geriatrРоссийский журнал гериатрической медициныRussian Journal of Geriatric Medicine2686-86362686-8709Сайт издателя10.37586/2686-8636-2-2020-115-130geriatr-32Research ArticleГЛАВНАЯ ТЕМАMAIN TOPICКлинические рекомендации «Старческая астения». Часть 2Clinical guidelines frailty. Part 2https://orcid.org/0000-0002-4193-688XТкачеваО. Н.TkachevaO. N.

Ткачева Ольга Николаевна, д-р мед. наук, профессор, директор

телефон: +7(499) 187-64-67

Москва

MD, PhD, professor, Director

+7(499) 187-64-67

Moscow

tkacheva@rgnkc.ruhttps://orcid.org/0000-0002-1628-5093КотовскаяЮ. В.KotovskayaYu. V.

Котовская Юлия Викторовна, д-р мед. наук, профессор, заместитель директора по научной работе

телефон: +7(499) 187-78-09

Москва

MD, PhD, professor, Deputy Director

+7(499) 187-78-09

Moscow

kotovskaya_yv@rgnkc.ruhttps://orcid.org/0000-0001-5272-0454РунихинаН. К.RunikhinaN. K.

Рунихина Надежда Константиновна, д-р мед. наук, заместитель директора по гериатрической работе

телефон: +7(499) 187-78-09

Москва

MD, PhD, Deputy Director

+7(499) 187-78-09

Moscow

nkrunihina@rgnkc.ruhttps://orcid.org/0000-0002-5569-5175ФроловаЕ. В.FrolovaE. V.

Фролова Елена Владимировна, д-р мед. наук, профессор кафедры семейной медицины

телефон: +7 (812) 598-52-22

Санкт-Петербург

MD, PhD, Department of Family Medicine

+7 (812) 598-52-22

St-Petersburg

efrolovamd@yandex.ruhttps://orcid.org/0000-0002-6253-621XНаумовА. В. NaumovA. V.

Наумов Антон Вячеславович, д-р мед. наук, профессор кафедры болезней старения ФДПО, заведующий лабораторией заболеваний костно-мышечной системы

телефон: +7(926) 890-40-20

Москва

MD, PhD, professor of Agerelated diseases Departament, Head of Laboratory of musculoskeletal diseases+7(926) 890-40-20

nanton78@gmail.comhttps://orcid.org/0000-0002-6021-7864ВоробьеваН. М.VorobyevaN. M.

Воробьeва Наталья Михайловна, д-р мед. наук, заведующая лабораторией сердечно-сосудистого старения

телефон: +7(915) 192-22-78

Москва

MD, PhD, Head of Laboratory of Cardiovascular Aging

+7(915) 192-22-78

Moscow

natalyavorobjeva@mail.ruhttps://orcid.org/0000-0003-1222-3351ОстапенкоВ. С.OstapenkoV. S.

Остапенко Валентина Сергеевна, канд. мед. наук, врач-гериатр, заведующая отделением гериатрической терапии

телефон: +7(916) 244-59-24

Москва

MD, PhD, Head of geriatrics department

+7(916) 244-59-24

Moscow

ostapenkovalent@yandex.ruhttps://orcid.org/0000-0003-2597-981XМхитарянЭ. А.MkhitaryanE. A.

Мхитарян Элен Араиковна, канд. мед. наук, доцент кафедры болезней старения ФДПО, старший научный сотрудник лаборатории общей гериатрии

телефон: +7(916) 653-36-78

Москва

MD, PhD of the Department of Aging Diseases

+7(916) 653-36-78

Moscow

melen99@mail.ruhttps://orcid.org/0000-0002-6465-4842ШарашкинаН. В.SharashkinaN. V.

Шарашкина Наталья Викторовна, канд. мед. наук, с.н.с. лаборатории общей гериатрии и нейрогериатрии

телефон: +7(903) 244-27-50

Москва

MD, PhD, head of Geriatricas and neurogeriatrics laboratory

+7(903) 244-27-50

Moscow

sharashkina_nv@rgnkc.ruТюхменевЕ. А.TyukhmenevE. A.

Тюхменев Евгений Александрович, канд. мед. наук, заведующий консультативно-диагностическим отделением, старший научный сотрудник лаборатории сердечно-сосудистого старения

eLibrary SPIN: 7746-8110

Researcher ID Web of Science: S-1048-2016

Москва

MD, PhD, head of outpatient department, senior research fellow, laboratory of the cardiovascular aging

eLibrary SPIN: 7746-8110

Researcher ID Web of Science: S-1048-2016

Moscow

etyukhmenev@gmail.comhttps://orcid.org/0000-0001-7168-3636ПереверзевА. П.PereverzevA. P.

Переверзев Антон Павлович, канд. мед. наук, научный  сотрудник  лаборатории гериатрии

телефон: +7(916) 538-87-81

Москва

MD, PhD, Researcher of the Geriatrics Laboratory

+7(916) 538-87-81

Moscow

acchirurg@mail.ruhttps://orcid.org/0000-0001-7891-6850ДудинскаяЕ. Н.DudinskayaE. N.

Дудинская Екатерина Наильевна, канд. мед. наук, заведующая лабораторией возрастных эндокринных и метаболических нарушений

телефон: +7(903) 191-46-90

Москва

MD, PhD, Head of age-related endocrine and metabolic disorders laboratory+7(903) 191-46-90

katharina.gin@gmail.comФГАОУ ВО РНИМУ им. Н.И. Пирогова Минздрава России, Российский геронтологический научно-клинический центрРоссияPirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation, Russian Gerontology Research and Clinical CentreRussian FederationФГБОУ ВО СЗГМУ им. И.И. МечниковаРоссияThe North-Western State medical University named after I.I. MechnikovRussian Federation20202505202002115130Copyright © Ткачева О.Н., Котовская Ю.В., Рунихина Н.К., Фролова Е.В., Наумов А.В., Воробьева Н.М., Остапенко В.С., Мхитарян Э.А., Шарашкина Н.В., Тюхменев Е.А., Переверзев А.П., Дудинская Е.Н., 20202020Ткачева О.Н., Котовская Ю.В., Рунихина Н.К., Фролова Е.В., Наумов А.В., Воробьева Н.М., Остапенко В.С., Мхитарян Э.А., Шарашкина Н.В., Тюхменев Е.А., Переверзев А.П., Дудинская Е.Н.Tkacheva O.N., Kotovskaya Y.V., Runikhina N.K., Frolova E.V., Naumov A.V., Vorobyeva N.M., Ostapenko V.S., Mkhitaryan E.A., Sharashkina N.V., Tyukhmenev E.A., Pereverzev A.P., Dudinskaya E.N.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.geriatr-news.com/jour/article/view/32

Данный документ представляет собой клинические рекомендации «Старческая астения», разработанные Российской ассоциацией геронтологов и гериатров. Документ ориентирован на врачей-гериатров, врачей-терапевтов, врачей общей практики, семейных врачей и врачей других специальностей, оказывающих медицинскую помощь взрослому населению. В данной части документа изложены принципы ведения пациентов со старческой астенией.

The paper represents clinical guidelines on frailty, developed by Russian Association of gerontologists and geriatricians. The guidelines are dedicated to geriatricians, internal medicine specialists, general practitioners, family doctors and other specialists, dealing with adult patients. This publication includes treatment options for patients with frailty.

старческая астенияавтономностьбазовая функциональная активностьгериатрический синдромfrailtyautonomybasic functional activitygeriatric syndromeReferencesFried L.P. Frailty in older adults: evidence for a phenotype. J. Gerontol. Med. Sci. 2001; 56 (3): 146–156.Fried L.P. Frailty in older adults: evidence for a phenotype. J. Gerontol. Med. Sci. 2001; 56 (3): 146–156.Mitnitski A.B., Mogilner A.J., Rockwood K. Accumulation of deficits as a proxy measure of aging. Scientific World J. 2001; 1: 323–336.Mitnitski A.B., Mogilner A.J., Rockwood K. Accumulation of deficits as a proxy measure of aging. Scientific World J. 2001; 1: 323–336.Vermeiren S. et al. Frailty and the Prediction of Negative Health Outcomes: A Meta-Analysis. J Am Med Dir Assoc. 2016; 17(12): 1163.e1–1163.e17.Vermeiren S. et al. Frailty and the Prediction of Negative Health Outcomes: A Meta-Analysis. J Am Med Dir Assoc. 2016; 17(12): 1163.e1–1163.e17.Weiss O.C. Frailty and Chronic Diseases in Older Adults. Clin. Geriatr. Med. 2011; 27: 39–52.Weiss O.C. Frailty and Chronic Diseases in Older Adults. Clin. Geriatr. Med. 2011; 27: 39–52.Clegg A. et al. Frailty in elderly people. The Lancet. 2013, Mar; 381(9868): 752–62.Clegg A. et al. Frailty in elderly people. The Lancet. 2013, Mar; 381(9868): 752–62.Collard R.M. Prevalence of frailty in community dwelling older persons: a systematic review. J. Am. Geriatr. Soc. 2012; 60(8): 1487–1492.Collard R.M. Prevalence of frailty in community dwelling older persons: a systematic review. J. Am. Geriatr. Soc. 2012; 60(8): 1487–1492.Kojima G. Prevalence of frailty in nursing homes: A systematic review and metaanalysis. J. Am. Med. Dir. Assoc. 2015; 16: 940–945.Kojima G. Prevalence of frailty in nursing homes: A systematic review and metaanalysis. J. Am. Med. Dir. Assoc. 2015; 16: 940–945.Gurina N.A., Frolova E.V., Degryse J.M. A roadmap of aging in Russia: the prevalence of frailty in community-dwelling older adults in the St. Petersburg district–the «Crystal» study. J. Amer. Geriatr. Soc. 2011; 59 (6): 980–988.Gurina N.A., Frolova E.V., Degryse J.M. A roadmap of aging in Russia: the prevalence of frailty in community-dwelling older adults in the St. Petersburg district–the «Crystal» study. J. Amer. Geriatr. Soc. 2011; 59 (6): 980–988.Остапенко В.С. Распространенность и структура гериатрических синдромов у пациентов амбулаторно-поликлинических учреждений г. Москвы: авторефер. дис. канд. мед.наук / В.С. Остапенко. М., 2017. 157 с.Остапенко В.С. Распространенность и структура гериатрических синдромов у пациентов амбулаторно-поликлинических учреждений г. Москвы: авторефер. дис. канд. мед.наук / В.С. Остапенко. М., 2017. 157 с.Ткачева О.Н., Рунихина Н.К., Остапенко В.С., Шарашкина Н.В., Мхитарян Э.А., Онучина Ю.С., Лысенков С.Н. Валидация опросника для скрининга синдрома старческой астении в амбулаторной практике. Успехи геронтологии. 2017; 30; 2: 236–242.Ткачева О.Н., Рунихина Н.К., Остапенко В.С., Шарашкина Н.В., Мхитарян Э.А., Онучина Ю.С., Лысенков С.Н. Валидация опросника для скрининга синдрома старческой астении в амбулаторной практике. Успехи геронтологии. 2017; 30; 2: 236–242.Gutiérrez-Valencia M. The relationship between frailty and polypharmacy in older people: A systematic review. Br J ClinPharmacol. 2018. DOI: 10.1111/bcp.13590.Gutiérrez-Valencia M. The relationship between frailty and polypharmacy in older people: A systematic review. Br J ClinPharmacol. 2018. DOI: 10.1111/bcp.13590.Buta B.J. Frailty assessment instruments: systematic characterization of the uses and contexts of highly – cited instruments. Ageing Res. Rev. 2016; 26: 53–61.Buta B.J. Frailty assessment instruments: systematic characterization of the uses and contexts of highly – cited instruments. Ageing Res. Rev. 2016; 26: 53–61.Morley J.E., Arai H., Cao L., Dong B., Merchant R.A., Vellas B., Visvanathan R., Woo J. Integrated Care: Enhancing the Role of the Primary Health Care Professional in Preventing Functional Decline: A Systematic Review. J Am Med Dir Assoc. 2017; 18(6): 489–494.Morley J.E., Arai H., Cao L., Dong B., Merchant R.A., Vellas B., Visvanathan R., Woo J. Integrated Care: Enhancing the Role of the Primary Health Care Professional in Preventing Functional Decline: A Systematic Review. J Am Med Dir Assoc. 2017; 18(6): 489–494.Reflection paper on physical frailty: instruments for baseline characterisation of older populations in clinical trials. https://www.ema.europa.eu/docs/en_GB/document_library/Scientific_guideline/2018/02/WC500244285.pdfReflection paper on physical frailty: instruments for baseline characterisation of older populations in clinical trials. https://www.ema.europa.eu/docs/en_GB/document_library/Scientific_guideline/2018/02/WC500244285.pdfSyddall H. et al. Is grip Strength a useful single marker of frailty? Age and Ageing. 2003; 32; 6: 650–656.Syddall H. et al. Is grip Strength a useful single marker of frailty? Age and Ageing. 2003; 32; 6: 650–656.Borson S., Scanlan J., Brush M., Vitaliano P., Dokmak A. The Mini-Cog: a cognitive «vital signs» measure for dementia screening in multi-lingual elderly. Int J Geriatr Psychiatry. 2000; 15: 1021–1027.Borson S., Scanlan J., Brush M., Vitaliano P., Dokmak A. The Mini-Cog: a cognitive «vital signs» measure for dementia screening in multi-lingual elderly. Int J Geriatr Psychiatry. 2000; 15: 1021–1027.Borson S., Scanlan J.M., Chen P., Ganguli M. The Mini-Cog as a screen for dementia: validation in a population-based sample. J Am Geriatr Soc. 2003; 51: 1451–1454.Borson S., Scanlan J.M., Chen P., Ganguli M. The Mini-Cog as a screen for dementia: validation in a population-based sample. J Am Geriatr Soc. 2003; 51: 1451–1454.Tsoi K.K., Chan J.Y., Hirai H.W., Wong S.Y., Kwok T.C. Cognitive tests to detect dementia: a systematic review and meta-analysis. JAMA Intern Med. 2015; 175: 1450–1458.Tsoi K.K., Chan J.Y., Hirai H.W., Wong S.Y., Kwok T.C. Cognitive tests to detect dementia: a systematic review and meta-analysis. JAMA Intern Med. 2015; 175: 1450–1458.Бойцов С.А., Драпкина О.М., Калинина А.М., Ипатов П.В., Вергазова Э.К., Гамбарян М.Г., Еганян Р.А., Карамнова Н.С., Горный Б.Э., Егоров В.А., Соловьева С.Б., Старинский В.В., Бунова А.С., Ткачева О.Н., Рунихина Н.К., Котовская Ю.В., Мхитарян Э.А. «Организация проведения диспансеризации определенных групп взрослого населения». Методические рекомендации по практической реализации приказа Минздрава России от 26 октября 2017 г. № 869н «Об утверждении порядка проведения диспансеризации определенных групп взрослого населения». М., 2017. 162 с. Утверждены главным специалистом по профилактической медицине Минздрава России 27 декабря 2017 г. Интернет ресурсы: http://www.gnicpm.ru; http://ropniz.ruБойцов С.А., Драпкина О.М., Калинина А.М., Ипатов П.В., Вергазова Э.К., Гамбарян М.Г., Еганян Р.А., Карамнова Н.С., Горный Б.Э., Егоров В.А., Соловьева С.Б., Старинский В.В., Бунова А.С., Ткачева О.Н., Рунихина Н.К., Котовская Ю.В., Мхитарян Э.А. «Организация проведения диспансеризации определенных групп взрослого населения». Методические рекомендации по практической реализации приказа Минздрава России от 26 октября 2017 г. № 869н «Об утверждении порядка проведения диспансеризации определенных групп взрослого населения». М., 2017. 162 с. Утверждены главным специалистом по профилактической медицине Минздрава России 27 декабря 2017 г. Интернет ресурсы: http://www.gnicpm.ru; http://ropniz.ruRamani L., Furmedge D.S., Reddy S.P. Comprehensive geriatric assessment. Br J Hosp Med Lond Engl 2005. 2014 Aug; 75 Suppl 8: 122–125.Ramani L., Furmedge D.S., Reddy S.P. Comprehensive geriatric assessment. Br J Hosp Med Lond Engl 2005. 2014 Aug; 75 Suppl 8: 122–125.British Geriatrics Society. Fit for Frailty Consensus best practice guidance for the care of older people living with frailty in community and outpatient settings [Internet]. 2014 Jun. Available from: http://www.bgs.org.uk/campaigns/fff/fff_full.pdfBritish Geriatrics Society. Fit for Frailty Consensus best practice guidance for the care of older people living with frailty in community and outpatient settings [Internet]. 2014 Jun. Available from: http://www.bgs.org.uk/campaigns/fff/fff_full.pdfПолипрагмазия в клинической практике: проблема и решения / под общей редакцией Д.А. Сычева, СПб.: ЦОП «Профессия», 2016. 224 с.Полипрагмазия в клинической практике: проблема и решения / под общей редакцией Д.А. Сычева, СПб.: ЦОП «Профессия», 2016. 224 с.Naples J.G., Handler S.M., Maher R.L. et. al. Geriatric Pharmacotherapy and Polypharmacy. In: Fillit H.M., Rockwood K., Young J.B. Brocklehurst's Textbook of Geriatric Medicine and Gerontology. 8th ed. Elsevier 2017; 849–854.Naples J.G., Handler S.M., Maher R.L. et. al. Geriatric Pharmacotherapy and Polypharmacy. In: Fillit H.M., Rockwood K., Young J.B. Brocklehurst's Textbook of Geriatric Medicine and Gerontology. 8th ed. Elsevier 2017; 849–854.Kanis J.A., McCloskey E.V., Johansson H., Odén A., Borgström F., Strom O Development and use of FRAX® in osteoporosis. Osteoporosis International. 2010; 21 Suppl 2: 407–13.Kanis J.A., McCloskey E.V., Johansson H., Odén A., Borgström F., Strom O Development and use of FRAX® in osteoporosis. Osteoporosis International. 2010; 21 Suppl 2: 407–13.Dent E., Visvanathan R., Piantadosi C., Chapman I. Use of the Mini Nutritional Assessment to detect frailty in hospitalised older people.J Nutr Health Aging. 2012; 16(9): 764–7Dent E., Visvanathan R., Piantadosi C., Chapman I. Use of the Mini Nutritional Assessment to detect frailty in hospitalised older people.J Nutr Health Aging. 2012; 16(9): 764–7Guigoz Y., Vellas B., Garry P.J. Mini Nutritional Assessment: a practical assessment tool for grading the nutritional state of elderly patients. Facts Res. Gerontol. 1994; 2: 15–59.Guigoz Y., Vellas B., Garry P.J. Mini Nutritional Assessment: a practical assessment tool for grading the nutritional state of elderly patients. Facts Res. Gerontol. 1994; 2: 15–59.Inzitari M. Gait speed predicts decline in attention and psychomotor speed in older adults: the health aging and body composition study. Neuroepidemiology. 2007; 29(3–4): 156–162.Inzitari M. Gait speed predicts decline in attention and psychomotor speed in older adults: the health aging and body composition study. Neuroepidemiology. 2007; 29(3–4): 156–162.Montero-Odasso M. Gait velocity as a single predictor of adverse events in healthy seniors aged 75 years and older. J. Gerontol. A Biol. Sci. Med. Sci. 2005; 60(10): 1304–1309.Montero-Odasso M. Gait velocity as a single predictor of adverse events in healthy seniors aged 75 years and older. J. Gerontol. A Biol. Sci. Med. Sci. 2005; 60(10): 1304–1309.Shinkai S. Walking speed as a good predictor for the onset of functional dependence in a Japanese rural community population. Age Ageing. 2000; 29(5): 441–446.Shinkai S. Walking speed as a good predictor for the onset of functional dependence in a Japanese rural community population. Age Ageing. 2000; 29(5): 441–446.Studenski S. Gait speed and survival in older adults. J.A.M.A. 2011; 305(1): 50–58.Studenski S. Gait speed and survival in older adults. J.A.M.A. 2011; 305(1): 50–58.Mahoney F., Barthel D. Functional evaluation: the Barthel Index. Md. State Med. J. 1965; 14: 61–65Mahoney F., Barthel D. Functional evaluation: the Barthel Index. Md. State Med. J. 1965; 14: 61–65Lawton M.P. and Brody E.M. «Assessment of older people: Self-maintaining and instrumental activities of daily living». Gerontologist. 1969; 9: 179–186.Lawton M.P. and Brody E.M. «Assessment of older people: Self-maintaining and instrumental activities of daily living». Gerontologist. 1969; 9: 179–186.Bohannon R.W. Reference values for the Timed Up and Go Test: A Descriptive Meta-Analysis. Journal of Geriatric Physical Therapy. 2006; 29(2): 64–8.Bohannon R.W. Reference values for the Timed Up and Go Test: A Descriptive Meta-Analysis. Journal of Geriatric Physical Therapy. 2006; 29(2): 64–8.Morse J. M., Morse R., & Tylko S. Development of a scale to identify the fall-prone patient. Canadian Journal on Aging. 1989; 8: 366–377.Morse J. M., Morse R., & Tylko S. Development of a scale to identify the fall-prone patient. Canadian Journal on Aging. 1989; 8: 366–377.Shumway-Cook A., Brauer S., Woollacott M. Predicting the probability for falls in community-dwelling older adults using the timed up & go test. Phys Ther. 2000; 80: 896–903.Shumway-Cook A., Brauer S., Woollacott M. Predicting the probability for falls in community-dwelling older adults using the timed up & go test. Phys Ther. 2000; 80: 896–903.Kristensen M.T., Foss N.B., Kehlet H. Timed «Up and Go» Test as a predictor of falls within 6 months after hip fracture surgery. Phys Ther. 2007; 87(1): 24–30.Kristensen M.T., Foss N.B., Kehlet H. Timed «Up and Go» Test as a predictor of falls within 6 months after hip fracture surgery. Phys Ther. 2007; 87(1): 24–30.Eagle J., Salamara S., Whitman D., Evans L.A., Ho E., & Olde J.Comparison of three instruments in predicting accidental falls in selected inpatients in a general teaching hospital. Journal of Gerontological Nursing. 1999; 25(7): 40–45.Eagle J., Salamara S., Whitman D., Evans L.A., Ho E., & Olde J.Comparison of three instruments in predicting accidental falls in selected inpatients in a general teaching hospital. Journal of Gerontological Nursing. 1999; 25(7): 40–45.Folstein M.F., Folstein S.E., McHugh P.R. «Mini-mental state». A practical method for grading the cognitive state of patients for the clinician. J. Psychiatr. Res. 1975; 12: 189–198.Folstein M.F., Folstein S.E., McHugh P.R. «Mini-mental state». A practical method for grading the cognitive state of patients for the clinician. J. Psychiatr. Res. 1975; 12: 189–198.Huntzinger J.A. Clock drawing in the screening assessment of cognitive impairment in an ambulatory care setting: a preliminary report. Gen. Hosp. Psychiatry. 1992; 14(2): 142–144Huntzinger J.A. Clock drawing in the screening assessment of cognitive impairment in an ambulatory care setting: a preliminary report. Gen. Hosp. Psychiatry. 1992; 14(2): 142–144Nasreddine Z.S. Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. 2005; 53: 695–699.Nasreddine Z.S. Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. 2005; 53: 695–699.Dubois B., Slachevsky A., Litvan I., Pillon B. The FAB: a Frontal Assessment Battery at bedside. Neurology. 2000 Dec 12; 55(11): 1621–6.Dubois B., Slachevsky A., Litvan I., Pillon B. The FAB: a Frontal Assessment Battery at bedside. Neurology. 2000 Dec 12; 55(11): 1621–6.Bingham K.S., Kumar S., Dawson D.R., Mulsant B.H., Flint A.J. A Systematic Review of the Measurement of Function in Late-Life Depression. Am J Geriatr Psychiatry. 2018; 26(1): 54–72. DOI: 10.1016/j.jagp.2017.08.011.Bingham K.S., Kumar S., Dawson D.R., Mulsant B.H., Flint A.J. A Systematic Review of the Measurement of Function in Late-Life Depression. Am J Geriatr Psychiatry. 2018; 26(1): 54–72. DOI: 10.1016/j.jagp.2017.08.011.Sivertsen H., Bjørkløf G. H., Engedal K., Selbæk G., Helvik A. S. Depression and Quality of Life in Older Persons: A Review. Dement Geriatr Cogn Disord. 2015; 40 (5–6): 311–39.Sivertsen H., Bjørkløf G. H., Engedal K., Selbæk G., Helvik A. S. Depression and Quality of Life in Older Persons: A Review. Dement Geriatr Cogn Disord. 2015; 40 (5–6): 311–39.Meeks T.W., Vahia I.V., Lavretsky H., Kulkarni G., Jeste D. A tune in «a minor» can «b major»: a review of epidemiology, illness course, and public health implications of subthreshold depression in older adults. Research Report. J. Affect. Disord. 2011; 129: 126–142.Meeks T.W., Vahia I.V., Lavretsky H., Kulkarni G., Jeste D. A tune in «a minor» can «b major»: a review of epidemiology, illness course, and public health implications of subthreshold depression in older adults. Research Report. J. Affect. Disord. 2011; 129: 126–142.Katon W.J., Lin E., Russo J., Unutzer J. Increased medical costs of a population based sample of depressed elderly patients. Arch. Gen. Psychiatry. 2003; 60: 897–903.Katon W.J., Lin E., Russo J., Unutzer J. Increased medical costs of a population based sample of depressed elderly patients. Arch. Gen. Psychiatry. 2003; 60: 897–903.Sheikh J.I., Yesavage J.A. Geriatric Depression Scale (GDS): Recent evidence and development of a shorter version. Clinical Gerontologist. 1986; 56: 165–173.Sheikh J.I., Yesavage J.A. Geriatric Depression Scale (GDS): Recent evidence and development of a shorter version. Clinical Gerontologist. 1986; 56: 165–173.Н.В. Погосова, Т.В. Довженко, А.Г. Бабин, А.А. Курсаков, В.А. Выгодин. Русскоязычная версия опросников PHQ-2 и 9: чувствительность и специфичность при выявлении депрессии у пациентов общемедицинской амбулаторной практики. Кардиоваскулярная терапия и профилактика. 2014, 13, 3Н.В. Погосова, Т.В. Довженко, А.Г. Бабин, А.А. Курсаков, В.А. Выгодин. Русскоязычная версия опросников PHQ-2 и 9: чувствительность и специфичность при выявлении депрессии у пациентов общемедицинской амбулаторной практики. Кардиоваскулярная терапия и профилактика. 2014, 13, 3Alexopoulos G.A., Abrams R.C., Young R.C. & Shamoian C.A.: Cornell scale for depression in dementia. Biol Psych, 1988, 23: 271–284.Alexopoulos G.A., Abrams R.C., Young R.C. & Shamoian C.A.: Cornell scale for depression in dementia. Biol Psych, 1988, 23: 271–284.Ткачева О.Н. и соавт. Методические рекомендации по предупреждению жестокого обращения с пожилыми людьми в учреждениях здравоохранения. Методические указания. М.: Российский национальный исследовательский медицинский университет имени Н. И. Пирогова, 2017. 25 с.Ткачева О.Н. и соавт. Методические рекомендации по предупреждению жестокого обращения с пожилыми людьми в учреждениях здравоохранения. Методические указания. М.: Российский национальный исследовательский медицинский университет имени Н. И. Пирогова, 2017. 25 с.http://rgnkc.ru/images/pdf_documets/Zhestokoe_obrashenie_preduprezhdenie.pdfhttp://rgnkc.ru/images/pdf_documets/Zhestokoe_obrashenie_preduprezhdenie.pdfМакушкин Е.В., Полищук Ю.И., Рунихина Н.К., Панченко Е.А. Выявление и профилактика жестокого обращения с пожилыми и престарелыми людьми в учреждениях здравоохранения и социальной защиты. Помощь жертвам жестокого обращения: Методические рекомендации. М.: ФГБУ «НМИЦ ПН им. В.П. Сербского» Минздрава России. 2017. 23 с.Макушкин Е.В., Полищук Ю.И., Рунихина Н.К., Панченко Е.А. Выявление и профилактика жестокого обращения с пожилыми и престарелыми людьми в учреждениях здравоохранения и социальной защиты. Помощь жертвам жестокого обращения: Методические рекомендации. М.: ФГБУ «НМИЦ ПН им. В.П. Сербского» Минздрава России. 2017. 23 с.Stevens P.E., Levin A.; Kidney Disease: Improving Global Outcomes Chronic Kidney Disease Guideline Development Work Group Members Ann Intern Med. 2013 Jun 4; 158(11): 825–30.Stevens P.E., Levin A.; Kidney Disease: Improving Global Outcomes Chronic Kidney Disease Guideline Development Work Group Members Ann Intern Med. 2013 Jun 4; 158(11): 825–30.Röhrig G. Anemia in the frail, elderly patient. ClinInterv Aging. 2016; 11: 319–26.Röhrig G. Anemia in the frail, elderly patient. ClinInterv Aging. 2016; 11: 319–26.Beghe C., Wilson A., Ershler W.B. Prevalence and Outcomes of Anemia in Geriatrics: A Systematic Review of the Literature. Am J Med. 2004; 116(7A): 3–10.Beghe C., Wilson A., Ershler W.B. Prevalence and Outcomes of Anemia in Geriatrics: A Systematic Review of the Literature. Am J Med. 2004; 116(7A): 3–10.Gaskell H., Derry S., Moore R.A., McQuay H.J. Prevalence of anemia in older persons: systematic review. BMC Geriatrics. 2008; 8: 1.Gaskell H., Derry S., Moore R.A., McQuay H.J. Prevalence of anemia in older persons: systematic review. BMC Geriatrics. 2008; 8: 1.Yeap B.B., Alfonso H., Chubb S.A., Walsh J.P., Hankey G.J., Almeida O.P., Flicker L. Higher free tyroxine levels are associated with frailty in older men: the Health in Men Study. Clin Endocrinol (Oxf). 2012 May; 76(5): 741–827.Yeap B.B., Alfonso H., Chubb S.A., Walsh J.P., Hankey G.J., Almeida O.P., Flicker L. Higher free tyroxine levels are associated with frailty in older men: the Health in Men Study. Clin Endocrinol (Oxf). 2012 May; 76(5): 741–827.Maxwell C.A., Yu F. Biological Processes and Biomarkers Related to Frailty in Older Adults: A State-of-the-Science Literature Review. 2018; 9:1099800418798047.Maxwell C.A., Yu F. Biological Processes and Biomarkers Related to Frailty in Older Adults: A State-of-the-Science Literature Review. 2018; 9:1099800418798047.Ritt M., Jäger J., Ritt J.I. et al. Operationalizing a frailty index using routine blood and urine tests. Clin Interv Aging. 2017; 12: 1029–1040.Ritt M., Jäger J., Ritt J.I. et al. Operationalizing a frailty index using routine blood and urine tests. Clin Interv Aging. 2017; 12: 1029–1040.Feng Z., Lugtenberg M., Franse C. et al. Risk factors and protective factors associated with incident or increase of frailty among community-dwelling older adults: A systematic review of longitudinal studies. PLoS One. 2017; 12(6): e0178383.Feng Z., Lugtenberg M., Franse C. et al. Risk factors and protective factors associated with incident or increase of frailty among community-dwelling older adults: A systematic review of longitudinal studies. PLoS One. 2017; 12(6): e0178383.Bjelakovic G., Gluud L.L., Nikolova D., Whitfield К., Wetterslev J., Simonetti R.G., Bjelakovic M., Gluud C. Vitamin D supplementation for prevention of mortality in adults (Review). The Cochrane Library 2014; CD007470. DOI: 10.1002/14651858.CD007470.pub3.Bjelakovic G., Gluud L.L., Nikolova D., Whitfield К., Wetterslev J., Simonetti R.G., Bjelakovic M., Gluud C. Vitamin D supplementation for prevention of mortality in adults (Review). The Cochrane Library 2014; CD007470. DOI: 10.1002/14651858.CD007470.pub3.Rubenstein L.Z., Josephson K.R., Wieland G.D., English P.A., Sayre J.A., Kane R.L. Effectiveness of a geriatric evaluation unit. A randomized clinical trial. N Engl J Med.1984; 311(26): 1664–70.Rubenstein L.Z., Josephson K.R., Wieland G.D., English P.A., Sayre J.A., Kane R.L. Effectiveness of a geriatric evaluation unit. A randomized clinical trial. N Engl J Med.1984; 311(26): 1664–70.Bachmann S., Finger C., Huss A., Egger M., Stuck A.E., Clough-Gorr K.M. Inpatient rehabilitation specifically designed for geriatric patients: systematic review and meta-analysis of randomised controlled trials. BMJ. 2010; 340: 1718.Bachmann S., Finger C., Huss A., Egger M., Stuck A.E., Clough-Gorr K.M. Inpatient rehabilitation specifically designed for geriatric patients: systematic review and meta-analysis of randomised controlled trials. BMJ. 2010; 340: 1718.Clarke R. et al. Screening for vitamin B–12 and folate deficiency in older persons. Am. J. Clin. Nutr. 2003; 77: 1241–1247.Clarke R. et al. Screening for vitamin B–12 and folate deficiency in older persons. Am. J. Clin. Nutr. 2003; 77: 1241–1247.Gould D. et al. Visual Analogue Scale (VAS). Journal of Clinical Nursing. 2001; 10: 697–706.Gould D. et al. Visual Analogue Scale (VAS). Journal of Clinical Nursing. 2001; 10: 697–706.Huskisson E.C. Measurement of pain. Lancet. 1974; 2: 1127–31.Huskisson E.C. Measurement of pain. Lancet. 1974; 2: 1127–31.Downie W.W., Leatham P.A., Rhind V.M., Wright V., Branco J.A., Anderson J.A. Studies with pain rating scales. Ann Rheum Dis. 1978; 37: 378–81.Downie W.W., Leatham P.A., Rhind V.M., Wright V., Branco J.A., Anderson J.A. Studies with pain rating scales. Ann Rheum Dis. 1978; 37: 378–81.Scott J., Huskisson E.C. Graphic representation of pain. Pain. 1976; 2: 175–84.Scott J., Huskisson E.C. Graphic representation of pain. Pain. 1976; 2: 175–84.Joos E., Peretz A., Beguin S., et al. Reliability and reproducibility of visual analogue scale and numeric rating scale for therapeutic evaluation of pain in rheumatic patients. J Rheumatol 1991; 18: 1269–70.Joos E., Peretz A., Beguin S., et al. Reliability and reproducibility of visual analogue scale and numeric rating scale for therapeutic evaluation of pain in rheumatic patients. J Rheumatol 1991; 18: 1269–70.Warden V., Hurley A.C., Volicer L. Development and psychometric evaluation of the Pain Assessment in Advanced Dementia (PAINAD) scale. J Am Med Dir Assoc. 2003; 4(1): 9–15.Warden V., Hurley A.C., Volicer L. Development and psychometric evaluation of the Pain Assessment in Advanced Dementia (PAINAD) scale. J Am Med Dir Assoc. 2003; 4(1): 9–15.

The authors declare that there are no conflicts of interest present.