Objectives The diagnosis of depression may be challenging in older adults with dementia because of atypical symptoms and overlap with other comorbidities. While the Cornell Scale for Depression in Dementia (CSDD) is the gold standard for screening, the Saint Louis University—Appetite, Mood, Sleep, Activity, and Thoughts of Death (SLU-AMSAD), another brief screening tool designed to assess late-life depression, seems to be more practical than the CSDD, with a shorter test duration. Design Cross-sectional validation study. Setting and Participants In this study, conducted at a geriatric outpatient clinic, a total of 111 patients with dementia were enrolled, and both depression and dementia were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria. Methods The SLU-AMSAD was administered to both patients and caregivers, along with the CSDD. Spearman's rank correlation coefficient was used to assess the correlation between the SLU-AMSAD and CSDD. The diagnostic accuracy of the SLU-AMSAD was evaluated using receiver operating characteristic analysis, with the area under the curve (AUC). Results Caregiver-reported SLU-AMSAD scores demonstrated a strong correlation with CSDD (r = 0.875; P < .001), whereas patient-reported SLU-AMSAD scores exhibited a moderate positive correlation (r = 0.384; P < .001). With an optimal cutoff of ≥3, diagnostic performance was substantially stronger for the caregiver-reported SLU-AMSAD—achieving 95.3% sensitivity and 93.6% specificity (AUC, 0.984; 95% CI, 0.965-1.000; P < .001)—whereas the patient-reported SLU-AMSAD yielded a sensitivity of 59.4% and a specificity of 83% (AUC, 0.731; 95% CI, 0.638-0.823; P < .001). Conclusions and Implications The SLU-AMSAD is a valid and practical screening tool for depression in older adults with dementia. Given the shorter duration and strong caregiver-reported performance, it should be integrated into clinical dementia assessment, facilitating early detection and intervention for depression in such a vulnerable patient group.

BACKGROUND AND AIM:Less is known about backward walking speed (BWS) in older adults. This study aims to establish a cutoff value for BWS to distinguish cognitively impaired individuals from healthy controls and to assess the association between backward walking slowing and risk of neurodegenerative diseases. METHODS:389 older patients, grouped into cognitively healthy (CH), amnestic mild cognitive impairment (aMCI), Alzheimer's disease (AD), Parkinson's disease (PD), and non-AD groups. BWS was measured using a standardized 4-meter protocol. Cognitive and functional status were evaluated via the comprehensive geriatric assessment. ROC analysis was used to determine the diagnostic threshold for BWS, and multinomial logistic regression was used to assess the associations. RESULTS:A BWS cutoff of 0.395 m/s effectively distinguished CH individuals from those with neurodegenerative diseases (AUC=0.723). After adjusting for age, each 0.1 m/s decrease in BWS was associated with 22% increased odds of having aMCI, 37% increased odds of AD, 28% increased odds of PD, and 59% increased odds of having non-AD dementia. BWS showed a positive association with global cognitive scores in patients with CH and aMCI (p< 0.05) and with semantic verbal fluency scores in those with AD and aMCI (p< 0.05). CONCLUSION:BWS is associated with an increased risk of neurodegenerative diseases, which can cause cognitive impairment, and may help indicate individuals at risk of cognitive decline.

BACKGROUND:Lewy body diseases (LBD) collectively share α-synuclein Lewy pathology, yet present wide clinical heterogeneity, with overlapping motor and non-motor features and progression patterns that challenge traditional diagnostic boundaries. METHODS:To resolve this spatiotemporal heterogeneity at the biological level, we applied a data-driven atrophy progression framework to MRI data from 833 individuals across Parkinson's disease, dementia with Lewy bodies, and prodromal isolated REM sleep behaviour disorder using the Subtype and Stage Inference algorithm. FINDINGS:Four transdiagnostic subtypes (A: Early cortico-limbic/late basal ganglia, B: Early basal ganglia/late limbic, C: Early temporo-limbic/late basal ganglia, and D: Early basal ganglia-cingulate/late cortex) emerged, each defined by a distinct spatiotemporal progression of atrophy that explained cognitive, motor, and psychiatric variability. An early cortico-limbic/late basal ganglia subtype represented a dementia-prone subtype across clinical diagnoses, with limbic involvement associating with the emergence of visual hallucinations. INTERPRETATION:These biologically relevant spatiotemporal atrophy subtypes provide an interpretable stratification of patients with LBD, with the potential to refine prognosis, improve clinical trial stratification, and guide precision therapeutic approaches. FUNDING:This work was made possible by an Ignition grant from the University of Sydney and University College London (Global Engagement Fund).

Background/Objectives: Dementia with Lewy bodies (DLB) is a clinically heterogeneous neurodegenerative disorder characterized by cognitive, neuropsychiatric, motor, and autonomic manifestations. Reduced striatal dopamine transporter availability on 123I-ioflupane single-photon emission computed tomography (SPECT) is an established indicative biomarker of DLB. However, the associations among expert visual interpretation, regional semiquantitative dopamine transporter measurements, autonomic manifestations, and dementia severity remain incompletely characterized. This study aimed to evaluate the relationship between visual 123I-ioflupane SPECT classification and regional DaTQUANT z-scores in patients with clinically probable DLB and to explore their associations with autonomic manifestations and dementia severity. Methods: This retrospective, cross-sectional study included 30 patients who received a clinical diagnosis of probable DLB according to the 2017 DLB Consortium criteria before the 123I-ioflupane SPECT results became available. SPECT images were assessed visually by experienced nuclear medicine physicians and semiquantitatively using DaTQUANT software. Bilateral striatal, putaminal, caudate, and putamen-to-caudate ratio z-scores were analyzed in relation to visual scan classification, Clinical Dementia Rating (CDR) scores, and retrospectively ascertained autonomic manifestations, including orthostatic hypotension, delayed orthostatic hypotension, supine hypertension, postprandial hypotension, constipation, and urinary incontinence. Results: Scans were visually classified as supportive of nigrostriatal dopaminergic degeneration in 23 of 30 patients (76.7%) and as non-supportive in seven (23.3%). Bilateral striatal, putaminal, and caudate z-scores were significantly lower in visually supportive scans than in non-supportive scans (all p < 0.001), whereas putamen-to-caudate ratio z-scores did not differ significantly between the groups. None of the evaluated autonomic manifestations was significantly associated with either visual scan classification or regional DaTQUANT measurements. No regional DaTQUANT measurement was significantly associated with dementia severity. A modest positive correlation was observed between the left putamen-to-caudate ratio z-score and CDR (Spearman’s ρ = 0.373, nominal p = 0.050); however, given the small sample size and multiple regional comparisons, this borderline finding was considered exploratory. Conclusions: Regional DaTQUANT measurements were consistent with expert visual interpretation of 123I-ioflupane SPECT in patients with clinically probable DLB. Associations of dopaminergic imaging measurements with autonomic manifestations and dementia severity were limited. Semiquantitative analysis may complement visual interpretation, but its findings should be interpreted within the broader clinical and biomarker context. Larger prospective studies incorporating standardized autonomic testing, appropriate control groups, longitudinal follow-up, and complementary biomarkers are warranted.

Introduction: Inflammatory cerebral amyloid angiopathy (iCAA) is an inflammatory condition seen in cerebral amyloid angiopathy (CAA) which is a disease pathologically characterized by β-amyloid deposition in the walls of cortical and leptomeningeal arteries. It contributes independently to cognitive impairment in older adults and is most commonly associated with Alzheimer’s disease (AD). Case reports: We describe a 73 year old male patient presenting with rapidly progressive cognitive decline with clinical dementia syndromes other than AD, namely idiopathic normal pressure hydrocephalus and dementia with Lewy bodies at the same time, who is not widely thought to be related to CAA and thus may have been overlooked. Conclusion: This case is striking to illustrate that inflmmatory CAA may also present in the context of multiple neurodegenerative diseases and interact with them leading to be an independent variable for rapidly progressive decline and immunosupressive treatment may help slow down the cognitive decline and cause improvement in Daily living activities in the life of older adults. It is of importance to diagnose and manage iCAA for the accurate patient care and for research settings.

Background: Hyponatremia is a common electrolyte disorder in older adults that can lead to poor clinical outcomes and increased mortality. This study aims to evaluate the interrelationship between hyponatremia and geriatric syndromes and drugs in older adults. Methods: This study included 1100 elderly patients admitted to a geriatric clinic. Patient records were used to obtain demographic information, comorbidities, geriatric syndromes, medications, laboratory results, and comprehensive geriatric assessment parameters. Results: The prevalence of hyponatremia was 23.9% in this study (mean age ± SD was 75.59 ± 8.13 years). The frequency of polypharmacy, dementia, falls, malnutrition and risk of malnutrition, frailty, probable sarcopenia, hypertension, cerebrovascular disease, and congestive heart failure was higher, and patients were older in the hyponatremia group (p < 0.05) than in the normonatremia group. After the adjustment of covariates, hyponatremia was shown to be related to drugs including escitalopram (odds ratio [OR]: 1.82, 95% confidence interval [CI]: 1.20–2.76), trazodone (OR: 2.27, 95% CI: 1.26–4.10), renin angiotensin aldosterone system (RAAS) inhibitors (OR: 1.71, 95% CI: 1.18–2.47), hydrochlorothiazide (OR: 1.83, 95% CI: 1.28–2.62), and opioids (OR: 4.46, 95% CI: 1.24–16.02) (p < 0.05). Polypharmacy, falls, and malnutrition with risk of malnutrition were still significantly associated with increased hyponatremia risk even after adjustment for age, sex, and comorbidity burden (p < 0.05). Conclusions: Hyponatremia seems to be associated with certain geriatric syndromes, as well as the use of some antidepressants and cardiovascular drugs in older adults. Malnourished older adults taking RAAS inhibitors, diuretics, opioids, and antidepressants may be at a higher risk of developing hyponatremia. They should be closely monitored, especially if they are taking multiple medications.

OBJECTIVES:To prevent the adverse effects, deprescribing is a structured approach aimed at reducing anticholinergic burden and improving clinical outcomes, particularly in those with cognitive impairment. The objective of this study was to ascertain the impact of alterations in the total number of medications and the Drug Burden Index (DBI) score on cognitive tests and Activity of Daily Living (ADL) scores during a 6-month follow-up period in older patients with major neurocognitive impairment. METHODS:A total of 232 older patients with major neurocognitive impairment were enrolled in this study, which was retrospectively designed and followed up. The alterations in the total number of medications and the DBI scores were evaluated at baseline and at the end of the sixth month, which were compared with the changes in cognitive tests and ADL scores. RESULTS:Comparing baseline and end-of-six-month Mini-Mental State Examination (MMSE) scores revealed a significant decrease in MMSE scores in patients with elevated DBI scores and those with increased medication intake ( P =0.001 and P =0.034, respectively). A subsequent comparison of the change in MMSE score across the groups revealed a significant decrease only among the group with decreased DBI score (Δ=0.45±3.29 and P <0.001). In the linear regression analysis, a 1-unit increase in DBI score and drug number was associated with a decrease in MMSE scores ( B : -0.245 vs. -0.197). CONCLUSIONS:The 6-month follow-up study demonstrated that deprescribing should prioritize the comprehensive evaluation of medication quantity and anticholinergic burden to enhance the efficacy of dementia care in older adults.

Background/aim:The Oral Frailty Index-8 (OFI-8) is a reliable screening for oral frailty. In our study, while presenting the Turkish reliability and validity study of the OFI-8, we also aimed to establish a cut-off value for oral frailty in Turkish population. Materials and methods:Patients who presented to the outpatient clinic between January 2024 and January 2025 were evaluated. The test's internal consistency and test-retest reliability were assessed. Divergent validity was evaluated using frailty scores, muscle strength, and nutritional status. A receiver operating characteristic (ROC) curve was generated to determine the optimal cut-off values for identifying frailty, malnutrition, and probable sarcopenia. Oral frailty status was then analyzed in relation to demographic characteristics, comorbidities, and geriatric syndromes. Regression analyses were performed to adjust for confounding factors. Results:In 162 patients, internal consistency was quantified with a Cronbach's α of 0.728, and test-retest reliability was quantified with an intraclass correlation coefficient (ICC) of 0.961. Construct validity was supported by exploratory factor analysis, and divergent validity was confirmed through significant correlations with frailty, muscle strength, and nutritional status. A cut-off score of ≥ 5 on the OFI-8 was identified for predicting physical frailty, malnutrition, and probable sarcopenia: for frailty status, the area under the curve (AUC) was 0.75 [95% confidence interval (CI) 0.67-0.82; p < 0.001], sensitivity 0.85 and specificity 0.56; for probable sarcopenia, AUC was 0.68 (95% CI 0.60-0.77; p < 0.001), sensitivity 0.71 and specificity 0.52; and for nutritional status, AUC was 0.76 (95% CI 0.68-0.84; p < 0.001), sensitivity 0.86 and specificity 0.55. Independent of confounding factors, probable sarcopenia, physical frailty, polypharmacy, malnutrition, and falls remained significantly associated with oral frailty (OFI-8 score ≥5). Conclusion:OFI-8 demonstrates good validity and reliability for detecting oral frailty in Turkish older adults, supporting early diagnosis and intervention to address better related conditions such as frailty, probable sarcopenia, and malnutrition.

Age-related physiologic changes and comorbidities make it difficult to estimate the glomerular filtration rate(GFR) in older adults. Although inulin clearance is accepted as the gold standard for measuring GFR, it is impractical in clinical practice. A total of 228 patients who underwent a 24-hour creatinine clearance test for the measured GFR (mGFR) were included in the study.The estimated GFR(eGFR) was calculated according to the Modification of Diet in Renal Disease(MDRD) and Chronic Kidney Disease Epidemiology Collaboration(CKD-epi), Berlin Initiative Study-1(BIS-1) and Full Age Spectrum(FAS) formula. The medians of the differences between mGFR and each eGFR equation were used for assessing the bias, and the interquartile range(IQR) of the differences was used for expressing the precision of each equation. The mean age was 76.98±7.83 years and the frequency of female patients was 58.20%. In all patients, FAS[bias=0.40(1.09%), IQR= 26.55 (%52.49)] and BIS-1[bias=1.36(4.27%), IQR=26.71 (%55.28)] were less biased.In the mGFR≥60 mL/min/1.73 m2 subgroup, MDRD was the most precise[bias= -1.73(-1.69%), IQR=25.14 (%49.75)]. in four equations.In patients younger than 75 years, MDRD and CKD-epi equations were less biased, and the CKD-epi equation had the smallest IQR[bias=2.80(4.52%),bias= -2.93(-4.29%), IQR=32.97(49.94%)], whereas, in those older than 75 years, BIS-1 and FAS equations were less biased. However, for the patients 30≤mGFR<60 and mGFR<30 mL/min/1.73 m2, BIS-1 had the lowest bias and smallest IQRs[bias=3.49(7.81%),IQR=14.28(33.20%) and bias=7.60(40.11%), IQR=13.81(39.59%)]. In conclusion, BIS-1 and FAS equations were less biased in older patients with mGFR<60 mL/min/1.73 m2, and MDRD and CKD-epi were less biased in patients with mGFR≥60 mL/min/1.73 m2.

Purpose: As a risk factor for cardiovascular disease, wide pulse pressure (PP) may be related to cognitive impairment across the lifespan. Methods: A total of 313 patients with dementia and 1117 cognitively healthy individuals were included in this study. Dementia was diagnosed according to The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria. Blood pressure (BP) measurements, demographics, comorbidities, laboratory results, and comprehensive geriatric assessment parameters were assessed. Results: While the mean age of the patients and the number of drugs were higher; the frequency of female sex and years of education were lower in the dementia group than in the control group (p

Objective: There has been great interest in using computer-based cognitive training (CBCT) to prevent or reduce pathological and normal agerelated cognitive decline. This study was carried out to examine the efficacy of a CBCT program on the cognitive functions of healthy older adults. An online CBCT program provided exercises for five cognitive domains. Materials and Methods: In a randomized controlled trial, the experimental group (EG) (EG, n=28) implemented CBCT while the comparison group (CG) (CG, n=31) was given standard services. Participants completed approximately 30-minute sessions over the course of eight weeks for a total of 24 sessions. Data were collected using the mini mental state examination, Oktem Verbal Memory Processes test (OVMPT), Wechsler Memory ScaleRevised (WMS-R) Visual Reproduction Subtest, WMS-R digit span forward and backward tests, verbal fluency tasks (category and phonemic), Stroop test & Ccedil;apa form, Trail Making test (TMT) (part A and B), Benton Judgment of Line Orientation test (JLO), Benton Facial Recognition test, and the 15-item version of the Boston Naming test. The data were examined using number, percentage, arithmetic mean, chi-square test, Mann-Whitney U Results: The EG showed greater improvements than CG on verbal memory (OVMPT, z=-3.386, p=0.001) and effect was moderate (r=-0.4524). EG significantly improved simple attention in WMS-R digit span forward (z=-1.995, p=0.046) with a low effect (r=-0.2665). EG showed significantly differences in verbal fluency tasks (category: z=-3.152, p=0.002, phonemic: z=-2.859, p=0.004) with low effects (r=-0.4212, r=-0.3820, respectively) and set shifting (TMT A: z=-2.906, p=0.004) with low effect (r=-0.3883). The EG group improved visuospatial functions for JLO (z=-2.894, p=0.004) with moderate effect (r=-0.3867). Conclusion: It is recommended that CBCT can be used for improving several cognitive domains of healthy older adults.

Alzheimer's disease and Dementia with Lewy bodies are neurodegenerative diseases often sharing clinical symptoms, causing frequent misdiagnoses. Using data from multiple cohorts we improve and apply the SuStaIn algorithm on regional brain volumes from magnetic resonance imaging (MRI), then assess biomarker/phenotype/histopathology associations among the discovered atrophy subtypes. The three data-driven subtypes of brain atrophy show divergent clinical/biomarker/histopathological profiles that could support differential diagnosis. Both clinical syndrome and post-mortem diagnosis aligned imperfectly but plausibly with subtype: limbic (more AD), cortical (more DLB). The Limbic subtype showed lower cerebrospinal fluid (CSF) amyloid-$\beta$, higher CSF phosphorylated tau, worse memory, and fewer hallucinations than the Cortical subtype. Our novel data-driven transdiagnostic approach shows promise for supporting in vivo differential diagnosis using only MRI. ### Competing Interest Statement NPO is a paid consultant for Queen Square Analytics Limited (UK) on unrelated projects. EM has received speaking and writing honoraria for the International Parkinson and Movement Disorders Society, Somnomed, and CSL Seqirus. RSW has received speaking and writing honoraria from GE Healthcare, Bial, Omnix Pharma, and Britannia; and consultancy fees from Therakind and Accenture. DA participated in advisory boards from Fujirebio-Europe, Roche Diagnostics, Grifols S.A. and Lilly, and received speaker honoraria from Fujirebio-Europe, Roche Diagnostics, Nutricia, Krka Farmaceutica S.L., Zambon S.A.U., Neuraxpharm, Alter Medica, Lilly and Esteve Pharmaceuticals S.A. DA declares a filed patent application (WO2019175379 Markers of synaptopathy in neurodegenerative disease). DF consults for BioArctic and has received honoraria from Esteve Pharmaceuticals S.A. JPT has received speaking honoraria from GE Healthcare and acted as a consultant for CervoMed and Eisai. ZW acted as a consultant for GE Healthcare. ### Funding Statement This work was made possible by an Ignition grant from the University of Sydney and University College London (Global Engagement Fund), and a travel grant from Alzheimer's Research UK. GCL and NPO acknowledge funding from the UKRI Medical Research Council (MR/S03546X/1, MR/X024288/1, MR/T046422/1). EM was supported by a National Health and Medical Research Council (NHMRC) grant (2008565). JPT is supported by the NIHR Newcastle Biomedical Research Centre. RSW is supported by a Wellcome Career Development Award (225263/Z/22/Z), Parkinson's UK, the Lewy Body Society, Michael J Fox Foundation, and by the National Institute for Health and Care Research University College London Hospitals Biomedical Research Centre CL was supported by the Medical Research Council (MR/R006504/1), Parkinson's UK, Hilary-Galen Weston Foundation and Michael J Fox Foundation. SJGL was supported by National Health and Medical Research Council fellowship grant (1195830) and the NHMRC/EU Joint Programme on Neurodegenerative Disease Research (2014513). DA was supported by research grants from Institute of Health Carlos III (ISCIII), Spain, PI18/00435, PI22/00611, INT19/00016, INT23/00048 to DA, and by the Department of Health Generalitat de Catalunya PERIS program SLT006/17/125. AB acknowledges support from Instituto de Salud Carlos III and co-funded by the European Union through the Miguel Servet grant (CP20/00038) and Fondo de Investigaciones Sanitario (PI22/00307), the Alzheimer's Association (AARG-22-923680), and the Ajuntament de Barcelona, in collaboration with Fundacio La Caixa (23S06157-001). EW was supported by the Swedish Research Council (VR) No. 2016-02282, 2021-01861; the Center for Innovative Medicine (CIMED) No. FoUI-954459, FoUI-975174; the regional agreement on medical training and clinical research (ALF) between Stockholm County Council and Karolinska Institutet No. FoUI-952838, FoUI-954893; The Swedish Brain Foundation (Hjarnfonden) No. FO2022-0084, FO2024-0239; The Swedish Alzheimer's Foundation (Alzheimerfonden) No. AF-967495, AF-980387; The Swedish Parkinson's foundation (Parkinsonfonden) No. 1557/24, 1521/23; EU Innovative Health Initiative Joint Undertaking (IHI JU) AD-RIDDLE; King Gustaf V:s and Queen Victorias Foundation; Olle Engkvists Foundation (Olle Engkvists Stiftelse) No. 186-0660, 224-0069. AH was supported by funding from StratNeuro, Demensfonden, Gun and Bertil Stohnes Stiftelsen (2024-029), Stiftelsen for Gamla Tjanarinnor (2023-016), and various grants from Karolinska Institutet (2024-02083). DF receives funding from the Swedish Research Council (Vetenskapsradet, grant 2022-00916), the Center for Innovative Medicine (CIMED, grants 20200505 and FoUI-988826), the regional agreement on medical training and clinical research of Stockholm Region (ALF Medicine, grants FoUI-962240 and FoUI-987534), the Swedish Brain Foundation (Hjarnfonden FO2023-0261, FO2022-0175, FO2021-0131), the Swedish Alzheimer Foundation (Alzheimerfonden AF-968032, AF-980580, AF-994058, AF-1010553), the Swedish Dementia Foundation (Demensfonden), the Gamla Tjanarinnor Foundation, the Gun och Bertil Stohnes Foundation, the Ake Wiberg Foundation, StratNeuro, Parkinsonfonden, Lindhes, Funding for Research from Karolinska Institutet, Neurofonden, and the Foundation for Geriatric Diseases at Karolinska Institutet, contributions from private bequests and academic agreements with industry. ZW received funding from ARUK and Lewy Body Society. This research was funded in whole, or in part by the Wellcome Trust [227341/Z/23/Z]. For the purpose of open access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: UCL Research Ethics Committee UCL Department of Computer Science Research Ethics Committee I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data were collected with appropriate informed consent under ethically approved clinical studies. Our secondary analysis of these data was approved by the UCL Research Ethics Committee under application 8019/005 and the UCL Department of Computer Science Research Ethics Committee under application UCL-CSREC-209-B.

Physicians may hesitate to perform lumbar puncture (LP) with advancing age, particularly in daily practice in those aged 80 years or older. This study aimed to evaluate the characteristics and complications of LP in the oldest-old. The medical records of all the patients who underwent LP in a geriatrics inpatient memory clinic were retrospectively reviewed with a specified protocol. As well as demographics, indication for LP, position during the procedure, the total number of LP attempts, the volume of CSF removed, post-LP headache (PLPH), and post-LP back pain at the LP site (PLPBP) were also obtained from the patients’ files. The patients were divided into two groups based on their ages as older adults and oldest-old adults. In this study, a total of 202 LPs were included, of which 39.6

ABSTRACTBackgroundRestless legs syndrome (RLS) is a disorder characterized by nocturnally exacerbating pain that leads to significant sleep disturbances. The hormonal and metabolic changes caused by sleep disruption may increase the incidence of muscle‐related diseases like sarcopenia in older adults, which is defined by a progressive loss of muscle strength and mass. This study aimed to investigate the relationship between RLS and sarcopenia, which may affect each other through common pathophysiological pathways in older adults.MethodsThis was a cross‐sectional study including 109 patients with RLS and 220 without RLS who applied to the geriatric clinic. RLS was assessed using the Turkish version of the International Restless Legs Syndrome Study Group (IRLSSG). Sarcopenia was diagnosed according to the European Working Group on Sarcopenia in Older People‐2 criteria. All the demographics, comorbid conditions, medications and findings of comprehensive geriatric assessments were recorded. The association between RLS and sarcopenia was examined by logistic regression.ResultsThe mean age was 75 ± 7.4 and 73.8 ± 7 years for the RLS and the control groups, respectively (p > 0.05) and the ratio of females was higher in the RLS group (69.7% vs. 57.9%) (p = 0.035). The frequencies of coronary artery disease (CAD), hypertension (HT) and peripheral artery disease (PAD) were significantly higher in RLS patients (p = 0.020, p = 0.047, p = 0.010, respectively), while the prevalence of anaemia was 41% and 25‐OH Vitamin D levels (25[OH]D) were higher than in the control group (p < 0.001). The frequency of probable sarcopenia and sarcopenia was higher in patients with RLS than in controls (20% vs. 11%, p = 0.037 and 8% vs. 2.3%, p = 0.047, respectively). A significant association between RLS and an increased likelihood of probable sarcopenia, sarcopenia and slow gait speed (odds ratio [OR]: 2.621, 95% confidence interval [CI] [1.265, 5.431]; OR: 4.542, 95% CI [1.284, 16.071]; OR: 2.663, 95% CI [1.432, 4.951], respectively) was found after adjusting for factors such as gender, HT, CAD, PAD, serum 25(OH)D levels, anaemia, chronic kidney disease (CKD) and nutritional status. However, the significance of low muscle mass disappeared (p > 0.05).ConclusionThis study demonstrated that sarcopenia is prevalent among older patients with RLS, which seems to be associated with low muscle strength and slow gait speed. Given the negative health outcomes related to sarcopenia, interventions aimed at preventing its development could be significantly beneficial for patients with RLS in older adults as well.

INTRODUCTION:There is still a requirement for concise, practical scales that can be readily incorporated into everyday schedules and predict the likelihood of dementia onset in individuals without dementia. This study aimed to assess the reliability of the ANU-ADRI (Australian National University Alzheimer's Disease Risk Index)-Short Form in Turkish geriatric patients. METHODS:This methodological study involved 339 elderly patients attending the geriatric outpatient clinic for various reasons. The known-group validity and divergent validity were assessed. The ANU-ADRI was administered during the baseline test and again within one week for retest purposes. Alongside the ANU-ADRI, all participants underwent a comprehensive geriatric assessment, including Activities of Daily Living (ADL), mobility assessment (Performance-Oriented Mobility Assessment (POMA) and Timed Up and Go Test), nutritional assessment (Mini Nutritional Assessment (MNA)), and global cognition evaluation (Mini-Mental State Examination (MMSE)). RESULTS:The scale demonstrated satisfactory linguistic validity. A correlation was observed between the mean scores of the ANU-ADRI test and retest (r = 0.997, p < 0.001). Additionally, there existed a moderate negative linear association between the ANU-ADRI and MMSE scores (r = -0.310, p < 0.001), POMA (r = -0.406, p < 0.001), Basic ADL (r = -0.359, p < 0.001), and Instrumental ADL (r = -0.294, p < 0.001). Moreover, a moderate positive linear association was found between the ANU-ADRI and the Timed Up and Go Test duration (r = 0.538, p < 0.001). CONCLUSION:The ANU-ADRI-Short Form was proved as a valuable tool for clinical practice, facilitating the assessment of Alzheimer's disease risk within the Turkish geriatric population.