demanding evaluations, and hence, may facilitate its timely diagnosis and management. The most common recommended screening test is SARC-F, whereas many others are proposed. We aimed to summarize the recent studies and evidence performed on SARC-F an...
Article
Purpose The total number of older adults in Turkey is striking, amounting to around 8 million, and this translates into considerably higher numbers of cases of osteoporosis (OP) and fractures in older adults. In this article, we outlined the current situation of OP in older adults in Turkey and investigated the differences between Turkey and a rep...
Article
Full-text available
Background The Task Force for the diagnosis and management of atrial fibrillation (AF) of the European Society of Cardiology (ESC) published in 2020 the updated Guidelines for the Diagnosis and Management of Atrial Fibrillation with the contribution of the European Heart Rhythm Association (EHRA) of the ESC and the European Association for Cardioth...
Article
Full-text available
Background The sarcopenia quality-of-life (SarQoL)® questionnaire is a multidimensional sarcopenia specific tool designed for community dwelling older adults.AimsThe aim of this study was to translate, to cross-culturally adapt and validate the SarQoL® questionnaire to assess sarcopenia-related quality of life in Turkish older adults.Methods The va...
Poster
Rationale: Sodium-glucose co-transporter-2 (SGLT-2) inhibitors have been recently introduced for type 2 diabetes treatment with significant cardiovascular, renal benefits. Yet, they have frequently been refrained in older adults. Metformin is regarded the firstline diabetes therapy in all ages; still it is associated with weight loss and frailty in...
Presentation
Full-text available
Giriş: Ülkemizde yaşlı nüfusu giderek artmakta ve yaşlılarda atlanan malnutrisyon tanı ve tedavisi morbidite ve mortalite oranlarını artırmaktadır. Yaşlılarda malnutrisyon tedavisinde oral nutrisyonel destek ürünleri kullanılarak yapılan çalışmalar mevcuttur. Ancak kişisel diyet tedavisinin fiziksel performans ve malnutrisyona olan etkisini incele...
Article
Objectives: A preserved ambulation is one of the keypoints for functionality and polypharmacy, a common problem in older adults, is associated with worse functional status. Our aim was to examine the associations of polypharmacy with certain physical performance measures used to evaluate ambulation. Methods: This retrospective, cross-sectional stud...
Article
Full-text available
Dysphagia is one of the most common and important complications of stroke. It is an independent marker of poor outcome following acute stroke and it continues to be effective for many years. This consensus-based guideline is not only a good address to clinical questions in practice for the clinical management of dysphagia including management, diag...
Article
Introduction Hospitalization is associated with acute changes in sarcopenia status in older people, but the influencing factors are not fully understood. Pre-admission care dependency level as a risk factor has not yet been investigated. Objective Evaluate if pre-admission care dependency level is an independent predictor of sarcopenia changes fol...
Article
Objectives: Sodium-glucose co-transporter-2 (SGLT-2) inhibitors have been recently introduced for type 2 diabetes treatment with significant cardiovascular, renal benefits. Yet, they have frequently been refrained in older adults. Metformin is regarded the first-line diabetes therapy for all ages; still it is associated with weight loss and frailt...
Article
Our aim was to investigate the prevalence of sarcopenia in stroke patients, the relationship between sarcopenia detected with different low muscle mass (LMM) adjustment methods, and between stroke-related parameters. Eighty-one patients with chronic stroke who underwent inpatient rehabilitation were included. Spasticity was evaluated by modified As...
Article
Purpose: Orthogeriatrics is a team approach that aims to provide adequate and timely intervention for individuals sufering from fragility fractures, particularly hip fractures. These patients are mostly the frailest older adults. The aim of orthogeri- atrics is to re-gain functionality as early as possible and to decrease disability and mortality....
Article
Full-text available
Objective We investigate the relationship between sarcopenia components and depression in geriatric outpatients, considering the effects of potential confounding factors. Methods Adults ≥60 years of age were selected from outpatient clinics. Muscle strength was assessed using handgrip strength (HGS) measured using a hydraulic hand dynamometer and...
Article
Sarcopenia has first been defined as skeletal muscle mass (SMM) loss by Rosenberg in 1989. Since then, many efforts have been undertaken to define sarcopenia by expert consensus groups and individual studies [1]. In these reports, some suggested assessing low muscle mass (LMM) by evaluating appendicular skeletal muscle mass (ASMM), some by total SM...
Chapter
Full-text available
Purpose: Orthogeriatrics is a team approach that aims to provide adequate and timely intervention for individuals suffering from fragility fractures, particularly hip fractures. These patients are mostly the frailest older adults. The aim of orthogeriatrics is to re-gain functionality as early as possible and to decrease disability and mortality. S...
Article
Full-text available
Purpose In the pathogenesis of severe COVID-19 complications, derangements of renin–angiotensin–aldosterone system (RAAS), vascular endothelial dysfunction leading to inflammation and coagulopathy, and arrhythmias play an important role. Therefore, it is worth considering the use of currently available drugs to protect COVID-19 patients with cardio...
Article
Full-text available
Objective Explicit screening tools and implicit evaluation methods have been developed to assist healthcare professionals in the management of pharmacotherapy in older adults. As prescribing habits and locally available medications vary considerably between countries, guides tailored to the needs of specific regions may be required. We aimed to rep...
Article
Objective To assess whether low systolic blood pressure (SBP) or diastolic blood pressure (DBP) due to antihypertensive medications might be related to mortality among nursing home (NH) residents. Design Observational, longitudinal. Setting Nursing home. Participants Age ≥60 years, receiving antihypertensive medications. Measurements Demographi...
Article
Background & Aims There have been several attempts to come up with a global operational definition of sarcopenia (S), and consequently, a definition of S has been established, to some extent. That said, the definition of sarcopenic obesity (SO), which is defined as the presence of obesity+sarcopenia, remains obscure, hindering evaluations of the pr...
Article
Background/Objective In 2018 EWGSOP2 has suggested low muscle strength as the primary parameter of sarcopenia. The consensus has recommended SARC-F questionnaire as a screening test to find cases with low muscle strength which has been designated as probable sarcopenia. We aimed to study the ability of SARC-F to find probable sarcopenia cases in ol...
Article
In the original version of the above paper there was an error in Results and Table 2, which shows the prevalence of low muscle mass.
Article
Background/PurposeThere has been a rapid increase in the use of non-vitamin K-antagonist oral anticoagulants (NOAC). Current guidelines recommend dose adjustments be made in accordance with certain criteria for each NOAC. This study is aimed at determining whether or not NOAC were prescribed for non-valvular atrial fibrillation (AF) in guideline-re...
Article
Background/objectives COVID-19 followed a mortal course in some young patients without any underlying factors, however, it followed a very benign course in some very older individuals with multiple comorbidities. These observations question if some genetic factors may be related to the vulnerability and poor prognosis of the disease. In this study,...
Article
Sarcopenia is defined as a progressive and generalized skeletal muscle disorder that is associated with an increased likelihood of adverse outcomes, including mobility problems and mortality. To reach a global consensus for its standard definition and diagnosis, more recently, a revised EWGSOP consensus (EWGSOP2) has been published. In EWGSOP2 defi...
Article
Full-text available
Background & Aims Computerized tomography (CT) is considered the gold standard for the evaluation of total skeletal muscle quantity. Skeletal muscle assessments at the L3 vertebra level revealed significantly correlated with total body muscle measurements. Clinicians need cut-offs to evaluate low muscle mass in various patients who already had CT i...
Article
Objective We aimed to compare European Working Group on Sarcopenia in Older People (EWGSOP2)-suggested and population-specific handgrip strength (HGS) thresholds to detect probable sarcopenia and their associations with physical-performance measures and frailty. Methods A retrospective cross-sectional observational-study included geriatrics outpat...